Allergic to Modernity
October 20, 2018 8:42 PM Subscribe
The Guardian discusses the recent, and startling, mass increase in allergy occurrences - possibly connected to delayed exposure to allergens, overly-hygienic practices, and lack of exposure to sunlight. Are our best laid plans in health and wellness wreaking havoc on our immune systems?
Interesting. The idea that (figuratively) eating a few handfuls of dirt when you were young was important for your immune system was folk wisdom when I was growing up. It’s nice to see some backing for it.
posted by Tell Me No Lies at 10:56 PM on October 20, 2018 [3 favorites]
posted by Tell Me No Lies at 10:56 PM on October 20, 2018 [3 favorites]
Hygiene hypothesis. I fell like this has been talked about for years, but that might just be in my circles. Part of this seems similar to autism diagnosis. It seems like there is a huge uptick in autism diagnosis, when in fact it’s just that we’re recognizing it earlier and in all its forms. Severe allergies in pre-modern medicine populations would be fatal. People wouldn’t know what killed Johnny- just that he turned colors and couldn’t breath after he ate something. But everyone else ate that something- and they didn’t die- must have been a fluke! Light allergies in pre-modern medicine populations could also be fatal. Sneezing and coughing so much that you’re ostricized for fear of something much worse, or the hay fever weakening your immune system to something like TB. I don’t deny that there’s been an uptick- I just feel we can’t know the true numbers of say, pre-1900 people’s with peanut allergies or even hay fever. If hygiene hypothesis is correct I suppose I should thank my mother for letting me play in the garden dirt in the back all I wanted as a kid. It was heavily amended with manure- guess that’s why I don’t have any real allergies, lol! (lactose intolerance doesn’t count- that’s genetic)
posted by Homo neanderthalensis at 12:13 AM on October 21, 2018 [35 favorites]
posted by Homo neanderthalensis at 12:13 AM on October 21, 2018 [35 favorites]
I'm allergic to trees. Well, not all trees; that would be silly. Just the ones that grow in the region where I live.
posted by The Underpants Monster at 12:20 AM on October 21, 2018 [26 favorites]
posted by The Underpants Monster at 12:20 AM on October 21, 2018 [26 favorites]
This was an interesting read. The part that was most intriguing for me on a personal level was the link between a lack of sun exposure and egg allergy. My grandfather had a near-fatal egg allergy. He was also so likely to sunburn that he had to keep himself covered or in the shade most of the time. (During WWII, the Army thought that the best way to get him over his allergy was to feed him lots and lots of eggs. It didn't work, to put it mildly.)
I do wonder about the hygiene hypothesis. Obviously due to my grandfather, my mom and I are predisposed toward allergies. But my mom and grandmother also kept their homes clean to the level of an operating theater.
And, like homo neanderthalensis, I wonder if modernity allowed people with allergies who would have died in previous centuries to survive and have children, which is why we are now seeing a higher level of allergies.
Maybe it's multiple factors?
posted by rednikki at 12:52 AM on October 21, 2018 [14 favorites]
I do wonder about the hygiene hypothesis. Obviously due to my grandfather, my mom and I are predisposed toward allergies. But my mom and grandmother also kept their homes clean to the level of an operating theater.
And, like homo neanderthalensis, I wonder if modernity allowed people with allergies who would have died in previous centuries to survive and have children, which is why we are now seeing a higher level of allergies.
Maybe it's multiple factors?
posted by rednikki at 12:52 AM on October 21, 2018 [14 favorites]
My theory for this is increased population mobility is eliminating localized resistances to allergies. That and increased airborne particulate from industrial activity.
posted by JauntyFedora at 1:35 AM on October 21, 2018 [15 favorites]
posted by JauntyFedora at 1:35 AM on October 21, 2018 [15 favorites]
I've recently seen someone point out that the fiction-trope poisoning symptoms - clutching the throat, quickly turning purple and dropping unconscious/dead as soon as you drink the poison - don't correspond to most/any poisons commonly used in the pre-modern age, but do correspond to symptoms of anaphilactic shock. I do wonder how many people throughout history were blamed for others dropping dead out of allergies to rare ingredients...
posted by I claim sanctuary at 2:18 AM on October 21, 2018 [111 favorites]
posted by I claim sanctuary at 2:18 AM on October 21, 2018 [111 favorites]
This is only anecdotal but I grew up in a scrupulously clean house and had lots of allergies, as did my stay at home Mum. (I was encouraged to play in dirt though, but I got scrubbed spotless when I came in.) Then I went to university and was an unhygienic student for three years and all my allergies cleared up. My Mum, who is still scrupulously clean, still has lots of allergies.
posted by dowcrag at 2:32 AM on October 21, 2018 [3 favorites]
posted by dowcrag at 2:32 AM on October 21, 2018 [3 favorites]
I don’t deny that there’s been an uptick- I just feel we can’t know the true numbers of say, pre-1900 people’s with peanut allergies
The surge in peanut allergies has been since the 1980s. It didn’t follow indoor plumbing, it followed rabid fear-of-allergens and anti-bacterial everything.
posted by Tell Me No Lies at 3:25 AM on October 21, 2018 [11 favorites]
The surge in peanut allergies has been since the 1980s. It didn’t follow indoor plumbing, it followed rabid fear-of-allergens and anti-bacterial everything.
posted by Tell Me No Lies at 3:25 AM on October 21, 2018 [11 favorites]
Frustrating how little is known as demonstrated by all the different theories.
data point: three daughters, all walking clouds of filth with no meticulous parental remediation, lots of outdoor time, confirmed dirt eating. Did not deliberately expose them to nuts but didn't avoid them either. 2 (identical twins) had anaphylaxis to a peanut candy at age 2 (at the same time, in a minivan with me driving ... ).
