Food Allergy Tests

It has been my experience that food allergy tests can be a bit unreliable. It is best to use combinations of allergy tests to get the most accurate readings and results. Normally you will have to ask your child’s allergist to do more than one type of test. You can even request that your doctor order the results to be sent to more than one lab for more accurate readings. Further, consider getting a second opinion from a different allergist. 

Sounds like a lot of work? Perhaps. But consider the impact of food allergies on your life and your child’s life. Eliminating a single food from your child’s or family’s diet can be a lot more work and for a much longer time. It can also contribute to stress in your life and in your child’s life because it affects both social life and school life. When food allergy testing normally comes around every year or two, it isn’t unreasonable to make sure the results are really accurate since you'll have to live with them for a long time. 

The following is a summary of food allergy tests that you can seek out for your child.  Due to the inaccuaracy rates of single tests, combining results can give you a clearer picture of your child’s situation. Further because different labs and doctors can produce different results from the same tests, don’t be shy about getting a second opinion. Call your insurance company about coverage for additional tests. Share the test results with all the doctors involved to they can learn as well. Any doctor who gets annoyed that you have asked for a second opinion does not have your child's health concerns first.

• Skin prick tests: This involves pricking the skin with various allergens. The benefit of this type of test is that it will probably not give a false negative meaning if the child has an allergy--it will appear. But the con is that it can give a false positive meaning that it may show an allergy when in fact the child can tolerate the food. 
• Blood tests: Several types exist such as the RAST (Radioallergosorbent Test) and ELISA (enzyme-linked immunosorbent assay).  The results can be misleading in that sometimes the child will be allergic to the food but the test will result in a negative result.  The blood taken from the child’s arm can be split and sent to two different labs for more accurate results.  You will need to request that this be done. 
• Kinesiology tests:  This is done by homeopathic physicians using a small vile of the allergen which is held in the hand of a patient while muscle strength is tested. It is a non-invasive non-painful test and easy to do--but the interpretive nature of the results may put some people off as to its validity. 
• Challenge tests: This test involves eating the offending allergy-food in the doctors’ office.  It is normally recommended when BOTH blood and skin prick tests are negative.  It is a lengthy test (3-4 hours most of which is waiting) and is normally done when there is a very good chance the child has outgrown the food allergy. 
• New tests in the future:  “A new kind of blood test could someday help doctors zero in more definitively on who is most likely to have allergic reaction to foods. Phadia AB, a maker of allergy tests, has developed a test, called Component-Resolved Diagnostis (CRD) that can determine which molecule within a food is sparking the antibody reaction. In the peanut, for example, only three of 14 different molecules are associated with anaphylaxis-causing reaction, according to the company. CRD has not yet been submitted for approval by the Food and Drug Administration, but it is in use in Europe…In the Manchester study, for example, the researchers found that almost all of the children who were highly allergic to peanuts reacted to a specific protein call Ara h 2…Knowing more about what specific molecules cause allergic reactions could help scientists understand more about the severity of allergic reactions, and someday help efforts to develop treatments to trick the immune system into behaving differently.”[1]
• Delayed allergy tests: Most allergy testing is for immediate allergies (with symptoms of hives, anaphylaxis, vomiting, breathing, swelling, rashes, eczema). But for many the symptoms are not so obvious--making the connection between cause and symptom downright difficult.  Delayed food allergies can be tested for through blood testing (only) as described above. But instead of searching for IgE antibodies, the lab must look for IgG or IgA antibodies. You will need to find an allergist who is knowledgeable in this area.  Parents and children dealing with asthma, autism and ADHD often have delayed food allergy antibodies. 

In summary, take your child to an allergist for allergy testing. Ask for more than one kind of test and consider getting a second opinion. Share results among the doctors and labs.  Understand that immediate allergies are different from delayed allergies, but both can affect a child's life drastically.

---

[1] Beck, Melinda, The Wall Street Journal, 1/26/2010, http://online.wsj.com/article/SB10001424052748703808904575025013194645130.html

Food Allergies can cause Eczema

When my first son was born he had cradle cap─patchy pieces on his scalp which I tried to oil and wash off painstakingly. He also developed a rash on his stomach, then on his arms and legs. I creamed this using a prescription cream from the doctor. Had I known better then I’d would have stopped eating and drinking dairy products─as he turned out to have a dairy allergy that has lasted for seven years thus far. I breastfed him and believe that the protein from dairy irritated his body. I often also wonder what other kind of discomfort it caused him. Did it give him cramps? Gas? Make him cry more? I finally figured out he had a dairy allergy and removed all dairy before he was a year old. His eczema was greatly reduced though his skin was still a bit dry, especially in the winter. Now, for the past year, since introducing fish oil into his diet, his dry skin isn’t a problem at all. We occasionally use a little cream, but mostly just on his hands and only in the winter.

