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Food Sensitivities - Part One



WHAT'S THE DIFFERENCE BETWEEN FOOD ALLERGIES, FOOD INTOLERANCES & FOOD SENSITIVITIES?
There are a number of symptoms that my patients most often describe during our visits:

  • Fatigue
  • Headaches
  • Irritable Bowel
  • Brain Fog
  • Weight Gain
  • Joint Pain
  • Rashes
Sound familiar?

In medical school I was taught to evaluate symptoms in order to form a diagnosis. That diagnosis was then used to determine which medication to prescribe - such as a pill for your headache or a cream for your rash.

20 years later my approach has changed. Rather than focusing on which medication to prescribe for your symptoms, I ask the question:
WHY are you experiencing these symptoms?

I use Functional Medicine to evaluate and treat the root causes of illness.

While there are many factors that can contribute to illness, perhaps none are more important than FOOD. I see it with patients every day - the food that you eat has an immediate and significant impact on the way that you feel.

Could food sensitivities or intolerances be causing your symptoms?

Many of the symptoms that my patients describe, including the most common ones listed above, are often the result of food sensitivities or food intolerances. Identifying these reactions and addressing their root causes can provide lasting symptom relief.

In part one of this food sensitivity series, we answer the question:
What’s the difference between food allergies, food intolerances, and food sensitivities?

FOOD ALLERGY
Food allergy reactions are immediate, within minutes of exposure to the trigger food.

They are immune-system mediated by IgE, a fast-acting immunoglobulin specific to particular foods.

Food allergy symptoms can range from mild to life-threatening and may include swollen or itchy tongue, runny nose, skin itching, hives, wheezing/shortness of breath, closing of the airway, abdominal pain or vomiting.

Common food allergy triggers include peanuts, tree nuts and shellfish.

With true food allergies, strict avoidance of trigger foods is critical, as reactions are potentially life-threatening.

While I have seen the terms food intolerance and food sensitivity used interchangeably in some media, I separate these terms into two different types of reactions when discussing with patients.

FOOD INTOLERANCE
Food intolerances are not mediated by the immune system, but rather are a result of the body lacking an enzyme or nutrient needed to properly digest or break down a particular food or a component of the food.

Symptoms of food intolerance generally occur within an hour of eating a trigger food. Common symptoms include gas, bloating, abdominal pain or cramping, nausea, and diarrhea, but may also include flushing, inflammation and flu-like symptoms.

One of the most common food intolerances is to lactose, a component of milk products. Those with lactose intolerance lack lactase, the enzyme needed to break down lactose, and will experience abdominal bloating and diarrhea after consuming milk products. Supplemental lactase may be given for better tolerance of milk products.

Less well-known trigger ingredients I commonly see with patients include histamine, preservatives/flavorings, sulfites and acidic foods.

Food intolerances are not immune system mediated. They are a result of the body lacking a substance needed to break down a food component.

FOOD SENSITIVITY
Like food allergies, food sensitivities are mediated by the immune system. Unlike food allergies (IgE mediated), food sensitivities involve reactions that are delayed and not life-threatening (IgG or IgA).

Food sensitivities essentially represent your immune system creating inflammation in response to foods you eat. Symptoms related to food sensitivities may occur several hours up to several days after eating a trigger food.

Symptoms will vary from person to person and and can include multiple symptoms outside of the digestive tract. Common symptoms of food sensitivities include:
  • Fatigue
  • Headaches
  • Irritable Bowel
  • Brain Fog
  • Weight Gain
  • Joint Pain
  • Rashes
Other symptoms can include mood changes, changes in menstrual patterns, migraine headaches, poor sleep, acne and nasal/sinus congestion.

Food sensitivities are common to gluten/wheat, dairy products, sugar, eggs, corn, nightshade vegetables and more.

Food sensitivities are most often the result of increased intestinal permeability - the breakdown of the intestinal barrier often referred to as “leaky gut”. This breakdown of the intestinal barrier, often associated with an imbalance of bacteria, yeast and other organisms in the gut, allows foods to more easily trigger the immune system, resulting in increased inflammation and symptoms.

Food sensitivities are the result of your immune system creating inflammation in response to food. Many symptoms throughout the body may be related to food sensitivities, and the root cause underlying most food sensitivities is increased intestinal permeability, or “leaky gut”.

Learn more about the root causes of food sensitivities in part two of the series, coming soon!

