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Millions of years ago, a child was born whose body did not understand the difference between harmless substances normally found in the environment (allergens) and agents that carried infections. As a result, the child reacted to allergens in the same way he reacted to infections-by producing antibodies (protective substances) against them. With these new antibodies, he fought the allergens in various organs of his body, causing an inflammation there. This inflammation is known as allergy. As allergic men and women got married, this weakness was compounded in their offspring. They became known as allergy-prone or atopic children.

Explanation of Terms

Atopy (or allergy proneness). This is susceptibility to a group of illnesses that develop naturally after contact with allergens. It has the following characteristics:

a. A family history of allergy. An atopic child will not inherit a specific allergic disease. He does inherit, however, the tendency to develop sensitivity to any allergen when he comes in contact with it. This contact cannot be avoided realistically, and it may take place months or years after birth.

b. A reaction to an injected allergen. This may be a swelling and an itch in the skin where an allergen, to which one is sensitive, has been injected.

Sensitization. When an atopic child is exposed to an allergen, he may become sensitive to it. Sensitization can be active or passive. An example of active sensitization is when an allergic child develops allergy to ragweed when he is exposed to it. An example of passive sensitization is illustrated in the following historic experiment. Blood serum from Dr. Kustner, who was sensitive to fish, was injected into the skin of Dr. Prausnitz, who was not. A few hours later, an extract of fish was injected into the skin of Dr. Prausnitz. Within thirty minutes, an inflammation and itching developed in the skin of Dr. Prausnitz, who had never before been sensitive to fish. The skin of Dr. Prausnitz, which did not contain antibodies against fish, acquired them through a passive transfer from Dr. Kustner’s blood serum, which did contain them. Passive transfer causes a local sensitivity that lasts only a short time, in contrast to active sensitivity which lasts much longer.

Sensitization can be immediate or delayed. One child may develop hay fever minutes after exposure to ragweed; this is an immediate type of sensitivity. Another child may develop poison ivy dermatitis days after exposure to poison ivy; this is the delayed type of sensitivity. The distinction between the two kinds of sensitivity is based upon the time required for an allergic reaction to develop following exposure to an allergen.

Some factors influence the type and likelihood of allergy:

a.     The route through which the allergen enters the body. Some allergens are more dangerous when given by injection and less dangerous when given by mouth. An example is penicillin.

b.     The presence of the allergen in the environment in quantity. Ragweed may cause allergies in children while they are in America because ragweed is present in abundance here; it does not cause allergies in the same children when they are in Europe because it is less abundant there.

ñ     Some substances have a stronger allergenic power than others and are therefore more likely to cause an allergy. The egg white has stronger allergenic power than the yolk,

d.     The capacity of a person to acquire an allergy. Twins growing up in the same environment may develop different kinds of allergies; also, one twin may develop an allergy, while the other may never develop an allergy.

Toxicity. Toxicity is not allergy; it is the reaction of the body to a substance given to it in quantity (such as the reaction of a person who is stung by many bees). Allergy, on the other hand, may result from an injection of a very small quantity of bee venom. Therefore, one definition of allergy would be an extreme sensitivity to a substance which is harmless to most persons when given to them in the same amount.

Shock Organ. The organ of the body which becomes inflamed in allergy is called the shock organ. In asthma, the shock organ is the lung; in hay fever, it is the nose; in eczema, it is the skin.

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You are probably beginning to understand how the complex and delicate balance of our reproductive systems can be upset by things we do, eat, or come into contact with in everyday life. Of all these factors, nutrition (getting your diet right and correcting any deficiencies) is probably the most important. It’s certainly a vital first step for any couple trying to improve their fertility, even if they eventually opt for an assisted conception.

However, when you keep trying to conceive and nothing happens it is easy to get into a panic and start thinking that something is seriously wrong – either with you or your partner. I describe the various medical tests you can both have, in order to check different aspects of your fertility. These tests can highlight specific medical problems and assess crucial factors like hormone levels and sperm quality. Sometimes simply going through the process of eliminating different possibilities can give you peace of mind and make you more relaxed (which can be helpful in itself). And the information you gain may be very useful. For instance, if you find that your partner has poor sperm motility you can target the problem directly with additional nutrients like L-arginine.

