Pink Book LDA Patient's Copy

LDA
Low Dose Allergen
Immunotherapy
Patient Instruction Booklet
How to regain your health through optimal immunotherapy
For patients treated with (ultra) Low Dose Allergen Immunotherapy
W. A. Shrader, Jr., M.D.
Fellow, American Academy of Environmental Medicine
Board Certified in Environmental Medicine
Jan 2018: 10th Edition
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1st Edition: May 2003
2nd Edition June 2005
3rd Edition July 2007
4th Edition February 2009
5th Edition January 2011
6th Edition February 2012
7th Edition September 2013
8th Edition May 2014
9th Edition Jan 2015
10th Edition Jan 2018
Copyright © April 2003 by W. A. Shrader, Jr., M.D.
All Rights Reserved.
This work (except for previously published and duly copyrighted material, with
permission of the copyrighting individual) may be reproduced on the condition that full
credit is given to the author.
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Table of Contents
ACTION OF LDA ................................................................................................................................... 5
ADMINISTRATION METHOD .................................................................................................................. 6
SAFETY ................................................................................................................................................. 6
FREQUENCY OF TREATMENT WITH LDA AND RESPONSE ...................................................................... 7
Reasons for Failure of LDA ............................................................................................................. 9
Disadvantages of LDA ................................................................................................................... 10
GENERAL RULES TO RECEIVE LDA ................................................................................... 11
OVERALL GUIDELINES ........................................................................................................................ 11
LEVEL 1: GUIDELINES FOR PATIENTS WITH ONLY SEASONAL HAY FEVER ....... 14
Do You Really Have Only Hay Fever? .......................................................................................... 14
Exertion & Temperature Do's and Don'ts ..................................................................................... 16
Food, Pollen and Mold Cross-Reactions ....................................................................................... 16
LEVEL 2: GUIDELINES FOR PATIENTS WITH FOOD AND OTHER MORE
COMPLEX PROBLEMS. ........................................................................................................... 17
LEVEL 3: GUIDELINES FOR PATIENTS WHO HAVE SIGNIFICANT CHEMICAL
SENSITIVITY .............................................................................................................................. 18
Transportation ............................................................................................................................... 20
Hotels/Motels ................................................................................................................................. 21
About Your Workplace During LDA Treatment (Level 3) ............................................................. 21
Chemicals at Work – for Patients Sensitive to Chemicals ............................................................. 21
LDA: REACTIONS AND SIDE EFFECTS ............................................................................... 22
IMMEDIATE AND LOCAL REACTIONS .................................................................................................. 22
DELAYED REACTIONS ........................................................................................................................ 23
DELAYED OR IMMEDIATE DEPRESSION ............................................................................................... 24
CIRCUMSTANCES WHEN YOU SHOULD NOT RECEIVE AN LDA TREATMENT .... 25
DRUGS OFTEN INTERACT WITH LDA ................................................................................................. 25
FOOD GUIDANCE FOR PATIENTS WITH MODERATE TO SEVERE FOOD ALLERGY OR INTOLERANCE .... 26
Fasting ........................................................................................................................................... 27
After the LDA Diet ......................................................................................................................... 27
Unmasking, Rotation Diets and the Very Mixed Diet .................................................................... 27
Food Idiosyncrasies ....................................................................................................................... 29
Boosting Tolerance ........................................................................................................................ 29
Stimulant Beverages ...................................................................................................................... 30
Vitamin C ....................................................................................................................................... 30
LDA AND GLUTEN SENSITIVITY .......................................................................................... 31
THE GUT AND LDA ................................................................................................................... 31
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CANDIDA: GUT PREPARATION AND ANTIFUNGALS ............................................................................. 31
ASTHMA, ECZEMA, ADHD, AUTISM.................................................................................... 33
Asthma ........................................................................................................................................... 33
Eczema ........................................................................................................................................... 34
Hyperactivity (ADHD, ADD) ......................................................................................................... 34
Autism ............................................................................................................................................ 34
RULES FOR IMMUNIZATION AND MALARIA PREVENTION ....................................... 36
DRUGS THAT WILL LIKELY INTERFERE WITH LDA: .................................................... 41
DRUGS AND TREATMENTS THAT HELP, MAY HELP OR DO NOT INTERFERE
WITH LDA: .................................................................................................................................. 42
DRUGS WHOSE EFFECTS ARE UNCLEAR ......................................................................... 45
THESE MAY ALSO INTERFERE WITH YOUR LDA TREATMENT: .............................. 45
LDA RECIPES ............................................................................................................................. 47
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Introduction to LDA – Low Dose Allergen Immunotherapy
This booklet, now known as the “Pink Book”, is written as a guide for patients
receiving LDA immunotherapy. Since there are a few rules related to LDA that
don’t apply to other forms of immunotherapy, I wrote this booklet to make it
simpler for patients doing LDA and to put the rules in one place. This booklet is
meant only as a guide, and your physician may have other ways of doing LDA
that are slightly different from those in this booklet.
