What symptoms does food intolerance cause?

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1 What symptoms does food intolerance cause? Food intolerances can lead to a wide range of symptoms and may involve a number of different symptoms in each individual. Commonly experienced symptoms include:- Anxiety, asthma, attention deficit disorder, constipation, depression, diarrhoea, abdominal bloating, inflammatory bowel disease, irritable bowel syndrome, gastritis, insomnia, headaches, migraines, fluid retention, arthritis, fibromyalgia, chronic fatigue syndrome, itchy skin, weight control problems, and hyperactivity. How can I suspect that a food is the link to my symptoms when I cannot be specific about the cause? Food intolerance reactions can include pharmacologic, metabolic, and gastro-intestinal responses to foods or food compounds. Food intolerance does not include foodborne illness although this can be a definite trigger as intestinal integrity is damaged. It is not a psychological response when a person simply does not like a flavor, smell or texture. Metabolic food reactions are due to inborn or acquired errors of metabolism of nutrients, such as enzyme deficiencies, diabetes mellitus, and phenylketonuria. Pharmacological or drug related can be broadly defined as any man-made, natural, or molecule made within the body which exerts a biochemical and/or physiological effect. Natural compounds can be found in many fruits and vegetables, nuts, spices, sauces, meats and are called salicylates and amines, or industrialised food additives, such as preservatives, colouring, emulsifiers and flavour enhancers. These chemicals are capable of causing drug-like (biochemical) side effects in sensitive individuals. Gastro-intestinal reactions can be due to malabsorption or other GI Tract abnormalities. Immunological responses are mediated by non-ige immunoglobulins, where the immune system recognises a particular food as a foreign body. Toxins may either be present naturally in food, be released by bacteria, or be due to contamination of food products. Toxic food reactions are caused by the direct action of a food or substance without immune involvement. What is the difference between allergy and intolerance? A food allergy usually involves a group of antibodies called IgE antibodies and food allergies (such as those to peanuts or shellfish) usually result in an immediate and often very severe reaction. Symptoms can include anaphylaxis, skin reactions such as hives, vomiting, sneezing, swelling, runny nose and fatigue. Unlike a true allergy a food intolerance can occur up to 3 days after consumption of the offending food and maybe due to a pharmacological effect such as that caused by the tyramine in red wine, an insufficiency of an enzyme such as in lactose intolerance, or to the

2 production of IgG antibodies to the offending foods. This delay in symptoms can make it notoriously difficult to detect food intolerances. Why should I DO THE Food Intolerance? The test identifies over 220 well known food irritants as well as being more specific and easier for clinicians to work with. It measures four subclasses of IgG antibodies IgG1, IgG2, IgG3, and IgG4; is predominantly involved in secondary responses; What is an IgG? IgG stands for Immunoglobulin G and are antibodies which are produced by the immune system in response to foreign bodies (antigens) entering the body. There are several different types of immunoglobulins with IgA, IgE, IgG, IgM being the most well known. Complexes are deposited in tissues and activate a complement and along with macrophages, stimulate inflammation. This can take hours or days, be reliant on the amount of antagonist ingested and last up to days to be cleared. What is an antibody, and how do IgG and IgE antibodies differ? An antibody is a special type of protein produced by the body s immune system in response to foreign bodies (such as viruses, bacteria and toxins). They are produced by white blood cells called B-Lymphocytes in order to protect the body against these foreign substances. IgE antibodies are a type of antibody mostly found in the skin, nose, lining of airways and lungs, and are usually produced in classical allergies. IgG antibodies are the type of antibodies that the Lab 21 food intolerance test checks for. It has been shown by various studies, that if foods producing high IgG levels are eliminated from the diet, the symptoms of food intolerance can be reduced. The IgE response is generally rapid after ingestion, produces histamine and classic allergy symptoms. Why do foods cause an IgG response? Foods are usually broken down as part of the digestive process into their component parts e.g. amino acids, glycerides etc. These mostly pass harmlessly through the gut into the bloodstream; however, sometimes small fragments of partially digested or undigested foods are able to pass through the gut wall into the bloodstream where they are recognized by the immune system as being foreign. The immune system then responds as if these food particles were a foreign body and makes antibodies (IgGs). In some patients, inflammation or irritation of the gut lining allows partially digested foods to leak into the bloodstream. This condition is called leaky gut syndrome or altered intestinal permeability and patients with this condition typically have high levels of antibodies to multiple foods.