Case History

Barbara was 41 when she came to see me. She had tried four IUI cycles with no success. She had been told her FSH levels were too high, ranging from 24 to 33 at the beginning of her cycles over a number of months. The cutoff level is 10 for most IVF clinics and levels as high as Barbara’s would normally indicate that she was beginning the menopause. The clinic had asked her to be tested each month to see how the FSH was fluctuating. Although the clinic was focusing on Barbara’s hormone levels, I Still suggested that both she and her partner should be tested for nutritional deficiencies and have these corrected, which they did. They both followed the Four-Month Preconception Plan and Barbara conceived naturally on a cycle with an FSH of 24. She now has a healthy baby boy.

Although it is important to investigate any possible medical problems, most couples are better advised only to start these investigations once they have implemented their preconception dietary and lifestyle changes by following the four-month plan. They should then try to conceive on their own for approximately six months. This is because many of the factors that will be tested – such as hormone levels, ovulation and sperm quality – will start to improve very quickly of their own accord, once both partners have established the recommended changes. The only exceptions to this are couples where the woman is older than 35 or couples who have reason to believe that they have a medical problem (such as the symptoms of an infection, which should be treated immediately).

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Nail brittleness

Nails so soft that they split into layers or split very easily once they grow beyond the fingertips.

What causes it?

No one knows for certain. Possibilities are:

• Circulatory disturbances causing poor nutrition to the nail bed, but there are usually other signs of this and it is not common in the fingers.

• An inherited tendency.

• Psoriasis. Usually the nails are also pitted.

• Iron-deficiency-the nails are usually spoon-shaped.

• Zinc-deficiency.

Prevention

• See a doctor for the treatment of any circulatory disorder you have.

• Get psoriasis treated.

• Take iron supplements or eat more iron-containing foods.

• Use nail hardeners or nail polish to prevent the ends from splitting.

• Increase the whole foods you eat and cut down on refined foods.

• Take a zinc supplement (up to 20 mg daily).

Nappy rash

It is a reddened area of skin in the nappy area of a baby. This can develop into tight, papery skin with some peeling. The common rash tends to spare the folds and creases, but babies with sensitive skins and those prone to seborrhea (cradle cap) may get a rash that extends into the folds and creases. A monilial rash (caused by thrush) has features of both and also has some spots elsewhere. It is also possible to have a rash that is purely monilial and consists just of isolated spots.

If a nappy rash is very severe there may be raised, red pustules which turn into raw, ulcerated areas. Undoubtedly a baby with this severity of rash will be irritable and will cry a lot.

What causes it?

• Common nappy rash is caused by urine irritating the skin in places where the nappy chafes. Plastic pants increase the humidity by preventing evaporation and so make this kind of nappy rash worse. It is thought that ammonia released from the urine is not the cause of this kind of rash but it can make the rash worse if the skin is already damaged.

• Diarrhea of any cause can make a nappy rash worse.

• Allergies are rarely a cause but some babies appear to be allergic to certain chemicals used in the manufacture of paper nappy liners.

• Airtight and watertight plasticized disposable nappies provide little or no ventilation and may promote nappy rashes.

• Occasionally a nappy rash is the earliest sign of atopic eczema.

• One in two nappy rashes is caused by monilia (thrush). Any rash that has been present for three days or more is likely to have monilia in it.

Prevention

Preventing the common kind of nappy rash is simple:

• Change your baby’s nappies frequently, never allowing him or her to stay for long in a wet or soiled nappy.

• Leave your baby without a nappy for as much of the time as possible-this is easier in the summer.

• Wash the bottom well and dry it thoroughly, and only then apply a barrier cream. Do this every time you change the nappy.

• Soak nappies in a sterilizing solution before washing.

• Ensure that nappies are thoroughly rinsed to remove all the soap and detergent.

• A one-way fabric nappy liner works wonders but paper ones can actually make rashes worse.

• Ideally, avoid using plastic pants, though this is the counsel of perfection because it often means soaked clothing, bedding, etc.

• If you think a particular brand of disposable nappy is the cause of your baby’s problem it could be the plastic or the deodorizer used. Try the baby in terry nappies for a few days to see if this will cure the condition. Once a culprit has been found, avoid it in the future.

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