What To Do After Food Sensitivity Testing

This is an update to a post I wrote in 2017.  Food sensitivity testing has come a long way since 2017, and so has how I approach the testing results and what to do with the results.  

I recently updated a post I wrote on the difference between different types of food sensitivity testing, which has changed a lot over the years.

I updated that post first because what you do with your food sensitivity results largely depends on the type of testing you did.  Each type of food sensitivity test and the company offering them has pros and cons, from panel size, laboratory techniques, cost, and turnaround time. 

Using Leaky Gut Testing As A Guide For Reintroduction 

First and foremost, I highly highly highly recommend that you do food sensitivity testing in conjunction with leaky gut testing.  

I used to say that if a practitioner hands you a food sensitivity test and tells you just to avoid certain foods with little other advice, they are doing you a disservice.  I still believe that (I don’t say it as often), but for different reasons than I used to.  If you have signs of a leaky gut, we don’t want to start reintroducing foods until we heal the gut. Because if you reintroduce foods while you still have intestinal permeability, you will restart the inflammation process all over again.  

I almost never run any type of food sensitivity test without running a leaky gut test simultaneously now.  If the test shows signs of a leaky gut, then I would encourage them to retest every 3 months and would not recommend introducing foods until there are no signs of a leaky gut.  If the leaky gut gets worse, we may need to do additional testing (more expansive food sensitivity panel, heavy metals, chemicals, microbiome) while you continue to avoid your food sensitivities.  If it improves or disappears, then we can talk about food introduction.  

Basically, think beyond food sensitivities as THE problem and instead a symptom of THE problem.  A leaky gut is THE problem, and food sensitivities develop in conjunction with a leaky gut and then worsen the condition in a vicious feedback loop.  

Should You Retest Your Food Sensitivities Before Introduction?

I am NOT a fan of retesting, except in very rare cases.  For example, my FIL did a food sensitivity test in March of 2020 that he was unable to follow because, well, March of 2020.  Three years later, he was ready to look at his food sensitivities again. We ran a new test.  But in general, I don’t love when practitioners recommend testing, avoiding, and retesting as a way to live.  Instead, you should be monitoring for leaky gut and using that as a guide.  You should only need to retest in very rare situations, such as a worsening leaky gut test eliminating the need for a more expansive food sensitivity panel.  Or, if signs of wheat intolerance show up on a smaller panel, I often recommend running a Cyrex Array 3, which is a very in-depth wheat panel and can catch both celiac and nonceliac gluten sensitivity, which is often more of a permanent need to be gluten-free.  

Therefore, it’s my opinion that you should not need ever retest your food sensitivities except in rare circumstances.   (There are tests I recommend people can do for preventative wellness, such as DNA, GI MAP, and DUTCH tests on a yearly basis, but not food sensitivity testing.) 

Food Avoidance vs. Elimination Diet (LEAP) 

Now that we have that info out of the way. There are two types of ways you can go about handling your food sensitivity results.  In either case, a skilled practitioner will consider aspects of food sensitivity testing such as food family reactions and cross-reactivity potential.  In other words, a skilled practitioner should be able to spot if you have multiple reactions to a food family.  Or multiple reactions to foods that are known to have protein cross-reactivity with each other.  

Food Avoidance: 

Food avoidance is most commonly used for IgG food sensitivity tests. IgG tests look at IgG reactions to various foods.    IgG antibodies have a half-life of 7 to 21 days or 14 days on average.  Because of this long potential half-life, in general, I recommend avoiding low to moderate-level reactions for ninety days and high levels for six months. If you tested negative for leaky gut, then we are monitoring symptoms and/0r blood work (such as autoimmune antibodies, inflammation, etc.) and looking for improvement before reintroduction.  

Two food groups that are difficult for some people to bring back into their diet are gluten and dairy.  Again, if I see a reaction to wheat/gluten on any IgG food panel, I suggest we take a closer look at that to try to determine if they have a permanent need for gluten removal in their diet.  Dairy is a bit more nuanced. It really depends on the individual.