They're fine, but their IgE numbers keep climbing and years of appointments with their allergist have lead me to the conclusion that nobody really knows what's going on or how to treat it. With each annual blood draw they pick up new nuts to avoid, but of course we're meticulous about checking everything now. Lots of promising sounding therapies pop up, but they all seem to amount to "lets expose them to trace amounts increasing over time and see if they don't die."
Racing to the ER while they both turned purple and clawed at their throats in the back of the van though, that will stay with me forever.
posted by roue at 4:11 AM on October 21, 2018 [26 favorites]
data point: three daughters, all walking clouds of filth with no meticulous parental remediation, lots of outdoor time, confirmed dirt eating. Did not deliberately expose them to nuts but didn't avoid them either. 2 (identical twins) had anaphylaxis to a peanut candy at age 2 (at the same time, in a minivan with me driving ... ).
They're fine, but their IgE numbers keep climbing and years of appointments with their allergist have lead me to the conclusion that nobody really knows what's going on or how to treat it. With each annual blood draw they pick up new nuts to avoid, but of course we're meticulous about checking everything now. Lots of promising sounding therapies pop up, but they all seem to amount to "lets expose them to trace amounts increasing over time and see if they don't die."
Racing to the ER while they both turned purple and clawed at their throats in the back of the van though, that will stay with me forever.
posted by roue at 4:11 AM on October 21, 2018 [26 favorites]
I'm another data point for "ate actual dirt, plenty of sunlight, lots of exposure to unusual foods, quite enough allergies thanks."
posted by aspersioncast at 5:03 AM on October 21, 2018 [10 favorites]
posted by aspersioncast at 5:03 AM on October 21, 2018 [10 favorites]
Yeah I am basically Pigpen and my seasonal allergies keep getting worse every year. Didn’t have them as a kid — I want to say they only emerged as a real problem in maybe my late twenties?
I’ve always wondered if, in certain places, the rapid growth of cities with poor families of 10-15 living on top of each other and with only like half the kids surviving to adulthood might have created somewhat of a bottleneck selecting for a, uh, vigorous immune response.
posted by schadenfrau at 5:26 AM on October 21, 2018 [9 favorites]
I’ve always wondered if, in certain places, the rapid growth of cities with poor families of 10-15 living on top of each other and with only like half the kids surviving to adulthood might have created somewhat of a bottleneck selecting for a, uh, vigorous immune response.
posted by schadenfrau at 5:26 AM on October 21, 2018 [9 favorites]
We're pinheads now
We are not whole
We're pinheads all
Jocko homo
posted by Meatbomb at 5:28 AM on October 21, 2018 [9 favorites]
We are not whole
We're pinheads all
Jocko homo
posted by Meatbomb at 5:28 AM on October 21, 2018 [9 favorites]
It may not be delayed exposure to dirt, pollen, and other allergens, but exposure to chemically-modified allergens that is able activate the previously restricted response to the biological chemicals. Think peanuts now treated with sprays of multiple compounds (including carriers, pesticides, ‘inert ingredients’) or pollen in the air, now coated with adherent particulate emissions or photochemically modified by reactions with NOx or ozone.
posted by sudogeek at 5:31 AM on October 21, 2018 [6 favorites]
posted by sudogeek at 5:31 AM on October 21, 2018 [6 favorites]
One note in support of the hygiene hypothesis -
The article says that "those Gen-X and older" remember scant few kids who had food allergies growing up. And then all of a sudden the number of people with allergies exploded.
You know what I remember exploding at about the same time as allergies? ....The use of hand sanitizers and anti-bacterial everything. There have also always been articles stating that "Look, hand sanitizers and anti-bacterial cleaning products are a blessing for people with severe allergies and compromised immune systems, but the rest of us really don't need them." But nearly everyone today has one of those little bottles in their bags.
posted by EmpressCallipygos at 5:34 AM on October 21, 2018 [14 favorites]
The article says that "those Gen-X and older" remember scant few kids who had food allergies growing up. And then all of a sudden the number of people with allergies exploded.
You know what I remember exploding at about the same time as allergies? ....The use of hand sanitizers and anti-bacterial everything. There have also always been articles stating that "Look, hand sanitizers and anti-bacterial cleaning products are a blessing for people with severe allergies and compromised immune systems, but the rest of us really don't need them." But nearly everyone today has one of those little bottles in their bags.
posted by EmpressCallipygos at 5:34 AM on October 21, 2018 [14 favorites]
I have severe pollen allergies and associated oral allergy syndrome. I've been doing helminth therapy with Necator americanus (human hookworm) for 2 years and it's completely resolved all my allergies, so long as I maintain a population of them in my gut. Helminth therapy is a fairly new area of research, but there are some hypotheses about why it works, such as organisms like hookworm being a keystone species in the gut that should never have been eliminated (deworming is often part of vaccination programs, for instance). I think certain populations are more vulnerable to autoimmune diseases for genetic reasons (such as being descended from those who survived the bubonic plague - the plague had a massive selective impact on the population) and the combination of proinflammatory immune system genetics with a lack of organisms like helminths in the gut to keep that type of immune system in check (which coincides with the hygiene hypothesis) could combine to increase the frequency of autoimmune diseases. I have proinflammatory genetics, atopy runs in the family, and I'm resigned to being a hookworm host to manage my allergies for the rest of my life.
posted by zenzicube at 5:38 AM on October 21, 2018 [28 favorites]
posted by zenzicube at 5:38 AM on October 21, 2018 [28 favorites]
JauntyFedora: "My theory for this is increased population mobility is eliminating localized resistances to allergies. That and increased airborne particulate from industrial activity."
