Cardamom Ring

This post is really just for me (although you are welcome to read it. Ha!). Every year about this time, I go looking in my email for my grandmother's cardamom cake recipe. Then, I try to remember how I made it gluten free. I am pretty sure this is accurate, although if I find Christmas Eve that I'm missing something, I promise to update. I'm hoping that this post will keep me from having to re-invent the wheel every, single year.

This is our traditional Christmas morning breakfast. James loves it. He eats nearly the entire thing himself every year.

This is an "oven saver," actually an oven pie guard, but it's a family recipe and we always called it an oven saver. When i went to buy my own as an adult, this caused endless confusion. I'll try to save you that trouble (affiliate link):

When I was a child, my mom used to carefully decorate it with candied cherries to look like a wreath. We just as carefully picked them off because - yuck! I have chosen not to decorate it. There's lots of tastier ways than candied cherries it could be done though.

Cardamom Cake

2 c gluten free flour

1/2 c sugar

3 T baking powder

1/2 t salt

1/2 t ground cardamom

1/4 lb butter, softened

2 eggs

1/2 c milk

1. Mix together the first 5 ingredients.

2. Cut in 1/4 lb softened butter.

3. Stir in egg and milk until only just

combined.

4. Spoon onto a greased oven saver.

5. Bake at 425 for 15 min.

6. Spoon on icing (1 1/2 c. conf.

sugar, few drops milk, 1/2 t vanilla).

Simplifying the Allergy Friendly Kitchen

I will not lie; my kitchen was already ... well used ... prior to food allergies. But, exploded might be a better description since James was diagnosed. A million and one different types of flour (all in tiny little bags), gadgets that will surely function to transform gluten free flour into a true wheat replacement (pro-tip: nope), any sense of flow lost under the day to day pressure of cooking everything.

Enter my friend, Karen, a simplicity coach (Keep it Simple is her website). Karen's focus is not organizing, but simplifying. I didn't understand the difference; if things were organized, my life would be simpler. However, after working with her, I get it. Organizing takes what you have and applies a system. Simplifying removes what you don't use or need, so you don't need a system.

She gave me homework, both physical and mental. Part one was to think about the flow in my kitchen and what I would want that flow to be ideally. Part two was to remove everything from the cabinets we would be working with.

Part 1:

We have lived in our house for almost eleven years. When you move in somewhere, you think about where it makes sense to store things. If you are anything like me, you don't think about it again for eleven some odd years. Looking at it from the perspective of, "What makes sense here?" allowed me to see my flow in the kitchen was clogged.

Part 2:

I got to this point (stuff from my appliance garage and three upper cabinets - seen in the background) and I messaged her, "I think this is all we have time for."

The Result:

We had time for much more than than I thought,mostly because I had already been thinking about what I wanted for function in my kitchen. I didn't have a lot of decision making left to do. We finished the appliance garage, four upper cabinets, and my entire walk in pantry - a huge mess.

Since a picture is worth 1,000 words:

And here are my counters:

It is peaceful in my kitchen now. I have countertops for prepping and am not constantly trying to figure out where to put something down.

How is the function in your kitchen? Do you think you could simplify it to work better?

Thanksgiving, Allergy Style

The food restrictions we will accommodate on Thanksgiving include: vegan, peanut, tree nut, soy, and wheat allergies, OAS to melon and tomato, avoids most legumes (not peas anymore! This means vegan butter is in. Hoping to re-introduce at least one more legume before Thanksgiving). My goal is not to make every dish meet every need, but for everyone to be able to eat a complete meal within their restrictions.

These are not my recipes, but the collection of what I will use and how I will adapt them.

Pre-Thanksgiving (with guests):

Avocado Pasta (with cheese on the side)

Taco Soup: No recipe, vegetable stock (4 c), salsa (1 small container), whatever add ins everyone can have and lots on the side. Suggestions for add-ins/toppings: black beans, cheese, tortilla chips, meat, avocado, corn, kidney beans, sour cream (yuck, not here).

