Allergic Or Intolerant?
I HAVE FOOD ALLERGIES!
I hate to burst your bubble, but you probably don’t.
I see so many patients who come through the door with a list of “food allergies.” These are often based on a person’s report of symptoms or past bloodwork from another naturopath or other practitioner. Regardless of the mechanism, I want to clear up, once and for all, the Myth of Food Allergies.
An ALLERGY is defined as a reaction by the body that involves elevated activity of an antibody strain known as IgE (Immunoglobulin E). This is a protein manufactured by the body that produces “immediate-type” of hypersensitivity. This is the most commonly understood type of allergy, familiar to all by redness, swelling, itching and inflammation. Think of hay fever; think hives; think asthma or reactions to bee stings.
Feeling itchy yet? A doctor can test for IgE with bloodwork, but more often this is examined by an allergist with skin-prick testing that involves the introduction of a suspected allergen (peanuts, bee pollen) via needle to the superficial layers of the skin. A positive reaction involves basically the production of swelling at the location of the introduction. Allergists essentially create a map of introduction and then observe for the body’s reaction.
An INTOLERANCE, on the other hand, involves the production of Immunoglobulin G, or IgG. This is a longer-acting, more slowly-produced protein that is tested for exclusively by blood draw. This is less likely to be tested for by conventional allergists and more likely to be what your naturopath tests for with bloodwork. Symptoms that we tend to see resulting from elevated levels of IgG are more VAGUE and widespread, such as digestive upset, fatigue, headaches, bloating, aching, etc. Though we feel some labs are very reputable in their ability to examine these levels in the blood (we use US Biotek, have for years, no affiliation just have had consistently good results with them), I still do not think this is 100% accurate. I have tested many, many patients over the last eight years and have determined that there is ONLY ONE WAY to determine if you have a food intolerance- eliminate the suspected food for a full two weeks, and then reintroduce it and observe. (see below for full instructions)
The reason I get frustrated, and shall we say inspired to clarify the terminology, is that there is no need to be dramatic about our diagnoses. I care about all symptoms that come through my door because I know they are disrupting a person’s ability to function optimally. If you have a food intolerance- meaning you struggle with symptoms when you eat a particular item, but no matter how miserable you might be, you are not at risk of anaphylactic shock- you usually can still eat that item without risking death. This is something that can be worked on, often by healing the gut and the ability to digest and absorb our food, and we almost always can achieve dramatic improvement in symptoms. This is something that can be frustrating but not likely to lead to death.
Severe IgE-mediated allergies can be life-threatening. They can also be improved with gut healing, immune support and other measures such as allergy shots, etc, but they are more severe and obviously more concerning. If you have food intolerances by all means let’s work on them! I have seen gas and bloating so painful and so severe that a patient ended up on the operating table, but for most of us a little gas isn’t life-threatening, so let’s be grateful for it and use it as an opportunity to improve our health, rather than dramatize it.
If you want to find out if you are INTOLERANT to a food, and suspect that you have mild to moderate symptoms a result of consuming it, follow the instructions below. (IF YOU THINK YOU MIGHT HAVE A TRUE ALLERGY DO NOT UNDER ANY CIRCUMSTANCES RISK EXPOSING YOURSELF TO THE OFFENDING ITEM BY FOLLOWING THE INSTRUCTIONS BELOW.)
1) Make some notes of the symptoms you think are occurring because of the food you suspect.
2) Do a full, 100%, two-week elimination of that item. Make sure it isn’t sneaking in to your diet in the form of hidden ingredients, i.e. check all labels.
3) Observe at the end of two weeks how improved your symptoms are, if at all. If they had been really bothering you, and now you feel much better, I sometimes advise taking a third week to complete the elimination.
4) Challenge: Day one of the challenge involves three large servings of the eliminated item. Days two and three should be back to 100% elimination. In this way you take three full days to observe for any delayed responses.
5) At the end of the challenge it is up to you to decide if this item is worth keeping in your diet. If you think you might be intolerant, consult your physician to discuss gut healing.