Inflammation

A Different Approach to Food Sensitivity Testing

The notion that a person may or may not suffer from a food sensitivity is certainly not a new thing.  This has been a concept that I hear people all the time asking about, experiencing, arguing with their doctors about, etc.  And this is something that I deal with all the time in my practice as I work with a particularly sensitive slice of the population.  It is my hope to shed some new light into this topic and try to explain why not all lab testing is the same.  Or why there is might be a high potential for false negatives on these tests.  And what in the world does one do when 90% of everything they tested for comes back positive?!?  Don’t worry.  There are answers. 

I just want to start out this discussion with my own personal story.  It is something that I have written about in years past but feel that it is particularly important to revisit here.  Almost five years ago now, through testing, I confirmed that I have a serious gluten sensitivity condition.  I had been having increasing headaches and weekly migraines that were no longer treatable by either mainstream or alternative methods.  Acupuncture had always worked in the past for these headaches but at some point became useless.  I had also developed psoriasis-like patches on my elbows and knees.  I even had elevations in my liver enzymes which were scary to say the least.   Those go high enough and a liver transplant is on the horizon.  So as much as I did not want to know the answer I tested myself with the best lab I could find.  What do you know?  I showed positive to not just gluten sensitivity but autoimmune reactions as well which are tightly associated with gluten.  The kicker to this story, and why I include it here, is that if I were to have gone the mainstream way of gluten testing, I never would have shown positive.  It would have been a classic false negative!  I didn’t have stomach pain and I did not show positive to the one marker that a mainstream practitioner would have looked for.  So I would have been looked in the eye and confidently told, “Mr. Chialtas, you do not have a gluten problem.  I urge you to continue to eat a whole grain based diet.  After all, it is good for you heart!”  It is important to realize here however that we show positive to things like gluten or other foods, or heck even to our own body by making antibodies that recognize small sequences of amino acids that make up the larger protein in question.  In this case gluten.  There is no antibody large enough to recognize the gluten protein.  Instead we make antibodies that recognize little corners of the protein.  I just so happened to not react to the gold standard corner or the protein that the mainstream chooses to look for. But thankfully the lab I used looks for a lot more corners!  And I was reactive to just about all of the others.  So I had my positive findings and started my new life.  Migraines reduced by at least 90% immediately.  Skin condition totally resolved after 6 months. Liver enzymes also returned to normal after a few months.  So I am one example of a patient who would be told there is no problem when in reality it was the testing that was the problem.  I can’t tell you how many people tell me with full sincerity that they have been tested and do not have a gluten problem.     I always beg the question…  How were you tested? 

But this food reactivity concept gets much MUCH deeper than just gluten.  People are routinely getting tested for 100-150 foods at a time.  And to be quite honest I used to not run these tests often because I kept seeing the same thing over and over.  I would get the report back and 120 foods out of the 150 would be positive!  What is a person supposed to do with that kind of information?  The typical approach would be to have that patient remove all of the offending foods and do a rotation program with the remaining foods available.  The trouble with this approach as I see it is twofold.  First, we have to remember human nature.  We are rebellious for the most part and tend not to accept strict dietary guidelines like that.  I have just seen this time and time again with my patients (and myself).  Failure here is a high likelihood.  Second, if that person would take the recommendations to heart and eat only those foods on the OK list it would only be a matter of time until that person began to develop reactions to those foods as well!  The reality of what is going on in these cases is that this person, for some reason or another, has lost what is called “oral tolerance.”  This means that the majority of things that go into their mouth are reactive to their system.  The immune system is on a hair trigger so to speak and reacts to the things it sees most often.  (Gluten is in 80% of our diet by the way.  And dairy is close behind that!)  So instead of eliminating the majority of a person’s diet how about we take out the few that are known to cause symptoms and then focus all of the support directly at how the immune system behaves? 

