What Role Can ALCAT Food Allergy Testing Play in Your Recovery from Celiac Disease and Gluten Sensitivity?

Celiac.com 05/21/2021 - If you're like most people with celiac disease or gluten sensitivity, you probably went through quite an ordeal to figure out that gluten was the cause of many of your health issues. In most cases, including mine, it can take years to figure this out, and those are years you've lost to poor health which you can never get back.

For most people with gluten sensitivities a strict gluten-free diet, usually for at least a year or two, will resolve most issues caused by gluten, but this is not true for everyone. In my case it took about two years to really feel good again, and I also had to exclude other foods like corn, cow's milk (casein), chicken eggs, tomatoes, and garlic, even though they are gluten-free, and considered safe for a gluten-free diet. At the 2-3 year point I felt so much better that I began adding back everything into my diet except for gluten, and it seemed that those items no longer bothered me.

Celiac.com Sponsor (A12):
Fast forward 25 years and I now realize that I've been having issues again with feeling bloated after I eat, which is accompanied by a growing waistline that isn't necessarily made up of fat, but seems more like inflammation in my intestines, similar to what I experienced when I was eating gluten, but not nearly as bad. I've rechecked my gluten antibody levels, and it doesn't seem to be related to hidden gluten in my diet. I'm not alone here, and it turns out that many celiacs will not make a full recovery without taking more steps than just a gluten-free diet.

To try to figure out what was going with me I decided to take an offer that I couldn't resist: One of the advertisers on Celiac.com, Roger Deutsch of PreviMedica, offered to give me a free ALCAT food sensitivity test panel in return for me writing this article about my experience (PreviMedica also offers a celiac test, included with their celiac, IBS, Crohn's array).

The ALCAT test analyzes the white blood cell (leukocytes) responses to blood that is incubated with extracts of foods, molds, chemicals/food additives, antibiotics and preservatives, and the company claims that this process can identify food intolerance issues that can trigger inflammation in sensitive individuals.

If you do some Google searches on the test you may find that it's been shown in research to help some people lose weight, and research has also shown that it may provide clinical improvement in those with IBS. While searching you may also find criticism of the ALCAT test, including claims that ALCAT test results are not consistent or replicable, which I brought up with Roger, and to which he responded: “Those statements are propaganda from a competitor. The test reproduces nicely...see independent studies from reputable institutions.” After sorting thought all this I decided that it was worth it for me to pursue ALCAT testing, in the hope that I could finally track down foods that might still be causing me issues.

Soon after my conversation with Roger I got a call from a blood draw company who makes house calls, and we scheduled a time for them to come by. The person showed up at my house on time, was very professional, and painlessly took the samples needed for the ALCAT testing. I got my results back around a week or two later, and to summarize them I ended up with 4 “severe” reactions to different foods that I should strictly avoid for at least 6 months, 23 “moderate” reactions to different foods that I should avoid for 3-6 months, and 66 “mild” reactions to different foods that I should only include in my diet on a 4 day rotational basis, unless the foods are items that I consume often, and if so, I should also exclude those items for an initial 3 month period.

At this point I must bring up a common criticism that I've seen regarding food allergy testing—that you're often faced with a daunting list of items that might trigger reactions, and avoiding all of those foods could be very difficult. The good news in my case was that the 4 items on my “severe” list, apple, red palm fruit, yam, and zucchini, are all things that were easy for me to avoid, as I've never been a big apple, yam or zucchini fan, and have never, as far as I know, even tried red palm fruit. However, several items on my “moderate” list were definitely a shock to me, and included items that would be very difficult from me to avoid, including: rice (white and brown), coffee, garlic, mustard seed, turmeric, almond, avocado, beef, pork, and casein (both cow's and goat's milk). Several of these foods are daily staples, including coffee, without which Celiac.com might not even exist! Yes, I'm a java junkie, so seeing coffee on this list was a serious and unexpected blow.

For the next four weeks I went all in, and successfully modified my diet to meet the new requirements of my ALCAT test results. The first thing I noticed was that I lost some weight, and, as it turns out weight loss is common when going on an ALCAT diet. I also noticed that my abdomen seemed to shrink, and it didn't seem to correlate directly to the relatively small amount of weight that I lost, so I believe that this part was directly related to a decrease in intestinal inflammation.

During the time I was on the diet I felt better than ever, but I also found that staying on the diet did not get any easier for me. In my case it was due to the fact that my wife does most of the meal preparation in our home, and given the fact that she's from Taiwan, my asking her to exclude things like rice, garlic, pork, and other key ingredients used in Asian cooking was pretty difficult for her, and she was not about to adopt my new diet. I also never really got used to living without coffee, and that was the first thing that caused me to waiver from the diet. After breaking down and adding coffee back into my daily routine, a few other things crept back in, mainly because my wife continued making some outstanding dishes that I found increasingly hard to refuse (ok, I blame myself here...there are no two ways around it!).

I was on my customized ALCAT diet for long enough to realize that it definitely had a positive effect on my weight, inflammation level, and overall feeling of well-being, but I also realized that one of the main criticisms I heard about food test results was true: excluding large numbers of foods is indeed hard to deal with. In this case the shortcomings were entirely mine, especially because the folks at PreviMedica had contacted me during the time I was on the diet to offer any assistance, including dietary counseling, which I declined.

At this point I've not given up on the ALCAT diet, and am trying to plan a better time for me to begin attempt number two. I've never smoked cigarettes, but have seen others quit them and know that it can often take several attempts to be successful. Perhaps the second or third time I try the ALCAT diet will be the charm?