I feel very strongly that LDA is far superior to other methods of allergy
treatment, and it offers a unique treatment for many autoimmune diseases that are
only otherwise treatable only with drugs, many of which are hazardous.
LDA was developed from EPD immunotherapy, invented by the most brilliant
allergist I’ve ever known, from Great Britain, Dr. Leonard M. McEwen.
Action of LDA
LDA is a method of immunotherapy that involves desensitization with combinations
of a wide variety of extremely low dose allergens (approximately 10-17 to approximately
10-6), given with an enzyme mixture containing beta-glucuronidase. The enzyme mixture
acts as a lymphokine, better signaling the immunizing effects of the allergens. LDA
induces the production of “activated” T-regulator cells.
Since LDA is compounded under my direction by a large compounding pharmacy,
and used by prescription for specifically named patients, it is not regulated by the FDA
the same way as a product sold by commercial manufacturer. It is legal for patients and
physicians to use, as long as it’s prescribed properly.
“Classical” immunotherapy for hay fever, dust mite or other IgE-mediated allergies is
largely antibody-mediated, and “neutralization” therapy likely works through low dose
tolerance, so both of these methods are generally not long lasting and cannot easily be
discontinued without the partial or complete return of symptoms. Medications are
frequently required routinely with the former, while avoidance is usually necessary with
the latter.
LDA immunotherapy, however, is primarily cell-mediated by T-regulator cells.
Since T-cells have a half-life of perhaps up to 80 days, although this figure is unclear,
LDA creates a much longer lasting desensitization than the conventional immunotherapy
used in the USA. Patients generally need fewer medications, and avoidance of allergenic
substances such as pollens and foods is much less necessary.
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Administration Method
LDA is administered by one or more tiny intradermal injections (into the skin itself),
usually on the inner aspect of the forearm, though it may be given on the legs, upper arms
or abdomen. Some physicians are using it sub-lingually (under the tongue), but there are
no long-term studies validating this. It appears to work.
Safety
There has never been a fatal or life-threatening systemic reaction to LDA treatment.
The dosage is simply too low for life-threatening reactions to occur, and indeed LDA can
be used to treat anaphylaxis to peanut and shrimp.
LDA includes mixtures of over three hundred allergens that act quite “universally.”
This means that patients allergic or intolerant to most substances, and with quite diverse
medical conditions, can respond to treatment. Available LDA mixtures include inhaled
pollens, danders, dust and mites, fungi, yeast (including candida species), molds, foods,
many food additives, most common chemicals and perfumes (except pesticides and
herbicides) and formaldehyde.
LDA food and inhalant mixtures are universally cross reactive, and Dr. McEwen put
every possible allergenic component into his original EPD. The mixes are proprietary, so
please don’t bother asking your LDA physician whether it contains particular substances
to which you are allergic. No matter what they are, the proteins in LDA are selected to
cover everything.
Since LDA does not contain pesticides or herbicides per se; patients who experience
adverse responses to these agents alone, and not to other related excitants or allergens,
will not receive significant benefit from LDA. However, these patients are rare, and if
such a patient additionally has concurrent food, chemical and inhalant problems, the
results can be good.
LDA is the only real immunotherapy that can be used to treat true (IgE-mediated)
food allergy, such as life-threatening reactions to peanut and shrimp (anaphylaxis).
LDA should not be used during pregnancy. There is no evidence that LDA could be
harmful during pregnancy, but as we know, anything can happen with pregnancy and
childbirth, and if a patient is on LDA, they could place the blame there. If a patient elects
to be treated when she is pregnant, precautions must be taken with drugs used in
conjunction with LDA, such as most antifungals and Vitamin A, and probably even a
simple substance like bismuth, if it is used, could harm a developing baby.
