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This 4-part series has been about why your symptoms have not improved since you have been gluten free (GF). As a reminder, I mentioned 4 keys reasons why your symptoms may still be manifesting:

1. You are unknowingly ingesting gluten (click here for this article)
2. You have additional food or food additive allergies (click here for this article)
3. You have additional food or food additive sensitivities or intolerances
4. There are factors other than food that are contributing

Based on the prior articles about unknowingly ingesting gluten or having a food or food additive allergy, you have done your due diligence and still are not rid of your symptoms or conditions. You say “what’s next,” as you are determined to get to the underlying reason for your problems. Are you ready to do some more detective work?

The third reason your condition has not improved may be that you are consuming a food or food additive that you have a sensitivity or intolerance. Let’s review how food sensitivities may be contributing to your symptoms.

 

Food Sensitivity Explanation and Symptoms

Food allergies tend to be more obvious. When you have an allergy to a food or drink, most of the time it is easier able to make an association with it and what you consumed since your symptoms are more acute. Food sensitivities or intolerances can be more difficult to determine.

Food sensitivities manifest in a multitude of ways and cause a delayed response. This delayed response could take place from several hours to days following ingestion. You can see that it would be difficult to associate something you are consuming with a symptom that manifests a couple days later. You may assume it is something new or an item you do not consume very often. Many times, though, it can be something you are consuming on a regular basis.

Often, you may start out with only one or a few sensitivities, yet over time, others may occur and multiple sensitivities can influence each other adversely.

Symptoms and Conditions of Food Sensitivity

There are many different signs and symptoms associated with food sensitivity:

• Dermatological: Acne, itchy skin, eczema or other skin conditions
• Gastrointestinal: Irritable Bowel Sydrome (IBS), bloating, reflux, diarrhea, colitis
• Respiratory: Asthma, congestion in sinus, ears, and/or nose, frequent colds and infection, runny nose
• Neurological: Headaches or migraines, chronic fatigue
• Musculoskeletal: Joint pain, arthritis, gout, muscle pain and weakness, tendonitis
• Metabolic, Endocrine, Hormonal (includes reproductive): Weight loss resistance, thyroid illness, infertility, miscarriage
• Immune System: Frequent infections, autoimmune conditions, heart problems
• Malabsorption: Nutritional deficiencies
• Psychological: Depression, anxiety, memory, mood

Food Sensitivities and Determining The Triggering Foods

The foods that can cause sensitivity or intolerance vary significantly and are individually based. Symptoms are not associated with specific foods. If you are sensitive to a particular food, you may have a higher likelihood to be sensitive to another food in the same food family. For instance, if you are sensitive to tomatoes, you may also have or develop sensitivity to white potatoes or peppers, all of which are in the nightshade family.

There are 2 methods to determine what foods are provoking adverse reactions in your body.

1. Food sensitivity testing
2. Elimination diet

An elimination diet requires diligence, intentionality, and complete compliance. There is testing available, however, it is not full proof. Thus, the food elimination diet should be pursued, as it is the gold standard for best accuracy in determining food sensitivities and intolerances. What the testing can do is be a tool to provide direction in determining what foods you should eliminate or confirming what you already suspect as a triggering food.

Food Sensitivity Testing

There are 4 key food sensitivity tests available:  

1. IgG ELISA (enzyme-linked immunosorbent assay)
2. LRA (Lymphocyte Response Assay by ELISA/ACT™)
3. ALCAT (antigen leukocyte antibody test)
4. MRT (The Mediator Release Test)

 

The tests that measure antibody reactions are the IgG ELISA and LAR tests. The ALCAT and MRT tests measure white blood cells responses. They have all some merit and have been debated with some in the medical and science community strongly believing in them while some do not. Some studies show them as having greater accuracy than others. This chart shows a comparison of each of these tests for what they measure.

You can certainly find a lot of information out there about each of these tests and the pros and cons. So, how do we know if we should have food sensitivity testing done and which one to choose?

Between those that measure antibody responses, the more advanced test seems to be the LRA. Between those that measure white blood cell responses, the MRT is a more advanced test. Which test you choose from there needs to be individual choice. One piece of criteria may be what and how many foods and chemicals they test, which varies with each test.

So, I’ll provide what my experience has been and hope it can help guide and give you some confidence in the testing. I have tried several of the food sensitivity tests, including both those that measure antibody reactions and those that measure white blood cell responses. The most recent test I had done is the more advanced MRT.  Click here for more details about this test.  Although I have had success with each test over the years, I would recommend utilizing the more advanced testing for improved accuracy.