The air (at least in places like the US) is actually cleaner now than it was 100 years ago.
posted by Mitheral at 5:43 AM on October 21, 2018 [6 favorites]
The air (at least in places like the US) is actually cleaner now than it was 100 years ago.
posted by Mitheral at 5:43 AM on October 21, 2018 [6 favorites]
My theory for this is increased population mobility is eliminating localized resistances to allergies. That and increased airborne particulate from industrial activity.
This is a pretty compelling theory - there's a lot of emerging research on the effects of constant exposure to bad air quality full of particulate matter (soot) - connecting it to chronic inflammation throughout the body, and a host of problems with how the body does its ordinary business. It's been tentatively connected to autism, obesity, and even Alzheimer's.
I'll add, too, that one of the donimant sources isn't industrial activity but vehicle traffic.
The air (at least in places like the US) is actually cleaner now than it was 100 years ago.
But we are only learning now how low the threshold for bad air is, and the full extent of its damage.
posted by entropone at 5:50 AM on October 21, 2018
This is a pretty compelling theory - there's a lot of emerging research on the effects of constant exposure to bad air quality full of particulate matter (soot) - connecting it to chronic inflammation throughout the body, and a host of problems with how the body does its ordinary business. It's been tentatively connected to autism, obesity, and even Alzheimer's.
I'll add, too, that one of the donimant sources isn't industrial activity but vehicle traffic.
The air (at least in places like the US) is actually cleaner now than it was 100 years ago.
But we are only learning now how low the threshold for bad air is, and the full extent of its damage.
posted by entropone at 5:50 AM on October 21, 2018
I had a really bad cough in the second winter after moving to England. Turns out this happens to lots of people who move to England from North America and is related to mite allergies and may be due differences in mite populations between countries/climates.
[also a pigpen kid who should definitely not manifest any hygiene related illnesses yet takes a daily antihistamine just to stay functionally alive]
posted by srboisvert at 5:53 AM on October 21, 2018 [6 favorites]
[also a pigpen kid who should definitely not manifest any hygiene related illnesses yet takes a daily antihistamine just to stay functionally alive]
posted by srboisvert at 5:53 AM on October 21, 2018 [6 favorites]
My theory for this is increased population mobility is eliminating localized resistances to allergies. That and increased airborne particulate from industrial activity.
There has actually been a downturn in population mobility in America.
posted by srboisvert at 5:53 AM on October 21, 2018 [5 favorites]
There has actually been a downturn in population mobility in America.
posted by srboisvert at 5:53 AM on October 21, 2018 [5 favorites]
My theory is also "pollution causing chronic low grade inflammation." I think our immune systems can't cope with the particulate load we inhale/absorb daily and the a triggering allergen on top of that.
posted by emjaybee at 6:47 AM on October 21, 2018 [11 favorites]
posted by emjaybee at 6:47 AM on October 21, 2018 [11 favorites]
I have assumed some causal connection between atopy and air pollution after living in Seoul (truly terrible air quality, several of the young students I taught had severe atopy) and then moving to Hawaii (fantastic air quality, an acquaintance from Japan said that her atopy improved in Hawaii and she believed that others would benefit similarly). Apparently this connection is still undergoing research / under debate - The role of air pollutants in atopic dermatitis - but a recent article in Nature Immunology argues there is a clear connection.
posted by spamandkimchi at 7:18 AM on October 21, 2018 [4 favorites]
posted by spamandkimchi at 7:18 AM on October 21, 2018 [4 favorites]
I have severe pollen allergies and associated oral allergy syndrome. I've been doing helminth therapy with Necator americanus (human hookworm) for 2 years"
zenzicube, how did you get started with that?
posted by dilettante at 7:38 AM on October 21, 2018 [1 favorite]
zenzicube, how did you get started with that?
posted by dilettante at 7:38 AM on October 21, 2018 [1 favorite]
I buy into a lot of this, including the hygiene hypothesis, but I have to say the shaming - from other parents AND FROM THE ALLERGIST - when my son had an anaphylactic reaction to his first ever taste of peanut butter at 5 months was pretty shitty. I adore peanut butter and ate it constantly throughout pregnancy. I ate trail mix like it was my job while breastfeeding to keep up with the caloric burn. Turns out his allergy is a hardcore systemic one that no exposure could have done anything about, but the allergist before the blood test was handing us literature about how we shouldn’t wait to introduce peanuts to a baby’s diet. IT WAS HIS FIRST TASTE. WE WERE FEEDING IT TO HIM AT FIVE MONTHS FOR EXACTLY THAT REASON. FUCK YOU, PLEASE TELL ME HOW TO MAKE MY BABY NOT DIE.
