Breaking Lactose: How Dairy Affects Your Gut and Going Dairy-Free

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glass of milk

Many of the gastrointestinal problems caused by milk consumption are related to the digestion of lactose. When a person with a lactose intolerance or dairy allergy consumes milk or other dairy products, some or all of the lactose remains undigested and ferments in the large intestine, resulting in gas, bloating and abdominal cramping. Symptoms range greatly, and are generally felt within 2 hours of consumption.

What is lactose, exactly? It’s the primary sugar found in milk, made of one molecule of glucose and one molecule of galactose. Lactase, a digestive enzyme, is required to properly digest whole milk. Many people are incapable of manufacturing lactase. This is common in people of Asian descent. Lactose intolerance can also occur as a result of a damaging gastrointestinal disorder, such as celiac disease, irritable bowel syndrome or ulcerative colitis.

Milk: To Drink, or Not to Drink

In my practice I see health problems related to milk consumption almost daily. I also know of many people who consume milk and dairy products on a regular basis and tolerate then quite well. Milk has the reputation as being the ‘Darth Vader’ of dairy products, but still has nutritional benefits … for those who can tolerate it.

Most people can tolerate small to moderate amounts of cheese and butter, but start noticing digestive problems once milk is added. Notice how I said small to moderate amounts? Cheese, butter, cream and chocolate are highly concentrated sources of dairy sugars and are consumed in amounts far too large for the average person’s digestive and immune systems to cope.

Lactose Intolerance vs. Dairy Allergy

It is rare for me to encounter a patient with true lactose intolerance. What I see much more are folks with a dairy (casein) allergy. I have also had patients diagnosed elsewhere with a lactose intolerance, only to find out via blood testing that they have an allergy, not intolerance. Another common misdiagnosis I see is irritable bowel syndrome. While it is possible to see people with a milk allergy and a bowel problem, I always suspect lactose intolerance when bloating, flatulence, cramping pains and diarrhea are experienced shortly after consuming milk.

Tips for Going Dairy-Free

-Avoid all milk and dairy products

An obvious but difficult one. Need a milk fix? Try rice milk instead. Soy milk can be a problem for many individuals, and goat’s milk, though not as likely, may be as well. Try to avoid any dairy products for several months, then re-introduce small amounts and see what happens. And don’t forget: chocolate is actually a type of dairy product.

-Make sure to get your calcium and magnesium

If you avoid dairy altogether, calcium supplementation may be necessary. Balance supplementation with good food sources such as dried figs, broccoli, almonds, sardines, molasses, tofu, sesame seeds, etc.

-Check your medications

Lactose is commonly used as a filler in pharmaceutical drugs. Check with your physician or pharmacist if you have any concerns with medication(s) you’re taking.

-Read food labels carefully
Avoid any foods containing listed dairy products or milk solids.

-Choose low-lactose cheeses for a fix

Parmesan and other low-lactose cheeses are some of the easiest dairy products to tolerate. Again, please consume in moderation.

-Add some Lactobacillus to your diet

Friendly bacteria may facilitate the digestion of dietary lactose and allow lactase-deficient individuals to avoid some of the more unpleasant effects associated with lactase deficiency. Lactobacillus is found in many fermented food products such as yogurt and sauerkraut.

dr eric bakkerAbout the Author: Eric Bakker B.H.Sc. (Comp.Med), N.D, R.Hom. is a highly experienced naturopathic physician who has been in clinical practice for 25 years. Eric is passionate about improving people’s lives through proven wellness and lifestyle principles, natural medicine practice as well as public and professional practitioner education. Eric specialises in candida yeast infections, as well as adrenal fatigue, and thyroid disorders. Dr. Bakker has written one of the most comprehensive books on yeast infections called Candida Crusher. Website:  candidacrusher.com  You can complete his online survey to determine if you have a yeast infection here, or link through to his many YouTube videos: www.yeastinfection.org  Dr. Bakker’s Blog:  www.ericbakker.com

References:

1.  Price, Weston, DDS, Nutrition and Physical Degeneration, Keats Pub. Inc., CT, 1989.
2.  Cohen, Rbt., Milk, the Deadly Poison, Argus Pub. Inc., NJ, 1998.

