Tracy had wisely trimmed her fingernails to avoid injuring her own skin, but as she sat in my office she continuously rubbed one part of her body or another with the ball of her thumb in order to relieve the itching. Dermatologists sometimes refer to this as, \u201cThe itch that rashes, rather than the rash that itches.\u201d The itching sensation seems to be emerging from within. That\u2019s \u201cleaky gut\u201d in a single sentence.<\/p>\n\n\n\n
Tracy was in her 20s, accompanied by her mother. Although I could see that Tracy was quite pretty, her face looked as if someone had splashed reddish-pink paint on it and one eyelid was swollen half shut. On the desperation scale, Tracy\u2019s Mom was clearly off the chart, distraught that her otherwise smart, lovely daughter dealt such an unfortunate hand of cards. <\/p>\n\n\n\n
They spoke at the same time, \u201cI have\/my daughter has eczema.\u201d <\/p>\n\n\n\n
Tracy was a theater major at nearby DePaul University. She\u2019d always been a sensitive child. Lots of ear infections as a toddler, and lots of antibiotics given in response. Skin rashes throughout childhood came and went and then came back again with daunting persistence. Tracy had been to most of the leading dermatologists in the city as well as getting an audience with the big kahunas over at one of the university hospitals. <\/p>\n\n\n\n
From her mom: “Cortisone. Steroids. That\u2019s all anyone ever gives her. And antihistamines for itching, but those make her too sleepy to think straight. Since she\u2019s been four years old I\u2019ve been slathering Tracy with steroids. And sure, they work fine\u2026until you stop using \u2018em. And they say they\u2019re all harmless, but I can\u2019t believe it doesn\u2019t get into your system. They also offered serious drugs to suppress her immune system, but when I read the side effects\u2026”.\u00a0<\/p>\n\n\n\n
I focused on the patient. \u201cTracy”, I began. \u201cYou\u2019ve lived with this for years. Tap into your factory-installed women\u2019s intuition and start listing everything you know that makes your eczema worse.\u201d\u00a0<\/p>\n\n\n\n
Her mother piped up, \u201cWell, for one thing\u2026\u201d<\/p>\n\n\n\n
This time Tracy and I spoke in unison, \u201cPlease, let me\/let your daughter do this\u2026\u201d.\u00a0<\/p>\n\n\n\n
(I made a mental note to discuss family dynamics with mom. I even toyed with a fantasy surgical procedure called a mommy-ectomy.) I motioned for Tracy to continue.
<\/p>\n\n\n\n
\u201cWhen I eat junk food, for one,\u201d she started. \u201cThere\u2019s so much of it in the vending machines in the dorm. My skin really cleared during my alternate quarter in Europe because the food was so fresh and clean! Oh, and stress makes it worse. Like when I was assigned a show to direct, which was exciting but so stressful. And my period. I\u2019m pretty sure I have PMS and eczema together.\u201d She paused. \u201cI can\u2019t seem to think of anything else.\u201d <\/p>\n\n\n\n
\u201cTell me about your eating habits. A typical day. Even the meals you skip, or the snacks you pop down when you get ravenous.\u201d <\/p>\n\n\n\n
Tracy rolled her eyes. \u201cOK, this is embarrassing. Especially with her (glancing at her mother) sitting here. Well, first, I usually don\u2019t have time for breakfast, but I sometimes grab something from a vending machine and some coffee on the way to class. When I do eat breakfast, it\u2019s those yucky dehydrated scrambled eggs in the cafeteria with a Krispy Kreme. Maybe before lunch, I\u2019ll also have a granola bar or some corn chips or a turkey jerky. The rest of the day I eat in the cafe because of my meal ticket. Burger, fries, spaghetti, pizza. The fried chicken is really good. Never fish, I hate fish. Some cookies or yogurt for dessert.\u201d\u00a0<\/p>\n\n\n\n
\u201cAnd to drink?\u201d <\/p>\n\n\n\n
\u201cMilk, pop, coffee. I like milk. Sometimes orange juice in the morning.\u201d <\/p>\n\n\n\n
\u201cThe doctors already tested her for food allergies,\u201d volunteered mom. \u201cThe scratch tests all came back negative.\u201d<\/p>\n\n\n\n
I explained that the scratch tests done by allergists looked for immediate reactions to foods, like when your lips swell with strawberries or you start itching with shrimp. Food sensitivities, on the other hand, occur more slowly, two or three days after eating a culprit food. First you eat the food, digest and absorb it, and then if you\u2019re sensitive your immune system creates antibodies against it. <\/p>\n\n\n\n
\u201cWe\u2019re going to look for the antibodies because it\u2019s these antibodies attacking food molecules that are responsible for your eczema.\u201d <\/p>\n\n\n\n
