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Overview: – Definitions, differences – the science behind (immune system) – Signs & Symptoms of each – Identifying and treating each (including traditional vs. newer functional testing options) – Root causes of each & all – Dr. Noosha’s approach

These terms are similar, but biochemically very different processes that occur in the body. You may be seeing a lot of new information out there in terms of allergy & sensitivity testing. It’s important to understand the basics to make the best decision for your health goals.

There is so much controversy out there about food sensitivity testing (keep in mind this is different than food allergy testing). I have mixed feelings about running a food sensitivity test and in this blog post I will do my best to explain why! That being said – I believe there is a time and place [where if you don’t mind spending an extra $400 can drastically make your life easier in the short term aka immediate 3-6 months] but in the end I’m interested in healing the root cause of your allergies which is often a leaky gut which leads to having an overactive immune response and chronic inflammation. Over time, if your body’s drainage & detox pathways are not open, you will accumulate a buildup of all sorts of toxins. This is where naturopathic medicine shines because we are trained to create individualized lifestyle protocols specific for you!

If you really want to run one of course I am more than happy to do that but regardless we will move, you through an elimination diet/reintroduction 3–6-month program. For those who don’t feel like spending another $400 on testing and are interested in getting to the root of their symptoms, I like to skip this test and going straight to a stool analysis and healing the gut microbiome via the 5 R framework which you can read about in another blog.

Keep reading if you suffer from any of these issues:

  • GI issues: abdominal pain, diarrhea, constipation, gas/bloating, nausea
  • Have been diagnosed with IBS, SIBO, leaky gut, any type of chronic unresolve infection, mole exposure/sensitivity
  • Allergy & sinus symptoms (a sign of dysregulated immune response): headaches, runny nose, itchy eyes/ears/throat, rashes, hives, seasonal allergies, hay fever

LETS DIVE IN:

The term “food hypersensitivity” refers to food allergies, sensitivities & food intolerances. Let’s start by defining these 3 seemingly similar terms and break them down so that we can better understand the testing options out there and what path may be the best for us.

Root causes associated with all:

  • genetics/enzyme deficiencies
  • lack of digestive enzymes and/or HCL
  • underlying infection
  • imbalanced microbiome
  • poor gut health: leaky gut, candida, parasites, SIBO
  • It’s also important to remember food sensitivities can perpetuate poor gut health by preventing healing of your gut lining

 

Food allergy (think IgE antibodies) involves a more systemic response and directly results from activation of your immune system; tends to be the most serious of the 3 and causes symptoms such wheezing or swelling of the lips, face, and eyes.

Common food allergens:

  • Milk, eggs, peanuts, soy, wheat, tree nuts, fish, shellfish

Testing for food allergies: a blood test or finger prick can measure your immune system’s response to foods. This can be done by your general primary care practitioner (PCP), or they may send you to a traditional allergist!

Symptoms of IgE mediated food allergies:

  • Skin: “hives” (red blotches or welts that itch), mild to severe swelling.
  • Eyes: tearing, redness, itch.
  • Nose: clear discharge, itch, congestion.
  • Mouth: itch, lip swelling, tongue swelling.
  • Throat: tightness, trouble speaking, trouble inhaling.

More serious signs & symptoms of an allergic reaction include the following and may require epipen or immediate transport/treatment in hospital:

  • skin rash that may include itchy, red, swollen, blistered or peeling skin
  • wheezing
  • tightness in the chest or throat
  • trouble breathing or talking
  • mouth, face, lips, tongue or throat start swelling

IgE mediated & non IgE mediated allergic reactions: 2 subtypes of food allergy reactions.

