Atopy, Food Hypersensitivities, and Obesity

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A Case Study Submitted By Scott Rigden, MD

Profile: http://plminstitute.org/scott-rigden-md/

 

 

Clinical Case Study on Atopy, Food Hypersensitivities, and Obesity

When she came to our office, Ursula* had an extensive medical history of severe allergies, eczema, asthma, folliculitis, and dry skin since birth, in addition to being overweight. She also had battled hypoglycemia for many years. Allergy work-ups showed numerous inhalant allergies, which required monthly allergy injections. She knew she had food allergies to soy and peanuts, and she was allergic to penicillin. Ursula had tried to lose weight many times, including following commercial weight-loss programs, self-directed regimens, and working with a personal trainer, but with no success. At the time of her first appointment she was working out with weights three times a week for a total of 120 minutes, combined with a rigidly disciplined 1400 calorie diet, and she had not been able to lose weight. Medications included Estrace 0.5 mg daily. She had had a total hysterectomy and tonsillectomy in the past.

Ursula’s physical examination was very positive for allergic nasal mucosa, allergic shiners around the eyes, mild wheezing bilaterally, and eczema on the hands, forearms, and posterior scalp. Extensive dermatitis and folliculitis were noted on the face and legs.

Ursula’s Initial Evaluation

Height: 65 inches

Weight: 179.3 pounds

Blood Pressure: 168/71

Waist circumference: 37 inches

Hip circumference: 45 inches

Cholesterol: 264

LDL: 154

Basic blood counts, TSH, liver function tests were all within normal limits.

RAST IGG4 test: very high reactions to eleven foods including egg, milk, corn, and wheat

 

Assessment

Ursula suffered from the following conditions:

1.       Atopic dermatitis, eczema, folliculitis, allergic rhinitis and asthma

2.       Obesity with associated IgG-mediated food hypersensitivities

3.       Elevated systolic blood pressure

4.       Elevated cholesterol and LDL

5.       History of hypoglycemia

 

Recommendations

1.       Initiate a 1300-1400 calorie, low-glycemic-load diet, with five to six small feedings per day. Also eliminate eleven foods including egg, milk corn and wheat which showed very high reactions in her RAST IgG test. Every morning, have two scoops of a hypo-allergenic rice-based protein powder.

2.       Keep careful daily records of food intake and symptoms.

3.       Continue weight training, with 20-minute walks four days per week.

4.       Drink at least 64 ounces of water daily.

5.       Commit to regular physician visits for monitoring, education, and motivation.

 

SIX MONTHS LATER

Initial         Final

Weight                           179.2 lb.     145.5 lb.

Waist Circumference      37 in.          32.5 in.

Hip Circumference                  45 in.          38.25 in.

Blood Pressure              168/71        145/93

Cholesterol                    264             202

LDL                               154             110

Skin Rashes(0-10)                   10               1

Allergic Rhinitis             10               1

Asthma                          5                 1

Scott Rigden MD

Septermber 2013

*case study is in The Ultimate Metabolism Diet: Eat Right for Your Metabolic Type, Scott Rigden MD, Hunter House

 

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