APPENDICES: PAIN-KILLERS
(Trade names are not given in this section, as the common pain-killers are used in a great number of different preparations. The ingredients are shown on the packet for those bought without a prescription.)
These are drugs that can block pain sensations. Our main interest in them is in connection with headache and migraine.
Aspirin and other salicylates (see Section 7A) reduce pain and damp down inflammation. They also have some effects on the blood platelets, and this may help to abort a migraine attack. Regular, prolonged use of salicylates can irritate the stomach lining and have other adverse effects, so this should be avoided. Paracetamol reduces pain but has very little anti-inflammatory effect. It has no ill-effects on the stomach, and as long as the maximum dose is strictly observed it is a very safe drug. However, it should not be taken long-term at the maximum dosage, nor should it be taken by anyone who has kidney or liver disease. There are rare instances of paracetamol causing skin rashes.
Codeine is a very mild opiate (a morphinelike drug) used in some migraine preparations. It is a fairly safe drug.
Caffeine is added to some pain-killers to speed up absorption and improve the effectiveness of the drug. Caffeine can also produce headaches, so heavy use of this type of pain-killer is not advisable.
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FOOD INTOLERANCE: PLANT FOODS
Potato family, Solanaceae: potato (but not sweet potato), tomato, aubergine, sweet peppers (green, red and yellow peppers), paprika, chilli peppers, tobacco, cape gooseberry.
Bean and pea family, Leguminosae:
peas, haricot beans (kidney beans, whether white-, red-, brown- or black-skinned, also baked beans and flageolets), peanuts, soya beans, lentils, split peas, broad beans, butter beans, mung beans, lima beans, chickpeas, black-eyed peas, carob, runner beans, green beans, snap beans, string beans, mangetout peas. Different kinds of haricot beans and their green forms (snap beans, string beans and green beans, including those sold as a frozen vegetable) are all the same species and should be regarded as the same food. Peanuts belong to a separate tribe from other members of the family, and experience with patients who are allergic to peanut suggests that cross-reactivity with other legumes is generally low, but peanut-sensitive people may react to soya beans. Patients sensitive to soya beans are
likely to react to a wide range of legumes. Anyone with these sensitivities is usually advised to avoid peanut and soybean oils as well, but this may not be necessary – such oils contain no detectable protein, and tests with allergic individuals showed no reaction to the relevant oil. But there might be a reaction if someone were intolerant of a non-protein component.
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NUTRITION SUPPLEMENTS: AN ELIMINATION DIET SHOULD TAKE A NUTRITIONAL SUPPLEMENT
Doctors who are concerned about possible nutritional defects suggest that anyone embarking on an elimination diet should take a nutritional supplement. They argue that many are likely to have deficiencies anyway, especially if they number diarrhoea among their symptoms, and that the restrictions of the elimination diet will only make the situation worse. Such doctors also recommend a special type of nutritional supplement to anyone coming off the Pill -and certainly to anyone staying on it. It is quite easy to overdo things with both vitamins and minerals, particularly with the fat-soluble vitamins, A and D, because these are stored by the body if taken in excess – water-soluble vitamins such as vitamin C can be washed out of the body in the urine. So grabbing a handful of ordinary vitamin pills is not the answer – they can be dangerous if the body already has an excess of vitamin A.
Ideally, anyone who is concerned about their nutritional status should have a full analysis done, so that a supplement can be tailored to their specific needs. Unfortunately, testing itself is a contentious issue. The traditional method of just testing a blood sample is now considered inadequate by many doctors. It appears that some nutrients – zinc for example – can be deficient as a whole but show normal levels in the blood. The suggestion is that the blood ‘needs’ the mineral more than other parts of the body, so there are mechanisms that ensure a good supply, scavenging the mineral from other tissues to keep the blood level high. A more extensive method of testing, using hair and sweat samples, as well as blood, often shows up nutritional defects that are not revealed by the blood alone. This form of testing seems to be vindicated by the results in individual cases – correcting the deficiencies shown by hair or sweat tests often does wonders for patients with previously intractable health problems. This Ts not hard, scientific evidence of course, and some carefully designed trials are needed to test these new approaches to nutrition.
In the meantime, what can be advised? Extensive nutritional testing is only available privately, but for those who can afford it there is little to lose, and. For anyone corning off the Pill, a special supplement is probably advisable.
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WHAT CAUSES FOOD INTOLERANCE? IS THE IMMUNE SYSTEM INVOLVED?
At the beginning of this book, we defined food intolerance as ‘any adverse reaction to food, other than false food allergy, in which the involvement of the immune system is unproven because skin-prick tests and other tests for allergy are negative. This does not exclude the possibility of immune reactions being involved in some way, but they are unlikely to be the major factor producing the symptoms.’ Because food intolerance has long been thought of as an ‘allergy’, most research into its causes has centred on the immune system. It is only in the last ten years or so that other possible reasons for intolerance have been investigated.
Despite extensive research, the evidence for immune-system involvement is fairly limited. The general consensus of opinion now is that immune reactions may have some role in food intolerance in some people, but they are only part of the story – something else must be going wrong as well.
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IN WHAT AGE MOST ALLERGIES ARE APPEAR?
Although most allergies first appear in childhood, particularly the acute types of food allergy, there are a few adults who suddenly develop an allergy for no obvious reason. Dr AW. Frankland, formerly of St Mary’s Hospital in London, describes the case of a woman of 50 who suddenly became allergic to sesame seeds, which she had previously eaten without difficulty. One day while eating a biscuit containing sesame, her mouth and throat began to tingle, and urticaria (nettle-rash) developed on her skin. These symptoms disappeared after an hour. When she ate another such biscuit two weeks later the reaction was far more severe. Her lips and eyelids swelled, urticaria developed all over her body, and she collapsed unconscious on the floor. Only prompt medical attention saved her life. This is an unusual, but not an isolated case, and is difficult to explain in terms of what we now know about allergies as inherited disorders.
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