{"id":4572,"date":"2012-03-05T15:09:59","date_gmt":"2012-03-05T21:09:59","guid":{"rendered":"http:\/\/wholehealthchicago.com\/?p=4572"},"modified":"2021-09-06T21:36:25","modified_gmt":"2021-09-07T02:36:25","slug":"yet-another-mystery-rash","status":"publish","type":"post","link":"https:\/\/wholehealthchicago.com\/blog\/2012\/03\/05\/yet-another-mystery-rash","title":{"rendered":"Yet Another Mystery Rash"},"content":{"rendered":"\n

These mysterious rashes that patients want help with are a real diagnostic challenge. Usually the visit begins with \u201cI\u2019ve been to dermatologists about this and all I get are steroids. Once I\u2019m done taking them the rash comes right back.\u201d<\/p>\n\n\n\n

In previous health tips, we reported on a young man who developed a very real sensitivity to latex that began after he walked along a Hawaii beach in flip-flops, sand scratching the soles of his feet. A few weeks later, I wrote about a woman whose puzzling rash was a rare manifestation of PMS. Now here\u2019s another\u2026<\/p>\n\n\n\n

Phyllis, an intelligent woman in her forties, rarely bothers with doctors because she doesn\u2019t need us: she exercises regularly, her diet is very healthful (\u201cstrictly Whole Foods, organic, all natural\u201d), and she keeps stress under good control. In other words, the last person you\u2019d expect to arrive in your office covered with an extremely itchy rash.<\/p>\n\n\n\n

I could even see dozens of tiny marks, called excoriations, <\/em>where she\u2019d been scratching herself in her sleep. Except for her rash, Phyllis felt, as she always did, \u201cjust fine.\u201d<\/p>\n\n\n\n

Her dermatologist had diagnosed her rash as neurodermatitis,<\/em> a sort of catch-all phrase used when the doc\u2019s not quite sure what\u2019s going on. He suggested she work on stress issues and prescribed steroid lotions. At our clinic Phyllis first saw my associate Dr. Kelley, who suggested she make sure all her detergents and cosmetics were chemical-free, start taking St. John\u2019s wort<\/a> to help with stress, and return for a skin biopsy in order to find out exactly what was going on.<\/p>\n\n\n\n

Skin biopsy holds a clue<\/strong>
Two weeks later, the rash was absolutely no better but her skin biopsy yielded an important piece of information. Phyllis\u2019 rash was clearly due to an allergy. There was something entering her body that her immune system didn\u2019t like one bit, her immune system was creating antibodies to get rid of it, and in the process these antibodies were triggering the rash.<\/p>\n\n\n\n

\u201cLet\u2019s go through your day, mouthful by mouthful,\u201d I began.<\/p>\n\n\n\n

Phyllis immediately protested that everything she ate was natural, no chemicals, squeaky clean.<\/p>\n\n\n\n

I reminded her that the word \u201cnatural\u201d doesn\u2019t have any real meaning on a product label (it\u2019s just marketing), and thus it doesn\u2019t let us off the hook. In addition, strawberries are natural, as are shellfish, and, come to think of it, so are bee stings and penicillin. People get bad rashes from all four.<\/p>\n\n\n\n

\u201cOK, I start with lots of fruit in the morning, whole grain bread, and Earth Balance spread. I really love Earth Balance. Have you ever tried it? It\u2019s simply delicious. I could live on it. It\u2019s almost addicting.\u201d<\/p>\n\n\n\n

At the \u201calmost addicting,\u201d I felt a chill run down my back. I explained to Phyllis that people who work with food sensitivities know that, for unclear reasons, the body starts to crave the food it\u2019s most sensitive to. We see this regularly with patients literally hooked on diet colas, 10 to 12 cans a day, who burst into tears when we tell them their symptoms may be due to a reaction to the chemical swill they\u2019re guzzling day in and day out and they\u2019ll have to stop, cold turkey.<\/p>\n\n\n\n

\u201cOh,\u201d said Phyllis, \u201cBut Earth Balance is completely natural.\u201d<\/p>\n\n\n\n

I went to their website to check. Then to the ingredients list<\/a>.<\/p>\n\n\n\n