Anyway meanwhile he eats dirt and lets the dog lick his spoon before he puts it in his mouth and his sister is a tornado of preschool germs and snot so god knows we’re trying to do our part on the hygiene front, but I’m so tired of the common interpretation of allergy research being about parents being overprotective or whatever. Sort it with your own kids, don’t shame other parents when you don’t know the backstories.
posted by olinerd at 8:13 AM on October 21, 2018 [34 favorites]
Anyway meanwhile he eats dirt and lets the dog lick his spoon before he puts it in his mouth and his sister is a tornado of preschool germs and snot so god knows we’re trying to do our part on the hygiene front, but I’m so tired of the common interpretation of allergy research being about parents being overprotective or whatever. Sort it with your own kids, don’t shame other parents when you don’t know the backstories.
posted by olinerd at 8:13 AM on October 21, 2018 [34 favorites]
We obviously can't expand single anecdotal samples to population-level analyses, but this particuar Gen-Y kid from the rural Rockies was exposed to pretty pristine air as a child, and nevertheless had a bunch of fun food/pollen allergies.
I'm reasonably convinced that sanitizing everything has negative side effects, and pollution, mono-cropping, population mobility are probably all factors (the first two are pretty horrid for plenty of other reasons). But I'm definitely swayed by I just feel we can’t know the true numbers of say, pre-1900 people’s with peanut allergies-type arguments.
posted by aspersioncast at 9:52 AM on October 21, 2018 [2 favorites]
I'm reasonably convinced that sanitizing everything has negative side effects, and pollution, mono-cropping, population mobility are probably all factors (the first two are pretty horrid for plenty of other reasons). But I'm definitely swayed by I just feel we can’t know the true numbers of say, pre-1900 people’s with peanut allergies-type arguments.
posted by aspersioncast at 9:52 AM on October 21, 2018 [2 favorites]
I've always had lots of allergies, and asthma. MY allergy plan of attack has always been, do nothing, deal with it. Until this year when my allergies went industrial strength, asthma also seems to be worse. I'm working my way through piles of over the counter meds. I'm not sure why, I just know that other folks with similar problems also seem to be having difficulties.
posted by evilDoug at 10:08 AM on October 21, 2018 [1 favorite]
posted by evilDoug at 10:08 AM on October 21, 2018 [1 favorite]
The idea that (figuratively) eating a few handfuls of dirt when you were young was important for your immune system was folk wisdom when I was growing up.
It may or may not have much of a scientific basis, but roughly-five-year-old me, who ate literal handfuls of dirt--until I vomited mud onto my grandmother's kitchen floor--feels retroactively vindicated. (I think that I had the idea that I could avoid eating vegetables by eliminating the middleman.)
posted by Halloween Jack at 10:15 AM on October 21, 2018 [8 favorites]
It may or may not have much of a scientific basis, but roughly-five-year-old me, who ate literal handfuls of dirt--until I vomited mud onto my grandmother's kitchen floor--feels retroactively vindicated. (I think that I had the idea that I could avoid eating vegetables by eliminating the middleman.)
posted by Halloween Jack at 10:15 AM on October 21, 2018 [8 favorites]
I've recently seen someone point out that the fiction-trope poisoning symptoms - clutching the throat, quickly turning purple and dropping unconscious/dead as soon as you drink the poison - don't correspond to most/any poisons commonly used in the pre-modern age, but do correspond to symptoms of anaphilactic shock.
The classic poisoning trope is a reference to strychnine, which has been used for hundreds of years, and before that, wolfsbane, which has been used as a poison for basically forever.
posted by betweenthebars at 10:15 AM on October 21, 2018 [20 favorites]
The classic poisoning trope is a reference to strychnine, which has been used for hundreds of years, and before that, wolfsbane, which has been used as a poison for basically forever.
posted by betweenthebars at 10:15 AM on October 21, 2018 [20 favorites]
I can't help but feel this thread is just working up to providing an excuse for people to have a bowl of dirt to give as Halloween treats.
posted by biffa at 10:44 AM on October 21, 2018 [10 favorites]
posted by biffa at 10:44 AM on October 21, 2018 [10 favorites]
Lots of allergy shaming in this thread.
posted by Faintdreams at 12:21 PM on October 21, 2018 [2 favorites]
posted by Faintdreams at 12:21 PM on October 21, 2018 [2 favorites]
That third point (urban environments and sunlight) is fascinating, given the civilization-wide migration away from rural areas and into cities.
posted by doctornemo at 1:26 PM on October 21, 2018
posted by doctornemo at 1:26 PM on October 21, 2018
Botanical Sexism Cultivates Home-Grown Allergies (Scientific American blog, April 29, 2015): It's the time year for watery eyes and itchy noses, and if you're among the afflicted, you may be surprised to learn that decades of botanical sexism in urban landscapes have contributed to your woes...
posted by Iris Gambol at 1:44 PM on October 21, 2018 [14 favorites]
Prior to the 1970s there was only limited demand for new street trees, since almost every street in America seemed to be lined with those big, grand, long-lived stately American elm trees. But then Dutch elm disease struck and suddenly millions of our city trees started to die. By the mid-1980s many millions of elms had died and many streets were suddenly treeless. Enter the new modern, university-recommended trees: the clonal males. In short order millions of these wind-pollinated trees were grown, sold and planted to replace the old insect-pollinated elms.(I still miss Dutch elms.)
