BHRT-Adrenal and Thyroid Support-Nutrition-Wellness-Supplements-Allergy Food Testing
501 Long Hollow Pike, Suite A, Goodlettsville, Tennessee 37072, United States | office@aliveandwellhealth.com
Food Allergy and Sensitivity Testing
Food Allergy and Sensitivity
We offer a full line of food allergy and sensitivity testing from Genova Diagnostics to include IgG and IgE foods, inhalants, molds, and spices. The key differences between IgE allergies and IgG sensitivities are summarized below:
For IgE-Mediated Allergies (foods, molds, inhalants):
- Immediate onset (minutes to hours)
- Circulating half-life of 1-2 days
- Permanent allergies
- Stimulates histamine release
- Related allergy symptoms include hives, stuffy or itchy nose, sneezing, itchy, teary eyes, vomiting, stomach cramps or diarrhea, angioedema or swelling, shortness of breath or wheezing, and anaphylaxis
IgG-Mediated Sensitivities (foods, spices, vegetarian foods):
- Delayed onset (hours to days)
- Circulating half-life of 21 days
- Temporary sensitivities
- Activates complement
- Does not stimulate histamine release
- Related sensitivity symptoms include gastrointestinal symptoms, headaches, joint aches, rashes, and other vague symptoms
A brief description of the food allergy and sensitivity testing options include:
- IgG Food Antibodies is an ELISA (enzyme-linked Immunoassay) test that provides insight into delayed reactions/sensitivities to specific foods. Additionally, the IgG Food Antibody Assessment includes information on implementing an Elimination Diet based on the patient test results.
- IgE Food Antibodies Profile analyzes serum levels of total IgE antibodies for 19 combined foods and total IgE.
- IgE Inhalants is a chemiluminescent test to evaluate serum IgE antibody levels to 14 region-specific common pollens and environmental inhalants. It is an ideal test for patients with suspected environmental and/or seasonal allergies.
- IgE Mold is a chemiluminescent test to evaluate serum IgE antibody levels to 15 molds. It is an ideal test for patients with suspected environmental allergies specific to molds.
- IgG Spices utilizes ELISA technology to evaluate serum for levels of IgG and total IgE antibodies for 24 frequently used culinary herbs and spices. It is an ideal test for patients with suspected intolerance to spices and herbs.
The Leaky Gut Syndrome
The "Leaky Gut" Connection
The presence of circulating IgG antibodies to foods may be suggestive of increased intestinal permeability, also referred to as "leaky gut syndrome." When the tight junctions forming the barrier in the gut don't work properly, larger substances can "leak" through, causing an immune response. This immune response may result in the production of IgG antibodies to foods. There are multiple dietary and lifestyle factors that contribute to increased intestinal permeability. These factors include alcohol, stress, chronic NSAID use, Western-type diet (high consumption of red meat, animal fat, high sugar, and low fiber food), and prolonged and strenuous exercise.
Immunology Testing Profiles
Immunology Testing profiles
Profile 1000 - IgE Food Antibodies (19 IgE foods) – Serum
Can be ordered as a stand-alone test or bundled with other profiles.
1. Identify True Food Allergies
The IgE Food Antibody Assessment is a blood test that measures IgE antibodies to 19 of the most allergenic foods. The panel also includes a total IgE measurement. The body can react to foods in many different ways. The prevalence of food allergies in Western countries is rising, with up to 10% of the population affected. This trend likely involves a complex interplay between genetic, epigenetic, and environmental risk factors.
2. When should testing for IgE Food Antibodies be considered?
Testing for IgE food antibodies is useful for individuals who suspect that a food is responsible for causing their symptoms. The presence of circulating antibodies may affect each patient differently. According to the American Academy of Allergy, Asthma, and Immunology, "A key message is that a positive allergy test result (skin or blood) indicates only the presence of allergen-specific IgE (called sensitization). It does not necessarily mean clinical allergy (i.e., allergic symptoms with exposure)." Therefore, test results should always be viewed in the context of the overall clinical picture.
