One of the most common questions I get asked is: how did you find out what foods you’re sensitive to? When my body started really crashing last fall, I eliminated some of the better known gut irritants such as dairy, gluten, corn and soy but I wasn’t rigid about it. When I began working with Rob I then did IgG testing, and he also eliminated foods that he suspected were causing various reactions even though they didn’t necessarily show up on my test. Because this is a pretty technical (and controversial) subject, I’m going to let him do all the explaining!
Food Allergies vs. Food Sensitivity
There is so much confusion on the topic of food allergies. Some health practitioners poo poo sensitivity testing whereas others praise the food sensitivity testing. People interchange allergy and sensitivity as if they are the same. But they’re not. The definition of these terms is different and it’s important to make a distinction between the two.
A lesson in Immune System 101 is necessary before delving into the differences between allergy and sensitivity. The immune system of the body is similar to the 5 branches of the military we have the Army, Navy, Marine Corps, Coast Guard and Air Force. Immunoglobulin antibodies are the “armed forces” of our body. They identify the bad guys (bacteria and viruses) for the immune system to attack and get rid of.
There are several types of antibodies of the armed forces: IgE, IgA, IgG and IgM. You can think of IgE as the Navy Seals of our immune system. IgE are small in number but strike quickly and precisely. Think of Will Smith in the movie, Hitch. Remember when his face blows up after eating sea food?! That’s a true food allergy. It happens within minutes.
If a doctor suspects you have an allergy, you’ll be referred to an immunologist who will test for food allergies via blood work. The blood work tests for elevated levels of food specific IgE antibodies which can cause an allergic reaction to foods. Technically, it’s a food-triggered basophil or mast cell histamine release (1). This is why Hitch was guzzling a bottle of Benadryl to lower the histamine response. Most people know if they’re allergic to a certain type of food because the allergic response is severe and fast.
So, what about a person who does NOT react to foods rapidly and severely? Some people react to certain foods but have no idea which ones or aren’t even aware they have an sensitivity. A food sensitivity is a delayed reaction of the immune system. It’s an immune complex triggered antibody-antigen complex (1). Food sensitivity panels screen for antibodies. This is the person who has milk and has no immediate reaction but wakes up with a stuffy nose.
IgA is the first line of defense against invaders. More specifically, secretory IgA (SIgA) forms immune complexes with invaders (i.e. parasites, bacteria, virus, yeast) to prevent them from penetrating the intestinal mucosa (2). However, if the body starts tagging food allergens (invaders) you eat at every meal, this can create inflammation and immune imbalances.
Food sensitivities can be a bit tricky.
For instance, a women may be tested for food sensitivities but the test results come back negative. She is certain she reacts to dairy, yet the test is negative. What’s going on? Often times, the test is negative for a food because of low SIgA levels. Low SIgA levels means the immune system defenses are down. SIgA levels have a very intimate relationship to cortisol, the stress hormone.
Stress can come in many forms:
- Your boyfriend is a jerk
- You just broke up
- Your job is crazy and you get no sleep
- You had a death in the family
- You can’t survive a day without 5 cups of coffee
- You exercise like crazy (yes you can workout too much!)
Does this sound like you? Cortisol is released to handle these stressors. Your body can handle 1 or 2 of these stressors at a time. But many women have all of these stressors at the same time! The consequence of chronically high cortisol levels is a suppression of SIgA levels.
Remember SIgA is your radar system to identify invaders. Since SIgA levels are low, you’re immune system becomes fatigued and can’t recognize invaders (i.e food allergens). Therefore food sensitivity tests will be negative.
To make matters worse, high cortisol levels inflame the small intestine. This irritates the tight junctions of the small intestine and create tiny little holes aka “leaky gut”. This allows pathogens and/or large food molecules to sneak into the sterile blood stream. This is a massive stressor to the body. The body should be releasing SIgA to handle these invaders but it can’t because SIgA levels are suppressed by high stress. It becomes a viscious cycle of leaky gut which allows undigested food particles to go unchecked into the blood stream and leads to multiple food sensitivities.
Before we had all of these fancy blood tests, the true gold standard for determining food sensitivities was a good old elimination/provocation diet (3). Most people consume the same 10-12 foods on a daily basis. If your not sure where to start, ELIMINATE THE BIG 6:
- Legumes (yes this includes peanuts).
Eliminate these foods for a minimum of 60 days. Most of these foods have the capacity to create inflammation in the small intestine. Eliminating foods will reduce inflammation and reduce the load on the immune system. It takes time for the mucosa to heal so be patient.
As a health practitioner, I may use a food sensitivity panel to help with recommendations for a client. However, food sensitivity testing is not 100% fool proof especially if high stress is affecting the outcome of the food sensitivity panel. It’s a tool. It’s not the end all be all for solving a person’s digestive issues. Eliminating food sensitivities is PART of the process. It’s only a few that notice immediate results when eliminating these foods.
If you eliminate the BIG 6 and have marginal results, an Adrenal Stress Index (ASI) test and/or Gastrointestinal Health Panel (GHP) may be necessary. There’s an underlying issue contributing to your digestive and hormonal imbalance. Further
investigation is required to resolve your health issues. If you’re interested in an ASI or GHP, we can test and consult remotely. You can contact my office firstname.lastname@example.org
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- Lord RS, Bralley JA. (2008). Laboratory Evaluations For Integrative And Functional Medicine. Duluth, Georgia: Metametrix Institute.
- Brandtzaeg P, Bjerke K, Kett K, Kvale D, Rognum TO, Scott H, Solid LM, Valnes K. (1987). Production and secretion of immunoglobulins in the gastrointestinal tract. Ann Allergy;59(5 Pt 2):21-39.
- Wood RA. (2015). Diagnostic elimination diets and oral food provocation. Chem Immune Allergy;101-87-95.