Food allergies and sensitivities are more prevalent and are a problem that clinicians are beginning to look into more seriously. Nearly 20% of individuals have food reactions, 4% of those being an immune-mediated response. These food sensitivities can cause symptoms immediately or days after ingestion. Frequently reported symptoms include inflammation, headaches, joint pain, hives, fatigue, and more.
Immunologic Reactions
Immunologic reactions are either immediate or delayed and can be broken down further and classified into 4 separate categories. Type 1, Type 2, Type 3, and Type 4.
Type 1: an IgE antibody-mediated reaction. This is an immediate hypersensitivity reaction occurring 2 hours or less once exposed to the antigen. Example: eating strawberries and breaking out in hives. Antigens bind to IgE antibodies and release chemical mediators like histamine.
Type 2: Cytotoxic hypersensitivity. This is an antibody-mediated response to IgG and IgM. This reaction is delayed, occurring 2 hours or several days after being exposed. This occurrence is seen when antibodies bind to either self-antigens or foreign antibodies, leading to killer-cell activity.
Type 3: Immune Complex-mediated reaction. This is also a delayed hypersensitivity and occurs up to weeks post-exposure. In this instance, the immune system creates too many IgG antibodies to a specific food.
Type 4: This is the cell-mediated form of delayed hypersensitivity. This can be the most serious and cause T-cells to be stimulated by cytokines. Later, these cytokines activate and induce an immune complex formation.
Testing For Sensitivities
There are several ways to test delayed and immediate sensitivities. One of the most common and frequently talked about is the Prick Test. This test is commonly used by allergists and is performed on the back or forearm of the patient. A small scratch is made and an allergen is inserted. If the spot has a reaction, this translates to a sensitivity.
An intradermal test is similar to the prick test but instead of inserting the allergen into a scratch, a small amount is injected below the skin.
The elimination diet is a great place to start when determining if a patient has a food sensitivity. They eliminate the food they think is causing a reaction and record their symptoms over a period of 90 days without ingesting that specific food.
A RAST test is performed via serum, which is a safe way to test for IgE antibodies in those who may have too severe of a reaction to a prick or intradermal test.
Below is an example of a food sensitivity test we use that tests for IgG and IgA Antibodies with the option of testing for an IgE Allergen:
It is recommended to record a detailed food diary along with symptoms before having a sensitivity test performed. This will allow the practitioner to see which test is best for you and make a specific plan. Additionally, an IgG antibody test also provides insight to the practitioner if the individuals may be suffering from leaky gut.
References:
Grisanti , Ronald. “Interpretation and Treatment of Food Allergy/Sensitivity/Intolerance Testing.” Functional Medicine University. 11 May 2020, www. functionalmedicineuniversity.com/members/ 465. cfm.
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