Food Reactions - Why can some food make you sick?
In this hour‑long radio program Dr. Paul Anderson explains the wide spectrum of adverse food reactions, from life‑threatening IgE‑mediated allergies to subtler, non‑allergic sensitivities. He outlines the immunologic basis of classic type‑1 (IgE) allergies, non‑IgE immune disorders such as FPIES and celiac disease, and the less‑well‑understood reactions involving IgG, IgA, IgM, T‑cell pathways, immune complexes, histamine release, insulin spikes, and digestive enzyme deficiencies. Dr. Anderson emphasizes that standard IgE testing only captures the most dangerous reactions, leaving many other mechanisms undetected. He advocates the elimination‑and‑rechallenge protocol as the most practical way to identify problematic foods when laboratory tests are insufficient, and he reviews the various commercial sensitivity tests (IgG, IgA, histamine/ALCAT, etc.), their strengths, limitations, and appropriate clinical use. The program also covers practical issues such as gut permeability (“leaky gut”), the role of digestive support, and how to safely re‑introduce foods after an elimination diet. Throughout, Dr. Anderson balances scientific detail with patient‑focused advice, aiming to help both clinicians and lay listeners navigate the complex landscape of food‑related health problems.
Chapters
And you're live. Good day and welcome to Medicine Health with Dr. Paul Anderson. That's me, I'm Dr. Paul. And today we're going to be talking about people's reactions to foods. So this is a really, really common question that I get and probably almost every doctor gets, I would imagine. And there's a lot of kind of shades of gray around people reacting to foods and why you react, how you react, all of that sort of stuff. So today we want to get into it a little, a little deeper. And I say deeper because I did a YouTube on the YouTube channel about food sensitivities versus food allergies. allergies and did about a 13, 10, 12, 13-minute little video on that. And that— yeah. Oh, you can hear me? Okay. Yeah, never mind. Yeah, I hear you in the background. Keep going. Sorry. Okay. So technical difficulties, everyone. There you go. We're back now. So anyway, I got a lot of questions from that short video, so I decided maybe to take a little bit more time here on the radio program and do an hour on it. And I think that's probably a really good use of my time. So this one, instead of going between, you know, allergy and sensitivity like I did on the YouTube channel and taking a little bit of time, I want to take a little bit deeper time and talk about food reactions overall. Because one of the things that will get somebody to ask their doctor about food problems is either something real specific, they eat a particular food and they get a particular reaction from it that they don't like, or they have a sense that something that they're eating is bothering them, but they really don't know what it is. Or maybe they have a history where they have a very bad reaction to a food and they want to find out, you know, what that is and how that's Affecting them and what they should do about that. Or sometimes the patient will not drive the question, but the doctor may say, you know, with your type of symptoms and with the things going on with you, I think it would be wise if we checked into some food allergy, food sensitivity, food reactions going on and take them, you know, take those foods that you react to out of your diet because that may help you overall. Do this a lot with chronically ill people. And so when it's your idea as a patient, sometimes what you run into is you'll have a lot of healthcare providers who'll say, well, if you really had an allergy, you'd be dead, or, you know, you would know about it, et cetera. And that's true. If you had a classic anaphylactic allergy to a food, you would really know that you reacted to that food. And so they'll say, well, if you're not having those kinds of reactions, let's, you know, there's no reason reason for us to test anything. So that can be a frustration. I'm going to explain why that happens. But on the other side of it, if you're the patient and you don't think you have any food problems going on, and then you have a doctor or some healthcare provider come to you and say, hey, by the way, you know, you've got these chronic problems. I think we should check into food allergy, food sensitivity, food reaction testing. And here's how I want to do it. Well, You may have the opposite problem where you don't believe that that's an issue and you're wondering why your doctor would, you know, would talk to you about that, which kind of goes both ways. So let's talk about all the— or maybe most of the reasons why people will and can react to food and why there's this big gulf of difference between, uh, you know, you might have a healthcare provider say, if you're not deadly allergic to the food, it doesn't matter, and, and we don't need to test you and all that, all the way over to, you may just be having a reaction to the food that's not good for you. You're not— you're never going to die from the food, but you still— so you still shouldn't be eating it. Why would you have all of those different sort of reactions? Well, you want to start to think about food reactions as far as kind of 2, uh, 2 parts of a tree or roots or whatever you want. On one side, you can have allergy, and food allergy can include those very, very bad top-tier things like the type 1 allergic anaphylactic reactions. And those reactions are going to usually be things that you know about because it'd be the same Same as if you know you're allergic to bees and you have to carry an EpiPen because your throat swelled up and you had all these problems. Well, if