Micki Rose is a nutritionist specialising in sensitivity but she is also, as she says, the most sensitive person she has ever treated! This puts her in an ideal position to test out her fascinating theories about the causes of disabling sensitivities such as her own.

Her Barrier Plan, now in its sixth month of operation, is going from strength to strength – as attested by the many posts on her Truly Gluten Free site from those who are following it.

If you want to skip her introduction below and go straight to the plan you can buy it it from the Pure Health Clinic Shop here. It will cost you £65 but, given the amount of work that has gone into it and the fact that it could totally revolutionise your life if you have serious sensitivities, it is an absolute snip!

Here’s the problem: you’re reacting to more and more things and your diet and lifestyle are becoming more and more restricted. Every time you try to follow the normal recommendations, you feel worse. You start to panic about the future: what are you going to do?

First, stop panicking, the stress won’t help! Second, let’s learn how I think it happens and what we can do to stop it.

Hyper-Permeability

This is a complex issue so I tried hard to boil it down to where it starts rather than get caught in what happens immunity-wise, which, let’s face it, is mind-boggling.
Most of the problem, in my opinion, seems to stem from either poor digestion or lack of ability to break elements of food down properly and from the increased permeability of the body barriers starting with, but certainly not limited to, the gut.
Once you have become hyper-permeable or, if you like, your barriers are broken, allergens from anything can gain entry into the body where they shouldn’t be. This is most likely to be via the gut first with food, obviously, but once skin, lung and blood-brain barriers are also hyper-permeable, you become sensitive to toiletries (via the skin), pollens and chemicals (inhalation) and onward.

Eventually, inflammation and immune processes, especially auto-immunity, can occur anywhere in any organ or tissue, which explains why the symptoms of allergy are so diverse.

Here’s a quick summary of the process as I see it: quite simple really when you break it down:

Here is a more complex look from immunologist Prof Vodjani at the process the body goes through when someone has become multiple-sensitive. In this case, he is looking at the way gluten is involved. Gluten is known to increase production of zonulin, a key substance that helps control barrier permeability:  

In essence, it shows that we need:

1. an environmental trigger of some kind (eg gluten, dairy, fungus, bacteria, stress, trauma, chemical toxin) plus

2. a genetic susceptibility which leads to

3. an unusually permeable gut leading to barrier-breakdown in other areas of the body later on, eg. skin (eczema/dermatitis), lungs (asthma), blood-brain (migraine), mucous membranes (sinusitis) and onward to

4. immune dysregulation leading to inflammation, either systemic (body-wide) or localised (as in the gut, joints, muscles, nerve fibres, fibromyalgia etc) and/or auto-immunity and molecular mimicry. This is where the body starts confusing similar-looking food structures for self-antigens of body tissues, glands and cells (as in Hashimoto's, type 1 diabetes, psoriasis, MS, coeliac disease, parietal cells causing lack of acid and enzymes, adrenal dysfunction etc - could literally be anywhere) hence what we have is termed:

A Multi-Organ, Multi-System problem.

The number of organs and systems involved depends on how many body barriers are weakened, how high the body's inflammation level has reached and how dysfunctional the immune system has become.

The trick, I think, is to get in and stop the process as soon as we can. It is a progressive problem - don't shoot the messenger!

How far have you gone, do you think?

It may be early days and you may have one or two foods giving you jip. This suggests a broken gut barrier and a small amount of immune involvement. You may already have a named auto-immune or inflammatory disorder in which case you are a lot further on and you can assume the broken barriers. It doesn't matter where you are really; the treatment is the same.

Barrier Testing

First, you want to know this is your problem before you launch into the treatment. In my - and others’ - opinion, the very presence of antibodies like IgG, IgA, IgM confirms the barrier problem: no antibodies would be formed if the substances hadn’t got through. Happily, there is also now a Barrier Test that checks to see if candida, bacteria and/or food has breached the barrier. The higher the levels, the more leaky you are. Rather than take up all my space here, I have posted the full test plan for you (see more info below).

Barrier Treatment

To know how to treat the problem once established, you have to understand the causes. First, I compiled a list of what is known to exacerbate or cause barrier hyper-permeability in the body. These are some of the main ones and it’s usually a combination of them that kicks off the problem:

Barrier Breakdown Factors

• Genetics especially gluten and zonulin
• Virus attack
• Bacterial imbalance or infection
• Candida/yeasts and moulds
• Drugs/Med damage
• Nutrient deficiency for barrier strength/repair, cellular energy, manufacture of acid and enzymes
• Excess alcohol
• Constipation
• Problem foods that do damage (eg certain lectins, saponins, additives, agrochemicals)
• Irritating foods (nitrates/nitrites, sulphur, amines etc)
• Low SIgA
• Lack of worms/change of internal milieu
• Lack of dnergy: eg. thyroid, adrenals, ATP production
• Insulin resistance and excess sugar
• Hormone imbalance/poor body communication/signalling
• Stress
• Electromagnetic field exposure

My case is a severe one. Trust me. It’s a good illustration of how it all fits together, though. I have the gene pattern for gluten sensitivity (not just the DQ2/8 coeliac genes), my sensitivities worsened significantly after a period of family stress which knocked my adrenals down (they were flat as a pancake on testing), my SIgA level dropped with them and I got a chronic mouth infection. I took tons of ibuprofen which just made the gut a whole lot more leaky and off I went with more and more food reactions.

