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There are no medical tests to detect this kind of intolerance. The only method of detection is exclusion dieting, leaving out foods and reintroducing them systematically, while monitoring symptoms. Almost any food can cause intolerance but the most common culprits are also those which often cause allergy. Why this should be so is not understood.

Some people seem to be intolerant to specific groups of foods. Some people do not tolerate proteins (for instance, meat and poultry) but have no problem with other types of food. Other people find, by contrast, that they do not tolerate fruit and vegetables well, but tolerate proteins or grains better.

Most people with food intolerance are sensitive to only one, or a tiny number of foods, and find that their problems can be resolved by avoiding those foods. Sometimes it can be something as simple as leaving out tea, coffee, chocolate, monosodium glutamate, alcohol or sugar. People with multiple food sensitivities often find that totally excluding their main troublemakers helps their overall tolerance level and they react less severely to foods that sometimes upset them. The ‘load factor’ that applies to chemical sensitivity appears to operate with food intolerance as well.

The only treatment for this type of food intolerance is managing your diet with the aim of reducing or totally avoiding the foods upset you. Advice on managing diets is given below. Some people are also helped by high doses of vitamins and minerals, especially if they are also chemically sensitive. Again, why this should be so is not known. Some people respond to neutralisation – a form of desensitisation.

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Reducing your load of common allergens, taking certain precautions with general diet, and limiting your exposure to chemicals can help generally in managing multiple sensitivity, and in preventing further allergies developing if you or your family have the tendency.

House dust mites and moulds both thrive in damp, poorly aired environments. Keep your surroundings as dry, warm, and aired as you are able to help keep them at bay. Ventilate properly and, in particular, keep beds and bedding (which harbour mites and moulds) aired and dry. Dry laundry (and anything else damp) outside the home and avoid creating damp and steam where possible. Gas and paraffin fires, heaters and cookers create damp when burning and it is best either to avoid their use altogether, or to take extra care in ventilating and removing condensation if you do use them.

To remove allergens, and to avoid dispersing them when cleaning, use filters on a vacuum cleaner or a special vacuum cleaner. This helps enormously to protect against all kinds of allergen which are usually blown back into a room by the exhaust. Over time, vacuuming with filters helps to remove allergens already lodged in furniture, flooring and furnishings. Also ‘damp dust’ – do the dusting with a cloth that is slightly damp, so that dust and allergens do not disperse into the air.

Avoid keeping pets and animals if you can. If you do have pets, make sure that they sleep outside the home, if possible. Above all, do not let them sleep on beds or in bedrooms (even during the day).

If you are allergic to pollen or mould spores, take care about going out at seasons when they are present at a high level in the air. Keep windows and doors closed as much as you can during peak periods.

To help prevent food sensitivity, vary your diet and limit the frequency at which you eat the most allergenic repeatedly each day; keep the whole diet full of choice and variety. Eat fresh and wholesome food and keep your use of processed food to a minimum. Sort out your diet properly if you need to, and avoid any foods that clearly upset you – even if you love and crave them. Variety plus avoidance of troublemakers will do more than anything to reduce your tendency to react generally.

Keep your use of any chemicals to the absolute minimum. Think before you use anything on yourself, your home, or at work or school. Do you really need it or is there a less aggressive alternative? Stop smoking and avoid smoky atmospheres. Take care with perfumed products of any kind. Air and wash anything new, and avoid situations or places where chemical fumes are high.

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Sodium bicarbonate, available from any chemist, is an effective deodoriser. It absorbs smells in rooms, or in enclosed spaces such as cupboards or refrigerators.

To kill smells in a refrigerator, place some sodium bicarbonate in a small glass jar. Pierce the lid and place the jar in the refrigerator. Replace the powder after a couple of months. Fridge Fresh is also a very effective refrigerator deodoriser. It contains activated carbon in an egg-sized, hard plastic container and absorbs smells more effectively than sodium bicarbonate. One container lasts for four months. These are sold in major supermarkets. Fridge Fresh can also be used as a deodoriser in cars.

Another way to reduce smells in a refrigerator or freezer is to wash down the surfaces with a solution of sodium bicarbonate or domestic Borax (one dessertspoonful to a bowl of warm water). Domestic Borax is stocked by or can be ordered from Boots the Chemist.

To remove smells from a carpet, sprinkle sodium bicarbonate generously over it. Leave for a couple of hours, then vacuum or brush vigorously to remove.

To remove smells from a cupboard or room, you can use Fridge Fresh (see above) or place sodium bicarbonate in an open bowl and leave it for a few days, or permanently. Replace every few months.

Persistent smells from a toilet are caused by bacteria and moulds in the bowl and under the rim. Either clean with an oxygen bleach (see Bleaches, above) or with a solution of Borax, as above.

To kill smells from a drain, place a tablespoon of washing soda (available from supermarkets) on top of the drain and pour very hot or boiling water down the drain.

To kill dustbin or wastebin smells, sprinkle neat sodium bicarbonate and Borax in the bin. Wash the bins regularly and leave to dry in the open air.

