Recommended reading in place, or at least addition, to this post is the more up-to-date one entitled Help or hindrance: do IgG tests throw us off track?
For more years than I can readily put a number to, I’ve one-hundred percent followed a holistic and “natural” path to heal my body, seeking herbal, supplemental and energetic solutions, rather than intervention or prescription ones. Yet, as I’ve mentioned a few times now, I recently underwent a series of voluntary and self-funded blood tests as it had started to feel like I needed to clarify a few things that were going on with my body. They included a comprehensive food intolerance test from York Labs and very thorough thyroid function, liver function and B12 absorption investigations.
So where do I stand, over three months after doing that? Am I any clearer, did I gain any traction? Its been such an interesting process because, in many ways, I feel only more “muddied” in my thinking and a little more defeated on days when I let myself slip that way whereas I tended towards feeling in control of my own destiny, even on the “bad” days, before I had these results in my hands. There’s nothing like a black and white sheet of paper full of baffling information, in variable and not always compatible unit measures, and sometimes containing contradictory results to other tests carried out in the same timescale, to make you feel like dropping your head in your hands and wailing. Then there are experts that I subscribe to, such as Anthony Williams (whose stock-in trade is blowing to smithereens the conventional “current day” paradigm around issues such as thyroid, offering what he considers to be a two or three decades ahead approach to these issues) who only confuse me more now that I have results that they would have contrary opinions on. The most bewildering set of results I had back was the food intolerance test that flagged up 24 food intolerances, most of those in the “red” (give up completely) rather than “orange” (avoid) zone. The day I received those results has to go down as one of the morale low-points of this whole journey…and yet I was only hell-bent on seeking these answers “for me”; the irony didn’t escape me.
So I set about doing what I could with those results and, as the thyroid issue flagged up is one that isn’t recognised by the UK medical establishment (and as I wasn’t sure I wanted to take desiccated thyroid anyway…), I set about solving all my anomalies through diet, thinking by doing so I was getting to the very root of the problem. This still feels like good instinct and is the basis of Ayurveda (another perspective I’ve worked hard to integrate into all of this) but the question I am left with, three months on, is whether healing the gut is necessarily something that should be subjected to the dictates of a blood test; and here’s why.
For almost four months, I have diligently followed my food intolerance advisory to the letter. That has meant total elimination of many of my favourite (and most convenient) foods such as yeast, milk, eggs, various herbs and spices, coconut…and the list goes on. I’ve also worked pretty hard to reduce the orange list foods down to, at most, rare consumption such as when I am going out and they are hard to avoid. The one exception to this has been garlic, which I eat pretty frequently in foods such as humus, although I have stopped cooking with it which means my intake must be down to about ten per cent of what it was. Even on holiday, I followed this diet to the letter…which took some stamina, I can tell you. All that time, I was hopeful that I was about to see some incredible dawn of a new day burst over the horizon, where my health was concerned. It’s now the end of October and I’m stil waiting. In fact, this last few weeks has seen the typical onset of intense nerve pain, fatigue and stiffness of the myofascia that accompanies every autumn for me. My stomach symptoms have been as yo-yo as ever and are mainly dictated by the electro-magnetic circumstances and my hormones. To be honest, I can live with that; my bowels are the least of my worries (since they are nowhere near problematic as they were half a decade ago) and it was the rest of my health picture I wanted to make brighter. When you sacrifice so much to gain a particular outcome, you at least expect a little positive feedback back as a pat on the back. After 16 weeks on the new diet, I am left with no particular feeling that any of the dietary changes I have made, according to the intolerance test, have impacted my overall health at all and even the lab gave me twelve weeks to report some remarkable differences.
Inevitably, this got me looking into these IgG types of food tests again and, rather than bash out a regurgitated account of what I found, I’m going to directly quote some of the sources of information that I came across:
While IgE can indicate the presence of an allergen, IgG hasn’t been shown to be a similar marker for intolerance. Instead, IgG is believed to indicate exposure to food and possibly even tolerance” Lavine wrote in the Canadian Medical Association Journal. (Elana Lavine is a paediatric immunologist in Toronto who now spends part of her time counselling anxious parents whose children have undergone food sensitivity testing).
There is no IgG testing of value,” said Robert Wood, a professor of paediatrics and chief of paediatric allergy and immunology at Johns Hopkins University in Maryland. “All of us make IgG to the foods we eat, and they are not related to disease, including food intolerance.
