Food Sensitivities, Intolerances & Allergies
By now, the term, “food sensitivity,” is one most of us know. Perhaps your friend (or you) says things like, “I think I’m sensitive to ____.” Today we clear the air on what “food sensitivity” means, and run through the different ways to test for reactions.
Topics like this get complicated, so we divided the article into “Basics” and “For the Geeks” sections. You choose how science-y you want to go.
The intestines make up a large portion of the body’s immune system (1). Therefore, the food we consume impacts that immune system. Think of this like a campfire. Food you eat either keeps the flame out, keeps it low, or flares it like a giant fire. The 131 Method makes recommendations to identify and reduce inflammatory foods with a goal of reducing inflammation (these pretend flames). Even low level flames cause harm when present for a long time. We call that “smoldering” or chronic inflammation. Over time, that’s a big problem. It not only contributes to weight loss resistance, but a number of other symptoms and diseases (1-2).
So, there is a difference between food allergies, intolerances and sensitivities. In this article, we discuss food sensitivities. Additional details on these differences can be found in the “For the Geeks” section below.
The least expensive way to test for food sensitivities is an elimination diet. This is when you remove inflammatory foods and reintroduce them to monitor symptoms. These symptoms go far beyond digestive discomfort. They include: headaches, skin rashes, sinus congestion, fatigue, etc.
FOR THE GEEKS
How food and our immune system talk:
The intestines host over half the body’s immune system, which recognizes and destroys foreign invaders (1). These invaders include: harmful bacteria, parasites, viruses and fungi. When stimulated, the immune system defends against these things.
Food contains proteins that can trigger the immune system the same way. The body sometimes mistakes food for an invader. The barrier that lines the intestine for protection, known as the mucosal barrier, is only one cell layer thick. And if compromised, the gut is more likely to mistake food proteins as harmful “invaders,” resulting in a food reaction.
Classes of food reactions:
There are three different classes of adverse food reactions: allergies, intolerances and sensitivities. These are three very different things that require differentiating. An intolerance means digestive insufficiencies, like an enzyme deficiency. Food allergies and sensitivities both involve the immune system.
- Food intolerance: An inability to properly digest a food due to lack of enzymes. Typical symptoms are digestive in nature: bloating, diarrhea, etc. Example: lactose intolerance (lack of sufficient lactase enzyme).
- Food allergy: An immune-mediated response that triggers IgE antibodies. There are different severities of allergies, so not all cause anaphylaxis, or closing of the throat. Typical symptoms arrive immediately or within 30 minutes and include: hives, swelling, itchiness and anaphylaxis. Example: peanut allergy.
- Food sensitivity: Immune-mediated response resulting in a low-grade, systemic inflammatory response. Food sensitivities manifest from multiple pathways. As many as 100 different mediators could be involved. They include mechanisms of IgA, IgG, IgM, T cells, etc. and appear immediately after food consumption, or up to three days after. Symptoms include: water retention, digestive issues, sinus congestion, migraines/headaches, stubborn weight loss, hormonal symptoms, low energy, chronic runny nose, etc. Like food allergies, food sensitivities can be dose dependent. A small amount of a food might not cause issues, while larger amounts trigger a reaction.
IgG and IgA in a bit more detail:
IgG: antibodies attach themselves to the food proteins that cross the gut barrier and create a cascade of events that release various inflammatory markers in different tissues. This leads to symptoms like joint pain, headaches and fatigue.
IgA: commonly called, “the first line of defense,” against microorganisms and pathogens. Most of this antibody is produced in the intestine, and when these antibodies bind to food in the intestines, they prevent those “invaders” from being absorbed. This diverts attention from fighting off bacteria, leading to bacteria dysbiosis.
Simmer Down Now
When you have food sensitivities, your body “simmers” with chronic, low-grade inflammation. This stands in the way of optimal functioning and health. Think of it like a little campfire burning for years, until one day, huge flames erupt and someone rushes to help. Little did they know, the process started years ago.
Gut health becomes compromised when the body uses its resources to calm inflammation. Since symptoms present anytime within a 72-hour window, and most people consume hundreds of food ingredients daily, it makes identifying sensitivities difficult. If you suffer from chronic inflammatory symptoms, food sensitivities might be to blame. Fortunately, tests exist to help expedite identification.
Identifying food sensitivities:
Gut issues and food sensitivities go together like peanut butter and jelly; where you have gut issues, sensitivities follow. Unfortunately, sensitivities also shift with gut permeability. Testing is a useful tool with accurate and properly applied evidence. But it can also be dangerous to eliminate foods indefinitely without doing some gut healing first. And, your gut changes EVERY MONTH! Which means your sensitivities can change as often! This test is now the gold-standard for home-testing. They designed it so you can identify issues, make changes, and re-test.
Food sensitivity testing:
Before we dive into tests, keep in mind the information provided in the 131 Method starts this process inexpensively. An “Elimination Diet” provides information for free. The process simply involves removing certain foods for a period of time (ideally 2-3 weeks) and intentionally reintroducing them and monitoring any reactions.
There is no “perfect” test. If there were, every health care provider would be using it and seeing amazing results with any client. The biggest benefit to a good test is the interpretation of results and recommended protocol. Not all tests and facilities are created equal. While that may be frustrating for some, science and technology continue to advance, which provides us with more tools and answers.
- Skin or scratch tests are commonly used and considered the gold standard for inhalant allergies. However, they are only about 50% accurate for food allergies. Some allergists won’t do allergy testing on very young children due to a changing immune system. A blood test measures the quantity of IgE (the more IgE produced the more intense the symptoms) and has a better accuracy rate for food allergies. Neither measures for chemical issues.
- The gold standard for food allergies is the “oral challenge” (an elemental diet for a few days and then introduce the suspicious food). Hospital conduct these due to liabilities. As a result, the cost is prohibitively expensive.
- While no test ever reveals all of your sensitivities–the average grocery store has 70,000 ingredients–many types of sensitivity tests exist. But some only measure the presence of one mechanism, IgG, or use 16s technology. Others test many mediators to foods. Some look at chemicals (natural and synthetic). Others only look at foods. Many are inaccurate. Before deciding- READ THIS!
- Sensitivities should not necessarily be treated like allergies, unless you desire a limited diet forever. Treating sensitivities like allergies, and opting for avoidance without healing, perpetuates the problem.
How to get tested?
Many integrative physicians, Registered Dietitians (RDs) or other providers work with food sensitivity testing. Search for a Medical Doctor, Osteopathic Doctor, Naturopathic Doctor, Physician Assistant, Registered Dietitian or Nurse Practitioner in your area to get testing through them. Some practitioners sell lab kits through their websites and provide virtual counseling.
Lastly, you can order testing directly through some of the companies listed above. However, prices are higher through a practitioner. You need to know how to interpret and safely implement any results. Many companies now send the tests directly through the mail. Viome is a brand we use and like.
- Search “Certified LEAP Therapist” + your city
- Lewis, Charles. CreateSpace Independent Publishing Platform; 3 edition. Enteroimmunology: A Guide to the Prevention and Treatment of Chronic Inflammatory Disease. March 2013.