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If Christmas dinner in your house means soggy Brussels sprouts, desiccated turkey and gloopy gravy that’s gone cold while you’ve waited for everything else to cook, you’re not alone.

But what if it didn’t have to be that way?

We asked some of the most renowned chefs in the UK to give their ultimate guide to making Christmas dinner.

Prep

This is key, says two-Michelin star chef Alex Dilling: “Any step you can do days ahead will help not only the time with your family but also there will be far less washing up.”

For TV regular and one-starred Tom Shepherd, this means doing the Yorkshire pudding batter and cauliflower cheese the night before, and prepping all the veg.

Tom Shepherd owns fine dining restaurant Upstairs by Tom Shepherd in Lichfield.
Image:
Tom Shepherd owns fine dining restaurant Upstairs by Tom Shepherd in Lichfield.

Brining the turkey

“I’m really into brining my turkey, I couldn’t recommend this enough,” says Shepherd, whose Staffordshire restaurant Upstairs is booked up more than a year in advance.

You'll be raising a glass too if your turkey comes out this good. File pic
Image:
You’ll be raising a glass too if your turkey comes out this good. File pic

Tom Shepherd’s brine

  • A simple 10% salt to water brine
  • A bit of thyme, garlic and orange peel thrown in
  • Leave it for 24 hours, then remove 90 minutes before cooking to dry it off, rub in butter and salt.

Cooking the turkey

Hrishikesh Desai, the renowned chef patron at one-star Country House Hotel in north Cumbria, does it like this to maximise flavour…

  • Take the legs off the turkey and debone them;
  • Take the wishbone off and create a gap between the skin of the turkey and the breast. Fill it with well-seasoned stuffing or butter or truffle butter. Leave in the fridge to rest;
  • Take as many sinews off the deboned legs as possible then flatten the meat and fill it with stuffing. Lay on an oiled foil sheet, season and wrap to form a roll. Make sure it is rolled tight. Cook in a preheated oven at 220C for 1.5 hours. Remove from the tinfoil, fry the legs on a pan to brown it evenly. Slice and serve;
  • For the main turkey, remove from the fridge, drizzle oil or brush with soft butter, place on a roasting pan and then into the pre-heated oven at 220C. Cook for at least 1 to 1.5 hours while basting every 10 minutes.
  • To ensure the turkey meat is cooked, use a carving fork, push through the crown and lift the turkey. If the juices run without any blood then it’s done;
  • Remove from the oven, cover with foil and rest for at least 20 minutes before carving.
Hrishikesh Desai
Image:
Hrishikesh Desai

For Shepherd, a resting time of at least 60 minutes is best.

Great British Menu legend Lisa Goodwin-Allen, executive chef at one-starred Northcote, says a leftfield choice might be to cook the turkey on the BBQ instead of in the oven.

“Not only does it give you more space in the oven on a busy Christmas Day, but it also gives the meat a lovely smoky flavour that adds an extra dimension to your Christmas dinner,” she says.

Turkey alternatives

Most of the chefs we spoke to aren’t fans of turkey.

“It has its place but there is a reason we only tend to eat it once a year,” says Dilling. “As a large bird with a low fat content, it can very easily become dry.”

For him, goose is “an incredible and underrated bird” as it’s a simple roast and full of delicious fat – which has the bonus of making your roasties super tasty.

Benjamin Ferra Y Castell, head chef at one-starred Pavyllon in London, recommends guinea fowl.

Benjamin Ferra Y Castell of Michelin-starred Pavyllon London
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Benjamin Ferra Y Castell of Michelin-starred Pavyllon London

“Many people overcook poultry to be sure it’s done, but that can dry it out,” he says. “The trick is to cook it in two stages.”

For a 1.2 kg guinea fowl…

  • Season well with salt, pepper and butter for extra flavour;
  • Roast it at 200C with the fan on for about 45 minutes until golden and crispy, basting it while it cooks;
  • Once the breast is cooked, remove the legs and cook them for another 15 minutes. If you’re unsure, use a cooking thermometer – when the thickest part of the breast reaches 57C, take it out and let it rest for 10 minutes. It’ll continue to cook and reach 63C, which is perfect for poultry. Don’t worry about the legs; they’ll stay juicy due to the collagen in the meat.

