ALLERGY\MEDICAL HELP: THE AIM OF THE NEUTRALISATION

The aim of the neutralisation testing is to find the strongest extract which does not cause a reaction in the skin – that is, that does not result in an increase in the size of the weal. After a positive reaction, a weaker dilution is tried, using the same procedure. If that is positive, the process continues using weaker and weaker doses until a negative reaction is found. That dilution is called the endpoint – the strongest dose that fails to produce a positive reaction. In practice, most people find that this endpoint – specific to them – turns off their symptoms, and they can encounter an allergen or eat a food without reacting to it.

The person is given either drops (to take under the tongue) or vaccine (to inject themselves) with their own endpoints which, used regularly, will protect them and control their symptoms. Multiple extracts can be included in one vial so that only one drop or vaccine is required to cover the various allergens. The neutralisation effect is not permanent – the drops or vaccine need to be taken regularly to prevent reactions. The intervals at which they need to be taken depend on the individual and the severity of their reactions. The effects of drops wear off after a few hours and are most convenient for foods eaten irregularly or substances not encountered every day. Injected vaccines have a longer lasting effect and, while most people need to inject once every two days, others need only to inject once or twice a week.

Neutralisation is most effective for inhaled allergens (such as moulds, dust mites and pollens) but it also works for food allergy and intolerance, and for chemical sensitivity. (Neutralisation for chemical sensitivity is usually done by placing drops of extract under the tongue and monitoring symptoms: when symptoms are relieved, the endpoint is found.)

When neutralisation works, the effect, like desensitisation, can be magical. Symptoms melt away and it can be a boon for people with multiple allergies and sensitivity. If on a very restricted diet, it can actually enable you to eat trigger foods with virtually no problems.

Neutralisation has its drawbacks, however. Many people do not reproduce symptoms on testing with inhalant allergens, but if you do, the process of testing can be tiring and painful. Occasionally people’s symptoms do not ‘turn off at the strongest negative dilution and for them, it is necessary to continue testing until the symptoms disappear.

It can also take a while for the endpoint to become effective. The neutralising effects of the endpoint do not always work fully at first and it can take a few weeks for the effect to build up. It can be a confusing and difficult time to experience.

Many people find that they do not need the neutralising endpoints permanently. Combined with avoidance, their system recovers sufficiently to cope without, and usually within eighteen months to two years, neutralisation is no longer necessary. In a minority of people, endpoints may shift from time to time within that period (often as the individual gets better), and the vaccines need retesting. It can be tiresome and time-consuming to retest, especially if you have many allergies, but it is worthwhile to have the endpoint right again.

Neutralisation is only available on the NHS at one or two centres in the UK. It is a relatively safe procedure – no fatal nor near-fatal reactions have ever been recorded. Like desensitisation, some people do not respond to it at all, but for those who do (particularly those with multiple sensitivity, with very severe reactions, or people intolerant of drugs), it can be one of their few means of relief.

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