3. Conditions associated with IgE food allergy:
- Hives or red, itchy skin
- Stuffy or itchy nose, sneezing or itchy, teary eyes
- Vomiting, stomach cramps or diarrhea
- Angioedema or swelling
- Shortness of breath or wheezing
- Anaphylaxis
4. Risk factors associated with IgE food allergies
Certain allergy risk factors cannot be modified including male sex in children, race/ethnicity (increased among Asian and black children compared with white children), and genetics (familial associations, HLA, and specific genes). However, the following risk factors can be addressed to reduce/prevent food allergy:
- Increased hygiene
- Microbiome imbalance
- Atopic disease manifestations (comorbid atopic dermatitis)
- Vitamin D insufficiency
- Dietary fat (reduced consumption of omega-3-polyunsaturated fatty acids)
- Reduced consumption of antioxidants
- Increased antacid use (reducing digestion of allergens)
- Obesity (being in an inflammatory state)
- Timing and route of exposure to foods
5. What advantage does the IgE Food Antibody test offer compared to other diagnostics?
An IgE allergic response involves immediate-hypersensitivity to a substance. It is generally easier for patients and clinicians to identify a food that causes an immediate response, although not always, and testing serum IgE antibodies can be helpful.
The National Institute of Allergy and Infectious Disease (NIAID) guidelines state that a combination of medical history, physical examination, and oral food challenge can assist in the diagnosis of food allergy, with the oral food challenge being the gold standard. In some instances, an oral food challenge may be dangerous for the patient and other tools may be helpful.
A skin-prick test involves the injection of an allergen on the skin then observation for a reaction. This method has low specificity and low positive predictive value, and the injection of a substance that can potentially cause a serious reaction should be monitored closely. Serum testing can be especially useful when skin-prick tests cannot be performed (for example, due to extensive dermatitis or dermatographism), or when antihistamines cannot be discontinued.
Allergen-specific serum IgE testing does not involve introducing an allergen in order to test. Instead, already circulating antibodies are measured, however, the patient must have been exposed to the allergen in the days leading up to testing in order to detect antibodies. The NIAID suggests, "sIgE tests are useful for identifying foods potentially provoking IgE-mediated food-induced allergic reactions and specified "cutoff" levels, defined as 95% predictive values, may be more predictive than skin prick tests of clinical reactivity in certain populations, but when used alone they are not diagnostic of food allergy."
Profile 1001 - IgG Food Antibodies (87 IgG foods + Total IgE) – Serum
1. Gain Insight into Symptoms Triggered by Food
The IgG Food Antibody Assessment (*not available in NY) is a blood test that measures antibodies to 87 commonly consumed foods. The panel also includes a total IgE measurement. The body can react to foods in many different ways. Adverse food reactions can lead to distressing symptoms and chronic health conditions. Often times it is unknown exactly which food(s) may be the cause and testing can help identify the problematic foods. Removal of the reactive foods often results in resolution of symptoms.
2. When should testing for IgG Food Antibodies be considered?
Testing for adverse food reactions is useful for individuals who suspect that a food is responsible for causing their symptoms, but can't quite identify which food(s). The presence of circulating antibodies may affect each patient differently. Circulating IgG food antibodies are not diagnostic for a specific condition, but indicate an immune response to that food. The immune response could be a normal response that would not necessarily cause symptoms. Therefore, test results should always be viewed in the context of the overall clinical picture. The role of IgG food antibody testing is still being researched however studies have shown the benefit of testing in certain conditions.
