Allergy Vs Intolerance

[Wisgal]

I'm a bit confused on this celiac vs intolerance vs wheat allergy thing. I've just had testing (intestinal biopsy and tTG). I have to wait another week or more to know the results. But in the meantime, in the last 3 days have tried to cut out gluten. I'm still learning, so not sure if I've gotten all the hidden sources. But for the last 2-3 days, I actually haven't had a stomachache at all and feel so much better- this is after >5 weeks of daily pain, someitmes very intense , and usually after eating. So I think whether or not the tests come back positive, I do have some kind of intolerance or allergy. But if it is negative for Celiac, are there specific tests that can measure for gluten intolerance? If so, which? I've read through some of the articles on this and reading Dangerous Grains, but still confused. Also, how is intolerance different than wheat allergy? I saw a few website that said true wheat allergy is actually very rare. I keep thinking allergy as a possibility b/c my eosinophil count was very high- this elevated white blood cell is normally seen in allergic reactions, rashes and parasites. But I don't have any rashes, no respiratory symptoms, no diarrhea, haven't been to a foreign country to contract a parasite.

Thanks for any help!

[dfish]

There is some confusion among professionals about what is an "allergy". They all agree that "true" food allergies are those that are mediated by IgE antibodies in our bodies. Those antibodies are the types that cause an immediate, histamine response by the body. Traditional "allergy" testing, such as skin prick testing, tests for true IgE mediated allergies, although they are more accurate for environmental allergies than for food allergies. What I have read (and I have been doing extensive research on this issue lately because I've had the same confusion) is that skin prick tests that test for IgE mediated responses to food are fairly accurate in ruling out IgE allergies (ie, a negative result is pretty much accurate) but not very accurate for ruling in food allergies (ie many false positives). And, this is for IgE allergies only If you have a food that you are highly allergic to, it will likely show up on a skin prick test and you will be told to avoid it. IgE mediated allergies are the type that cause anaphylaxis (ie, you accidentally get some cross contaminated soup with shellfish, throat starts swelling, pass out, shock, possible death, etc) and require people to carry around Epipens, etc. I had skin prick testing done to foods and had many that were "borderline" but four that were very, very high (strange ones like bananas, peaches, and celery and then all tree nuts). I now have to have an Epipen and have to make sure that I avoid these foods like the plague because, frankly, I could die if I eat them.

Where the debate is among medical professionals is whether or not food reactions that are mediated by IgG antibodies can be considered true food allergies. Some doctors and researchers say yes, some say "no". I'm inclined to believe myself that an IgG reaction is also an allergy. However, they are NOT the kind of allergies that will cause anaphylaxis. Rather, IgG food allergies are the kind that continue to cause gut permeability, brain fog, GI symptoms, etc. They are still bad for you and, I've come to think of them as the "long slow painful death" antibodies (ie, you're not going to die from anaphylactic shock, but in about twenty years, after corroding your body this way, it's bound to take it's toll somehow). There are not really any accurate tests that your doctor will likely give you for these types of allergies because the ELISA, the panel used to test for IgG antibodies specifically, seems to have fallen out of favor with doctors. One theory I have read frequently is that they have "fallen out of favor" because they only cost about 140 bucks whereas skin prick testing, the kind your doctor will likely do if you tell them you think you have food allergies, cost about 1600.00 and your doctor can bill you a lot higher for them. However, York Labs does an ELISA panel for IgG mediated allergies (but not IgE). Also, Great Smokies Laboratories will test both IgE and IgG food reactions but you have to have the tests ordered by your physician. If you have a good doc, they may be willing to order these tests for you. My research indicates that this may be the most comprehensive food allergy testing laboratory out there, it's just getting your doctor to cooperate that is the problem.

I should also note that, when talking about the accuracy of the skin prick tests in ruling out food allergies, that is only to rule out IgE mediated allergies. So, let's say that you test negative for milk on a skin prick test. It is fairly accurate that you do not have an "anaphylaxis" allergy to milk. But, you could still test positive to an IgG test for milk and that doesn't mean that the first test was wrong. It just means you don't have that histamine response to milk, but you are still allergic to milk. In sum, just because a skin prick test says "no" and that is found in the research to be accurate, it doesn't necessarily mean you should eat that food without first investigating your IgG antibodies as well.

Food intolerances, lastly, are not mediated by any type of antibody. They do not cause any type of "immune" response in the body, although they do cause discomfort and feeling ill. Lactose intolerance is a perfect example of this. A person who is lactose intolerant likely does not have the proper ability to digest the enzymes in lactose and when they eat it they feel terrible, get diarrhea and bloating, etc, BUT they are not having any antibodies in their body identifying that food as foreign and attacking it. A person who has a true milk allergy gets an immune response in their body when they drink milk. They have either IgE or IgG antibodies that attack the milk proteins.

Sorry for such a long post, but in my research, these are the conclusions I have come to. Food "allergies" are caused by antibodies and a true immune response in the body attacking the food protein as foreign. Food "intolerances" are a body just saying "eww, I don't like this and makes me feel yucky, don't eat that".

Hope that helps if you were able to wade through it!

Rachel

[Guest DanceswithWolves]

Wow...Rachel...I'm impressed!

That had to be the most well-explained description I ever heard on that topic. Bravo! I can't believe how pricey the test is, though. $1600? Is that the average rate?

[dfish]

Thank you for the nice response! It has been a huge struggle for me to try to figure out what could "kill" me soon if I eat and what's going to "kill" me down the road. I've done so much research on the topic, I seriously thought about going back to school to become an allergist! Might make all this time and effort worth something Anyway, I'm not sure what the "average" rate for skin prick testing is but I have seen in most documents that it is generally between 14 and 1700 dollars. I got the bill for my skin prick tests about three weeks ago and it was 1679.00; that didn't include the doctor's fee. Fortunately, I have excellent insurance that paid for it all, but it won't pay for an ELISA. Gotta love insurance companies!

[Guest DanceswithWolves]

What's interesting is my mother and father show the same symtoms as me...they just don't consider it possible that they have food allergies. We are always yawning...almost all the time. I asked my mother just five minutes ago...did you have bread?

I would love to figure this all out for myslef instead of having a doctor tell me "oh you have allergies to wheat, rye, yeast" or whatever. It would be nice to save all that money. My insurance is already giving me a headache. They claim that I had a pre-exsisting condition so they will not pay for my Gastrologist visit. Ok enough about me...I didn't mean to steal this thread! SORRY!