QUESTION: I have a 70 yo pt with Hyper IgE syndrome presenting as lifelong severe eczema. We’ve made lots of progress but want to make sure I’m not missing something in his genetics.
I’ve done genetic testing and he is homo: VDR Bsm, MAO-A R297R, SHMT1 C1420T. He is hetero: COMT, COMT, MTRR, MTRR, BHMT, CBS
ANSWER: In high IgE with lifelong Atopy I consider the following things (even if negative in the past) as Atopic folks ‘collect’ causes due to the underlying atopy and are always best treated in the “big picture”. This big picture often at least includes the following: Mold and Environmental allergy / sensitivity; GI: Always have chronic dysbiosis at the best and that plus parasites (even if commensal) on and off through their lives; Direct GI cytokine and IgE triggering. Big with these folks.; GI calming therapies …
Some initial thoughts to consider:
- In high IgE with lifelong Atopy I consider the following things (even if negative in the past) as Atopic folks ‘collect’ causes due to the underlying atopy and are always best treated in the “big picture”.
- Mold and Environmental allergy / sensitivity (even if tested and non-reactive there are often aggravations from these with the atopic)
- GI: Always have chronic dysbiosis at the best and that plus parasites (even if commensal) on and off through their lives. Some well-rounded GI testing with PCR plus O&P X3 is a good screening although it isn’t 100%. I find parasites and hemolytic bugs in these folks guts all the time. Treat what you see and if you don’t see it consider Tx anyway. (even with a marginal GI test I’d do 8-12 weeks of GI clearing herbs and lots of Probiotics).
- Direct GI cytokine and IgE triggering. Big with these folks. I run ALCAT tests as they are based on Histamine release due to foods and although not a true cause removes some to a lot of the inflammatory triggers.
- GI calming: Curcumin and Quercetin, and some data says Iodine drops enterocyte production of Histamine / IgE so I have started adding I- to their Tx.
As for the SNP’s:
A good “active B-Complex”, an added multi trace mineral (like Pure Encapsulations), Extra P5P at dinner (60-100 mg), as much Mag as his GI tract can handle. Keep the accessory Histamine pathways active with 500-2000 mg Pantothenic acid as well.