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If the baby shows no sign of reaction after the food tested on the first day, wait four days before retesting that specific food. On the fifth day, repeat the test process. A baby may not react to a food the first time around, but may have been sensitised by that first eating. So test the food systematically second time around as well. If the food then seems fine, include it on your list for the baby’s permanent diet.

The reason why you wait four days to retest is that it gives your baby’s system time to clear a food. Any symptoms which might be masked by eating every day then become clear when the baby eats the food again. In addition, eating a food at a fixed interval in this way (called ‘rotation’) can help control mild allergy and intolerance by moderating the baby’s system’s exposure and controlling any overload. It helps to prevent sensitivity developing.

Test the next foods

On the second day of introducing foods, try a different food from the first day, follow the same test and monitoring process, and wait for a four-day period before testing that food again. Follow the procedure of testing and waiting four days with four foods, one per day, consecutively.

By Day Nine, unless your baby has reacted to any of the first four foods, you should have identified four tolerated foods which can form the core of the baby’s diet. If this is the case, see page 261 for advice on how to build up and expand your baby’s diet.

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Some of the most adaptable allergenic moulds are also found in indoor environments. Their presence is not a sign of insanitary conditions, inadequate cleanliness, or poor housekeeping. They simply thrive invisibly in particular conditions. Indoors they cling to damp surfaces in bathrooms or showers where they can feed on tiny traces of soap or human skin. Kitchen or other damp walls also provide a feeding ground from paint, glues or wallpaper. Moulds can feed on dusty objects like art treasures or old tapestries. They thrive in damp cupboards; they cling to damp clothes and shoes; to drying laundry and used tea-towels. They waft up from waste pipes, lurk under the rim of lavatory bowls and sit in pools and drops of condensation. They feed on old dusty books and paper, especially if damp. They sit in the soil of pot plants. They grow in the encouraging dark damp of pillows, duvets, upholstered furniture and cushions. They are keen on damp, poorly ventilated areas. They prefer warmth but will tolerate colder parts, even freezers and refrigerators.

The little patches of sooty grey-black deposits that are often found on window frames or in pools of condensation are perennial moulds. The pinky-grey slime that you see around sinks, taps, on tiles, lavatories and bathroom walls contains moulds.

Moulds are usually found close to the environment where they feed and grow, but their spores can be carried long distances by winds and then deposited in areas far from their source. Thus people who live in cities can be allergic to moulds and suffer attacks on days in summer and autumn when mould spores are swept into the atmosphere and carried distances by strong winds. Even though you apparently live far from their source, you can be affected by moulds in the atmosphere.

Remember, though, that although some of the allergenic moulds are ubiquitious, most of the time they will not cause you much harm. They will be producing spores quietly and gently at a level that is unlikely to cause you to react. At times, however, they produce spores in high concentrations and it is these situations that will give you severe reactions.

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Some people become anxious and uptight just hearing the words “sex therapy,” because they don’t understand what sex therapy involves.

Try to look at it this way. Imagine that you are someone who is afraid of public speaking. You get extremely anxious and tense before you have to talk in front of a group of people. You’re afraid your speech will fall flat, your audience will be bored, or someone will ask you a question you have no idea how to answer. You feel your throat closing up as your nervousness increases. All the witticisms you so carefully rehearsed, the jokes and anecdotes you collected for this occasion, desert you in your moment of need. This is performance anxiety. It’s the same thing that sometimes hits a man when he gets in bed with a lover. He worries that he won’t get or maintain a good erection and that his partner will be disappointed. Maybe he’s been rehearsing the encounter over and over in his head, and feels like he’s about to go onstage.

There are professionals who can teach you to relax and be a better, more confident public speaker. Well, a sex therapist can offer the same kind of help for some men with erection problems. Specifically, sex therapy can help men whose erection problems are caused by anxiety, nervousness or other psychological distress; and men whose erection problems have a physical cause or a physical contributing factor, but who want to learn how to increase their sexual pleasure and possibly improve their erections, as much as possible. Sex therapy can teach you how to pleasure yourself and your partner; how to enjoy other types of sexual contact besides intercourse; and how to communicate better with your partner.

Can sex therapy help you? The best answer to that question comes from some self-evaluation and from an assessment by a trained, experienced sex therapist. In general, however, there are certain characteristics which make someone more likely to benefit from sex therapy, and more able to learn solutions to correct an erection problem.

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To treat ED, thin stainless steel needles—about the thickness of a human hair—are carefully placed in the lower spine and coccyx, as well as in the groin. They are inserted less than a quarter of an inch below the skin’s surface, and usually left in place for fifteen to twenty minutes. Little, if any, discomfort is felt. Some people describe the sensation as a mild tingling.

Acupuncture is performed in every state in this country. An estimated three thousand medical doctors and osteopaths have studied and used acupuncture in their practices. Approximately seven thousand nonphysician practitioners currently use the technique to help control pain and treat addictions, depression, insomnia, and other health problems. You should be aware of the licensing regulations in your state. To find a physician/acupuncturist in your region, contact the American College of Acupuncture at 212-876-9781.