3.  “Relief for Ear Infections,” Natural Healing, Miami Dade Edit., June 2002.

4.  Kradjian, Rbt., MD, The Milk Letter: A Message To My Patients, www.afpafitness.com/MILKDOC.HTM, Feb.7, 1999.

5.  Whitaker, Julian, MD, Health and Healing, Vol. 6, No. March 1996.

6.  “Lactose Intolerance Actually Normal,” Sun Sentinel of South FL., Feb.24, 2002.

7.  Brown, Ellen, JD, Hansen, Richard, DMD, FACAD, The Key To Ultimate Health, Advanced Health Research, Pub., CA, 2000.

8.  Health Science Institute, Nov 2002.

9.  Jacobsen, Michael, et al, Safe Food, Center for Science in the Public Interest, Living Planet Press, CA, 1991.

10. Mackic, J. B., Department of Neurological Surgery, Children’s Hospital of Los Angeles, University of Southern California School of Medicine, USA. Invest Ophthalmol Vis Sci. 35(3):804-810, 1994.

 

Good Gluten Gone Bad: Dr. Bakker’s Guide to Gluten Intolerance and Celiac Disease

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no glutenTo gluten, or not to gluten

Have you been thinking about going gluten free, but fear the thought of complex recipes using obscure, tasteless ingredients? Many of my patients who want to go gluten free think they are heading for a world of joyless, bland food. But this couldn’t be further from the truth—with accurate information and a little imagination you will be making delicious, gluten-free food with no troubles (and likely wondering what all the fuss was about in the beginning!).

Is gluten actually bad for me?

Of the many patients I have seen in my clinic over the years, the ones who avoid gluten tend to be amongst the healthiest. Why is this? Because avoiding foods containing gluten (and wheat products in general) tends to benefit one’s digestive system, and a healthy digestive system is vital to good whole-body health. You don’t have to be gluten intolerant to avoid gluten. I am not gluten intolerant myself, but I do avoid gluten and wheat as much as possible and shy away from virtually all types of bread, biscuits, crackers and baked (flour) goods.

What exactly is gluten, anyway? Gluten is a complex protein made up of many smaller components, including the simple protein, gliadin. Gliadin is often considered to be the toxic component of gluten. Recent research suggests that gliadin is one of the leading causes of intestinal damage in the Western world, where a large chunk of gluten and wheat products are consumed. In people with a gluten intolerance, the body does not process gliadin properly. When a food or drink containing gluten is consumed, the immune system sees gliadin as an invading object and goes on alert. The immune system then launches an aggressive attack by creating specific antibodies to fight against the gliadin. One of the side effects of this epic battle is inflammation, which can result in stomach pain. Those with a gluten intolerance who consume gluten on a regular basis stand to cause serious potential damage to the intestinal tract and other parts of the body, like the brain and neurological system.

Celiac disease and gluten: Enemies for life?

If you have celiac disease, your body treats gluten as a harmful substance, leading to digestive inflammation and irritation. This can lead to the lining of the small intestine becoming damaged. Since many nutrients are absorbed through this lining, celiac disease can lead to deficiencies in minerals and other nutrients. If you are a true celiac (diagnosed by way of a small intestine biopsy, not just a blood antibody test), consuming even the smallest traces of gluten can cause serious and lasting health problems. The most common problems associated with celiac disease originate in the digestive system and include diarrhea, bloating, constipation, stomach pain, and ulcers and lesions. Non-digestive specific problems include significant weight loss, osteoporosis, migraine headaches, chronic fatigue, iron-deficiency anemia, and mood disorders such as depression and irritability.

Managing celiac disease and gluten sensitivity

The only way to truly get a grasp on celiac disease and gluten sensitivities is to avoid gluten in any and all forms. For many, the only real option is to avoid gluten on a lifelong basis, as difficult as this may be. Each meal needs to be adapted and made with careful consideration of ingredients, and finding gluten-free options in a restaurant can be especially tricky. For some, assistance from a dietician experienced in gluten-free diets can be helpful.

