Food allergy is believed to be the single most contributory factor of chronic disease and therefore warrants consideration when evaluating the patient. Immune reactions to ingestants are much more complex than inhalants which tend to be a fixed allergy. To the physician who understands the basic history and complex symptomology of food hypersensitivity, evaluation has a relevant place in determining cause of disease and impaired health in many patients.
There are two major types of food allergy–fixed and cyclic. Other responses such as IgA and IgM will not be addressed here. A fixed food allergy is designated as a IgE response that occurs each time the food is consumed regardless of how long it has been avoided and may include anaphylactic reaction. A cyclic food allergy reaction is designated as IgG response and is related to frequency and quantity of the consumption of the offending food. The initial consumption of the food gives a stimulus that the patient may enjoy and as this wears off, the undesirable symptoms begin. Often the patient erroneously believes because they do not notice a symptom immediately, that the food is safe. Theoretically food sensitivity or IgG response is the only allergic condition that can be perfectly controlled. This is a bold statement without regard to conditions which can increase the sensitivity of the patient such as leaky gut syndrome.
If symptoms improve with fasting for several days, then food allergy should be considered. If symptoms worsen after a meal or symptoms are temporarily relieved after certain foods are consumed, food allergy should be considered. And if cravings for favorite foods are common, food allergy should be considered.
A personal history should be taken to include home and occupational environment, all organ systems, and detailed history back to childhood. Medications and supplement list should be compiled and alcohol intake should be evaluated. The tests and methods to determine food sensitivities all have limitations but a combination of these tests often produces a treatment plan with good outcomes.
Food Diary Evaluation: A food diary of at least seven days, to include all fluids as well, is an important component to determine a correct diagnosis.
If a patient fasts for a period of four days, and most of the offending symptoms lessen or disappear, allergy is a contributor. Additionally patients who tend to eat the same food over and over again, an irritation occurs in the gut resulting in small particles of the same crossing the gut barrier into the blood stream and are recognized as foreign bodies. The immune system attacks them and sensitivity is developed, hence symptoms occur. The diagnosis and treatment of food allergy can be accomplished by several different methods.
Oral Food Challenge – yourtotalhealth.ivillage.com/food–challenge-test.html
Food diary evaluation
Rotary diversified diet (Rinkel) www.food-allergy.org/page2.html
Elimination Diet (Rowe) www.blackwell-synergy.com
4-day rotation food families (Randolph) www.frot.co.nz/dietnet/resources/ediet_howto.htm – 74k
Commercial tests include RAST, IgE, IgG, Elisa and usually are not covered by insurance unless certain criteria are met meeting insurance standards such as eczema, psoriasis, autoimmune disease, neuropsychiatric issues, antihistimine failure, prednisone usage or under 4 years of age.
These tests along with diagnostic criteria will be discussed further in future articles as we continue to look at allergy and its impact on health.