What your doctor never told you about allergies
Allergies is a common topic that is so complicated, the average person either can’t understand without a biology degree or they don’t care enough to spend the time learning. I am going to try and break it down enough that you can understand what an “allergy” is and know enough of how the immune system works to be able to make changes and informed decisions with regards to your own health.
The basic concept is that there are antibodies (aka immunoglubulins or simply proteins) in your body that are responsible for recognizing other proteins that they encounter in your environment from anything you come in contact with. (air, food, skin, etc.) When one of these antibodies “recognizes” a protein from your environment, the antibody sends an alert to the immune system that there is an invader, and the immune system is supposed to attack that invader and destroy it.
The most common mistake in understanding allergies is that people think there is only one kind of allergy. Most people think that you are “allergic” or not. This could not be more far from the truth. The antibodies I mentioned are what determine whether you are allergic or not and there are actually 5 different types of antibodies. The 5 types are IgA, IgD, IgE, IgG and IgM. Depending on which of the 5 antibodies is triggered, your body will take a different route to destroy the invader. While only an IgE mediated reaction is considered a true allergy, ALL antibodies create inflammation and result in symptoms ranging from headaches to asthma.
The 5 major types of antibodies are as follows:
- IgA antibodies are found in all mucosal areas. These include the gut, brain barrier, respiratory tract and genitourinary tract. Their main function, based on their location is to keep bad things from getting into their respective systems. IgA formation is regulated by Th3 cells. (don’t worry about the Th1, Th2 and Th3 numbers for now) IgAs are associated with arthritis, lupus, celiac disease and any other autoimmune diseases like most forms of thyroid disease in the US. One of the main sensitivities here is wheat.
- IgD antibodies function mainly in immature immune cells (B cells). These B cells are responsible for creating more antibodies, in a way turning up the immune system. Common triggers for IgD antibodies are food dyes. (This is my personal most sensitive reaction, yellow dye #5)
- IgE.THESE ARE THE ANTIBODIES YOU MOST LIKELY KNOW ABOUT. IgE antibodies bind to allergens and trigger mostly a histamine release. This is the typical allergic response, usually causing a severe immediate reaction, even anaphylaxis. This is the most frequent antibody test performed in the form of a skin prick test or blood test. The red skin you see after a skin prick test is primarily due to the histamine release.
- IgG comprise the majority of antibodies. They can make up to 75% of all antibodies in circulation. IgG antibodies have a 21 day half-life. This means that opposed to IgE, they take a longer, slower approach to creating a reaction in the body. They also seem to build up over time rather than creating an immediate histamine reaction. IgGs are also able to cross the placenta, thus provide antibodies to the fetus.
- IgM is an antibody that is activated short term while the other immune antibodies, are activated. It is the first to be produced in the body for new infections or invaders.
While IgE allergies are the most severe and obvious, the other antibodies IgA, IgD, IgG and IgM can cause very similar symptoms, but they develop over time. Many people go to their doctor and get their IgEs checked only to find out they are not “allergic” to anything and dismiss allergies as a cause or even a correlation with their symptoms. This is why there has recently been a strong distinction between allergy and intolerances (aka sensitivities). While IgE testing isn’t necessarily a bad thing, it is not usually necessary because you likely feel bad immediately after ingesting these foods or contacting these substances. They are things that you notice. It is important to remember that IgE testing only rules out 1 of 5 possible immune reactions.
Many food allergies are IgG related. With a half-life of 21 days, this means that if you have an IgG inflammatory response and you stop eating a food for a few days you may not notice a difference although you still may be having a reaction.
So how do you go about finding out what sensitivities you have? There are a few different methods to try, depending on your preference. The first is the elimination diet or a rotation diet. Both are essentially free and easy to do. The next method is to do laboratory testing. After you have done simple IgE testing, testing for IgA and IgGs can give you added information. Lab testing is preferred by many practitioners, but it can get quite pricey. Running full gluten panels (including cross-reactivity) for example can run anywhere between $400 and $2,000 dollars and is not covered by insurance. Some IgAs can be tested more affordably via saliva testing. Diagnos-techs offers saliva testing for gluten, soy, milk and egg proteins, but the test must be ordered by your doctor. A simple warning, most conventional doctors don’t like saliva testing and insurance does not pay for it. The last way to test for intolerances is via neurological muscle testing. This is the method I employ most frequently as it provides immediate information and offers quicker results for most patients. This can be performed in-office.
Some of the most common allergies in children include eggs, milk, peanuts, tree nuts, soy (in formula and foods) and wheat. In adults the allergies can include the same as children but may also include fish, shellfish and solanines (the nightshade/potato/tomato family).
As a last note, non-IgE allergies can be highly affected by the status of your immune system and gut. If your immune system is already too vigilant and an antibody sends a message to attack an invader, then the inflammatory response can be too strong causing widespread pain and inflammation. If you have a “leaky gut,” the common term for what research calls intestinal permeability, you will develop many more intolerances and sensitivities. The leaky gut must be addressed first to stop the various foods from passing through the digestive tract directly into the blood stream. By addressing the gut in when needed, many patients can go from being intolerant to many foods down to only a few.