Thanksgiving Day:

Turkey
Mashed Potatoes (will not make vegan)
Sweet Potato Casserole (will be vegan)
Green Bean Casserole (Will not be wheat and maybe soy? safe. James doesn't eat it so I honestly don't really know the allergens present. Also not vegan - my sister also doesn't eat it)
Stuffing stuffed pumpkin
        Vegan Version: Wild Rice and Brussels Sprouts  (but I replaced the nuts with sunflower seeds)
         Non-Vegan version: Sourdough Artichoke (I will use GF Jules recipe to make baguettes)
Pumpkin Ravioli with a Sage Pesto
     Pasta Recipe
     Pumpkin Filling (no cheese)
     Pesto recipe (pumpkin seeds to replace the walnuts)
Caesar Salad and Autumn Salad (to be vegan)
Gravy (not vegan)
Cranberry Sauce

Seriously, I already feel sick looking at that collection. But, we still have ...

Dessert:

Apple Pie (vegan)
Whoopie Pies:
     Pumpkin and Chocolate but both using the pumpkin version's filling

My Action Plan:

Making Now:

The pumpkin ravioli and the wild rice stuffing are already in the freezer. I am going to pre-bake and freeze some baguettes. And, I will pre-make and freeze the cranberry sauce. I'm hoping to test out and maybe freeze the whoopie pies before Thanksgiving. Maybe some "Whoopie! The election is over" pies.

A Day or Two before Thanksgiving:

Bake the sweet potatoes and prep the casserole. Make the green bean casserole. Bake the mini pumpkins, make the artichoke stuffing and stuff the pumpkins. Make the apple pie.

Thanksgiving Morning:

Make the whoopie pies (if they aren't done). Prep the salads. Make the pesto.

Right before eating:

Bake all that needs to be baked, make the mashed potatoes and gravy. Boil the ravioli.

My husband dos the turkey (and the gravy and Caesar salad for that matter) so that doesn't make my plan. He usually cooks it outside (either smoked or fried) so it also doesn't interfere with oven space.

Have you started your Thanksgiving plans?

An Apple Every Two Years

is apparently not enough to keep the doctors away.

But, here is James, his first apple in two years.

His Apple History:

He reacted to a fruit salad (no apple) on June 30, 2014, the day before his 12th birthday. He had a two system reaction and so self administered his epi-pen. Later that summer, he got an itchy mouth when eating apple, although he had applesauce earlier that day with no reaction. This disparity led his allergist to test him for oral allergy syndrome (OAS). In one of those weird twists, he did not test positive for apple (on the fresh apple skin test, no IgE was taken). However, he tested positive for other fruits and vegetables, including the melon that we now know caused his reaction.

His allergist advised me that we could do an at home challenge for apple. However, at the time, he was having issues with more and more foods and we were in the process of simplifying his diet. He had no desire to try apple. Since he could eat most apple products, just not fresh apple, we left it alone.

Fast Forward:

He has improved immensely, both physically and emotionally. His IgE for grasses, which is what causes his OAS allergies, are now nearly negative (0.24 and 0.37, a 90% and 89% reduction). We are joining friends this weekend on a hike followed by apple picking; he wanted to be able to eat an apple.

So, we decided to go ahead with the challenge recommended two years ago.

Please note: I am not giving medical advice or recommending you follow these steps. I am describing the steps recommended only in this particular case by a board certified allergist. If you have questions specific to you or your child, please consult your own board certified allergist. Thank you.

What was supposed to happen:

1. Take a thin slice of apple, put it to his lips, wait 15 min.

2. Microwave a small slice of apple for 10 sec. Take a nibble. Wait 15 min.

3. Slowly finish the microwaved slice over 15 min. intervals.

4. Repeat with a fresh slice.

5. Continue eating more until an entire apple has been eaten.

What did happen:

1. Hand James the apple slice to put to his lips.

2. He eats before I can say anything.

3. "What, was I not supposed to eat it?"

The results:

The first day he tried apple (about half of the entire apple), he got some very minor digestive problems. This is not entirely out of the ordinary for him and he was likely nervous. So, we stopped for the day and said we would come back to it.

