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NAET (Nambudripad Allergy Elimination Technique) is an alternative medicine technique described as a treatment for allergies. It was founded in 1976 by U.S. chiropractor and acupuncturist Devi S. Nambudripad. Her technique draws on applied kinesiology, reflexology, acupuncture, and radionics. NAET has not been demonstrated to be effective for any medical condition, and lacks scientific rationale or physiological basis.

History
NAET was first discovered by Devi S. Nambudripad in 1983. She was a licensed chiropractor and student acupuncturist at the time; she had a violent reaction to eating some carrot, and attempted to overcome the reaction through a self acupuncture treatment. Unbeknownst to her, there was still a little bit of carrot stuck to her skin at the time. After the acupuncture treatment, she found that her carrot allergies had disappeared. After consulting her bewildered professors, she began experimenting with the treatment on her husband and son, with similar results. She began incorporating this discovery into her acupuncture/chiropractic practice, testing her hypothesis on numerous patients, free of charge. “I didn’t feel right to charge them for experimental treatments.”, She discovered that almost everyone she treated had many food allergies. Treating them using NAET created noticeable differences in their health. NAET has grown a lot since 1983, with over 7000 world-wide practitioners by 2003 ,

What is an Allergy?
Allergies can be defined as “an unusual sensitiveness of the body which causes certain people to be affected in a bad way by something usually harmless”. There are 9 general categories for allergens: Inhalants, ingestants, contactants, injectants, infectants, physical agents, genetic factors, Molds and Fungi, and Emotional Stressors. Immediate or delayed reactions to these Allergens can cause symptoms such as:

Short Term Long Term Each individual is affected by different allergens, and in different ways. This can make it difficult for doctors to identify specific allergens. While sneezing is commonly caused by spring pollens, migraines may also be a reaction to the same pollens in a different person. NAET offers a quick diagnosis through NST, and claims to eliminate allergies, rather than just treating them. According to NAET testing, almost everyone has a long list of food allergies. These allergies are apparently the cause of most human illnesses (xvi).
 * Swelling
 * Asthma
 * Hives
 * Fever
 * Excessive mucous
 * Occasional cough
 * Mild wheezing
 * Poor clarity
 * Dizziness
 * Headaches
 * Vertigo
 * Insomnia
 * Fatigue
 * Walking pneumonia
 * Backaches
 * Hair loss
 * Anger
 * Depression
 * Irritability

NAET appointments: what to expect
In preparing to have an NAET treatment, the following guidelines may be helpful: Testing for allergens requires a specific controlled environment. Only two people are allowed in the environment-the patient and the practitioner. This helps prevent interference with the patient’s electromagnetic field. No one besides the practitioner should be within 10 feet of the patient. According to NAET protocol, A NAET treatment room should have walls or curtains made of “wood, Leather, Metal, or thick plastic…Doors, windows, dividers, thin fabric, or other materials are not sufficient to prevent energy transfer from one person to another.” The walls should be at least 7 feet tall, and they should touch the floor.
 * Shower before arriving
 * get a drink of water
 * Eat at least a snack before being tested
 * Get enough Sleep
 * Wear minimal Jewelry
 * Wear loose, undecorated clothing
 * Bring the patient’s medical records.
 * Wash hands just prior to treatment.
 * avoid perfumes, strong deodorants, or other strong smells
 * Warn the practitioner about any previous anaphylactic (extreme allergic) reactions.

Neuro-Muscular Sensitivity Testing
To detect an allergen, NAET practitioners rapidly test many substances, often using NST. NST is branch of Applied Kinesiology. It determines an allergen by comparing muscle strength before coming in contact with a potential allergen, and during contact with a potential allergen. Testing can be performed while standing, sitting, or lying down; lying down seems to provide the most accurate results. A standard NST test measures arm strength. other methods are discussed in the appendix. The subject lies on a firm surface. One arm is raised in an upward direction, somewhere between 45 and 90 degrees of a vertical position. The palm should face the feet. The other hand, and specifically the fingers, should not be in contact with any surface at this point, as this may provide inaccurate results. (See fig. ***) At this point, the tester applies 5-10 lbs of pressure to the arm, pushing toward the feet. The muscle should remain strong, with minimal movement towards the feet. If this does not occur, the subject’s energy needs to be balanced. One way of balancing a patient consists of simultaneously rubbing two points on the midsagittal plane of the patient’s body in a clockwise direction. The first point is located halfway between the belly button and the hips. The second is located along the nipple line. (See fig ***) This may need to be done more than once. Once the subject has successfully resisted the tester’s gentle pressure on their arm, they are ready to be tested for allergens. The tester hands the subject a glass bottle containing a potential allergen, then presses gently on their arm. If the subject’s arm successfully resists the pressure, they have no immunity. However, if the patients arm does not resist the pressure successfully, they have an allergen to the substance (153-159). In this way, many different allergens can be tested quickly. NST takes a significant amount of practice to get accurate results; after completing Advance 1 training, NAET practitioners must be re-certified in NST annually for the next three years to ensure proper technique. Once detected an allergy can be treated using NAET.

