Can you believe it’s October already??? I can’t!! The year has gone by in the blink of an eye and to tell you the truth, I’m tired!! After a very busy spring and summer, I was looking forward to a quieter fall, but that’s not really happening either.
Question of the Month
Finding Relief From The Outside-In
If you’ve ever suffered from an eczema flare, then you’re probably familiar with the burning, itching, crawling sensation on your skin. And, you know how horrible it is!!
Your immediate instinct is to calm what’s happening on the outside… you just want to stop the scratching and bleeding and oozing.
In functional medicine, the goal is always to address the root causes and heal from the inside-out.
But when it comes to eczema… I know you need to have some relief on the outside first so that you can focus on the actual underlying causes— not just the symptoms.
What I’ve seen with skin issues, especially eczema, is that there’s no one-size-fits-all remedy.
Something that really irks me is when you go to message boards and people are like, “Oh, (insert favorite remedy) is my miracle cure….” or “I use dead sea salt baths” or “I use coconut oil” or “I use apple cider vinegar.” Don’t get me wrong, these things are all helpful, but everybody is so highly individualized that it’s hard to say any one thing will work across the board.
Eczema is more specific to the individual than any other condition we treat in our clinic, so we encourage people not to get caught up in other people’s hype. Do the work to heal inside, but in the meantime you can find ways to help soothe the rash.
9 Healing Bath Options
Something I’ve used myself, and have gotten back feedback from patients and colleagues alike is on the benefit of a healing bath. There are lots of different things you can put into a bath, but these are my top 9:
- Magnesium sulfate/Epsom salt. These minerals can be very soothing for an eczema flare for a couple of reasons. Epsom salt helps decrease inflammation which can reduce the swelling of lesions and calm itching. It also has antimicrobial properties keeping your skin free of bacteria.
- Dead Sea Salts. I’ve gotten a lot of positive feedback about this one which is in the mineral category. Dead Sea Salts aid in hydrating dry skin and can provide some itching relief with it’s anti-inflammatory properties. And more than Epsom salt, it’s packed with lots of minerals that help balance pH.
I like to add dead sea salts with baking soda or Epsom salt with baking soda to my bath— usually a cup of each if the itch is bad. You can buy them at any natural food store or on Amazon.
- Borax/Boron. You might be familiar with Borax (sodium tetraborate) as a cleaning agent, but it can also be very soothing for an eczema flare. It helps lower inflammation and can be used to treat infection.
You’re probably starting to see a pattern that most of these have an anti-inflammatory response which helps decrease itching (but it’s all about finding out which ones work best for YOU).
Read here for further information on the many benefits of Borax, because like many of these remedies you can use it for many application.
- Essential Oils. Essential oils (EOs) have a variety of healing benefits, but you have to be very careful because for some people they can incite more of a flare. Even if they’re used in small, diluted quantities in the bath, they still can be a little caustic to the skin.
I tell people to use them very sparingly if you’re going to use them. Tea tree oil or lavender oil are the two that I tend to use most frequently and recommend starting out with.
Of all the EOs, tea tree oil is one of the best for treating eczema symptoms. It has antibacterial components that help fight infection and stop it from spreading. It also has antifungal and anti-inflammatory properties that reduce itching.
Lavender oil can be calming for both your mental and physical state. It helps restore and balance healthy nutrients in the skin which reduces irritation. Bonus- lavender also minimizes the stress that goes along with an eczema flare.
- Sitz Baths, Herbal Blends, and Chamomile Tea bags. If you’ve ever given birth, sitz baths are commonly recommended for their healing properties. I used them after both of my births and they significantly helped with the soothing and healing my skin.
I had an “A-ha” moment with my second baby last year because I’d had an eczema flare because of the hormones during pregnancy. I thought to myself, “Hey, I can probably use this for the eczema too,” so I tried it.
I actually bought Earth Mama Angel Baby (which just recently changed its name just to Earth Mama) since they make pre-made sitz bath pouches. I bought those because, quite frankly, who has the time to make them when you’ve got a new baby or kids or just have a busy life?
I also augmented it with dried chamomile that I got from a natural food store that I put that in cheesecloth or a sock if you don’t have cheesecloth. Soaking with those for about 20 minutes really soothes my skin (and my mind). Chamomile tea bags also work instead of preparing the dried herbs.
Bonus tip— sitz herbs are also recommended for hemorrhoids and diaper rash!
- Colloidal Oats. I put a big asterisk by this one because of the *gluten issue*, but some of my patients have experienced healing benefits from colloidal oats or oatmeal so I didn’t want to exclude it.
Many people with skin and gut issues tend to have problems with gluten internally and sometimes externally. Those with Celiac can get a skin manifestation called dermatitis herpetiformis. I’ve seen people who have not been diagnosed with Celiac, but do have the dermatitis herpetiformis and it’s misdiagnosed as eczema.