Ingredients and food products to avoid

Baking ingredients are the most common sources of gluten, but it is also often used in processed foods where flour is used as a binder, filler or processing agent. Wheat starch is processed to remove the protein, but it still contains some traces of gluten as it is not possible to remove all protein. Note: When flour is used as a processing agent, or as part of another compound, it does not have to be declared on the label. Here are some common food sources of gluten:

  • Wheat flour and wheat products
  • Spelt
  • Barley
  • Biscuits
  • Bran
  • Bread
  • Bulgur wheat
  • Cake cereal filler
  • Cereal protein
  • Couscous
  • Licorice
  • Malt
  • Modified wheat starch
  • Oats pasta
  • Pastry
  • Rusk
  • Rye
  • Semolina
  • Soy Sauce
  • Triticale wheat
  • Wheat breakfast cereals
  • Wheat starch
  • Wheat germ

Living gluten free can be quite challenging and frustrating at times, but it doesn’t have to mean eating joyless food forever. For a list of recipes and tips, check out the gluten-free food guide on my website.

dr eric bakkerAbout the Author: Eric Bakker B.H.Sc. (Comp.Med), N.D, R.Hom. is a highly experienced naturopathic physician who has been in clinical practice for 25 years. Eric is passionate about improving people’s lives through proven wellness and lifestyle principles, natural medicine practice as well as public and professional practitioner education. Eric specialises in candida yeast infections, as well as adrenal fatigue, and thyroid disorders. Dr. Bakker has written one of the most comprehensive books on yeast infections called Candida Crusher. Website:  candidacrusher.com  You can complete his online survey to determine if you have a yeast infection here, or link through to his many You Tube videos: www.yeastinfection.org  Dr. Bakker’s Blog:  www.ericbakker.com

Stress and Leaky Gut: Implications and Solutions

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leaky pipeStress has many negative effects on gastrointestinal function, including increased intestinal permeability—otherwise known as “leaky gut.” When a person experiences stress, the brain releases a chemical called corticotrophin releasing factor (CRF). CRF triggers a cascade of other chemicals which eventually cause the release of the stress hormone, cortisol, from the adrenal glands, but CRF receptors are also found located in the gut itself. This means that the release of CRF impacts the digestive system directly. Through the effects of CRF on the gut, stress can result in changes in intestinal motility, sensitivity, and inflammation which may be experienced as constipation, pain, or gastrointestinal upset. Stress can also alter intestinal permeability—how easily the intestines allow various substances to pass through their walls.

The entire digestive tract is a continuous tube that runs from the mouth to the anus and separates materials inside the lumen of the tube (which is technically outside the body) from the rest of the body by a single layer of cells. The role of the digestive system is to extract nutrients from food and to provide protection against toxins or pathogens. Adjacent cells of the intestinal epithelium (that layer of cells lining the tube) adhere tightly to one another so that the passage of fluids and other substances can be carefully regulated and controlled. Some substances such as chloride and potassium diffuse freely without any assistance. Others like glucose and amino acids are actively transported across by proteins. If the integrity of this barrier is compromised, substances that should not ordinarily be allowed to pass—bacteria or large proteins from food—may slip through the wall.

When this happens, the immune system tags the substances as “antigens” and mounts an immune response against them, increasing inflammation via the use of chemical messengers and creating antibodies against the antigens. Some of these antibodies may cross-react with the body’s own tissues (i.e. attack them), leading to an autoimmune reaction, while increased inflammation contributes to the etiology or progression of other disorders such as depression.