Are you suspicious that food sensitivities or food intolerances may be casing your symptoms? Are you ready to start your journey to feeling better? Contact our office to schedule an appointment! 231-638-5585


Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. During the COVID-19 pandemic I continue to see both new and returning patients using our secure, easy video-visit format. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

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FOOD SENSITIVITY TESTING & The Next Generation FIT Test

FOOD SENSITIVITY TESTING and
The FIT Test by KBMO Diagnostics


In my medical practice, we look for root causes of symptoms and chronic disease, rather than focusing on simply treating symptoms with prescriptions. This is what sets Integrative and Functional Medicine apart from traditional Western Medicine. 

b2ap3_thumbnail_inflammation.jpg Inflammation is one of the main root causes of nearly everything I see wrong with my patients.  Food is a primary trigger for inflammation and should be considered as playing a large role in most symptoms, chronic disease, and autoimmune disease.  Like I often say to my patients:

Every time that you eat, you are making a decision to either
increase or decrease inflammation in your body.


FOOD SENSITIVITIES & SYMPTOMS
First things first, we are not talking about food allergies.  Food allergies are mediated by an IgE immune system reaction, which produces immediate and often serious or life-threatening symptoms that require immediate medical attention.  In contrast, food sensitivities (also referred to as food intolerances) are mediated by an IgG immune system reaction that is more delayed and generally less serious. Reactions may take up to 3 days to develop, and the IgG antibodies can remain in your body for up to three weeks.
Click here to read more about Food Allergy vs. Food Sensitivity

With food being a primary driver of inflammation, and inflammation underlying most symptoms, the argument could be made that food may be a trigger of nearly any symptom in the body!  The most common symptoms that I see in my practice that have a strong association with food include:

  • b2ap3_thumbnail_Abdominal-Pain-Is-It-Appendicitis_article_main.jpgRashes, Acne, Eczema and other Skin Conditions
  • Joint Pain
  • Digestive Issues, including IBS
  • Headaches
  • Fatigue/Energy and "Brain Fog"
  • Autoimmunity of any kind
  • Hormone Imbalance
  • Weight Gain
  • Mood Disorders, including Depression, Anxiety and more

 

DETERMINING FOOD SENSITIVITIES
Traditionally, the Comprehensive Elimination Diet has been considered the “gold standard” for determining food sensitivities. The Comprehensive Elimination Diet involves removing the food, drink, and additives that are most commonly associated with inflammation and symptoms, including:

  • b2ap3_thumbnail_Donuts.jpgGluten/Wheat
  • Dairy
  • Sugar
  • Eggs
  • Soy 
  • Corn
  • Peanuts
  • Nightshade Vegetables
  • Citrus Fruits
  • Caffeine 
  • Alcohol

The Comprehensive Elimination Diet needs to be done for at least three weeks (if you recall from above, the IgG antibodies associated with food sensitivities can remain in the body for three weeks, this allows time for them to "flush out").  After this time foods may be re-introduced one at a time while monitoring for an increase in symptoms.  For those patients who are able to complete a Comprehensive Elimination Diet, the process can be life-changing.  In my patients who complete this process, I frequently see a dramatic reduction in symptoms, improved energy and mental clarity, and better sleep. However, for many others, this process can be difficult or nearly impossible.


FOOD SENSITIVITY TESTING and the FIT TEST
One of the most common Food Sensitivity laboratory tests (and the one I have previously used) involves measuring IgG antibodies in the blood to a variety of foods.  The presence of these IgG antibodies indicates an immune system reaction to that food.  While the information on an IgG food sensitivity test can be useful, I have found several problems associated with this testing:

  • Some patients have so many IgG food reactions that they could not possibly remove these many foods from their diet.
  • We cannot always correlate a positive IgG food reaction directly to inflammation or a patient's symptoms.
  • These tests can be expensive!

FIT = FOOD AND INFLAMMATION TEST
b2ap3_thumbnail_KBMO.jpgThe FIT Test by KBMO Diagnostics is, in my opinion, the next generation in Food Sensitivity Testing.  Rather than simply measuring IgG antibody reactions, the FIT Test measures IgG and Complement-mediated Immune Complexes.  Translation = by adding the measurement of immune complexes the FIT test may more accurately identify the foods that are actually causing inflammation in the body.  

Other benefits of the FIT Test:
  • The FIT Test measures sensitivities to up to 132 different foods,  as well as coloring and additives.
  • The FIT Test can diagnose increased intestinal permeability, or "Leaky Gut", through the identification of a positive Candida immune-complex response.
  • There are less positive reactions to work with, allowing patients to more easily remove inflammation and symptom-triggering foods.
  • In addition to the 132 item option (currently $275), the FIT Test offers a more-affordable 22 item option which includes the most commonly identified food and antigen triggers (currently $100).*
Click here to learn more about the FIT test, see a list of the foods tested, and view a sample report.

Are you interested in the FIT Food Sensitivity Testing?  Do you have questions?  Feel free to send me an email at This email address is being protected from spambots. You need JavaScript enabled to view it. or contact our office 231-638-5585.

*I do not make any profit of the FIT Test, or any other laboratory test offered in my practice. Any costs associated with laboratory testing are related to the laboratories themselves.