Admittedly it looked pretty harmless and clearly the Earth Balance people had gone out of their way to be careful as far as ingredients went. Everything was non-GMO, though there was that useless word \u201cnatural\u201d again, as in \u201cnatural oil blend.\u201d There was also \u201cpure\u201d salt (whatever that means). The label overall looked pretty good, but I didn\u2019t know what \u201cannatto\u201d was. I\u2019d never seen the word. Nor had Phyllis.<\/p>\n\n\n\n

I clicked to the source of all knowledge in the universe, aka Wikipedia, and quickly learned that annatto<\/a> (also known as roucou and achiote) is a subtropical seed used primarily for coloring cheese and solid oils, like Earth Balance. Apparently a lot of these products would look pretty much like squares of lard or tubs of Crisco without their annatto coloring.<\/p>\n\n\n\n

Scrolling down the Wiki article, my eyes widened when I got to \u201cPrecautions.\u201d<\/p>\n\n\n\n

\u201cAh, here we go,\u201d I said aloud, and read the precautions<\/a> to Phyllis, \u201cIn one study in 1978, among 61 consecutive patients with chronic hives\u2026that\u2019s what you have, Phyllis\u202656 of them had their hives orally provoked by ingesting annatto after an elimination diet.\u201d<\/p>\n\n\n\n

That means after deliberately eliminating annatto for a few days and then eating some, virtually all developed a rash. In addition, even when given the tiny amount generally used to color products, 26% of them still reacted to it. Clearly, in the right person this stuff is a potent trigger for allergies, higher, in fact, than the artificial colors tartrazine, Sunset Yellow FCF, and Food Red 17.<\/p>\n\n\n\n

So much for \u201cnatural\u201d<\/strong><\/h3>\n\n\n\n

\u201cIt\u2019s the annatto,\u201d I said. \u201cYour Earth Balance craving will have to go. And from now on, you\u2019ll need to check ingredients, even on these so-called natural foods.\u201d Phyllis was relieved the solution was straightforward, but sad to say goodbye to her morning toast spread. I asked her, \u201cBy the way, when did you discover Earth Balance?\u201d<\/p>\n\n\n\n

\u201cI think last Spring sometime, maybe April.\u201d<\/p>\n\n\n\n

\u201cAnd the rash began\u2026?\u201d<\/p>\n\n\n\n

\u201cA month later, but obviously I never made the connection.\u201d She paused. \u201cI really, I mean really<\/em>, like the stuff. You won\u2019t believe this, but every time I ate it, I actually felt tingly all over my body, like a healthy glow. It felt\u2026good.\u201d<\/p>\n\n\n\n

This spurt of new information made me smile. \u201cTingly? Phyllis, you were having an allergic reaction. Your tingly morphed into your rash!\u201d<\/p>\n\n\n\n

For her morning toast, I suggested Phyllis start using a little grass-fed butter like Kerrygold<\/a>. Trader Joe\u2019s has a grass-fed butter too and Organic Valley calls theirs pasture butter. Spendy, yes–though less expensive than steroid creams–but the yellow in this spread comes with all kinds of healthful nutrients from grass-grazing cows.<\/p>\n\n\n\n

Would she enjoy it as much as Earth Balance, Phyllis wondered.  I wasn\u2019t worried, and sent Phyllis on her way with a \u201cJust as long as it doesn\u2019t make you tingly\u2026\u201d<\/p>\n\n\n\n

Be well,<\/p>\n\n\n\n

David Edelberg, MD<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

These mysterious rashes that patients want help with are a real diagnostic challenge. Usually the visit begins with \u201cI\u2019ve been to dermatologists about this and all I get are steroids. Once I\u2019m done taking them the rash comes right back.\u201d In previous health tips, we reported on a young man who developed a very real […]<\/p>\n","protected":false},"author":2087,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[197,28,2,531,3,51,4,20],"tags":[],"class_list":["post-4572","post","type-post","status-publish","format-standard","hentry","category-allergies-food-sensitivities","category-alternative-therapies","category-blog","category-case-studies","category-knowledge-base","category-m","category-r","category-y"],"yoast_head":"\r\nYet Another Mystery Rash<\/title>\r\n<meta name=\"description\" content=\"Would she enjoy it as much as Earth Balance, Phyllis wondered.\u00a0 I wasn\u2019t worried, and sent Phyllis on her way with a \u201cJust as long as it doesn\u2019t make you tingly\u2026\u201d\" \/>\r\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, 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