Note: Before trying acupuncture to treat ED or any condition, consult with your doctor. As is the case with other forms of alternative medicine, acupuncture should be used only as an adjunct to regular medical treatment—never as a substitute for it.

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Once I told the patient about the anti-ED medication, he was game to try it. One week after taking the most effective antihypertensive medication for his condition, Gary felt his ED had worsened. Then he enrolled in the Vasomax trials. The anti-ED drug worked. Ecstatic, he reported to me that he never felt better. “I’m so relieved. I have my health—and my sex life—intact.”

ED medication is also effective for men on cholesterol-lowering drugs. When Michael, fifty-seven, came back to my office after his ultra-fast CT test, the special five-minute heart exam confirmed the presence of plaque in his coronary arteries. This was not surprising; he had a family history of heart disease coupled with his own high cholesterol levels.

I prescribed Lopid (gemfibrozil) to lower his cholesterol and triglyceride (fatlike substances) levels in his blood and reduce the risk of a heart attack. Lopid seems to work by raising the level of high-density lipoprotein (HDL) cholesterol, which counteracts the effects of the low-density lipoprotein (LDL) cholesterol, the type that increases the chance of having a heart attack. I informed Michael that the drug would probably work well for him—but that it might also cause erection problems. Knowing the danger he was in, Michael agreed to start medication at once.

At his next visit, I was satisfied to see that his cholesterol levels had dropped to an acceptable level—210 mg—and that his triglycerides had plummeted as well. But Michael’s reaction to the good news was one of indifference. “Sure, the results are great,” he sighed. “But 1 can’t have sex—so, I still don’t feel so good.”

I explained that now that his life-threatening condition was under control, we could address the medication’s side effect. As part of the Vasomax trials, he tried the pill.

A month later, Michael’s wife, Louise, called me. “I just want to tell you myself how grateful we are. Knowing that Michael is healthy is such a relief. Knowing that we can be together the way we want is a gift.”

For those men battling depression with medication, there is hope as well. For Richard, a thirty-five-year-old lifelong depressive, taking Prozac was, in his words, “like watching a dark curtain lift and seeing the sun again.” With his life and outlook much improved, he began dating and was several months into a loving relationship when he came to see me. “I’m perplexed,” he began. “Sometimes I can’t get an erection and other times I’m really hard—but I don’t come.”

Under treatment with a therapist, Richard rejected the idea of switching to another SSRI medication to see if his erection problems would disappear. He felt that the mental stability he had achieved with Prozac was too precious to jeopardize. Instead, he wanted to know if the erection pills could work for him.

I informed Richard that information on the ability of Vasomax to overcome the sexual-inhibiting effects of the SSRIs was limited. So far, few of the men participating in the trials were on antidepressants. The same was true with the Viagra studies. I went on to say, however, that the anecdotal evidence I had seen with Vasomax was positive and worth pursuing. In Richard’s case, the results he achieved with Vasomax were consistent with that of other patients: the SSRIs did not hamper the workings of the pills, and his erectile problems disappeared.

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The question has already been raised by leading urology experts: if a man has ED, why shouldn’t he take two different erection pills simultaneously, thereby producing a more potent treatment package than the one-pill regimen? In fact, the issue is not why two or more drugs will be prescribed to be used simultaneously by men to enhance erections, but when this will actually happen. It’s not inconceivable that this special drug mixture, combining either Vasomax or Viagra with some newer oral medication or topical gel, will be widely used for men with moderate to severe ED.

What would happen if Viagra and Vasomax were given simultaneously? We know that each drug influences a different chemical messenger system in the body. So, in theory, once they were teamed up they could then develop greater effectiveness, possibly diminishing each other’s side effects while enhancing erection capability.

Already, expert urologists are enticed by the idea because there are ample comparisons. Often, in the treatment of hypertension and certain cancers, physicians prescribe chemical “cocktails.” In doing so, they combine two or more drugs in such a way that any potentially negative aspects of the stronger drugs may be offset by the positive effects of the milder ones. The end result could be an even more potent treatment that works much more effectively.

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Lack of time is another major factor in this scenario. Although William clearly views sex as something of great importance, he often plans it as literally the last thing to do on a busy, event-filled day. He doesn’t give his sexual relationship time when he is well rested, free of tension, relaxed. If William had decided to wait until Saturday morning instead of late Friday night, he would have been more relaxed, more rested and possibly found that he had no problem.

It’s important to take time out for sex. Sex therapists tell people to allocate one hour per day to sensually caressing, massaging and relating to one’s partner. But you don’t have to pay a therapist to benefit from this advice and to reap the pleasurable results.

Sensual Pleasures

William has problems making love with his wife because he focuses on making his penis do what he wants rather than enjoying being close to Sharon. Forced erection is a false notion. Although he caresses and cuddles her, he doesn’t concentrate on her touch, the smell of her hair, the taste of her lips and the sight of her body. Instead, he is preoccupied with whether his penis will “work.” That’s like eating dinner and being involved with the knife and fork, rather than the gourmet feast before you. What a waste.

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