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Frequency of Treatment with LDA and Response
Since T-cells have a long half-life, LDA treatments need only be given every 2
months at first, then less often. Generally, patients with most conditions are treated every
two months for six to eight times, or about a year. After that, treatment intervals
generally increase. Children usually require less treatment and can more easily stop
treatment then can adults.
Although rare, hay fever strictly due to seasonal pollen allergy is initially treated
with 1 to 3 doses per year. It is preferable to get the first injection 3 to 4 months before
the onset of the season, and a booster dose 2-3 weeks before the season peaks. After the
first season, only one booster dose may be required yearly, given 3 weeks before the
season starts. However, for some patients, treatment every two months is necessary to
create immunity. The best results are seen when LDA is started about a year before the
allergy season for any particular patient.
Most allergies, including food allergy or intolerance, tend to be less simple. Initial
doses tend to be at 2-month intervals for the first six to eight treatments. Subsequently
the frequency of the desensitization can be reduced. LDA injections cannot be given
more often than every 7 weeks. Foods that cause the most adverse reactions, such as milk
and wheat, usually take the longest time to desensitize completely.
When the response is well established and patients feel pretty well for the whole two
months between treatments, generally between the sixth to the eighth dose (fewer doses
in children), the frequency of treatment for most illnesses may often be extended to every
three months, then every four months, and so on.
Our study of over 10,000 patients showed that half of the patients with multiple
problems can stop LDA completely after 16 - 18 doses. The other half can at least go for
long intervals (1-4 years) between treatments after that time. Children usually respond
more quickly and may stop sooner.
How Long Does It Take To Improve?
The effect of LDA is usually immediate, and 70 % of patients feel well immediately
after their first treatment. If not, most patients respond by the third treatment. However,
the full benefit of LDA will take longer. In particular, some patients with food allergy or
intolerance may only notice sustained improvement only after three to six doses, i.e. 6-12
months from the start of treatment, and severely reactive foods may take two years to
become tolerable in moderate to large amounts. For the rare patient, a few foods may not
totally desensitize.
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The response to LDA has two distinct phases after an injection:
1. Immediate Reaction: An immediate temporary “cure” of symptoms may result
after LDA. This may begin immediately after the first treatment and usually
should last 2-5 weeks. Two to three weeks of significant improvement is typical
with the first two to three treatments, after which symptoms begin to return. One
may see this for the first several treatments. The first shot that should “work” —
at least to some degree — for most patients will be either the first, second or
third. A positive response to the first injection occurs on an average about 70%
of the time, a "neutral" response about 23%, and a "poor" response about 7%.
Response rates generally improve with subsequent injections. If there is no
response at all (better or worse) by the third treatment, there could be a problem
that your physician should look into. No response by the 6th treatment is rare, but
means LDA will usually fail.
Some patients do not feel well shortly after they start the “LDA Diet”, and
after the first to third treatment may have a few days of not feeling well. Vitamin
B-complex injections work well for children who are severely nauseated when
they go on the LDA diet.
Rare patients (about one in 20) do not feel well for the first 2-3 weeks
after their initial treatments. I tell patients to try very hard to ignore
unpleasant symptoms that occur in the first days to three weeks after
treatment, and not call their physician about every weird symptom that
might develop. These will usually improve dramatically by three weeks,
and will happen much less (or never) with subsequent treatments.
2. Delayed Action: This should begin after 3-4 weeks (after the lymphocytes
mature) and may last to some degree for 2 to 4 months at first, then much longer
later on in treatment. This response begins usually between the sixth and eighth
treatment, when there may be no apparent immediate response to the shot, but as
lymphocytes mature, more and more positive effects are noted. Occasionally I
see a patient who has this response with the first treatment. In either case,
patients may complain for 3 weeks after a treatment, only to find their shot
“kicks in,” almost like magic, at about 3-4 weeks.
Once the first injection takes effect, you should note you feel better in many ways
usually for 2 to 5 weeks. When the injection begins to wear off, your symptoms will
return to some degree and you must wait until the next injection for a continued response.
There may be a decrease in response to any LDA treatment, after which continued
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improvement is again noted. The reason for this is unknown. You cannot receive an
LDA treatment sooner than 7 weeks from the last.
