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When we don’t have any significant health concerns, questions about what foods to eat or avoid often seem insignificant or burdensome. However, when our health is not perfect, we look for solutions.
For many of us with vague, chronic, or, mysterious health concerns, we find ourselves without helpful answers from our usual healthcare providers. Unfortunately, nutrition and diet are completely overlooked in the standard training of 99% of the doctors worldwide. It is rare to find one who considers diet and nutrition in addition to the other causes and treatment options. When we do research, we find that many people are looking for and finding answers in the realm of diet. One of the most common solutions people discuss is that they find relief eliminating specific problematic foods.
We have all seen the changing offerings in every grocery store:
Why are these offerings so popular? Could this be helpful to me?
Our intestines handle, digest, absorb, and excrete the remains of 3-5 pounds of food per day. That’s close to a ton of food per year passing over around 3000 square feet of intestinal membranes. That is the largest exposure our bodies face every day. And food can be... difficult. Think about the questionably cooked meals, the additives, preservatives, pesticides, chemicals, etc, not to mention the incredible variety of foods you eat. If you have digestive complaints or health concerns not easily solved by other measures, there is a good chance that one or more of the things you are eating is not agreeing with you.
Additionally, just inside the intestinal membrane lays the largest array of immune cells in our bodies. Everything you eat gets monitored by your immune system in it’s effort to protect the body from invasion by microorganisms and viruses. It’s no wonder that the immune system and intestinal health are so closely linked. Sometimes, the immune system gets confused and becomes reactive to a chemical or food.
And that is what most food allergy testing is looking for: Immune reactions to food. When foods trigger our immune systems, the result can be quick and severe, like an anaphylactic reaction (throat and face swelling) or slow and insidious, like a gradual imbalance in the immune system leading to chronic inflammation and disease. The quick reaction is called the “Classic Allergy.” Because it can be fatal in minutes, we have good testing available through the skin and blood.
The slower immune reactions to food are harder to pinpoint, but testing is available.
Blood tests such as IgG, IgA, and ALCAT are useful, but not perfect. There are some false positives and negatives, but they are a good starting point. This testing is not always covered by insurance, but may be worthy of the expense if you are looking for solutions to problems that have been evasive, or even just trying to optimize your health and start some long-term prevention.
To complicate things further, there are other reactions to foods that are not related directly to the immune system. These can include drug-like effects of certain chemicals in foods or the result of the actions of breakdown products of foods or additives. These reactions are even harder to pinpoint. For years, the gold standard has been the “Elimination Diet and Challenge”. In this approach, a person narrows their diet to a few non-problematic foods, or chooses a handful to eliminate. They avoid the suspect foods for 3 weeks and look for improvements in the symptoms. Then, we add the questionable foods in, one at a time for 3 days each and look for aggravation of the symptoms. Those time frames are usually enough to catch any changes. This approach is difficult for most to accomplish because it requires absolute adherence to the avoidance of the foods in question. While I have done this myself and seen benefit with many patients, I usually do not recommend it as a first line approach for patients. It is often easier and more fruitful to start with blood testing. However, if finances are a major issue and a patient is flexible enough to handle the effort required, an elimination diet can be useful. Also, if further confirmation is needed, elimination diets can be useful after other testing.
As an example, I had a patient with severe eczema. We decided to do an elimination diet, but her eczema actually got worse on the diet. When we analyzed the diet, we decided to shift things around, adding some foods in and eliminating others. We found that, of all things, broccoli was the main cause of her eczema! She was eating a lot of it on the original elimination diet and it caused a worsening of symptoms. When she stopped eating it consistently, her eczema resolved.
I’ve seen more cases of ear infections, chronic cough, chronic diarrhea, and other conditions resolve with the uncovering of a food cause than I can count. I've also seen serious conditions like RA and Ulcerative Colitis improve significantly.
The following are a list of conditions that sometimes or often respond well to avoidance of specific foods:
Loose and/or frequent stools and IBS
Pruritis Ani (Chronic itchy anus)
Fatigue not caused by other medical conditions
Poor growth in children
Autoimmune conditions, including Rheumatoid Arthritis, Lupus, SLE, and others
Inflammatory bowel diseases like Crohn’s, UC, and Celiac Disease
Hay fever and asthma
Weight Gain or loss not explained by other medical conditions, or inability to lose weight
Frequent ear, sinus, throat, or respiratory infections
Autism, Asperger's, and spectrum disorders
Other chronic, mysterious, or elusive conditions or symptoms.
Once a problematic food is found, it’s not the end of the world. There are several options depending on the type and severity of your reaction. It may involve avoidance of the food for a period of time. There are also desensitization techniques like sublingual drops or rotation of the food in your diet on a specific schedule to reduce your reactions to it. From there you should be experiencing improvement or cure from the issue the food was causing, and a general improvement in health and wellbeing.
It is important to have a visit with a physician who understands the various causes of health and disease, including the importance of food to our health. Unfortunately, nutrition and diet are completely overlooked in the standard training of 99% of the doctors worldwide. It is rare to find one who considers diet and nutrition in addition to the other causes and treatment options.
Luckily, you have access to an expert. As a physician with 10 years experience treating a wide variety of conditions in a range of settings, I will help you navigate the intricacies of health and health care and give you reasonable and comforting support in finding solutions. I have helped many patients like you using food testing and other approaches, and I’d be happy to discuss whether I believe food testing or other approaches would be helpful for your specific concerns.