Two days later, he finished an entire apple with no symptoms. And just like that, one food is down.

Moving Forward:

I plan to celebrate this victory for a while before moving forward. Whether he never had OAS to apples or he if his environmental allergies improved enough that he can now tolerate it, it is a victory. He is confident enough that he will try foods he has been avoiding.

The next food I plan to re-introduce is green beans. His allergist also felt that his issue with legumes is more of an intolerance. Legumes are histamine liberators. Since he has had a histamine type reaction, it is possible that, while his body was recovering from a reaction in particular, he had trouble digesting them. I will not be home trialing any that he was specifically tested for (all were positive) without discussing with his allergist. But, I am ready to lift the "avoiding legumes" label if possible.

Update:

In perfect irony, James got sick, so we will not be going apple picking this weekend. Nothing to do with apples or allergies, just your standard virus. Considering that in two years, he has not had a fever ever, I am debunking the "apple a day keeps the doctor away" advice.

Chronic Urticaria and Low Histamine

I have played with a low histamine diet for James, as it is a fairly common on-line (read: not doctor) recommendation for those with chronic urticaria. And then, last week there was this article:

"A Popular myth – low-histamine diet improves chronic spontaneous urticaria – fact or fiction?"

The points I felt most significant were:

1) they were on the diet for 3 weeks (which truly, is a very short time)
2) 75% of the participants had some improvement
3) 61% reached the endpoint goal of the study

The specific diet they used in the study is not mentioned in the abstract. I would love to see it. Part of my halfheartedness in using a low histamine diet exclusively is that there is so much on-line information, and a lot of it does not agree.

The other issue I have had in completely embracing low histamine is the mental effects. For an already food restricted teen, having to lose more food for a more nebulous health reason (that is, more nebulous than a clear food allergy) is distressing.

Here is how I have handled it:

1) No leftovers. I am trying to adhere to this as strictly as I can. I was a huge leftovers fan. With only three of us, it was easy to cook a meal and then use whatever was leftover in a meal later in the week. James had what we think was a histamine type reaction (leftover tuna, spinach, and blue cheese in a salad) and Dr. Li specifically advised against leftovers (and limiting blue cheese, which we have been fairly successful with).

2) Emphasizing the foods he can eat, trying to add in more of those foods which are low histamine rather than eliminating all the high histamine ones. My thought with this is that if he is full of low histamine foods, he will be not eat as many high histamine ones.

I have been using this list because I like how it is organized. Dr. Bowdish kindly replied on twitter with this option 

.@hollysjoy I've used a variation of this list from Allergy & Immunology Associates of Michigan https://t.co/eUufyigd6x

— Matthew Bowdish MD (@MatthewBowdish) September 17, 2016

It's one I also like because of it's clarity and limited nature (ie. not every food you eat is listed as high histamine).

These two reasonable steps are working for us. If this article had been posted when James had active and severe chronic urticaria, I would have done a stricter version, at least for three weeks to see any results.

At this point in James's life, I try to make any dietary changes or limitations part of teaching him how to eat as an adult, not that far away. In some ways, his diagnosis was the best thing that happened to him, because he had no idea one could eat without, in particular digestive, pain.  He is learning to listen to his body and eat accordingly. And this will serve him much longer in life than if I forced a certain diet.

Allergy Friendly Dog Treats

In honor of National Dog Day, I'm going to share a couple of "recipes" (more like directions) for dog treats I make for this guy

He has been known to have digestive issues from liking his snacks a little too much. So, this first recipe is for those who want to have their treats and eat them too.

Pumpkin Dog Treats

1 can pumpkin

flour

Really, that is it. I put one can of pumpkin in the mixer. I add flour (for us, a blend of whatever GF I have on hand) until the mixture is able to be rolled.

Roll out thinly, cut into squares (or whatever shape) and bake for 20 min at 375. Flip and bake for another 20 min.

These can be stored at room temperature.