  • IgE-mediated reactions typically occur immediately after ingestion whereas non-IgE mediated are delayed and take up to 48 hours to develop, but still involve the immune system (unlike the other two terms we still have to define).
  • What is IgE? I’m glad you asked  Let’s dive into the science (skip this part if you’re not interested!)
    • Ig stands for, Immuno – Globulins, also called antibodies. An antibody is a large Y shaped protein made by specific white blood cells & used by the immune system to counteract [identify and neutralize] foreign objects that the body recognizes should not be there. These “things” are called antigens and include pathogens (bad microorganisms that span the categories of bacteria, viruses, fungi/yeast, parasites/worms) and other toxins.
    • The body has 5 different types of antibodies. Each antibody has different binding sites (yay biochemistry) that matches with a specific antigen (on the bad guys). Again, skip over this next section of infographics if you’re not interested in the science!
      • IgA: primarily found in mucosal tissues (intestines, mouth & vagina + saliva, tears & breast milk). It’s one of the body’s first line defenses against infection. It prevents pathogens from sticking to the body’s tissues.
        • Having too high or too low levels of IgA can cause immune dysregulation issues. Having abnormal levels is often seen in those sensitive to a lot of allergens and those with celiac disease + other autoimmune disorders
      • IgD: less focused on, less understood antibody. Accounts for .25% of all antibodies. Apparently it does not actively circulate but instead binds to B cells and instigates the immune response in early signs of infection.
      • IgM: along with IgA, IgM is one of the first antibodies used by the immune system to fight infection. IgM is high in immediate or acute infections whereas IgG is high with chronic or past infection.
      • IgG: 75% of all antibodies. IgG can either tag a pathogen so another immune cell will recognize and deal with it OR it can activate another portion of the immune system called the “complement system” to directly destroy the microorganism.
        • note: IgG can sometimes trigger flares in people with autoimmune diseases or suffering from autoimmune reactivity (the early stages of developing autoimmunity) – causing the immune system to accidentally attack its own cells & tissue. This is why autoimmune diseases can be triggered by a simple viral infection because to your delicate immune system… it’s overwhelming.
      • IgE: is responsible for the allergic response & fighting off all types of parasites! Once activated, IgE triggers a cascade of reactions resulting in the release of mast cells, which break open and release histamine (the inflammatory compound responsible for your allergic symptoms) into the blood stream.

 

 

Now that we’ve talked about what antibodies are & different roles they each play in the immune system let’s talk about ANTIBODY TESTING.

  • Remember, this can be different from but is most similar to food allergy testing which is different from food sensitivity testing which is different from testing for specific intolerances.
  • So because antibodies (Igs) are matched to a specific pathogen, this is one method that can be used to diagnose certain diseases based on their unique structure. Antibody tests are used to help diagnose a wide variety of infectious & autoimmune diseases, including: Crohn’s Disease (IBDs), CVD19, cocksackie virus, CMV, diptheria, EBV, H. pyliori (and other bacterial infections), HIV, influenza, Lyme disease, Mumps, Mycoplasma pneumonia, Pertussis, Polio, Rubella, Tetanus, Toxoplasmosis, VZV (chicken pox virus).

 

What to remember about Antibody testing:

  • It’s important to remember antibody tests do not detect the actual pathogens, but the antibodies that your immune system has or had produced in response to the infection.
  • It’s important to remember that depending on the disease it may take time for enough antibodies to be produced to reach detectable levels. If done too soon, the test may deliver a false negative result.
  • In people with true allergies, IgE tests can be used to confirm that an allergic response has occurred where your immune system releases mast cells & histamine causing those typical symptoms

 

 

Food sensitivity (think IgG) does not involve the immune system at first. It tends to stem from the digestive system but can start to involve the immune system if left unchecked since it can lead to leaky gut, thus a leaky immune system and a whole host of chronic diseases based in inflammation

FOOD SENSITIVITIES ARE A SYMPTOM, NOT A ROOT CAUSE

  • This is the main reason why we recommend our 6 month gut healing program prior to or instead of food sensitivity testing…

 

Common food sensitivities:

  • Dairy, gluten, sugars, eggs, soy, caffeine

Root causes of food sensitivities & a leaky gut: more details in another blog.

  • Chronic stress (dysfunctional stress response – reach out if you’re interested in cortisol testing!)
  • Over exercising
  • Hypothyroidism
  • Pylori overgrowth (other bacterial overgrowths – IBS, SIBO)
  • Other pathogens & parasites
  • High histamine / toxic load
  • No or slow gallbladder
  • Low immunity (leaky immune system) due to leaky gut

 

Signs of food sensitivity in adults: same symptoms listed above

  • GI issues: abdominal pain, diarrhea, constipation, gas/bloating, nausea
  • Have been diagnosed with IBS, SIBO, leaky gut, any type of chronic unresolve infection, mole exposure/sensitivity
  • Allergy & sinus symptoms (a sign of dysregulated immune response): headaches, runny nose, itchy eyes/ears/throat, rashes, hives, seasonal allergies, hay fever

Signs of food sensitivity in kids: in another blog post.