Lisa Goodwin-Allen’s perfect roasties

Before we get to this, we need to decide what potatoes to use. Benjamin Ferra Y Castell likes Ratte potatoes as “they’re small, cook quickly, and are full of flavour”. For Hrishikesh Desai, it has to be Maris Piper.

As for how to cook them, here’s Goodwin-Allen’s guide uncut…

“You want a good chipping potato that’s going to be light and fluffy on the inside and good texture on the outside.

“I don’t use just regular water – I take water, duck fat, a couple of crushed garlic cloves and tie some rosemary up, bring it to the boil and let it simmer for at least two hours or overnight to get a lot of flavour into the water.

Lisa Goodwin-Allen
Image:
Lisa Goodwin-Allen

These aren't Lisa Goodwin-Allen's roasties, but they look good nonetheless...
Image:
These aren’t Lisa Goodwin-Allen’s roasties, but they look good nonetheless…

“When that’s ready I put the potatoes in, bring it to boil and then simmer them until they’re partially done. You should be able to just slip your knife through them. I then take them out and fluff them up. A great little tip here is to mix a bit of rice flour with garlic granules and dust them, then put them onto a tray.

“Then, you want to freeze them! Freezing them breaks down the carbohydrate inside them which is going to help them turn out perfectly.

“When you bring them back, put a tray of duck fat into the oven – get it really nice and hot. This can be done from frozen. When you put them in, they should really sizzle because you want them to fry, not boil. You could also fry them (three to four minutes from frozen, then take them out and fry again for 15 minutes before serving). They will be nice and crispy on the outside and really decadent and fluffy on the inside. That’s what a good roast potato is all about.”

Jean Delport, executive chef at one-starred Restaurant Interlude in West Sussex, adds a knob of butter to his duck fat to ensure they get super crispy. A common tip is to get the fat up to temperature, 220C, before putting the roasties in.

Jean Delport
Image:
Jean Delport

Delport says you need to shake them, both initially and at 15-minute intervals, to prevent sticking.

Tom Shepherd adds minced garlic after cooking.

Other veg

The Shepherds will be having creamed cabbage.

“It’s a winner in our house,” he says, revealing his method…

  • Grab a humble white cabbage, remove the root and slice as thinly as possible;
  • Boil in salted water until softened, and chill
  • Meanwhile, reduce a pan of double cream with garlic and thyme in by half, and whisk in some grated parmesan, season with salt and pepper, and reintroduce the cabbage to the mix – you won’t regret it.

Niklas Ekstedt, Michelin-starred chef and owner at Ekstedt at The Yard in Westminster, roasts root vegetables like parsnips, carrots and beets with a drizzle of teriyaki sauce and some ginger.

“The sticky sauce and fresh ginger adds a real depth of flavour that elevates the vegetables for a delicious side dish,” he says.

Niklas Ekstedt
Image:
Niklas Ekstedt

How do you make Brussels sprouts taste nice?

Brussels sprouts absorb a lot of water so do not boil them, says Dilling.

Instead, cut them in half and mix them with duck fat, bacon lardons, garlic and herbs. Roast them till charred and tender.

Admittedly not everyone's favourite vegetable, but still a Christmas classic. File pic
Image:
Admittedly not everyone’s favourite vegetable, but still a Christmas classic. File pic

Gravy

Ferra Y Castell shares his recipe…

  • 100g diced shallots
  • 3g cracked black pepper
  • 60g soy sauce
  • 140g sherry vinegar

“Reduce these ingredients in a pan until nearly dry,” he says. “Then, add the reduction to a good beef stock, add a dash of cognac, and you’ll have a rich, flavourful gravy.”

What's a roast without gravy? Again, this gravy was not made by the chefs mentioned here
Image:
What’s a roast without gravy? Again, this gravy was not made by the chefs mentioned here

Shepherd says “the tray you roast your meat on is like gold dust”.

Add onions for your meat to sit on and some roughly chopped carrots, he says. Once the meat is resting, you can get going.

“I begin with placing the tray on the stove and heat,” he says. “Add a little garlic and flour, cook that out until no longer clumpy and start by deglazing the tray with a glass of wine, then once that has evaporated, add some meat stock, ideally the same stock as your chosen meat, ie, beef or turkey. Boil that and reduce to a gravy consistency, pass through a sieve and enjoy.”