One other concept that I see missed all the time in both mainstream and alternative approaches alike is to determine the status of a person’s antibody count in general.    Let’s be frank here…  Getting a full food reactivity panel done is not cheap.  Nor is it covered by insurance for the most part.  So for that reason alone I like to make sure that a test like this would actually provide an accurate reading. I want to help clear the concerns about false negatives.  Because remember, if a paper says no reaction but there really is, the person will keep on eating the offending food.  And in a lot of cases that means destruction of an organ!  So the basis of what I am describing here has to do with the antibodies our immune systems make to recognize, and mark for attack, any particular amino acid sequence it feels necessary such as the ones found in gluten for example.  The most common way to screen for these reactions is to look for two types of antibodies called IgG and IgA.  A person may have IgA antibodies to Alpha-Gliadin for example which is the most common gluten marker (the one I did not show positive to).  But if that person did not make enough IgA antibodies in general they couldn’t make enough of the Alpha-Gliadin IgA antibodies to show positive on the report.  That does not mean however that there is not a reaction going on anyway.  So before I have my patient spend a lot of money and emotion on a test like this I want to make sure that they are able to make enough of these antibodies to provide accurate reporting.  This is just not something I see going on out there. This is just one more way that a person could be given a false negative report which means they keep eating the offensive food!   And in an autoimmune condition like with MS let’s say, reactions like this could literally mean continued destruction of brain and spinal cord cells!  If you are going to go down this road be sure to ask these questions of your practitioner.  And if they can’t answer them then move on.   Practicing with this level of understanding and detail is key to your success. 
And finally something to realize about just about every food testing lab but one is that they do not all test in the same way. Each lab has their own methods and they are not all equal.   Let’s just take egg protein for example.  Egg is a common reactive food for people.  Most all labs however only run these antibody tests against raw foods.  When you cook a food the heat changes the structure of the protein.  So raw egg protein looks slightly different than cooked egg protein.  That means that there will be two different antibodies as well!  Antibodies are very specific to structure.  Now unless you are Rocky Balboa you probably are not eating your eggs raw.  So why, I ask are you looking for raw egg reactions and paying hundreds of dollars too-boot?  Way too many of these tests in my opinion are steering people in the wrong direction by giving results based on food a person isn’t even exposing themselves to like raw eggs!  It is important to test for the foods we actually eat.  I personally eat both raw and cooked spinach. So if I were tested I would want to know both!  I only know one lab who understands and offers this kind of detail. 

So in closing I just wanted to propose a few different tactics to working with the results of food sensitivity testing like these.  If for example one or two foods came back positive then by all means cut them out.  We pray for those reports.  They are straight forward and easy to take to heart.  But if the test comes back mostly positive make sure you take out the heavy hitters right away like gluten and dairy for starters.  And any others that the person may recognize as symptomatic in some way.  But be sure to take measures towards gut lining repair as well.  This is a lengthy discussion by itself and I am happy to consult with you individually.   But more than that, steps need to be taken to help the immune system not react as easily to what it is coming in contact with.  Each individual will present with a unique set of needs to achieve optimal gut repair.  So a good functional blood chemistry work up is vital.  Things like anemia or blood sugar disorders can all work against a healthy gut and can in time lead to things like food intolerance.  The rabbit hole is deep here and it takes a practitioner with a keen eye to spot all of the cycles at play.  This is the kind of thing I love to work through with my patients.  I love seeing them light up when all the pieces finally connect for them and they start feeling better.  So I am putting out a call to action for anyone suffering strange reactions to their foods.  Or anyone for that matter with a known autoimmune disease or a condition that their MD’s just don’t know what to do with.  There are gut concerns at the core of these most all of the time.  And the answer could be as simple as changing some dietary habits.  

CBD - An Emerging Tool In The Fight Against Inflammation

I wrote a piece a while back about my 30 day trial of a CBD oil supplement that I had a good experience with.  Since that time I have had some interest from some of my patients and other readers as a result.  And since that time as well I have done some more research about Cannabidiol (CBD) and have found some very compelling modern scientific research articles on the topic.  I want to describe just some of the things that I have found that I feel are not only interesting but potentially game changing for a lot of chronically ill people.  But not only chronically ill people can benefit.  The research that I have been reading shows great promise in the area of preventative medicine as well.
 