The period of improvement should lengthen over time, and gradually you should feel
quite well for the whole 2-month period between injections. When this happens, you can
begin to stretch the interval between LDA injections. This will generally occur in adult
patients somewhere between 6 to 8 injections (about a year). Children should be able to
stretch their injection intervals sooner. It is better to go longer and begin to have
symptoms than it is to get a treatment “early” for some convenience (travel, etc.).
WARNINGS: If you have any history of eczema, skin allergy of any kind, hives, swelling
of the lips, face or body, autoimmune disease, or especially anaphylactic reactions or
anaphylaxis, be certain the doctor knows about this before you ever receive LDA: it is
often important that this type of patient receives prednisone prior to at least the first
treatment, and perhaps for several subsequent treatments.
Also, if "neutralizing" or standard immunotherapy is administered as the first several
LDA injections appear to "wear off," there is evidence that this could destroy the success
of LDA immunotherapy.
Reasons for Failure of LDA
The primary reasons (in order of decreasing importance) for failures of LDA I have seen
are:
 Improper dosage – most commonly under-dosage of foods. This is the most
common reason LDA may not seem to work very well at first, or, more
commonly, stops working after a treatment or two. This is sometimes
unavoidable, since certain patients (those with anaphylaxis, eczema), MUST be
started on the low LDA foods (LX). Often that will be the correct dose, but if
your LDA works less and less better, you likely need a dose increase.
 Failure for some patients to follow the more important “rules” for LDA.
Medications are the principal reason for this type of failure.
 Low Vitamin D levels. This can be checked with a blood test.
 Silicone breast or other implants, active infection (e.g. in a root canal), or other
immunological issues. Women with breast implants, either silicone or salinefilled,
have been known to fail on LDA. Sometimes even removal of the
implants may not solve the problem, as it takes years for silicone antibodies to
clear, and if there has been implant leakage, they may never clear.
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 Rare: Interference by organisms from the gut, usually yeast, and/or improper
patient preparation for this problem.
 Rare: Interference from extremely high levels of heavy metals (even patients who
have had their dental amalgams removed are not exempt from this problem),
 Occasionally LDA fails for reasons we do not understand.
Disadvantages of LDA
The disadvantage of LDA is that it generally may take 6 to 8 injections to achieve a
sustained effect that lasts for the full two months between injections (except for simple
dust and pollen allergy, which usually requires fewer injections). LDA cannot be
considered to have failed until 6-8 treatments have been given without any benefit. Even
then, there is often “delayed” success 6 months or so after the treatments are stopped.
Rare patients have very little response until they have had 6 treatments.
NEVER PLAN TO START LDA UNLESS YOU’RE WILLING
TO BE TREATED FOR 12 MONTHS BEFORE
YOU MIGHT SEE LASTING RESULTS
This having been said, you should see relief long before then. I have found that LDA
tends to give more permanent relief than any "standard" form of immunotherapy I’ve
ever used.
To protect the result of LDA from being disturbed, it may be necessary for you to
follow some of the guidelines discussed in this booklet around the time of treatment.
Failures of LDA are often due to non-observance of one or more of the rules in this
booklet.
Medications, some herbals, homeopathics, other treatment modalities, and activities
not “restricted” in this booklet should be considered to be "unknowns." My best advice,
especially if you have significant illness, is to avoid “questionable” things for 3 weeks
after an LDA injection whenever possible.
If we don’t know whether newly developed medications and those not listed in
this Booklet will cause LDA to fail, my general advice is: 1) Avoid it for three days
before LDA and three weeks after, 2) If you are unable to do this, avoid it for the
three critical days around LDA, 3) If you are unable to do this, avoid it for the day
before and the day after LDA, and 4) if you absolutely must take it all the time, I
advise that you take it all the time. However, if your LDA fails, you must then look at
this as the primary reason and find a substitute for the medication.
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General Rules to Receive LDA
Overall Guidelines
In order for LDA therapy to work well, for most patients the most
important guidelines to follow are the food and diet guidelines and to the drugs to
avoid, discussed in this booklet.
The success rate of LDA depends partly on factors that interfere with it. The
guidelines in this book are meant to help make this treatment work best.
LDA is an extremely low dose immunotherapy. Since the dose is so low, there are
factors that can interfere with your response to it. Other low-dose forms of
immunotherapy have the same problems. The lower the dose, the more potential there is
for interference form “outside” things.
Interestingly, there are patients who do very little to try to help the therapy succeed
and it works well. On the other hand, some patients need to follow most guidelines in
this booklet in order to insure their treatment works well.
