5 Major Problems with Most OTC Food Sensitivity Testing

Chelsea Newbrough, RDN

In a world where dietary choices play a pivotal role in our well-being, understanding how our bodies react to certain foods has become more crucial than ever. Many individuals grapple with mysterious symptoms—ranging from digestive discomfort to unexplained fatigue—that conventional diets and medical advice fail to address comprehensively. Enter the realm of food sensitivity testing, a growing field that aims to unveil the hidden triggers behind these elusive health issues.

Before we discuss how these tests work and the pros/cons, lets back up and talk about the differences between food intolerances, allergies, and sensitivities.

A food allergy is a sometimes life threatening response to contact with, or ingestion of, an allergen. The top 9 most common allergens are milk, peanuts, egg, fish, tree nuts, shellfish, wheat, soy, and sesame. Symptoms happen fast, and are caused by increased production of the IgE antibody. IgE response = allergic response. Food allergy testing is only performed by a doctor or other licensed healthcare professional.

A food intolerance is when your body lacks the enzyme necessary to break down a certain food. The most common example is lactose intolerance, where a person lacks the enzyme lactase that is required to break down lactose, which is the type of sugar found in milk. It's not life threatening, and there are tests your doctor can do to help find the culprit. These are not immune-mediated reactions.

A food sensitivity is an immune response to a food that isn't life threatening. Unlike allergies, which elicit immediate and often severe reactions, food sensitivities are subtler, manifesting over time and frequently flying under the radar. It can cause mild to moderate symptoms like bloating, brain fog, fatigue, GI upset and headache. These are harder to pin-point and can require a lot of trial and error. It makes perfect sense that people turn to tests to help them out, but how much are they really helping?

How They Work

Most food sensitivity tests are measuring IgG antibody response. These are the most common antibodies we have and are different from the IgE antibodies that are produced in an allergic response. IgG antibodies are a natural response to an exposure to a food, and may even be associated with food tolerance. So, if you eat a lot of almonds, you're probably going to show a high reactivity to almonds on your IgG test, however that doesn't actually correlate to sensitivity. Because of the unreliable science, the vast majority of medical professionals, scientists, and organizations like The American Academy of Allergy, Asthma, and Immunology recommend against using these tests.

The Problems

1. The presence of IgG antibodies does not definitively indicate a sensitivity.

Do you have a high amount of IgG antibodies with almonds because you eat them a lot or because you're actually sensitive to it? Who knows! The research just isn't there (or moving in that direction) to support that there is any credibility to using this metric to identify food sensitivities.

2. It can lead to unnecessary elimination of foods

Even after you know that your test isn't enough on it's own to determine what you are intolerant to, it is almost impossible to un-see those results. This can lead to over restriction of perfectly healthy foods, and even under nourishment in some cases. Elimination diets are a useful tool, but they should be done so with guidance from a professional.

3. It can trigger disordered eating

Over restriction is never a good thing, and if you have ever previously struggled with any type of disordered eating or eating disorder, it may be exacerbated by these results. Again, elimination diets should be done under the guidance of a professional.

4. You don't get any professional help

Ah, yes, this again. If you ordered one of these tests on your own, you're not getting the support you need from a nutrition professional to give you any context or guidance. You are left on your own to figure out how to navigate life with this information. Anybody dealing with suspected food sensitivities should be working with a nutrition expert, period!

5. It's expensive

These tests aren't covered by insurance, and so you're going to pony up for them out of pocket. Most tests start around $200 and go wayyy up from there, which is an awful lot to spend on something that isn't helping you. You're much better off putting that money toward professional help that is going to get you real results.

Are there any reliable options out there?

The most promising test currently available is called the Mediator Release Test (MRT) by Oxford Biomedical Technologies. (This is not a sponsored ad, I'm getting zero dollars for writing this.) It works by measuring pro-inflammatory mediators released from white blood cells in response to 140 different foods and 30 food chemicals. These mediators include things like cytokines, histamine, leukotrienes, and prostaglandins. The test is intended to be used in conjunction with the Lifestyle Eating and Performance (LEAP) protocol to heal the gut and avoid sensitive foods.

This is the test that I have chosen to use in my practice with great results in combination with the LEAP protocol. Doctors and dietitians that use this test are often highly trained in food sensitivity protocol and will be able to give you an individualized plan to implement your dietary changes. It's one thing to know something, and it's an entirely other thing to make diet and lifestyle changes. You need support!

What should I do if I think I have a food sensitivity?

1. Get expert help

If it is accessible to you, I always vote to meet with a dietitian first. This is our jam. Food sensitivities are so tough to figure out and it can really impact your emotional and physical well-being. They're going to be able to determine what tests and options are the most appropriate for you and will get you feeling better the fastest.

2. Start a food journal

Whether you see a dietitian or not, start with a food journal. Track what you eat for a week or so, along with how you feel in the hours afterward, and see if there are any obvious culprits. If you can identify one, try eliminating that one thing for about 6 weeks and see if symptoms improve. Remember, it can take several weeks to start feeling better.

3. Look beyond food

How are you sleeping? How's your stress level? Are you exercising? The gut-brain axis is a real thing, so don't overlook the impact that other factors besides food could be having on your symptoms. There is growing evidence that suggests leaky gut may be the culprit for many food sensitivity symptoms too, in which case the solution will extend beyond cutting out a specific food. This is a complex problem, and it might take some time to figure out the root cause of your symptoms, but help is out there!

Have more questions about food sensitivity testing? I want to hear from you! Email me at chelsea@themilspousedietitian.com

This content is for informational or educational purposes only and does not substitute professional medical advice or consultations with healthcare professionals.