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Welcome to the website for Jim Chialtas, L.Ac., and Laurel Acupuncture Clinic of Functional Medicine, located in San Diego.

Click on the tabs above to learn more about what Functional Medicine is, and about many of the health concerns I specialize in. Or scroll down for my blog. You might find it helpful to use the labels in the lower right column to find topics that interest you.

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3/8/16

A Different Approach to Food Sensitivity Testing

The notion that a person may or may not suffer from a food sensitivity is certainly not a new thing.  This has been a concept that I hear people all the time asking about, experiencing, arguing with their doctors about, etc.  And this is something that I deal with all the time in my practice as I work with a particularly sensitive slice of the population.  It is my hope to shed some new light into this topic and try to explain why not all lab testing is the same.  Or why there is might be a high potential for false negatives on these tests.  And what in the world does one do when 90% of everything they tested for comes back positive?!?  Don’t worry.  There are answers. 

I just want to start out this discussion with my own personal story.  It is something that I have written about in years past but feel that it is particularly important to revisit here.  Almost five years ago now, through testing, I confirmed that I have a serious gluten sensitivity condition.  I had been having increasing headaches and weekly migraines that were no longer treatable by either mainstream or alternative methods.  Acupuncture had always worked in the past for these headaches but at some point became useless.  I had also developed psoriasis-like patches on my elbows and knees.  I even had elevations in my liver enzymes which were scary to say the least.   Those go high enough and a liver transplant is on the horizon.  So as much as I did not want to know the answer I tested myself with the best lab I could find.  What do you know?  I showed positive to not just gluten sensitivity but autoimmune reactions as well which are tightly associated with gluten.  The kicker to this story, and why I include it here, is that if I were to have gone the mainstream way of gluten testing, I never would have shown positive.  It would have been a classic false negative!  I didn’t have stomach pain and I did not show positive to the one marker that a mainstream practitioner would have looked for.  So I would have been looked in the eye and confidently told, “Mr. Chialtas, you do not have a gluten problem.  I urge you to continue to eat a whole grain based diet.  After all, it is good for you heart!”  It is important to realize here however that we show positive to things like gluten or other foods, or heck even to our own body by making antibodies that recognize small sequences of amino acids that make up the larger protein in question.  In this case gluten.  There is no antibody large enough to recognize the gluten protein.  Instead we make antibodies that recognize little corners of the protein.  I just so happened to not react to the gold standard corner or the protein that the mainstream chooses to look for. But thankfully the lab I used looks for a lot more corners!  And I was reactive to just about all of the others.  So I had my positive findings and started my new life.  Migraines reduced by at least 90% immediately.  Skin condition totally resolved after 6 months. Liver enzymes also returned to normal after a few months.  So I am one example of a patient who would be told there is no problem when in reality it was the testing that was the problem.  I can’t tell you how many people tell me with full sincerity that they have been tested and do not have a gluten problem.     I always beg the question…  How were you tested? 

But this food reactivity concept gets much MUCH deeper than just gluten.  People are routinely getting tested for 100-150 foods at a time.  And to be quite honest I used to not run these tests often because I kept seeing the same thing over and over.  I would get the report back and 120 foods out of the 150 would be positive!  What is a person supposed to do with that kind of information?  The typical approach would be to have that patient remove all of the offending foods and do a rotation program with the remaining foods available.  The trouble with this approach as I see it is twofold.  First, we have to remember human nature.  We are rebellious for the most part and tend not to accept strict dietary guidelines like that.  I have just seen this time and time again with my patients (and myself).  Failure here is a high likelihood.  Second, if that person would take the recommendations to heart and eat only those foods on the OK list it would only be a matter of time until that person began to develop reactions to those foods as well!  The reality of what is going on in these cases is that this person, for some reason or another, has lost what is called “oral tolerance.”  This means that the majority of things that go into their mouth are reactive to their system.  The immune system is on a hair trigger so to speak and reacts to the things it sees most often.  (Gluten is in 80% of our diet by the way.  And dairy is close behind that!)  So instead of eliminating the majority of a person’s diet how about we take out the few that are known to cause symptoms and then focus all of the support directly at how the immune system behaves? 