It took a number of years for these new trees to mature enough to start to bloom, but eventually they did and with them came more city pollen and the “epidemic of allergy and asthma.” Many of these same trees are still alive and well and getting even larger, and the bigger they get, the more pollen they shed.
posted by Iris Gambol at 1:44 PM on October 21, 2018 [14 favorites]
My mother developed asthma and allergies after being sprayed by a crop duster plane when we lived next door to a commercial apple orchard. We asked the farmer if he'd let us know in the future what days they'd be spraying so we could stay indoors with the windows closed and he laughed in our faces.
posted by The Underpants Monster at 3:00 PM on October 21, 2018 [3 favorites]
posted by The Underpants Monster at 3:00 PM on October 21, 2018 [3 favorites]
My own allergies are minimal - just itchy eyes and post-nasal drip, and they're intermittent and I can keep them at bay with Flonase. But - it occurred to me that I didn't have them until about 2001-2002, when I was living about 2 miles from the Twin Towers Ground Zero, and the ensuing pillar of smoke that was coming from there for about for whole months. I actually looked into whether I qualified for health testing based on "living near the Towers" but I lived too far north of the border they established for "near".
posted by EmpressCallipygos at 3:57 PM on October 21, 2018
posted by EmpressCallipygos at 3:57 PM on October 21, 2018
On the subject of localized immunity, I grew up in Minnesota, within a 50-mile radius of where my ancestors have lived going back 6 generations. Seasonal hayfever the whole time.
Then almost 20 years ago I moved to Montana, and had several blissful years of no allergies! Except gradually they came back; my doctors believe it just took time for my immune system to sensitize to the new species of pollen out here. It's still not as bad as it gets every time I go back to Minnesota visiting, but that's something I chalk up to drier air and lower primary production in this climate.
posted by traveler_ at 5:53 PM on October 21, 2018
Then almost 20 years ago I moved to Montana, and had several blissful years of no allergies! Except gradually they came back; my doctors believe it just took time for my immune system to sensitize to the new species of pollen out here. It's still not as bad as it gets every time I go back to Minnesota visiting, but that's something I chalk up to drier air and lower primary production in this climate.
posted by traveler_ at 5:53 PM on October 21, 2018
One of the big holes in this article is that it glosses over some huge holes in scientific knowledge about how allergies actually function, and uses an over-broad description of "allergies" that fails to distinguish between true allergies and nonallergic inflammatory responses, especially those that have histamine responses (e.g. nonallergic rhinitis).
There are two big types of allergies: Immunoglobin E (IgE) and non-IgE responses (as well as some that are both IgE and non-IgE responses), and there isn't really solid evidence to show that the underlying prevalence, rather than the diagnoses rate, is increasing. This is in part because it's really hard to diagnose most allergies, and the only really reliable tests are challenge tests, which basically involve giving larger and larger doses of a potential allergen to see whether someone has an immune response. They're uncomfortable at best and dangerous at worst, and there's at least some documentation that they can induce allergies themselves (particularly to exposure-based allergens like latex and bee venom).
Contrary to this article, the genetic explanation for allergic response is nowhere near being complete or predictive, especially when compared to individual allergens. Your IgE responses can be mapped to a vague genetic profile, but that will only increase the ability to predict whether you'll be allergic to something, not to any specific thing (though being allergic to one thing predicts being allergic to others).
Complicating this even further is that since the public doesn't use "allergy" in a precise sense, the idea that allergies have increased in prevalence is made harder to support by the increased use of "allergy" to describe either distaste or non-allergic reactions to irritants. Like, most vegetarians aren't allergic to meat, though plenty will swear they are (vegetarian here). They may have adverse reactions to it for a variety of reasons, but it's incredibly unlikely that they are having a specific immune response to a foreign animal protein in their gastrointestinal tract. Likewise, sugar allergies, and most gluten allergies. Even "sensitivities" aren't allergies.
But wait, there's more! Roughly 85% of people with documented food allergies diagnosed through challenge testing find that they are no longer allergic when retested five years later (sample size: 6,300). Most of these were milk, eggs, soy and wheat; peanut allergies have only a 20% chance of being outgrown. But broader testing has suggested that many allergies to environmental triggers, e.g. pollen, are also similarly transient. Simultaneously, nonallergic rhinitis (which can be prompted by things like dust, ash, pollution, etc.) is more likely to recur — you can even lose your actual IgE allergy while gaining a nonallergic rhinitis sensitivity to the same trigger (often molds) where you're not having the immune response but are getting the same histamine response symptoms. The only way to tell whether you're actually having an allergic reaction to them is, again, having the challenge test (or, for many allergens, a blood test can give 95% confidence).
So, given all that, my hunch is that the spike in actual allergy prevalence we've seen over the last couple decades is much smaller than we think and that the combined expansion of the use of the term allergy to cover nonallergenic symptoms and the improved diagnostics of some allergies (especially non-IgE allergies like Celiac) accounts for more than an increased endemic propensity. But even that might be wrong — we just don't know anywhere near enough about human immune systems to have solid ground to make any sweeping pronouncements.
posted by klangklangston at 7:15 PM on October 21, 2018 [23 favorites]
There are two big types of allergies: Immunoglobin E (IgE) and non-IgE responses (as well as some that are both IgE and non-IgE responses), and there isn't really solid evidence to show that the underlying prevalence, rather than the diagnoses rate, is increasing. This is in part because it's really hard to diagnose most allergies, and the only really reliable tests are challenge tests, which basically involve giving larger and larger doses of a potential allergen to see whether someone has an immune response. They're uncomfortable at best and dangerous at worst, and there's at least some documentation that they can induce allergies themselves (particularly to exposure-based allergens like latex and bee venom).
Contrary to this article, the genetic explanation for allergic response is nowhere near being complete or predictive, especially when compared to individual allergens. Your IgE responses can be mapped to a vague genetic profile, but that will only increase the ability to predict whether you'll be allergic to something, not to any specific thing (though being allergic to one thing predicts being allergic to others).