you had, you know, you ate shellfish and that happened, or you ate, you know, avocados, or you ate something else and you had that reaction, you would know about it. And you might even wear a bracelet because people would need to know, you know, if you're, if you're in distress, that you're having an anaphylactic reaction, you know, to the food. Now, those reactions are mediated by a B cell product, an immune protein, immune globulin E, IgE, like Edward. And IgE is related to allergic anaphylactic reactions. What that means is, is you can go into anaphylaxis and anaphylactic shock, and that is the type of reaction that generally would kill you because you get cardiovascular and respiratory effect from that. So that's why those are the most dangerous type of allergy. But you can also have an allergic reaction to the food where you may not die, thankfully, but you might get hives, your joints might swell up. There may be any other number of things that the IgE reaction causes. So that's why those are considered sort of, you know, true food allergy is that sort of top tier of IgE reacting. Okay. Foods and substances. Those tend to be the kind of things either we find out the hard way where we're exposed to the food and we have this reaction, and then usually you go to the allergist and you get tested, and they say, yes, you, you know, you have reactions to these things and you really, you should not eat these foods because you have a life-threatening, potential life-threatening allergy to those foods. Right. And so your job at that point is to carry some protection like an EpiPen and then avoid those foods. Don't, don't eat them. If you're out eating and you don't know what's being cooked, you need to tell people that you're allergic to those things so that they don't inadvertently cross-contaminate your food with, you know, something from something else that they're cutting up or cooking. And, and that's usually very highly respected at restaurants because obviously they don't want people having anaphylactic reactions in their restaurant because of something that they did. So always tell, you know, tell your server up front if you have those sort of reactions. Well, there's other things that are very serious and have a similar type of a trigger, triggering. And those, there's a common, and they call them non-IgE mediated, even though most of the machinery is the same. And these are common in children usually. And so, you know, down to newborns, infants, and children. And one of the more common ones, they all kind of sound the same. Is an acronym, FPIS, F-P-I-E-S, food protein-induced enterocolitis syndrome. So, and then there's food protein enteropathy, and then there is eosinophilic esophagitis, epicutaneous problems, all sorts of other stuff, but FPIS is a common one. Usually what this is, you'll have a baby or a young child that winds up with very severe Severe vomiting. They can get swelling around the mouth. They can have all sorts of gastric distress when they eat particular foods. Now, in there are other things that might do this, but this is actually a very violent sort of thing that happens. There's a mechanical problem called pyloric stenosis, where the upper sort of gate valve at the stomach. sphincter, it's called, will spasm and the baby will have this very effusive vomiting, you know, like a fountain. And it will be whenever they, you know, eat. This happens a lot with dairy, etc. And in days gone by, they used to do a lot of pyloric stenosis stenotomies on infants and young children. when they would have these, thinking that it was all a mechanical problem. Well, it can be mechanical, but what we know now is also it can be literally a reaction, an immunologic reaction to the food. And so in those cases, what they normally do is they put, like say it's FPIES or one of the other ones, they'll put the child on a restricted diet that doesn't allow any of that in. And they might give them medication and there may be other strategies, but one of the main strategies that is used is removal of the food. Okay, so when you think about that, well, that will relieve the problem. And so you have sort of in the world of allergy and immunology, IgE, allergic, anaphylactic continuum. Okay, then you have non-IgE mediated allergy problems like FPIES and all of the other ones, but they're even though the IgE is not involved, they're mediated through a lot of the same machinery because IgE isn't the only thing that's associated with the trigger. Well, then there are other things that don't have the IgE part to it, like gluten-sensitive enteropathies. So most people have heard of, oh, you know, someone will say, well, I went gluten-free and I feel better, I lost weight or whatever, which is true, that happens a lot. And Here's the thing with gluten. So gluten is a protein found in a lot of grains, wheat and other wheat relatives. And you'll even, you know, you'll hear in cooking, et cetera, well, there's, you know, there's a, this is a high gluten product and we're using that to help with the baking. Okay, so the baking is enhanced by the amount of gluten that's in there. There are some breads where they actually add gluten into the bread. And if you don't have a problem with gluten, That's, that's not such a problem. But if you look at gluten enteropathies, these again are not a traditional IgE allergic anaphylactic problem, but there's a disease called celiac sprue, and celiac disease is associated with severe malabsorption and malnutrition. It's also associated with a lot of other autoimmune phenomenon in a lot of people. Yeah. Uh, such as Hashimoto's thyroid disease and a number of other things. So you have another very serious disease state where it's caused by gluten, but it's