A photo posted by AllergicRevolution (@allergicrevolution) on Apr 23, 2016 at 2:50pm PDT

Liver treats

This one is for people who buy their meat in large quantities and so end up with offal. Or, those who don't mind handling offal for their dogs.

Ingredients

Beef Liver

Yup, that is it.

Cut the liver into small pieces (this is much easier if it is still partially frozen). I have a dehydrate setting on my oven but if you don't, you can set your oven to 200. Put on parchment paper on cookie sheets. I dehydrated it for a total of 2 hours, flipping at the 1 hour mark. That was not long enough and they are still sticky. I would recommend flipping every hour and dehydrating for at least  4 hours. I will update when I try this.

Especially because they are not completely dry, I am storing this in the refrigerator.

 

Is this it?

We traveled to New York last month for James's 20 month follow up with Dr. Li. I really have no new blood work results to report, because, on paper, his testing is perfect. His improvements, even from last July, when he had already made a huge number of gains, are incredible. With that in mind, my first query to Dr. Li was:

"Is this it?"

James's quality of life has improved so significantly since beginning treatment, combined with the difficulty of tapering his Allegra down further, made me think that perhaps we had reached the end point of his treatment - and I was ok with that.

Dr. Li felt he still could go farther.

Her first recommendation was to have him have a food challenge, still on Allegra, and at most half the normal dose for a food challenge, eating that amount regularly. One of the benefits of seeing Dr. Li each day was that I could relay this to James's local allergist and have a response while still in daily contact with Dr. Li. Many times I have wished I could get them both in the same room to hash things out - this was the next best thing.

James's local allergist did not outright say no, but definitely expressed concerns. His first concern was that if James was still taking Allegra, minor symptoms might be suppressed and any reaction might be more serious before noticed. To combat this, the allergist said we would have to admit James to the hospital for the challenge and have an IV put in.

The allergist's second concern was with EoE. I know this is a controversial subject. I am reporting his concerns, not adding commentary because I think the research is still out. He felt that OIT had an increased risk of EoE and not doing a full challenge was too similar to OIT. Challenging when we weren't sure that James's immune system was fully healed could put him at a higher risk.

So, ultimately, the ball was in my court. James's allergist was willing, but ... Dr. Li recommended it.

I asked Dr. Li if it was even possible for James to develop EoE; his blood work shows 0% eosinophils in his blood. She said that yes, he could. Eosinophils can be in tissue and not blood.

I will be honest, EoE terrifies me. James has had digestive problems in the past (and to some extent, continuing) and I don't want to tip the scales. It seems the ultimate jumping out of the frying pan into
the fire.

And so, we decided to wait.

Inadvertently, we seem to have started James's Allegra taper again. Last Tues, the pills got stuck in his throat and he threw them up. This Tues, he forgot to take them. Unless I hear otherwise, I'm going to drop his Tuesday dose since he's gone two weeks without it with seemingly little effects. October will be a year since we began the taper. My goal now is to be done by next October!

Goal Setting

When James started treatment, my goal was pretty clear: I didn't want him to be allergic anymore. The allergy seemed the mountain to be conquered.

What I didn't know was how ill he had always been. Having been told, "this is normal," what I didn't hear is: "This is normal for him. This is not life threatening."

The food allergies were obviously not normal and obviously life threatening, so they became the enemy.

His health improvement was so fast and so nearly complete that it quickly became obvious that his previous struggles were not normal, not even normal for him. It became clear how completely they were affecting his daily quality of life. Since it had always been that way, none of us knew.

He had a brief, slight regression and seems to have recovered. I realized that his allergies were no longer the main mountain we were climbing.

I want to clarify our goals while seeing Dr. Li this month:

• Can he maintain his gains (or improve more)?
• Will he be able to maintain them even when eventually weaned from treatment?
• Realistically, should we be planning on food challenges or should we be focusing on getting him healthy, without attempting to introduce the foods he's allergic to?