What I mean by success is that when I removed the provoking foods (based on the test results) from my diet, many of my symptoms resolved completely and some were reduced. Those that were only reduced I determined were based on other contributing factors, which we will talk about in the next post (part 4 of this series). I kept the offending foods out of my diet from 3 to 6 months, completed healing protocols during that time, and was able to reintroduce nearly all of them successfully. Reintroducing them successfully means adverse symptoms did not return when I began eating them again.

Here are online services to purchase the respective testing without requiring a doctor’s order. Although you do not need a doctor’s order, you will still have to go to a formal lab or medical facility for your blood draw. There are also online labs that are available that require you to use an associated practitioner so that is an option if you prefer that route:

• IgG ELISA: Cyrex Lab testing through Dr. Tom O’Brien. Cyrex Array 4 and Array 10 are most relevant for food sensitivities. However, I recommend you read the Lab Test introduction to have a better understanding.  Before using this kind of test or any that uses IgG antibody (a.k.a. immunoglobulin) responses, it is best to understand your levels.  If you have low levels, the testing based on using these antibodies will not be accurate.  If you do not have strong levels of IgG or IgA antibodies and wanted to do this kind of testing first, it would be best to test your antibody levels.
• LRA
• ALCAT Comprehensive Wellness #1 Test
• MRT

Elimination Diet

The elimination diet has a two-fold purpose. It is a diagnostic tool to use to determine what foods may be causing your adverse symptoms and conditions. After determining the trigger foods, it then becomes a therapeutic tool and time to heal from the bodily burden the offending foods have been.

Whether eliminating foods as a diagnostic tool or a therapeutic one, be very aware of what you are eating and read food labels carefully. You could unknowingly be ingesting a food you have eliminated based on it being in a recipe of a food you ate at someone’s house or in a processed/packaged food. Be diligent at reading labels and asking questions if you are eating something you did not make yourself.

 

Elimination Diet As A Diagnostic Tool

If you already have an idea of the trigger foods (based on food sensitivity testing or otherwise) but you want to confirm, remove them all from your diet. This is much easier if it is only a handful of foods, as you want to ensure you will be completely compliant throughout this process.

After 3 weeks, you can begin to reintroduce them 1 at a time. Waiting 3 weeks is essential, as you want your body completely rid of the symptoms and inflammation calmed. If you reintroduce more than 1 at a time and you have a reaction, you will not know which food was the trigger. Because it can take up to 72 hours for your symptoms to reappear, it is best to reintroduce 1 food per week. However, if you do have a reaction, it is best to wait 2 weeks to reintroduce another food to allow time for your body to calm back down before reintroducing a new item.

You must go through the reintroduction process for all initially eliminated foods in order to confirm all your triggering foods. A key to this entire elimination and reintroduction process is journaling. You should begin to journal before eliminating foods and then continue the process after you have removed foods and while you are reintroducing them. This will enable you to keep better track of your activity and your associated symptoms and trigger foods.

Steps – Journaling While Eliminating and Reintroducing Foods

1. Make a list of all the foods you intend to eliminate. Remember, this diagnostic tool is namely for when you have a handful of items you suspect. If there are numerous items that may be the culprit, having a food sensitivity test will provide much needed guidance.
2. A few days before you remove potential trigger foods, begin to journal. Your journal should include what you eat (all ingredients in a recipe or packaged food) for each meal and snack and any signs or symptoms you have at any point. Remember, food sensitivity reactions can occur as far out as 72 hours. Log any signs or symptoms that are physical (e.g., bloating, gas, diarrhea, nausea, brain fog, headache, fatigue, etc.) or emotional (e.g., irritable, depressed, anxious, etc.). This will give you a baseline.
3. After journaling for 3 to 5 days (before making any changes to your diet), now you can eliminate your potential trigger foods 1 at a time.
4. Continue journaling and noting all foods being eaten, signs, and symptoms. Do this for 3 weeks while all potential trigger foods remain eliminated from your diet.
5. Once you recognize that your signs and symptoms have disappeared, you can begin to reintroduce foods you have eliminated, 1 at a time. If it takes longer than 3 weeks, don’t rush the reintroduction of any of the eliminated foods.
6. If you reintroduce a food and no signs or symptoms seem to occur over a week’s time, then you can reintroduce the next item. If, however, you notice signs or symptoms coming back, keep that food out of your diet and wait 2 weeks before reintroducing the next item.
7. Continue this process for each food item from your initial food elimination list.
8. Since you are completing this process for only a handful of items, the reintroduction process may only take a couple months.

