If there were a parallel universe, and in that universe medicine, instead of being based on science, was simply a gemisch of various folkways and superstitions, medicine in that universe would be called “naturopathy”.
Hey, how come this never works with water?”
I’ve discussed the absurdity of naturopathy
nux vomica ad nauseum, but a loyal reader mentioned hearing that naturopathy might be good for allergies. This will require a bit of science to start off (unless, of course, Spock’s rocking the goatee).
Seasonal allergies are caused by a pathophysiologic process called “type I hypersensitivity”. For those of us with a genetic susceptibility to seasonal allergies a normally harmless environmental substance, such as pollen, make us miserable. The first time I was exposed to pollen, it lodged in my nose and was consumed by immune cells patrolling for invaders. It was chopped up, processed, and it’s proteins presented to other immune cells. Eventually, B-cells were exposed both to these cells and to pollen, matured into plasma cells, and started cranking out IgE antibodies. These antibodies are specific to the pollen I was exposed to. They can bind to it. But the other end of the antibody binds to cells in my nose called basophils and mast cells. These cells, with all of the pollen-specific IgE sticking out of them, hang out in my nose. When the pollen comes back, it locks on to these antibodies, causing the cells to flood my nose with histamine and other nasty substances. This makes my nose run, makes me sneeze, and makes me cranky.
That’s a very basic look at the science. We have a number of ways of blunting this reaction. We can use antihistamines to fight the effects of histamine. We can use mast cell stabilizers to prevent histamine release. We can avoid allergens. We can use inhaled steroids to block the late inflammatory responses. We can use desensitization therapy (allergy shots). All of these are based on an understanding of the way our immune system causes the condition we call “allergies”.
The website for the American Association of Naturopathic Physicians has a different approach to allergies, a more creative one. They recommend dietary changes to alleviate allergy symptoms, none of which are supported by any evidence in the literature, and most of which show just enough knowledge of immunology to get things spectacularly wrong. For example:
Red meat contains a substance called arachadonic (sic) acid, which helps to produce the cytokines and leukotrines that cause your immune system to react with allergic inflammation. While you need a small amount of arachadonic acid for your immune system to function, your body can produce this amount naturally. Simply eliminating red meat from your diet can reduce the level of this acid, thus lessening your allergic reactions.
Arachidonic acid metabolism is very important both for normal physiology and pathophysiology. AA is a substance our bodies made and use in a variety of ways. Some pathways of its metabolism involve the production of substances involved in inflammation, and certain drugs such as aspirin interfere with this. Some drugs, such as leukotriene inhibitors, interfere with another part of the pathway and are used to treat allergies and asthma. While dietary linoleic acid is necessary for the production of arachidonic acid, there is no evidence that changing this intake, or that any dietary interventions significantly aid in the treatment of allergies. There are a few non-clinical studies of certain dietary supplements, but none of these show convincing evidence for treating real people who have allergies.
The naturopaths have some further other-worldly recommendations:
Your options don’t end in the grocery store and vitamin shop! Naturopathy and other natural modalities offer a broad range of solutions to seasonal or year-round allergies.
Homeopathic remedies involve taking an extremely diluted form of selected allergens in liquid or sugar-pill form sublingually (under the tongue). These miniscule doses serve somewhat like a vaccination, stimulating your immune system to an effective rather than extreme response.
No. In this universe, with its particular laws, homeopathy is just water. It contains nothing but water, and that water remembers nothing of what might have been in the bottle it once came from. The “miniscule” doses are too miniscule to have any effect on the immune system, other than moistening it.
Naturopaths have no business treating allergies with anything they list on their website, at least not in this universe. And yet, they still try.