One other concept that I see missed all the time in both mainstream and alternative approaches alike is to determine the status of a person’s antibody count in general.    Let’s be frank here…  Getting a full food reactivity panel done is not cheap.  Nor is it covered by insurance for the most part.  So for that reason alone I like to make sure that a test like this would actually provide an accurate reading. I want to help clear the concerns about false negatives.  Because remember, if a paper says no reaction but there really is, the person will keep on eating the offending food.  And in a lot of cases that means destruction of an organ!  So the basis of what I am describing here has to do with the antibodies our immune systems make to recognize, and mark for attack, any particular amino acid sequence it feels necessary such as the ones found in gluten for example.  The most common way to screen for these reactions is to look for two types of antibodies called IgG and IgA.  A person may have IgA antibodies to Alpha-Gliadin for example which is the most common gluten marker (the one I did not show positive to).  But if that person did not make enough IgA antibodies in general they couldn’t make enough of the Alpha-Gliadin IgA antibodies to show positive on the report.  That does not mean however that there is not a reaction going on anyway.  So before I have my patient spend a lot of money and emotion on a test like this I want to make sure that they are able to make enough of these antibodies to provide accurate reporting.  This is just not something I see going on out there. This is just one more way that a person could be given a false negative report which means they keep eating the offensive food!   And in an autoimmune condition like with MS let’s say, reactions like this could literally mean continued destruction of brain and spinal cord cells!  If you are going to go down this road be sure to ask these questions of your practitioner.  And if they can’t answer them then move on.   Practicing with this level of understanding and detail is key to your success. 
And finally something to realize about just about every food testing lab but one is that they do not all test in the same way. Each lab has their own methods and they are not all equal.   Let’s just take egg protein for example.  Egg is a common reactive food for people.  Most all labs however only run these antibody tests against raw foods.  When you cook a food the heat changes the structure of the protein.  So raw egg protein looks slightly different than cooked egg protein.  That means that there will be two different antibodies as well!  Antibodies are very specific to structure.  Now unless you are Rocky Balboa you probably are not eating your eggs raw.  So why, I ask are you looking for raw egg reactions and paying hundreds of dollars too-boot?  Way too many of these tests in my opinion are steering people in the wrong direction by giving results based on food a person isn’t even exposing themselves to like raw eggs!  It is important to test for the foods we actually eat.  I personally eat both raw and cooked spinach. So if I were tested I would want to know both!  I only know one lab who understands and offers this kind of detail. 

So in closing I just wanted to propose a few different tactics to working with the results of food sensitivity testing like these.  If for example one or two foods came back positive then by all means cut them out.  We pray for those reports.  They are straight forward and easy to take to heart.  But if the test comes back mostly positive make sure you take out the heavy hitters right away like gluten and dairy for starters.  And any others that the person may recognize as symptomatic in some way.  But be sure to take measures towards gut lining repair as well.  This is a lengthy discussion by itself and I am happy to consult with you individually.   But more than that, steps need to be taken to help the immune system not react as easily to what it is coming in contact with.  Each individual will present with a unique set of needs to achieve optimal gut repair.  So a good functional blood chemistry work up is vital.  Things like anemia or blood sugar disorders can all work against a healthy gut and can in time lead to things like food intolerance.  The rabbit hole is deep here and it takes a practitioner with a keen eye to spot all of the cycles at play.  This is the kind of thing I love to work through with my patients.  I love seeing them light up when all the pieces finally connect for them and they start feeling better.  So I am putting out a call to action for anyone suffering strange reactions to their foods.  Or anyone for that matter with a known autoimmune disease or a condition that their MD’s just don’t know what to do with.  There are gut concerns at the core of these most all of the time.  And the answer could be as simple as changing some dietary habits.