Treatment
''According to Oriental medical principles, 'when the body is in perfect balance, no disease is possible.'. Any disturbance in the homeostasis can cause disease. Any allergen capable of producing a weakening muscular effect in the body can cause disturbance in homeostasis. Hence, diseases can be prevented and cured by maintaining homeostasis. According to acupuncture theory, acupuncture and/or Acupressure at certain acupuncture points is capable of bringing the body to a state of homeostasis by removing the energy blockages from the energy pathways known as meridians. When the blockages are removed, energy can flow freely through the energy meridians, thus bringing the body in perfect balance.''

NAET treatments are designed to remove these energy blockages using the following procedure. The patient holds a glass bottle containing the allergen, and lies face down. Using acupressure techniques, the practitioner will stimulate different acupressure points on your back. If you are over 10, they will also stimulate different points on the front of your body using either acupressure or acupuncture. After treatment, patients will be asked to rest quietly for 20 minutes while holding a glass jar containing the allergen. During this time, patients should not read, cross their hands or feet, or touch anything with the palms of their hands. This will help prevent confusion as the body focuses only on the item treated. Lying or resting with a calm mind will be beneficial (428-1&2). After the treatment is completed, patients will again be tested for an allergic reaction. If they pass, they are no longer allergic to that substance. However, they still need to avoid the previously allergic substance for the next 25 hours.

Why the 25 Hours?
According to Traditional Chinese Medicine, there are 12 energy meridians within the human body. These Meridians are associated with various vital organs and specific spinal nerves. These organ systems are: the lungs, large intestine, Stomach, Spleen, Heart, Small intestine, Urinary Bladder, Kidney, Pericardium, Triple Warmer, Gall Bladder, and Liver. Energy flows from one system to another, and each system is at its peak energy flow for a specific two hours every day. Therefore, because NAET reprograms the body to accept a substances energy frequency, each body system needs to experience this reprogramming. If a complete, uninterrupted energy cycle is not completed, the remaining body systems remain allergic and must be treated again. Additional exposure to the allergen being treated causes an interruption in this cycle. 24 hours is the minimum amount of time needed to complete an energy cycle. NAET recommends 25 hours as a precautionary measure. 25 hours to 7 days after a treatment, patients are retested to ensure that their entire body has been desensitized. NAET has no known side effects.

Certification Comparisons
Most NAET practitioners are chiropractors or acupuncturists. According to NAET.com, the requirements for becoming a certified NAET practitioner include: attending both two day basic and advanced training sessions within 12 months of each other, taught in CA once a month. Be recertified annually for the next three years in NST by a certified NST instructor, and purchase two NAET allergy test kits. In comparison, the American Board of Allergy and Immunology (ABAI) lists the following certification requirements for immunologists: They must be previously certified by the American Board of Internal Medicine or the American Board of Pediatrics, complete 24 full-time months of continuous training in an accredited program, submit 4 clinical competence evaluations, 1 procedural skills assessment form, 2 letters of recommendation, proof a valid medical license, and a letter of recommendation from the program director including an affirmation that the student is clinically competent, has had 24 months of continuous training, and is prepared for the ABAI certification exam. By passing this exam, the physician receives an ABAI diploma.

