So you think you are allergic to a food?

So, you think you are allergic to a particular food? 

When I first started to really suspect that food was perhaps the problem behind my psoriasis, joint pain, and hemorrhoids (sorry), I ended up leaning heavily on the wisdoms of Dr. Kenneth Fine, developer/owner of Enterolab in Dallas, Texas.  Back when I was tested there for gluten and dairy allergies (10 yrs ago), Enterolab was relatively new and somewhat small by comparison today.  I was able to email Dr. Fine with questions and it was he who said to me that if you are at the point where you suspect a particular food to the point that you are seeking an allergy test, then you are likely correct in your suspicions.  Coming from someone who has spent his career studying gastroenterology (basically the study of the intestines and the process of food digestion) and subsequent years of research concerning food allergies, I say he is someone 'in the know'.  It makes sense, people who don't think they have food related allergies aren't running out getting tested!

You might be asking yourself:

1)   What type of test should I get?
2)   Do I need a test? 


What type of test should I get?

Well, the answer to the first question and what type of test is easy:  I recommend only Enterolab for those people suspecting allergies to gluten, dairy, soy, yeast, and eggs.  This includes potential celiacs.  The test is performed on a sample of your stool that you send them.  (Poor UPS!)  (Wait!  Poor lab people!)  They have an abundant amount of information on their site which will help you sort out which tests to order.

Enterolab's website:  http://enterolab.com/

Why do I recommend Enterolab and their stool test?  Because it is the only reliable test, as proven to me and countless others.  Blood tests are not reliable.  They produce many false negatives.  A U.S. study found that, particularly in children who also suffer from eczema, the normal blood tests that are performed to test for sensitivity may be misleading and may show a reaction where the food can actually be tolerated.  One of the reasons for this is the blood tests are looking for a reaction from the IgE antibody (immunoglobulin E) which is not the antibody responsible for the symptoms of most food allergies.  (See my page "Immunology of Food Allergies" for a more complete understanding of the different antibodies.) 

Skin tests (the skin prick tests) also test for an IgE reaction.  IgE is the antibody responsible in any anaphylactic reaction to a food or allergen.  Tissue swelling, wheezing, fainting, severe vomiting, hives, etc.  Can you see how getting an IgE blood test or an IgE skin test for a food allergy in which IgE is not the antibody creating the response, that you will get a false negative?

But don't believe me.  Do your own research.  I am not paid anything by Enterolabs nor am I associated with them in any way.  Just a decade of watching people get tested using various methods and alot of research has proved that a stool test is the only way to go when testing for food allergies that are beyond the classic IgE response.

Do I need a test?

The second question is something to which only you can decide the answer.  Do you need a test?  My experience with people who are wondering if they have a food allergy and whether or not they need a test depends on one or more of several things:

1)  How much they are convinced their symptoms are absolutely due to food allergies.
2)  How sick they are of their symptoms and see a direct correlation between eating and symptoms.
3)  How attached they are to the food they think is the 'problem food' and their willingness to give it up.
4)  How confused they are about their collection of symptoms and why they might have them.

If you see a direct correlation between, say, eating wheat and your symptoms, and you feel so sure about it that you don't need convincing, then you likely don't need a test to motivate you to do what would logically take place next:  a three week gluten-free trial.  Most people need convincing.  For some people, giving up a food they love is a bit like experiencing a death.  For others that loss is not so great.  Herein lies my comment that only you can decide whether or not you should get tested.  Ultimately, I would suggest that if you suspect you are allergic, get tested.  It's psychologically supportive for most people.


How does it work to get tested by Enterolab?

Enterolab tests your stool for the presence of a particular immunoglobulin (another name for an antibody).  Once you log onto their website  ( http://enterolab.com/) and decide which tests you want to order, they will ship you a box with the 'poop container' and all the items and instructions necessary to ship it back to them when you have collected a sample.

Once you've read the instructions and you are ready to deliver, you do your duty into the poop container. (Don't worry, the container they provide fits nicely on the toilet seat.  It sorta looks like a Cool Whip container with wings!) (You need at least a cup of poop!  I don't know about you but I'd never measured my poop before and didn't start then!  You just have to guess.)  Then.....believe it or not....you put the container in your freezer until you arrange for the shipper to pick it up.  As my dear friend, Melissa, so humorously pointed out, you now have a Poopsicle in your freezer!

After shipping your Poopsicle, it takes about 3 agonizing, long weeks before you get your results.  They send them via email to whatever email you provide.


