Doctors practising today have been trained in the subject of allergy on the basis of what is scientifically proven – that a range of specific symptoms results from an over-reaction of the immune system, and that objective evidence can be provided by skin and blood tests proving the involvement of the immune system. When doctors use the word ‘allergy’, this is virtually always what they mean – a much narrower definition than the original one. Most do not accept that illnesses such as migraine, arthritis, colitis and mental symptoms can result from an adverse reaction to something in the environment, apart from certain well-researched kinds of food intolerance, for instance, or exposure to high levels of chemicals.
Some doctors, however, still work with a much broader definition of what allergic disease encompasses. They prefer the term ‘allergy and environmental medicine’ to describe the field. (In the United States, this is commonly called ‘clinical ecology’.) This definition covers a wide range of illnesses and symptoms, including true allergy in the strict immunological sense, but also encompassing food intolerance, chemical sensitivity, and other disorders that respond to avoidance or elimination of specific substances from the individual’s environment.
If you know that you react to something in your environment, you may feel that these distinctions do not really matter if the end result for you is the same, i.e. that you react to a given substance and you have to avoid it to stay well. In simple terms, you are right. It doesn’t matter, for instance, whether you are ‘allergic to chemicals’ or ‘chemically sensitive’ if the outcome is the same in practical terms, that you have to avoid certain chemicals. However, there are differences in the types of therapy and treatment you might find helpful, and in the guidelines on avoidance, so making a distinction does help you to have a greater understanding of what you are asked to do.
It also matters in another important respect. Doctors disagree (sometimes passionately) about what allergy actually is, what its symptoms are and how to treat it. You may get one diagnosis and suggested course of treatment from one doctor, and a totally different approach from another. Many practitioners (on both sides of the argument) make assertions about the nature of allergy when the facts are not fully known, and when the reality is manifestly complex. You need to understand the background to the controversy – and the facts, as far as they are known – in order to be able to make sense of what doctors say to you.
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