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The Immune System and Allergies: A Different Perspective

By Kaleb Montgomery, DTCM
Allergies are a malfunction of the immune system; therefore, any discussion about allergies has to start there. Reduced to its most basic terms, the immune system differentiates between cells that are harmful and those that are favorable or benign.
After making this identification, it then seeks out the harmful cells, engulfs and eats them. These cells could be foreign pathogens, such as the flu virus, or they could be our own cells causing the problem, like cancer.

Our immune system grows and strengthens because it collects a database of every pathogen it encounters. Consequently, when our immune system runs into these pathogens again, it brings up the stored knowledge of the previous encounter to give our body a better chance of successfully dealing with the pathogen. That is the theory behind vaccinations and why we only get the chicken pox one time.

Again, the first job of the immune system is recognition. Once our body identifies the particle as foreign or problematic, it sends white blood cells to the area to fight the possible infection (i.e., the redness and swelling around a sliver or acupuncture needle insertion). When everything is working well, our immune system quickly recognizes trouble, sends white blood cells to the area, and the problem is handled before we even realize we were "invaded" or sick.

This process is energy intensive. That is why we feel so tired when we have a cold or the flu. Our body ensures we rest so that no energy is wasted in activity, and all of our precious energy resources can go towards coping with the problem at hand. With that brief examination of immune function, we will now focus on what happens with immune malfunction.

There are four main ways that the immune system breaks down: it can overreact or underreact to either internal or external threats. Let's explore each possibility in more detail using examples.

One of the easiest malfunctions to describe is when our immune system underreacts to external threats. One way this can manifest is as chronic colds or the flu. In this case, either our body has trouble recognizing the external pathogens as harmful or it recognizes them but does not have sufficient resources to fight them off. Here our defenses are weak and easily overwhelmed by these foreign pathogens. People in this situation often are sick for extended periods of time. Before we delve into problems with internal threats, I wanted to go into another aspect of immune function in a more in-depth fashion.

Every cell in our body functions to support the whole organism (us). When looked at it in that light, each cell lives in a symbiotic relationship with all of the other cells in our body. The lung cells exchange gases so the stomach cells have oxygen to digest food, so the kidney cells have the nutrients needed to filter the blood, and so on. When a cell grows not to support the whole organism, but only for itself, we run into trouble. These "selfish" cells, left unchecked, grow into cancer.

In an interesting aside, the increased incidence of cancer today mirrors in deadly irony what we are doing to the earth. Our species, growing unchecked, without regard to the other life on our planet, destroys and denigrates ecosystems and spews out toxic chemicals into the environment, which, in turn, increases the rate of cancer in our own species.

Anyway, back to the subject at hand. An example of our immune system underreacting to internal threats is cancer. Here there is a mistake in the reproductive mechanism of some of our cells. These cells are reproducing faster than our immune system can cope with and/or our immune system does not recognize this threat and therefore does not act accordingly. Cancer kills because the unchecked growth of the tumor uses up the nutrients and energy that is destined for the organ that the cancer is growing on. Now this organ can no longer function properly because the cancer is stealing its nutrients. Therefore, the whole organism suffers because the liver is no longer doing its job. It is interesting to note that our immune system successfully deals with "cancer" every moment of every day. The vast majority of the time our immune system recognizes those cells that are growing too quickly and mobilizes the white blood cells in time to stop the problem from becoming unmanageable. The very few times that this does not occur, we develop cancer.

The next possible way for our immune system to malfunction is the opposite from cancer; it overreacts to internal threats. Here we develop autoimmune diseases. Our immune system thinks that our own properly functioning cells are a threat and attacks and eats them. Autoimmune diseases are a large, shifting and vaguely understood category of diseases. An example of one is multiple sclerosis, where the body eats away the myelin sheath that surrounds and insulates the nerve fibers. Here the problem is that our immune system is too sensitive and attacks when it should not, like a security light in the backyard that goes on every time a squirrel runs by.

