FUNCTIONAL MEDICINE BLOG 

Includes over 800 monographs reporting on emerging studies in the medical and scientific literature of practical clinical importance, easily searched for content.

Histamine intolerance

Histamine intolerance is a widespread phenomenon that can mimic allergy. It plays a role in many diverse conditions including IBS and inflammatory bowel diseases, asthma, postural orthostatic tachycardia syndrome (POTS), complications of pregnancy, drug hypersensitivity, and intestinal permeability (by means of which it contributes to autoimmunity). It can be objectively evaluated with serum DAO activity. HI can be ameliorated by supplementation with DAO. Practitioners need to be astute in its diagnosis and management.

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Food allergy testing with IgG4 is not recommended

"...food-specific IgG4 does not indicate (imminent) food allergy or intolerance, but rather a physiological response of the immune system after exposition to food components. Therefore, testing of IgG4 to foods is considered as irrelevant for the laboratory work-up of food allergy or intolerance and should not be performed in case of food-related complaints."

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Neuropsychiatric illness, autoimmunity and the role of microbes

Neuropsychiatric illness often involves brain inflammation for which there may be an autoimmune origin. The authors of a paper* recently published in Current Opinion in Rheumatology set out to..."illustrate how microbes might participate in the pathogenesis of neuropsychiatric illness by triggering the production of autoantibodies that bind to brain targets."

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Hepatitis C antibody-postive patients need but often don't get confirmatory testing

Hepatitis C infection needs to be confirmed by PCR (RNA or DNA amplification) because antibody levels can remain high for many years after the infection is completely cleared by antimicrobial therapy or innate immunity. This is true for numerous other pathogens as well including Borrelia b. (Lyme disease). A paper just published in The American Journal of Medicine documents that RNA testing for hepatitis C is often not done.

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Brain atrophy is promoted by both high and low blood pressure

Brain atrophy, with progressive cognitive impairment, can include among causal factors neuronal loss due to diminished oxygen perfusion. Earlier posts have documented the importance of not over-medicating hypertension. A study just published in JAMA Neurology provides evidence that brain atrophy is promoted by low diastolic blood pressure in addition to hypertension.

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Autoimmune Autoimmune

Autoimmune inflammation can elevate serum 1,25-dihydroxy vitamin D

I have found that patients with an autoimmune component to their case often have elevated 1,25-dihydroxy vitamin D (calcitriol). This is not the 25-hydroxy vitamin D3 (cholecalciferol metabolite) that we always test to determine vitamin D3 sufficiency. Often with normal and even low vitamin D3 levels, patients with various degrees of active autoimmunity are testing for elevated 1,25-dihydroxy vitamin D levels. Now research published in PLOS One (Public Library of Science) shows how autoimmune inflammation and elevated 1,25-dihydroxy vitamin D are associated.

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