Dr Isabel Skypala, who runs a food allergy clinic at the Royal Brompton & Harefield NHS Trust, believes these tests are unlikely to be helpful for food intolerances, which “do not by definition involve the immune system, so testing for the presence or absence of a component of the immune system, such as the IgG antibody, makes no sense.”
“The methodology is plausible…IgG and IgA food intolerance testing has been published in peer-reviewed literature and independently verified by more than one research group. And as for the third question, whether IgG and IgA results are consistent and reproducible, that one’s definitely harder to answer. Clearly in many or, I would say, even most cases, the answer is no.
Chris Kresser (RHR: Are Food Intolerance Tests Accurate?), who goes on to suggest that variables in lab practice and whether raw or cooked antigens are used, amongst other issues, contribute to unreliability.
“…many serum samples show positive IgG4 results without corresponding clinical symptoms. These findings, combined with the lack of convincing evidence for histamine-releasing properties of IgG4 in humans, and lack of any controlled studies on the diagnostic value of IgG4 testing in food allergy, do not provide any basis for the hypothesis that food-specific IgG4 should be attributed with an effector role in food hyper-sensitivity. In contrast to the disputed beliefs, IgG4 against foods indicates that the organism has been repeatedly exposed to food components, recognized as foreign proteins by the immune system. Its presence should not be considered as a factor which induces hypersensitivity, but rather as an indicator for immunological tolerance, linked to the activity of regulatory T cells. In conclusion, food-specific IgG4 does not indicate (imminent) food allergy or intolerance, but rather a physiological response of the immune system after exposition to food components. Therefore, testing of IgG4 to foods is considered as irrelevant for the laboratory work-up of food allergy or intolerance and should not be performed in case of food-related complaints.
“So where does immunoglobulin G (IgG) come in? IgG molecules mediate interactions of cells with different cellular and humoral mechanisms. IgG antibodies signify exposure to products—not allergy. IgG may actually be a marker for food tolerance, not intolerance, some research suggests:
▪ Children with eczema and egg or milk allergies with higher levels of IgG to milk/egg were more likely to be tolerant of these foods at a later age.
▪ Resolution of cow’s milk allergy is associated with increasing IgG
▪ A study found increasing IgG in patients who underwent oral immunotherapy for milk or peanut allergy
That research is continuing. But given the lack of correlation between the presence of IgG and physical manifestations of illness, IgG testing is considered unproven as a diagnostic agent as the results lack clinical utility as a tool for dietary modification or food elimination.”
From the Science-Based Medicine website which goes on to cite a number of studies drawing the same conclusion, including this from the American Academy of Allergy, Asthma and Immunology & American College of Allergy, Asthma and Immunology: Allergy diagnostic testing: an updated practice parameter::
“IgG and IgG subclass antibody tests for food allergy do not have clinical relevance, are not validated, lack sufficient quality control, and should not be performed.”
Now, I have an extremely open approach to science v what many people regard pseudo-science; I don’t take a hard-line against either and like to mix it all up. However, the theme forming across the internet seems to be that IgG testing is still a “murky” area for science; and that, though peer reviewed literature exists, many other professional opinions suggests that these tests are at best unreliable or inconsistent (there are reports of completely different results coming back from different labs) and at worst confusing or downright problematic. In my own case, I was utterly baffled that gluten came up as having no reaction and was even very low down my list of foods, in order of reaction…so much so that I joked that perhaps I should start eating it again (thankfully, I didn’t). However, now that I better understand the tests (and that understanding didn’t come from the report I received or the follow up session I had with a nutritionist) I see how that is because my abstinence from eating gluten for the last two to three years means my body simply doesn’t make antibodies for gluten any more; not that I don’t have an intolerance. In fact, many symptoms that I have noted in myself over the years have repeatedly indicated that I have an intolerance to gluten and I am far more inclined to listen to them than a piece of paper. The one result that I found most intriguing in my report related to kale, which triggers an acute response whenever I eat it; thus I don’t and it must be a long time since I had any. So for kale to generate the same antibody response in me as, say, milk-products or eggs, which I was eating all the time prior to taking the test, is most interesting and tells me my body has quite an acute and long-lasting reaction to it (or, perhaps, the test is prone to throwing up bizarre or meaningless results).
