DEAR DR. GOTT: I recently underwent an endoscopy. My doctor wanted to check things out because I have acid reflux (which is currently under control with Protonix). From the biopsies taken, I was diagnosed with eosinophilic esophagitis. My doctor said this was caused by a food allergy and recommended test.
I went to an allergist and tested mildly positive to wheat, soy and oat. I have been advised to avoid these foods due to the long-term effects they will have on my esophagus, which apparently already has rings on it.
I am also hypothyroid (taking Synthroid) due to Hashimoto’s which, as you know, is an autoimmune disorder. I have been reading recently about a possible connection between allergies causing havoc with the immune system and Hashimoto’s. This is another reason I am trying to cut my known allergens from my diet; however, I am finding is very difficult. Wheat and soy are hidden almost everywhere under so many different names, such as protein and starch. Even French fries and grilled chicken breasts at a well-known fast food restaurant have it in them. Any advice?
DEAR READER: Fast foods and processed foods are no longer a viable meal option for you given your wheat, oats and soy allergies. As you have discovered, these three products are in just about every convenience or processed food known. Therefore, my advice is to start eating a more natural diet. Fresh fruits and veggies, lean cuts of meat, beans/legumes and nuts should make up the bulk of your diet. You will have to avoid most breads, pastas and baked goods, as they usually contain wheat and/or oat flour. Rice pasta is available and should be a suitable substitute. You should also consume moderate amounts of low-fat diary products such as milk, cheeses and yogurts to ensure an adequate calcium intake.
Now, for those of my readers unfamiliar with Hashimoto’s and eosinophilic esophagitis, I will briefly explain them.
First, Hashimoto’s is an autoimmune disorder caused when the body mistakenly creates antibodies that attack otherwise healthy thyroid gland tissue. It can slow the production of the hormones that the gland produces, leading to low levels within the body. Common signs and symptoms include hair loss, dry/pale skin, hoarse voice, puffy face, high cholesterol, sensitivity to cold, fatigue, joint pain, muscle aches or weakness, constipation, and more.
In the early stages, hormone deficiency may not occur, so careful monitoring is all that is needed. If hormone deficiency is present, treatment with synthetic hormones is recommended. Thyroid hormone derived from pigs (such as found in Armour Thyroid) can also be used but has not been proven to be any better than the synthetic forms. It is important that the same formulation is used, meaning if a generic bran is used, the patient should request the same brand for each refill.
Eosinophilic esophagitis is a condition in which high levels of eosinophils (a specific type of white blood cell) that regulate inflammation and play an important role in allergic reactions) concentrate in the esophagus, likely in response to an allergen. In most cases, the allergen is a food. Symptoms of esophagitis in general (there are several types based on the underlying cause) can include painful or difficulty swallowing, cough, decreased appetite, chest pain, nausea, vomiting, and more.
Treatment of eosinophilic esophagitis essentially consists of avoidance of the offending allergen. It can also include oral steroids to reduce the symptoms of an allergic reaction and proton pump inhibitors if acid reflux is thought to be involved.
Readers who are interested in learning more can order my Health Reports “Allergies”, “Thyroid Disorders” and “Hiatal Hernia, Acid Reflux, and Indigestion” by sending a self-addressed, stamped number 10 envelope and a $2 (for each report) to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print an order form from my website, www.AskDrGottMD.com.
