News
Confused about food sensitivity testing?
27/Mar/12 06:08 PM
by Kate Whimster, BCom, MIFHI, ND
This subject is covered in a past post What's the difference between food sensitivity, allergy, or intolerance?, but given the recent media attention on food sensitivity testing I wanted to provide a pro/con (in this case beginning with the “con” side) summary for anyone who might have questions. Then I’ll explain how I look at food sensitivities in my practice.
Question: Is there value to food sensitivity testing?
Con:
There has been a lot of media coverage in response to an article (unfortunately you need to be CMAJ member for full access) by Dr. Elana Lavine in the Canadian Medical Association Journal criticizing food sensitivity testing.
Pro:
There are several counter-arguments to be made to Dr. Lavine’s assertions:
Contrary to what Dr. Lavine asserts, there is research evidence for the use of food sensitivity testing:
Here is a good, succinct rebuttal from Dr. Elaine Chin and here is a press release from the Ontario Association of Naturopathic Doctors.
My thoughts:
In my practice, food sensitivity testing is not my first choice for treatment, but I have used it in certain circumstances. Here are some key points I consider:
This subject is covered in a past post What's the difference between food sensitivity, allergy, or intolerance?, but given the recent media attention on food sensitivity testing I wanted to provide a pro/con (in this case beginning with the “con” side) summary for anyone who might have questions. Then I’ll explain how I look at food sensitivities in my practice.
Question: Is there value to food sensitivity testing?
Con:
There has been a lot of media coverage in response to an article (unfortunately you need to be CMAJ member for full access) by Dr. Elana Lavine in the Canadian Medical Association Journal criticizing food sensitivity testing.
- Here is an article from the Globe and Mail: Tests for food allergies, sensitivities a ‘waste of money,’ doctor says
- And here is a video with a bit of a more balanced perspective from the CBC: Food sensitivity tests
Pro:
There are several counter-arguments to be made to Dr. Lavine’s assertions:
- IgE testing (for food allergy) and IgG testing (for food sensitivities) are different things. For a great comparison, here is a presentation from Rocky Mountain Analytical, one provider of food sensitivity testing. For a good summary, check out the chart on slide 11.
- A skin-prick test, while considered the gold standard “allergy” test, is not a method that tests your response to food in the way you are actually exposed to food. You don’t eat through your skin, you interact with food via your digestive tract. And the response that your body makes to food can be an IgE response (quick, itchy, clear cause and effect) or an IgG response (delayed, vague symptoms, difficult to identify cause).
- Only a medical professional (naturopathic doctor ideally or a medical doctor well-versed in nutrition) can understand how to best administer the test to get the most useful results and use this information for effective treatment.
Contrary to what Dr. Lavine asserts, there is research evidence for the use of food sensitivity testing:
- This article summarizes some research on IgG allergy testing
- Food-specific serum IgG4 and IgE titers to common food antigens in irritable bowel syndrome
- Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomised, cross-over trial
- Serum IgG responses to food antigens in the italian population evaluated by highly sensitive and specific ELISA test
- Specific humoral response to cows' milk proteins and ovalbumin in children with atopic dermatitis
- Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics
- A critical review of IgG immunoglobulins and food allergy implications in systemic health
- I’m sure there is even more to be found - check out PubMed if you are interested.
Here is a good, succinct rebuttal from Dr. Elaine Chin and here is a press release from the Ontario Association of Naturopathic Doctors.
My thoughts:
In my practice, food sensitivity testing is not my first choice for treatment, but I have used it in certain circumstances. Here are some key points I consider:
- The test measures only one point in time. Human beings, however, are constantly adapting and changing. At the time of testing, results indicate a particular response to foods. But how might these responses change as your immune system is balanced such that it does not react to substances that are not harmful? I see changes in immune response all the time, most commonly when I treat seasonal allergies. I’ve treated patients who have progressed from constant anti-histamine usage (that was still not controlling symptoms) one year to nearly no symptoms and no need for medication the next.
- Nutrition is a major part of my treatment with most patients. My approach to nutrition is that there are no “bad” foods, just foods that work well for you (the patient) and others that don’t fuel your body in the best way to achieve optimal wellness. I look to personalized nutrition to identify what the best nutritional approach will be for each individual.