NAET
Perhaps the most important question available concerning NAET is this: Does it work? Excluding testimonials, there is a great deal of controversy over this topic. First, NAET treatments are currently regarded as Complementary medicine. According to the National Center for Complementary and Alternative Medicine (NCCAM), ''Although scientific evidence exists for some Complementary and Alternative Medicine (CAM) fields, most have key questions left unanswered by a lack of well designed scientific studies, questions like: "is it safe?" or "does it work?"''. There have been studies performed on NAET practices–Clinicaltrials.gov lists 6-but nearly all studies have been performed by the Nambudripad’s Allergy Research Foundation, creating a potential, if unavoidable, conflict of interest. Additionally, there are still questions left unanswered. NAET, built upon Traditional Chinese Medical beliefs, uses acupuncture and acupressure to manipulate the putative energy fields (also called biofields) of the body. The existence of biofields has yet to be clearly proven by conventional instrumentation

Acupuncture
Acupuncture is also somewhat controversial. It is effective at relieving certain forms of pain. However, Western Medicine has not been able to adequately explain why this is the case. Current theory suggests that acupuncture increases the rate of electromagnetic signals. This may improve the function of the body’s immune system and pain killing endorphins. Acupuncture has also been shown to affect parts of the nervous system controlling involuntary reactions, such as immune reactions, blood pressure, and body temperature.

Applied Kinesiology
NST, a form of applied kinesiology, is perhaps the most controversial part of NAET allergy elimination. In a recent study, 7 patients with a confirmed allergy to wasp venom were tested by 4 kinesiology examiners. Both patients and examiners were blinded. 10 capsules containing wasp venom and 10 capsules containing placebos were used. The results were accurate between 40%-60% of the time, suggesting kinesiology was not an effective tool for determining allergy, at least in cases involving wasp venom and examiners with average skills In contrast, Caruso and Leisman performed a study suggesting a 98% chance that an experienced tester would test accurately, while a less experienced tester would be accurate only 64% of the time, nearly equivalent to the higher value found by the wasp study Cooperstein and Gleberzon also discussed other conflicting results in kinesiology studies. A large proportion of kinesiology studies are poorly performed or presented, drastically reducing the number of useful studies on the subject. It is difficult to measure Kinesiology because of the sheer number of possible variables; it is performed in a variety of ways such as: the amount of force involved, the timing, the muscle used, the definition of a response, and what a response means. It has also been applied toward many uses: Nutrient deficiencies, learning disabilities, emotional needs, Allergies, and numerous other disciplines.

Dr. Nambudripad
Dr. Nambudripad’s qualifications are also subject to scrutiny. For example, Dr. Stephen Barrett’s view on NAET is not favourable. Among other statements, he challenges Nambudripad’s claim that vitamins can cause allergies allergies are only related to proteins. There are exceptions to this rule however, including Haptens. Haptens are small molecules capable of causing an allergic reaction when they attach to a protein. This protein can originate in the body. Haptens may be organic or inorganic, or even elemental, such as an allergy to an iron filled protein

Other sources also contest Nambudripad's claims. Angelfire.com claims that Nambudripad’s MD degree comes from the University of Health Sciences in Antigua, although this claim was not cited. This university is not recognized by the Medical Board of California ,yet Dr. Nambudripad trains NAET Practitioners in  California.

Studies
Some controlled studies designed to test the validity of NAET treatments have been performed. However, most have been conducted under the supervision of Nambudripad's Allergy Research Foundation(NARF), One the one hand, this leads to a potential conflict of interest. On the other, it makes sense that a foundation already interested in NAET would be performing these studies.

The Medical Community
NAET is largely regarded by the medical community as unscientific, with placebo effects at best. One recent review of complementary allergy tests writes that "NAET has to be the most unsubstantiated allergy treatment proposed to date.", another concludes that "there have been no studies supporting the use of these techniques, and several have refuted their utility."

Dr. Stephen Barrett, after an examination of the technique and Nambudripad’s credentials, writes that:


 * NAET clashes with the concepts of anatomy, physiology, pathology, physics, and allergy accepted by the scientific community. The story of its “discovery” is highly implausible. Its core diagnostic approach – muscle testing for “allergies” – is senseless and is virtually certain to diagnose nonexistent problems. Its recommendations for dietary restrictions based on nonexistent food allergies are likely to place the patient at great risk for nutrient deficiency, and, in the case of children, at risk for social problems and the development of eating disorders. I believe that practitioners who use NAET have such poor judgment that they should not be permitted to remain licensed. If you encounter a practitioner who relies on the strategies described in this article, please ask the state attorney general to investigate.