Some physicians do not follow the standard dietary (or other) rules of LDA and seem
to have success. Whether this success is less than would be seen if their patients had
followed to rules has not been determined. My advice for patients is to follow the rules,
since Dr. McEwen made them in the 70’s. Short of that, I tell patients to follow the rules
at first. Once they see how LDA should work for them, they could certainly experiment
later.
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THE BASIC LDA DIET – For Level 2 and Level 3 Patients
I will mention the "3 critical days" frequently in this booklet. This term
means the day before LDA, the day of LDA and the day after LDA.
You should eat ONLY:
 Lamb, rabbit, venison (only if you rarely or never eat it) or white fish (if you are not
specifically allergic to it). Some other unusual meats may be acceptable. Discuss
these with your physician. Salmon is probably a poor idea due to the high omega 3.
 Sweet potatoes (any type) or yams
 Parsnips, rutabagas, tapioca root products or cassava root, manioc, yucca, sago
(turnips OK for some)
 Cooked carrots, celery and cabbage
 Potatoes – any type – (may be a problem for some patients)
 Lettuce – any type, but no other greens – raw (outer leaves only) or cooked (all
leaves OK)
 Tapioca granules, flour or starch, plain (see tapioca wafer recipe in recipe section)
 Rhubarb
 Pure Baking soda (without additives)
 Sea salt: plain sea salt (non-iodized – do not use "regular" salt).
 Bottled, R/O, filtered or purified water, flat or fizzy for drinking and cooking
Note: no margarine is safe to use during the 3 critical days. Avoid all margarine
and all other seasonings totally. The only seasoning permitted is sea salt, such as
Haines'® brand in the yellow container (do not use the iodized kind).
NOTE: Any food not listed above is unsafe to eat in any quantity during the critical
three days. This includes medications (unless advised by the doctor), herbs,
beverages, chewing gum, and any other things you might put in your mouth; and no,
sorry, coffee and tea are NOT allowed!
Children under the age of 8 may have trouble with this diet because of food
withdrawal. They may experience nausea and vomiting. Consult the doctor if your
child is receiving LDA (remember B-complex injections).
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Note: For LDA to work well, you need to have relatively normal levels of
Vitamin D in your body (blood). This can be determined by a simple blood
test. Your Vitamin D level should optimally be about 40. If not, ask your
doctor about Vitamin D supplementation and re-check your level.
There are three levels of rules with guidelines to follow for patients with
different types of problems discussed in this booklet.
Level 1: Guidelines for Patients with ONLY Seasonal Hay Fever
Do You Really Have Only Hay Fever?
NOTE: Very few patients have only "simple" hay fever and may be classed as Level
1. The following questionnaire should help you determine this. If you really have
only seasonal allergy, your answers should be the ones in italics below; if they are
not, you are very likely Level 2.
1. Symptoms in: Spring and/or Fall ONLY? yes/no
2. Eyes affected? yes/no
3. Nose affected? yes/no
4. Chest affected? yes/no
5. Swelling/tingling in mouth after any food? yes/no
6. Winter symptoms? yes/no
7. Eczema/skin rashes? yes/no
8. Irritable bowel syndrome yes/no
9. Severe problems with any chemical odors? yes/no
10. Gastrointestinal symptoms? yes/no
11. Headaches/Migraine? yes/no
13. Close family members with hay fever? yes/no
14. Do your symptoms clear up completely in winter? yes/no
15. Have you been told you have "Candida"? yes/no
So if your answers to the questions above are not the ones in italics, you very likely
have food or other problems, and you almost certainly need to follow stricter guidelines
(usually Level 2).
At the time of LDA:
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 Avoid alcohol for 10 days after treatment. You may cook with it as long as it is
heated enough to evaporate the alcohol before it is served.
 Don’t snuggle with your pets (especially cats) and avoid indoor molds at the time
of treatment. Try to limit your exposure to pollens and dust 12 hours before and
36 hours after LDA (for example, don’t sleep with your cat or dog during that
time). If you receive LDA inhalants near a pollen season, and you are
experiencing symptoms outdoors, you may need to extend that time.
 If you have ever had a water leak in your home and mold was discovered, you
might do best to stay elsewhere during the three critical days.
 You may exercise as you normally would during LDA, but avoid fatiguing
exercise, extreme heat, and sunburn for 3 days after LDA.