‘Unbelievable’ stuffing

This one comes from Dilling – or rather his mum.

“She always used to make a sage, pork and onion stuffing with lots of celery and good homemade chicken stock,” he says. “She would put it in a gratin dish and bake it in the oven. Crisp on top and soft underneath. Just writing this I am salivating. Unbelievable.”

Two Michelin-starred Alex Dilling, of Alex Dilling at Hotel Cafe Royal on Regent Street
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Two Michelin-starred Alex Dilling, of Alex Dilling at Hotel Cafe Royal on Regent Street

Yorkshire puddings – yes or no?

Delport is firmly in the no camp.

“Not for me. I’m not their biggest fan, but for Christmas there are too many other options I would rather add to our selection,” he says.

Shepherd takes the opposite view.

“Yorkshire puddings are essential with any roast dinner, especially at Christmas!” he says. “A non-negotiable!”

If you’re with Shepherd and fancy making your own, here’s a recipe courtesy of one of the best chefs in Yorkshire, James Mackenzie from the one-starred Pipe and Glass Inn…

Pic: Tony Bartholomew
Image:
Pic: Tony Bartholomew

Ingredients (makes 10)

  • Six eggs
  • 300ml full fat milk
  • 260g plain flour
  • Goose or duck fat or beef dripping, or rapeseed oil if preferred
  • Salt and freshly ground white pepper

Method

  • Preheat the oven to 180°C/gas mark 4;
  • Place the eggs and milk into a mixing bowl and whisk together, sieve the flour in and mix with a hand blender until you’ve got a smooth batter. Leave to stand for at least 10 minutes;
  • In a 12-hole baking tray, place a tablespoon of fat into each mould and put in the oven until smoking hot;
  • Season the batter immediately before you pour it into the smoking hot tray – this will stop the salt breaking down the egg and your puddings will rise really well;
  • Fill up 10 moulds nearly full around the edge of the tray, leaving two moulds in the middle free to allow the heat to circulate evenly;
  • Bake for 35 minutes and don’t be tempted to open the oven door earlier or they will collapse.

Dessert

Delport offers his guests a massive cheeseboard, with a variety of sweet things alongside, while Shepherd likes a homemade tiramisu – but suggests leaving Christmas pudding to the experts…

“No one beats Marks & Spencer for me,” he says.

For a leftfield choice, Ekstedt suggests Risgrynsgröt (rice pudding).

“It’s a Swedish classic, but I like to add a little twist. I sometimes serve it with a salted caramel sauce or some roasted nuts – it’s delicious and full of nostalgia.”

In case you were wondering what Risgrynsgröt looks like. File pic
Image:
In case you were wondering what Risgrynsgröt looks like. File pic

Leftovers

“My favourite part,” says Shepherd.

His suggestion is piling hot turkey, stuffing, creamed cabbage and roast potato into a sandwich or Yorkie pudding, with a hot pot of gravy on the side to dip it in.

“Incredible,” he says.

Desai, however, has a different philosophy…

“Don’t have any leftovers, just eat it all, you get Christmas only once a year!”

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Oleksandr Usyk beats Tyson Fury to retain heavyweight titles

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Oleksandr Usyk beats Tyson Fury to retain heavyweight titles

Tyson Fury has responded after his defeat to Oleksandr Usyk in their heavyweight world title rematch in Saudi Arabia.

British fighter Fury, 36, had hoped to take revenge after his previous defeat to Usyk in May.

The Ukrainian, 37, who had entered the bout as a narrow favourite, retained his WBO, WBC and WBA heavyweight titles with his win at Riyadh’s Kingdom Arena.

But, the fight went to the scorecards with all three judges scoring the fight 116-112 in Usyk’s favour.

“I swear to God, I thought I won it by at least three rounds,” Fury said shortly after the fight.

“I felt a little Christmas spirit in there and I think he got a little Christmas gift from them judges. An early Christmas gift.

“I was confident I had won that fight again. I thought I’d won both fights but then again I’ve gone home with two losses on my record. I will always believe until the day I die that I won that fight.

