Biting into Food Allergies

JAMA Network’s study results from  2019 estimated that 10.8% of the 40,000 adults who participated in the study have food allergies and another 8% believe they have allergies.  At our functional medicine clinic, we are by no means surprised at this study’s findings, nor the summary conclusion by the authors. On the other hand, while we agree with the findings, we disagree the actions they conclude to be necessary; we disagree with their statement that healthcare providers should extensively test patients and weed out those who are not“really” allergic so they don’t avoid foods unnecessarily (Gupta 2019).

We here address potential food reactions in every one of our patients from the beginning.  We may not test everyone, but we do ask them if they suspect any foods to be contributing to their symptoms.  Many do suspect that they have an allergy or at least wonder about it. Some know for sure, some suspect, and some feel it unlikely.  Regardless, we work through the possibilities and determine if an elimination diet or a food antibody test is warranted.

    We don’t test everyone for several reasons. First, food antibody testing can only be properly applied with medical interpretation. Second, a much less expensive alternative exists: if the patient already suspects a food as a symptom trigger, we simply ask them to avoid that particular food for 4 to 8 weeks and observe the results (an elimination trial).  Third, the test costs money, and we try to allocate patient’s testing expenses to test which will definitely help us in treating the patient. Fourth, some food reactions are not immune related and therefore will not show up on antibody testing. In those cases, we use the tried and true history and elimination trial (i.e. avoid that food for a time period and see what happens).

 Ultimately, I agree thatthe food allergy epidemic is not only large, but also growing and alarming.  Something is triggering this epidemic. The human genome not change quickly enough to explain it. That leads me to my disagreement with their action step conclusion.  

While I do enjoy the times when I can instruct a patient to “add that excluded food back in” after they have avoided for a long time, there is more to patient care than ruling out a reaction.  We should be digging into the cause for such an epidemic. If we have 2 measles cases somewhere, the reaction seems like a national emergency. Our health care system demands an explanation for the “outbreak”.  

We have millions of adults going through life with food allergies, some severe enough to require ER visits.  These reactions can even result in deaths. Most allergies just cause ongoing symptoms, impairing patients in various ways throughout their lives.  Where is the national panic demanding an explanation for these reactions?

At Sanctuary we keep digging in order to get at the root causes of our patient’s suffering, probing for root causes with caution and decisiveness, rather than throwing tests at the wall and hoping some stick.  We often find the root causes behind food allergies. In some cases we uncover leaky gut. In some we find heavy metals. In some we find mold toxicity. For those individuals, we provide answers and a road to healthier more abundant lives. Nevertheless, I still pray we can someday also be a part of solving the greater national problem of food allergies with education and advocacy.  

Article Conclusion

“This data suggests that at least 10.8% (>26 million) of US adults are food allergic, whereas nearly 19% of adults believe that they have a food allergy. Consequently, these findings suggest that it is crucial that adults with suspected food allergy receive appropriateconfirmatory testing and counseling to ensure food is not unnecessarily avoided and quality of life is not unduly impaired.”

Gupta RS, Warren CM, Smith BM, et al. Prevalence and Severity of Food Allergies Among US Adults. JAMA Netw Open. 2019;2(1):e185630. doi:10.1001/jamanetworkopen.2018.5630

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2720064

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