Alternatives
NAET is not the only procedure out there. Other allergy treatments do exist. The most common allergy treatments are discussed below.

Medication
Allergy Medication is available to treat various allergic reactions. It is most effective when proscribed by an allergist certified by the ABAI. Common Rhinitis treatments may include antihistamines, decongestant drugs, and anti-inflammatory nasal sprays and eye drops. However, allergy medication sometimes has harmful side effects. Some antihistamines may impair reflex and performance speeds, and inhibit classroom learning. These sedative antihistamines may increase the risk of accident or injury while operating heavy machinery. The effects of Nasal decongestant sprays erode over time with heavy usage, and may cause rebound nasal congestion worse than the original symptoms; decongestant spray usage is limited to one week. Anti-inflammatory sprays such as corticosteroids do not have a rebound effect and do not lose effectiveness over time. Over-the-counter allergy medications also carry some risk. Detecting a sedating antihistamine may be difficult without adequate information. Treating persistent asthma with over-the-counter medication has the potential to cause irreversible damage or death Over the counter medication is available starting below $10 and insurance may help cover costs

Allergy Injections
An allergy injection, or Immunotherapy, is another common method of treating allergies. Like NAET treatments, allergy injections attempt to desensitize the body’s reaction to a substance. The shots are normally given over a 5 year period. For the first few months, the allergic substance is injected in small amounts into the body. Gradually, the dosage is increased until a sustained maintenance level has been reached. Finally, treatments are performed less and less frequently. Allergy treatments are considered safe and effective, with less than 2% of patients experiencing anything more than mild reactions at the injection site. However, because there is a slight chance of a severe reaction, allergy injections are performed only in a controlled environment by a certified immunologist. Patients are also asked to wait 20-30 minutes before leaving to make sure there is not an adverse reaction. While the Asthma and Allergy Foundation of America endorses allergy shots, the National Institute of Allergy and Infectious Diseases states that research is still needed to conclusively prove its effectiveness.

Injection pricing is split into two sections: Antigen and injection. Antigen serum vials are quite expensive-for the first year a single vial is around $700. In subsequent years prices drop to around $175. This is due to the increased time between injections This totals $1400 for a complete 5 year cycle, not including injections. Injections themselves may cost anywhere from $4 at Texas A&M University, to $25. Insurance varies widely.

Avoidance
Another common alternative is avoiding the allergen altogether. This form of treatment is cheap, simple, and effective for some allergies. However, it does have some drawbacks. An allergy to a common food source may require checking labels and avoiding fast food or restaurants constantly. While this may make a smarter consumer and healthier eater, the benefits may not be worth being on constant alert. With airborne allergies, the allergic individual’s movements may be restricted on certain days, and they may need to purchase expensive air filters. Still, avoidance may be the way to go if they have mild or infrequent allergies.

NAET
Basic NAET treatments, designed to desensitize the body, have no known side effects.(pdf egg) There are 15 basic NAET treatments, focusing on essential nutrients. After these 15 are completed, patients may focus on other treatments more specific to their situation. Like allergy shots, patients are asked to wait 20 minutes before leaving the office after being treated, though for different reasons. They are also asked to avoid the allergy treated for the following 25 hours. They can have another treatment immediately after the 25 hours if they wish. NAET practitioners usually recommend that patients stop being treated if they don’t notice any improvement after 10-15 treatments Subsequent visits usually cost between $55 and $75 (13). This price difference probably due to the fact that an initial visit includes testing the patient’s response to a large array of potential allergens. It is unlikely that insurance companies will cover NAET treatments at this time.

Conclusion
The allergy treatment field has many proponents, both in and out of traditional medical fields. While traditional fields often clash with complimentary or alternative fields, they also disagree with each other. Most available methods for testing allergies are deemed unreliable in some way. It’s difficult to even define an allergic reaction because they differ person to person. Once an allergy has been tested and diagnosed, there are many treatment options available. Consequently, everyone has a different approach to allergies. It is up to the consumer to decide which treatments to use. Patients can choose one, more than one, or none. NAET, while controversial, may be the best option for some individuals. For other individuals, another treatment may be more effective. Although allergy treatments hardly fit into the ‘one size fits all’ category, the sheer number of treatments available makes it seem likely that individual relief exists. Whichever option patients choose, they should be well informed and know what they’re getting into.