I also want to share some questions I had for Roger during the course of writing this article, along with his, and his colleague's responses, which are below:

Q: During the late 1980's I had RAST (radio-allergo Sorbent Test) serum allergy testing done, and was told by my allergist (Rudolf Kallenbach, MD) not to eat several foods daily, including wheat, and to only eat them once per week at most. I ignored this, and around 5 years later ended up with full blown celiac disease. I still wonder if I could have avoided celiac disease by following my doctor's orders. What do you think?

A: If you are HLA DQ 2.5 and 8 homozygous or even heterozygous positive for one or both alleles you should have avoided wheat altogether. If you had avoided wheat and other gluten containing grains it is almost certain that you would have avoided developing celiac disease.

Q: My original RAST test results were very different from the ALCAT results. In brief, how does the RAST test compare with your ALCAT test, and which one is more accurate for food sensitivities or allergies?

A: The difference is that the RAST measures the levels of serum IgE antibodies and the ALCAT Test measures the response of an ex vivo (outside the body but analyzing live blood tissue) challenge with a food on the part of the innate immune cells. They are intended for different things. The RAST is quite a good guide for what is called, classical or Type 1 allergy; the ALCAT Test is excellent for determining non-IgE mediated allergy, or, sensitivity. These are different branches of the immune system and they present quite differently. IgE allergy produces rapid and pronounced symptoms, maybe even anaphylaxis say to peanut or crustacean. Food sensitivities maybe delayed for hour, even days, and symptoms are more chronic and less acute. The ALCAT Test, for example will tell you if you have a response to a naturally occurring food toxin (all plants produce toxins to protect from pests) and these can produce a wide range of symptoms that can effect any target organ or tissue in the body. Please see The Right Stuff: Use of Alcat Testing to Determine Dietary Factors Affecting Immune Balance, Health, and Longevity, as this paper explains the differences in greater detail.

Q: My results indicated that I have a moderate reaction to casein, as well as to egg yolk. The results don't differentiate between cow's milk, goat's milk, or sheep's milk, nor do they differentiate between chicken eggs or duck eggs (shortly after my celiac disease diagnosis I could not tolerate casein or chicken eggs, but could tolerate goat's and sheep's milk, as well as duck eggs). Can you explain why your test seems to not differentiate between these items?

A: The eggs that are tested in the ALCAT Test are chicken eggs. When following the results and avoiding reactive foods, we recommend not consuming any foods that were untested. Therefore, we would recommend the avoidance of duck eggs.

The proteins, casein and whey, are in goat’s, cow’s, and sheep’s milk, although the forms are somewhat different. The ALCAT Test tests one form of casein (which contains both A1 beta casein and some A2 beta casein) and when reactive will eliminate cow’s milk, goat’s milk, and sheep’s milk since they all contain casein. The ALCAT Test does test directly for the reactivity to cow’s milk, goat’s milk, and sheep’s milk as well.

Q: As mentioned, I have celiac disease, so I've been gluten-free for over 25 years now. My test results show that I don't have a reaction to gliadin, the part of wheat that is responsible for the autoimmune reaction seen in celiac disease, and a mild reaction to gluten. Can you explain why I seem to not react to gliadin, and why your test differentiates between gluten and gliadin reactions?

A: The ALCAT Test is testing the white blood cell response, not the antibodies to tissue transglutaminase or deamidated gliadin peptide which would be the response indicating an active celiac process, as you know. When individuals react to gluten and/or gliadin in the ALCAT Test, a sensitivity to the gluten and/or gliadin, not celiac disease, is indicated. When individuals with celiac disease do not react to gluten/gliadin in the ALCAT Test, this does not mean it can be safely consumed.

Q: Two items that I was surprised to see in my "Moderate" reaction list were white and brown rice, which have been daily staples and are in many gluten-free foods that I eat. I've never noticed any issues when I eat rice. Likewise, apples are in my "Severe" list, but I don't eat them often. Can you explain why some foods that I seem to have severe or moderate reactions to don't have noticeable effects after I eat them?

A: Keep in mind that the white blood cell reactivity (change in number and size) the ALCAT Test identifies, is an inflammatory response. (see scientific dossier attached page 4) Inflammation is the contributing factor to the most common chronic health problems we experience in the US. We don’t always feel inflammation but it is happening whether we feel it or not. IF symptoms are noticed from sensitivities, they can be noticed ~2-3 hours after ingesting the offending food or the next day or even 4 days later. (unlike the allergy response symptoms which would be noticed minutes after ingesting the offender up to 2 hours later).

Q: My experience so far, after being only a week and a half into my dietary changes, are that the ALCAT test results can be overwhelming. They can cause many people to have to make huge dietary changes, and have to spend a lot of time shopping, planning and preparing each meal. Is this feeling pretty common among those who get your test results, and do you have any advice for me?

A: Feeling overwhelmed is very common when seeing the results. That’s why we do what we do in PreviMedica- every test comes with ½ hour complimentary review of the results to explain how to implement the results. More in depth nutrition therapy and individualization is offered when patients choose to work with us in PreviMedica Nutrition for individual nutrition sessions or monthly memberships. We also provide customized meal planning tools and Sensitivity Friendly Menus for patients.

DISCLOSURE: For writing this article I received a complimentary "474 Items Previ Premium" ALCAT food sensitivity test panel from PreviMedica with a retail value of $1,115.00.