A food sensitivity panel is the best way to identify leaky gut – and devise a specific recovery plan. Dr. Doni covers all the basics of food sensitivity testing.
Part 2 of 3: Dr. Doni’s Leaky Gut Basics
Elimination diet vs. food sensitivity panel – what is the best way to figure out your food sensitivities and whether you have leaky gut? That is the question we are covering today.
Before I begin to answer the question, let’s start first by understanding the reason for the question.
Is it possible that the symptoms you’ve been experiencing – whether it’s headaches, sinus congestion, body or joint pain, bloating, weight gain, anxiety, sleep issues, autoimmunity, allergic reactions, and/or fatigue – might be related to what you are eating?
And not just what you are eating, but the way your body is responding to what you are eating.
In other words, is your immune system working overtime trying to protect you from the foods you eat every day? And in doing so, leaving behind damaged intestinal cells and inflammation which is then flooding your body with stress signals?
Study upon study explains that this scenario is not only possible, but common. (references below)
It is well established: Stress of various types – from physical injury to emotional crisis, to daily deadlines and demands – makes it harder for us to digest our food and more likely that our intestinal cells are not going to be able to perform the way we need them to.
And in the end, this sets us up for a vicious cycle of inflammation, referred to as intestinal permeability or leaky gut, which has been associated with a wide range of health issues.
Here’s the problem. Most doctors don’t diagnose it.
You won’t find out about it at your annual visit. If you see a gastroenterologist or allergist, it’s not likely to come up. Even if you see a dietician – it is simply not on the radar of conventional medical practitioners.
Perhaps this is because it doesn’t show on standard blood work. They can’t find it with imaging. And there is not a drug to treat it.
So you might feel that you are “on your own,” so to speak, when figuring out leaky gut – whether you have it and what to do about it.
I’m writing this article so that you are not all on your own, and you have the information I have learned over the past 20+ years to inform your decisions about your health.
My Own Leaky Gut and Food Sensitivity Story: A Pathway to Understanding
First, I want to explain that I was originally trained as a nutritionist. I could have completed an internship to become a dietician but realized, that was not going to allow me to help people with the information I knew I wanted to share. So instead, I trained to become a naturopathic doctor. I graduated from Bastyr University in the year 2000 and completed a residency.
And during that time, I was experiencing severe migraines and had a long history of allergies, digestive issues and reactions to food. So while I was a student and resident, I tried everything on myself to try to solve these health issues.
I did an elimination diet. An elimination diet is a process over three to four weeks where you remove certain foods from your diet – the foods most likely to be triggering a response. Common foods to avoid are soy, gluten, dairy, eggs, and in some cases nuts, corn, and sugar. Over the three weeks of elimination, it is best to journal and notice any changes in the way you feel. Then, at the end of the three week, you reintroduce the foods you’ve been avoiding, but not all at once. You reintroduce them one at a time, with three to five days in between so that you can observe for an increase in symptoms.
And by doing the elimination diet I figured out that I react to soy products, but when I avoid soy, I still get migraines. So I kept on searching. I did various food tests – all different types. Most of them told me very little or only what I knew already. I knew my mouth itched after I ate apples, and that I got canker sores when I ate strawberries.
Still, I couldn’t solve the migraines, and by this point I had graduated and was practicing. I was seeing patients with some of the same health issues I struggled with, which lead me to read even more research and try other approaches.
I trained in a therapy called NAET, an acupressure technique used to reverse food allergens. It helped some of my patients, but I was intrigued by the patients who it didn’t help. What was different about those patients? What was different about me?
Finally, I put it together. When I helped patients to heal leaky gut, then they stopped reacting to their food allergens.
But how could we identify those patients ahead of time? How could I pick up on whether leaky gut needed to be addressed.
Available Tests for Leaky Gut:
At the time, testing for leaky gut didn’t exist and even today, tests are being developed, but are not as accurate as I would hope. The tests that are currently available are:
- Breath test. This simple test measures your ability to digest table sugar. Healthy intestines have no trouble digesting it, but when leaky gut damages your intestines, this test is able to detect changes in the pH level of your breath.