Complicating this even further is that since the public doesn't use "allergy" in a precise sense, the idea that allergies have increased in prevalence is made harder to support by the increased use of "allergy" to describe either distaste or non-allergic reactions to irritants. Like, most vegetarians aren't allergic to meat, though plenty will swear they are (vegetarian here). They may have adverse reactions to it for a variety of reasons, but it's incredibly unlikely that they are having a specific immune response to a foreign animal protein in their gastrointestinal tract. Likewise, sugar allergies, and most gluten allergies. Even "sensitivities" aren't allergies.
But wait, there's more! Roughly 85% of people with documented food allergies diagnosed through challenge testing find that they are no longer allergic when retested five years later (sample size: 6,300). Most of these were milk, eggs, soy and wheat; peanut allergies have only a 20% chance of being outgrown. But broader testing has suggested that many allergies to environmental triggers, e.g. pollen, are also similarly transient. Simultaneously, nonallergic rhinitis (which can be prompted by things like dust, ash, pollution, etc.) is more likely to recur — you can even lose your actual IgE allergy while gaining a nonallergic rhinitis sensitivity to the same trigger (often molds) where you're not having the immune response but are getting the same histamine response symptoms. The only way to tell whether you're actually having an allergic reaction to them is, again, having the challenge test (or, for many allergens, a blood test can give 95% confidence).
So, given all that, my hunch is that the spike in actual allergy prevalence we've seen over the last couple decades is much smaller than we think and that the combined expansion of the use of the term allergy to cover nonallergenic symptoms and the improved diagnostics of some allergies (especially non-IgE allergies like Celiac) accounts for more than an increased endemic propensity. But even that might be wrong — we just don't know anywhere near enough about human immune systems to have solid ground to make any sweeping pronouncements.
posted by klangklangston at 7:15 PM on October 21, 2018 [23 favorites]
My own allergies are minimal - just itchy eyes and post-nasal drip, and they're intermittent and I can keep them at bay with Flonase. But - it occurred to me that I didn't have them until about 2001-2002, when I was living about 2 miles from the Twin Towers Ground Zero, and the ensuing pillar of smoke that was coming from there for about for whole months. I actually looked into whether I qualified for health testing based on "living near the Towers" but I lived too far north of the border they established for "near"."
Probably not allergies. Probably nonallergic rhinitis prompted by exposure to noxious chemicals. Unfortunately, you're less likely to grow out of that than actual allergies.
posted by klangklangston at 7:17 PM on October 21, 2018
Probably not allergies. Probably nonallergic rhinitis prompted by exposure to noxious chemicals. Unfortunately, you're less likely to grow out of that than actual allergies.
posted by klangklangston at 7:17 PM on October 21, 2018
Dilettante I got mine from one of the providers listed at the Helminthic Therapy Wiki (MeMail me for more details). That wiki has some of the best information on the treatment, from researchers and also those who are undergoing treatment themselves. If you do intend to try it, I'd suggest doing a proof-of-principle test with HDCs (H. diminuta cysticercoids), which are a kinder, gentler (but very temporary) introduction to the treatment. Biome Restoration sells them and actively researches their therapeutic use, as well.
posted by zenzicube at 7:24 PM on October 21, 2018 [4 favorites]
posted by zenzicube at 7:24 PM on October 21, 2018 [4 favorites]
Complicating this even further is that since the public doesn't use "allergy" in a precise sense, the idea that allergies have increased in prevalence is made harder to support by the increased use of "allergy" to describe either distaste or non-allergic reactions to irritants.
Right; there are three drugs to which I have a sensitivity rather than a true allergy. Nevertheless, on my doctor's advice I list them under "Drug Allergies" whenever I'm going into the hospital or filling out new-patient paperwork at a medical office, because there isn't a place to list sensitivities. I make sure to explain this to the person who's treating me, but at least the information is there on paper.
posted by The Underpants Monster at 8:05 PM on October 21, 2018 [1 favorite]
Right; there are three drugs to which I have a sensitivity rather than a true allergy. Nevertheless, on my doctor's advice I list them under "Drug Allergies" whenever I'm going into the hospital or filling out new-patient paperwork at a medical office, because there isn't a place to list sensitivities. I make sure to explain this to the person who's treating me, but at least the information is there on paper.
posted by The Underpants Monster at 8:05 PM on October 21, 2018 [1 favorite]
I've been doing helminth therapy with Necator americanus (human hookworm) for 2 years and it's completely resolved all my allergies, so long as I maintain a population of them in my gut. Helminth therapy is a fairly new area of research, but there are some hypotheses about why it works, such as organisms like hookworm being a keystone species in the gut that should never have been eliminated (deworming is often part of vaccination programs, for instance).
Whaaaaaat!! I didn't even know this was a thing! You're blowing my mind, here. I don't know if there's negative, practical fallout from being a hookworm host, but thanks for sharing, this is so interesting.
posted by lollymccatburglar at 2:52 AM on October 22, 2018
Whaaaaaat!! I didn't even know this was a thing! You're blowing my mind, here. I don't know if there's negative, practical fallout from being a hookworm host, but thanks for sharing, this is so interesting.
posted by lollymccatburglar at 2:52 AM on October 22, 2018
This was an interesting read after spending the week in a hospital after going into anaphylaxis shock over an antibiotic. I'm still in a mild allergic state until my system calms down, which I've been told will take a week or so more, and by mild I'm on two different steroids, two antihistamines, and use cortisone cream to deal with the hives between my fingers.