“I’m not going to cry over spilt milk. It’s happened now.”

Fury left the ring without doing an interview, leaving his promoter Frank Warren to speak on his behalf.

“How can Tyson only get four rounds in this fight? It’s impossible,” Warren told TV network DAZN, adding he thought Fury had won.

“Only four rounds. Each of them gave him four rounds, four different rounds. I’m not saying this because I’m biased, but everyone along the front there all thought it went the same way.

“It’s nuts. It’s nuts, I don’t get it. I’m really disappointed with that. I thought he was in control of the fight and boxed extremely well. Usyk was on the back foot for most of the fight, but it is what it is.”

Tyson Fury reacts during a press conference after losing his latest boxing match. Pic: Action Images via Reuters/Andrew Couldridge
Image:
Fury reacts during a press conference after losing his latest boxing match. Pic: Action Images via Reuters/Andrew Couldridge

Usyk became the only man to inflict a professional defeat on Fury when he beat him on points in May, becoming the first boxer to hold all four major heavyweight belts at the same time and the first undisputed champion in 24 years.

But his reign over the four belts ended just a month later when he gave up his IBF belt to fight Fury in a rematch because he was unable to make a mandatory defence against the organisation’s interim belt-holder, Daniel Dubois.

“I win,” Usyk said simply after the fight, “it’s good”.

Oleksandr Usyk celebrates winning his bout. Pic: Action Images via Reuters/Andrew Couldridge
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Usyk celebrates winning his bout. Pic: Action Images via Reuters/Andrew Couldridge

He also paid tribute to Fury.

“He’s a great fighter, a great opponent and it was a great 24 rounds. Unbelievable 24 rounds in my career. Thank you so much,” Usyk said.

Daniel Dubois, the IBF heavyweight title holder, was quick to call for a fight with Usyk following the result.

“I want my revenge,” he told Usyk directly. “Let’s go.”

Oleksandr Usyk and Tyson Fury stare at each other for 11 minutes
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Usyk and Fury stared at each other for 11 minutes ahead of the fight

Dubois, 27, defended the IBF belt with a fifth-round knockout of fellow British rival 34-year-old Anthony Joshua in October.

He faces Joseph Parker on 22 February and the Usyk win could set up a future fight to unify all of the titles.

Ahead of the bout, Usyk and Fury engaged in a stare-down for more than 11 minutes in a head-to-head press conference on Thursday.

Fury weighed in at a career-high 20 stones 1lbs, while Usyk weighed 16 stones 2lb, the heaviest he has recorded, although both men were fully clothed when they stepped on the scales.

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Princess of Wales asked Lady Gabriella Windsor to help with Christmas carol service

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Princess of Wales asked Lady Gabriella Windsor to help with Christmas carol service

It’s been revealed that the Princess of Wales asked Lady Gabriella Windsor, whose husband died earlier this year, for her help to plan her annual carol service.

During the summer, Kate invited Lady Gabriella, the daughter of Prince and Princess Michael of Kent, to join her team organising her annual Together at Christmas event at Westminster Abbey.

The heart-warming gesture was very much in tune with the overall theme of the service, recognising those who have shown love, kindness and empathy to others in their communities.

Speaking of Lady Gabriella’s reaction, a friend said she felt “honoured” and “very touched and grateful to the princess to be asked to contribute to her very special concert”.

The Princess of Wales arrives for the Together At Christmas carol service at Westminster Abbey in London. Picture date: Friday December 6, 2024.
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The Princess of Wales arriving for the carol service earlier this month. Pic: PA

Kate is understood to have been incredibly grateful for her contribution.

Lady Gabriella’s husband, financier Thomas Kingston, died on 25 February from a head injury and a gun was found near his body at his parents’ home in the Cotswolds.

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Kate Middleton hosts Christmas carol service

In October a coroner concluded he took his own life and during the inquest his widow warned about the effects of drugs used to treat mental health problems after the hearing was told Mr Kingston was prescribed drugs following complaints of trouble sleeping following stress at work.

Lady Gabriella, also known as Ella to her friends, supported Kate and played an advisory role with the organising team around the music performances that featured during the service.

The carol service took place on 6 December, with Kate joined by Prince William and their three children Prince George, Princess Charlotte, and Prince Louis, who all held candles during the service, as did the other guests in the congregation.