In fact, many varied symptoms and conditions are associated with increased intestinal permeability including abdominal bloating, indigestion, joint pain, food allergies, fuzzy thinking, rashes, mood swings, fatigue, and hay fever. To test for leaky gut, a person drinks a liquid with two substances dissolved in solution: mannitol, a small molecule easily absorbed through the intestines, and lactulose, a larger molecule not well absorbed by a healthy intestinal lining. Urine is then collected and the amount of each molecule measured. In a healthy individual, levels of mannitol will be high while levels of lactulose will be low. If intestinal permeability is compromised, levels of both molecules will be high, reflecting increased absorption of both.

If you have leaky gut, there are many things you can do to help heal your intestinal epithelium. First, identify and eliminate any foods that may be contributing to the problem. (See my earlier blogs on making sense of food allergies, identifying food allergies, and eliminating food allergies and sensitivities for more on problematic foods). Then, utilize nutrients that can support repair of the tissue. Glutamine is the primary fuel for intestinal cells. It preserves intestinal structure and maintains healthy permeability. Quercetin, a flavonoid, also supports intestinal barrier function. Both L-glycine and phosphatidylcholine help to support normal levels of inflammation. Nutrients such as vitamin A, vitamin C, and zinc enhance intestinal repair and function.

Stress impacts many different conditions through its damaging effects on the gut; by supporting your gut, you may be able to improve your health in a multitude of areas as well.

About the Author

Dr. Lise NaugleDr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.

Eliminating Food Allergies, Sensitivities, and Intolerances

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just say no by Flickr user marc falardeau

In part 1 and part 2 of this blog, I explained various ways you may be sensitive, allergic or intolerant to certain foods, how these can impact your health and put additional stress on your adrenals, and some ways to begin to identify problematic foods.  In Part 3 below, I’ll show you how to clarify your suspicions that some foods may be bothering you and eliminate these problem foods from your diet.

The value of an elimination and challenge diet

If you are eating nutritious foods, getting sufficient rest, exercising, and creating quality time alone or with people you care about yet don’t feel as well as you think you should, hidden food allergies, sensitivities and intolerances could be at fault. They can impact your immune system, your digestive system, and your ability to tolerate stress.  They are associated with and can cause or complicate chronic health problems – particularly the following:

  • auto-immune conditions
  • digestive issues
  • joint or muscle pain
  • neurological or emotional issues (like migraines, ADHD, depression, and some coordination problems)
  • eczema or allergies

There are many variations on the elimination and challenge diet, but all share common characteristics. In a nutshell, the elimination portion of the diet removes potentially offending foods from your diet; the challenge portion puts the foods back into your diet one at a time and allows you to discover which ones are causing problems. Unlike an immediate allergic reaction such as hives, swelling or shortness of breath, many food sensitivities or intolerances create more subtle or chronic problems in your body – such as joint pain, fatigue, digestive disturbances, or emotional or behavioral issues. If you eat the problematic food regularly, the related reactions can be so chronic that there is no clear cause and effect between the offending food and your symptoms. By removing the food for a short period of time, you can allow your reaction to lessen. Then after a period of time, you reintroduce the food. If you then experience the same symptoms that you had been experiencing chronically, a link between the food and the symptom becomes more easily identifiable.

How to begin an elimination diet

Before you begin the elimination, list any symptoms that are currently problematic for you across the top of a page. Below them list today’s date, then give each symptom a numerical value from 1-5 based on average severity over the past 2 weeks (1 = extremely mild, 5 = extremely severe). These symptoms may be anything from abdominal cramping to mood swings. If you have a symptom that isn’t always present but rather comes and goes, such as a migraine or heart palpitations, record how frequently you experience it (e.g. once a month, twice a week, etc.) It can also be helpful to record your weight and body measurements at this time since food sensitivities can sometimes contribute to water retention.

Eliminating foods

NOTE: Do NOT do an elimination and challenge diet without consulting your doctor if you have ever experienced an anaphylactic reaction to a food or are already aware of food allergies which cause airway restriction.