- Urine test. This measures the absorption of complex carbohydrates (lactulose and mannitol) across the lining. Lactulose should not cross the lining, so when it is found in the urine it indicates that the lining is leaky. Mannitol should cross the lining, so if it is not found in the urine then it tells us the cells are not absorbing nutrients well.
- Blood tests. Two blood tests are currently on the market. One tests for actomyosin and other proteins that are released when the intestinal cells and tight junctions are damaged, tells us if intestinal cells are being actively destroyed. The other tests for zonulin, a hormone that opens up the spaces between the intestinal cells (called tight junctions), increasing gut permeability and allowing undigested food to get through the intestinal wall where it can trigger the immune system.
I have found that these tests are better at identifying severe leaky gut, but not mild or moderate leaky gut. And because it’s beneficial to address leaky gut even when it is mild or moderate, I want a test that is more fine tuned.
That’s when I found the IgA and IgG antibody panel. The panel is a quantitative ELISA (Enzyme-Linked Immunosorbent Assay) analysis of antibodies to foods that has helped me and thousands of patients since then.
The Best and Most Accurate Food Sensitivity Panel
The IgA and IgG antibody panel shows us which foods are triggering an immune response. The most common misconception about food sensitivity testing is that people think that the results are inaccurate when they show that a person is reacting to foods they eat often.
Actually, when a person reacts to foods they eat often, that is the indication that leaky gut exists.
Leaky gut is when undigested food leaks between the intestinal cells to the area underneath, whether the immune system is ready to protect us. So when you eat a food each day, and it not only doesn’t get digested well (because of stress), but also leaks through the intestinal barrier, the immune system will try to protect you from that food, leading to the inflammation associated with leaky gut.
That means the food panel does two things: identifies the foods to avoid and 2. identifies leaky gut.
From there, all we need to do is remove those reactive foods from your diet and provide the support your body needs to grow back new healthy intestinal cells. This support comes in the form of enzymes, nutrients, and herbs* – so that we help the intestinal cells to recover.
PLUS the IgA and IgG antibody panel is able to show us foods your immune system reacts to that you might not have figured out from other tests or approaches. It finds the sneaky, delayed reactions triggering IgA and IgG antibodies to be produced.
What is the difference between IgA and IgG? IgA antibodies can last a few days or up to a week, whereas IgG antibodies can last for 3 weeks. So if a person does a 21-day elimination diet, they might still be reacting to the foods they are avoiding and not figure it out in the course of an elimination diet.
That’s what happened to me!
On my IgG panel, way back in about 2004, it showed a reaction to gluten. Not a high reaction, mind you, a LOW reaction. But because I was in experiment mode and wanting to understand the potential benefits of the test, I removed gluten from my diet. And would you know, I felt better.
The elimination diet, the other food tests I had done – which included ALCAT, NAET, and many others – never showed gluten as an issue for me.
But when I eliminated gluten, my health changed, profoundly.
From then on, I started researching gluten, and consider it to be one of the biggest “trouble causers” when it comes to leaky gut. Why? Because gluten CAUSES leaky gut.
Thanks to Dr. Alessio Fasano, we now know that gluten stimulates a hormone called zonulin in the gut, which opens up the spaces between the intestinal cells. It literally created leaky gut. And not just in people with Celiac disease or gluten sensitivity. It can happen to anyone and everyone.
News flash! In order to heal leaky gut, we need to at least reduce gluten intake (if not avoid it altogether). I’ll cover that more in the next article in this series.
For now I want to emphasize that what I discovered through my research and helping patients, which has been further proven and solidified year after year. The best way to identify leaky gut (and then develop a plan to heal it) is with an IgA and IgG food sensitivity panel.