mediated through non-IgE allergic anaphylactic means, but it's still very, very bad. So it's a food reaction that is under the severe allergy tree, if you will. Yeah. Now, one thing to keep in mind is, you know, you go 15 years ago or more, and they used to say, well, the incidence of celiac disease is 1 in about 850 to 900 people. And then as time went forward and we got better at diagnosis, but also the pathology associated with biopsies and other things, We now realize that gluten sensitivity in North America is in 1 to— 1 in 85 to 90 people, so it has this tenfold increase in its frequency. Well, people always were that sensitive, it's just that the disease of celiac or celiac sprue is so aggressive and noticeable that you saw that in a more— in a minority of these people with gluten sensitivity. Yeah. So I'll usually tell people, now there's different testing that you can do for it. You don't, you don't have to wait till someone's that sick. So one of the things is if you, if you test positive for the celiac markers, there's a blood panel for it. You just have to be cautious that you remove all forms of gluten from your diet so that you're not challenging your immune system with this thing that's going to constantly stimulate. Because what will happen then is not only will you, will you have some degree of malnutrition Because your absorption goes down in your digestive tract, but also you will you will wind up with a a lot of stimulation of your immune system that's not appropriate. So kind of pushing it towards autoimmunity. So if you look, because people will say, well, I've read the signs and symptoms of celiac sprue or celiac disease, and you know, and my you know my brother says that they're they have a celiac. or they have gluten sensitivity, and my brother didn't have any symptoms of celiac disease. That's because they have a lesser presentation of it, but it's still just as meaningful. It's still just as disruptive to the health. Okay, so that's another one that's kind of on the big bad side. So you've got allergic anaphylactic problems mediated through IgE, like Edward, which is a B cell B-cell product, and then you have the non-IgE-mediated things like FPIES and celiac or gluten sensitivity, etc. So all of that is possible as you go along. But then what about food reactions? Well, when we think about food reactions, we often call them sensitivities. So you're sensitive to the food, you may not be allergic to it like an IgE, or a non-IgE allergy, et cetera, but it doesn't mean it's good for you. You're still sensitive to it. Well, what are those? Well, if you remember, I said there's a B cell. Okay, so you've heard of T cells and B cells in the immune system. There is a B cell allergy, IgE allergy, that comes from, you know, the B cell lines. Well, there— are there other immunoglobulins that go up when we have a sensitivity to food that aren't IgE? Well, indeed, there are a lot of others. The IgM, like Mary, goes up. IgA goes up right away. And then IgG, like George, will go up too with some people. Now, these things are known and they're seen in the science that the IgG, A, and M will go up and down with people with a food reaction, but they are unclear as their importance or their interpretation Now, one of the things that you have to be a little bit careful about if you look at the science and scientific literature around this is you'll get to the end of a paper about Ig, let's say IgA or IgG, you know, food reactions, and it will get to the end and it will say, well, There is no relationship to food allergy if the IgA or the IgG goes up when a person, uh, on their testing for foods. So that's saying 2 things, but it seems like it's saying one thing. On one hand, it's making the sort of logical statement that if we define allergy, food allergy, as IgE, like Edward going up, then by definition any other immunoglobulin, any other B cell product, is not going to be part of the IgE family. Okay, so remember, allergy is defined as IgE reactions or these other special exceptions that we've decided, the non-IgE things like FPIES and gluten sensitivity, etc. So they're saying, well, it has nothing to do with allergy. Well, what they should say is it has nothing to do with IgE reaction, because in reality, if you look at the immunology of the digestive tract, you have a special local immunoglobulin in the GI tract where you absorb your food, and it's the IgA, like alpha IgA immune protein from the B cell lines, and that is specifically there for protection of your mucous membranes, which is what your digestive tract is. So when you're looking at IgA, there's a very specific action that goes on when you ingest something or you have an infection in your GI tract or whatever. where IgA, like alpha, is produced first. And so why would your body's immune system produce immune proteins against the food anyway? Well, it's the same as any other allergic response. An allergic response is a misguided response of the immune system against something that really isn't going to hurt you, but it— but you have an immune response anyway. Okay. Okay. Now, in the IgA, like alpha production inside the gut, what happens is normally as the permeability of the membrane of the GI tract gets worse, and there are mechanisms by which you get permeability of your GI tract membrane. Some people use sort of a blanket term. They'll call it like leaky gut or something like that. That's sort of a nonspecific term, but it's very descriptive. What you're really looking at is membrane permeability, and if The membrane permeability is less than together, patent, you'll start to get food proteins going in that should have been digested better. Then the immune system will see this. You have all these immune