Dr. Vicki: Foods and Allergies

Monday, March 14, 2011

Victoria Rhoades, ND
By Victoria Rhoades, ND

When foods attack! To be clear, “allergies” is a bit of a misnomer, since “allergy” means only type of sensitivity reaction that is based on the response of one type of immune chemical in the blood, an immunoglobulin called IgE. This type of food hypersensitivity tends to be fast and severe, and foods that commonly cause this reaction include (but are not limited to) peanuts and shellfish. This is the classic food allergy, and people with it frequently carry emergency medicines in case of accidental exposure. The classic medical test for this type of allergy is a skin prick test.

A more general term that is seeing more frequent use is “food sensitivity.” It does not discern the specific cause for a food causing the problem, but recognizes that there is an actual problem that occurs. The problem may be a result of a different immunoglobulin, or because of an inability to digest or metabolize a food.

Possible symptoms that can be caused by different food sensitivities include digestive problems (diarrhea, constipation, bloating, gas), skin problems (rashes, eczema), respiratory problems (chronic runny nose, sinusitis, asthma), and other problems like ringing in the ears, joint pain, or headaches. More subtle symptoms are trickier to identify, as they may be caused by either a delayed type of hypersensitivity (such as celiac disease), by something unrelated to the immune system at all (such as lactose intolerance), and may not be related to food sensitivities at all. These are things for a doctor to discern.

Other immunoglobulins include IgM, IgA, and IgG, and each of them are associated with different immune reactions. A test for IgG and IgA food reactivities is a blood sample, which is fairly straightforward, although results are dependent on whether or not someone has been exposed to the food in question. If someone avoids a food for long enough for symptoms to subside, many times the blood test results will be ambiguous since the immunoglobulin levels have also subsided.

If the problem is not an immune problem, such as lactose intolerance, then the blood test for immunoglobulins will be negative (although it’s possible to have lactose intolerance AND an immune response to dairy products).

Another way to test for food sensitivity – which covers all types of food sensitivity – is called the elimination/reintroduction diet. The suspected foods are first eliminated, while insuring that basic nutritional needs are still being met. The period of elimination varies depending on the practitioners’ judgment. After that time, each food, in its simplest form, is gradually reintroduced. A diary is kept throughout the elimination and reintroduction, to monitor symptoms for improvement or worsening. This test should be done under a doctors’ supervision to make sure that you are doing it correctly and that it’s the right test for you.

If you have unexplained symptoms, such as those listed above, I urge you to see a medical practitioner who can guide you through this process. There are certain foods that frequently cause problems, and each patient will have their own concerns and needs. Your best bet may be a blood test, but it may be a skin prick test, or it may be the elimination plan.

Victoria Rhoades, ND, practices in Lake Forest Park, and she avoids gluten and strawberries; no strawberry shortcake for her! She helps her patients with food allergies through tests, food elimination, and by providing recipes and locations to find specialty foods.

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