Food allergies, sensitivities, and intolerances – oh my!
Food intolerances result from a lack of enzymes needed to break down components of certain foods in the GI tract, and usually lead to GI symptoms like bloating and diarrhea within 1-3 hours of consuming the food. Food sensitivities are delayed immune system responses that result in systemic inflammation within 2 to 72 hours of food consumption. The symptoms can be severe, but are not immediately life threatening. Many patients feel frustrated when they see an Allergy/Immunology specialist for their symptoms and come away with negative testing and no answers – sometimes they are even encouraged to continue to eat the foods that are making them feel poorly, so as to avoid nutrient deficiencies. The fact that true IgE allergies to foods are absent in many cases doesn’t mean that food sensitivities and intolerances shouldn’t be taken seriously. Functional Medicine can help.
With the industrialization of the food industry over the past 100 years, our bodies have had to deal with a lot of changes. Stressors like processed foods and drastic changes in food production methods have made it hard for our bodies to keep up! This manifests physically as allergies, sensitivities, and intolerances to various foods – and the symptoms can be present in any system in the body.
The most common food allergies and sensitivities include:
Gluten
Dairy
Eggs
Nuts
Nightshades
Soy
How Can Functional Medicine Help?
The functional medicine approach focuses on addressing the ROOT CAUSE of imbalances in the body. In the case of food sensitivities, there is an imbalance in the immune system’s response to foods as they are absorbed through the small intestine. In each case where symptoms of food sensitivities are present, I perform a thorough history to identify possible factors that may have contributed to food sensitivities, then prescribe a treatment plan to address them at their root. This includes looking at your family history (do other people in your family have food allergies/sensitivities?), how were you born (vaginal vs c-section), how many courses of antibiotics have you had over your lifetime, when did you start experiencing sensitivities (after a trip abroad? after a case of the stomach flu? after a stressful/traumatic event?) Dietary and lifestyle changes can calm and retrain the immune system response so that your symptoms can be reduced and any tissue damage it has caused can heal. I recommend eliminating reactive foods for at least 6 months before trying to reintroduce previously problematic foods back into your diet.
There are 2 notable exceptions to this rule: IgE allergies to foods, and celiac disease. If you have IgE allergies to foods, it is only recommended to reintroduce them under direct supervision of an Allergy/Immunologist in the office, with epinephrine and medical equipment readily available to reverse a life-threatening anaphylactic response. If you have been diagnosed with celiac disease, you should NOT reintroduce gluten into your diet after 6 months, or after any other period of time due to the increased risk of lymphoma with any degree of gluten consumption.
If you’re curious whether food sensitivities may be causing your symptoms, you don’t need special testing, although many food sensitivity tests are available. The problem with these tests is that they all test only ONE part of the immune system response to foods – but the human body has many immune cell lines capable of mounting an inflammatory response whenever we consume a meal. Performing an elimination diet by removing one or more foods for at least 3-4 weeks is the “gold standard” whole body test and can help you identify what is causing your discomfort. Our office does offer food sensitivity testing if an elimination diet does not resolve all of your symptoms, but these tests are not covered by insurance, and there is no test that is as reliable as a basic elimination diet.
–Julia Buchkina, MD, MPH, ABIHM, IFMCP