cells in your digestive tract, and they'll say, wait a minute, that we don't even know what that is, uh, because normally it's broken down before it gets into the bloodstream. So let's make an immune protein IgA against it. Okay. Well, then you'll start to make other immune proteins. Now, does the presence of IgA, like Alpha, or a little bit later IgG, like George, does the presence of either one or both of those mean that you're going to have an allergic reaction to that food in this case? Not really. It's not going to be like an IgE like Edward, IgE reaction, where you may have hives, you may have joint swelling, you may have anaphylaxis, you may have any other number of bad things. But is the flip side true? So it's not an allergy, so it's inconsequential to my immunity and it doesn't bother me, it's not a problem for me. Well, that's not true either. Okay, now this is where different healthcare professionals will Disagree about this. Okay, because if you come from the point of view that the allergy family, meaning IgE or the exceptions, the non-IgE-mediated problems that we accept as pathologies, if you come from the view that that's the only food reactions we care about and those are the only food reactions that will bother you, then You might say, well, IgG like George or IgA like Alpha, if you find those against the food, it's meaningless. Well, my opinion and my experience with people is it's not meaningless, it's just different than an allergy. So you can have multiple things that are true at the same time. You fully can embrace that we don't want people dying from anaphylaxis from You know, type 1 reactions, IgE reactions to food, but you can also say that there are people that have IgA or G reactions to food, and if you remove those foods, they feel better, their labs may even look better, etc. They're less inflamed. That's still true. Now, do they have an allergy? No. But do they have an immune issue with that food? Yes, apparently so. So in the sensitivity realm or food reaction realm, there's a lot of other mechanisms by which these things happen. So if you say, go to, um, maybe the digestive specialty gastroenterology, or maybe you go to an allergist, allergy immunology doctor, and, uh, you know, they've tested you for IgE problems and gluten sensitivity, and, you know, you're not an Infant, or you don't have FPIES, that sort of thing. So they've kind of felt like they've ruled out the big bad things, but you say, I still— man, there's something when I'm eating, there's a problem. What are they going to do with you? Well, if they want to get to the bottom of it, usually they will not test IgG like George or IgA like Alpha. They might, but they usually won't. What they will usually do at that point is give you instructions on how to do an elimination And rechallenge test with food. Why is an elimination and then rechallenge test with food so useful medically speaking when you're not showing up with IgE testing that's positive, or your your gluten tests are negative, or your other tests are negative that are in the camp of true allergy or allergy-like reaction? The reason that the elimination and rechallenge testing is, uh, so well accepted for all the other reactions is— and, and I'll, I'll get into it in the second half of the program— there's so many reasons that you might react to food that have nothing to do with IgE or its relatives. That there's no way to test for all of those things. So why don't we just take the foods away from you, have you be without them long enough for your immune system to calm down, and then challenge them so you eat them one at a time. So how would you do that? Well, you would take away these major groupings of foods that are most commonly, you know, triggering of allergy and reaction and sensitivity, etc., etc. And normally you don't eat them for a period of a number of weeks, usually 4 weeks, sometimes 6 weeks, sometimes longer. Then at the end of the abstinence period, the reintroduction thing is you don't eat them all at once. So for instance, let's say you're gonna remove dairy products and the dairy products that are normally in your diet. include milk, butter, yogurt, and cheese. Okay, we'll keep it simple. You actually are going to reintroduce each of those individually. You're not going to have like a dairy festival. The reason is there's a lot of people when they reintroduce butter, they don't have a problem with it, but then when they reintroduce, let's say, cheese or milk, they do have a problem. Yeah. So you have to introduce them alone. Same with, you know, let's say you took wheat out of your diet, you took corn out of your diet, uh, you took a few other grains out of your diet, and now you want to try grains again. You're going to try each one individually. So you can see that this is a labor-intensive process. It doesn't really cost you much. It just costs you time and effort. Now, what normally we would recommend people do would be because the immune system can have sort of immediate and delayed reactions is let's go back to our dairy products idea. Let's say that you really like, you really miss milk and you want to know if that was a problem. So 4 to 6 weeks you haven't eaten any of it. So you're going to have your first challenge be milk. So you're going to drink some milk and you're going to wait and see how you react through the day. So you're going to have a few doses of milk there in the morning and just see how you do through the day. If you didn't react, what we recommend is day 2, you drink some more milk and make sure you didn't have like a delayed reaction. Because I've had people where immediately they had a problem, they got, you know, a skin issue or they got headaches or they felt sick to their stomach