Gulp. I decided I needed a plan.

Trouble was there was no existing treatment plan that I thought was right. For a start, most supplements and meds recommended include the very substances that exacerbate the barrier breakdown which is not a great start to healing! Most also included the foods I had discovered were only likely to progress the problem.

So, I sat down and wrote a really detailed treatment plan.

The essence of it is to first stop doing stuff that compromises barrier strength and, second, to repair the damage and achieve normal permeability levels.

There are three stages. A lead-in to get rid of some of the issues above and start to bring the inflammation down. This has to happen before you start repair work for many different reasons: one, for example, is that glutamine, a key repair nutrient, is known to feed candida so if someone has candida, which in itself causes leaky barriers, you’re just going to make things worse if you miss this step out.

Next is the Barrier Diet and Lifestyle to remove the problem foods and toxins.

Third is the Barrier Protocol to speed the healing up.

The Barrier Diet

You need to know what foods might cause or exacerbate hyper-permeability. After all, what's the point in eating foods that are only going to make you develop more food problems later on?

The diet plan I settled on is roughly based around the Primal diet (foods we evolved on and can cope with), the Specific Carbohydrate Diet (no complex starches to feed candida or bacteria to allow the gut to heal) and my own TrulyGlutenFree grain and dairy free diet (since all grains contain gluten and gluten is the single biggest cause of barrier hyper-permeability because of its effect on zonulin). It contains no dairy as I find most people with multiple sensitivity cannot tolerate it either – this despite all the dairy-based supplements of whey and colostrum being touted for the leakiness… It is also low in specific lectins, saponins and foods like alcohol and chilli, all known to have an effect on barrier integrity.

Most experts believe that re-establishing barrier strength can take anywhere from 6 months to 2 years, and even more in severe cases. Oh heck.

I needed a way to speed things up and came up with a grain and dairy free supplement protocol. Believe me: that was the toughest bit as there are hardly any that fit such strict criteria, despite what many manufacturers will tell you. Check my article for FM: Grain and Corn Free Supplements: A Nightmare for more on this.

The Barrier Protocol

The Barrier Protocol is a fully-researched, product-specific grain, corn and dairy free supplement programme designed to encourage the healing process.

In essence, you need to replace the baby bowel flora if necessary and rebuild the flora layer to a protective thickness, bring the inflammation down, feed and repair the linings, encourage absorption, improve SIgA, calm the hyperactive immune system and remove any attacks on the barriers like candida, bacteria, food allergens. Quite a tall order, but it can be done.

Multiple food intolerance does not build overnight, nor does it get better overnight. Generally, people feel better symptomatically within weeks, days sometimes, but I normally recommend initial re-testing of the barrier or foods after about 3-6 months depending on the case.

How Have I Got On?

I’ll use my own case as an illustration since I know that one well! I started the full diet about 6 months ago and the protocol has been building slowly but probably on it fully for only 2-3 months on and off; I couldn’t tolerate the supplements before that. I have dramatically reduced my symptoms – migraine, chronic fatigue, eczema, PCOS, restless legs, aching muscles and joints etc etc.

My general illness score has gone down from 12 some days (10 = bad) to a general 1-2 most of the time. When I do get a reaction, it lasts 2 days instead of 4/5 and the reaction is about 2-4 with an occasional 6 in severity. A way to go, but I am determined to get there.

It’s not easy, is it, this multiple sensitivity lark? And neither is the treatment, but at least I now feel like I’m doing something that might stop the process. Fingers and toes crossed. For all of us.

The full Barrier Plan complete with diet and supplement protocol costs £65 and is available from the Pure Health Clinic Shop here, along with a raft of further reading and supporting documents.

Micki no longer sees individual patients but embarking on the barrier plan gives you entry to an extremely busy interactive community of fellow sufferers, monitored by Micki, through her Truly Gluten Free site. Any problems you may have will be swiftly addressed either by Micki herself or by one of your fellow Barrier Plan followers.

If you want to do some further reading before committing yourself to the plan, there is a huge amount of information available on the Truly Gluten Free site (follow the links from the black horizontal bar on the site) and/or you can download Micki's free 30 page Multiple Food Intolerance factsheet here.

First published in June 2012

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