Protocol Update:

Currently James is taking:

• Digestion Tea 2 (in tea form, not capsules. Most of the teas he takes are in capsules. There's one herb in the capsule version he cannot have, so he gets the drinkable version). We give 1/2 a packer of 6 different herbs mixed together in hot water twice a day
• Shu Chuan Tea - 6 capsules twice a day
• Shi Zhen Tea 1a - 6 capsules twice a day
• Good Mood Tea - 5 capsules twice a day
• Niu Bang Zhi (2 packets), Huang Bai (2 tsp), and Shi Zhen (1 capful) mixed together in his bath once a day
• Cream 3vb once a day

His focus in treatment has shifted to focus more on his GI problems and keeping his skin clear.

Misdiagnosis

Allergies are particularly prone to misdiagnosis but, the truth is, as you can see in the infographic below, misdiagnosis is a common problem.

Part of this, I believe, is that doctors play the game of statistics. They are looking for the ordinary, what they see most frequently. In general, they get it right (19 out of 20 times). But, what if you are that one?

James was diagnosed by his first pediatrician with lactose intolerance, based on symptoms and statistics. Once he had that diagnosis, it was used by every doctor he saw to explain his frequent diarrhea and cramping. I was obviously not being careful enough with his diet. Eventually, I couldn't stand it anymore and removed all dairy, in all forms, from his diet and discovered for myself that lactose intolerance was not the problem.

Unfortunately, his gastrointestinal problems are returning. In talking to Dr. Li, explaining to her why he was misdiagnosed for so long, she said, "But of course you were careful enough!"

And truly, I was. Not that I can't make mistakes, but I didn't make nearly a decade of mistakes. I should have advocated, both for myself and for James, to get more testing and intervention sooner.

And honestly, I need to keep this in mind, because I am not convinced we have reached the end of his diagnostic tangles.
Adventist University of Health Sciences

Raw Truth

I wrote this last week.

I'm tired. A lot has nothing to do with James's protocol, but when life wears me down, it is an added "too much."

And, I worry. I worry that his health seems to be backsliding. He has improved so much since first starting with Dr. Li, but some of the old issues are starting to resurface - GI problems, complaining about breathing, tonsil stones.

And did I mention, I'm tired.

I'm frustrated that we can't successfully remove his antihistamines even though he's been down dosing since October.

Logically, I know he has been taking antihistamines for a decade. It's not surprising it would take some time to remove them.

But, I'm tired of his body being so sensitive and I'm tired of feeling like I'm playing whack-a-mole with problems.

And, that's my raw truth.

I let it sit. Posting on a low is tougher than posting on a high.

I had my consult today. I was reminded of what I already know: he has come so far. This is not a straight line treatment. His immune system is being rebuilt. There is progress he hasn't lost. Now, his treatment needs to change direction to support his digestion.

Am I still tired? A little. Would I like an easy solution? Hell yes!

But, what I have realized with a couple steps back health wise is that the progress made is precious. Even, dare I say it, enough. This is not to stay we're stopping. We're not done yet. But, I am going to stop looking at the endpoint as passing an oral food challenge. If he could eat all his allergens, but had daily hives and diarrhea - what is point?

Back to Camp

I had really hoped to skip camp this year. I had every reason to believe that not only would it not be necessary, but we could even stretch our visits out to a year, avoiding the expensive summer season.

Life laughs.

In addition to his atopies, James has Tourette Syndrome. It was, comparatively,  minor by the time we saw Dr. Li and had been for some months.

Since James has been reducing his medications (both Allegra and melatonin), his tics have increased exponentially. At 10 years old, his tics were bad enough that he asked to be medicated. He tried but the side effects to the medication were intolerable. His tics have increased to that point, perhaps beyond.

Dr. Li asked about increasing both Allegra and melatonin. I explained my hesitation at increasing either, but particularly Allegra. We will not e able to do any food challenges if we can't remove him from Allegra. She concurred and we met in the middle. His Allegra will remain the same, his melatonin will be increased. She is making a custom herbal formula for him. Hopefully, he will see some improvement. She asked him to try acupuncture locally, which I am in the process of arranging.

And, we are going back to camp.

