Case Study: Detecting Food Sensitivities

Have you ever wondered if you have a food sensitivity due to pesky symptoms such as headaches/migraines, bloating, constipation, anger or moodiness?

I try really hard to follow an anti-inflammatory diet, so the idea that lingering problems may be caused by certain foods I eat was a real eye-opener that I decided I must explore.

Here’s a step-by-step scenario showing how I’ve come to seek and discover potential food sensitivities that may be delaying my healing progress. Below you’ll find the dialogue between myself and two physicians whom I trust and consult to help manage my patient care.

Elisa: I’ve been having aches and pains the past couple of months, which is unusual for myself during the summer. I’ve also been more tired than usual.

I’m currently off all medication except for using Ibuprofin as needed (as minimally as possible).

A typical daily food intake for me is either fresh green juice or a green smoothie for breakfast, a large green salad and/or soup for lunch, and water-sauteed veggies with kale or collards and tofu, tempeh or beans on top for dinner. Banana whip for dessert!

I take Gentle Care Formula, Osteo Sun with D3, Favorite Flora, Perilla Sinus, DHA and I’ve recently resumed Metagenics high concentrate fish oil to help reduce inflammation in my body. I’ve also started taking DHEA (per your previous recs) even though I noticed no benefit from that in the past.

The crux of the issue is that since last Nov 2010, my left ankle has been aching. It started with an occasional dull pain after a long day, but has steadily grown to a stronger more consistent ache. I am able to run, lift and cycle on it with no problem however.

When I saw my Rheumatologist last Nov, the week that the ankle pain started – he indicated that if it continues he’d like to do an x-ray to check for a stress fracture. This doesn’t feel like a stress fracture to me – it feels more chronic/inflammatory than acute.

It’s also worth noting that I’m feeling more inflammation systemically right now and that my right ankle also aches occasionally but not nearly as consistently as my left. The pain in my left ankle also exists in my left calf and shin. I even have some days where I feel the fibromyalgia again.

Today, I discovered that something I ate once a week had “sprouted almonds” in it – so I’ll definitely be avoiding that moving forward.

I did a 12-day water fast back in April, a 10-day juice fast in May and I will be doing another 10-day juice fast starting Tues Sept 6th. I’m sure this will calm things down temporarily, but I’m concerned about the long-term outcomes. It feels like I could be limping soon.

I did get new orthodics for my shoes last summer and have considered re-visiting my podiatrist, but like I said this feels more like systemic inflammation rather than a localized issue.

What I’m asking, is if there’s anything else I should be doing to avoid an unnecessary x-ray and to get this ankle pain under control? Any basic labs that I should have checked (considering that my current plan requires me to pay for lab work myself)? My last lab draw was Nov. 2010. I suspect my Rheumatologist’s recs will be to take meds – which is not an option in my mind.

I’m also wondering if there’s any benefit to Nutrition Response Testing or any tests I should have completed to detect potential food allergies. I’ve been feeling, for a while now, like something isn’t quite right. No matter how diligent I am, I still have daily headaches, allergies, increased bloating (since fasting), etc… I’ve been at this 3 years and although I see very gradually improvement – I wonder what I might be missing.

I’m going to keep a food/symptom log and introduce one food at a time following this next fast to try to detect any food sensitivities from lectins or other similar culprits.

Doc 1: I agree with your thinking. It may be that there are specific foods other than sprouts in your diet, that you are reacting negatively to. Go back to just wild rice, butternut and acorn squash, string beans, zuchinni, and stewed greens for a few days to see if you feel better, without the fruit, nuts and beans. Then add them back one at a time.

Try a food IgG panel and a RAST test to see what comes up. The IgG is not accurate for allergies, but it may give us some possibilities of foods to check or be careful with.

If Nutrition Response Testing is that muscle testing with food, then I think it is a complete scam.

Elisa: I’ll definitely try those foods along with a detailed log and slow introduction of additional food.

How might I go about getting an IgG panel and a RAST test? Will that require a prescription and if so can I call your office to obtain that? Any idea how much these tests cost out-of-pocket?

It looks like this Nutrition Response Testing (NRT), which is new to me, is an analysis done through testing the body’s neurological reflexes and acupuncture points. I actually first heard of it from a client who saw a guest speaker discuss it at a Whole Foods Market presentation in MI.

Doc 1: Yes, those blood tests can be ordered by any physician. I do not know how much they cost. The RAST is priced per every 8 foods, so you make a list of the one’s you want to test. I think Genova has a total IgG panel we could look into. I do not think it is too expensive. Certainly, I can give you the script for the RAST, but you would have to list the foods you want on the test.

Elisa: Ok great. I started a juice fast today to use up some of the pre-bought produce and to calm the inflammation in my body. After a few days of that I’ll ease into an elimination diet to help determine which 8 foods to test. Once I do that, I’ll call your office to get the scripts for IgG panel and RAST.

So I did some juicing, an elimination diet for several days and contacted Doc 1′s office. Here’s a post detailing how to use an elimination diet to detect food sensitivities. Note, this method can be tricky depending when the onset of symptoms occurs. If it’s days after ingesting, this can be nearly impossible to detect via a food/symptom diary – especially if the symptoms constantly persist.

