In my office I typically do one of two things to determine if a food allergy is causing symptoms. You can always run a food allergy test which is only about 70% accurate to determine if you are symptomatic. Food allergy testing is not helpful in evaluating food intolerances such as soy or lactose intolerance.
Symptoms of food allergies can be insidious or immediate and include symptoms such as: skin rashes, dermatitis, eczema, psoriasis, seborrheic dermatitis, irritable bowel syndrome, fatigue, suppressed immune system, autoimmunity, rheumatoid arthritis, depression, brain fog, neurological symptoms and much more.
Because 70% of our immune system surrounds our gut in the form of GALT (Gut Associated Lymphatic Tissue) it only makes sense that food allergies and intolerances easily place a burden on our immune system, and increase the total inflammatory load.
If you suspect you have a food allergy the easiest thing to do is eliminate the food you suspect may be causing allergy or intolerance for a period of 1-3 weeks until the symptoms resolve completely or improve dramatically. Rate your symptoms on a scale of 1-10 with 1 being no symptoms and 10 being severe symptoms. Then reintroduce the food with at LEAST 3 servings per day for 3 days straight. If the symptoms reoccur or worsen then you know they are triggered by that food.
When challenging a food be sure to use the purest form of that food so there is no confusion between wheat or another ingredient in bread like yeast for instance. If the food allergy is anaphylactic such as commonly seen with peanuts or seafood you should NOT go about testing the foods this way and should instead work only under the guidance of a naturopathic physician. Usually when anaphylaxis is of concern I will work to heal the gut and modulate the immune system before even thinking about re-testing the food allergy. Anaphylaxis allergies are IgE mediated and most patients have IgG and IgA food related allergies. It is best to test for all three antibody types, however this can be expensive and for that reason most naturopathic doctors test IgG food allergies when the symptoms are slow and insidious and not sudden or life threatening.
Symptoms in children will typically resolve faster than in adults, and thus kids may only need to eliminate a potentially problematic allergen for 1-2 weeks. Frustrated and stressed parents may still see benefit from a shorter allergy elimination period and thus Be more likely to adhere to the diet. I work with a lot of kids with autism and many parents have difficulty adhering to the Gluten Free/Casein Free diet that is typically found of help. When we can commit to a one week elimination trial with a heavy reintroduction of gluten and casein the parents are typically inspired to continue with the diet as it is easy for them to complete one week of elimination and when behavior and digestive problems dramatically worsen with reintroduction then it helps them understand the severity of the food allergy or intolerance.
Because food allergy testing is only 70% accurate the Gold Standard for determining food allergies/intolerances is therefore “The Elimination Diet.” I have stopped prescribing full elimination diets in my private practice because it is just too difficult for the average, busy, working person to adhere to. Most patients prefer to have their allergies tested, and then eliminate and challenge the particular foods that come up. If symptoms persist and we are not able to target the exact culprit we will then proceed with a full Elimination Diet that typically consists of brown rice, pears, veggies and non-citrus fruits for a period of 3 weeks followed by a re-introduction and challenge period. This can be especially helpful in revealing food additives such as MSG, aspartame, caffeine, and certain spices that are not commonly tested for on standard food allergy panels.
So how would you go about testing your food allergies? I typically look at my patients dietary habits by asking them to keep a one week food journal that also documents their symptoms on a scale of 1-10. I always ask what foods they cannot live without as many people are addicted to the foods they are allergic to. This happens because endogenous opiods are formed when their is a food allergy reaction in the system. If we aren’t able to get a good idea of what the probelm is from observation then I would order a food allergy test. If the results came back positive for both wheat and dairy I would then have the patient eliminate both wheat and dairy for 2 full weeks or longer if we have not seen improvement in symptoms. Then we would reintroduce dairy for three full days followed by wheat for three full days, in order of patient preference. This challenge portion is important to validate the food test and confirm that the test is correct.
What many doctors fail to tell patients with food allergies, is that many food allergies can be healed. The white blood cells that are forming the inflammatory antibodies to the foods you are reacting to will inevitably die off, and thus your body can “forget” the food allergy if you consistently eliminate the food for a 2-3 month period. After a few months of complete elimination you will then want to repeat the challenge portion and reintroduce the food in high doses to see if it will precipitate symptoms. IgE allergies that cause anaphylaxis will take much longer to heal from but many children do “outgrow” childhood allergies based on this same principal.
Food allergy testing can be helpful when people have what is referred to as “Leaky Gut Syndrome” in the naturopathic community. I see “Leaky Gut” often in my patients with IBS, chronic diarrhea, constipation, GERD, ulcers in the stomach or mouth and chronic pain. When I receive the results of a food allergy test that has multiple positive food results it is vital to heal the lining of the digestive track with L-glutamine, demulcent herbs like slippery elm, aloe vera, licorice, and marshmallow root; as well as use long term high dose probiotics to re-establish healthy gut flora. Otherwise new food allergies may continue to crop up. Treating stress and adrenal burnout is also critical when healing patients from their food allergies. When the body is under stress and secreting cortisol, digestion is shut down. Chronic stress thus leads to dysfunctional digestion. Understanding the underlying causes and triggers for your food allergies is imperative to the healing process.
If you are concerned that you may have food allergies I highly recommend the individualized care you will receive by working with a naturopathic physician who will look for the cause of your food allergies, treat the symptoms, and also help you heal from your food allergies. Obviously this information is just a general guideline for patients with food allergies to understand how naturopathic care may help them and inspire them to seek an individualized plan to address their food allergies.