or whatever. But I've also had people where the first day it wasn't such a big deal, second day, wham, it really hit them hard. Well, if you have a reaction on the first or the second day, it's probably a food best left alone. So then you're done with milk, and let's say you really want to hit the dairy hard. So, you know, then on the third day, you're going to try yogurt and do the same thing again. Now, here's the thing. If you— let's say you get to yogurt and it's horrible, you have an immediate bad reaction. You don't have to rechallenge it the second day. You can let the dust settle. Now, if you have a real bad reaction, we usually have you take a day off of the challenge. Don't add anything new in. So then let's say day 5, uh, you're gonna leave butter alone, but you really would like to try, uh, wheat. So then you try wheat and you kind of see how this goes. And you just keep track of your reactions to the things. Now, the reason that the elimination and reintroduction challenge test is so, uh, desired and, you know, it kind of is useful is all of the things I'm gonna talk about now that can be responses and food reactions, food sensitivities, can be largely sorted out by doing an elimination and rechallenge test. You can do testing for some of the things I'm gonna talk about, but not all of them. Okay. So So why would there be such a big pool of negative reactions to food that are non-allergic, but they are sensitivity or reactive foods that are just not good for you? How come so many things? Well, let's start with the relative of the bad allergy, the B-cell reaction. You can have an IgA, like alpha, G, like George, or M, like Mike, reaction to foods or all of the above, and that will stimulate your immune system. But generally that doesn't stimulate it in a way that will kill you or cause great harm. It just makes you sick. So you can have B-cell type reactions to foods, and that might be a problem. You also can have non-B-cell immune reactions called T-cells. Remember the cell-mediated immune system? You can have T-cell reactions, and those go on, and those are now accepted and known as a As a legitimate food reaction that can go on, and that can be something that can be investigated. Now, sometimes those are related to the B-cell things, the IgEs. Sometimes they're separate. Okay. None of those are going to be caught on your standard IgE test or say, you know, most say other types of standard testing. Right. There's also immune complex problems. So if you have an antibody that's from the B cell family, an antibody like IgA or IgG alone, it may be non-reactive. But if you have antibody and then antigen that clump together— antigen is just the foreign protein or whatever it is— that complex of antigen and antibody can become immune stimulating Together, okay? The complex of antigen and antibody stimulates an accessory part of the immune system that could then make you feel unwell when you ate that food, but it has nothing to do with IgE allergy. What are other ways where you can have food reactivity? Well, one is you can have reactions because of the insulin stimulation from the. So obviously to most people, if they eat, you know, something that's pure sugar, they would expect that their body is going to release some insulin to help them to, you know, get the sugar into the cells. So that's a classic insulin response. In the case of foods, what is Interesting is if you follow different types of foods and you look at the insulin and blood sugar response to that food across different groups of people, some people have a much more aggressive insulin and blood sugar response to a food than another person will. And so, for example, They may, with a raw version of the food, have very little sort of blunted response to that vegetable or whatever. But if the vegetable is cooked, because the carbohydrates are more accessible, et cetera, it may have a more aggressive response. Well, in some people, the response of insulin release will cause a downstream effect that's not really immunologic, but you still don't feel well. So I've seen this with people where they thought that they were allergic to something or another, and they noticed when they, uh, when they stopped eating that, they stopped having particular symptoms. Well, that can be— it's a sensitivity that's maybe driven by B cells or T cells or something like that. But also I've seen it where that thing that they were eating is associated with a sudden rise in blood sugar and insulin, and then they get symptoms from that. So they might feel sleepy, they might get a headache, they may have other things that go on. And so it was a sensitivity to the food, but it wasn't necessarily like an immune sensitivity. It was an insulin and blood sugar sensitivity. There's also direct reactions of eating the food and then having it change your chemistry, so to speak. So you can think of it sort of like like fermentation, if you will. The food goes in and your stomach, which is the first to receive it and start to work on it, just doesn't react well with that food. It may be non-immune, but that food, for whatever reason, does not digest well for you. And so you'll get reactions to that food and responses from that food. Right. But they're not really immune. They're more inflammatory or digestive. So we often would call that, say, maldigestion. So in the bigger, in the bigger setting, a lot of people have a lot of foods that they react to, and it's not really allergic. It's just that their digestive capacity is diminished. And so they don't feel well when they eat that food. Yeah. Okay, so lower digestive capacity is a really common reason for reacting to foods. So let's think about this a minute. If I have a lower digestive capacity, I'm