If you believe that your food reactions are linked to only a few foods, you could choose to simply eliminate those to begin with. However, it is usually best (although more difficult) to remove as many potentially problematic foods as possible, not only to increase your odds of discovering the ones that are causing difficulties, but because sometimes it is the combination of foods, rather than a single food, that is at issue. Also, it is sometimes the foods you crave and eat regularly that are the main culprits. The primary categories of food to include in the elimination and challenge are below

Categories to Eliminate Examples of Category (not comprehensive)
Wheat and Gluten-containing grains white or wheat bread, pasta, bulgur, rye crackers, barley, spelt, barley, soy sauce
Dairy and dairy products milk, ice cream, cream-based soups, yogurt, cheese, casein, butter, cookies
Corn and corn products popcorn, corn syrup, corn batters, dextrin, ketchup, tortillas
Citrus fruits oranges, orange juice, lemons, citrus beverages
Eggs mayonnaise, noodles, cakes, bread, albumin
Shellfish shrimp, crab, mussels, scallops, clams
Processed meats hotdogs, sausage, lunch meats
Soy soy sauce, tofu, tempeh, edamame, soy ice cream
Peanuts Peanut butter
Artificial preservatives, colorings, sweeteners BHA, BHT, yellow dye # 5, aspartame, saccharine, MSG
Sugar, caffeine, alcohol, hydrogenated oils Dextrose, high fructose corn syrup, coffee, chocolate, colas, beer, wine, partially hydrogenated oils

If a food is not on this list but you eat it almost every day, it may be helpful to test that food, and obviously, if you suspect a food other than those included on the list above, add it to your list. For example, some people with joint pain are especially sensitive to substances called alkaloids found in a group of plants commonly known as nightshades. If joint pain is an issue of yours, it may be helpful to eliminate and challenge nightshade vegetables as well. These include potatoes, tomatoes, eggplant, and peppers.

Supporting yourself through the process

The goal is to eliminate each of the foods on your list for a period of 1-3 weeks. Although the concept of an elimination diet is relatively simple, it is anything but easy. If you suddenly feel panicked at the thought of giving up your morning latte and scone, allow that feeling and observe it. Sometimes psychological “addictions” to foods are clues to sensitivities. Give yourself time to prepare for the elimination emotionally. It can be hard to completely alter your eating patterns, and it often involves altering your lifestyle as well. I encourage you to nurture yourself during the elimination and to use the time to take care of yourself emotionally, socially and physically, eliminating those things, people or behaviors from your life which are not healthy, and bringing in those that are.

This is a good time to incorporate a yoga, meditation or gentle exercise program. It is not a good time to begin a very strenuous exercise program if you are not already used to it! As you eliminate foods, your body may experience some physical withdrawals or detoxification reactions. In fact, sometimes headaches, body aches, fatigue and irritability may actually increase the first few days. During this time, drink plenty of water and eat a variety of colorful vegetables and fruits. These foods are high in antioxidants and provide important nutrients required by the liver to carry out detoxification. Extra vitamin C (non-corn sourced) can be helpful as well. Be gentle with yourself and realize that this is not an exercise in deprivation; you have chosen to eliminate and challenge these foods to discover more about your body and experience more energy and vitality! Also remember that the elimination phase does not last forever.

Reintroducing foods

If all your symptoms are completely gone after a week, you may begin the challenge phase. If not, I typically encourage people to wait 14 days. By this time, food related symptoms are usually gone or have noticeably decreased, yet you are still within the window of time in which your reactions will be relatively easy to identify. To challenge foods, reintroduce the foods you eliminated one at a time. Pick one and ingest it two times in the same day (unless you have an obvious reaction after the first ingestion). Don’t change anything else in your diet for the next 48 hours because sometimes reactions can take up to 2 days to appear. During this time, evaluate your symptoms. Record the food eaten along with the date in the left hand column of your symptoms list and rate each of your symptoms. If you have no reaction to the food after 2 days, you may then incorporate it into your diet and challenge the next food. If you do have a reaction, remove the food from your diet again and wait until your reaction has calmed down before challenging the next food. This process will help you uncover allergies, sensitivities, and reactions to foods.

