By David J. Getoff, CCN., CNC., FAAIM
When most of us think about allergies, we generally think about sinus problems such as a stuffed or runny nose and itchy eyes. These symptoms may be caused by an allergy to a food, a pet, a pollen or many other natural or man made substances. Sometimes we think of the itch caused by rubbing up against a pet’s fur that we are allergic to or possibly an allergy to wool or a particular plant. Although these are some of the most common allergies, they are far from the only ones which cause us grief.
There are two main distinctions in allergic responses. Is it an immediate response (within 60 minutes of the exposure) or a delayed response, which might not produce a symptom for many hours or even up to two or three days after the exposure. The medical profession generally refers to an allergy as something called an IgE mediated response and these occur very soon after exposure to the offending allergen. They are histamine reactions and they cause the familiar symptoms mentioned above. These standard medical allergies do not include the delayed response type. In reality however, (as opposed to in traditional medicine) if your body reacts to something in an other-than-normal manner, we would likely call it an allergy unless it is a toxic reaction to a poison. For example, we would not consider dying from a bullet wound to be an allergic reaction. We should also not think of a reaction to a toxic substance such as chlorine, insecticides, herbicides, certain cosmetic chemicals, or mercury to be an allergic response. These are poisonings and not allergies. The human body was never designed to be exposed to toxic chemicals. A reaction to these chemicals is therefore normal, even though they may not cause a noticeable symptom in everyone. Those persons whose biochemical detoxification systems are not working quite as well (a rapidly growing segment of our population) are the ones which appear more sensitive to exposure to these poisons.
Any reaction to a substance which should not be considered as a poison by our body, may be referred to as an allergy or an intolerance. A short list of possible allergens could include foods (but not food additives), fabrics, pollens, leaves, metals, plants, and natural odors such as from flowers or essential oils, etc. These are all substances which the body of a normal healthy individual would generally not react to.
Another useful list would be the reactions themselves. What ways might your body react and therefore what kinds of symptoms may actually be allergic in nature. This list is a long one, and includes dandruff, sinus problems, difficulty breathing, itching, difficulty concentrating, hyperactivity, attention deficit, pain in the joints or muscles, hormonal dysregulation, heart irregularities, inability to sleep, fatigue, various emotional disorders, and many more. All of these symptoms may be caused by sensitivities to foods or other triggering allergic substances. It is amazing how many problems can be allergic in nature. Other good examples are: fatigue, chronic sinus problems, low immune function and ADD or ADHD in children or adults. These are rarely looked at as having any possible underlying allergic cause. More often they are just treated with symptom suppressing drugs without even looking for a cause to what might need to be addressed. Remember, drugs are generally developed for the purpose of suppressing (making go away) an irritating or unwanted symptom. It is extremely rare that a drug actually corrects the underlying problem rather than a symptom.
Many tests have been developed to help determine whether an individual is allergic or reactive to a substance. These are generally called allergy tests and there are quite a few different types available. Some are direct provocation tests where the person being tested is actually exposed by a skin scratch or micro injection to determine whether there is a reaction to the substance. Many others involve the use of a blood sample from the individual. In the latter forms of testing, either the blood or the serum is examined (such as under a microscope) to determine what reactions occur when specific substances are introduced. When it is noted that the blood reacts in an unnatural manner to a specific substance, this is recorded as a reactive substance. Most of these tests have reaction “levels” and they are listed on a 1 to 3 or a 1 to 4 severity scale for each substance being tested.
A few examples of allergy tests using blood samples are RAST, Cytotoxic, ALCAT, and various IgE and Igg tests offered by numerous laboratories around the country.
Having listened to numerous physicians and scientists at dozens of conferences, it is interesting to note that there seems to be no definitive agreement as to which tests or which laboratories are the most accurate. The only agreement I hear continually, is that the skin scratch test is useful for inhalant allergens but is not accurate to test for sensitivities to foods. As far as which of the many tests each individual physician or clinician prefers for food testing simply depends on who you ask. The three which appear to be liked the most seem to be Igg testing, Cytotoxic testing and the ALCAT test. Many of the professionals that I queried, had never compared one test against another nor had they looked at any research done to prove the validity or repeatability of their test of choice. This lack of comparison can cause a great deal of wasted money on useless test results. If a patient or insurance company will be paying hundreds of dollars for an allergy test, two things should always be of prime importance. These are the validity and repeatability of the test. Repeatability is simply a quality control issue. If you were to take a sample of blood from an individual and divide it into two separate tubes, labeled as if they were actually different people, the tests results should come out almost identical if sent to the same lab. This is called a “split sample” and it is the gold standard used to test a laboratory’s repeatability. If blood from the same person split into two samples were to give you 50% different results, than the lab test would not be useful since you would not know which results were correct or even if any of the results were correct! In fact, a study published in the Townsend Letter for Doctors a number of years ago investigated this exact problem. The study, which was done by professionals at Bastyr University, sent split samples to three well known Igg allergy laboratories. Only one of the three labs had the repeatability that is required for accurate testing.