going to get my food into the stomach and maybe it's going to sit there and it's not really going to digest appropriately. It's going to create a lot of fermentation. Maybe it will trigger some bacteria that shouldn't be triggered. Maybe it'll just trigger some other neurological responses where I just don't feel well when I eat. So we have had people where we see that going on, and as sort of a test, an intervention, we'll say, well, you know, let's just make sure it's not a digestive deficit. And so we will give them some digestive enzymes. Okay. And maybe some betaine hydrochloride, a hydrochloric acid supplement. And always talk to your doctor, don't just take these things willy-nilly. But so they take them while they're eating. By the way, you don't want to take these things away from— you want to take them when you eat, right? And they say, gosh, you know, when I take those digestive support supplements, I don't get near as sick when I eat. Well, then that sort of gets us down to, well, okay, there's something that's slowing down your digestive capacity. Now that's a lot of things. That could be a genetic problem. It could be literally what you are eating, what's associated with what you're eating is triggering bad digestion. It can be certain hormonal problems. For example, thyroid. If your thyroid is low, your digestive function slows down. And we see that a lot with low thyroid. So the enzymes and the digestive supports are a way just to see if that's where the smoking gun, where the trouble is. There are also things that are genetically inherited, such as fructose intolerance. There's 2 main types of fructose intolerance. So fructose is the sugar that's in fruit, hence the name fructose. It's a little bit different than other sugars, and so it requires different transport into your blood than other sugars do. Fructose is special. So there's a transporter problem that you can be born with, and then there's a biochemical transporting problem you can be born with. If you have either one of those and you eat fructose, the fructose will not break down appropriately, and it will actually cause a lot of digestive and other symptoms in your body. That is usually tested, you can nowadays, you can look at the genetics behind that, but that is usually tested with a fructose tolerance test that is done, sort of a specialized test. It's like a glucose tolerance test only using fructose where you see, you know, what happens after you give a fructose challenge. So, and there's other intolerance digestive sort of things that can go on with food that aren't really an allergy, There's also, if you can believe it, you think about the big bad allergies, the IgE allergy that we know is allergic anaphylactic, and then the non-IgE big bad things like celiac disease and FPIES and all these other things that go on. Well, there's also something sort of in the middle where a food or other substance goes into the digestive tract And it may not trigger the IgE response, but it triggers a component of it downstream called histamine. So it might be a histamine response. Now, if you have an IgE allergic anaphylactic response, you will have a histamine response all the time, but you also can have a non-IgE anaphylactic response where you're dumping histamine from a food more locally, and that will just make you sick. It won't necessarily make you have, you know, anaphylaxis and die. So there is sort of this hybrid type reaction that can go on. Now, this— these— there are other things too, but these are the main reasons why you or others will have reactions to foods. So you can see how frustrating it is to try and look and say, okay, we have testing for IgE-mediated reactions, the big bad allergic anaphylactic reactions to foods. And we know we don't want you to have those and die. So that's great. We'll be testing that. All these other things I just talked about though, imagine because they are other types of B cell product like IgG, A, and M, there are T cell products, there's immune complex products. There are non-IgE histamine products. There are insulin-based reactions. There's transporter-based reactions. There's biochemical reactions, digestive reactions, on down the line. All of those, there's no one blood test that's going to find all of those things. Now, your elimination and challenge test will find those things, at least from a symptomatic point of view, which is why if you don't have have the big bad IgE allergy problem, your doctor will probably say, let's do an elimination challenge. That's why. It's because category number 2, the non-allergic sensitivity reactions, are almost any other problem you can have in your body. So what I would like to do, we've got, you know, enough time here, is talk about Okay, in category 2, where there's all these problems going on, what are ways that we could test those different things? And so here's where you have to have a little— it's kind of a take a step back and take kind of a macro look on things. There are tests to look at a lot of these other reactions. But what you have to remember with them is they only test the one reaction out of, you know, just the ones I mentioned. There's about 15 others. So you can, and usually your insurance won't cover them, but you can do these other tests to get— try and get to the bottom of the reactions. And there's nothing wrong with that. But what you want to remember is, because I've had people come back and they did one of these tests and they're like, well, You know, this test says I'm allergic to X, Y, and Z, but, but when I eat this food, I know I get sick when I eat this food and it's not on the list. It didn't react. So the test must be junk. Well, no, it's just your reaction to that food you react to isn't— is