3. Conditions associated with IgG food sensitivity:
- Irritable Bowel Syndrome (IBS)
- Major Depressive Disorder
- Migraine headaches
- Skin rashes such as eczema
- Joint aches
- Autoimmune disease
- Crohn's Disease
- Obesity
4. What advantage does the IgG Food Antibody test offer compared to other diagnostics?
IgG food antibodies can result in a delayed response to a food. Whereas IgE antibodies can result in immediate-hypersensitivity to a substance. It is generally easier for patients and clinicians to identify a food that causes an immediate response. A delayed-response to food may be more challenging to determine, and testing can be helpful. The IgG Food Antibody test assesses total IgG (1-4) versus only testing for IgG4. This offers a more complete assessment, however, IgG4 testing is available for clinicians interested in that specific component of IgG.
The body of scientific evidence continues to build regarding correlation with clinical symptoms and conditions for IgG testing (see conditions above). Furthermore, a study comparing methodologies showed that "IgG ELISA testing is more reliable and consistent than cell size testing for identifying food sensitivities." Examples of cell size testing or cytotoxic testing include mediator release testing (MRT), antigen leukocyte antibody testing (ALCAT) and lymphocyte response assays.
Other types of adverse food reactions that are not mediated by the immune system are referred to as food intolerances. Food intolerances include lactose intolerance due to lactase enzyme deficiency in the gut; testing is available for suspected lactose intolerance. Testing is not available for all food intolerances. These include vasoactive amines like histamine and tyramine, food additives and preservatives (nitrites, sulfites, MSG, aspartame), salicylates, nightshades, lectins, FODMAPs, oxalates, etc. Since testing is not available for every type of adverse food reaction, the elimination/rechallenge diet remains the gold standard for identification of symptom-producing foods.
Profile 1002 - IgG Vegetarian Food – Serum
1. Gain Insight into Symptoms Triggered by Food
The IgG Vegetarian Food Profile (*not available in NY) is a blood test that measures antibodies to 21 vegetarian foods. The panel also includes a total IgE measurement. The body can react to foods in many different ways. Adverse food reactions can lead to distressing symptoms and chronic health conditions. Often times it is unknown exactly which food(s) may be the cause and testing can help identify the problematic foods. Removal of the reactive foods often results in resolution of symptoms.
2. When should testing for IgG Vegetarian Food Antibodies be considered?
Testing for adverse food reactions is useful for individuals who suspect that a food is responsible for causing their symptoms, but can't quite identify which food(s). The presence of circulating antibodies may affect each patient differently. Circulating IgG food antibodies are not diagnostic for a specific condition, but indicate an immune response to that food. The immune response could be a normal response that would not necessarily cause symptoms. Therefore, test results should always be viewed in the context of the overall clinical picture. The role of IgG food antibody testing is still being researched however studies have shown the benefit of testing in certain conditions.
3. Conditions associated with IgG food sensitivity:
- Irritable Bowel Syndrome (IBS)
- Major Depressive Disorder
- Migraine headaches
- Skin rashes such as eczema
- Joint aches
- Autoimmune disease
- Crohn's Disease
- Obesity
4. What advantage does the IgG Vegetarian Food Antibody test offer compared to other diagnostics?
IgG food antibodies can result in a delayed response to a food. Whereas IgE antibodies can result in immediate-hypersensitivity to a substance. It is generally easier for patients and clinicians to identify a food that causes an immediate response. A delayed-response to food may be more challenging to determine, and testing can be helpful. The IgG Food Antibody test assesses total IgG (1-4) versus only testing for IgG4. This offers a more complete assessment, however, IgG4 testing is available for clinicians interested in that specific component of IgG.
The body of scientific evidence continues to build regarding correlation with clinical symptoms and conditions for IgG testing (see conditions above). Furthermore, a study comparing methodologies showed that "IgG ELISA testing is more reliable and consistent than cell size testing for identifying food sensitivities." Examples of cell size testing or cytotoxic testing include mediator release testing (MRT), antigen leukocyte antibody testing (ALCAT) and lymphocyte response assays.
