Immunity Allergies And Autoimmunity: What We Often Misunderstand

“If you are allergic to a thing, it is best not to put that thing in your mouth, particularly if the thing is cats.” — Lemony Snicket

In South Africa, allergies have increased noticeably over the past 20–30 years, particularly in urban areas. This mirrors global trends linked to urbanization and lifestyle changes. We have more westernised diets, reduced microbial exposure and a lot more pollution.

There has been a significant increase in asthma, hay fever and eczema throughout South Africa and urbanised children have about 5 x higher incidents of food allergies compared to their country cousins.

I used to wake up at 4 A.M. and start sneezing, sometimes for five hours. I tried to find out what sort of allergy I had but finally came to the conclusion that it must be an allergy to consciousness.” — James Thurbe

As much as we would love to know exactly what we are allergic to and exactly how to avoid or treat it, allergies, as with pretty much all aspects of human health, things are not always straightforward.

Allergy panels (whether skin prick tests or blood tests measuring specific IgE) are not perfectly accurate for many well-known reasons.

These panels work by detecting sensitisation, in other words, the presence of IgE antibodies to an allergen. However, sensitisation does not equal clinical allergy.

Many people test positive yet tolerate the substance without any symptoms, leading to frequent false positives (up to 50–60% in skin prick tests for foods, for example).

These tests can therefore not be used as stand-alone diagnoses.

For instance, we see many people who avoid foods which they love and which, in the past, gave them no symptoms, purely because a panel said they have an x% of being allergic to that food.

There are many limitations to allergy testing:

Autoimmune disease diagnosis is also often not perfectly accurate because these conditions lack a single definitive test.

Instead, diagnosis relies on a combination of clinical symptoms, physical findings, imaging, and multiple laboratory markers.

Symptoms frequently overlap with other illnesses such as infections, fibromyalgia, or even mental health problems. Symptoms can wax and wane, and vary widely between individuals or even within the same disease.

Many patients are “seronegative,” meaning standard autoantibodies are absent despite clear disease activity.

This leads to potential delays, misdiagnoses, or the need for repeated assessments.

Rheumatoid factor (RF) is a classic example of this variability. It is an autoantibody detected in roughly 60–80% of people with rheumatoid arthritis, but sensitivity can range from as low as 26% in early disease to 90% depending on the population and test method.

Specificity is only about 85%, so a positive RF can appear in healthy individuals (especially older adults), other autoimmune conditions, chronic infections, cancers, or even transiently after certain vaccinations or illnesses.

This is why it is always important to take a lot of care when exploring potential autoimmune disorders, and as the symptoms are always overlapping, lifestyle health improvements are worth it no matter the final diagnosis.

Although some of us are genetically predisposed, lifestyle and environmental factors often play a larger role.

The “Old Friends Hypothesis” (proposed by Graham Rook in 2003) is the most widely discussed refinement of the 1980’s theory referred to as the “Hygiene Hypothesis of Disease”.

It reminds us that we actually co-evolved with certain harmless microbes, parasites (helminths), and environmental organisms. These “Old Friends” train our immune system to develop proper tolerance. The rise in allergies and autoimmune diseases is seen as a result of losing contact with these essential “old friends”.

This explains why improved gut-microbial diversity and a variety of nature therapies are so good at the treatment and prevention of allergies and autoimmunity.

Time in nature, variously called forest bathing, shinrin-yoku, forest therapy, nature prescriptions or green prescriptions, and increasingly practised in Japan, South Korea, Finland, Germany, Sweden, Canada, New Zealand, Australia, the UK and even the USA.

Any long-term treatment of allergies and autoimmune responses should include time in nature: time interacting with ‘clean dirt’. It should not only focus on suppression treatment in urban clinical settings.

Other modern contributing factors include:

When it comes to the treatment of immune dysfunction, fasting is seen by many as a miracle intervention, and well worth exploring.

“Instead of using medicine, better fast today.” — Hippocrates (c. 460–370 BC, Father of Medicine

Research supports its potential role in modulating overactive immune responses. Prolonged fasting promotes autophagy, the body’s mechanism for clearing damaged cells and regenerating healthier ones.

“Fasting is the greatest remedy — the physician within.” — Paracelsus (1493–1541)

In rheumatoid arthritis, clinical studies have shown reductions in disease activity scores, tender joint counts, and inflammatory markers such as ESR, CRP and IL-6, particularly when fasting is followed by an anti-inflammatory diet.

“Fasting is the supreme medicine.” — Ancient Sanskrit proverb

Fasting gives the digestive system a period of rest, which can aid repair of the intestinal lining and reduce permeability linked to immune activation.

For allergic conditions, evidence suggests it can help dampen hypersensitivity pathways, including those involving IgE and Th2-driven inflammation. Improvements in symptoms such as joint pain, skin issues and allergic responses are frequently noted, alongside better energy levels.

“Fasting is the mother of health.” — Saint John Chrysostom (c. 347–407 AD)

Any temporary shifts in markers during the fast differ from the sustained benefits seen after refeeding. Fasting is not appropriate for everyone and requires careful medical evaluation.