Last year, I was in the position of advocated for camp and Darren and James were more reluctant. This year, they are the enthusiastic ones and I am ... worn. Darren and I spent a day re-arranging travel plans. We have a family trip scheduled, also Back East, for the week following camp. Planes needed to be changed, hotels booked, logistics figured out. But, it is done.

What I'm doing differently this year:

1. A full kitchen, not a microwave, mini-fridge, cook in the bathroom combo. I couldn't face that again this year.

2. Gulp. A red eye flight. We couldn't find anything else (using airline points). Anyone want to wager that this will be my 'never again' point next year?

3. Not make any plans of tourist things to do. What we see is fine, but, I found last year, James needs rest after acupuncture. Often, by the time he had the energy to go out and see, it was night. Not that there isn't a lot to see at night!

#100daysofFunFood

Some of you may remember this post about 100 days of happiness by my friend, Stacey. (Incidentally, Stacey has her own blog now, Chew the FATT). I was invited to participate in the 100 Days challenge this year - but what to do?

A photo posted by elle luna (@elleluna) on Apr 6, 2016 at 5:22am PDT

What does every allergy mom do all the time anyway? Cooking!

I cook constantly, but honestly, I don't really enjoy it. I used to love to cook, but with a million substitutions and never knowing if something will work or not, it's a chore.

So, for 100 days, I am going to focus on fun food. For me, that means either playful or something I wouldn't normally attempt. I expect to fail, but hopefully, at the end of 100 days, I will have some new recipes and renewed enjoyment in the kitchen.

It starts next Tuesday. You can follow me on Instagram to see what I accomplish.

Protocol Update

Disclaimer: As always, this is one experience with Dr. Li's protocol. Each protocol is personalized. No generalizations to your own situation should be made. Thank you.

I have tried all sorts of options to organize James's protocol. So, I thought I would give you a glimpse into my fancy system as it stands now.

Eat your heart out, Martha Stewart!

I have been through several different pill sorting boxes and have outgrown them all. I have finally take to saving pill bottles and cream jars, labeling, and filling them. This box has a weeks worth of sorted pills and any open pill bottles. It lives on a shelf in the bathroom so James can help himself.

This is in my closet and is the unopened pills for two months. Our expenses are currently about $1000 a month.

This is a nightly pill container. I can tell it is for night time because of the Allegra poking out. His protocol from Dr. Li does not change pill wise from morning to night.

He is currently taking:

8 Mei Huang tea 5 Tea capsules 2 times a day
8 Shi Zhen Tea 1a Tea capsules 2 times a day
6 Shu Chuan Tea capsules 2 times a day
5 Mu Lian pills 2 times a day
5 Good Mood Tea capsules 2 times a day
1/2 an allegra once a day
2 tsp of Huang Lian in the bath, once a day
2 packets of Niu Bang Zi in the bath, once a day
Cream IIIVB, full body application, once a day

For James, the most exciting change has been dropping the cream from twice a day to once. I cannot describe how much he hates the cream.

For me, it has been inching closer to being able to remove Allegra entirely from his protocol. This month, Dr. Li asked us to hold steady at half a pill for a month (we had been dropping half a pill every other week). I have noticed that when he reduces the amount, he has seasonal allergy symptoms for a day or two after. This week was particularly bad and he was unable to sleep for a night. However, they resolve fairly quickly so I have to guess that it is his body adjusting to the lower dose of antihistamine. Assuming all goes well, he will no longer use antihistamines in the beginning of June and we will be able to schedule skin testing.

If you had told me when we got his blood test results  that it would be at least 7 months until he was able to have skin testing, I would have thought you were crazy. And, I am not going to lie and say that the waiting is easy. Every year between March and June, James has had a major flair of his hives. If he can get through this season successfully while reducing his antihistamines, it will be a huge victory.

So, we wait.

Tregs for the Rest of Us: Part 2 Vitamin A & D

Both Vit A and D are involved in the regulation of the immune system and inflammation of tissue. In order to be used by the body, they need to be modified by enzymes.

There are many different kinds of Tregs. for simplicity, I have not specified the types in this review.