not mitigated by whatever I was testing on this test here. So you do have to be careful that you understand that these other tests that don't test for food allergy, but look at food sensitivity are looking at what they look at and not Nothing else. You can still be made very sick by a food and, and have a completely normal test for it in these other, uh, in these other types of testing platforms. And so this is another reason why a lot of times the allergists don't like those tests, because, you know, it's not going to tell you about life-threatening, uh, you know, reactions, uh, and it's only going to tell you about this one immunologic reaction that we're looking at. The way I look at it is Used appropriately in the right patients, some of these other tests are useful to at least say, gee, this is not 100% of the picture, but your body really is not reacting well to these foods here that came up positive. So let's take them out of your diet. What's another reason these tests might be useful? Well, another reason the test might be useful is you may have just crashed and burned doing your elimination challenge diet because it was just too overwhelming, too many foods. And so you may do this test, you get this test back, and it's only got— it's got a smaller list of foods, so you can take those out of your diet a little bit easier. and see how your health improves and then challenge them one at a time later on. So a test like one of these, you know, newer sensitivity type tests can help you narrow down what you might want to do elimination challenge with. So there's a lot of reasons why they can work well. So what are some of the common ones that are commercially available? There is a— remember the B cell things like IgE, which is the allergy anaphylactic thing. I always recommend that, you know, if you're having any concern about allergy, that you always as a baseline do IgE testing, E like Edward. Make sure you don't light up an IgE on a food that you didn't realize you had a bad reaction to, because people say, well, I never died from eating the food before, and here I have IgE reaction. Good. But when you have IgE reaction, E like Edward, to a food, and you haven't gotten sick from it yet, you probably will. You'll get sensitized to it, and then you might have an allergic anaphylactic reaction. You don't want to do that. So always rule out the big bad IgE allergies. But after that, IgG, like George, is a real common food sensitivity test. There's a lot of different labs that do this. You want to work with your healthcare provider because they'll have different labs that they have checked out and they think are a good one. But IgG is a pretty common Sensitivity type test. Now, is it perfect? No, none of the tests are, but it will help you get in the neighborhood of foods that just aren't good for you that may cause some inflammation, and you can remove them and see how much it helps. There's also now IgA-like alpha. Now remember I said IgA is the first thing made against odd food proteins in your digestive Like IgG, it doesn't tell you anything about true allergy, allergy, type 1 allergy, anaphylactic allergy, but it does tell you there's an immune response to the food. So that might mean actually that you have a digestive system permeability problem that you're going to want to work on. But here's the thing, if you're having reactions that are IgG like George and IgA like Alpha, to foods, one of the ways you rebuild your digestive permeability is to remove those foods so you're not constantly beating up on your lining of your digestive tract and it can heal up. So you're sort of just taking away the offending substances temporarily. So IgG, IgA, those you can test. There are also some tests, food inflammatory tests, and food inflammatory complex tests that look at that antigen-antibody complex or some of the T-cell reactions. So those are available, or some of the new more modern ones that go on. The other thing that you can look at is that sort of hybrid problem where there is a histamine response but you don't have an anaphylactic IgE association. So in the, uh, in the old days, originally there was a test developed called an LHRT, a leukocyte histamine response test, and that was used specifically to see what your white blood cells did and how much histamine they dumped out when they challenged it with a particular molecule like a food protein or a drug or something. So So we use that a lot because back in those days there wasn't, uh, there wasn't a lot of specific testing for a lot of unusual medications and certain foods and stuff like that. And so that test, the leukocyte histamine response test, sort of morphed into a more modern group of testing that sometimes are, uh, sometimes mediator response, sometimes, uh, ALCAT, A-L-C-A-T. ALCAT. Uh, is a histamine type response test. And if you just look at histamine response testing, that's the basis. So what is that looking at? It's not— so, and here's the— I've had people get really confused about this. They'll say, well, I've had IgE, the real live hardcore IgE type 1 testing done for food allergies, and I'm allergic to one food. Only one food lit up on that panel. And here you give me this histamine test and I've got foods on there that have high positive histamine responses. Yeah. with, and they're not on my IgE test. How can that be? Well, there's a lot of reasons why histamine will be triggered in your body that don't require IgE as, as one of the inciting triggers. So a histamine response test like an Alcat or one of the relatives is a functional test of how your body is doing today with these foods. And you're— so you get a blood draw, your cells are harvested, they're kept alive, they're overnight shipped to the