3 Is a food intolerance test appropriate for me? If you are experiencing one or more of the symptoms above and you have checked with your GP to ensure that you have no medical causes for your symptoms, then a food intolerance test may well be a sensible next step. Are the tests covered by health insurance companies? Some companies will cover tests but it s best to check with your insurance provider as policies vary. Does it matter when I do the test? The blood sample can be taken anytime and results take a day or two Will this test pick up all foods that are likely to be affecting me? The test is checking for the presence of elevated levels of IgG antibodies in blood and this is one of the key ways in which food intolerance can manifest itself. Some foods however may cause a classical allergic reaction involving the production IgE antibodies. These will not be detected by any IgG food test. In addition there are also many foods that can cause a reaction in the body without involving the immune system.. For example, some food additives such as tartrazine can cause hives, rashes and asthma; monosodium glutamate in Chinese dishes produces sweating and dizziness; amines in chocolate, cheese and red wine may cause migraines; and Nightshade alkaloids in potatoes, tomatoes and peppers can affect the joints. These are very difficult to test, but you should avoid them if you suspect they are affecting you. Are there any medications that will affect the results? Immunosuppressant s which are often given following an organ transplant will reduce the immune system s ability to generate antibodies. High doses of steroids will also affect antibody production. If you are in any doubt, please consult your GP. I have been avoiding a food for more than 3 months; will this food show up in the test? When foods are avoided antibody levels tend to decline and therefore it is very likely that the food test will be unable to detect an elevated level of antibodies. If you wish to test whether you can now tolerate the food concerned and feel happy that you can cope with the symptoms that may occur, include a portion of that food every day for 5-7 days before taking the blood sample. If the food concerned causes you extreme symptoms, however, then do not to re-introduce that food at all Are there any research papers to support these tests?

4 Yes, a number of studies have implicated food IgG antibodies in the development of food intolerances and chronic illnesses such as eczema, arthritis and irritable bowel syndrome. Have there been any trials to support these tests? An independent audit, conducted in 1998, studied symptom reduction in over 2000 individuals following an elimination diet based on the food intolerance IgG test. The audit demonstrated that more than 70% of patients reported a significant reduction in symptoms after eliminating the foods giving high IgG levels in the test. What do the borderline foods mean? The borderline foods are slightly above the normal values and ideally should be reduced to a minimum in your diet. Therefore, we recommend that you rotate those foods showing a borderline result, once every 4 days if possible. Why would I have no reaction to some members of a food family (i.e. lentils, carob, peanuts) and yet other members of a food family come up positive (e.g. soya, haricot, kidney) even though not eaten for years, Some antigens in foods are less able to initiate an immune response than others i.e. they are less immunogenic and, as a result, antibody production to them is less easily stimulated. Also while members of the same food family may be antigenically similar such that antibodies to one member will cross-react with another member, they will also exhibit antigenic differences depending on how closely related they are. Hence, it is possible that foods that have caused strong antibody responses which remain detectable even though they have not been eaten for years, do not cross react with other members of the same food family. I have been told to eliminate a particular food from my diet, but have not eaten it for years, why do I have a high IgG reading? This is because either a) you have been eating x in other foods unbeknown to you, or b) you have been eating foods within the same food family and these are causing antibody production; c) antibodies stimulated by other foods cross react with x in the test. Does that mean that other results may be due to cross reactivity? Yes they may be but to start it is a good idea to eliminate all foods identified by the test. Is it possible to have high IgG levels and not have symptoms? Yes, some people do have high IgG levels to certain foods without symptoms. This may be due to their immune system being extremely efficient at clearing away the antigen-antibody complexes before they can be deposited in the tissues and cause a problem.

5 Is there any evidence for complexes actually causing symptoms? A study of infants with milk intolerance showed that symptoms appeared within hours of cow s milk consumption and that this was accompanied by notable immune complexes appearing in the serum. Would a single positive response indicate a leaky gut? No. Food antibody responses occur naturally without increased gut permeability (leaky gut). Does a Leaky Gut need to be repaired before those foods can be eaten again without symptoms? Yes. If you have a number of food intolerances then it is worth having a consultation so that we can look at what is causing your gut to be leaky and advise you on the best way to repair the damage. Why do some foods seem more likely to cause food intolerances than others? Two main factors influence the development of IgG food intolerances: the amount of a particular food in the diet and how well it is able to stimulate antibody production. Foods eaten in large quantities are more often associated with food antibody production and in addition some foods are more immunogenic than others i.e. are more able to cause antibody production. What is Leaky Gut Syndrome? Leaky Gut Syndrome is a condition in which gaps appear between the cells of the intestinal wall causing large quantities of partially digested food to leak into the bloodstream. Symptoms can include: abdominal pain, heartburn, insomnia, bloating, anxiety, gluten intolerance, malnutrition, muscle cramps and pains, poor exercise tolerance, food allergies. Why do high IgG antibody levels cause symptoms? IgG antibodies at high levels combine with the protein in the food to form an antigen-antibody complex. These complexes are usually eliminated by other cells in the immune system. However, if the immune system is overloaded, these molecules can become deposited in various body parts such as the head, lung tissue, gastro-intestinal tract, skin and joints where they produce symptoms such as headaches, asthma, irritable bowel syndrome, eczema and rashes, and arthritis. RESULTS AND ACTIONS Once I have done a test what do I do next? Once you have the results for your test, it is recommended that you book a consultation so that we can help you to understand the results and give you more help with addressing the underlying causes of your food intolerances.