I’ve heard friends talking about the oozing red rash behind their child’s elbow or knee. Or they talk of the variety of creams they’ve tried. One of the mothers interviewed in my book was so adamant about finding the cause of the eczema or rash on her infant that kept him and her up at night for weeks from the probable burning and itching feelings that she asked herself and her doctor over and over until she found the solution herself. She found her son was allergic to dairy by removing it from her own diet and seeing his eczema “clear up by ninety percent,” in her words. Sometimes the discovery can take place by accident. In Robyn O’Brien’s book, The Unhealthy Truth, she discovered her son’s eczema cleared up when they went on vacation and he didn’t drink the many cups of milk that he normally consumed. Upon returning home and to his old habits, the eczema returned, as well as his cough and earaches. Eventually Robyn weaned him from milk, yogurt, cheese and other dairy products, which healed him.[1]

Over the years, I read a lot about itchy, red, bumpy rashes to try to understand why eczema and food allergies are created. I developed the following layperson’s understanding: Eczema is caused by the inability of the infant’s immature digestive system (or a child's or adult's digestive system) to digest certain proteins, such as the dairy proteins, which can be hard to break down. These hard-to-digest proteins travel through the digestive system and go into the blood stream undigested. The liver then tries to cleanse the blood stream of this undigested protein. This works for a while, but then the liver becomes overloaded and cannot clean the bloodstream sufficiently. As a result, the immune system comes to the rescue and builds antibodies to attack the foreign proteins. Once the immune system creates antibodies, the allergic reaction is in place. The immune system’s antibodies tell the body to attack that foreign substance as if it were a virus or disease, which can cause the body to go into overdrive, possibly resulting in anaphylactic shock, or less severe yet equally devastating delayed allergic responses that can contribute to asthma, ADHD or autism. In the meantime, this foreign substance still needs to be excreted from the infant’s body, so the skin is used for excretion rather then the digestive system. Thus the skin becomes the cleanser of the body and shows a rash as the foreign substance comes out.[2]

I am sure that other things can irritate the skin. Environmental factors such as pets, dust mites, pollen can all contribute and make eczema worse, not to mention that there are other unrelated rashes caused by things like poison ivy─my worst nightmare. But I think people often overlook the fact that much of eczema can be caused by the food allergies to dairy, eggs, wheat, soy, peanuts, tree nuts, fish and shellfish. No matter how old you are or your child is, it can be a worthwhile experience to try to eliminate on of these foods for a week and see what happens. If nothing seems to change, try eliminating a different food for the next week. You may be pleasantly surprised at what problems you can solve without any medication or cost.

---

[1] Robyn O’Brien, The Unhealthy Truth, Broadway Books, NY, 2009, p 147-150.

[2] A. Anderson, Flourishing with Food Allergies, Papoose Publishing LLC, CT, 2008, p. 35.

Autism, ADHD, Asthma and Allergies

How can food allergies affect children who have the disorders of autism, ADHD and asthma?

There are (at least) two types of antibodies that can be created by a child's body: IgE and IgG. The IgE antibody normally produces an immediate-food-allergy reaction. The IgG antibody normally produces a delayed-food-allergy reaction.

Immediate-food-allergy reactions can produce hives and anaphylaxis (swelling of the lips, tongue and throat along with trouble breathing).  Reactions normally occur within a few minutes of eating the offending food, but can take up to 24-hours to occur. 

Delayed-food-allergy reactions normally take at least a few hours or days to occur.  The symptoms of this type of reaction can be more difficult to spot.  Specifically, delayed-food-allergy reactions can be responsible for the behavioral disorders of autism and ADHD as well as reactions of asthma. 

