With an increase in awareness of food intolerances, particularly gluten and dairy, many people are now curious about food allergies. They wonder if they have food allergies, and if they too should be avoiding certain foods to improve their health. This can be a confusing topic, so let's look a little deeper into the difference between allergic food reaction and food sensitivity or intolerance and whether you might benefit from food sensitivity testing.
Before we continue, it is helpful to have a mini biology lesson and learn a little about our IgA, IgE, and IgG immune responses. IgA, IgE and IgE refer to immunoglobulins, or “antibodies.” These antibodies are part of our immune system, and are made in response to things we come in contact with on a daily basis. Our bodies make antibodies to foreign substances like bacteria and viral cells, but can also respond to foods, dust, animal dander, and pollen. Antibodies help the body prepare an immune system response (“fight”) against what is sees as foreign trespassers in the body.
IgA and IgG reactions are known as delayed response reactions, that include food intolerances or sensitives.
IgE responses are immediate and are considered a true food allergy.
IgA and IgG reactions may not be evident straight away, but can take hours to days to show up in your skin or intestines, and cause a wide range of symptoms which you might not even attribute to what you eat.
These symptoms can be related to inflammation like headaches, fatigue, brain fog, or joint pain. People with food intolerance may experience digestive upset like nausea, constipation, or diarrhoea, or skin rashes including conditions like eczema and psoriasis.
IgE immediate hypersensitivity reactions are characterised by the hives, and throat swelling that accompany anaphylactic reactions some people experience when exposed to certain foods. Other symptoms can include wheezing, coughing, a runny nose, vomiting, swelling of the lips or tongue, tearing or redness of the eyes, or even a weak pulse and loss of consciousness. Common foods that trigger IgE reactions are peanuts, shellfish, egg, dairy products, soy, tree nuts, wheat and fish.
IgA immunoglobulins are present in our mucus membranes and helps us fight bacteria and viruses. IgA increases in response to foods when the foods we eat cause inflammation, and in response to stress, disease, or alcohol.
An IgG reaction to food proteins suggests tolerance related to immune cell reaction. Repeated exposure, inflammation, and immune reactivity contribute to sensitivity and high IgG in response to food proteins.
Testing for Food Allergy and Sensitivities
IgE allergic reactions are tested with skin prick or patch testing as well as blood testing to know what foods and other allergens must be avoided and when an Epi-pen is an appropriate prescription.
While you can test IgG and IgA for rood reaction, this is not diagnostic of hypersensitivity or allergy. These tests may indicate a sensitivity and intolerance, as well as inflammation. While blood testing is available for food sensitivity reactions, these tests are controversial as the results are commonly not reproducible and are not as reliable as elimination diets for uncovering food sensitivity.
What About Coeliac Disease?
IgA and IgG testing can test for whether you might be gluten sensitive or intolerant. If you are not diagnosed with coeliac disease, you may be gluten sensitive (not gluten intolerant). Those who have a true allergy to gluten have coeliac disease, which is caused by an autoimmune response to proteins found in wheat and some other grains, and harms the cells of your small intestine. Testing for celiac disease is done with a blood sample looking for more specific immune reaction to gluten and gliadin and confirmed with a biopsy of the small intestine.
Why would you consider testing for IgA and IgG food sensitivities if the tests are not 100% reliable?
• You like to see lab data with recommendations on how to improve.
• Someone you know did the testing and it helped them to feel better.
• An elimination diet may not work for you for one of these reasons:
o They are time consuming and can take months to go through the process of eliminating and then challenging foods.
o You have a picky/growing kid who already avoids some foods. You don’t want to restrict kilojoules or food groups entirely, or risk food aversion, or tension that can go along with an elimination diet.
o You are busy, enjoy eating out, or don’t have time to cook, and have limited time for the shopping and meal planning that is required to follow a restricted elimination diet.
If food intolerance or sensitivity testing seems like it might be a good fit for you, or if you prefer to try an elimination challenge diet to address your symptoms, then book in for an initial consultation with me to get started and work out the best solution for you.
I have been wanting to write a blog post for a while on this, and then I found one which articulated so well what I have been wanting to say, that I am reposting it here. It has been written by the marvellous Jules Galloway, a fellow naturopath who is doing some awesome work.
Here it is in it's entirety (reposted from www.julesgalloway.com).
Yours in good health, Josie
"I’m fired up today.
