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How Accurate Are Food Sensitivity Tests?
By: by Amy Lucas
If, after eating, you’re experiencing digestive trouble or are prone to migraines, headaches, or skin issues, then you may be wondering if food sensitivity could be the culprit. Your research on food intolerance leads you down the path to food sensitivity tests. These tests, however, are not proven and are typically not covered under insurance, potentially draining your bank account of hundreds of dollars. Before you spend your hard-earned money, let’s take a look at the accuracy of food sensitivity tests and see if there’s a more cost-effective way to discover the foods that could be making you sick.
Food Allergies vs. Food Sensitivities
The methods for diagnosing and treating true food allergies vs. food sensitivities are different, and since one is possibly life-threatening it’s important to have an understanding of each.
A food allergy causes your immune system to react to certain food allergens, such as peanuts, soy, or eggs, by releasing immunoglobulin E (IgE) antibodies. Symptoms come on quick:
- Difficulty swallowing or breathing
- Hives
- Rashes
- Nausea and vomiting
- Anaphylaxis
If you think you may be experiencing allergic reactions to a specific type of food, including gluten, a visit to an allergist for allergy testing is in order.
A food sensitivity, or food intolerance, manifests in the digestive system, which takes longer than the immune response to react to trigger foods, and causes:
- Digestive upset (nausea, gas, bloating, constipation, cramping)
- Joint pain
- Skin problems (acne, eczema)
- Headaches and migraines
Food sensitivities occur when your body is unable to properly break down food. A prime example is lactose intolerance. You might be missing the necessary digestive enzymes, or reacting to a specific additive, like sulfites or artificial colors. Your sensitivity might be caused by an intolerance to caffeine or even natural sugars found in foods like onions and Brussel sprouts.
Food Sensitivity Testing and Its Accuracy
Before we delve into the specifics of food sensitivity tests, here are some general considerations to be aware of:
- There is a dearth of evidence validating the accuracy of food sensitivity tests.
- If following a diet based on food sensitivity test results, you can potentially suffer from nutrient deficiencies.
- Discrepancies in lab results abound: most labs draw from raw food extracts, and heating, cooking, and processing food changes the makeup of the antigens.
- These tests can also be administered as home test kits, which may blunt the accuracy.
That being said, let’s take a look at available food sensitivity tests.
Antibody Food Sensitivity Tests
Antibody-based food sensitivity tests check levels of immunoglobulin G (IgG) in response to certain foods. Studies show that when foods are eliminated based on antibody test results there is marked improvement in migraine and IBS symptoms, but researchers caution that more tests are warranted to validate these findings.
There are staunch opponents to antibody food sensitivity tests. These researchers point out that the presence of specific IgG antibodies may indicate protection against food allergies, not evidence of a food sensitivity.
There is also evidence that lab results have a poor duplication rate. If pursuing an IgG test, opt for a blood test that uses side-by-side duplicate testing to ensure more accurate results. Antibody tests can also be done using a skin prick, but the reliability of this method has not been tested.
Cell-Based Food Sensitivity Tests
In the 1950s the cytotoxic test brought cell-based food tests into the limelight. By 1985, this test was banned due to prevalent inaccuracies.
Advances in technology and testing led to the implementation of more accurate cell-based tests: the Antigen Leukocyte Cellular Antibody Test (ALCAT) and the Mediator Release Test (MRT).
ALCAT
The ALCAT was the first cell-based test to emerge on the scene, and is still offered by many healthcare providers and laboratories. It measures changes in the sizes of white blood cells when the collected blood sample is exposed to food antigens. When white blood cells shrink, it’s believed that they release antibodies such as histamine and leukotrienes that bring on food sensitivities.
One study showed that 4 weeks on an elimination diet based on ALCAT results improved IBS symptoms such as stomach pain; however, participants did not report significant improvement in IBS relief or quality of life (1).
MRT
This patented test is considered potentially more accurate than the ALCAT in measuring reactivity because in addition to measuring white blood cell size it measures the ratio of solids (white blood cells) to liquid (plasma) in reaction to food antigens.
Based on these test results, your registered dietitian or healthcare practitioner will develop a LEAP diet, which stands for Lifestyle Eating and Performance and eliminates the foods you are sensitive to. Currently there are no studies on the MRT published in PubMed, the premier source for medical research.
Provocation and Neutralization Test
A rather uncomfortable food sensitivity test, the provocation and neutralization test involves injecting extracts of specific foods underneath the skin of the upper arm. If a wheal (swelling) develops, it signals a food sensitivity reaction.
This reaction is then neutralized with a diluted dose of the antigen. It may take several rounds of neutralization to find the correct dose. Treatment involves regular injections to desensitize yourself to the antigen.
One study indicated that when people were administered injection tests for 5 food antigens, results matched oral challenges in 78% of cases (2).
Muscle Response Food Sensitivity Test
Applied kinesiology, known as muscle strength testing, is considered a pseudoscience and has less validity behind it than other food sensitivity tests.
During a muscle response test you’ll hold a vial of the suspected food antigen in one hand while the practitioner tests the muscle response (or strength of your other arm). If your extended arm can be easily pushed down, then you have a food sensitivity to the particular antigen.
Published studies indicate that muscle strength testing is no more accurate than guessing.
Electrodermal Screening Food Sensitivity Test
Electrodermal food sensitivity screening uses acupuncture points to measure your skin’s electrical response to digitized food antigens. A probe is held in one hand and a second probe containing the digitized frequencies of a specific food is connected to different points on the body. A high electrical reading on the galvanometer indicates a food sensitivity. There are no published studies confirming the accuracy of electrodermal screening for food sensitivity.
The Elimination and Challenge Test: A Budget-Friendly Alternative
As the accuracy of food sensitivity tests are not 100%, many healthcare practitioners recommend a more budget-friendly approach: listening to the cues your body sends in response to different foods. While this approach takes more effort and commitment, it is more effective and precise over the long term.
You can start by keeping a detailed food diary for at least 2 weeks. Record every single ingredient you eat, including the brand of food you eat and the time of day you eat it. Take note of every adverse reaction you experience, even if it’s a quick digestive pain or reaction. Patterns should start to emerge, indicating the ingredients that are triggering food reactions.
From there you can start an elimination and challenge test. You eliminate the foods that exacerbated symptoms for at least 2 weeks. That’s how much time it can take for symptoms to subside and for your body to go through withdrawal.
After 2 weeks of elimination, introduce the oral challenge test. One by one try the foods you’ve eliminated to see which ones trigger your food sensitivity symptoms.
You can also engage the help of a dietitian or health coach to lead you through a customized elimination and challenge test. If you are a DIYer, then you can try popular self-guided elimination diets such as the Whole30 Program.
How to Stay Healthy While Testing for Food Sensitivities
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