Is it really asthma?

A short time ago a concerned father brought his 7 year son into my office with a diagnosis of asthma. This young boy had a persistant cough that affected him daily. He had wheezing that occured occassionally and seemed to get worse after meals. His parents were growing increasingly frustrated because at least 5 other doctors had seen their son, all of whom prescribed oral steroids, steroid inhalers or multiple rounds of various antibiotics. None of these medications were having any noticeable impact on the boy so the parents decided it was time for a different approach.

The father had heard about me from a friend and called to achedule an appointment. The boy appeared well developed and nourished and did not have any noticeable problems in my office. His physical examination was unremarkable. But during our conversation and history intake, the topic of nutrition and eating habits came up, as it usually does.

It has been my personal and professional experience that everything we put into our mouths will ultimately have biochemical consequences, good, bad or indifferent.  His breakfast and dinner meals were varied and were reasonably healthy, but lunch, expecially during the week, raised some red flags. His dad made his lunch everyday and always, always, made his sons favorite sandwich, peanut butter and jelly on wheat bread. This is what the boy ate everyday at school during lunch time.

From a clinical perspective, the repetitive consumption of any food or drink, no matter how healthy the choices may be, ultimately and potentially render the body’s immune system vulnerable and hyperactive. We can handle some bad things for a short time and some good things for a longer time, but eventually, in some cases, the body begins to react aggressively against the offending food or drink resulting in symptoms that mimic asthma. Of course all suspected cases of  asthma should be taken seriously as the constriction of airways is a potentially serious problem that may need to be treated with medication until the underlying cause can be discovered.

There is always an underlying cause. And in all cases of asthma, the underlying cause of asthma is not a deficiency of steroid inhalers or antibiotics!

After a thorough evaluation of this boy’s condition, we elected not to prescribe any additional medications. Instead, my recommendation was to eliminate peanut butter from the boys diet for a minimum of two weeks. After two weeks a follow up visit would determine what progress, if any,  had been made.

The boy and his father returned to myoffice two weeks later. Dad just looked at me for awhile without saying anything. I began to feel a bit uncomfortable. The dad finally said, “you know doc, we have seen many doctors and tried many drugs trying to help my son, then we came to you and all you did was tell us to stop eating peanut butter!”

He went on “I thought you might be a bit crazy”. But he said they would try it anyway just to see what would happen. So I asked him how the boy had been doing the past two weeks, hoping to hear good news. The father reported that within two days of eliminating the peanut butter his sons cough went away! His wheezing went also went away. In fact, all of his symptoms completely went away. Without drugs, steroid inhalers or antibiotics.

Dad was happy that we solved his sons dilemma, but he also expressed some anger and frustration at the same time, because he had spent alot of time, effort and money trying to deal with this issue with no results.

You see, his son did not have asthma at all, he only had a strong hypersensitivity to peanut butter,  and most other nuts too.

This in only one case of hundreds I could talk about, but the bottom line is this; do your homework and ask questions of your doctor whenever the word asthma comes up. The majority of the diagnosed cases of asthma are heavily influenced  by food, drink, chemicals and other environmental factors. A comprehensive history and detailed conversation, and occasionally a blood test, is usually all that is required to identify the underlying cause of so called asthma.

Powerful medications are certainly necessary and helpful in many cases, but are not always needed or necessary. I am not against medications as I do prescribe them as necessary on a case by case basis. But as good and helpful as medications can be, it is most important to take the time required to learn what is causing a condition or illness instead of simply covering up the symptoms with drugs. We must treat the cause.

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