- There are several health concerns that warrant investigation into food sensitivities, such as: most digestive concerns (IBS, constipation, diarrhea, acid reflux), asthma, migraines, chronic fatigue, fibromyalgia, allergy symptoms, skin issues (eczema, psoriasis, acne), arthritis), failure to thrive, and more. The question is, what is the best way to determine foods that may contribute to these conditions?
- Before testing, I encourage patients to do an elimination diet, which is considered the gold standard for identifying foods that may be contributing to symptoms. This approach is both diagnosis and treatment at once: patients usually experience a significant reduction in symptoms while in the elimination phase (confirming that eliminated foods contribute), they immediately begin to alter habits (perhaps the most challenging aspects of naturopathic treatment), and they gain firsthand experience of how foods affect them during the reintroduction phase.
- However, some patients prefer more objective information via a lab test and find this more motivating for changing habits. Also, some patients may find the elimination diet very challenging and would prefer a more focused elimination diet based on lab results. In either of these cases, it is important to use the test results as a guide and symptoms as feedback to determine if the treatment approach is effective.
- In the case of gluten sensitivity, I also find lab results more motivating for patients, since 100% avoidance of gluten can be challenging and having “hard data” as well as other lab results to monitor (one example would be anti-thyroid antibodies) can help ensure higher compliance and therefore improved outcomes.
Comments
D'Adamo Personalized Nutrition opens
24/Aug/11 11:35 AM
by Kate Whimster, BCom, MIFHI, ND
Congratulations to Dr. Peter D’Adamo on opening D’Adamo Personalized Nutrition in Williamsburg, Brooklyn!
Staffed by naturopathic doctors Maura Henninger and David Levi, this beautiful location includes a store stocked with products from the D’Adamo Personalized Nutrition line as well as space for nutritional consultations, including SWAMI GenoType diet software.
For more info and photos, check out Maura’s blog.
Congratulations to Dr. Peter D’Adamo on opening D’Adamo Personalized Nutrition in Williamsburg, Brooklyn!
Staffed by naturopathic doctors Maura Henninger and David Levi, this beautiful location includes a store stocked with products from the D’Adamo Personalized Nutrition line as well as space for nutritional consultations, including SWAMI GenoType diet software.
For more info and photos, check out Maura’s blog.
Taking homeopathy seriously
02/Feb/11 12:55 PM
by Kate Whimster, BCom, MIFHI, ND
The debate over homeopathy rages on! I just read this article in the Huffington Post in which Nobel Prize winner Luc Montagnier (the virologist who discovered the AIDS virus) explains why he supports homeopathy. The article cites a fair bit of research into homeopathy, which makes for a great read if you want to learn more. Thanks Theresa Jahn, ND for sending me the link!
The article makes some great points in favour of homeopathy that I wanted to highlight:
Reading through the comments on this article, I also found a link to this page on frequently asked questions about homeopathy. This is a really detailed Q&A on all the most-asked questions about homeopathy and is a great place to start if you want to learn about this wonderful modality. Enjoy!
The debate over homeopathy rages on! I just read this article in the Huffington Post in which Nobel Prize winner Luc Montagnier (the virologist who discovered the AIDS virus) explains why he supports homeopathy. The article cites a fair bit of research into homeopathy, which makes for a great read if you want to learn more. Thanks Theresa Jahn, ND for sending me the link!
The article makes some great points in favour of homeopathy that I wanted to highlight:
- “Most clinical research conducted on homeopathic medicines that has been published in peer-review journals have shown positive clinical results,(3, 4) especially in the treatment of respiratory allergies (5, 6), influenza, (7) fibromyalgia, (8, 9) rheumatoid arthritis, (10) childhood diarrhea, (11) post-surgical abdominal surgery recovery, (12) attention deficit disorder, (13) and reduction in the side effects of conventional cancer treatments. (14).”
- “In addition to clinical trials, several hundred basic science studies have confirmed the biological activity of homeopathic medicines. One type of basic science trials, called in vitro studies, found 67 experiments (1/3 of them replications) and nearly 3/4 of all replications were positive. (15, 16).”
- Homeopathy “gained widespread popularity in the U.S. and Europe during the 19th century due to the impressive results people experienced in the treatment of epidemics that raged during that time, including cholera, typhoid, yellow fever, scarlet fever, and influenza.”
- “High dilutions of something are not nothing. They are water structures which mimic the original molecules."