 Follow the rules for drugs known to interfere with LDA and immunization.
 Do not put ointments, creams and lotions on the site of the injection(s) on the day
of treatment.
 Use an unscented soap and shampoo (e.g. Magick Botanicals shampoo or similar)
on the day you receive LDA (or the night before if you bathe at night).
 Do not wear perfumes or other scented agents to the office on the day of LDA
(this is partly to protect your doctor’s patients who have chemical sensitivity).
 Avoid yard-work for the three critical days.
 If you know you are allergic to your pets (especially cats), and your pets spend
time inside the house, you should not stay in your home during the three critical
days. Wash your hands after handling your pet. The danger is sensitization to a
pet, and this has been shown to occur in rare patients, usually after 3 to 6
injections. If this does happen, the sensitization can be reversed with the next
LDA, but stricter guidelines must be followed. If you are not allergic to your
pets, try to keep them out of the bedroom and don’t snuggle your face into your
pets’ fur.
 If you are allergic to feathers, do not sleep with a feather pillow or down
comforter for at least a week after LDA. Use a cotton or foam pillow.
 Do not have LDA if you are trying to get pregnant within 2 weeks of the
injection.
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Exertion & Temperature Do's and Don'ts
For one week after LDA:
 Do not take a sauna
 Do not do excessive sunbathing. Sunbathing more than 5 days before LDA is
likely to be an advantage (enhances Vitamin D production in the skin).
 You may use ChapStick® during the three critical days, but probably best to
avoid it on the day of LDA.
 You may wear make-up during this time
Do your best to avoid high concentrations of mold spores indoors: mold floats
indefinitely in the air inside houses that are damp, suffer from condensation, smell musty
or even have had a leak or water damage in the past. Keeping the door of a damp room
or cellar shut is not likely to give effective protection, since the spores float so well in the
air. If you have a mold problem, keep windows open night and day while you are in the
house, if possible, to reduce your exposure. It is sometimes best to stay at a friend's dry,
modern, mold-free house with no pets for the day before, the day of and the day after
LDA. If your house is extremely damp and there has been any evidence of mold, you
should try very hard to get away from it during this time. Don’t worry about outside
mold.
Food, Pollen and Mold Cross-Reactions
Patients who suffer from allergy to tree pollens, especially birch or ironwood, must
not eat nuts, fresh apples and oranges, raw carrots or celery for about a week after LDA,
if those pollens are in season in your part of the country (spring). Mold spore allergens
from different species may cross-react with LDA. If you are allergic to inhaled mold
spores, avoid tea, cheese, and other fermented or aged foods for 10 days after LDA. If
the desensitization is unsuccessful, discuss the use of an antifungal regime for your next
LDA treatment with the doctor.
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Level 2: Guidelines for Patients with Food and Other More Complex
Problems (in addition to, or instead of seasonal allergy) Note: Most patients
are in the Level 2 category.
If you are a patient who has intestinal, food issues or autoimmune disease, may or
may not have pollen allergy, and do not have significant chemical sensitivity, the
guidelines you will follow appear in this section.
Also, if you think you only have pollen allergy and you have a sub-optimal response
to LDA on the Level 1 regimen, you must strongly consider following more of the Level
2 or 3 guidelines in this booklet. If you’re not sure which category you belong, discuss it
with the doctor.
So, if you have problems other than simple hay fever, you must follow all Level 1
guidelines, AND in addition:
Before LDA:
 Again, you must also follow all Level 1 guidelines
 Take a good multivitamin/mineral supplement, approved for LDA (less than 500
mg. of Vit. C – not during the three critical days).
 Use an appropriate bowel preparation for candida, if determined necessary by the
doctor. If you have toenail or fingernail fungus, tell your doctor!
 Take zinc 20-30 mg. daily, in addition to the amount you may be receiving in
your multiple vitamins for a week before and three weeks after LDA.
 Take magnesium (citrate or glycerinate, preferably), 200 mg./day in addition to
the magnesium you may be receiving in your multiple vitamins, for a week
before and three weeks after LDA.
On the day of LDA:
* Do not wear lipstick or eye-liner (or any make-up that might get in your eyes) on
the day of LDA.
* Do not put anything in your mouth except the foods permitted on the LDA diet
Critical three days:
* Follow the LDA Diet
* Do not use ChapStick® or other lip balm on the day of LDA.