The only lab which I know of that repeatedly has blind split sampling done to test and verify their repeatability is Immuno Laboratories in Florida. This lab actually asks certain doctors to split sample them without their knowledge, in order to continually test their tight standards of repeatability. They are the only lab I use for what is referred to as delayed food sensitivity or Igg testing which I will discuss shortly.
The other important test is that of validity. In other words, is the test a valid test. Even if a test is repeatable, if it is not a valid test then it is simply a waste of money to everyone except the lab. What is meant by validity is this: Does the elimination of the foods which test out as being reactive, result in an improvement in symptoms and a betterment of the health of the patient. If removing the reactive foods from the diet does not help the patient, then the test is not a valid indicator of those foods which are harmful or are triggers of various problems. Both Immuno Laboratories and ALCAT have studies which show that their tests are valid in this regard. There have been various studies over the years on some of the other tests, but as far as I know, they were not laboratory specific. In other words the type of test was studied, but not in relation to a specific laboratory. If we are to trust an allergy test, with all of the variables I have just outlined, then the specific laboratory which runs the test is at least as important as the test itself.
So what is a delayed sensitivity test and why are they so important? Medically accepted allergies are IgE reactions and are not delayed. They occur within the first 60 minutes after exposure to the substance and most often within the first 10 minutes. This fact generally makes it much easier for us to have discovered which substance affect us in this way. If we are smart, we will avoid these substances for the benefit of our health. Igg or delayed sensitivities, on the other hand, may not occur until many hours or even a couple of days after exposure to or ingestion of the triggering food and this causes a great deal of problems. The trouble is that we simply have no idea what substance might be causing the reaction and absolutely no simple method of determining the offending trigger foods or substances. The least expensive most time consuming and most accurate method of determination is probably the elimination/provocation diet challenge. To do this, it is necessary to live in a cave in the middle of nowhere and have all your foods shipped in to you by a Star Trek transporter unit. I am joking. It is so difficult to be certain that you do not inadvertently consume some food that you are trying to avoid, that it becomes almost (but not quite) impossible to do this long enough (a few months) to get the desired information. First, you would need to set up a healthy and complete diet which is devoid of every food that you might conceivably be reactive to. Since you have basically no idea which foods these are, you can see how difficult this would be. You must eat only foods that you prepare from scratch, since frozen, packaged, canned, and store or restaurant prepared foods usually contain many ingredients not specified on their labels. Second, you need to remain on this hopefully non-allergic diet for two to three weeks and then you would bring in just one single new food at a time for a period of four days. If you noticed no reaction of any kind, you would leave that food in your “okay” list, and add in another for the next four days etc… If any food gives you a reaction of any kind, you would immediately eliminate it and wait until the reaction totally clears before trying the next food. Sound like fun? I didn’t think so, but it is accurate and it is cheap.
The easier method is accomplished by sending a blood sample to a lab such as Immuno Laboratories. In addition to being a great deal easier, however, it is also more costly. Immuno Labs tests about 115 foods and they supply a nice color chart showing your reactivity level as well as giving you a pocket or wallet card listing your allergies. I have found this test to be extremely helpful in my practice.
Of all the problems relating to allergy and sensitivity testing, there is one which is the most bothersome. We simply do not know (and therefore cannot test) all of the ways in which our body may react to undesirable substances. The result of this problem is that you may have thousands of dollars worth of testing done and still not find all your offending or triggering substances. In addition, this also means that there may be a food which shows up as non reactive on a high quality test, but which you know for certain you react to. This simply indicates that you are reacting in a way that the test is not able to determine or measure. Hopefully, some time in the future, we will have additional tests which will be able to isolate some of the other ways in which our bodies react to exogenous substances. Even with this problem, being able to test over a hundred foods with a simple test can be a real lifesaver. Many people have been greatly helped by identifying these delayed food sensitivities and eliminating them from their diet. After the offending food has been completely eliminated for 30-60 days, those which react at a level of +1 or +2 can generally be rotated back into the diet once a week without a reaction. The more sever reacting foods may always cause a symptom or may need to be eliminated for a longer period. Immuno Laboratories supplies all this information with the test results that are sent to the patient.
The normal cost for the 115 food delayed sensitivity (igg) panel that I use the most often varies greatly from doctor to doctor. It depends on the number of tests that each doctor orders per month as well as the amount that the physician needs to mark up the test in order to cover his costs of overhead. Generally physicians charge between $500-600 for this test.
Immuno Labs is the only lab that I currently recommend since many laboratories doing food testing are extremely inaccurate. In one study, some of the other labs had differences of 50-83% on two samples taken from the same person and sent in on the same day. The samples were given different names so that the labs did not know that they were being tested. This is called split sampling. Although there must certainly be other labs that are good, I am not certain which they are at this point.
Immuno Laboratoriess tests may be ordered by your physician or you can go directly to the company if your physician is not interested in helping you with this. To find the nearest physician who works with these tests or to get information on ordering them yourself if no physician is in your area, call Immuno Labs at 1-800-231-9197.
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Copyright 2003 David J. Getoff