This is termed \u201cleaky gut\u201d, a topic of a recent Health Tip<\/a>. Once considered a \u201ccontroversial\u201d diagnosis until researchers actually saw the leaks in an unhealthy intestine damaged by a diet rich in ultra processed junk food, and various foods that may be inflammatory to that particular person. I pointed out to Tracy\/Mom that \u201cskin\u201d and \u201cintestinal lining\u201d are really one continuous system. Inflaming one (gut lining) manifests as inflammation of the other (eczema). Naturopathic doctors go so far as to add \u201cAll illness begins in the gut.\u201d They\u2019re probably pretty close to the mark on this.<\/p>\n\n\n\n Then I examined Tracy\u2019s skin and hair. It struck me that everything about her was extremely dry. Even the areas of skin not affected by the eczema were flaky, as was her scalp. And her hair was unhealthy looking. <\/p>\n\n\n\n \u201cTracy,\u201d I began again. \u201cIt\u2019s not just that I think your diet is pretty awful, which it is, but I think you might be sensitive to a lot of your daily fare. The usual food sensitivity suspects are dairy, egg, corn, gluten grains, citrus, and even soy. If you look over your typical day, every meal contains something that includes these ingredients.<\/p>\n\n\n\n Also, you very likely have some vitamin and mineral deficiencies, as well as deficiencies in what are called essential fatty acids.<\/p>\n\n\n\n I watched as Tracy counted the six common offending foods on her red and itchy fingertips. Then, like a chorus, the two of them, \u201cI\/my daughter can\u2019t stop eating. I\u2019ve\/she\u2019s got to eat!\u201d.<\/p>\n\n\n\n Step One: Tonight you\u2019ll receive an invoice from Rupa Health Labs, the central clearing house for just about all functional testing. I\u2019m ordering two tests: Intestinal Permeability (\u201cleaky gut\u201d) by Genova. ($129), 96 Food Sensitivities US Biotek ($169). When you pay the invoice, you\u2019ll receive the kits with full instructions. <\/p>\n\n\n\n Step Two: From here, I\u2019ll march you two to our apothecary where you\u2019ll be instructed on our Food Sensitivity Elimination Diet with Gut Rehabilitation. <\/p>\n\n\n\n Foods eliminated: egg, dairy, corn, gluten, citrus, and soy and ALL foods containing additives, chemicals, preservatives. This elimination is NOT permanent but will help guide us toward what can be reintroduced. The main dietary villains of both eczema and acne are sugar and junk foods! <\/strong><\/p>\n\n\n\n Gut rehabilitation uses several products purchased through a company called Fullscript. Sometimes these are stocked in our apothecary, otherwise they will be mailed to you.<\/p>\n\n\n\n I continued, \u201cTracy, really, starvation is reserved only for my worst cases. Why don\u2019t you and your mom meet with our apothecary staff or our <\/strong>nutritionist Tam Dickson-Meyer <\/a><\/strong>and review our food allergy elimination diet. You\u2019ll stop eating the culprits for several weeks and then reintroduce them to see which causes your eczema to flare.\u201d<\/p>\n\n\n\n Four weeks later, Mom, without Tracy, showed up during Tracy\u2019s scheduled return visit to review the food sensitivity blood test and the leaky gut results. Apparently the patient herself had an unexpected rehearsal that coincided with the appointment.\u00a0<\/p>\n\n\n\n I told her mother that the food sensitivity blood tests clearly showed several culprit foods. In addition, Tracy\u2019s small intestine was, like a sieve, leaking large molecules of incompletely digested food. <\/p>\n\n\n\n A photo of Tracy on her mom\u2019s phone showed significant progress in clearing the eczema, this a result of the food elimination diet. Then, apparently for dramatic effect, her mom pulled out a paper bag and dumped onto the examining table 23 twisted sticky tubes of various cortisone creams and six half-empty bottles of antihistamines. <\/p>\n\n\n\n Mom smiled. \u201cI had to show you what her life had been. Now I can throw them out.\u201d And she swept them all into a nearby wastebasket. <\/p>\n\n\n\n \u201cHer skin looks great. Something has been irritating her skin all these years. Now, on this elimination diet, when she starts getting a little tired of rice, she looks in the mirror, laughs with sheer pleasure, and asks for a second helping.\u201d <\/p>\n\n\n\n \u201cAnd the supplements?\u201d <\/p>\n\n\n\n \u201cHer ritual, she never misses a dose.\u201d<\/p>\n\n\n\n \u201cAnd how are you doing with all this?\u201d<\/p>\n\n\n\n She paused. \u201cWhat can I say? I\u2019m her mother. I used to look at her, at those terrible rashes and my heart would break. She\u2019s\u2026so beautiful, even if I am her mother. When I peeked in and saw her looking in the mirror, touching her cheek and smiling, I realized I\u2019d never seen her do that and I started crying. Then she saw me and we both started crying. She\u2019s very happy. We\u2019re very happy. You\u2019ll come and see her show?\u201d <\/p>\n\n\n\n \u201cWith pleasure.\u201d<\/p>\n\n\n\n Be well,<\/p>\n\n\n\n David Edelberg, MD<\/em><\/a><\/a><\/a><\/a><\/a><\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":" Tracy had wisely trimmed her fingernails to avoid injuring her own skin, but as she sat in my office she continuously rubbed one part of her body or another with the ball of her thumb in order to relieve the itching. Dermatologists sometimes refer to this as, \u201cThe itch that rashes, rather than the rash […]<\/p>\n","protected":false},"author":2087,"featured_media":31626,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[531,2334,43,2780,2781],"tags":[2067,2785,2783,1986,2784],"class_list":["post-31623","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-case-studies","category-naturopathic-medicine","category-nutrition-nutritional-supplements-vitamins-herbal-remedies","category-supplements","category-vitamins","tag-dermatology","tag-diet-and-nutrition","tag-medical-case-study","tag-naturopathic-medicine","tag-patient-journey"],"yoast_head":"\r\nReversing Eczema<\/h3>\n\n\n\n
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Four Weeks Later<\/h3>\n\n\n\n