Peter Attia· MD
cell as a receptor so it docks into the receptor after it binds to the peanut and then that receptor on the cell surface activates histamine release of the cell and that occurs within minutes so the histamine goes through the body and within six minutes causes swelling can cause mucus and that mucus can be in your lungs can be in your eyes can be in your nose and it also releases histamine that cell releases histamine and that histamine can cause itching on your skin it's very similar so what would happen if you got a mosquito bite you want to itch you want to get rid of that mosquito in the same way the body's trying to get rid of that food but unfortunately you've already eaten it it's already in your body and so you see these reactions via IG and they release histamines and in my mind it's a very skewed reaction the body's trying to do something that it was meant to do prehistorically but it doesn't help the person at all in fact the histamine becomes so high that it can cause sometimes death and within minutes if you already have asthma if you already have lung issues that mucus can become so strong that it clogs up your lungs and that's what often times can lead to those very rare fatal reactions or there's another chemical called brainin that is released by these cells once that receptor docks when the IG docks into the receptor once that receptor tells the cell to release it releases histamine and it releases something called brainin that's another bad actor chemical the brainen can affect our blood pressure system that can lead to dizziness and can lead to heart issues that's the second reason why people have fatal reactions so you can imagine when you take epinephrine through an injectable epinephrine device that helps both the lung clear the mucus and it helps the heart and the blood pressure stay strong so that you don't have one of these near fatal or fatal reactions but it all is linked to the immune system and how it reacts and it's a very fast reaction is my memory correct that the cell that's releasing the histamine is a massed cell am I remembering that good I was hoping you'd ask that so again you're seeing both sides of the story for the immune system the humoral response which is IG and now the cellular response so once that receptor gets docked into by the IG the cells that have that specific receptor on them are called mass cells they're also called eosinophils and for those of you sort of listening there's another type of disorder called eosinophilic disorders which you know that's a different type of food allergy but also related and then those mass cells exist in tissues but they're not in the blood eosinophils are in the blood the other third type of cell is called the basophil that's in the blood so this is such a potent system because it's got these cells ready to go in the tissues the mass cells mass cells are in the skin they're in the gut they're in the lung in the eyes in the nose and then you also have these other cells floating around the blood that are also secreting histamine and braine and they're like The Messengers across the whole system and then you have the mass cells embedded and the mass cells can live a very long sign time in tissues so these basophils and eosinophils are in the blood these mass cells can live a long time in the tissues and that's why someone's reactions can build up over time sometimes because every time they eat that food or have that allergen exposure their mass cells are going to remember because of the immunoglobulins that bind to them is the implication Carrie that each sucessive exposure gets worse um and and as a sort of followup to that question how often is a person's first brush with a food allergy a fatal one right excellent question so we're only as good as our data we're only as good as epidemiological studies as well so um typically and this is again typical there's always exceptions if you're if you learn about your allergies before the age of two those food allergic reactions are typically vomiting and hives they're not not typically related to lung and heart so babies for example although there are rare exceptions Toddlers and babies typically do not have fatal reactions to their first ingestion of food but there's a lot behind this so if you actually dissect out who dies and who doesn't die from a food allergy it's typically people that already have a heart problem already have a lung problem or didn't get to the EpiPen uh fast enough so it would seem logical like you're um inferring that with every dose that you take your reaction could get worse and worse with the same dose but it depends it depends for example if you're at elevation it depends if you already have a cold it depends if you have Arrow allergies and you're allergic to a dog and a dog came by you that week and you also ate a peanut so there there's a lot that changed that but yes in general if all things being equal each time you ate it your immune system would remember more and more and will boost up that response now luckily with therapy there's a way to retrain your immune system but that takes regular interaction with the food every day not every week if you take it every week it actually boosts your immune system to become more allergic take it every day so there's something to the Circadian rhythm and the dial C which we haven't talked about this yet but what I love about the immune system is it can be trained and you just need to know how to train it and you can train it away from becoming allergic and and train it into becoming more protective well I I absolutely want to focus on that because it's you know I think the most hopeful aspect of all of this but I want to kind of go back and understand more these environmental factors that are predisposing uh children and