If there's a way to keep anyone suffering, I'm all for more research.
posted by 80 Cats in a Dog Suit at 3:06 AM on October 22, 2018
If there's a way to keep anyone suffering, I'm all for more research.
posted by 80 Cats in a Dog Suit at 3:06 AM on October 22, 2018
But more seriously about the cats:
This is all anecdotal, but I know a number of people allergic to cats who are no longer allergic to their cats. That is, they get cats and while they're still allergic to other people's cats, after a bit they no longer get symptoms around their cats. But I know my anecdata is not evidence!
posted by Anonymous at 4:01 AM on October 22, 2018
This is all anecdotal, but I know a number of people allergic to cats who are no longer allergic to their cats. That is, they get cats and while they're still allergic to other people's cats, after a bit they no longer get symptoms around their cats. But I know my anecdata is not evidence!
posted by Anonymous at 4:01 AM on October 22, 2018
QUICKLY EVERYONE
MORE CATS
posted by schroedinger at 5:33 PM on October 21 [5 favorites +] [!]
Sure shroedinger leave out whether they should be alive or dead. Keep us hanging why don't you.
posted by srboisvert at 5:14 AM on October 22, 2018 [7 favorites]
MORE CATS
posted by schroedinger at 5:33 PM on October 21 [5 favorites +] [!]
Sure shroedinger leave out whether they should be alive or dead. Keep us hanging why don't you.
posted by srboisvert at 5:14 AM on October 22, 2018 [7 favorites]
When I had cats I always thought I was more allergic to other people's cats. My cats lived to a very old age, then died, and I did not get any more. Since I moved from the house where I lived with them, my itchy eyes and sneezing and hacking symptoms are about 98% gone. So perhaps it is more that I was just at a chronically allergic baseline, it was normal to feel like that. But having such a stable level of symptoms, I would notice that new cats worsened it.
I love cats and still miss my kitties every day. But I am going to resist getting more of them, for as long as I can. It's like addiction in that way.
posted by elizilla at 5:47 AM on October 22, 2018
I love cats and still miss my kitties every day. But I am going to resist getting more of them, for as long as I can. It's like addiction in that way.
posted by elizilla at 5:47 AM on October 22, 2018
I had a really bad cough in the second winter after moving to England. Turns out this happens to lots of people who move to England from North America and is related to mite allergies and may be due differences in mite populations between countries/climates.
Oh good God, is this why despite the fact I live in a nerd equivalent of Miss Haversham's wedding chapel, all action figures covered in dust, I'm still an allergic wreck? Fucking dust mite populations?
posted by Katemonkey at 6:36 AM on October 22, 2018
Oh good God, is this why despite the fact I live in a nerd equivalent of Miss Haversham's wedding chapel, all action figures covered in dust, I'm still an allergic wreck? Fucking dust mite populations?
posted by Katemonkey at 6:36 AM on October 22, 2018
(Western, industrialized countries) People live with less direct contact with animals and dirt. I have a dog, he brings me dirt, dander, fur, and would lick me raw if allowed. People, esp. in the US, keep their windows closed 12 months a year, ride in closed cars, work in closed offices. People eat a lot of protein (allergies are often activated by a protein in the allergen, not by fat, carb or other food component). People have upholstered furniture and thick mattresses that are an excellent home for mites. There's more and more plastic and formaldehyde in our homes, offices, cars.
The hygiene hypothesis doesn't hold together for me - being free of tetanus, e.coli, salmonella is pretty great, and the latter 2 are prevalent in our foods. I think the germphobes are kind of silly, but I also think hygiene is pretty awesome. Pasteur is a hero, hand-washing is a lifesaver.
I'm fortunate to have only mild hay fever, and lactose intolerance (which many Westerners will have as they age; lactose tolerance is globally non-standard and tends to wear off). Grew up with dogs, cats, played outside.
side note: The more time kids spend outside, presumably with access to distant objects to view, the less likely they are to need glasses.
posted by theora55 at 8:56 AM on October 22, 2018 [1 favorite]
The hygiene hypothesis doesn't hold together for me - being free of tetanus, e.coli, salmonella is pretty great, and the latter 2 are prevalent in our foods. I think the germphobes are kind of silly, but I also think hygiene is pretty awesome. Pasteur is a hero, hand-washing is a lifesaver.
I'm fortunate to have only mild hay fever, and lactose intolerance (which many Westerners will have as they age; lactose tolerance is globally non-standard and tends to wear off). Grew up with dogs, cats, played outside.
side note: The more time kids spend outside, presumably with access to distant objects to view, the less likely they are to need glasses.
posted by theora55 at 8:56 AM on October 22, 2018 [1 favorite]
And there are a ton of antibiotics in meat, no idea if that contributes to allergies, but likely the source of plenty of problems, notably antibiotic resistance, which is typically blamed on consumers. Hidden components of our diet and environment seem like a good place to look for allergens.
posted by theora55 at 9:02 AM on October 22, 2018 [1 favorite]
posted by theora55 at 9:02 AM on October 22, 2018 [1 favorite]
The more time kids spend outside, presumably with access to distant objects to view, the less likely they are to need glasses.
My severely myopic, spent-my-childhood-outside self would like to point you to my above comment regarding allergy shaming.
posted by olinerd at 12:35 PM on October 22, 2018 [1 favorite]
My severely myopic, spent-my-childhood-outside self would like to point you to my above comment regarding allergy shaming.
posted by olinerd at 12:35 PM on October 22, 2018 [1 favorite]
Hey, there is more and more of a condition, we don't know why...
"Have you tried:
A: Blame the victims?
B: Blame their mothers?