Cons of Food Avoidance Approach:

1.  You don’t account for all the untested foods in the world.  So by just avoiding the foods that show up high, you are still exposing yourself to potentially inflammatory foods that were not tested.  This is why if I’m doing food sensitivity testing, I really try to carefully select the correct panel.  Smaller panels for fewer symptoms, more expansive panels when clients have multiple autoimmune conditions, lots of symptoms, or the budget capability to get a more expansive panel.  
2. Because you are still exposing yourself to potentially inflammatory foods, the inflammation never entirely dissipates.  Because the inflammation never fully dissipates, the immune reaction redirects itself to new foods instead of just calming down.  This will likely cause the need to retest.  (This is most often seen in my clients who avoid gluten and then develop food sensitivities to gluten-free grains such as corn and tapioca.) If you are monitoring for leaky gut, though, the risk of the inflammation never dissipating is minimal. But, if you aren’t monitoring for leaky gut, it’s absolutely possible.  

Pros of the Food Avoidance Approach: 

1. Your diet can be more liberal and enjoyable than the elimination diet approach.  
2. You have the choice of how expansive of a panel you want to run. The more expansive the panel, the more food sensitivities you catch.  

Elimination Approach – The Leap Protocol (Lifestyle Eating and Performance)

Another approach taught to practitioners who use the Oxford MRT Test is a strict elimination diet that progresses in phases.  While they suggest it for the MRT test, you could technically use it for the ALCAT, which is a similar test, or even an IgG test. 

• Phase 1 Limiting to foods that were tested as the lowest reaction/ safe.  This can be around 20-25 foods (including spices and lasts 9-11 days.) 
• Phase 2 Start adding in more safe foods.  
• Phase 3 They start adding in untested foods that are not a part of the food families or chemicals we identified.
• Phase 4 Begin testing medium-level reactions, reintroducing medium-level reactive foods at around 90 days.  
• Phase 5 Around 6 months, we trial the introduction of high-level reactive foods.  

Benefits of Following the LEAP Protocol

1. It’s a highly personalized approach that accounts for all the untested foods in the world. 
2. This approach is a heavy hitter for fighting inflammation. You are limited to so few foods it’s unlikely you miss anything.  Making the need to monitor for leaky gut, much less of an issue, but I would still want to. 

Cons of Following the LEAP Protocol

1. The protocol is brutal and requires you to have total control of every single meal you eat.  No traveling. No sharing meals with family (at least at the beginning.)  It’s pretty intense.  
2. To be very frank, this type of intense approach just isn’t necessary for most clients. And it neglects the possibility that something other than food might be going on, such as gut microbiome imbalances or chemical or mycotoxin exposure.  The majority of people can resolve leaky gut or inflammation issues by looking at gluten and common cross-reactive foods such as AIP foods   

A Note On Polyreactivity 

I can’t times I’ve heard people say. I can only eat like 10 safe foods.  

If that’s true, you likely had a polyreactive food sensitivity test.  A test that shows (regardless of the panel or type of test) reactivity to almost every food on the test.  In this scenario, I immediately would be thinking bigger than the food sensitivity test.  In other words, I would be thinking, how bad is the leaky gut?  What else is causing a heightened immune system response?  Chemicals, gut microbiome, mold, yeast? Something else is going on.  Food is the way you stay alive. There is no way you are actually reacting to every single food on the test.  In that case, it’s a sign that the immune system is in a severely heightened state, and we need to look at what other factors might be causing that.  Please don’t let any practitioner send you away with just 10 safe foods as your permanent way to live.  That’s not addressing the root cause of the problem.  

More information about GI Health and Food Sensitivities:

• What Is Inflammation?
• Why You Need Probiotics for Optimal Health 
• Prebiotics to help retain the probiotics
• Healthy Fats for Digestion
• Food Sensitivity Test Options