Food Sensitivities

Food sensitivities and intolerances have been on the rise.  When once it was rare to have a sensitivity to gluten or dairy, it is becoming increasingly common to develop reactions to these foods and a host of others.  Mention “food sensitivities” to most conventional physicians and it’s often shrugged off.  Conventional medicine only recognizes overt allergies, like those to bee-stings or peanuts.  Many fail to recognize the importance of identifying underlying sensitivities and its relation to gastrointestinal and whole body discomfort. 

What’s the Difference?

A true food allergy is immediate.  Hives, respiratory constriction, elevated heart rate, and anaphylaxis.  These are the things we typically think of when someone mentions they have a nut allergy.  A food sensitivity or intolerance is different.  It is mediated by an entirely different leg of the immune system, known as IgG, whereas true immediate allergies are mediated by IgE.  IgG is cumulative & delayed, meaning that repetitive exposure can worsen severity and that the symptom might not happen till hours or even days later!  This makes it very difficult to identify the offending food without using a test. 

What are the Symptoms?

The list of symptoms for food sensitivities is long, extensive, and can be nonspecific.  The reason for this is because food sensitivities cause inflammation in the body.  This inflammation can then result in gastrointestinal symptoms, like IBS, constipation, diarrhea, and bowel pain.  It can cause dermatologic issues, like acne, eczema, rosacea, and psoriasis.  It can affect the muscles and joints, contributing to arthritis, muscle weakness & pain, and even fibromyalgia.  It can affect the brain, causing memory lapses, brain fog, and difficulty concentrating.  It can tank energy levels causing fatigue, lethargy, difficulty waking, and afternoon energy slumps.  It can even affect mood, contributing to anxiety, depression, and OCD.  Unfortunately, this is an abridged list – many other manifestations may develop.

How do they Develop?

Nearly all food, whether it comes from plants or animals, contains protein.  Chemically, proteins are like a pearl necklace.  Each one of the beads on the necklace is called an amino acid.  The way these amino acids are grouped together differentiates one protein from another. 

Under normal circumstances, our digestive system is supposed to break this necklace into a bunch of free beads in our intestinal tract.  These beads are small enough to then cross right through the cells that line the intestinal tract.  Once absorbed into the body, they are reassembled into whatever we need them for – muscle, immune cells, hormones, etc. 

HOWEVER!  Our digestive tracts can become compromised and gaps / spaces can develop between the cells that line our intestines.  This is called Intestinal Permeability, or Leaky Gut.  When this happens, intact proteins (necklaces) can be absorbed into our body before being broken down to free amino acids.  Our bodies recognize these foreign proteins as invaders, mistakenly thinking they’re bacteria, viruses, or parasites.  In response, the immune system launches an attack to get rid of these invading proteins, causing inflammation.  Repetitive consumption of these foods increases this degree of inflammation, eventually manifesting as fatigue, skin issues, joint or muscle pains; everything described above.

To make matters worse, if the structure of these food proteins happens to look like one of our own bodily proteins, like our thyroid, we run the risk of developing autoimmunity.  Essentially, our body gets confused between fighting the structurally similar foreign food protein and our own tissue.  Often, this is what drives autoimmunity. 

How can I get Tested?

Dr. Castanho can perform a simple finger prick in office.  The small amount of blood collected is then sent out for processing.  It is rehydrated with a special reagent and then complexed with 184 different food and food additives ranging form animal proteins to vegetables to herbs & spices.  Depending on the magnitude of reaction, the degree of inflammation is quantified and a report is compiled detailing 3 levels of sensitivity.  Dr. Castanho will review the report with you, helping formulate an appropriate diet plan.  All patients leave with the report for their own reference. 

Other than being well-hydrated, there is no special prep beforehand.  Those on immune modulators or immunosuppressants, like steroids, may have altered results.  This should be discussed with Dr. Castanho beforehand.

Support:

In a randomized controlled trial with IBS patients, elimination of IgG food sensitivity foods (following IgG Food Sensitivity Testing) was shown to reduce IBS symptoms by 10-26% over a sham diet, with greater benefit in more compliant patients. When patients reintroduced IgG food sensitivities symptoms increased 25% over the sham diet reintroductions.(1)

In a double-blind, cross-over diet study, a sub-population of patients with Crohn’s disease IgG testing revealed that approximately 80% of patients had food sensitivities to processed cheese and yeast. Following a specific diet in this population resulted in reduced stool frequency and lessened abdominal pain, as well as general well being score improvements.(2)

In patients with migraines and IBS, elimination of IgG food sensitivities reduced pain, frequency, and discomfort scores in both conditions. (3)

In patients with migraines and IBS, elimination of IgG food sensitivities reduced pain, frequency, and discomfort scores in both conditions. (4)

And a systemic review found “Among modalities used by many conventional and alternative practitioners, immunoglobulin G (IgG)-based testing showed promise, with clinically meaningful results. It has been proven useful as a guide for elimination diets, with clinical impact for a variety of diseases.” (5)

References:

1. W Atkinson, T A Sheldon, N Shaath, and P J Whorwell. Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial. Gut. 2004 Oct; 53(10): 1459–1464. doi: 10.1136/gut.2003.037697

2. Bentz S, Hausmann M, Piberger H, et al. Clinical relevance of IgG antibodies against food antigens in Crohn’s disease: a double-blind cross-over diet intervention study. Digestion. 2010;81(4): 252-64. doi: 10.1159/000264649.

3. Aydinlar EI, Dikmen PY, Tiftikci A, et al. IgG-based elimination diet in migraine plus irritable bowel syndrome. Headache. 2013 Mar;53(3):514-25.doi: 10.1111/j.1526-4610.2012.02296.x

4. Mullin GE, Swift KM, Lipski L, Turnbull LK, Rampertab SD.  Testing for food reactions: the good, the bad, and the ugly. Nutrition in Clinical Practise. 2010 Apr; 25(2): 192-198. doi:10.1177/0884533610362696.