Getting my results from Enterolab

Your results will be reported as a number of units either above or below the number 10.  In my case, my gluten sensitivity test was reported as 12 units.  My son's was reported as 300 units.  This is where you have to let go of the fact that we associate a higher number MORE.  In this case, if your results are over 10 units, you are having an allergic reaction to the food for which you tested.  So, at 12 units, I am not just a little bit allergic.  I am as 'allergic' as my son who tested at 300 units.

I have seen people test at 9 or 10 units, and much later go on to remove the food from their diet anyway and end up feeling much better.

This is what Enterolab's site says about interpreting test results:

"Our antibody tests range numerically from a positive value of 10 to as high as 500 Units. The average positive value is about 45 Units. The "units" are based on the amount of antibody detected in the assay which is reflected by more color developing as the result of a color-generating chemical reaction. Thus, the more antibody present, the higher the units of positivity. However, the amount of antibody present is not a measure of clinical severity, but rather, the amount of antibody being produced by the plasma cells in the intestine in response to gluten at that site. A positive value of any degree means your immune system is reacting to dietary gluten in the way the immune system reacts to an infection. With an infection, this immune reaction ultimately kills and clears the infectious organism. But with gluten, the reaction continues as long as it is eaten. Thus, the only way to halt this immune reaction is to remove all gluten from the diet. This is true whether your positive test is 10 units, 500 units, or anything in between."


(Immunology is a rather complex science and beyond the scope of my brain.   I present a rudimentary look at how it works in relation to food allergies on my page "Immunology of Food Allergies".)


Now what do I do now that I know I am allergic?

According to Canadian researcher and M.D., Dr. Stephen Gislason, you need to remove the offending food from your diet.  For the first ten days you may feel pretty darn bad.  I know I did.  My psoriasis raged out of control, my joints killed me, old injuries ached, my throat was sore constantly, and my hemorrhoids (sorry!) were the worst ever.  By day 10,  I was convinced the whole experiment wasn't working!  Didn't he say 10 days??  Lo and behold, I woke up on the morning of day 11, and my psoriasis was reduced in severity by 50%, my joints didn't hurt and I actually felt good.  It was so amazing I swore I would never forget it....and I haven't.  Some people may take a little longer but most people fit within the 10 day window of crumminess before they start feeling better.

If you get off the offending food and don't feel worse and don't feel better, then you still have a source of it somewhere in your diet.  You have to learn how to read labels, how to know where your offending food lurks.  Gluten shows up in wheat, barley, and rye (and oats are controversial).  That means that 'malted barley', which is used as a sweetener in many foods, contains gluten.  A product that says "Wheat Free" but doesn't say "Gluten-Free" means there just happens to be no wheat; it doesn't mean there isn't any gluten in the product.

The portion of dairy to which one is allergic to is the 'Casein'.  It shows up as 'Casein' and is in ALL non-dairy cheeses except for a few brands.  For several months I bought 'Unsweetened Carob Chips' because I have an allergy to chocolate.  That entire year I kept having reactions whenever I would eat those chips.  Depressed, I assumed that I was allergic to carob as well.  Finally, one day I read the ingredients on the bulk bin from which I bagged them.  NONFAT MILK POWDER was used in them and used to sweeten them a bit!  How dumb could I be?!!  But man, was I relieved.  I could still have carob.   Unfortunately for me, there are no carob chips out there that are not sweetened with either milk powder or malted barley.  And I've got to tell you, there is a major taste curve in getting used to truly unsweetened carob chips.  Just carob and fat mixed together.


What tests should I order if I think I may be a celiac?

Enterolab's site answers that question splendidly.  I won't fill this space with all the advice they give, you can read it for yourself on their website on their page titled:  Which Test to Order.  If you are still confused, write me and email or a comment and I'll try to help you out.


What happens if I eat the offending food after I've been off of it for awhile?


Well....you'll feel bad. 
And if you accidentally ate it...in other words, you didn't know it was in the food you ate, then you can be sure you will be driven to figure it out.  Each time you accidentally or intentionally ingest the offending food, your dislike of the bad reaction you experience will strenthen your resolve to never touch it again.  It doesn't take long before you start seeing that food as 'The Poison'.  People will be amazed at your willpower.  They don't realize that is has nothing to do with willpower once you get to the "It's-Poison" level. 

For me, pizza?  Pancakes?  Doughnuts?  Pasta?  Those things caused me so much grief my whole life growing up prior to discovering I was allergic to gluten that even today I don't try to duplicate them with non-wheat flours.  I'm just not interested in them anymore.


Will insurance pay for the tests done at Enterolab?

In most cases, your insurance will pay for it.  If in doubt, call your insurance company and explain exactly what you are doing and find out if you need a referral.  In all cases where insurance will pay for it, you will have to file the claim yourself.  The email Enterolab sends you carries all the information you will need in order to submit a claim.