6 I have a lot of positive results, how do I cut out everything? If you have a lot of positive results, it can be a challenging task to cut out everything whilst maintaining a nutritionally well balanced diet. In this situation we recommend that you have a consultation so that we can help you to avoid the foods with a strong positive response, and to rotate the foods with a lower positive result. What does it mean if I have lots of positive results? Potentially, you may have a condition known as Leaky Gut. Again a consultation will help us to advise you on what you can do to improve this situation. How long will I need to avoid these foods for? We recommend that you avoid foods for at least 4 months by which time hopefully you will have noticed an improvement in your symptoms. After 4 months you can start to gradually introduce foods back in one at a time leaving 4 days in between each reintroduction. If you don t experience any new symptoms then you should be able to keep on eating that food on an occasional basis. How long does it take for elevated levels of IgG antibodies to return to a normal level? Over time, the levels of IgG antibodies to particular foods gradually decreases, although the exact time for this to happen depends upon how elevated the levels of antibodies were to start with and how strictly the food has been avoided.. Do I need to completely avoid all food causing intolerances in order to reduce my symptoms, or can I still have a little occasionally? The best way to reduce symptoms is to eliminate the food completely. As long as exposure is maintained, antibodies will continue to be produced and the immune system primed to react. It is also best to avoid foods of the same food family. I feel worse not better since I started to avoid foods from my diet, is this normal? Many people do in fact feel worse in the first few days after excluding a food or foods from their diet due to withdrawal-type symptoms. This is not abnormal and usually passes after a week or two.. Do I need to have a re-test after a few months? It is not always necessary to have a retest but if you have a lot of symptoms and would like to see if any new foods might be causing a problem then a retest may be a good idea. We normally advise a period of 6 months between tests. If your symptoms have improved and you have been able to successfully re-introduce the foods, then a re-test is unnecessary.

7 If I have been avoiding foods from my diet but would like them tested, how long should I introduce them before the test? We advise that you introduce a portion of these foods every day for at least 7 days before taking the blood sample. However, if you experience severe symptoms as a consequence, then immediately stop eating them and assume that you are still intolerant to them. I sometimes feel better immediately after eating a food that I am supposed to be intolerant to. Does this mean the test is wrong? No. Research has shown that some foods to which we are intolerant can cause endorphin like reactions which can make us feel good immediately after we have eaten then. However this initial sense of well being is often followed by symptoms that occur hours or even days later. What is cola nut and what foods is it in? Cola Nut is the seed kernel of a large African tree. It contains stimulants such as caffeine, theobromine, tannins and phenolics. In addition it contains phlobaphens, the antocyanin pigment kola red, betaine, protein and starch. The cola nut is used as one of the main ingredients in cola soft drinks and in addition is used in diet and high energy products such as food bars as well as being used as flavouring in some alcoholic beverages, frozen dairy desserts, baked goods, sweets, gelatin and puddings. Why is cola nut a common positive on this test? Many people drink cola drinks on a daily basis and may also be exposed to the cola nut through consumption of some of the products detailed above. QUESTIONS RELATED TO MILK INTOLERANCE What about my calcium levels if I cut out cow s milk and dairy completely? There are a number of other good sources of calcium including green leafy veg, wholegrains, nuts (such as almonds and brazil nuts), tofu, tinned fish such as sardines and salmon, quinoa, bottled waters such as vital and badoit and fortified milk alternatives and cereals. It may also be prudent to take a calcium supplement What alternatives are there to cow s milk? Goats and sheeps milk are alternatives to cow s milk, but as they contain proteins which are very similar to cow s milk then they may also cause symptoms. Other alternatives include oat milk, rice milk, soya milk, quinoa milk, and nut milks such as hazelnut milk and almond milk. What are the symptoms of lactose intolerance?