Some examples of success

This is not an easy process. However, if you do discover a significant food reaction, eliminating it from your diet can make a huge impact on your life and your health. I had a 9 year old patient who was having a range of emotional and behavioral issues: difficulty concentrating in school, being disruptive in class, fighting with other children, and being unable to sit still at home. During the course of an elimination and challenge, we identified a reaction to corn. His parents removed corn and corn products from his diet, and his behavior transformed. He became attentive and well-behaved in class, stopped getting in fights and began playing well with other kids, and his mother said for the first time since she could remember, he participated with the family in the evenings watching television or talking.

I had another patient who came to me complaining of excruciating abdominal pain that sent him to the ER an average of twice a month. He had had extensive imaging done and had been given prescriptions for pain, all to no avail. I ran labs on him and discovered a marker for gluten sensitivity. Using an elimination and challenge diet, we discovered that gluten was a major issue. He eliminated gluten from his diet, and his abdominal distress disappeared completely.

Final Words of Encouragement

Knowledge is power. The more you know about the things that impact and affect your health, the more choices you have in how to deal with them. I have outlined the basic process for an elimination and challenge diet for you, but there are many resources to help you through the confusing details. Websites such as celiac.org and godairyfree.org are just a few places that offer recipes as well as assistance in locating hidden derivatives of foods in the diet. Adrenalfatigue.org has a section that discusses the connection between adrenal function (i.e. stress) and allergies (Adrenal Function in Health Conditions – Allergies) and also lists many of the foods that contain the common allergens (Adrenal Function in Health Conditions – Allergens). Challenge yourself to try an elimination and challenge diet; you may discover that the foods you were eating regularly were adding to your stress and that without them you feel better than you ever thought you could.

Image Credit: Just say no by Flickr user marc falardeau

Dr. Lise NaugleAbout the Author: Dr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.

Identifying Food Allergies, Sensitivities, and Intolerances

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food allergy test by Flickr user brooke bina

In part 1 of this blog, “Making Sense of Food Allergies, Sensitivities, and Intolerances,” I explained the various ways you may be sensitive, allergic or intolerant to specific foods and how these can impact your health and put additional stress on your adrenals. In Part 2 below, I will help you understand some ways to identify them, and in my next blog, Part 3, I’ll show you how to eliminate them.

IgE Food Allergies – The Usual Suspects

In order to overcome any type of food reaction, you must first identify which foods are causing problems. Eight foods are responsible for approximately 90% of food allergies: shellfish, milk, egg, wheat, peanut, tree nuts, fish, and soy. In the case of the “typical” food allergy it is usually easy to identify a problem if you ingest the food. One bite can cause an immediate allergic reaction.  These allergic reactions are known as IgE mediated allergies or immediate hypersensitivity reactions. IgE refers to the type of antibody produced by the immune system in response to the allergen. Antibodies are the immune cells your body makes against something your body identifies as “foreign.”

Because this type of reaction can be severe, it is preferable to determine IgE allergies without actually eating the food in question.  IgE allergies can usually be discovered via a skin prick test by an allergist. A tiny amount of the food is applied to pricked skin. A positive test causes a red wheal (hive). This test is very sensitive, but not very specific. That means that sometimes someone will react to the test for a food when they actually are sensitive to a related food. For this reason, it’s important to use this test along with a thorough diet history and only test relevant foods. Also, there is a small chance that someone could have a severe allergic reaction to the test foods.

A possible alternative is to test for IgE allergies via a blood test, called a RAST test, and avoid the possibility of a dangerous allergic response. Just know that these are fairly expensive, aren’t as sensitive, are not available for all foods, and typically need to be confirmed by eating the foods in question and looking for a response. (Because IgE mediated responses can be dangerous, it is best to do this under the care of a physician.)

In the case of food sensitivities in which an immune reaction results from antibodies other than IgE, there are different lab tests that can be done. Typically these test IgG or IgA antibodies. IgG is the main antibody in the blood while IgA is the primary antibody in the digestive and respiratory tracts. Typically IgA and IgG food allergy tests involve adding a drop of your blood to food antigens (the protein portion of the food to which the immune system reacts) and looking for a reaction. The IgG test is more sensitive (it can detect the correct antibodies more easily) but less specific (it sometimes detects the wrong antibodies). The IgA test is more specific and less sensitive.