As you might notice, today I have managed to write about everything except allergies. I wanted to lay the groundwork with some basic information about the organ system most related to allergies, the immune system. By briefly exploring how the immune system works as a whole, we can better understand its role in allergies and better understand how to successfully treat allergies.

This is not a comprehensive overview of the immune system. This four-category system of looking at immune malfunction is one way to look it. Like all theoretical frameworks, this one has its limitations. Those of us that use TCM diagnosis understand this idea. Sometimes organ system or five-element diagnosis explains the pattern well, other times four levels, six levels or channel theory does the trick. We use whatever system best explains the problem. This immune system theory is like that. Use it as a tool to augment your understanding of how the immune system works, not as the monotheistic literal truth.

Next time, we will delve into allergies and the immune system using this framework.


Allergies, the Immune System and Boundaries

By Kaleb Montgomery, DTCM
If you remember my last article, I talked about a system of describing immune system malfunction in four categories, the first three being: constantly getting colds and flues by underreacting to external threats, underreacting to internal threats (e.g., cancer), and overreacting to internal threats categorized by autoimmune diseases.
Today we will explore the fourth category, overreacting to external threats manifesting as allergies.

What is an allergy? We experience allergy symptoms when our body encounters a substance that we are sensitive to. These substances generally are innocuous to most people and only cause problems to those with an allergy to that specific substance. For example, you can be allergic to cat dander and not to dog dander.

As I mentioned, the substances people are allergic to usually are harmless. There is nothing inherently dangerous in ragweed pollen or in dust. The problem occurs because of the immune systems overreaction to the substance. The runny nose, red itchy eyes and scratchy throat of a ragweed allergy sufferer do not occur because the pollen is a noxious substance, but because the person's immune system malfunctions.

When the allergy sufferer's immune system recognizes the ragweed pollen in their nostrils, their immune system immediately jumps into overdrive and reacts like it has encountered a disease-causing pathogen that has to be eliminated immediately. All of those uncomfortable runny and mucous symptoms are the body's attempt to flush out the pathogens. The unfortunate part is that all of those alarm bells are unnecessary in this case. Ragweed is not harmful; it's the body's overreaction to the pollen that causes the problem. This parallels TCM's view of external pathogen disease etiology, whereby the external pathogen enters the body only because there is something wrong with the zang/fu and wei or zheng qi is weak.

Another good example of the immune system overreacting to a harmless substance is athlete's foot. The fungus that causes athlete's foot does not harm us at all, it only feeds on dead skin. The problem is that our immune system recognizes that the fungus is a foreign substance and mobilizes its resources, creating the red itchy immune reaction that is athlete's foot.

Of course, allergic reactions come in all sorts of shapes and sizes - not only the runny nose and red itchy eyes but also hives, psoriasis and all sorts of other skin problems; digestive symptoms if the allergy is something ingested; or even death, in the case of the anaphylactic reaction to a bee sting or the fungus that grows on peanuts.

In TCM, we are not surprised that there are so many skin reactions to allergies. The organ in charge of the wei or protective qi is the lung. The lung is the most external of the zang organs and the only one in direct contact with the outside world through the air. In parallel to this, the skin, the lungs external manifestation, is the boundary between ourselves and the outside world. When we have difficulty with our internal boundary definer, the immune system, it's only natural that the problems occur often on our most external boundary: the skin, eyes and nose. These boundary problems also have other reflections besides the external physical symptoms.

Looking at the problem from the mind/body connection perspective, these boundary problems are often reflected in an allergy sufferer's personality. This is true of all four of my categories. You often can see this reflected in the language used to describe the disease.

For example, the full name of the flu is "influenza," the Latin root of which means "under the influence of." Often, people who suffer from chronic colds and flu have difficulty setting up their own personal boundaries. They are "under the influence" of everyone but themselves and do what other people want more than they follow their own inner compass. Behaviorally, this often manifests as a difficulty in saying no or standing up for what they want or feel is right. The consequence of doing this over and over again every day is that we lose track of what we want and run ourselves empty in fulfilling the desires of others. In my practice, I notice that people with cancer also suffer from the same difficulty in saying no.

