Have you been thinking of getting tested for food sensitivities? Before you run out to your MD, chiropractor or naturopath for a food sensitivity test I want to take a moment to educate you on the differences between the different types of tests that are available.
1. Food allergy tests are typically done in a doctor’s office (MD, DO) or allergist’s office. In my experiance, this is one of only two types of food-reaction tests “normal” doctors will run (the other being for lactose intolerance). These tests measure the antibody IgE, and detect reactions to food that are usually very fast and severe. The classic example of this type of reaction is a child with a peanut allergy- their throat closes up, they can’t breathe, and someone has to administer an epi-pen to save the day.
This test does not identify food sensitivities (also known as food intolerances). However, this is the test that insurance typically will pay for.
2. Applied Kinesiology is usually practiced by chiropractors, and involves using muscle testing to determine which foods do and do not agree with your body. The appeal for such a testing method is obvious; no need for painful blood draws or messy poop tests, no expensive lab fees. However, I personally do not do this in my office.
This may be chiropractic heresy, but I do not think that muscle testing is an accurate or reliable way to identify food sensitivities.
3. Stool Testing for food sensitivities is available through labs such as Enterolabs, and measures antibodies in the patient’s stool. To my knowledge, this test only looks for sensitivities to dairy and wheat. This test only measures IgA, which tends to give a LOT of false negatives in anybody who has any sort of gut inflammation (aka anybody who is seriously considering doing this type of test). My other big problem with this test is that, like most other gluten tests, it only looks for anti-gliadin IgA, which is one very small fragment of what gluten sensitive people can have a problem with.
I think that this type of stool testing is just an expensive version of the crappy (hah!) testing that most MDs do (which are covered by insurance, but borderline useless).
4. IgG Food Sensitivity Testing is done through a number of private labs (Doctor’s Data, Genova, US BioTech) and is the one most commonly run at a naturopath’s office. These panels test for 90+ foods and typically give you a range (either a +1, +2 type scale or red, orange, yellow, green scale) to distinguish between severe reactions, mild reactions, and harmless foods.
I have a few “beefs” with this type of test. Most importantly, these tests almost always leave the patient confused and frustrated because of their weird range/scale reading system. “Eggs are red-orange, but blue berries are orange-yellow… So I guess I have to avoid all of them?” Not only is it hard to figure out what a real positive result is from those scales, but these tests often come up with 10 or more foods to be avoided. If that wasn’t enough, some labs add another layer to the mess by advising you to rotate the less severe allergens in one at a time and give you a complex food schedule to follow. I think the reason these tests have come under so much ridicule and scrutiny is because they’re just too darned hard to figure out and follow.
I get really frustrated when I see how these labs break down the foods that they test. I have had patients show me these tests many, many times, and each time I want to rip my hair out. For example, such tests will show results for the following:
Patients will be told that they can have yogurt and sour cream, but not cow’s milk or cheddar cheese, etc when what they really have is an intolerance to all dairy. I don’t know why these tests come back the way they do, but when I see these patients they generally do not feel a difference until they cut out all dairy. On the opposite side of the spectrum, the test for gluten sensitivity on these panels will come back as simply a test for Wheat. This type of test yields a tremendous amount of false negatives.
Lastly, my other issue with this type of test is really good at overwhelming you with foods to cut out, but is it worth the headache (as opposed to the alternative)? For example, you may genuinely have a slight reaction to blue berries, lemon, coconut, alfalfa sprouts, honey, sword fish, and 20 other foods… But wouldn’t it make more sense to test for the big players- the foods that cause the most inflammation, and see if the rest of your issues resolve after eliminating those? I find that most people who get these tests done and have 8 or more things come back positively have deeper problems that need to be addressed. I almost always find that sensitivities to more normal foods (bananas?) are a symptom of something else, not a problem in and of themselves.
I only use this test in my office as a way to fine-tune things. I test for the big-guys first (see below), give the gut time and the nutrients it needs to heal, check for other causes of GI discomfort, and then use one of these panels as a last resort. For more on IgG testing check out this article here.
5. Cyrex Testing for both Gluten Sensitivity and “cross reactive foods” plays a huge role in my office. These tests look at three antibodies, IgA, IgG and IgM, and are the most comprehensive I have yet to find. Not only that, but their gluten sensitivity test tests for ALL of the components of wheat, barley and rye that you can have a reaction to, so there are few (if any) false negatives. The same goes for the different parts of dairy (casein, whey, and other proteins).
The good news is that it is relatively easy to get this test done, now. You can always contact Cyrex labs and find a doctor near you who is able to run the tests, or it can be run by me. I am now doing long-distance appointments via phone and skype, and am able to run the majority of the tests I offer in all states except New York.
If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham “triangle” area.