The service, shown on television on Christmas Eve, will start with a recorded voiceover from the Princess, featuring extracts from a letter given out alongside this year’s order of service.

She will say: “The Christmas story encourages us to consider the experiences and feelings of others.

“It also reflects our own vulnerabilities and reminds us of the importance of giving and receiving empathy, as well as just how much we need each other in spite of our differences.

“Above all else, it encourages us to turn to love, not fear. The love that we show ourselves and the love we show others.

“Love that listens with empathy, love that is kind and understanding, love that is forgiving, and love that brings joy and hope.”

Read more:
William and Kate to launch mental health programme

Prince William praises ‘amazing’ Kate

Olympic cycling champion Sir Chris Hoy, who is terminally ill with prostate cancer, lit a candle, as did Lindsey Burrow, the wife of former rugby league star Rob Burrow who died in June following a much-publicised battle with motor neurone disease.

Readings were given by Prince William and actors Richard E Grant, Michelle Dockery, Sophie Okonedo, and Olympic swimming gold medallist Adam Peaty.

The service will be broadcast as part of the programme Royal Carols: Together At Christmas, screened on ITV1 and ITVX on Christmas Eve, and will also feature three films about people and organisations who have inspired, counselled and comforted others in their times of need.

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‘I walk into a room and people start coughing’: Rare condition makes people allergic to sufferers

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'I walk into a room and people start coughing': Rare condition makes people allergic to sufferers

On rare occasions that Medinah leaves her home, people around her will cough, sneeze and rub their eyes.

“I am the allergen,” the 23-year-old, who did not want her full name used, tells Sky News.

She is one of a group of people with a condition so rare it does not have an official medical name.

It is known simply as People Allergic To Me – often shortened to PATM.

Medinah spent a year online searching her symptoms before she found social media support groups and the name that had been coined there.

During those months, she worried she was “crazy”: “I thought, yes, I’m losing it now. But then after a year and the constant reactions with people, I just realised this cannot be in my head, I can’t be crazy, I’m seeing this in real time.”

Hay fever-type symptoms

Several of the people in those groups spoke to Sky News. They described people developing hay fever-type symptoms in their presence, saying as much as 90% of a room would start coughing, choking, or sneezing when they entered.

They detailed the immense toll of isolating themselves to avoid these reactions. Some said they had been suicidal; others talked of losing friends, giving up jobs, and spending hundreds of pounds on possible remedies.

Last year, PATM sufferers had a glimmer of hope. A researcher in Japan published the first cohort study on the condition – and it indicated there could be a physical cause.

Medinah for PATM feature
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Medinah has suffered from People Allergic To Me since 2020

Speaking to Sky News from Tokyo, Professor Yoshika Sekine from Tokai University describes what he found when he compared the skin gases emitted by 20 people with PATM to a control group of 24.

He discovered the PATM group had “very specific characteristic skin gas patterns”, giving off higher levels of certain chemicals that are known to provoke respiratory symptoms in people exposed to them.

One of them, toluene, is used in the manufacture of explosives, paints and plastics and as a solvent in some types of paint thinner and glue. It can cause irritation to the eyes, nose, throat and respiratory tract, according to Public Health England – and people with PATM emitted 39 times more of it than the control group.

The other chemicals Prof Sekine identified as being particularly important are sulphur compounds, which have a “very strong, pungent odour” and hexanol, which has a hay-like smell.

These chemicals are known to trigger respiratory symptoms and skin irritation and are both linked to sick building syndrome, a condition recognised by the World Health Organisation where people are made ill by the building in which they live or work.

The study concluded: “We must carefully consider the possibility that the chemicals emitted by the PATM group may induce chemical intolerance in those around them.”

‘You feel you don’t have the right to live’

It’s been about 18 months since Fahima started noticing reactions from people around her.

“Wherever I go, if I go into a shop, if I’m out, if I walk past someone, people will sneeze and hysterically cough,” she tells Sky News.

In that time, she’s shifted to working entirely from home. She has stopped attending her nine-year-old son’s school plays because “I don’t want to impact the children”.

She shops in the early, quiet hours. The school run is the only time she regularly leaves the house.