Fired up because last night I witnessed a thread unfold on Facebook that made me realise that there is still so much work to do.
It was in a business group for women that is 19,000-strong, and began with a discussion about a new ad on TV that suggests that 9.1% women are gluten free. The thread started with a comment that included the words “WTF is wrong with our women that they choose to miss out on vital nutrients because it’s fashionable?”
REALLY??? YOU THINK I’M DOING THIS BECAUSE I FOLLOW FASHION?
Fashion, fad, pseudoscience, attention-seeker, hypochondriac… I’ve heard them all, and I’ve had a gutful of people being cut down for taking steps to restore their health. Whatever happened to women supporting other women?
(Oh, and side note – I’m not missing out on ANY vital nutrients by eating this way – but that’s another blog post entirely…)
I was reminded of the time recently when this very topic was brought up on a top rating TV show, in that instance the gluten free diet was labelled a “fad” by the co-hosts. Weird… I thought the definition of a “fad” was something that was around for a very short period of time. I’ve been GF for the better part of a decade, and I can’t see it ending anytime soon. Surely we’ve outgrown the “fad” label simply by the sheer amount of time that gluten free foods have been popular?
BUT WHAT SCARES ME IS THIS:
How many women listen to outdated opinions such as the comment above, and it prevents them from embarking on a gluten, dairy or sugar free diet? How many women are putting off their wellbeing because they don’t want to feel singled out in social situations or risk being labelled as flaky?
WE ARE SICK PEOPLE TRYING TO GET WELL, NOT SUPERFICIAL FAD-FOLLOWERS
I’ve been working in the natural health industry for nearly 15 years, I’ve been a qualified practitioner for over 10 of those, I’ve also been GF for a large amount of that time, and I can assure you that the vast majority of people with a gluten intolerance are not “making it up” because they think it’s cool. You know what I think would be cool? Being able to walk into a bakery/cafe/deli/wedding/party and eat anything I want without worrying about feeling sick afterwards. I used to cry my eyes out after social events, wishing I didn’t have to eat this way. I had massive FOMO around food. Worse still, often I would cave in and eat gluten to fit in, so that I wasn’t singled out as being difficult, and then I would feel unwell for days, sometimes weeks. It affected my digestion, my skin, my hormones, my immune system, my energy levels and my mental health.
I can assure you that the majority of my clients don’t feel “fashionable” when they turn down a pizza date with friends or can’t eat the birthday cake at a party. They’ve made a conscious and informed decision to do this for their health’s sake. And it’s bloody hard sometimes.
I was inspired by the (many!) comments that followed in the Facebook thread, detailing personal experiences with a gluten free diet. There were reports of better skin, improved moods, anxiety levels decreasing, thyroid health improving, autoimmune diseases being kept in check… it went on and on. But throughout the thread there remained a vocal few who were keen to debunk the gluten free diet, rather than stop and listen to the vast amounts of evidence before them.
ACCORDING TO SOME, THERE ARE STILL ONLY TWO TYPES OF GLUTEN SENSITIVITY – COELIAC DISEASE, AND NONE.
Seriously – how long do we have to wait before gluten intolerance/non-coeliac gluten sensitivity is accepted? Why are people ignoring the mounting scientific research? Why are those of us being proactive about our health still being singled out as doing it to feel special?
If you want good, solid evidence, watch Cyndi O’Meara‘s new movie “What’s With Wheat.” The experts are there. The studies are there. But for some reason, there are people who would rather stick their heads in the sand and pretend this research doesn’t exist. (Maybe they’re scared they’ll have to give up gluten?)
Honestly, if you want to continue eating gluten (and you’re sure it doesn’t affect you) – FINE! Really – I’m cool with that. Not everyone is gluten intolerant. Not by a long shot. But my job is to support those women who are making the changeover to a healthier diet (one that’s right for them), not to try and win over those intent on disproving the theory. If you can eat gluten without repercussions – lucky you! Have some for me. But all I ask is that you don’t go after the ones who are making these changes in their lives.
We live in a nation that is increasingly overweight, where type two diabetes is rife, where conditions like autism, depression, anxiety and ADHD are increasing, where there are unprecedented amounts of chemicals being put in our foods, and now we’ve used so many antibiotics that we have created unprecedented resistance. And we’re putting our energies into debunking a gluten free diet? I think we need a shift in our priorities here."
Naturopath, Nutritionist and Herbalist