Consider Dr. Kenneth Bock's thoughts in his book, Healing the New Childhood Epidemics where he states, "A very significant advantage of blood testing, as opposed to skin testing, is that it reveals the presence of IgG reactions.  IgG reactions typically don't show up during skin testing, because they often don't begin to occur until a few hours, or even a few days, after contact with the food.  In contrast, IgE reactions generally occur almost immediately, enabling doctors to spot them during the short duration of the skin testing procedure.  IgG reactions are very common, and very troublesome.  They are extremely common among kids with 4-A disorders [Autism, ADHD, Asthma and Allergies].  They tend to create less severe symptoms than IgE reactions, but their symptoms still can be very destructive, particularly when IgG reactions to several foods occur at once, causing combined, cumulative damage, or when they combine with IgE reactions."[1]

While hives and eczema can be symptoms of immediate-reaction food allergy, it is behavioral issues that are a symptom of delayed-reaction food allergy. As Dr. Josef Burton explains in Flourishing with Food Allergies, “Reactions can be both visible and invisible. We can see rashes and hives, but there are reactions that are not as easy to identify such as grumpiness and irritability. If a child’s tongue or lips can swell, why can’t his brain swell too? Offending foods probably make our internal organs swell at times that can make it difficult or nearly impossible for a child to do the things we expect, such as sit and study or act the way we expect him to act.”[2]

When an undigested protein particle gets through the intestine walls it goes into the blood stream and the immune system is called upon to “handle it.”  Depending upon the child, his or her body breaks down this protein particle the best it can.  But during this breakdown process there can be side effects from the chemicals produced by the child’s own body.  For instance, Dr. Scot Lewey writes on autism, “Many parents report a casein-free (dairy protein) and gluten-free diet increases eye contact, attention, and mood while decreasing aggressive or oppositional behavior, tantrums, and poor attention. Theories for improvement of casein-free diet include improved brain function due to removal of cow’s milk protein by-products that have opiate-like effects. Casomorphin is protein fragment or peptide sequence derived from casein that is considered to have an opiate like effect. There are several casomorphins produced by digestion of casein from cow’s milk. People who stop eating wheat and dairy containing foods commonly report withdrawal symptoms.”[3]

People who crave certain foods are actually feeding a negative circle of addiction to something that is harmful for their particular bodies.  Specifically, “[A]ddictive cravings and withdrawal symptoms are said to exist in many food allergy patients when they stop eating the offending foods. ‘It has been suggested that this may be because some protein fragments formed when food is broken down are similar to endorphins, which the body produces naturally to counteract pain and produce euphoria. Then the allergy sufferer’s body becomes adapted to that level of endorphin activity and so craves the allergen in order to maintain the endorphin levels.’[4]”

Common delayed-reaction allergy foods include:

• ADHD/ADD: Dairy, wheat, oranges, eggs, chocolate, artificial colorings, artificial flavorings, food preservatives and natural chemicals found in apricots, berries and tomatoes. 
• Autism: Dairy, wheat, gluten, caffeine, chocolate, artificial colorings, artificial flavorings, soy and corn.
• Asthma: Dairy, wheat, egg, yeast, preservatives, colorings and coffee. 

The above list is taken from Dr. Kenneth Bock’s book.[5]  He details nutritional supplements to boost the immune system and cleanse the body from heavy metals that can lodge in brain tissues and disrupt normal functioning. Supplementing properly can result in improving and often eliminating the symptoms and behaviour associated with ADHD and autism, which Dr. Bock places on the same spectrum. Additional research, studies, interviews and examples of improving symptoms of asthma, ADHD and autism can be found in Flourishing with Food Allergies, in chapters dedicated to those topics.

To test your child for delayed-reactions, you must do a blood test. (The skin prick test can only find immediate allergic reactions.) Blood tests can locate both the IgG (delayed) and IgE (immediate) antibodies.  You’ll need to locate an allergist who understands this and can order and evaluate the results.  

---

[1] Bock, M.D., Kenneth, Stauth, Cameron, “Healing the New Childhood Epidemics: Autism, ADHD, Asthma and Allergies.  The Groundbreaking Program for the 4-A Disorders,” Ballantine Books, an imprint of Random House, New York, NY, 2008.

[2] Anderson, A., “Flourishing with Food Allergies,” July 2008, Papoose Publishing LLC.

[3] Lewey, Dr. Scot, “Autism linked to cow’s milk protein when GI symptoms present: More thoughts on the brain gut connection,” January 3, 2007, <http://thefooddoc.blogspot.com/search?q=Casomorphin+is+protein+fragment+>, (11/9/07).

[4] Thurnell-Read, Jane, “Allergy Equals Addiction, ”<http://www.shareware123.com/articles/part9/allergy_equals_addiction.htm>, (11/10/07).

[5] Bock, M.D., Kenneth, Stauth, Cameron, “Healing the New Childhood Epidemics: Autism, ADHD, Asthma and Allergies.  The Groundbreaking Program for the 4-A Disorders,” Ballantine Books, an imprint of Random House, New York, NY, 2008.