“From the minute I wake up, the first thought is, how are people going to react to me today? I have to minimise myself so that I don’t impact other people.”

She says she also gives off an odour that developed from sweat to fish and then faeces.

There is a medically recognised condition called trimethylaminuria (TMAU) – sometimes called “fish odour syndrome” for the smell sufferers emit – that is sometimes grouped together with PATM.

However, there are PATM sufferers who say their symptoms are not accompanied by any discernible smell.

Dr Robin Lachmann, one of the country’s leading doctors specialising in TMAU, tells Sky News that unlike PATM, TMAU is a condition “which we understand well and can treat”.

A key difference is that while people around the patient may find the odour unpleasant, “these responses aren’t allergic”.

Fahima took a test for TMAU which came back negative – but even getting the test took a year of “legwork” on her part, she says.

“With PATM, doctors say even if you want to get tested, there’s no diagnosis. There’s no way to treat it.”

The reactions Fahima gets aren’t just involuntary coughs and sneezes, she says, but insults and abuse.

“You know what? I don’t blame people. Especially the people that are having allergic reactions to us, we’re physically making them sick, so I don’t expect them to have any other reaction.”

But it’s “draining”, she says, and makes her “incredibly depressed”.

“It makes you feel like you don’t have the right to live, almost. Because why should you be in a place making someone else feel uncomfortable?”

Anonymous woman at the window. Pic: iStock
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Sufferers describe isolating themselves to avoid reactions from other people. Pic: iStock

Fahima says the allergic reactions vary depending on her diet. If she eats a lot of sugar, meat or carbohydrates, the following day she will notice a lot of people sneezing.

Her son mostly doesn’t react to her, she says, but when she eats meat his reactions are so severe she will give him an antihistamine.

Prof Sekine says while skin gases are typically influenced by diet, he hasn’t yet been able to find a link for PATM. But he has spoken to people who have improved their symptoms by cutting out dairy, increasing their intake of antioxidants and working on boosting good gut bacteria.

He also suggests why not everyone reacts to people with PATM. He says it could be to do with sensitivity to chemicals, with some people affected by very low doses in the air around them.

Just as not everyone suffers from hay fever when there’s a high pollen count, not everyone will be sensitive to the higher chemicals in the skin gases of PATM patients.

‘It’s all in your head’

The PATM sufferers who spoke to Sky News invariably said they had been told the condition was “all in their head”.

There is a recognised psychological condition that bears similarities to PATM called Olfactory Reference Disorder, or ORD.

People with ORD are preoccupied with the belief they are giving off a bad smell despite there being no odour, explains Professor David Veale, a consultant psychiatrist at the Nightingale Hospital.

It can have a “devastating” impact on peoples’ lives as they dedicate their energy to tackling the perceived problem and avoid social situations out of fear of being “shamed, humiliated, rejected”, he says.

“They are very stressed and very disabled by it. But no one can convince them that they can’t smell them. They think they’re just saying that to be nice.”

Prof Veale says the difference between PATM and ORD appears to be that ORD patients are preoccupied with their perceptions of what other people think about an imagined smell, while PATM sufferers perceive physical reactions in other people.

Prof Sekine also identifies this difference in his research, concluding PATM is unique “in that it affects the people around them, at least based on descriptions by people with PATM”.

Woman sneezing in an office. Pic: iStock
Image:
File pic: iStock

Sandra, who did not want to use her real name, says she seriously considered whether her condition could “be in my head” after her doctor suggested she had ORD.

“I’d had too many incidents happen for that to be true,” she says.

“I was even bullied at work about it in one job.”

Almost 60, Sandra has lived with the condition for 15 years. She says she used to have a good career, but no longer works “partly due to the stress and anxiety that this causes”.

Her first sign of PATM came when she returned to work after a bout of sickness and her boss had a “sneezing fit” every time he came into her office.

A deep clean didn’t sort what she thought was a dust issue – and then she noticed other colleagues reacting in the same way, then friends and even her husband.

“Eventually it occurred to me that it must be me causing this, which filled me with horror,” she says.

“When the reactions are at their worst, I have a similar reaction myself, that is I become allergic to myself.

“I have other symptoms like a bad taste in my mouth, itchy throat, itchy skin with a mild rash on my abdomen and spiking mild temperature.”