Other types of adverse food reactions that are not mediated by the immune system are referred to as food intolerances. Food intolerances include lactose intolerance due to lactase enzyme deficiency in the gut; testing is available for suspected lactose intolerance. Testing is not available for all food intolerances. These include vasoactive amines like histamine and tyramine, food additives and preservatives (nitrites, sulfites, MSG, aspartame), salicylates, nightshades, lectins, FODMAPs, oxalates, etc. Since testing is not available for every type of adverse food reaction, the elimination/rechallenge diet remains the gold standard for identification of symptom-producing foods.
Profile 1003 - IgE Inhalants (14 IgE inhalants + Total IgE) – Allergy Test – Serum
1. Identify Indoor Household Allergies and Outdoor Seasonal Allergies
The IgE Inhalants Profile is a blood test that measures IgE antibodies to 16 common indoor and outdoor inhalants specific to 18 North American geographic regions. The profile also includes a total IgE measurement. Testing can help identify whether an allergen is triggering the common symptoms associated with seasonal, pet or mite allergies. These symptoms include sneezing, coughing, itchy and watery eyes, and others. The patient can experience relief with symptom management, and by avoiding ongoing exposure to the identified allergen.
2. When should testing for IgE Inhalant Antibodies be considered?
Testing for IgE inhalant antibodies is useful for individuals who suspect that they are reacting to an environmental stimulus. Household inhalants include cat and dog dander, cockroach, and mites. Outdoor inhalants include trees, grasses, weeds, and molds, and may bloom or pollinate at various times depending on the region.
An IgE allergic response involves immediate-hypersensitivity to a substance. It is important to test when the patient is symptomatic. Circulating IgE antibodies have a short half-life of around 1-2 days, and will only be produced after exposure to the substance. The presence of circulating antibodies may affect each patient differently. According to the American Academy of Allergy, Asthma, and Immunology, "A key message is that a positive allergy test result (skin or blood) indicates only the presence of allergen-specific IgE (called sensitization). It does not necessarily mean clinical allergy (i.e., allergic symptoms with exposure)." Therefore, test results should always be viewed in the context of the overall clinical picture.
3. Symptoms and conditions associated with IgE inhalant allergies:
- Stuffy or itchy nose, sneezing, rhinitis or sinusitis
- Itchy, teary eyes, conjunctivitis
- Cough, shortness of breath, wheezing, asthma
- Skin rash or hives
4. What advantage does the IgE Inhalants Profile offer compared to other diagnostics?
Identifying airborne allergens can be difficult and testing serum allergen-specific IgE antibodies is helpful. Allergen-specific serum IgE testing does not involve introducing an allergen in order to test. Instead, already circulating antibodies are measured, however, the patient must have been exposed to the allergen in the days leading up to testing in order to detect antibodies.
A skin-prick test involves the injection of an allergen on the skin then observation for a reaction. Serum testing can be especially useful when skin-prick tests cannot be performed for example, due to extensive dermatitis or dermatographism, when antihistamines cannot be discontinued, or those with a history of anaphylactic reaction.
1004 - IgE Molds (15 IgE molds + Total IgE) – Allergy Test – Serum
1. Identify Indoor and Outdoor Mold Allergies
The IgE Molds Profile is a blood test that measures IgE antibodies to 15 common indoor and outdoor molds. The panel also includes a total IgE measurement. Everyone breathes in airborne mold spores, and in people with mold allergies, symptoms mainly affect the respiratory tract. Testing for mold allergies can identify whether mold is causing the symptoms. The patient can experience relief with symptom management, and by avoiding ongoing exposure to the mold source.
2. When should testing for IgE Molds Antibodies be considered?
Testing for IgE mold antibodies is useful for individuals who suspect that they are reacting to an environmental stimulus. Household molds can persist throughout the year and are found in household plants and damp places, such as bathrooms, kitchens, and basements, or in areas that have been exposed to leaks or flooding. Outdoor airborne mold ranges from extremely low levels in freezing temperatures to peak levels in late summer and early fall. Warmer, humid climates can have elevated mold counts year-round.
