Food Sensitivity Test
Table of Contents:
Food Sensitivity Test: Testing
Foods can illicit immediate and delayed hypersensitivity reactions. Immediate hypersensitivity reactions involve IgA and IgE. Delayed reactions involve IgG. Now, if someone wants to start a heated conversation with a more traditional Western allopathic doctor, just mention IgG food testing. This is despite much experience in actual clinical practice that this is of value, as well as studies backing up this form of testing and the profound impact on the gut when these foods are eliminated. One such study was published in the British Medical Journal Open Gastroenterology in 2017.124 This looked at IgG testing and irritable bowel syndrome (IBS) patients. By eliminating foods identified on IgG testing as being problematic, this notoriously hard-to-treat group of patients was substantially better after only 4 weeks and profoundly better at 8 weeks. No other changes were made other than just to stop eating a few foods which tested positive on a simple IgG test.124 Immediate hypersensitivity reactions tend to happen fast and dramatically enough that people can figure out the food they are sensitive to. If a child eats a peanut and they have to go to the emergency room due to throat tightness, they should not eat peanuts. This is an IgE immediate hypersensitivity reaction.125 If someone drinks milk or eats ice cream and within 10 minutes, they are bloated and gassy and have diarrhea, it is obvious that this person has a cow’s milk dairy immediate hypersensitivity reaction. This is an IgA reaction.126 These are the only type of food reactions that are usually tested for and include skin prick testing or blood testing. IgE and IgA testing can be relatively inaccurate at times.127128 The tests may say a specific food result is negative, but the person has a bad reaction every time they eat it. Or the test is positive, but the food doesn’t cause any immediate reactions after the person eats it. Typically, the patient can do a good job at determining what foods bother them immediately and which ones do not, compared with this type of traditional testing.
Now, foods can also bother us several days or even 3 to 4 weeks after we consume them. These are known as delayed hypersensitivity reactions or IgG reactions.129*130 These IgG reactions do not cause the dramatic “hit” that the immediate hypersensitivity reactions do. They are not going to send someone to the hospital like an immediate hypersensitivity reaction to peanuts for example. Instead, they tend to create a scenario where the person says “I have all this chronic, smoldering inflammation, crud, just driving my body crazy in so many ways. I do not know what is causing this, but I don’t think it is what I am eating. I can actually go a couple weeks without eating a certain food and I don’t feel any better. I then eat this food and it doesn’t make me feel sick right away. So, I don’t think that this food is bothering me.” The problem is, by the time they say this, they still haven’t gotten “hit” from the last time they ate this food, let alone cleaned up all that chronic, smoldering inflammation, crud that has been going on for years if not decades by now. This is why testing can be so important.
Perhaps the debate on this one will go the way of the “no way an infection can cause stomach ulcers” debate. We now don’t think twice about the concept and test for and treat an H. pylori bacterial infection of the stomach that causes stomach ulcers all the time. Or the “leaky gut” debate that has morphed into “intestinal permeability disorder,” despite all the data on disruption of the intestinal tight junctions and its negative impact not only on gut function but chronic disease in general. There are different companies that provide IgG testing kits. Some kits test for more foods than others. Some testing companies can test up to 500 different foods. In our office, we most often use ones that will test for 96 different foods, grading each food 0-4. These tests provide qualitative measurements of allergenic foods and their degree of severity.
Now with AD, everyone with any autoimmune process for sure will have a delayed hypersensitivity reaction to wheat/gluten proteins and cow’s milk dairy proteins.131 Everyone. No exceptions. These two always need to be eliminated from the diet even if they do not show up as positive on testing.
Food Sensitivity Test: Assessment
The food sensitivity test that I tend to run is one that assesses 96 different foods for an IgG reaction that the foods produce which is the delayed hypersensitivity reaction (Figure 6.11). Each food is graded from 0 to VI. The foods of concern, which need to be eliminated, are the ones graded I to VI. Zeros are zeros. Typically, the problematic foods need to be eliminated for at least 4 to 6 weeks since the half-life of IgG is 21 days.
So much needs to happen to heal the gut once it has been so disrupted that it now sees certain foods as its “enemy,” and just eliminating the food for a while is not enough. Celiac is an AD that attacks the small intestine and tends to not only produce abdominal pain and other gut symptoms but also diffuse systemic dysfunction including pain in general.33 As mentioned previously, having all sorts of systemic symptoms, including pain with minimal or no gut symptoms, occurs in eight out of ten celiac patients.33 This is one reason four out of five celiac people are never diagnosed but also a great example of what a central mechanism the gut is.33 Simply eliminating gluten from oral consumption does not allow the gut and immune system to reset, and these patients at times continue to develop new ADs and chronic diseases in general. These include type 1 diabetes, multiple sclerosis, anemia, osteoporosis, infertility, miscarriage, seizures, migraines, intestinal cancers, and dermatitis herpetiformis.33
There are also tests that can look at up to 500 different foods. The detail achieved with these tests is amazing. Testing will include things like white pepper, black pepper, sage, oregano, and MSG. When someone sees this kind of detail they may ask “the body really can tell the difference between white pepper and black pepper?” Yes, the body can tell the difference between the proteins in white pepper and black pepper. White pepper may be totally fine while black pepper creates a response. Many people can have sensitivities to foods not included on the 96-foods test. The thing is, most of the self-correcting when we address central mechanisms is done by the body itself. We just want to put the body in a position to be able to start fixing problems on its own. Most of the time people are going to self-correct and clear food sensitivities even if we do not know exactly all that are involved. People of course need to eliminate any foods that produce an immediate hypersensitivity reaction as well.132-138
FIGURE 6.11 Food sensitivity test.
Food Sensitivity Test: Treatment
Every person with an AD has a delayed hypersensitivity food reaction to gluten/wheat and cow’s milk dairy proteins.131
I will typically ask a person with chronic pain along with AD to avoid wheat/gluten and cow’s milk dairy products to start with if they have not tried this for at least 4 weeks already. If these are the only two foods bothering them, by the 8-week follow-up office visit, they should feel much improved. If they do not, then other foods are most likely problematic as well. Food sensitivity testing needs to be done and the identified foods eliminated.
After the person’s pain and multi-organ system issues are a lot better, there is a good possibility that they have reset the food sensitivities. Now food challenges can be done. This is done by having the patient eat the food being tested two times a day for 3 days straight and then wait the rest of the week. If everything feels just fine, then they have reset the food and can eat it as much as they want. If they feel poorly in any way, such as increased pain or brain fog, stomach issues, or fatigue, etc., they have not reset the food yet and they need to take it out again. They may repeat the food challenge with this food again in 3 to 6 months to see if it has reset by that time. If they still feel badly with a food challenge, they can re-test every 3 to 6 months as often as they want in the hopes of resetting the food eventually. It may take several challenges before someone resets a food or, potentially, they may never reset certain foods despite their best efforts. The reason only one food is tested per week is that we are testing delayed hypersensitivity reactions. Usually people feel poorly if they have not reset a certain food by day 1, 2, or 3. But at times they may only start to feel poorly on days 4 to 7.
A person should keep a diary of the date and the food being tested as well as any reactions they experience.
With AD patients though, they will never fully reset wheat/gluten proteins. These will always need to be avoided if they are to maintain optimal control over the chronic pain and immune system dysregulation.131 The body actually attacking itself is like going off a cliff. You’ll never fully recover from that. But over time, many people will lose much of their sensitivity and they can “cheat,” three to four times a year, and only experience mild symptoms of intolerance, rather than the typically severe reactions to these offending foods they experienced early on.