Carin Nielsen, MD Integrative MedicineLooking for a personalized approach to your healthcare? I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms and chronic disease simply by prescribing medication doesn't address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface" to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

 
 
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Your gut has everything to do with your health - Part Two

What causes problems with your gut... and what to do about it.

We have a recurring theme this month. It's about our cells and the information we present to them.

Integrative Medicine Leaky GutRemember, our bodies are made up of trillions of cells, and each cell contains a complete copy of our genetic blueprint, which makes us unique. Different parts of our blueprint will be activated in different cell types (muscle cells vs. skin cells).  The parts of the blueprint activated will also change depending upon the information presented to the cell. Food is information.  Many people do not realize that the information our food gives the cells in our body is as powerful, if not more so, than the information provided by prescription medicine.  Let's take this one step further - do you know how one medication may cause side effects in one person but not another?  That is because of our different genetic blueprints.  The same thing happens with the food that we eat.  Depending on our blueprint, the food that we eat will affect us differently.

Recently, I wrote about the gastrointestinal (GI) tract, or gut, and the huge role it plays in our immune system, nervous system, mood and more. I explained how a properly-functioning digestive system works, and also what can go wrong and cause gut imbalance and "leaky gut" - leaking food particles and proteins into your bloodstream that the cells of your immune system don't recognize, activating inflammatory pathways which can lead to many medical problems, including autoimmune disease, eczema, fatigue and more. Today we'll explore the causes behind "leaky gut" and how to repair and rebalance your GI tract.

Causes of "Leaky Gut"

There are many factors that can contribute to your GI tract becoming out of balance, including:
  • Chronic stress and use of over-the-counter pain medications, antacids or PPIs (proton pump inhibitors like Prilosec or Nexium) reduce your stomach acid. Other medications can reduce saliva production.
  • If your gallbladder has been removed you lack the "control switch" on your bile salts. 
  • High intake of sugar, alcohol or genetically modified (GMO) food can break down the protective mucus barrier that lines your intestines.
  • Loss of "good bacteria" from low fiber intake and use of antibiotics may impair digestion and breakdown of food particles and increase growth of "bad bacteria", which along with toxins and irritants can attack and break down both the mucus barrier and the intestinal wall.

Healing your leaky gut.

Identifying and healing your core gut imbalances is one of the most important first steps you can take to promote health and well-being. Originally pioneered by naturopathic physicians, the "4Rs" program of gut repair is used routinely by Functional Medicine physicians to restore health and balance to the GI tract.

The "4Rs" Program

REMOVE - Get rid of what might be irritating your system! Start an elimination diet to remove commonly offending foods. Consider testing for food sensitivities with IgG antibody testing. Identify any abnormal bacteria, yeast or parasites with functional stool testing (I use the "GI Effects" test from Genova Diagnostics) and take appropriate measures to remove them!

REPLACE - Replace any missing factors needed for proper digestion. Working with a functional medicine practitioner can be useful to identify which enzymes or acids are missing. Betaine HCL can be used to replace low stomach acid, digestive enzymes can replace low pancreatic enzymes, and bile salts can be added if needed. The idea is not to remove acid, but rather to support your digestion with the acids and enzymes it needs, giving your gut less work to do!

REINOCULATE - Add back "good bacteria" with a high-quality probiotic blend and promote growth of good bacteria by increasing your intake of fiber and fermented foods.

REPAIR - Promote healing of the GI tract lining by supplying needed nutrients, such as zinc, antioxidants, fish oil, and glutamine.

In my experience, patients generally see positive results in as little as 10 days of this process, with less pain, bloating and stiffness, clear skin, improved energy and mental clarity.


Yours in Health,

Carin Nielsen, MD
www.CarinNielsenMD.com



Carin Nielsen, MD Integrative MedicineI use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms and chronic disease simply by prescribing medication doesn't address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface" to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
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Your gut has everything to do with your health - Part One

The Functional Medicine TreeMy traditional family practice has evolved into an Integrative/Functional Medicine practice, and my approach to health and healing has changed in many ways. Digestive health and wellness is one of the biggest changes.

Every day, I sit across the table from my clients and talk about the gut. The "gut" we speak of is referring to the gastrointestinal (GI) tract, which is a long tube that starts at your mouth and ends "where the poop comes out" (I have twin 10-year-old sons, so in my house we have many terms for this area).

As a Functional Medicine physician, I often look to the gut first when encountering any chronic medical condition. Why? Because your gut has everything to do with your health. I'm not just talking about symptoms like abdominal pain, bloating or abnormal bowel movements - there are many more symptoms and conditions that occur outside of your gut, yet may be closely linked to GI tract imbalance, including:
  • chronic headaches
  • weight gain
  • eczema/skin rashes
  • asthma
  • depression
  • fatigue/low energy and "brain fog"
  • autoimmune disease (such as rheumatoid arthritis and lupus)
  • chronic sinus problems
  • joint and muscle pain
  • mood swings

Read more about Functional Medicine


Why is the gut so important?