So back to my own thinking; it is this. I suspect there is a place for IGg testing for those who are looking for clues relating to stomach issues such as bloating or diarrhea that won’t go away, rather than a much broader and symptom-diverse chronic health situation such as my own. In my own case, I don’t regret getting the test done; what I suspect it has mostly done for me is that it has given me a rest from foods that I was somewhat “stuck on” which wasn’t giving my body a break at all. A point in case is coconut which, in addition to being my cooking oil and spread, the filler in my sweet treats and often my milk, I was drinking as coconut water in fairly hefty amounts to replace electrolytes when I felt a migraine or episode of nerve pain coming on. Garlic too is something where I took the health benefits rather too seriously, throwing fistfuls into almost everything I cooked (how I must have wafted a cloud of garlic-aroma wherever I went…) and, whilst I plan to keep on eating it, I feel moderation is the key. In fact, to summarise, that is what this exercise has reminded me…that moderation in all things in life is the key, and that little and often of a great variety of things is far better for us than specialising, as it were. My little holiday from some of my favourite foods has allowed my system to recalibrate and for me to start afresh. To quote the findings of Stapel et al once more: “The explanation for the presence of increased levels of food-specific IgG(4) in serum is probably that the immune system of some individuals tends to react more actively to (harmless) antigens than that of others”. Yes, its fair to say my body reacts to many things more than the average person and, though I can’t expect to eliminate all those triggers, I can make sure they are varied as much as possible. Repeatedly eating the same food, to the detriment of others, is going to put a great deal of additional strain on a body that is over-sensitised and what this exercise has reminded me is that there is room for a great deal more diversity in my diet than I had before since I have been forced to try out many new things. This is, actually, the opposite effect to the typical one resulting from blood intolerance testing where people (according to the forums that are our there) are often left feeling desperate and demoralised by the fact that their food choices apparently just got narrower and more limited than ever. Using it, instead, to broaden my food options feels like the result I would like to take from the experience.
If I plan to re-introduce some of these foods then I intend to do so mindfully and cautiously and, of course, I won’t introduce them all at once. I’ll listen to my body’s cues and not just at the stomach level. I’ve already had mozzarella cheese (twice) to no ill effect and yeast-containing bread (twice) again, with no noticeable aftermath except my stomach “felt weird” for half an hour after the first time. Eggs – being at the top of my red list – will be approached with far more caution and I might try half of one, hard boiled, and see how that goes for a few days before even considering another try. Even then, I suspect my egg-a-day habit of the summer will be reduced to maybe once or twice a month…but there’s nothing like missing a thing to make you prepared to accept it back on almost any terms. I suspect my consumption of cheese will never go back to where it was; I have had a subtle intolerance to milk for many years and its elimination has certainly altered my body shape for the better. At most, it might be a delicacy I say yes to when a particularly nice organic cheese is offered to me when I am out rather than filing my own fridge with it since I have genuinely learned the benefits of a diet without this food that used to be almost an addiction. When it comes to all of these foods and, indeed, everything I eat, I intend to listen closely to my body, not eat anything out of habit, convenience or politeness. Already today, I have put aside my first attempt at breakfast toast since all my instincts told me that it didn’t feel right for me to consume. I always did this (more and more, over the years, as I noticed that my top lip would tingle, my throat contract or my stomach knot with pain even at first sight of a food that didn’t agree with me…) but I intend to listen to these signals more than ever now; not take them for granted or override them.
My most-philosophical self is left with these thoughts. When we go the conventional medicine route we agree to subscribe to a whole paradigm of meaning, with all its expectations and definitions. It’s all very left brained whereas the more holistic approach focuses on the right-brained approach using instinct and considering “how does it feel” while listening closely to the body. Its like any area of our life (so, that’s pretty much all of them!) where we attach meaning. As soon as we have an opinion or reaction to something, it’s because we have attached associations of good and bad to it. As soon as we say we are trying to put something right by a process, such as by elimination of what we deem to be “a problem”, we are suggesting that the current situation, or thing we seek to eliminate, is “bad”. This was one of my prime concerns about continuing with the elimination diet: I suspected that the longer I refrained from eating these particular foods, the more likely it was that I was creating a future problem for myself in relation to that food type, thus preventing me from ever being able to go back to eating it. My hope was always to go back to these foods at some point but all my instincts kept telling me that the longer I refrained from eating them, the wider the breach was getting. As one of those sources I quoted above points out, the presence of antibodies to a particular food actually tells us that the body is prepared to receive and thus process that food (which is why we have the most antibodies to foods we eat very often)…so when we entrain the body to stop producing that antibody, we potentially make it much more likely to react in the future. Looking back over the last few months, I see what part these tests have played in my broadest understanding of myself and even in how much I trust my own instincts as sovereign. I will continue to bear their results in mind, as part of a much bigger picture; while my focus will be upon healing my leaky gut and encouraging more variety in my diet.