C: Blame government do-gooders
D: Blame cities
E: dismiss trend without evidence: i.e. maybe we just notice it more
Works for autism, cancer, allergies, opiates, obesity, type II diabetes, unemployment etc
posted by Anchorite_of_Palgrave at 4:35 PM on October 22, 2018 [3 favorites]
"Have you tried:
A: Blame the victims?
B: Blame their mothers?
C: Blame government do-gooders
D: Blame cities
E: dismiss trend without evidence: i.e. maybe we just notice it more
Works for autism, cancer, allergies, opiates, obesity, type II diabetes, unemployment etc
posted by Anchorite_of_Palgrave at 4:35 PM on October 22, 2018 [3 favorites]
I don't know that anyone here is doing the first part of E., just the second part. And I haven't specifically noticed anyone doing the others, although I suppose the article does the second by implication.
My understanding (love for any resident epidemiologists to weigh in) is more along the lines of "there are so many potential contributing factors to X health issue that it's often difficult or even irresponsible to draw singular causal conclusions. At least now we're able to diagnose and treat it when it happens. Of course, now that we have slightly more of an idea how this works and have named it, we'll see a lot more reported cases. It's tempting to revise diagnoses from the past that seem to match the symptoms as we understand them, but probably at least as useful to work on actual new data we can collect, and take a stab at trying to fix the problem from multiple angles."
In the real world probably with a (un)healthy dose of "is there any way to for Pfizer et al to make money off this" and "is there any way to exploit the uncertainty of a singular cause to peddle even more dubious woo" (I'm glad it's working for you, but helminth therapy in adults is still pretty dubious y'all - have you ever been around a human or animal with an advanced hookworm infection? I have. Both. Give me fucking allergies any day).
Really this applies to autism and many cancers as well.
posted by aspersioncast at 8:18 PM on October 22, 2018 [1 favorite]
My understanding (love for any resident epidemiologists to weigh in) is more along the lines of "there are so many potential contributing factors to X health issue that it's often difficult or even irresponsible to draw singular causal conclusions. At least now we're able to diagnose and treat it when it happens. Of course, now that we have slightly more of an idea how this works and have named it, we'll see a lot more reported cases. It's tempting to revise diagnoses from the past that seem to match the symptoms as we understand them, but probably at least as useful to work on actual new data we can collect, and take a stab at trying to fix the problem from multiple angles."
In the real world probably with a (un)healthy dose of "is there any way to for Pfizer et al to make money off this" and "is there any way to exploit the uncertainty of a singular cause to peddle even more dubious woo" (I'm glad it's working for you, but helminth therapy in adults is still pretty dubious y'all - have you ever been around a human or animal with an advanced hookworm infection? I have. Both. Give me fucking allergies any day).
Really this applies to autism and many cancers as well.
posted by aspersioncast at 8:18 PM on October 22, 2018 [1 favorite]
"Hey, there is more and more of a condition, we don't know why...
"Have you tried:
A: Blame the victims?
B: Blame their mothers?
C: Blame government do-gooders
D: Blame cities
E: dismiss trend without evidence: i.e. maybe we just notice it more"
Absent a cure, a stable incidence in population (number of new cases) will lead to an increase in prevalence (the proportion of population members with the condition).
A comprehensive literature review noted conflicting studies, with the strongest evidence supporting an increased prevalence of peanut allergies in young adolescents, which is likely tied to more infants and young adolescents surviving anaphylaxes that would have killed them earlier. Aside from that, we just don't know, though some of the increased prevalence of serious food-based allergies is consistent with an underlying increase in incidence.
But all of that is supposition because the strongest evidence is expensive and dangerous, and self- or physician-reported incidence is three to four times higher than verifiable incidence.
So, frankly, you have E exactly backwards: We lack the evidence to confidently assert this as a trend. The burden of proof is on those who are making a positive claim.
posted by klangklangston at 8:32 PM on October 22, 2018 [1 favorite]
"Have you tried:
A: Blame the victims?
B: Blame their mothers?
C: Blame government do-gooders
D: Blame cities
E: dismiss trend without evidence: i.e. maybe we just notice it more"
Absent a cure, a stable incidence in population (number of new cases) will lead to an increase in prevalence (the proportion of population members with the condition).
A comprehensive literature review noted conflicting studies, with the strongest evidence supporting an increased prevalence of peanut allergies in young adolescents, which is likely tied to more infants and young adolescents surviving anaphylaxes that would have killed them earlier. Aside from that, we just don't know, though some of the increased prevalence of serious food-based allergies is consistent with an underlying increase in incidence.
But all of that is supposition because the strongest evidence is expensive and dangerous, and self- or physician-reported incidence is three to four times higher than verifiable incidence.
So, frankly, you have E exactly backwards: We lack the evidence to confidently assert this as a trend. The burden of proof is on those who are making a positive claim.
posted by klangklangston at 8:32 PM on October 22, 2018 [1 favorite]
“…helminth therapy in adults is still pretty dubious y'all - have you ever been around a human or animal with an advanced hookworm infection?”
There is nothing at all dubious about helminthic therapy, which uses only four specially selected helminth species, all of which are safe in the low numbers that are employed in therapy.
posted by Jayess at 10:35 AM on November 5, 2018
There is nothing at all dubious about helminthic therapy, which uses only four specially selected helminth species, all of which are safe in the low numbers that are employed in therapy.
posted by Jayess at 10:35 AM on November 5, 2018
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posted by Jonathan Livengood at 9:43 PM on October 20, 2018 [2 favorites]