If you decide to do these tests, it is very important that you have been eating the foods you’re testing for roughly 6 weeks or longer before you have your blood drawn. Your body does not make antibodies against an antigen (the food in this case) unless it is exposed to it. So even if you are reactive to a food, after you haven’t eaten it in a while your antibody levels will go down – wonderful news when treating the condition, but problematic when testing. Unfortunately, these tests are also relatively expensive, not always reproducible, and the results on paper don’t always correlate with the symptoms you experience.

Celiac Disease

In celiac disease, an autoimmune disorder, a very specific type of immune reaction occurs. The body creates antibodies against certain proteins found in wheat and other grains, and these antibodies then attack the body’s own intestinal cells mistaking them for foreign cells (auto=self: autoimmune = immunity against self).  Historically, a biopsy of the digestive tract has been considered the gold standard for diagnosing celiac. Now there are lab tests which some physicians feel can predict celiac as accurately as a biopsy if used in conjunction with a food challenge. The most commonly ordered tests are for anti-gliadin antibodies (antibodies against a specific portion of the gluten protein) and tissue transglutaminase antibodies (antibodies that attack the intestinal cells).

These same tests can sometimes be useful in looking for gluten sensitivity unrelated to abdominal or intestinal problems, but there are limitations. One of the primary problems is that there are many proteins on the grain in addition to those that we know cause celiac disease, and lab tests aren’t available for most of them. If you are reacting to a protein in the grain other than the few we have a test for, nothing will show up on the lab test.

Testing for Food Intolerances

For food intolerances there are sometimes tests available. For example, in the case of lactose intolerance, there are two common tests. Each begins with drinking a liquid with high levels of lactose. In one, blood sugar levels are measured after a couple hours. If your blood sugar doesn’t rise, you aren’t breaking down and absorbing the milk sugar. In the other test, the amount of hydrogen you exhale is measured at regular intervals for up to 3 hours after drinking the liquid.

Typically, people don’t exhale a large amount of hydrogen, but if you are not absorbing the lactose, the milk sugar gets broken down by colonic bacteria that create a lot of hydrogen and other gases (one of the main reasons lactose intolerance is so painful!). Lab tests don’t exist for every food intolerance though, or for most of the sensitivities related to the drug-like components in food. In the case of caffeine, sometimes an elevated heart rate or blood pressure will let you know that you are sensitive to the stimulant effects, but for many pharmacological components, there is nothing easily measurable.

If you’ve been reading closely, you may have noticed some patterns emerging:  although many lab tests exist and can prove useful, none is 100% accurate, most are fairly expensive, and there are many situations for which we don’t even have lab tests. This is why in my practice I encouraged my patients to do an elimination and challenge diet rather than a laboratory test (except in the case of IgE mediated allergies). The diet is much less expensive than the labs; will help detect various types of food reactions- allergies, sensitivities, intolerances, and reactions to pharmacologically active food constituents- and it is the first step in treatment as well. Stay tuned for the next blog in which I describe how to do the elimination and challenge diet.

Continue to part 3 – Eliminating Food Allergies, Sensitivities, and Intolerances

Read part 1 – Making Sense of Food Allergies, Sensitivities and Intolerances

Dr. Lise NaugleAbout the Author: Dr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.

Making Sense of Food Allergies, Sensitivities, and Intolerances

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allergic reaction by Flickr user Gumdrop SweetIn this post, I address the meanings, misuse and differences between allergies, sensitivities and intolerances. In the next post, I talk about what you can do to identify food allergies and sensitivities. The final post in this series is on eliminating allergies, sensitivities and intolerances.