But making others react is the worst part: “It makes me feel dreadfully guilty to be causing all of this and I have severe anxiety and depression as a result.”

Alex’s 24-year-old brother Miguel first noticed PATM symptoms about 10 years ago, but didn’t tell his family until he was 19.

Many people with PATM say close relatives do not get symptoms, and Alex does not notice himself reacting to his brother.

He says it’s also hard to say whether more people cough and sneeze around his brother because it’s such a commonplace thing – but Miguel will notice every cough or nose scratch, and someone having a coughing fit can be enough to make him stay in his room for days.

Alex recalls being at a restaurant with their grandparents when Miguel first told them about the condition, and his grandmother agreed she could hear people “just constantly coughing in the restaurant”.

“That seemed like an increase to what’s normal. But then how do you know what normal is if you’re not paying attention to it?”

PATM is easy to write off as “just” psychological because “it sounds ridiculous”, Alex says, but his first concern when his brother opened up about the condition was to find a way to cope with the impact on his mental health.

“That’s the important thing – and then it doesn’t matter whether it’s real or not.”

What causes PATM?

The cause of PATM is a puzzle to sufferers and researchers alike. Some people say their symptoms started during a time when they were eating a lot of fast food or experiencing high stress.

Sufferers trade theories about possible triggers: a disrupted gut microbiome, fungal infections, sinus problems.

“You’re like your own doctor, your own medical team,” Medinah says. “I literally stay up all night researching.”

Sandra and another person who spoke to Sky News found their PATM flared after a course of antibiotics, while others described developing skin issues before other symptoms.

MEBO Research, a small collective of researchers investigating rare genetic metabolic diseases, has conducted exploratory studies of PATM without being able to pinpoint a cause beyond an apparent issue with the body’s “detoxification process”.

Mehmet Ali, MEBO’s director of community outreach and strategy, tells Sky News PATM needs attention and research from the medical community.

Prof Sekine’s research also did not identify a cause – although it is his goal to find it. “I would like to define the criteria for what PATM is, and what it is not. This is a very difficult point,” he says.

Without even a criteria of what PATM is, there is no formal diagnosis. NHS England told Sky News it follows NICE guidelines, and there are none for PATM.

A spokesperson for NICE said it “can only look at treatments that are licensed by the UK regulators… If they have not been licensed for PATM, we cannot recommend them for the condition”.

But finding a treatment seems a distant dream to sufferers who share remedies on Facebook and Reddit: supplements of every variety, antibiotics, digestive enzymes, probiotics, herbal treatments.

Sufferers go to extreme lengths in search of solutions. Fasts; eliminating sugar, gluten and dairy; raw veganism and its opposite, the “carnivore diet” – essentially just eating meat, eggs and dairy.

But what might grant one person temporary relief doesn’t necessarily work for someone else.

Sandra sees no end to her 15 years of misery: “We are all just waiting for a cure with our lives in effect on hold but I’m nearly 60 now and not confident it will happen in my lifetime.”

‘It crushes you like nothing has crushed you before’

Amir, who did not want to use his real name, says without family relying on him “I wouldn’t be here, that’s how bad I feel sometimes”.

He describes a life that has become “really, really unbearable”. He says he has lost all his friends “because they can’t be in the same areas as me” and even avoids the mosque.

“I do an experiment – I stay out of the room to see if anyone is coughing, then go in the room for a few minutes. The majority of people will start reacting.”

Not everyone with PATM who spoke to Sky News isolates themselves. Some hold down jobs and socialise – but none seem immune to the mental health impacts of the condition.

They describe the loneliness of not just being physically isolated, but of being misunderstood by doctors, friends and family; the guilt of feeling you’re making another person ill; the despair of there being no treatment or cure.

Medinah describes her mental health as “shattered, it’s non-existent”.

“In the beginning it crushes you, it crushes you in a way that nothing has ever crushed you before.”

She says she quit her job as a teaching assistant because she was getting “aggressive” reactions, and now life is at a “complete stop”.

She gets emotional talking about the future: “I don’t feel excited at all. I don’t even like to think about it. The reality is so sad. I can’t even go to the local park, I can’t do anything.”

Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.

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