By Jim Paoletti, B.S. Pharmacy, FAARFM, FIACP | Director of Education, Power2Practice
In this short article, I will briefly discuss the various food allergy/sensitivity testing methods, including the elimination diet, along with my suggestions for healing the damage caused by inflammation within the GI tract.
Food Allergy/Sensitivity Testing Methods
Conventional allergy testing uses radioallergosorbent (RAST) scratch testing to measure IgE directly and detects acute allergies involving only IgE antibodies.
Enzyme-linked immunoassays (ELISA) tests can better detect food sensitivities and chronic non-typical allergic responses as they measure both IgE and IgG antibodies.
ALCAT directly measures the allergic response of white blood cells to various panels of antigens and detects sensitivities that produce delayed responses. ALCAT testing can be very useful in determining food sensitivities in patients
Another method of testing for food sensitivities is the Mediator Release Test (MRT). MRT measures the mediators that white blood cells release from all immune based reactions. Dr. Mark Pasula, the inventor of both the ALCAT test and the MRT test claims that MRT is more accurate (higher sensitivity and specificity) than ALCAT.
Elimination diets are an inexpensive method, as certain foods are eliminated totally from the diet for a period of time, and then reintroduced in small amounts to see what effect it has on a patient’s symptoms. What is eliminated depends on the approach the practitioner prefers and what the patient feels they can be compliant in doing. Some practitioners have the patient eliminate the top food sensitizing groups: gluten, dairy, egg and soy. Other practitioners will start with gluten, and if symptoms do not significantly respond, then remove dairy, and then egg, and so on.
The patient may crave food that they are sensitive to. It has been suggested that the antigen for gluten or dairy may cross react with morphine-like receptors, so the food a patient is sensitive to and harming them may also be a comfort food for them. So if a patient eats a lot of or craves a certain food, it might be wise to eliminate this food first.
Patients may actually feel worse the first few days on an elimination diet. Most feel improvements in 1-2 weeks. A number of protocols suggest eliminating the food for 2 or 3 weeks, and then reintroducing it. Most patients are reacting more through the IgG immune response, and improvements should begin after 72 hours off the food.
However, IgA immune responders may have a much more delayed reaction, so I suggest they remain off the food for at least 4 weeks, preferably 6 weeks, before reintroducing. And if the patient shows very significant improvements of symptoms, I suggest they assume they are sensitive and do not reintroduce. At reintroduction, or if there is accidental consumption, exposure to even a small amount of the offending food can occasionally cause a more severe reaction in some individuals.
Healing GI Damage
The inflammation from a food sensitivity reaction damages the lining of the gut. Healing the lining is important to prevent absorption of larger not totally digested proteins that the immune system may respond to.
- A probiotic daily for at least 2 months is recommended.
- Glutamine is a vital nutrient for the intestines to rebuild and repair, and should be given daily for at least 3-4 weeks.
My suggestion to a patient is to start the probiotic along with the elimination diet, but start the glutamine once they are fairly certain they can be compliant with the elimination diet. Exposure to the sensitizing food re-inflames and damages the gut, and glutamine should be taken for 3-4 weeks after that time.
Jim Paoletti, BS Pharmacy, FAARM, FIACP, is the Director of Education at Power2Practice and a nationally-recognized expert in pharmacy, BHRT and custom compounding, and has previously served as Director of Provider Education for ZRT Laboratory and Education Director for the Professional Compounding Centers of America. At Power2Practice, Jim applies his wealth of knowledge and experience by hosting live webinars and creating clinical support tools, such as podcasts and blogs.
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