On top of the skin testing, Dr N ran some blood panels. One panel was for candida yeast, one was a liver panel that was ordered preemptively because it’s necessary for the candida yeast treatment, and one was to check the likelihood that I could have an anaphylactic allergic reaction. Apparently, candida yeast overgrowth in the esophagus could cause my EoE symptoms.
Candida yeast is always present on and in human bodies, and is usually completely innocuous. When something causes an overgrowth of candida yeast, however, then there are problems. Several things can cause an imbalance that allows the yeast to flourish. Providing the yeast with the perfect environment can cause it to grow too quickly for the “good” bacteria and organisms to keep it under control. Prolonged use of antibiotics can also cause the yeast to flourish since the antibiotic kills off the bacteria that keeps it in check. Vaginal yeast infections, the kind most people think about, are usually due to providing the perfect environment for the yeast: consistently warm and moist, and relatively undisturbed. Wearing a wet swimsuit or wet underwear/pants all day can be enough to send the yeast into overdrive, which is why it’s a good idea to change out of wet undergarments quickly. This same type of surface infection (vaginal yeast infections occur on skin surface) can occur in armpits, behind knees, on the inside of the elbow, feet, etc. They aren’t much fun. The yeast infection I ended up getting in my ear was also caused by candida yeast overgrowth. I had been on antibiotics for a few months by then and, apparently, my bacteria decided that they had had enough. With the bacteria gone, the yeast in my ear proceeded to throw a wild frat party.
There are three different antibody tests for candida yeast. The first two are Immunoglobulin A (IgA) and Immunoglobulin M (IgM), which are the “first responders” of antibodies (IgA responds when you call 911, IgM responds when IgA needs reinforcement). Less than 10 U/mL (I’m guessing it’s units per milliliter, but I’m not sure) means that those two antibodies are in normal levels. The final antibody test is for IgG, which is kind of like a permanent crowd control officer (meaning that IgG is created when you have a long term yeast infection). If the IgG levels are less than 30 U/mL, then you do not have a long term yeast infection (well, shouldn’t… I imagine some people with immunodeficiencies may not produce the antibodies properly). Luckily, all of my antibody tests came back in the normal range, so no yeast infections! My liver panel also came back normal (protein, albumin, bilirubin total and direct, alkaline phosphatase, AST, ALT).
Now, the anaphylactic test is interesting. First, your likelihood to have an anaphylactic reaction is genetic (new info for me), so this number shouldn’t change much (it can fluctuate when around allergens, but it’s not going to skyrocket out of nowhere). Secondly, I found out that anaphylaxis is not just the throat closing. Apparently, anaphylactic reactions are full body reactions which also involve your blood pressure and heart rates dropping dramatically, as well as your breathing slowing. No wonder they are so dangerous and the emergency treatment for them is pure adrenaline.
IgE is the name of the antibody responsible for causing anaphylactic allergic reactions. The higher the amount of IgE in your system, the more likely you are to have a reaction. The range of IgE goes from 0-100 IU/mL. Numbers from 0-20 mean your chances of anaphylaxis are low, and I can’t seem to remember the medium to high risk ranges. I asked Dan to guess what my number was, and he guessed 55. He was wrong. My number? 3!!!! THREE!!! Yes, three! I’m very happy that I finally have a medical test give me good news! And since my tests were taken during one of the worst allergy seasons Colorado has had in the last few years, and it was still a three, I’m pretty stoked.
So, the good news is that I don’t have anything wrong, and I shouldn’t have an anaphylactic reaction to anything. However, we still don’t know if I have any triggers for my EoE. The search continues…