According to my four-category system, cancer is an example of our immune system under-recognizing internal threats. Looking at the above explanation, this makes sense: If you think that someone is too busy trying to please others, then they would not be aware of what is going on inside themselves and miss the problems occurring there, because they are too focused on problems outside of themselves.

Using this same mental emotional approach, you can see that in autoimmune diseases, in which we overreact to internal threats, a person might be overly harsh and critical of themselves, attempting to dissect and purge themselves of every little flaw until, in an unfortunate parallel, their body starts to eat away at itself.

This brings me to another excellent point about how the immune system works. I mentioned in the first article that when the immune system recognizes a problem, it sends white blood cells to the area, and they engulf and eat the problem cell, pathogen, etc. This is very interesting. The immune system does not just kill the problem; it eats and digests it. It treats these products very much like our digestive system treats food - breaking the substance down, using what is useful and excreting the waste. It's a considerable paradigm shift to consider a serious immune system problem like cancer as food for our system, but that is exactly how our body treats anything the immune system deems as "not us."

If anyone has had the privilege to work with cancer patients, you have seen that this attitude is common. Many people with cancer get to a place where they say the cancer was the best thing that ever happened to them. They often feel that getting cancer was a big slap in the face. It made them realize that what they thought was important was not really that important after all, and that life is too short and precious to waste energy on things that do not feed them.

Back to the point at hand about allergies: When the immune system overreacts to external threats, the mind/body analogy extends as well. Here, people often have their boundaries way too far out. They are like the hypersensitive security light that turns on when a squirrel runs by, an analogy I presented in my last article: They overreact to the slightest hint of a possible threat. One of my patients fits this mold exactly.

He suffered from adult-onset extreme food allergies. If he were even in the same room as a chocolate bar, he would break out in hives, get severe headaches and lose energy, like a damaged dilithium crystal. The more harshly he tried to cut back and restrict his diet, the worse his allergies got and the more things he became allergic to. Interestingly enough, these problems started during the time he belonged to a severe religious group in which the goal was to restrict and cut back on every pleasure, including food, warm clothes, sleep and any activity that was not a religious practice. In an unfortunate symmetry, these practices also reflected his own behavioral tendencies to purge himself of any habit that was "harmful." This also included exercise. He was a long-distance runner and would keep pushing himself farther and faster in hopes of becoming completely healthy. A series of flu shots finally pushed him over the edge and he crashed, able to eat only brown rice and a few vegetables.

When he came to see me, we started to look at how critical he was of himself and see the connection between his thought processes, behavior and his health. He realized that if he let his symptoms master him, his life would keep on shrinking until it was sucked dry of any pleasure at all. After a few acupuncture treatments and the continued mind/body counseling work, encouraging him to change his reaction to his symptoms, his allergies started to ease off and he slowly started to add new things to his diet and life.

This brings me to another important point: Clinically, it always surprises me that even though TCM has a theoretic mind/body approach built into its conceptual framework, little practical time is devoted in school, in China and in texts to this aspect of the medicine. The Inner Classic reflects this mind/body aspect in the quote, "All good needling first addresses the spirit." This point was struck home further when I was preparing a class on TCM diagnosis for my students. In the workbook companion, Bob Flaws and Phillippe Soinneau state that the major cause of all endogenous disease processes is the seven emotional factors. We are missing a powerful tool for healing if we do not heed this advice and reincorporate the mind/body back into TCM.

I have found clinically that looking at the mind/body aspect of a patient's problem often leads to a startlingly quick resolution of the disease. More importantly, using the mind/body approach always works best in the long run. There are two reasons for this. The first is that if the cause of all endogenous diseases, which make up the majority of our practices, is the seven emotional factors, then we are missing a major causative factor if we do not address the mind/body aspect. The second is that by showing patients how their thought processes, behavior and emotional state are connected to their health, we are helping to empower the patient to directly participate in the maintenance of their own health. I am reminded here about the story of the emperor's physician who stopped getting paid when the emperor or his family got sick. Let us rekindle this spirit and fulfill the old primary role of the TCM doctor, to help keep the patient from getting sick in the first place.