If you suffer considerably with many symptoms and chronic conditions, I would recommend having a food sensitivity test done. You probably have a significant amount of inflammation in your body and a large number of foods that are causing adverse reactions. Food sensitivity testing will help guide you (remember it is not full proof) in uncovering the triggering culprits.

Elimination Diet As A Therapeutic Tool

Once you are aware of your trigger foods, you will want to keep them out of your diet for at least 3 to 6 months. If you completed food sensitivity testing, you should have severity information for each food. Meaning, how severe your response is to a trigger food. For more mild responses, eliminating them for 3 months before reintroducing them should suffice. For those that are more severe, eliminate those for 6 months before reintroducing.

During the time you have removed your trigger foods, you will want to take action to heal your gut. Removing the provoking foods will certainly aid in allowing your body to calm the inflammatory response. However, during this time, going through a healing and recovery protocol will ensure that you are in optimal condition before you begin to reintroduce foods back into your diet.

Gut Healing and Recovery Nutrients

Doctors and nutritional experts recommend the following nutrients to support gut healing. I have also experienced great healing results from the following:

TIP: It is best to use a combination of these items to ensure healing.

 

• Food
  • GAPS diet
  • Bone broth: You can make your own or you can purchase it in liquid or powdered form.
  • Fermented/Cultured drink and veggies: You can make your own or purchase them.
• Nutritional Supplements
  • Digestive enzymes
  • L-glutamine
  • Colostrum: Be cautious with this if you have an allergy or sensitivity to casein, which is in dairy. It is said, though, that many with dairy sensitivity can tolerate colostrum. If you have any doubts, do not use it.
  • Probiotics
  • Quercetin

If you reintroduce a food and your symptoms reappear, you must remove that food from your diet for another 3 months and try reintroducing again. When reintroducing foods, it is always best to keep a journal so you can log the foods you eat and symptoms you have in order to determine whether or not the food is still causing an adverse reaction.

The ultimate goal is to be able to bring and keep back as many foods as possible and not to have to eliminate many foods long term.

How To Avoid Food Sensitivity and Intolerance Symptoms

If you think about it, if you are consuming something that you are sensitive to on a regular basis, your body is in a constant state of stress and inflammation. Your system never has enough time to heal and recover in between times you are consuming things that are irritating and inflammatory. We know that inflammation leads to dysfunction, which leads to disease.

Once we stop consuming the triggering items, our immune system burden is reduced. In the case of food sensitivities, we are not speaking of intolerances such as being lactose intolerant. We know that this is caused by a lack of lactase enzyme, which allows the body to digest the lactose in dairy foods. In this situation, you can either choose not to consume dairy products that contain lactose or you can take a lactase enzyme when you eat foods containing lactose.

 

 

To rid yourself of nasty food sensitivity symptoms that besides being bothersome, can escalate into serious life impacting conditions:

1. Food Elimination: Complete the food elimination and reintroduction process. Do not continue to consume foods that cause adverse signs and symptoms.
2. Heal Your Gut: Take action to heal your gut: Sure, removing provoking foods will reduce continued inflammatory response and harmful attack on your body. However, you must also heal the damage that has been done.
3. Food Rotation: Rotate your foods so that you are not eating the same thing every day. Preventing overexposure to foods will decrease your sensitivity to them. This also enables you to consume a broader array of nutrients.

The next and final article of this series will focus on items that are not food related but can still be great contributors to your adverse symptoms.

 

 

 

References

• Food Allergy Research & Education website. https://www.foodallergy.org/about-food-allergies.
• The Food Intolerance Institute of Australia website. https://www.foodintol.com/food-sensitivities.
• Food Sensitivities. The World’s Healthiest Foods website. http://www.whfoods.com/genpage.php?tname=faq&dbid=30#what.
• Inflammatory symptoms, immune system, and food intolerance: one cause – many symptoms. Cell Science Systems website. https://cellsciencesystems.com/education/research/inflammatory-symptoms-immune-system-and-food-intolerance-one-cause-many-symptoms/.
• https://cellsciencesystems.com/education/research/inflammatory-symptoms-immune-system-and-food-intolerance-one-cause-many-symptoms/.