 

There is a lot of misunderstanding and misinformation regarding food sensitivities and their effects on your body. When you’re under stress or if you have adrenal fatigue, it is important to nourish your body with healthy foods. However, in some people, the ingestion of certain (normally healthy) foods can create a physiological stress that adds to the total body burden and challenges the adrenal glands. Identifying and removing offending foods from your diet can help reduce your stress load and improve your health—especially if your adrenals are fatigued—but it is important to know what to look for and to understand what you are dealing with.

Most people are aware of the classic food allergy: you take a bite of shrimp, your tongue swells and you break out in hives. The problem is that some people assume that if this isn’t happening to them, they don’t have food sensitivities—which isn’t necessarily the case. On the other hand, many people experience an energy crash after they ingest sugar and think they are allergic to it—which isn’t possible. That doesn’t mean that sugar can’t create its own set of problems in your body. (I’ll get to that in a minute). My goal in this blog is to help you understand the various types of food allergies, sensitivities, intolerances and reactions to pharmacologically active (those that induce a drug-like effect) food components. Any of these may stress your adrenals and cause them, and in some cases your immune system, to work overtime.

Let’s start with some definitions. An allergy is a type of hypersensitivity to a food—an adverse immunologic response to a protein found in the diet. This is why sugar can’t be an allergen. Sugar is pure carbohydrate, not protein, and a protein is required to trigger the immune response. The example I used with the shrimp is what is known as an IgE mediated allergy, the most widely recognized food allergy. IgE, or immunoglobulin E, is a type of immune cell. In this type of food allergy, IgE triggers symptoms such as hives, swelling, and in some cases anaphylaxis (a life-threatening condition that causes airway constriction) shortly after ingestion of the offending food.

Other types of hypersensitivity (mediated by different immune cells such as IgA or IgG) can also occur. Although not an “allergy” in the classic sense, they can create an inflammatory response and are responsible for many chronic disease states. Gluten, a protein found in wheat, barley, rye and other grains, often affects the body in this way and can be responsible for bloating, diarrhea and abdominal discomfort. In the worst cases, gluten can cause celiac disease, an autoimmune disorder that severely damages the intestinal lining. Celiac is associated with other autoimmune disorders such as diabetes and thyroiditis. Gluten sensitivity, even without intestinal effects, has been linked to psychiatric and neurological problems, including bipolar disorder, schizophrenia and ataxia, a disorder that causes loss of muscle coordination.

Food intolerances, such as lactose (milk sugar) intolerance, are often the result of a deficiency in metabolism. In the case of lactose intolerance, the digestive enzyme called lactase that is needed to break down the lactose is missing or present in insufficient quantities. As a result, the milk sugar enters the large intestine incompletely digested, and the bacteria that live in the intestine ferment it, producing large amounts of gas as a byproduct, which causes bloating, loose stools and abdominal discomfort.

Some foods have a pharmacological (drug-like) effect on the body. Caffeine is a central nervous system (brain) stimulant and can cause rapid heart rate and increased blood pressure. A substance called tyramine, found in smoked meats and fermented foods like cheese, causes release of certain neurotransmitters in the brain and has been implicated in the development of migraines. Opioids are chemicals that act like narcotics and may induce pain relief and sedation. Opioids have been found in both wheat and dairy proteins. Some people report sensitivities to additives such as artificial sweeteners, chemical flavor enhancers such as MSG, and certain dyes.

Finally, some foods influence the body’s metabolism and cause physiologic effects that way.  Sugar is the primary source of energy for the brain. If blood sugar is allowed to drop too low—because you’ve gone too long without food or because you ate too much sugar too quickly and compensatory mechanisms have overshot their mark—the brain doesn’t receive the sugar it needs and produces symptoms such as irritability, palpitations, anxiety or even a personality change.

Now that you are aware of the various ways foods can negatively impact and create stress in your body, I’ll help you learn some ways to identify which foods may be causing your problems.

Continue to part 2 – Identifying Food Allergies, Sensitivities, and Intolerances

Continue to part 3 – Eliminating Food Allergies, Sensitivities, and Intolerances

Image Credit: Allergic reaction by Flickr user Gumdrop Sweet

Dr. Lise NaugleAbout the Author: Dr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.