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Intriguing Cases

A very slow 'reaction'

Dr David L. J. Freed, MB, MD, MIBiol

We know that allergic reactions to foods can happen because sometimes they are quick and convincing.If a child gets asthma every time he has egg, within five minutes, that's convincing. But if reactions take two weeks to occur - and especially if they take weeks of months to subside, the connection is far less obvious because so many other foods have been ingested in that time.

We know that "masked allergies" can occur only because they sometimes "unmask", that is, abstention from the food followed by a challenge a few weeks later causes a swift and convincing reaction. Masked allergy is a diagnosis that can only be made in retrospect - before stopping the suspect foodstuff the patient is usually unaware of any "reactions", in fact quite the contrary. Taking that substance (wheat, caffeine, milk, tobacco or whatever) probably makes him feel a bit better, at least for a little while. During the first few days of avoidance there may be a withdrawal reaction, during which the sufferer feels worse, not better, and gets very irritable, headachy and depressed. This does not prove masked allergy but it does demonstrate addiction ( a closely related phenomenon, perhaps the same thing) and suggests that perseverance might well pay off. In short, slow food-induced illnesses that take weeks or more to happen are far harder to spot and less susceptible to proof than quick ones. So what about a process that takes six months?

The prostate is a spherical organ the size of a walnut that sits at the lower end of the male bladder. The urethra (urinary outflow tube) passes through the middle of it, and there within the prostate it is joined by the two vasa deferentia (sperm tubes) coming from the testicles. Since we males have the eccentric practice of using the same penis both for urination and for copulation, we have to be careful not to urinate during mating, and the prostate helps by becoming engorged during an erection, closing off the urinary outflow. In older men the prostate can become perpetually swollen and stiffened, so that the normal flow of urine is obstructed even without an erection. Once urination has been achieved, the stiffness of the prostate tissue prevents it from closing easily, so "trickling" of urine occurs. The usual treatment is surgery; the surgeon goes in with a sharp circular blade (or these days with a laser) and reams out the tube. Not pleasant.

I developed early prostate symptoms at the amazingly early age of 41.
First I noticed trickling, which by the age of 45 had become quite problematic. I was starting to smell of stale urine, like an old man, and I was forced to start using my wife's panty liners. Most embarrassing. By this time I could not help noticing that the flow of urine was a lot thinner than it used to be, and sometimes I needed to exert quite an effort to get the flow started, especially first thing in the morning.

I wondered what could have caused the problem. The only thing I could think of that I had changed was my intake of coffee, which for various reasons had increased considerably at around my 40th birthday. I cut down on coffee again, and the trickling did in fact improve to an extent. Nevertheless by the time I was approaching 50 the symptoms were getting bad again, and I reluctantly went to my GP. Donning a plastic glove, he inserted a probing finger into my rectum (what some people will do for a living!) and confirmed that the prostate was indeed enlarged and stiffened.

I resisted his suggestion of a consultation with a surgeon, and instead stopped tea and coffee completely, cold turkey. For the first week I was overwhelmed by sleep at the times of day when I would normally have had my hot drink, but that went away after a week. After that, nothing happened at all. The trickling continued.

After three weeks I noticed that the trickling, and the effort needed to start urination, were worse. This phase lasted about six weeks. It was another 2-3 months before I noticed anything else, and then, yes, at last the urine was flowing faster and more freely than hitherto. The trickling remained.

Six months after starting my tea/coffee avoidance the prostate symptoms had virtually gone. Like all addicts, I got cocky. "Surely", I thought, "one occasional cup can't do me any harm?!" I had a cup - what bliss! And next morning - no problem! You can guess what's coming. Within a week I was back on my daily fix of coffee - and within another three months the prostatism was back in full force. Reluctantly grasping the nettle, I went cold turkey again, and again the symptoms slowly, so slowly improved. I have now been through that cycle three times, enough to prove causation to me. Nowadays I have maybe a dozen cups of tea or coffee per year, and I have only slight prostatism - but I know full well I'm still young, not quite 60, there's time yet for big trouble. If I hadn't known what to look for, and if I hadn't been so loath to submit to the surgeon's knife, I'd never have spotted the dietary connection. One wonders if other men with prostatism would respond to this simple dietary manoeuvre, and how many other chronic ailments associated with "old age" would respond, however slowly, to elimination dieting. And I wonder how many simple food "reactions" we never see, simply because they are too slow (multiple sclerosis maybe?).

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