* Use unscented soap only.
* Use unscented shampoo and conditioner.
* Do not use toothpaste. Use pure baking soda instead.
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* Sexual activity may be a problem, especially in women, since they risk
sensitization to their husbands' semen. This seems a particular risk for eczema
sufferers. Intercourse probably should be avoided for the critical 3 days of LDA
therapy.
* Minimize your exposure to animals, perfumes, aerosols, sprays, painting, etc.
* Never take any vitamins, minerals or other supplements during the three critical
days, and only take meds you discuss with your physician.
After LDA
* Avoid foods that have caused you to have significant symptoms in the past for
three weeks after LDA. This does not necessarily include foods for which you
had a positive blood test unless you know you react badly to them.
* Optional: Folic Acid, 10 mg. daily, may be taken to attempt to enhance the effect
of LDA for 30 days after LDA (side effect: possible nausea, so take with meals).
Vitamin and Mineral Supplements
Certain vitamin and mineral supplements theoretically improve the effect of LDA.
These supplements act primarily by affecting the T-cell receptor sites we are stimulating.
The following recommendations for supplements may be important for patients who have
moderate to severe problems. These should be taken along with an approved
multivitamin and mineral. Patients with milder problems, and kids under the age of 12
generally do not require these supplements. Patients with mild problems should probably
only take the supplements directed. Discuss this with the doctor if you aren’t sure
whether you should take any or all of these supplements. Vitamin D seems particularly
important, and all adults should probably take 2000 to 3000 IU per day.
Level 3: Guidelines for Patients Who Have Significant Chemical Sensitivity
(in addition to, or instead of the preceding problems). This is the least
common Level. Level 1 and Level 2 patients do NOT need to follow these following
guidelines, so if you do not have significant chemical sensitivity, skip to “LDA:
Reactions and Side Effects”.
Those of you with significant chemical problems should follow all of the preceding
instructions in this booklet for Level 1 and Level 2 patients. “Significant” means that
you are made ill for day or more when you are around perfumes or other scented agents,
you probably can’t go to the store without becoming ill, or your primary problems have
to do with exposure to various chemicals. In addition, our advice is that you follow the
remainder of these guidelines in this booklet as closely as possible, at least for the first
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several injections. Later on, especially after you've had 6-8 injections, you might be able
to be less careful about these rules.
You should do as well as you are able to adhere to the instructions without totally
disrupting your life. Whether you do or you do not have chemical sensitivity, mild
chemical exposures or chemical exposures for a brief time will not affect your LDA.
In addition to Level 1 and 2 guidelines, you should also do the following:
For at least 12 hours before and 2 days after LDA (preferably 3 days after):
* Do not read the newspapers, glossy magazines, or new books.
* Use no insecticides that produce vapor or might be breathed in: sprays, aerosols,
etc. Use traps or bait if you must have insect control.
* For cockroaches, etc., use boric acid and put it in the cracks under the skirting or
molding, etc., where the insects hide. The protection is long lasting and unlikely
to cause problems.
For the Three Critical Days:
* Avoid ointments, creams and lotions on any part of the body, especially
anywhere near the site(s) of the injection(s). This includes "homeopathic"
creams and ointments, as many contain agents that are problematic.
* Use no aerosols, spray polishes or perfumed sprays.
* Use no scents (perfumes, etc.) or air fresheners of any kind.
* No chemical deodorants. Use a mineral rock crystal (such as The Body Crystal®)
or baking soda during this time. At other times, use "natural," non-aerosol
deodorants made without aluminum compounds (look in health food stores).
* Makeup should not be used during these three days. If you choose to use it, it
should be kept to the absolute minimum, not perfumed, and not near the eyes.
Use only non-scented, "hypoallergenic" types. You run the risk of becoming
sensitized to makeup if you are sensitive.
* No bath oil, liquid soap, dishwashing or laundry liquid/powder, especially on the
hand of the treated arm. Use plastic or vinyl -- not latex -- gloves for
unavoidable washing dishes, etc. (many physicians have these available for
purchase in their offices).
* No hair sprays, hair mousse, hair conditi

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Tuesday:10:00 AM - 6:00 PM
Wednesday:Closed
Thursday:11:00 AM - 7:00 PM
Friday:Closed
Saturday:8:00 AM - 4:00 PM
Sunday:Closed

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