Integrative Medicine GI TractYour GI tract contains the first line of defense in your body. 70% of your immune system lies in your gut! Every day, when you eat, drink and breathe, you bring various toxins and infectious "bugs" into your body through your mouth and nose. Your gut provides one of the most important and difficult balancing acts of your immune system, seeking out and destroying these foreign invaders (toxins, viruses, bacteria) while ensuring that proper nutrition and micronutrients can be absorbed and assimilated from the foods that you eat.


Your gut is a key factor in regulating your emotional health and nervous system. There is an enormous amount of communication that occurs between your GI tract and your nervous system (which consists of your nerves and brain). The connection between your gut and your nervous system is so strong that scientists have referred to your gut as your "second brain"! Your gut balance can directly affect your mood - 95% of your serotonin (a key neurotransmitter involved in depression and mood) is in your GI tract, and serotonin regulation is a key factor in depression, anxiety, and other mood disorders.

"Leaky Gut"
How GI tract imbalance can affect your entire body

If you used the term "leaky gut" with me 10 years ago, I may have looked at you like you were crazy! As a matter of fact, if you use this term with many of my traditional Western medicine colleagues, they will probably do the same. That is because this is a concept that is not familiar to traditional Western medicine. This is part of Functional Medicine, which involves "getting under the surface" to determine the underlying cause of your symptoms, rather than just treating your symptoms with a medication.

Let me describe "leaky gut" to you the way I described it to my patients in the office. 

A healthy, properly functioning GI tract looks something like this: 
  • Saliva and chewing break the food in your mouth
  • Stomach acid breaks down food particles further, while muscles and nerves work together to keep everything "moving forward" in your intestines.
  • Digestive enzymes and bile salts (from your pancreas and liver) break down your proteins, fats, and starches.
  • Food particles then enter the small intestine. The small intestine has a very important job! 

This is where all of the nutrients and proteins in the food that you eat are absorbed into your bloodstream, while at the same time preventing toxins and infections from being absorbed. In order for everything to work as it should in the small intestine, several things need to be in working order:
  • First, the small intestine has a thick mucus lining that provides protection against toxins, infections, and other irritants.
  • Second, the small intestine contains adequate amounts of "good bacteria". These bacteria work to digest your food and also maintain a balance that prevents overgrowth of "bad bacteria" or other infections.
  • Third, the wall of the small intestine is tight and strong. This wall is what separates the food particles from your bloodstream. If the wall of your small intestine remains healthy and intact, only well-digested small food particles and proteins are let through into your bloodstream. 
So, when everything is functioning properly, your food is digested well, infections and irritants are kept from getting out of control, and small nutrient particles and proteins are entered into your bloodstream where they can find and enter your cells to provide them the nutrition and energy they need.

What happens when the gut becomes leaky?

Integrative Medicine Leaky GutIf your food is not broken down properly, the size and structure of the nutrient particles and proteins presented in your small intestine may be larger and shaped differently. If the integrity of your small intestinal wall is compromised, these larger, different nutrient particles and proteins may be let into your bloodstream.

As we have discussed before, food is information! The food you eat provides information that interacts with the genetic code that resides in each and every cell in your body. By changing the structure and size of these food particles and proteins, you are changing the information presented to your cells, which may activate pathways that promote inflammation.

The cells of your body's immune system are particularly sensitive to this. High inflammatory foods, such as sugar, along with increased "bad bacteria" or toxins in the gut may send a signal to your immune system to be "on alert" for problems. This is followed by the altered food particles and proteins entering the blood stream, causing your immune system to feel under attack! The cells of the immune system activate pathways that increase inflammation. Depending upon your genetic code (or "blueprint", as I like to call it), certain cells may be affected more than others. That is why leaky gut may present with a rash in one person, fatigue and headaches in another, and autoimmune disorders like rheumatoid arthritis in yet another person. Your genetic blueprint determines your susceptibilities.

Common signs of "leaky gut" include:

  • rashes/eczema
  • headaches
  • fatigue and "brain fog"
  • muscle and joint pain
  • weight gain and water retention
The good news - identifying and healing your core gut imbalances is one of the most important first steps you can take to promote health and well-being. We've covered the basics of digestive health and where problems can arise, stay tuned to learn more about the causes of "leaky gut" and what to do about it!

Yours in Health,

Carin Nielsen, MD
www.CarinNielsenMD.com



Carin Nielsen, MD Integrative MedicineI use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms and chronic disease simply by prescribing medication doesn't address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface" to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
 
 
 
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