Food allergies seem to be increasing at epidemic rates. While the exact cause of this condition is not fully understood, it is evident that it is due to a number of environmental and lifestyle factors. These conditions continue to be ignored by many physicians. Our office utilizes the most advanced blood testing procedures to identify and correct this condition.
For more Information: Call our office for a DVD of Dr. Arnone and Daniel Dantini MD discussing Delayed Food Allergies
Food Allergies and the Immune System
A food allergy develops when your immune system, by means of an odd mixture of immune cells, antibodies and chemical mediators, reacts in an attempt to reject a food in your diet. This is called an autoimmune reaction. An autoimmune reaction is an event where the immune system is reacting and attacking substances that it should normally recognize as harmless. There are four different types of autoimmune reactions. These are called Types 1, 2, 3, and 4. More than one type of reaction can occur at the same time in the same allergic individual. These reactions are well documented in medical literature and studied in all medical colleges and referred to as the Gel Coombs classifications.
Type 1 Autoimmune Disorders ( Immediate Onset )
The best known and well-studied form of food allergies is called a Type 1 immune reaction. Type 1 food allergies occur in less than 5 percent of the population -- mostly in children, They are also called immediate-onset, IgE-mediated and/or atopic food allergies. Usually occurring in the genetically predisposed individual, the immune system begins creating a specific type of antibody called IgE (immunoglobulin IgE) to certain foods. One side of the IgE antibody will recognize and tenaciously bind to the allergic food. The other side of the antibody is attached to a specialized immune cell packed with histamine, called the Mast cell. Primed for action, the IgE antibody now only have to patiently wait for re-exposure to food allergens. When you eat the allergic food the next time, IgE antibodies hungrily latch onto the food. Instantaneously, histamine and other allergy-related chemicals -- called chemical mediators -- are released from the mast cell, rapidly bringing on the unwelcome appearance or stomach cramping, diarrhea, skin rashes, hives, swelling, wheezing or the most dreaded of Type 1 reactions, anaphylaxis. Since this pathway occurs immediately, it is easy to recognize as a problem after an individual is exposed to the irritant. This is the immunological pathway behind seasonal allergies. The most common test for this type of reaction is the Scratch Test which is performed by most allergists.
Type 2 & 3 Autoimmune Disorders (Delayed-Onset Food Allergy)
Type 2 & 3 immune reactions are much more commonly involved in food allergy than Type 1 reactions. A Type 2 & 3 food allergy also involves the immune system. They occur when your immune system creates an overabundance of IgG, IgA, and IgM antibodies to a particular food. The IgG, A & M antibodies, instead of attaching to mast cells like IgE antibodies in Type 1 allergies, bind directly to the food as it enters the bloodstream, forming different sizes of so-called circulating immune complexes (food allergens bound to antibodies circulating in the bloodstream). These antibodies will then target connective tissue. Since connective tissue is present in all muscles, joints, organs, and arteries, these reactions can lead to inflammation and destruction to any system in the body. The allergic symptoms in Type 2 & 3 autoimmune reactions are delayed in onset, appearing anywhere from within two hours up to several days after consuming allergic foods (Example: migraine headaches characteristically first appear 48 hours after allergic foods are eaten). Delayed food reactions may emanate from any organ or tissue in the human body, provoking over 100 allergic symptoms and well over 150 different medical diseases. An estimated 60 to 80 million Americans suffer from clinically significant food allergies, most all of whom suffer delayed symptoms.
Immediate vs Delayed Food Allergy
There are many factors to consider when comparing Type 1 autoimmune reactions to Types 2 and 3 autoimmune reactions:
* Recent research seems to support that the delayed pathways may be a more common problem in children than the immediate reactions.
* Allergic symptoms in immediate reactions occur within two hours of eating. Allergic symptoms in delayed reactions do not appear for at least 2 hours, not infrequently showing up 24 to 48 hours later (there are even reports of delayed symptoms appearing 3 to 7 days after eating). This makes them very difficult to identify through dietary observation. Because a small amount of a single food is involved and the allergic symptoms appear immediately, immediate food allergy is usually self-diagnosed. You eat the food. It causes symptoms quickly. You see the connection. You stop eating it. Due to a combination of delayed symptoms, multiple foods, and food cravings, Type 3 delayed-onset food allergies are rarely self-diagnosed. Blood testing is required to correctly identify Type 2 & 3 reactions.
* Immediate food allergy involves foods that are rarely eaten. Unfortunately, delayed food allergy involves commonly eaten foods, foods that you eat every day and may even crave.
* Immediate food allergens primarily affect the skin, airway and the digestive tract. Virtually any tissue, organ or system of the body can be affected by delayed food allergy. This includes the brain, joints, muscles, hormone-producing glands, lungs, kidneys, and nervous system. In fact, delayed-onset autoimmune reaction is linked to over 100 medical conditions involving every single part of the body and some 100 different allergic symptoms.
* Immediate-onset food allergies are frequently permanent and fixed allergies. Once you develop an allergy to peanuts or shellfish, for example, it's for life. Delayed-onset food allergies are commonly reversible. If you strictly eliminate the allergic foods for 3 to 6 months, you can bring most of them back into your diet and remain symptom-free. Because delayed-onset food allergies are so often undetected and untreated, they lie behind many of chronic medical conditions of unknown cause. These allergic people suffer for years, even decades, without ever suspecting that their health problems are rooted in what they eat.
* Delayed autoimmune reactions frequently change over the course of the years. Individuals can develop new autoimmune reaction pathways to foods that are eaten frequently. This is usually due to gastrointestinal permeability problems (Leaky Gut ). This complication requires that in addition to the elimination of offending foods, a rotation diet must be established to properly correct the problem.
* Immediate-onset food allergy is often a skin-test positive allergy. The doctor can diagnose it with a simple skin test. Delayed food allergies are skin-test negative. The traditional skin tests are poor tests for detecting delayed food allergies. Instead, delayed reactions food often require state-of-the-art blood tests. These tests detect serum levels of IgG antibodies to foods -- IgA antibody as well as IgG in gluten sensitivity and celiac disease.
Treatment in our office begins with a complete exam and history to determine if an individual has the indications of an autoimmune disorder. Frequently, general blood studies are ordered prior to food testing to evaluate for other health conditions and to help establish the diagnosis of Food Allergies. Once it is determined that food allergies are possibly responsible for a patient's condition, Delayed Food Allergy Tests are ordered. Our office utilizes the most advanced blood studies available for this testing.
A typical program includes a 6 week elimination and rotation diet followed by an introduction phase. Symptomatic recovery is usually experienced within the 6 week elimination. However, dietary modification may continue for 12 to 24 weeks. Once recovery is complete, a patient can expect to get a lot of foods back in their diet. However, there are usually a number of foods that should always be avoided.
Some Conditions Associated with Food Allergies:
Irritable Bowel Syndrome ( IBS )
Headaches and Migraines
Chronic Sinus Congestion
Graves and Hashimoto's Disease
Unexplained Joint and Muscle Pain