As an integrative provider who focuses on gut-related issues, I tend to see people who have been to multiple doctors without relief, so I bump into food sensitivity a lot. The conversation often goes something like this:
Me: “Do you have any food sensitivities?”
Them: “My doctor tested me and said I don’t.”
Me: “OK. Did you have your blood drawn or skin pricked?”
Them: “Skin pricked.”
This is a very common scenario, and I am going to let you in on a little secret:
There is more than one way to have a food sensitivity.
Skin prick tests are checking for a specific, fast-acting, potentially life-threatening reaction. This is by no means the only way that one can react to a food.
Food sensitivities masquerade as many other things.
This is but an abbreviated list of the troublesome symptoms that have food sensitivity as the root cause. These pesky, insidious symptoms that never quite go away, those are driven by a different type of immune reaction, and thus require a different course of evaluation.
This is why using blood tests to check for food sensitivities can be very insightful. These evaluate for non- life-threatening, chronic, slow-to-develop symptoms that seem to be so many other things besides a reaction to a food. The two most common blood tests for food sensitivity are the ELISA (Enzyme-linked immunosorbent assay) and the ALCAT.
The ELISA test measures a type of immune molecule called IgG. It quantifies the amount of antibody your immune system makes to dozens and dozens of different foods. The ALCAT measures the amount of immune cell activity against a large list of foods.
The results of tests are best taken in context with your current symptoms and nutrition, rather than something by which you absolutely live and die.
Let me explain. When I run these tests on my clients, I am typically looking for a few different scenarios.
First, one or two foods come up really strongly. These are typically common allergenic foods like gluten, dairy or eggs. Next, perhaps many foods come up with mild-to-moderate reaction. Or, you can have a combination of the two.
When a test comes back lit up with more than a couple of sensitive items, it is not as if the person has 37 food sensitivities, it’s that there is an issue at the lining of the gut, where the immune system and the food interface. In this way, I use food sensitivity testing to evaluate for intestinal hyperpermeability.
Unless the test comes back squeaky clean, I typically recommend at least a 30-day elimination of foods that popped up in conjunction with gut restoration. Gut restoration calms the immune system and heals leaky gut. You then have a clean slate to determine what your true sensitivities are and what were a consequence of leaky gut or other issues (like infection or autoimmunity).
By systematically adding foods back in, one at a time, four days apart, your body will let you know what it is sensitive to. Delayed reactions can take 72 hours to manifest, hence the gap in reintroduction and why ferreting out sensitivity can be so tricky without some type of an elimination diet. Because no test is perfect.
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