An IgE allergic response involves immediate-hypersensitivity to a substance. It is important to test when the patient is symptomatic. Circulating IgE antibodies have a short half-life of around 1-2 days, and will only be produced after exposure to the substance. According to the American Academy of Allergy, Asthma, and Immunology, "A key message is that a positive allergy test result (skin or blood) indicates only the presence of allergen-specific IgE (called sensitization). It does not necessarily mean clinical allergy (i.e., allergic symptoms with exposure)."1 Therefore, test results should always be viewed in the context of the overall clinical picture.
3. Symptoms and conditions associated with IgE mold allergies:
- Stuffy or itchy nose, sneezing, rhinitis or sinusitis
- Itchy, teary eyes, conjunctivitis
- Cough, shortness of breath, wheezing, asthma
- Skin rash or hives
4. Occupations at greater risk of developing a mold allergy:
- Farmers
- Dairyworkers
- Loggers
- Bakers
- Mill workers
- Carpenters
- Greenhouse employees
- Winemakers
- Furniture repairers
5. What advantage does the IgE Molds Profile offer compared to other diagnostics?
Identifying airborne allergens can be difficult and testing serum allergen-specific IgE antibodies is helpful. Allergen-specific serum IgE testing does not involve introducing an allergen in order to test. Instead, already circulating antibodies are measured, however, the patient must have been exposed to the allergen in the days leading up to testing in order to detect antibodies.
A skin-prick test involves the injection of an allergen on the skin then observation for a reaction. Serum testing can be especially useful when skin-prick tests cannot be performed for example, due to extensive dermatitis or dermatographism, when antihistamines cannot be discontinued, or those with a history of anaphylactic reaction.
Biotoxin illness related to chronic inflammatory response syndrome (CIRS) has become an emerging field of research. Biotoxin illness is not an IgE-mediated allergic reaction. Instead, patients may experience mold toxicity as a systemic inflammatory response. Genova does not offer CIRS testing. Genova's mold testing is specific to the allergic response only.
Profile 1005 - IgG Spices (23 IgG spices + Total IgE) – Serum
1. Gain Insight into Symptoms Triggered by Food
The IgG Spices Profile (*not available in NY) is a blood test that measures antibodies to 23 culinary herbs and spices. The profile also includes a total IgE measurement. The body can react to foods in many different ways. Adverse food reactions can lead to distressing symptoms and chronic health conditions. Often times it is unknown exactly which food(s) may be the cause and testing can help identify the problematic foods. Removal of the reactive foods often results in resolution of symptoms.
2. When should testing for IgG Spice Antibodies be considered?
Testing for adverse food reactions is useful for individuals who suspect that a food is responsible for causing their symptoms, but can't quite identify which food(s). The presence of circulating antibodies may affect each patient differently. Circulating IgG food antibodies are not diagnostic for a specific condition, but indicate an immune response to that food. The immune response could be a normal response that would not necessarily cause symptoms. Therefore, test results should always be viewed in the context of the overall clinical picture. The role of IgG food antibody testing is still being researched however studies have shown the benefit of testing in certain conditions.
3. Conditions associated with IgG food sensitivity:
- Irritable Bowel Syndrome (IBS)
- Major Depressive Disorder
- Migraine headaches
- Skin rashes such as eczema
- Joint aches
- Autoimmune disease
- Crohn's Disease
- Obesity
4. What advantage does the IgG Spice Antibody test offer compared to other diagnostics?
IgG food antibodies can result in a delayed response to a food. Whereas IgE antibodies can result in immediate-hypersensitivity to a substance. It is generally easier for patients and clinicians to identify a food that causes an immediate response. A delayed-response to food may be more challenging to determine, and testing can be helpful. The IgG Food Antibody test assesses total IgG (1-4) versus only testing for IgG4. This offers a more complete assessment, however, IgG4 testing is available for clinicians interested in that specific component of IgG.