Before I get in to the details here I feel it is important to cover a few basic topics about medical cannabis that are common misconceptions or flat out judgmental bias about these compounds.  First and foremost CBD and THC are two different compounds. It is the THC that people know about and is the compound that produces the “high” from marijuana.  CBD is another compound found within the plant that does not lead to feeling high but instead has some pretty profound medical implications as research is showing us.  Interestingly, THC is found in much higher concentrations in the traditional marijuana plant.  Marijuana has much more THC and less CBD content.  The hemp plant however looks the same, grows the same and can even cross breed with marijuana but is a different strain.  The hemp plant contains very little THC and higher levels of CBD.  Basically smoking hemp would lead to a bummer of a high.  It just does not contain enough THC to produce any effect.  So why in the world it is not legal here in the States is beyond me.  CBD products however are legal in the States.  In fact they are legal for sale in every State in the US without the recommendation of a medical doctor.  The products that I am carrying now are all from hemp plants and contain virtually no THC whatsoever.  Nope….  Taking this stuff will not get you high but it will do a lot more for you.

One of the first concepts that I have heard people using CBD’s or Hemp oil for is in the treatment of cancers.  Now it is very important for me to point out that there is very little scientific literature out there at the moment that demonstrates a benefit of taking CBD products for the treatment of cancer. However, there is mounting anecdotal evidence coming in constantly about people who were at their end with chemotherapy and began using high quality and high dose CBD products (or other medical cannabis products) only to find their tumors were shrinking.  There are plenty of stories of people going into full remission as a result of adding in products like these and their MD’s having no explanation for the sudden turn of events.  So with any luck there will be some good studies in the near future on this topic. I for one will keep my eyes peeled.  Cancer however is not a specialty of mine.  The next bit of info however fits my patient population much better.

In pouring over some of the more current literature on the subject of CBD’s and physiology I have been surprised to learn just how extensive the benefits can reach.  I have written in the past about inflammation and how it can impact so many different parts of our health.  Indeed just about every chronic disease has its root in inflammatory activity.  I work a lot with autoimmunity and I see things like blood sugar disorders all the time.  Type II Diabetes is a growing epidemic in this country with the largest population of people developing the disease being teens and young adults!  In these cases there are soaring levels of blood sugar in the system with equally high levels of the hormone Insulin.  Insulin is essential for life but the idea is to keep these levels as low as possible.  Because even though it is essential, too much and you set off a cascade of inflammatory mechanisms that all lead to disease in the end.  The best plan is not to start things off in the first place.  But alas the reality is that we are already there folks! 

Before I describe some of the benefits of these compounds I feel that it is important to explain what I mean when I say “inflammation.”  In this case I am not talking about a swollen ankle that started during that beach volley ball match.  Sure, that joint is inflamed.  But rather, I am talking about molecules that the immune system releases into the blood as a result of some trigger.  These molecules called “cytokines” literally float around and wreak havoc on everything in their way.  If they land on a brain cell that brain cell suffers and even dies.  If they land on a hormone receptor that receptor fails to work optimally.  If they attach to the tissues lining the arteries that artery becomes sticky and attracts plaque leading to vascular disease and the leading cause of death – heart attack.  And something that I work with a lot in my practice, if that cytokine interacts with other immune cells they can lose their ability of self-control and begin attacking our own tissues!  That is autoimmunity.   Once the body loses the ability to determine the difference between self and non-self we are now forever under attack from our own forces.  This is not good…   Longevity rarely ever accompanies autoimmunity.  The focus on this article is a particularly nasty inflammatory cytokine called NF-kB.  The name isn’t all that important but trust me.  NF-kB is one of the really nasty bad guys you do not want to spin out of control.  If it does take hold you can end up with one or many of the things I just described above.  NF-kB plays a key role in vascular disease, autoimmunity, cancer, dementia, etc.  A lot of what I do with my patients is finding ways of lowering NF-kB activity so that their disease states do not spin out of control.  As of now there is no medication on the market that directly lowers this inflammatory cytokine.  Most drugs target the things that come as a result of this kind of activity.  Interestingly there are a few natural compounds that have shown to lower this cytokine activity. 

