1. Sensitivity Does Not = Allergy or Intolerance
2. Sensitivities Don’t Just Affect the Gut
3. Additives Can Muddy the Waters
4. Elimination is a Good First Step
5. Test to Liberalize

Have you ever looked at the back of a box of kid’s breakfast cereal? If you have, can you pronounce or understand most of these ingredients? Can you find a packaged product that doesn’t contain wheat, dairy, eggs, soy, or nuts?We have long departed from what is natural or like foods existing in nature. Instead, place our modern diet into an ancient GI environment that sees these Frankenfoods as a foreign invader—no wonder my clinic fills with people with GI distress.Given this modern affront on the gut, let’s explore How to Determine Food Sensitivity. 

How to Determine Food Sensitivity Does Not = Allergy or Intolerance

An important point of differentiation is that of sensitivity versus allergy. Often these terms are used interchangeably, but those of you with allergies will know the difference.To understand the difference between allergies and sensitivity, we need to understand our immune system. When you consume something, it enters the gut and breaks down through chewing and stomach-churning, and enzymes as in the pancreas.Eventually, this foodstuff will arrive in your intestine, where it is in the form of a fundamental building block and absorbed through the lining of your intestine. During this travel, immune cells will interact with your food, sometimes in a friendly fashion, and sometimes your immune system will see your food as a foreign invader.When this happens with a sensitivity, your immune system launches into attack mode via a molecule called immunoglobulin G (IgG). IgG activates a cascade of signals within the cell visa via NF-kappa beta and releases inflammatory molecules termed cytokines (like interleukins and tumor necrosis factor-alpha).Symptoms of Food Sensitivity include:

• Nausea, vomiting
• Diarrhea
• Abdominal pain or cramping
• Bloating and excess gas
• Fatigue
• Brain fog
• Joint pain
• Rashes

As an added point, food intolerances, usually due to digesting the food (such as lactose intolerance), can look similar in terms of symptoms. However, the issue is not primarily an immune reaction but rather problems with digesting the food and usually an interaction between the food gut lining and your microbiome.In the case of allergies, your body will use mast cells, basophils, and eosinophils to release allergy-inducing molecules like histamine and bradykinin via (most of the time) a messenger called immunoglobulin E (IgE).Symptoms of food allergies include the following:

• Itching of the skin or eyes
• Hives
• Shortness of breath, sneezing, coughing, wheezing

Worse yet, your immune system remembers the instigating food item and the next time you interact with the food. You can even have worsening of this interaction and cause an acute allergy response called anaphylaxis.Symptoms of anaphylaxis include:

• Difficulty breathing or tightening of the airway
• Swollen throat or a lump with eating
• Rapid pulse
• Dizziness or feeling faint
• Diffuse reddening of the skin
• Shock or blood pressure collapse

Anaphylaxis is a true medical emergency, and people with prior anaphylaxis should carry medications like epinephrine and Benadryl to counteract this reaction. If you feel this way after eating, seek emergent medical care. 

Sensitivities Don’t Just Affect the Gut

Determining Food Sensitivities are central to the gut but can sometimes cause symptoms outside of the GI tract, like rash, joint pain, fatigue, and brain fog. In the following few paragraphs, we will discuss how interaction with your cheese puff can cause problems with your brain.Most people who experience these sensitivities will have concurrent GI distress, namely:

• Reflux
• Heartburn
• Nausea, vomiting
• Abdominal pain or cramping
• Diarrhea
• Constipation
• Bloating
• Belching
• Flatulence of gas

These interactions occur due to the food interacting with immune cells within your gut and releasing their contents (inflammatory cytokines) within the gut. However, to deliver oxygen-rich nutrients to the bowel and eliminate carbon dioxide from the bowel, your body has blood vessels.As such, these blood vessels can also deliver your irritated immune cells anywhere in the body. They can provide inflammation to your joints, causing pain and swelling. They also can use these inflammatory molecules to push the barrier between your brain and your circulation (aptly named the blood-brain barrier) to leak and allow inflammation into your brain!Such a cascade of events can cause fatigue (inflammation is tiring) and brain fog, often associated with food sensitivity. Therefore, it is essential as a healthcare provider not to poo poo your patient’s symptoms even if they are outside the gut. 

Additives Can Muddy the Waters

I wish that I could tell you that all the symptoms people experience are just from food itself.Unfortunately, much of the “food” people consume is not food at all, but rather a Franken-food composed of molecules that can significantly affect your gut.Food additives supplement previously natural foods, which can add color, taste, texture, or longevity. Additionally, this study in the Annals of Internal Medicine demonstrated striking amounts of microplastic found in human stool. These additives and plastic affect human health via hormone modulation and carcinogen risk and significantly impact the sanctity of the gut barrier and microbiome.In addition to microplastics, one category of additives is emulsifiers like carboxymethylcellulose. Emulsifiers allow two liquids to mix into one steady state.In mice, these compounds can change the gut microbiome toward inflammatory type bacteria, increase the risk of colon cancer, change the nerves and behavior. In addition, human ex vivo models show that you can induce colitis with such compounds.Other than emulsifiers, thickening agents like maltodextrin and synthetic amorphous silica can affect the microbiome and gut permeability. Studies in animals show a reduction in protective mucous, cause inflammation and even shift gut bacteria resulting in Salmonella infection.