The body of scientific evidence continues to build regarding correlation with clinical symptoms and conditions for IgG testing (see conditions above). Furthermore, a study comparing methodologies showed that "IgG ELISA testing is more reliable and consistent than cell size testing for identifying food sensitivities." Examples of cell size testing or cytotoxic testing include mediator release testing (MRT), antigen leukocyte antibody testing (ALCAT) and lymphocyte response assays.
Other types of adverse food reactions that are not mediated by the immune system are referred to as food intolerances. Food intolerances include lactose intolerance due to lactase enzyme deficiency in the gut; testing is available for suspected lactose intolerance. Testing is not available for all food intolerances. These include vasoactive amines like histamine and tyramine, food additives and preservatives (nitrites, sulfites, MSG, aspartame), salicylates, nightshades, lectins, FODMAPs, oxalates, etc. Since testing is not available for every type of adverse food reaction, the elimination/rechallenge diet remains the gold standard for identification of symptom-producing foods.
Profile 1006 - Celiac (Gluten Sensitivity) – Serum
Can be ordered as a stand-alone test or bundled with other profiles.
The Celiac Profile uses widely accepted immunologic biomarkers to aid in the diagnosis of Celiac disease (CD). Epidemiologic studies estimate a worldwide prevalence of CD of approximately 1:100 individuals, with a considerable proportion of patients remaining undiagnosed and untreated.
Clinical management of the patient with Celiac disease involves strict, lifelong elimination of gluten.
1. What is measured on the Celiac Profile?
The Celiac Profile is a blood test that measures important markers to aid in the diagnosis of CD including Total IgA, Anti-Tissue Transglutaminase IgA (tTG IgA) and IgG (tTG IgG), Anti-Deamidated Gliadin IgA (DGP IgA) and IgG (DGP IgG), and reflex Anti-Endomysial IgA (EMA IgA). Along with these results, Genova's unique report configuration provides a simple diagnostic algorithm to aid clinicians in assessing likelihood of disease.
2. What is Celiac Disease and when should testing be considered?
Celiac disease is defined as an autoimmune enteropathy of the small intestine, caused by exposure to dietary gluten in genetically pre-disposed individuals. In susceptible individuals, gluten ingestion generates an inflammatory reaction predominantly centered in the upper parts of the small intestine. This mucosal injury will eventually reduce the intestinal absorptive area and interfere with uptake of micronutrients.
3. Conditions and symptoms associated with Celiac disease:
- Chronic diarrhea with weight loss
- Steatorrhea
- Postprandial abdominal pain
- Bloating
- Malabsorption with nutrient deficiencies (iron, B12, calcium)
- Irritable bowel syndrome
- Elevated liver enzymes
- Cerebellar ataxia
- Peripheral neuropathy
- Type I Diabetes
- Autoimmune hepatitis
- Autoimmune thyroiditis
- Infertility
- Dermatitis herpetiformis
- Sjogren syndrome
- Addison's disease
- Parathyroid disorders
- Growth hormone deficiency
- Primary biliary cirrhosis
- Primary sclerosing cholangitis
4. Testing should be performed while the patient is still on a gluten-containing diet. The exception is follow-up testing for monitoring treatment efficacy.
5. What advantage does the Celiac Profile offer compared to other diagnostics?
Intestinal biopsy is considered the gold standard for the diagnosis of Celiac disease. International guidelines suggest that measuring immunologic analytes and genetic markers are favored to increase detection of CD. The European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) introduced a revised guideline for CD in children based on the optimization of antibody assays. According to this guideline, children can be diagnosed with CD without a duodenal biopsy when presenting with suspicious symptoms, a strongly elevated tTG-IgA (>10 confirmed cut-off value), confirmed by a positive EMA-IgA on a separate occasion, and positive genetic testing (HLA-DQ2 and /or HLA-DQ8).5 Genova does not offer the HLA-DQ2/DQ8 genetic markers.