Enter CBD…  According to an article published in the Am J Physiol Heart Circ Physiol. Jul 2007, CBD has demonstrated a significant ability to squash the NF-kB elevations otherwise associated with the Insulin surges found in Type II Diabetics.  In essence this article describes a compound that can literally act as an “antidote” to Diabetes and recommends that further research on this subject be at a high priority! 

Another article from the British Journal of Pharmacology (2008) suggests that the potential for anti-inflammatory activity of CBD could lead to a new class of anti-inflammatory drug.  So this means that the pharmaceutical industry sees the benefit.  These are mainstream medical scientists who are publishing articles on the benefits of a compound found in medical Cannabis!  I personally find this to be somewhat of a huge step forward in an otherwise closed field of pharmaceutical control of symptom rather than source. 
    
My personal interest as I have mentioned, aside from the rampant blood sugar patterns I see all the time out there, is autoimmunity.  This particular patient population is literally awash in an intermingled web of inflammatory cytokine activity and NF-kB is at the core of a lot of it.  In an article published in the Am J Physiol Heart Circ Physiol. Jul 2007 it was stated that CBD has already been approved in the treatment of inflammation, pain, and spasticity associated with multiple sclerosis in humans. Multiple Sclerosis (MS) is an autoimmune disease.  And the CBD did not benefit the MS condition specific to the nervous system precisely.  Rather, it worked on the immune system which is at the root of the MS in the first place.  It is important to understand that an autoimmune disease is not just a disease of the particular organ or gland under attack.  First and foremost it is a disease of the immune system not knowing self from non-self!  So studies like these demonstrate potential benefits for all autoimmune diseases.  It just so happened that this particular study was focused on MS patients.
 
So in closing I just want to leave off with one more quote from my good friend and colleague         Dr. Chris Rasmussen, MD…  

Let me put this into perspective. If we had a drug that could effectively, and safely, attenuate or reverse the effects of our first-world, inflammatory lifestyle, while allowing patients to continue their destructive habits-the classic American way to approach healthcare-it would outsell statins [Cholesterol lowering medications and the go to treatment for heart disease currently] within the first year. That’s at least 30 billion in sales per year (some sources quote 200 billion in annual sales). Moreover, by operating at the root level and suppressing NF-kB, a real cure for atherosclerosis could be realized, and with it cures for a hundred more diseases of affluence. That could change the face of medicine folks. It would be as important, if not more so, than when penicillin was first introduced 70 years ago in the treatment of that generation’s biggest killer-infectious disease. 

I just want to point on one thing from this quote.  Disease of affluence as he states it is nothing more than people driving themselves into a disease state through inflammatory means.  This could be due to gallons of soda, cookies, etc.  Or due to food sensitivities to the ever increasing garbage and “frankenfood” we are being served and not to mention serving our children. It could be due to a lifestyle that is high in drugs, nicotine or alcohol.  And it could all be made worse by our high stress high intensity pace we have learned to accept.  Regardless, the lifestyle we have become accustomed to as Americans is literally killing us through mechanisms like NF-kB and its hydra head of consequences!  Will this lifestyle fade away any time soon?  Well, I think not.  But it is always nice to see new emerging tools we can draw from to turn down dangerous inflammatory activity like this.  It is time we put down the stigma of whatever “Cannabis” means to you and take a closer look at what is really waiting there for us to re-discover.  Remember, this is an herb that has been used for millennia up until the 1920’s when William Randolph Hurst stigmatized Cannabis and assigned it the rather derogatory name of Marijuana coined from Mexico which tied nicely into the rampant racism of that era.   But that’s another story altogether... 


…cannabis is a source not only of D9-THC, CBD and D9-THCV but also of at least 67 other phytocannabinoids and as such can be regarded as a natural library of unique compounds. The therapeutic potential of many of these ligands still remains largely unexplored prompting a need for further preclinical and clinical research directed at establishing whether phytocannabinoids are indeed ‘a neglected pharmacological treasure trove.’ - Journal of British Pharmacology (2008)