I’ve just spent a happy morning updating the Allergy & Intolerance Tests page for you. Some great new food tests have come out from Precision Point Diagnostics and I’ve been assessing and comparing them, checking we have the most relevant and technologically up-to-date testing to find reactive foods.
Why is this important? Simply because I am finding more and more that unless people sort out their sensitivities, they just don’t get well. Often its the actual food reactions causing the symptoms and conditions in the first place. Of course, we don’t want life to be all about avoiding foods and I’m working on a Hypersensitivity Plan for you to address the underlying causes. BUT, if we can identify the main triggers, life can pretty quickly get a lot nicer! This new test should pull out the priority ones instead of getting a huge, scary list!
The new Precision Allergy 88 Test is going to be really useful. Why? It measures four different types of reaction, including classical IgE, and then totals the whole lot up and provides an Immune Index list of your most likely problem foods. Not only that, it separates the foods out so you can see what type of foods you might be most sensitive to (eg grains, dairy, seafood, seeds, whatever). And, even better – I whooped at this – they list the foods so you can clearly see if you are mainly reacting to eg. histamine foods, salicylates, phenols, lectins, FODMAPs etc etc. SO useful, huh?
You can see a sample report here, but here are my fave highlights.. (I shouldn’t get so excited, should I?!)
Very clever, I think.
On top of that, we have a new mucosal food sensitivity PP Dietary test where they measure the 88 foods against SIgA. Why is that useful? Well, SIgA is the first response in the immune system at the barrier/surface level so you’re likely to catch earlier reactions there. I think it will be most useful for people with mucosal area symptoms ie. the gut, urinary tract, skin, lungs, mouth and if people have not found anything on the PP88 test. This is new stuff so I need to learn more about it yet. I shall, of course.
You can see the new Allergy and Intolerance Testing page here, but I’ll copy the relevant bits below for you too, including the cute cat picture I use on the page to give you some light relief!
If in doubt on what food intolerance test to do and you are still eating the suspect foods, choose the Precision Allergy 88 Test. Simply the best I’ve ever come across. Don’t forget to do a GAM Test (PHC) to check your levels of total antibodies first if poss – see why this matters below. If you are autoimmune or at risk of it, or suspect a gluten related disorder, look at doing some Cyrex testing. For specific issues like Histamine, DAO, Oxalates, Tryptase, Fructose and Lactose, see the recommendations below.
Allergy Testing (IgE)
The medical definition of food allergy is an immediate immune system reaction sparked by the binding of an IgE antibody to a mast cell thereby causing a release of histamine. It is this type that confers a risk of anaphylaxis. Here, you can look at foods or inhalants eg. for hayfever, rhinitis, asthma sufferers etc.
If you’re not sure if IgE allergy is involved, start with a Total IgE Immunoglobulin E Test (MC). If this is high, then allergy is involved somewhere and you would then start to test for allergens. If not, then start looking for intolerances instead.
You can choose one of several IgE Allergy tests. The PP Allergy 88 measures four types of food sensitivity, including IgE, so if it’s food you’re after testing and you don’t want to suffer the consequences of a skin prick test, do this.
Food Intolerance/Sensitivity Testing (IgA, IgG, IgG4, Complement etc)
Even though IgE classical allergy is the one most accepted in mainstream medicine, food intolerance is much more prevalent, certainly in my experience! The overall definition of food intolerance is a delayed reaction to a food which does not involve IgE, the symptoms of which are extremely varied and can be behavioural, emotional or cognitive as well as physical.
It is worth noting that a reaction may only be ‘delayed’ by a matter of minutes, but is usually from 2-4 hours later and can last several days (3 mostly, but more mildly up to 10 is very common). There is a sense that allergy is worse to have than food intolerance and that is understandable because of the risk of anaphylaxis. However, food intolerance sufferers are often sensitive to more foods and have more frequent reactions affecting more body systems so it can be awful to live with in a different way.
Some types of reaction, but not all, involve antibodies such as IgG, IgA and IgM. IgA signifies a developing problem, IgM suggests an early reactivity and IgG, the most common one tested for, usually denotes a chronic problem with a food. There are four sub-classes of IgG: 1-4.
Measuring total immunoglobulins first….
Be aware that some people can have low levels of these antibodies if the immune system is not brilliant. If doing an important – and often expensive – food intolerance/sensitivity test, it is wise to do a quick check on your totals. You would use a GAM Test (PHC) which will show you if any of your IgG, IgA or IgM antibody levels are low. If, say, your IgG was low in total ie. you’re not producing much, then any further testing that measures IgG might show allergen reactions are lower than they really are. It’s not that you can’t have those tests done; more that you have to factor that in when looking at your results. In that scenario, you’d think: ‘Aha, this IgG test result for beef is borderline, but I know my IgG is low so it is probably more likely higher than that and positive.’ Do you see?
The importance of complement…
Research suggests that most of us can develop IgA and IgG antibodies to foods and that whether we will react to them or not depends on if those antibodies have activated complement, a part of the immune system known to trigger an inflammatory cascade in the body. Newer tests have been developed that now allow us to measure the antibodies and see if they are bound to complement. This usually results in far fewer positive foods and helps us target the key problem foods rather than getting a whole list of possibles. This is good news!
The Precision Allergy 88 Test (RG) is a great all-in-one as it measures IgE, IgG, IgG4 and complement (C3d) reactions to 88 of the most common foods. The report sorts your results to help you determine if certain food groups (eg. grains, seafood etc) or types of intolerance could be your issue eg. oxalates, histamines, lectins, phenols, salicylates, amines, nitrite, glutamates and FODMAP foods.
It includes an Immune Index which totals up your four types of intolerance and gives you a top foods to avoid list. Really clever. You can see a sample report here. It looks complicated, but actually makes sense when you go through it. I can always help too, of course. For more info, see this useful handout. By far the best food test I’ve seen over 30 years of doing this, I have to say! I whooped.
Do bear in mind that you have to be eating a food regularly for an antibody to show up on testing. After a couple of weeks, the antibody levels start to drop so you won’t find them!
The report gives you a couple of diet options to follow, depending on your severity and situation. Generally, in my clinical experience, you do the test, knock out the highest offending foods from the Immune Index for minimum 8 weeks (preferably 12), re-test to see if the immune complexes have come down sufficiently and, when they have, you reintroduce one at a time, noting symptoms. You then retest if you wish again (or just enjoy your new-found energy and health!) and make sure that the immune complexes are not rising again.
If you still react to something, you need at least a year off it, by which time the inflammation complexes should have reduced sufficiently (the average seems to be 10.5 months according to some experts), then start the reintro and retest process again.
In general, anti-inflammatory treatment should be done alongside the removal of the foods to help lower the systemic inflammation in the body. And investigate any of the possible sensitivity types they highlight ie. histamine, lectins etc.
Note that the PP Allergy 88 samples need centrifuging, so choose a phlebotomy service that does that – often a Nuffield.
A word on SIgA Testing
New to the market, you can now also test food sensitivity using salivary SIgA (secretory IgA) antibodies. If your PP Allergy 88 test doesn’t show what you think it should and/or your symptoms are in the mucosal system (that’s gut, skin, vagina, mouth, lungs, urinary tract etc), then this can be a great double-checker test. You will get earlier reactions by measuring SIgA as it is the first antibody reaction if something is going wrong immune-wise with your foods. It’s a test that sort of goes further back in the immune response, if you like. You can see the PP Dietary Test here, which measures 88 foods to SIgA. Read more about it here.