Doc 2 (at the same office) called me and advised me to order an IgA test through Enterolab.com. He said that the stool test has been found to be more reliable. I did as he intsructed and Doc 2 interpreted the following results:

Doc 2: It looks like you should avoid gluten (wheat, rye, barley), corn, soy, animal products.

Food you likely can tolerate are nightshades, rice, gluten-free oats.

Foods you may want to decrease or eliminate (moderate sensitivity) are cashews, almonds, and walnuts. I would experiment with these because you may do ok on a limited amount of nuts. Focus on more seeds and avocado in general.

I think this may help you. Make the changes now and see how you do in a few weeks time.

Elisa: Looking at my supplements, I see that GCF contains corn and Favorite Flora contains traces of soy – both of which I consume daily. My body is highly sensitive. Should I play it safe and stop these supplements?

Doc 1: I do not think those microscopic amounts there could have any effect. Since is a significant amount of those plant proteins are necessary to worsen your lupus.

I decided to play it safe and to hold off on these supplements for now, replacing with 100 mcg B12 every other day and soy-free Acidophilus (probiotic) daily. Meanwhile, I altered my diet accordingly and I stopped using a body lotion that contained soy.

Elisa: It’s been about 3.5 weeks since adjusting my diet to avoid gluten, corn, soy, cinnamon (due to rashes), most nightshades and most nuts most of the time.

Some mild improvements: less bloating, less rashy, more regular bm’s with buckwheat in the a.m., more consistent weight at 110 lbs, 63″.

Symptoms: daily headaches (past 10 yrs), congestion/sinusitis (upper teeth ache) leading to migraines past 3 days, lack of energy with migraines, left ankle throbbing (steadily getting worse, started last Nov. at this time), arthritis, moody/emotional/angry, chilblain season starting

I’ve done some research and see that the IgE test (which you sent a script for but I have not fulfilled until we discuss) is for acute food allergies (seconds to an hour after ingesting). I’m aware that some foods cause immediate problems for me such as: sulfites, liquor, wine and chocolate. I avoid these foods and keep a daily food log.

My current issue is that I always have some sort of headache (unless I take something: 60 mg allegra, advil, or migraine relief – depending on the type/degree of headache). Therefore, it is nearly impossible to pin-point the trigger.

I believe I might have multiple delayed food sensitivities that don’t necessarily manifest until 1-3 days later and are therefore difficult to detect.

Someone recently shared with me that they had an IGg4 test, which detects delayed food allergies (hypersensitivities). They learned they had an issue with avocado and raspberries and by removing those foods are doing much better.

The Extended Food Allergy Testing that I’m interested in combines the IgG4 and IgE via ELISA method. It seems like this would be a way to kill 2 birds with one stone?

I called and spoke to the Meridian Valley Lab office and I’m able to order the combo to test 190 foods for $257.00.

I didn’t want to make this investment without getting your feedback first, when time permits.

Doc 2: The reason I haven’t suggested the IgG testing is because it doesn’t correlate well with sensitivities to food. For example, when testing one person twice in the same day and sending in the samples for IgG testing, they both were very different even though they should have been exactly the same. IgG for certain foods can be high and it doesn’t cause a reaction or physical symptom, unfortunately. However, sometimes it does correlate and so we’d have to not take the results as truth unless it made more sense and it could at the very least be a way to test things one at a time to find out.

I agree that you need to wait at least 3-4 days to be able to see a physical reaction that came from a trigger food. The IgE testing is, you are right, for quick same day allergic reactions and it is less likely that you need to test this, but it may be our next step.

I think you could get the IgG panel you mentioned and we can talk about the results together, but stay off of the other foods for now so that you get about 2 months away from them to see how you do.

Elisa: Just for clarification, do you think I should do the ImmunoCAP Specific IgE adult food allergy panel or the IgE/IgG4 next?

I should also mention that I’ve had grass, tree, ragweed, mold, dust mites, dog and cat allergies for 11 years now, hence the headaches.

I hear what you’re saying about IgG’s inconsistencies. I’m desperate enough that if it would detect some fruit or veggies that I eat regularly – I feel that could be of value to me. I’m not sure what the IgE actually tests (food-wise), but I do like that this IgE/IgG4 tests many foods that I do eat.

Should I go ahead and order the IgG and hold off on the IgE for now, recognizing that the IgG may not be totally accurate?

I don’t intend to consume any gluten, soy, corn, nuts and minimal nightshades until I am symptom free and test negative.

I’m also wondering if there is any need to test for the following from Genova Diagnostics:

1) Intestinal Permeability Assessment ($109)

2) Intestinal Barrier Assessment Test ($79)
http://www.integrativepsychiatry.net/gastrointestinal_tests.html

Doc 2: I think it is ok to get the combo IgE/IgG test and that will be similar to the ImmunoCAP results. The intestinal permeability test isn’t necessary, and I think that was part of the gluten testing you already did with Enterolab anyway.

I ordered the combo from Meridian Vally Lab and I’m waiting for the kit to arrive now. I’ll return here to update the outcomes as they happen.

Please note, I’m calling these food sensitivities based on this definition from a peer dietitian. Check out the link for an explanation defining the difference between food allergy, food sensitivity, and food intolerance.

Have you had food allergies, intolerances or sensitivities in the past or presently? If so, how were they detected and how reliable have the results been in relation to your overall progress? Please share with us in the comments below.

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