Think your safe with non-caloric sweeteners? It turns out that Sucralose, Saccharine, and Aspartame all can alter the gut microbiome resulting in dysbiosis and issues with regulating glucose (which is why the food industry uses them!). Dysbiosis occurs as your gut filters nasty pathogens through the veins that deliver blood to the liver (portal vein) can cause liver inflammation as well. So even natural alternatives to such sweeteners like Stevia can alter the microbiome and your glucose regulation similarly to saccharin.  If you love that ruby red cherry or deep purple grape drink, food coloring can also affect the GI tract.Like the above additives, ingesting food coloring can impair diversity in the gut and positive organisms (Bifidobacterium and Lactobacillus), inducing inflammation and directly reducing the length of your colon cells.   Other than additives and plastics, pesticides can also impact the sanctity of the gut. Aside from their numerous impacts outside of the gut, including neurotoxicity, fetal disruption, and cancer, compounds like organochlorine pesticides can increase Firmicutes and Proteobacteria and decrease Bacteroidetes Verrucomicrobia, Actinobacteria, Candidatus, and Saccharibacteria. Other toxic chemicals like chlorpyrifos can impact the gut via increased permeability of the intestine and impair liver metabolism, thus affecting glucose regulation. Imazalil and nitenpyram can alter the abundance of the gut microbiome by increasing Akkermansia, Fusobacterium, Firmicutes, and Bacteroidetes while lowering Lactobacillus (definitively a good guy). The scariest thing is that maternal exposure to both compounds during gestation can also cause these effects in newborns, which persist after birth. I know this section was dense in biochemical terms and the impact of such products on the gut. However, it is essential to note the difference between food sensitivity and reactions to food additives. Using non-plastic storage containers and vessels and eating natural and free food additives and pesticides can keep your microbiome happy and gut barrier intact. 

Elimination is a Good First Step

Okay, now that we understand the complexity and How to Determine Food Sensitivity, let’s get everyone feeling better. Placing someone on a “diet” adds a certain stigma. It implies that this process is temporary and that it has a specific category of food products to hold up on a pedestal and demonize. I assure you that the Maximal Being Elimination Diet is not that, but rather a lifestyle change.When I started on my health journey as a medical trainee, I was like many, falling prey to the common knowledge of the wellness industry of restricting and black or white, good or bad all or nothing food plans. However, with time, I have cultivated a diet, the means of which I have used for the last 14 years.Most importantly, the elimination diet is good for you, your bank account, and your gut.It is sustainable and not a “diet.”By putting the hard work in initially and using the scientific method, you can achieve a healthy and happy GI tract.The principles are the following:

• Remove common gut-irritating food categories
• Remove additives, pesticides, and dangerous food containers
• Introduce food diversity in color and nutritional benefit
• Introduce foods that can positively impact the gut
• Allow gut adaptation
• Reintroduce foods and test your response
• Add nutraceuticals and botanicals to boost your benefits

Common GI irritants are everywhere in the standard American diet (SAD diet). Such common gut irritants include alcohol, processed foods, gluten (found in wheat, rye, and barley), lactose (milk, cheese, ice cream, yogurt, butter), corn, legumes (beans, peanuts), fructose/sugar, for some soy and eggs. It seems challenging to do, right? However, most packaged foods have one or more of these things, and convention sources of protein will often be fed these things, thus meaning you are eating it. Using a keen sense of skepticism and inquiry will serve you well and keep you on the road to a healthy gut.Not only are the types of food that you remove essential, but also the duration that you do this restriction. Many think that because they avoid lactose for one day, they will feel better or that because people still feel awful after removing lactose that they don’t have lactose tolerance issues. However, the gut is a constantly changing and adapting environment that adapts to your nutrient choices. My rule of thumb is to make changes for six weeks or more.You can still have all veggies, fruits, and non-gluten grains (like quinoa, amaranth, oats, rice). You can also have meat from animals fed foods they are supposed to consume (vegetation). Also essential are healthy vegetable oils and nuts like walnuts, almonds, pecans, etc.A rapid departure from the SAD diet, but trust me, this is a great way to eat.This combination of veggies and clean protein/fats will be used as fuel to heal your gut barrier and shift your microbiome back to the good guys.If these six weeks are extremely tough for you, the next step is to introduce single variable foods like gluten for two weeks, track your response (write it down), and if you tolerate gluten, for instance, you can have gluten in your diet. A single-variable reintroduction is a scientific approach that adds foods that benefit YOU as an individual.For some, the Maximal Being Elimination Diet plan is a grueling six weeks of departure from all that is the norm in the standard American diet (SAD). However, with six weeks of work and a little investigation, you can significantly heal your gut and microbiome. 

Test to Liberalize

How to Determine Food Sensitivity and allergens right out of the gate is to TEST. Again, note that food allergens are IgE and food sensitivity is IgG.Many conventional labs have food sensitivity panels your provider (or Maximal Being) can order for you. A kit will ship to your home, and bingo, you know all of the foods that are no-nos for you.  The obvious downside to this process is cost, usually 200-400 US dollars. However, the benefit is that you do not have to be restrictive from the get-go. I like the Cyrex food sensitivity panel Array 10, 10-90, and 10-90X. If you are interested, click HERE and Enter Shaffer Mok as the provider.   

Summary of How to Determine Food Sensitivity.  

Millions of people experience the brunt of food sensitivities every day through gastrointestinal and non-gastrointestinal symptoms like joint pain and brain fog. So, firstly, differentiate between allergies that are life-threatening and sensitivities that make you feel awful. Next, look at your food for additives, microplastics, and pesticides, and avoid them at all costs. Finally, you can only try the elimination protocol (which we can help you with) or food sensitivity testing and HEAL YOUR GUT. Would you please make sure that you pursue your symptoms with a licensed healthcare provider to ensure you don’t have a life-threatening illness?