Food Sensitivity: Immediate vs. Delayed Reactions
Now I want to clarify – IgE antibodies are a completely different thing. IgE antibodies are associated with allergies – food allergies specifically. An allergy to peanuts is a great example. IgE antibodies cause an immediate response to a food, and the person could even need to go to the emergency room due to swelling in their throat. That’s the antibody allergists specialize in, and for which allergy shots are given.
I’m not talking about IgE antibodies or “allergies.”
I’m talking about DELAYED food sensitivity. I feel that the word “sensitivity” can make it seem unimportant or insignificant. Please don’t be fooled by that word. Food sensitivities ARE definitely significant. Studies have shown them to be the underlying cause of everything from anxiety and depression, to weight loss and weight gain, to PCOS, autism, ADHD, skin rashes, and more.
Why are they not addressed in the conventional medical system?
Well I think it is because the “treatment” so to speak is dietary changes, nutrients and herbs, which medicine doesn’t specialize in. It’s not in the doctor’s tool box.
So if you think you might have leaky gut, you’ll need to get an IgA and IgG food panel on your own. And they usually are not covered by insurance – at least not from the highest quality labs. But you can do them from home. It is a simple blood test that you do with a finger poke.
What do you do from there?
The whole point is NOT to just eliminate the foods you react to – forever. Please don’t stop there.
We need to take the information we get from the IgA and IgG food panel and use it to actually heal leaky gut. As leaky gut heals, the food reactions decrease, and in the case of most of the foods you react to, you’ll be able to go back to eating them again. Why? Because you’ve actually addressed the cause: Leaky gut.
Another thing that I have to emphasize is that 50% of people who have leaky gut do NOT have any digestive symptoms. 50%.
That means you might be thinking that your gut is just fine. You might be saying that your digestion never bothers you; your stomach is never the issue. Still you must consider leaky gut as a possible underlying cause because leaky gut means that the food is leaking into the space outside of your intestines, where your immune system responds to protect you from the undigested food, triggering a cascade of inflammatory messengers that can go anywhere in your body that they want.
Patients have reported improvements in everything from skin rashes to headaches, memory issues, pains, abnormal pap smear results and HPV, fertility issues, hair loss, autoimmunity, and weight issues.
Leaky gut is not just a gut issue. It starts in the gut, but doesn’t stay in the gut.
And to solve your health issues, you’re going to need to consider leaky gut. And the best way to evaluate for leaky gut is with an IgA and IgG food panel.
Now I want you to know that there is a difference in the labs that offer food panels. Some provide results, but when patients implement the information, they don’t feel better. That is not the lab to use. I’ve tried them, compared, and checked again, over the years.
The IgA and IgG food panels I recommend have yielded the best results for my patients, and that is what matters to me. In fact, I worked with the labs I use to develop panels based on what I find provides the most useful information.
- ImmunoLab checks for 96 of the most common foods – with IgA and IgG
- U.S. Biotek 48 food panel – IgA and IgG
Common Questions About Food Sensitivity Panels
Here are some of the patient questions that come up in my practice:
- Is testing for more foods better? No. Testing for more than 96 foods is simply too much information that is not necessary for healing leaky gut. Over and over, working with the most severe cases, I’ve found that if we eliminate the most common reactive foods, leaky gut can heal.
- Is it better to check just IgA or just IgG? No. It is best to check both IgA and IgG. They are different antibodies, and provide different information. We can’t anticipate whether your immune system will make IgA and/or IgG to a given food. The only way to know is to test for the antibodies. Both are important to know, and by having information about both antibodies, I find patients improve faster.
- Do I need to stop or start eating any particular foods before I do the panel? No. We are checking to find out whether or not you react to the foods you eat now. If you’ve been avoiding gluten, let’s say, for over 6 months, we don’t want you to add it back and feel worse. What we want to know if whether the antibodies are still reactive while you are avoiding gluten, and if you are doing a good job avoiding gluten. So don’t wait, don’t change, just test.
- Can I do this panel from home? Yes! As long as you, or someone in your home, is able to poke your finger with a lancet, you can do this panel at home and mail it in to the lab.
