Tuesday, March 29, 2011

Food Sensitivity Testing - let's talk about your options!

So as promised in the last posting, today I'll give you a little more information about testing for Food Sensitivities.  And just to backtrack a little .. food sensitivities happen when the body reacts to proteins in specific foods and the immune system is activated by those proteins in much the same way as it is activated by proteins on bacteria.  A reaction is mounted by the immune system and can cause inflammation both at the gut level but also systemically.  Because of the complexity of the immune reaction, food sensitivities are often one of the key triggers for many different complaints.  I almost always think about them when dealing with three key complaints including: skin conditions like eczema or psoriasis, GI upset including anything from heartburn to diarrhea, and behavior difficulties in kids (ADHD, temper or Autism Spectrum Disorder).  And  many people with autoimmune disorders and arthritis or migraine benefit from knowing if there are any food triggers aggravating their symptoms.

So we know its important to check for food sensitivities but how do you do it?  There are three different testing choices available to identify food sensitivities. Please note, that food sensitivities are very different from food allergies and the following testing methods are not adequate to diagnose food allergies. The gold standard is an Elimination and Challenge test.  In this case, we limit the diet to a very restricted set of hypo-allergenic foods (usually foods that are outside the normal diet) for a good period of time (usually 3-6 weeks).  The goal is to allow the body a chance to heal up as we take away any provoking foods.  Then we slowly add one food type at a time and gauge for reactions.  For example, we might do our elimination for 3 weeks and eat only lamb, pear and brown rice, then introduce dairy products for a few days while we watch for skin or tummy symptoms.   This type of diet needs a lot of planning and commitment and, because it is so limited, it should not be done without the supervision of a qualified practitioner.  And it should be mentioned that challenging with foods can cause quite a pronounced reaction and should be done exceptionally carefully with asthma or autoimmune conditions.

The next type of testing is called EAV testing, which is also known as Biomeridian or VEGA testing.  This testing evaluates the energy in specific acupuncture meridians and how that energy reacts when challenged with foods.   It sounds a little odd but is really very effective for many complaints.  The advantage to this is  that it can be done quickly and in-office and is non invasive.  It does require that the patient be able to sit relatively still for a period of time, so it can be difficult with younger kids or kids with restlessness/hyperactivity.  On the down-side, the testing isn't well accepted by conventional medical practitioners and so isn't my first choice when we are also working with an allergist or other specialist.

The last type of testing and the only one that can allow us some information about food allergies is called ELISA testing.  ELISA testing is a specific testing procedure that measures how much (if any) of an antibody (immune) reaction there is to specific food proteins.  There are many lab companies in North America that offer this testing and they have widely variable pricing and reliability of their tests.  Most have different food lists available that can be chosen specific for the patient's needs (ie. vegetarian panels or specific testing for food allergies).  This testing does require a blood sample, but depending on the type of tests, it is either with an arm drawn sample or more commonly a dried blood spot taken using a finger stick.  Most kids find the finger prick quick and easy, enough that they don't complain.. at least not much.  I find this to be the best choice for most people as the company I use has excellent pricing and turn-around time and has a choice for an expanded panel with many extra spices and foods.  In addition, ELISA testing is a common procedure and one that is being used by conventional allergists to explore food allergies.  So as a testing method, it is one that conventional physicians can identify with.

For patients coming into my office, I always suggest we discuss your complaints and talk about the testing options to figure out which, if any, is the best choice.  This might depend on your financial situation, time goals and the condition itself.  Most Naturopathic Physicians have done a good investigation into the testing options available in your area and can give you good guidance.  To find a Naturopathic Physician in Canada go to http://www.cand.ca/index.php?findnd&L=0 to find one in the US try http://www.naturopathic.org/AF_MemberDirectory.asp?version=1  .

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