Food Allergy Testing - The Future
In 1994 a two and a half year old child was brought to see a Dr. Grant Born in Grand Rapids. The child had already seen many physicians. His parents had packed their clothes and made the decision that they would go from doctor to doctor until they found the answer to his severe eczema. The boy appeared in the office as a very malnourished little child who cried most of the time. His body was covered with eczema from head to foot. He was wearing shorts, scratching his thighs so hard that there was blood literally running down his legs as he sat there. It was such a pathetic, sad case that the nurse was in tears. Before this the boy had been to the University of Michigan Medical School and had been seen by some of the big allergy research centres. All they did was give him Atarax for the itching and medication for his abdominal bloating.
Dr Born ordered an IgG ELISA test from a leading American laboratory to check his IgG antibody reactions to foods. Amazingly this little boy was allergic to roughly 30 different food items. The doctor put him on the personalised rotation diet provided by the laboratory. To create a nourishing diet for a 2 year old child with 30 food allergies was very difficult, but the lab came up with a good programme for him. Dr Grant also put the child on essential fatty acids, selenium and panthothenic acid, and removed the 30 reactive foods from his diet.
Two weeks later his skin was totally clear, the rash was gone, he was sleeping all night and his appetite was back. His mother reported that the child was eating 5 pancakes for breakfast and had put on a couple of pounds in just 2 weeks. He was eating them out of house and home!
The boy’s mother subsequently guessed that he had also had severe knee pain along with the eczema, because he kept telling his mother that his “owie is all gone” while touching his knees. He also had an incredible attitude change, the mother said. He started potty training, which prior to beginning the allergy programme he had not been interested in. He had begun playing with his sister all day, where before he just sat and cried. To his mother, it was all a miracle.
In Miami, Florida Dr Jeffrey Rubin, has been successful in treating patients with gastrointestinal problems, asthma, and other conditions which can be traced to adverse food reactions. For example, nine-year old Tommy Proskow was having attention deficit-type troubles at school. Dr Rubin ordered an IgG ELISA food allergy test on Tommy and discovered that his antisocial behaviour was directly related to allergic responses to certain items in the boy’s diet.
By removing the unfavourable foods from him and commencing Tommy on a programme of nutritional supplementation, Dr Rubin had the child functioning more normally. His teachers kept a behaviour chart that scored his actions and found that he improved day by day. When early on in the treatment Tommy’s mother put back foods that had been removed from his diet, she and the boy’s teachers noticed a reversion to deviant behaviour. “The mother added back a couple of those foods that my laboratory testing advised should be eliminated,” said Dr Rubin. “His behaviour worsened. When she stopped feeding these same foods again, he behaved better right away.”
Dr. Fred Srebnick focuses on adverse food reactions of patients as an integral part of his medical therapy. He has experienced some strong benefits occurring to patients. Dr Srebnick described several dramatic cases of patients who were amazed by the number of foods to which they responded adversely. They had not known of their allergies until they took an IgG ELISA test. Dr Srebnick knew that immunological reactions can be assayed for specificity and sensitivity.
For example, Dr Srebnick recently took care of a fifty-year-old diabetic man, a 260 pound ex-football player who currently earns his living as the “deal-maker” in the international securities trades. This man was taking 40 units of insulin morning and night. Even with his 80 insulin units, the big man struggled on a Pritikin-style diet and was unable to control his food intake. Dr Srebnick ordered an IgG ELISA test on him and, responding to the reported results, removed six hypersensitive foods from the man’s diet.
“Within one month, my patient lost fifteen pounds without even trying,” said Dr Srebnick. “He never went hungry but merely avoided the adverse foods to which he reacted. The insulin he requires today has dropped to 28 units in the morning and 20 at night. Every time he checked previously, his blood sugar had been elevated to well above 200, but now it remains down in the 90s.”
As it turned out, Dr Srebnick was himself among the best subjects. He discovered that his immune system responded adversely to 12 different foods. In testing his own blood serum twice – the second time under a pseudonym to check the test’s reproducibility – Dr Srebnick reports that he was very impressed with the accuracy of results from the American laboratory who performed the tests for him.
What makes food allergy testing so difficult?
As shown by the above case histories, food allergy testing can lead to wonderful recoveries. Yet food allergy testing in the UK is rarely so successful. Why? Until recently there have been several forms of allergy testing available in this country, including cytotoxic, computerised cytotoxic, ALCAT, applied kinesiology, and VEGA tests. Each of these tests offer benefits, but each share the same critical disadvantage – they do not give consistently reliable results.