Testing for food sensitivities: I always start with an elimination /reintroduction diet to help you identify foods that may be contributing to your symptoms.

  • There are a ton of food sensitivity tests on the market and I do use two in my practice based off the case and circumstance. I think they can be helpful while we do a 3-6 month elimination / reintroduction diet if you are extremely reactive to a whole host of foods. Speaking from experience, running a sensitivity test when I was going through my own was extremely helpful! Otherwise I’ve seen it perpetuate negative eating patterns which is something we want to avoid if not handled properly!
  • After 3-6 months of the elimination / reintroduction phase, I recommend another 6 months at least of healing the gut! Running a stool analysis here would be helpful to get to the root of leaky gut, leaky immune system and allergic type symptoms! If programs like this don’t resonate with you, you can also request a specific test and do 1:1 follow ups until you get your desired results!

Food intolerance is when you have difficulty digesting certain foods or usually due to lacking a chemical or enzyme needed to digest it. It’s not usually serious in acute situations, but eating the food you’re intolerant to can make you feel unwell and build up over time to cause leaky gut and a whole host of immune related and allergic issues. If you have an intolerance, you usually get symptoms a few hours after eating the food or ingredient you’re intolerant to.

Symptoms of food intolerances:

  • often vary and can be very similar to food allergies & sensitivities, which can make it hard for your doctor to help you determine what your body/immune system are reacting to!
  • They most often involve the digestive system, skin & respiratory systems:
    • GI symptoms: diarrhea, bloating, constipation, pain, NAUSEA (a big one for sensitivities & intolerances), GERD/REFLUX, flushing of skin
    • RASHES: and other skin symptoms (itchiness, hives, etc)
    • Other symptoms: Headaches, Fatigue, Runny nose & head/eye/ear/nose/throat symptoms
  • Symptoms can last for a few hours – days.

8 most common food intolerances: check out our Instagram page and stay tuned for another blog post deep diving into these categories.

  • DAIRY:
    • lactose (a sugar found in milk)
    • casein (a protein found in milk)
  • gluten (a protein found in grains such as wheat, casein, and barley)
  • Caffeine
  • Salicylates
  • Amines (histamines?)
  • FODMPAS
  • Sulfites
  • Fructose

 

How I approach identifying & healing food sensitivities & intolerances:

  • Chances are if you have a food allergy and you are an adult you already know this and have an epi pen on hand. If you’re concerned your child may have allergies, please talk to their pediatrician, or seek out an allergy specialist (they will test IgE antibody levels for this type of allergy which is again more serious and may be life threatening)
  • Healing food sensitivities & intolerances is an area where naturopathic medicine shines. My job is to educate you on your options and help you decide on a path that feels right for you! These are those less serious, but equally damaging reactions that occur over time and contribute to inflammation and are perpetuated by a leaky gut, imbalanced microbiome & overreactive immune system!
  • Food intolerances are commonly diagnosed by elimination diets specifically designed to narrow down offending foods. Through other functional testing methods we can also run a food sensitivity panel (1 of 2).
  • Elimination diets remove foods most commonly associated with intolerances for a period of time until symptoms subside. Foods are then reintroduced one at a time while monitoring for symptoms.
  • This type of diet helps people identify which food or foods are causing symptoms based on your individual body.
  • How I as a naturopathic doctor approach them (giving you options to choose what feels right because any and all these paths work)
    • 1) Elimination diet of the top 8 allergens (or we can work on your specific triggers that you know or we can run a food sensitivity test) for 3-6 months
    • 2) Reintroduction phase

There are 2 functional labs that I’ve taken trainings on and have experience running & analyzing which I will dive into in another post. You can book a free discovery call to inquire about specific testing and learn about the packages and programs we have to offer!

References:

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