As I said above, empirical tests are our attempt to assign meaning; and where we apply meaning we put wood on the fire of a separation paradigm or “duality”, creating a particular viewpoint at the expense of any other (in other words, this thing is “good” and that is “bad”). The irony is that what science attempts to make universal by applying consistent, fixed, unchanging rules “across the board” of human experience actually reinforces many subjective perspectives; and I never felt more locked into such a subjective view-point than I did whilst trying to adhere to such a narrow set of eating rules. I literally found I couldn’t “join in” with the rest of the world going on around me and it felt very limited and small. First assumptions and then beliefs grow up around the meaning we apply to things happening in our personal experience; and once we believe something is true, it is very hard for us to go back and believe something different. I could feel myself entrenching in my own personal viewpoint of what was and wasn’t good for me; and into the “vegan” lifestyle that was enforced on me as I was apparently forced to give up all dairy food, though I never thought I would go that far. I never intended to limit myself so completely, nor to identify with so many labels or identities…and, at some fundamental level, it didn’t feel right to the expansive and light-filled being that I consider myself to be. Such a contracted, guarded and inherently narrow version of life is not what I came here to experience and four months of that has been a useful exercise in many ways but that is quite enough where my diet is concerned. The way I have been feeling about food, especially this last month or so, has felt out of alignment with the expansive nature of awareness; which then clips my wings across all the other aspects of my life. I guess it’s why I never sought a medical opinion before; I kind-of knew this was the risk if I went that way and I was right. Outside of a diagnostic paradigm, I can experience uncomfortable or even deeply unpleasant sensations in my body without having to think of them as “wrong”; I guess that is one of the fundamental things that feel different, and less natural or desirable, along this daignostic route. Since “getting tested” I have actively felt like there is something wrong with me whereas, believe it or not, across 12 years of chronic pain, I never actually thought there was.
Any diagnosis that comes to a person via a “test” presents this conundrum; do I plunge into all the inherent meanings that this piece of paper suggests to me or do I keep myself expansive and broad, exploring new possibilities that the black and white test results know nothing about. Whatever that diagnosis is (for instance, it could be something as apparently black and white as cancer) it is the meaning we choose to give to that, and the outcomes we continue to deem possible, that determine the outcome, not the piece of paper itself. When we lock ourselves down into the perspectives of what is thought to be known or proven by “science” we shut off many avenues; likewise, when we remain open to looking at old data through new eyes, our own experiential eyes (not the inherited beliefs that are passed onto us by another) moment to moment, we leave the door wide open for a new set of circumstances to emerge, breaking the mould of any diagnostic paradigm that might otherwise have seemed so cut-and-dry, not to mention doom-laden. We might even get to turn that diagnosis around into the best news, instead of the worst (yes, I’ve seen this happen, even with cancer), leading to a very different outcome. Remember always, it’s not the diagnosis that matters but the meaning that we give to it!
Of course, I’m not talking about cancer here but it’s the same realm of thought; as soon as we reach out for a medical diagnosis, this is the scenario we are faced with…subscribe to it utterly and hope for the best or keep the picture very broad, open and exploratory. If you go the latter way, be prepared to bend the so-called rules and trust your own instincts; go with the science only as far as feels comfortable but, if it no longer seems to fit, be prepared to go a different way, with confidence and innate wisdom. Know you are your own best lab technician, doctor and therapist; you, of all people, know what is going on behind the scenes of your own body and no one else, ultimately , can get in that deep. Above all, you get to change outcomes, to write different endings, to turn scenarios around on their head to face a completely different way and even be thankful for all the twists and turns that got you there. When we stay away from too many assigned meanings and keep ourselves mostly in the direct experiences we are having (that is, the self-evident sensations that are readily available to us as constant feedback in every second), we retain access to the most important aspect of life, which is the unfolding of it, moment to moment…something which offers a far broader array of different endings than most of us know; and we get to choose which one we are reaching out for. That’s where we get to decide “what do I really want my life to look like”; and then it can really start to become the outward expression of the unlimited being that we really are.