If a patient’s blood sample is split into two and sent to the same laboratory under two different names to be tested for food allergies one would hope to receive back two identical sets of results. But this is very difficult to achieve. Food allergy testing has been known as a very imprecise science. When laboratories using the older techniques mentioned above have been challenged with split samples there has only been 50-60% agreement between results that should ideally have been identical. At this level of reliability the patient may have an allergy to a certain food, or they might not. Such a poor level of accuracy cannot be used as the basis for successful treatment, and this is why the medical profession have disregarded this kind food allergy testing for so long.
In fact most doctors even dispute the existence of the kind of ‘food allergy’ being discussed here. Doctors are taught that the only real allergies are those which show immediate reactions, for instance when someone faints because they ate shellfish, or when their lips and throat swell if they accidentally eat citrus fruit. These are classic food allergies, fully recognised by the medical profession. It is now known that they are triggered by antibodies called IgE (or immunoglobulin E).
Actually very few of the reactions we commonly have to foods are of this immediate kind. Most of the food sensitivities, or intolerances as they are sometimes called, take some time (approximately four hours to four days) to develop after eating the offending food. For that reason they are sometimes called ‘hidden’ or ‘delayed’ food allergies.
IgG ELISA antibody testing
A new approach to food allergies, IgG ELISA antibody testing, was first introduced to the UK two years ago. IgG antibody testing is based on the theory that delayed food allergies are caused by a different antibody, not IgE in this case but IgG. The problem is that the ELISA method used to detect IgG antibodies is extremely sensitive and can easily give what are called ‘false positives’, in other words the danger is that the ELISA test may signal that there is an allergic reaction when in fact there isn’t.
However, accurate IgG testing has been pioneered by John Rebello Ph.D, lab director of Immuno Laboratories in Florida. Dr Rebello, working over many years to overcome these problems, has managed modifying the ELISA method to give a very much higher level of reliability than has been achieved by any other method. With his modification he has been able to double the sensitivity of the ELISA test while at the same time excluding the possibility of false positives. The validity of using IgG ELISA method, modified in this way by Dr John Rebello, has now been validated by a double blind placebo-diet crossover study conducted independently by Dr Sidney Baker MD and presented at the American Academy of Environmental Medicine Advanced Seminar at Virginia beach in October 1994.
ELISA actually stands for ‘enzyme linked immunosorbant assay’. This test is based on the fact that a food specific antibody will bind itself to a food antigen (the protein part of an offending food). First the blood serum sample is diluted to the optimum level and placed in a microtiter plate which has already been coated with various food antigens. The serum is then incubated for two hours as the IgG antibodies bind to the allergen coated wells. Many more delicate processes follow after which a coloured compound is generated in the wells which indicate an allergy. The plate is then put into an automatic spectrophotometric reader which deciphers the wells on the plate and reads them into a computer. In Dr Rebello’s system the wells are compared to standards (each patient has their own standard, controls and serum blanks) as part of an elaborate quality control system.
Dr Rebello has now performed over 100,000 successful IgG ELISA tests (testing for IgG1, IgG2, IgG3 and IgG4) and has been able to refine his method to such a degree that his laboratory can guarantee over 95% reproducibility. This means that if you send in the same person’s blood under two different names you will get virtually the same result. This is an historical advance in food allergy testing. To ensure they maintain their standards Dr Rebello’s laboratory split a sample on themselves blind each week to check they still have this very high level of reproducibility.
Today other US and UK laboratories are offering IgG ELISA testing, although most only test for IgG4. How do you choose a good laboratory that will give you accurate reliable results? Jeffrey Bland PhD, the well known medical researcher, when asked what made the difference between a great lab and a mediocre one said, “having been a lab director myself for seven or eight years, I can answer that one with some degree of personal experience . . . it’s the lab director. Someone like John Rebello, where you have a person whose pride and attention to detail and focus and energy goes into reproducing numbers and data and taking great personal pride in that quality control, that’s what determines the outcome of any lab.” It is this level of expertise that you should look for in any laboratory you order a test from.
Remember that IgG ELISA testing is a very long way from being reduced to a simple reliable kit that works like a cookbook recipe. Look very critically at any laboratory just starting in the field of ELISA testing for foods. A laboratory can buy ELISA test equipment off the shelf and start up in business, but they will be years away from accurate testing. When you think you’ve found a good lab, the only real way to test them is to send them a split sample without letting them know what you’re doing. If the results come back virtually identical you know you’ve found a first class laboratory.
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