Vit A Derivatives and Treg Function

For reference, a derivative is an analogous compound to the vitamin. A metabolite is a compound created in vivo. When I say Vit A (or D3) given to a patient, I am referring to derivatives. I specifically note when I am discussing metabolites.

Vit A can be a problem unless there is the proper level; both too much and too little is problematic.. A deficiency can cause a Treg imbalance (too much Th1 and not enough Th2). A different study showed that too much Vit A in vitro causes development of Th2 cells.

A metabolite of Vit A (ATRA) converts one type of T-cells into Treg cells (again, in vitro). The resulting Treg cells suppressed effector Tcells, particularly in intestinal epithelial cells.  ATRA is also able to prevent the conversion of Treg cells into inflammatory TH17 cells. This provided some protection in a colitis model. There is some evidence that probiotic bacteria and Omega-3 fatty acids affects the functioning of ATRA in the body.

Vitamin D3 Derivatives and Treg Function

UVB exposure as well as a topical Vit D3 treatment can lead to creation of Tregs on the skin. Supplementation has also shown to have a positive effect with brain inflammation and diabetes (in terms of increasing Tregs).

MS patients have lower levels of Vit D3 metabolites, suggesting that the Vit D3 metabolites have a role in controlling inflammation and Treg formation. There is a possibility as well that Vit D3 metabolites affect the stability of Tregs in diabetic patients, but more studies are need to clarify any role they have.

Vit A and Vit D Crosstalk to Maintain Immune Homeostasis

Vit Aand  Vit D's signaling receptors are interconnected. There are two cell signaling pathways which are the same for Vit A and D. These pathways use different macromolecules to signal for either Vit D or Vit A. This leads to the hypothesis that they are both involved in maintaining a healthy balance in the immune system.

My Thoughts

Although it is not uncommon to have Vit D levels checked in a person with allergies, I have not done so for James. We live in an area with a lot of sun and he is outside without sunscreen each day. I have not heard of people testing Vit A levels, although they might. He is offered (but doesn't always eat) a wide variety of fruits and vegetables. I do not give him a multivitamin.

Since too little Vit A skews to too much much Th1 and not enough Th2, one might think that a deficiency would be good for those with allergies. However, I, personally, would not withhold a vitamin in the hopes that it changes the immune system. Vitamins have other functions besides affecting the immune system and if you over-activate the Th1 arm, there are also serious consequences (pot meet fire).

If his levels are low, I would suspect an underlying issue (he can't process Vit D for some reason, not that he doesn't get enough). It is another thing that I may address when he is done with treatment.

Part One

Allergy Friendly Chinese New Year Collection

Twelve years ago, for the last Year of the Monkey, we were in China, adopting James. Technically, we were there just after the New Year; it's a lunar holiday so the dates move. But this year, the first day of the New Year and the day we adopted James fall on the same day, Feb. 8th.

For years, we had a Chinese New Year's party, with friends, food, and red envelopes. After James's diagnosis with food allergies, we stopped. Pretty much everything we made, had at least one ingredient he couldn't have.

Over the years, I have slowly started cooking Chinese food again. I am not one who creates recipes. However, I've gotten pretty good at adapting. And a hat tip here to Sharon at Nut Free Wok, who has given me the confidence and recipes to begin branching out. So this year, we will again be celebrating Chinese New Year - nut free, peanut free, soy free, and wheat free.

 I have collected here for future years (and others) the recipes we are using and adapting.I hope you enjoy them.

Appetizers and Soups:

Hot and Sour Soup (from Closet Cooking) Adaptations: I will leave out the tofu and double up on mushrooms. I will use coconut aminos for soy sauce. I used to make one low/no heat and one spicy when James was younger, but I think we can skip that step now.

Chicken Potstickers (from Nut Free Wok) with the GF wrapper recipe from Food & Wine Adaptations: Replace soy sauce with coconut aminos.

Egg Rolls (from Steamy Kitchen) Adaptations: Replace soy sauce with coconut aminos. Leave out the meat for a vegetarian dish. Replace the egg roll wrappers with rice paper wrappers.