8 Lactose intolerance can cause symptoms such as bloating, diarrhea, flatulence and nausea What is lactose intolerance? If production of the lactase enzyme is inadequate then Lactose intolerance will result. Lactose intolerance is the inability to absorb lactose the predominant sugar in milk into the digestive system. If lactose is not absorbed properly, it ferments and this results in abdominal pain, a bloated stomach, stomach rumbling, increased wind and diarrhoea. Lactose is a disaccharide sugar, which means that it is made up of two smaller sugars bound together. In order for lactose to be absorbed, it must be split into those two sugars by the lactase enzyme. Lactase activity is generally high in babies and declines as the amount of milk in the diet decreases. Some people may have very low lactase levels but not have any symptoms. The reason for this is unknown. A lactose tolerance test, a hydrogen breath test, or a stool acidity test is required for a clinical diagnosis. What are the main proteins in milk? There a couple of different proteins in milk. The primary group of proteins are the caseins. All other proteins in milk are grouped together under the category of whey proteins. The major whey proteins in cow milk are beta-lactoglobulin and alpha-lactalbumin. If cow s milk comes up positive, does that mean that I am lactose intolerant? No not necessarily. The food IgG intolerance test does not detect the lactase enzyme and therefore cannot diagnose lactose intolerance. QUESTIONS RELATED TO WHEAT INTOLERANCE If I have a positive result for wheat, does that mean I have Coeliac Disease? Coeliac disease is a lifelong intolerance to gluten that is found in wheat, rye and barley. In the Lab 21 test gluten has to be isolated from the grains that contain it using alcohol extraction. The wheat extract does not contain gluten but includes other proteins found in wheat that can be extracted using an aqueous solution. Therefore, a positive wheat result does not diagnose coeliac disease. Why are my IgG levels to wheat still high even though I have completely eliminated wheat from my diet for many months now? Over time, the concentration of IgG antibodies to particular foods gradually decreases. However some foods such as wheat are commonly used as additives in the food industry in apparently unlikely foods such as chicken breasts and frozen chips. It is therefore easy to inadvertently consume these foods without realizing it. By continuing to eat such foods even in small quantites it can prevent the antibody levels from returning to normal..

9 I know that wheat disagrees with me and have been avoiding it, but it did not show up in the test, why? If you have been avoiding a particular food for a few months, it is possible that antibody levels to the food concerned have reduced to a level undetectable by the test. Why has gluten come up positive but not wheat? The wheat extract does not contain gluten but other proteins found in wheat such as seed storage proteins. The gluten extract does not contain these proteins but is a pure preparation of gluten. If you have antibodies to gluten but not to other proteins found in wheat, wheat will not show a positive result. Similarly, if you have antibodies to non-gluten proteins, wheat will show a positive result and in the absence of antibodies to gluten, gluten will remain negative. What alternatives are there to wheat? Other grains such as barley, rye, oats, corn & rice are commonly used in baked products, pastas and cereals instead of wheat. These foods can be purchased in supermarkets and healthfood stores. What is durum wheat and why has that not come up positive, although wheat has? Durum wheat and common wheat are different species of wheat. Durum wheat is usually used to make flour and semolina for pasta. The protein content is different and therefore one can show up positive and not the other. Many people find that they can tolerate durum wheat if they are positive for wheat but negative to durum wheat. QUESTIONS RELATED TO YEAST INTOLERANCE If I come up positive to yeast, do I need to avoid products containing brewers yeast as well? Yes, the test includes both bakers and brewers yeast. If you come up positive to yeast, it is vital that you plan ahead as yeast is present in many different foods. If the yeast comes up positive, does that mean I have Candidiasis? No, not necessarily, the test just shows that you have an elevated level of antibodies to yeast in your body. If you would like to confirm whether you have Candidiasis, then we have a separate test for specific antibodies against the Candida albicans yeast. What alcoholic drinks do not contain yeast?

10 All alcoholic drinks depend on yeasts to produce the alcohol, however distilling and filtering will tend to remove most of the yeast. Spirits, such as gin or vodka will have the lowest amount of yeast present compared with wines and beers. What foods contain yeast? Bread, doughnuts, some cakes, Marmite and yeast extracts, stock cubes, wines, beers and champagne all contain yeast. If you are intolerant to yeast, you may also find you react to fermented foods including soy sauce, vinegars, miso, tempeh etc., as well as foods that harbour yeast such as ripe fruits and shelled nuts.