lab and then they put them in these little wells. They challenge different foods and substances and you see how much histamine is dumped from it. Again, most of the times those are not things that are going to kill you, but they will make you not feel well. What's also related there, a lot like the IgG or IgA things, if you're dumping histamine in your gut when you eat these foods every day when you're eating, that is another thing that will ruin the permeability of your digestive membranes. Yeah. Okay, so you need to remove those foods to let kind of let the fires burn out, let the, let the embers die down, as it will. So again, you can do all these tests, but remember that they only look at what they look at. So for example, just clinically speaking, we'd have people, we check their IgE and maybe find what we find there, but they still We, you know, pretty sure there's some foods. We couldn't remove all their foods and we wanted to fast-track to an elimination challenge situation. If they were very acute and very inflamed and everything, I would usually use a histamine response type test like an Alcat or something. And I would say, okay, let's remove the, the top 2 tiers of response, the high and the medium responders. Yeah. And let's get them out of your diet and see if your health improves, and then we'll work on maybe challenging them later, and we'll work on fixing up your gut. I would do that because the histamine response is a little more global. If they were more chronic and they weren't, you know, really inflamed, they're just chronic, a lot of times the IgG like George or IgA and G together was good because it was probably a long-term chronic immune thing that we could look at from the point of view of IgG array. And we'd say, okay, Take these foods out of your diet. And I had people literally, uh, you know, with bad joint pain and all kinds of other things, uh, that when they remove these things, you know, their migraines improve, their joint pain improved, whatever. And they'll say, well, why won't my insurance pay for these tests? Uh, it's because your insurance looks at allergy and allergy testing as, you know, what the allergist would do, an IgE type test or something like that. So they are out of pocket. So you do have to keep that in mind. Now, what about the other things I mentioned? Digestion and fermentation and maldigestion. Usually those things, if you're not going to do elimination challenge, you can look at, like I said, some digestive support challenge with your healthcare practitioner. And if it improves the symptoms, then what they'll look at is let's get rid of some foods that aren't good for you. Let's get you on some digestive support and let's heal up Your GI tract, help your digestive system, because you're probably getting a permeability problem with the inflammation, etc. So what I hope— we've just got a couple of minutes left here anyway, but what I'm hoping is that this, I hope, clears up this big question that comes up all of the time between, you know, one doctor said there's only one kind of food allergy, everything else is a bunch of BS. Another doctor said, no, there's a lot of type of reactions to food, plus there's food allergy. They don't seem to agree. Well, they're really both talking about the same things just from different points of view. So there can be foods that are allergic that could kill you. Obviously, nobody wants you eating those foods. But there's also foods that can just plain be bad for you for immune reasons, for histamine reasons, for inflammatory reasons, for digestive reasons, for biochemical reasons, and it's still useful to your overall healthcare to get that stuff out of your body and figure out how to calm all that down. Now, in the last minute and a half that I have left here, I just want to talk about one other thing, and that is a really common practical question, which is, okay, I did one of these other tests, so not allergy but sensitivity, and I found a food that I really like and you told me to stop eating it. Can I ever eat that food What I have found is if you eliminate— let's say there's 7 foods you find or 5 or whatever, and you eliminate them. The only way you know if you can eat the food again is rechallenge it. So in most cases, somewhere between 60 and 80% of foods that you take out, you'll be able to eat a little bit or periodically after you get them out of your system and heal your gut up. Okay. The other foods you're going to react every single time, and you just better left those alone and leave them out. There's an in-between group of foods where you might eat it once in a while and you're fine, but if you start eating it every day, you'll start to notice that it makes you sick again. So the answer of, can I put those foods back in my diet after I do the elimination and work on my digestive health and all this stuff? The real answer is it depends on the reintroduction, and you really have to keep track of that because sometimes. Yeah. The food was just a problem because your digestion didn't work. Sometimes the food was a problem because of other stuff, and sometimes the food's a problem for you forever. It's just best to leave it out of your life. Well, that was a whirlwind tour through food reactions. So allergy versus non-allergic type reactions, and how vast and wide and varied those reactions are, and why it's so hard to chase it down, but also why it's It's important to do it. I'm Dr. Paul Anderson for Medicine Health with Dr. Paul, and that is the program you listen to if you didn't know that. I am available online, D-R-A-N-O-W, Dr. A Now, dranow.com. You can find all the links to my other programs, the books, everything else, and I will see you all on the radio next week. Thank you.