Reading through the comments on this article, I also found a link to this page on frequently asked questions about homeopathy. This is a really detailed Q&A on all the most-asked questions about homeopathy and is a great place to start if you want to learn about this wonderful modality. Enjoy!
Homeopathy: cure or con?
14/Jan/11 12:02 PM
by Kate Whimster, BCom, MIFHI, ND
Tonight CBC Marketplace will air a report called Cure or Con? on homeopathy. Even though the report has not aired yet, there are lots of comments! From what I can tell from their preview, I doubt that these journalists have actually investigated homeopathy in-depth and that their “research” is likely a waste of time and money. I look forward to watching it to see what they have done.
I use homeopathy as part of my practice with great results and have written blogs about it on this site. If you are interested in learning more about homeopathy, start with my blog Homeopathy primer. For information about research into homeopathy, check out Homeopathy literature review.
What most people consider research is often only the tip of the iceberg as far as information goes. True “evidence-based medicine” encompasses clinical experience as well! Check out my blog Is evidence-based medicine compatible with naturopathic principles for a more a discussion on this topic and my blog Mythology of science-based medicine for even more insight into medical research.
Tonight CBC Marketplace will air a report called Cure or Con? on homeopathy. Even though the report has not aired yet, there are lots of comments! From what I can tell from their preview, I doubt that these journalists have actually investigated homeopathy in-depth and that their “research” is likely a waste of time and money. I look forward to watching it to see what they have done.
I use homeopathy as part of my practice with great results and have written blogs about it on this site. If you are interested in learning more about homeopathy, start with my blog Homeopathy primer. For information about research into homeopathy, check out Homeopathy literature review.
What most people consider research is often only the tip of the iceberg as far as information goes. True “evidence-based medicine” encompasses clinical experience as well! Check out my blog Is evidence-based medicine compatible with naturopathic principles for a more a discussion on this topic and my blog Mythology of science-based medicine for even more insight into medical research.
More vitamin D commentary
26/Dec/10 02:01 PM
by Kate Whimster, BCom, MIFHI, ND
More recent commentary on vitamin D as covered by Natural Medicine Journal:
Let the Science and Evidence Guide Clinical Decision-Making on Vitamin D for the Benefit of Patients, Alexander G. Schauss, PhD, FACN
This article discusses biochemical individuality, as well as evidence in favour of vitamin D as relates to frailty in elderly populations, genetic and racial variations, and immune support. Ultimately, he reiterates that we must “consider the individual,” which is what naturopathic medicine is all about!
Broad-Brush Recommendations Are a Disservice to the Public, Geovanni Espinosa, ND
This article summarizes conditions associated with vitamin D deficiency and provides some broad intake recommendations.
Media Coverage Further Confounds Recommendations, Susan W. Ryan, DO
This article highlights one major issue plaguing media coverage of health issues - inaccurate or incomplete reporting. Unfortunately, as a naturopathic doctor I find this to be all too common! What gets covered in major media is not necessarily representative of the information that exists on a topic, it is slanted more towards what is strange/interesting/controversial/trendy. This also includes such information available on the internet. There is a lot of great information to be found on the internet, but your best bet is to find out what is best for YOU from a trained health professional, such as your naturopathic doctor.
More recent commentary on vitamin D as covered by Natural Medicine Journal:
Let the Science and Evidence Guide Clinical Decision-Making on Vitamin D for the Benefit of Patients, Alexander G. Schauss, PhD, FACN
This article discusses biochemical individuality, as well as evidence in favour of vitamin D as relates to frailty in elderly populations, genetic and racial variations, and immune support. Ultimately, he reiterates that we must “consider the individual,” which is what naturopathic medicine is all about!
Broad-Brush Recommendations Are a Disservice to the Public, Geovanni Espinosa, ND
This article summarizes conditions associated with vitamin D deficiency and provides some broad intake recommendations.
Media Coverage Further Confounds Recommendations, Susan W. Ryan, DO
This article highlights one major issue plaguing media coverage of health issues - inaccurate or incomplete reporting. Unfortunately, as a naturopathic doctor I find this to be all too common! What gets covered in major media is not necessarily representative of the information that exists on a topic, it is slanted more towards what is strange/interesting/controversial/trendy. This also includes such information available on the internet. There is a lot of great information to be found on the internet, but your best bet is to find out what is best for YOU from a trained health professional, such as your naturopathic doctor.