- How long do the results take? The results generally take 2 to 3 weeks.
- How long must I avoid the reactive foods? That depends. It depends on how severe leaky gut is for you. Also, on the severity of your health issue. And it depends on how much you are able to implement leaky gut healing tactics. And it depends on your body, your genetics, and your STRESS exposure. Leaky gut heals over time. As each cell gets replaced by a new healthy cell, you grow closer and closer to having fewer food reactions.
- When should I retest? I suggest waiting at least 6 months, or even a year. In fact, re-checking each year or two can be helpful information so you know what is working and whether you are staying ahead of the leaky gut current.
That’s right. Leaky gut is inevitable in the world we live in. That is because stress, toxins, pesticides, injuries, and medications all cause leaky gut. So really, the goal is how to give your body the support it needs on an ongoing basis to prevent leaky gut.
AND THAT is what we are going to cover in the next article in this series.
In the meantime, if you’d like my help to find out if you have leaky gut, and then to address leaky gut once and for all, here are the options I offer:
1. Food Sensitivity Panel
Order a food panel and use my suggestions from this article (and the next one in the series) to “do it yourself.”
- ImmunoLab checks for 96 of the most common foods – with IgA and IgG
- U.S. Biotek 48 food panel – IgA and IgG
Determining whether you have leaky gut is only the first step on this journey, but it is an important one that allows you to be sure that you’re treating the right thing.
2. Group Program
If you are not quite ready to do a food panel, and want to start with an elimination diet of the most common food allergens, you can follow the Stress Remedy 21-Day Program for that purpose. The meal plan is gluten-free, dairy-free, soy-free, and egg-free. It also guides you to reduce sugar and balance your blood sugar. It will help you learn a lot about your body over a 3-week period of time.
However, please remember that my patients get the best results by doing an IgA and IgG food panel, and then following my Leaky Gut Healing Protocol, which you can read about in the next blog.
Thank you for your curiosity and for being here to learn more about what you can do to improve your health.
4th May 2020
*Please keep in mind that any and all supplements – nutrients, herbs, enzymes, or other – should be used with caution. My recommendation is that you seek the care of a naturopathic doctor (with a doctorate degree from a federally-accredited program) and that you have a primary care physician or practitioner whom you can contact to help you with individual dosing and protocols. If you ever experience negative symptoms after taking a product, stop taking it immediately and contact your doctor right away.
- Fasano A. All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases. F1000Res. 2020;9:F1000 Faculty Rev-69. Published 2020 Jan 31. doi:10.12688/f1000research.20510.1
- Cai C, Shen J, Zhao D, et al. Serological investigation of food specific immunoglobulin G antibodies in patients with inflammatory bowel diseases. PLoS One. 2014;9(11):e112154. Published 2014 Nov 13. doi:10.1371/journal.pone.0112154
- Vojdani A, Lambert J. The onset of enhanced intestinal permeability and food sensitivity triggered by medication used in dental procedures: a case report. Case Rep Gastrointest Med. 2012;2012:265052. doi:10.1155/2012/265052
- Karl JP, Margolis LM, Madslien EH, et al. Changes in intestinal microbiota composition and metabolism coincide with increased intestinal permeability in young adults under prolonged physiological stress. Am J Physiol Gastrointest Liver Physiol. 2017;312(6):G559‐G571. doi:10.1152/ajpgi.00066.2017
- Oligschlaeger Y, Yadati T, Houben T, Condello Oliván CM, Shiri-Sverdlov R. Inflammatory Bowel Disease: A Stressed “Gut/Feeling”. Cells. 2019;8(7):659. Published 2019 Jun 30. doi:10.3390/cells8070659
- Bischoff SC, Barbara G, Buurman W, et al. Intestinal permeability–a new target for disease prevention and therapy. BMC Gastroenterol. 2014;14:189. Published 2014 Nov 18. doi:10.1186/s12876-014-0189-7