Char Siu Bao Adaptations: Use the Char Siu recipe below, with coconut aminos, cornstarch, some cha siu marinade, sugar, and green onions for the filling. I have made gluten free bao before but have not perfected my recipe. It's close enough to work but still in progress. If I get it perfected, I will share.

Main Dishes:

Roasted Braised Duck (from The Woks of Life) Adaptations: Replace soy sauce with coconut animos. Wish me luck as I have never cooked a duck before!

Char Siu (from Nut Free Wok) Adaptations: Replace soy sauce with coconut aminos. Replace black bean paste with ketchup.

Desserts (100% non-traditional):

Chocolate cupcakes: The recipe is from The Cake Mix Doctor Bakes Gluten Free (affiliate link). I plan to decorate them with red frosting with yellow piped characters.

Fortune Cookies (from Honest Cooking) Adaptations: I plan to dip them in white chocolate and add red sugar sprinkles.

Tregs for the Rest of Us: Part 1 Probiotics

Treg, or Regulatory T cells, have the job of regulating the immune system. Many treatments of allergies have been found to influence the Treg population (DBV's peanut patch, FAHF-2 (Chinese Herbal Medicine in trial with the same doctor James is seeing, OIT, and SLIT  (the SLIT research I found regarding Tregs was for environmental allergies, not food).

T cells are made in the bone marrow. Depending on chemical influences, a T cell, when made, will either become a Treg cell or a Teff (effector) cell. Everyone has both types of cells, but in different ratios. Increasing Tregs is a part of the puzzle on how to increase tolerance.

I ran across an article, "Influence of Dietary Components on Regulatory T Cells," from the Biotech Research and Innovation Centre in Copenhagen. Fair warning, it is dense. I've done my best to summarize it below, but if you find the information interesting, you should take a stab yourself.

It is a literature review, so there are many other articles referenced if there's an area you are particularly interested in and want to dig further.

Probiotics in the Gut


There are dendritic cells (a type of immune cell, not related to neurons) in the gut that help to balance immunity and tolerance. Dendritic cells can both activate effector T cells and promote non-inflammatory T cells, such as Treg. If Tregs are low in the gut, it can result in chronic inflammation.

With the exception of H. pylori (and the point of the experiment was to induce inflammation using H. pylori and then use Tregs to reduce it), all experiments reviewed showed a positive reaction of the intestinal disease with the use of probiotics.

Probiotics Outside of the Gut

Probiotics have been shown help with asthma, arthritis, and other inflammatory diseases. There needs to be more research on different organs to see how the Tregs in the gut can influence them.

It is important to note that different probiotics behave differently and some can be inflammatory. There appears to be evidence that different probiotics work with different dendritic cells in the gut and this may account for the differences.

Probiotic Caveats

Some studies have shown that probiotics can cause or contribute to inflammatory illnesses. The studies are not standardized, with different probiotics, doses, and type of administration. Additionally, genetics may play a role in the differing results. How any treatment behaves in vivo, with all the complications of an entire system can differ from results found in vitro.

There is the possibility that Tregs are increased simply by exposure to bacteria, and that any probiotic results are due more to the general bacteria load verses something special about any particular probiotic strain.

The data is not clear enough to allow a statement that all probiotics are protective.

My Thoughts - Or, the more I learn, the less I know

James does not take a probiotic, for a couple reasons. The first is that I would like some clarity that the probiotics available on the market are beneficial. The second is that he already takes so many pills (some of which have research to support that they affect Tregs) that I hesitate to add any more pills.

After he is weaned (someday) from Dr. Li's protocol, I will likely find a probiotic for him daily, under the "it can't hurt' philosophy.

Part 2

No News is Good News

Other than a cold, we are starting off 2016 in the best possible way - completely boring. James is still reducing his Allegra, he still has no symptoms. Hopefully, this trend of nothing interesting will continue through May, when he will be done with his Allegra and starting the nest phase of progression.

I'm going to change directions slightly for a while and focus on research. My hope is to continue to have no personal news for a few months.