Now, the cool thing is, really, it doesn’t matter what you label something on the skin. You’re going to end up treating it essentially the same especially because these are all in the autoimmune realm.
Like I said, I’m really careful when it comes to recommending anything that is grain-based, but this is where bio individuality comes into play. One person’s poison can be another’s medicine. If you’re going to do this, make sure it’s gluten-free. If gluten is an issue for you, and you don’t know it yet, you want to make sure you’re not adding fuel to the fire.
You can read more about the uses and benefits of colloidal oats here.
- Hydrogen Peroxide. Most of us have this under our bathroom sink to clean out cuts or as a natural cleaner. When added to a bath, it helps disinfect eczema sores and promotes new cell growth.
Be sure to use a food grade hydrogen peroxide and add no more than one cup to your bath. I recommend starting off a little slower with maybe ½ cup to see how you tolerate it.
- Baking Soda. This is another household item that has many uses. I buy a giant bag at Costco because of the quantities I use and it’s way more economical. I add this to almost every bath for myself and kids even when I don’t have a flare because of its other benefits.
As I mentioned in #1, combined with Epsom salt it makes for a great detox bath.
- Apple Cider Vinegar. Similar to the previous point, apple cider vinegar is also multifunctional. It has compounds like riboflavin, vitamins, enzymes, and mineral salts which can improve the quality of your skin.
It acts as an astringent and helps remove surface bacteria that shows up when the skin is compromised from a flare.
Experiment with the quantities that work for you, but I would start by adding ½ – 1 cup to your bath.
Many of these are items you likely already have in your home for other reasons, or you’ve built yourself a “natural medicine cabinet.” Start with one ingredient at a time. Go slowly by using ¼- ½ cup with of the powdered ingredients or single drops of essential oils initially, then work up to the full dose you need from there.
If something completely doesn’t work for you, try something else from the list. Remember that it may take some time to see what works for you and dial in your recipe. You can always tweak it once you see what works for you.
Most people will get some type of relief from something on the list, even if it’s only a small amount.
Resist the urge to go hog wild with any of the ingredients because you could end up stoking the flames and adding fuel to the fire. It’s so easy to go overboard when you finally find a remedy that provides some relief. But heed my words… don’t do it!! (I know from personal experience and it was a disaster!)
There’s no one blanket approach to calm an eczema flare which is why I like to suggest a variety of options. All of these are going to provide different healing properties. Some are going to balance the pH while others will have antimicrobial effects, but they’re all going to be anti-inflammatory to some extent.
Have you experimented with any of these healing baths? Let us know in the comments section!
I frequently get asked to do talks on summits, podcasts, and master classes. I often speak about eczema, gut and skin health, and preventing autoimmunity in children. But aside from those, one of the most common topics I’m asked about is how to find an experienced functional medicine practitioner (we covered this a bit on this podcast).
And, I totally get it!!!
Finding a new practitioner can be difficult itself- let alone a well vetted functional medicine practitioner.
This space has blown up in the past three to five years, and it seems a little like the wild west.
Trying to decipher credentials, training, and experience can make your head spin.
I’m fortunate that I know many practitioners, so that if I need help for myself, a family member, or a patient that needs referral, I have a solid base to choose from. However, I’m in the dark as much as the next person when I don’t have a word-of-mouth recommendation or a person to refer to.
Truth be told, I kind of dread it.
Having a checklist of wants and needs can inform the process and make it much less daunting. Hopefully this information will guide you in your process 😊.
What To Look For
- What is their focus/specialty. If you have specific needs such as skin issues, gut issues, or cancer, you probably want to see a specialist rather than a generalist. They typically have experience treating a great number of patients with your concerns and needs which is important.
For example, our practice specializes in eczema and autoimmunity, but at the core of those issues are gut, hormone, and immune system imbalances. Every practitioner within the practice has extensive experience treating all of these areas.
We’re definitely not cancer specialists and would refer you to an appropriate practitioner if that was the reason you reached out to us. We know our strengths and focus on them!
2. Formal Education/Degree. The practitioner’s base education may vary depending upon your needs. If you are first beginning your healing journey and would like assistance with lifestyle coaching or tweaking your diet, then a health coach would likely suit you well. They are trained in walking people through those processes step-by-step.
Sometimes health coaches work alone or as part of a team. We have a few that we work with when we feel somebody needs a little extra help dialing in their diet or lifestyle.
When you have something more significant going on, like eczema, an autoimmune condition or IBS, you’ll likely want to work with a higher-level practitioner that has an advanced degree (preferably one where they’ve learned in physiology, biochemistry, pathology, differential diagnosis, etc.) plus Functional Medicine training. Doctoral, advanced nursing degrees, and physician assistants (MD, DO, DC, ND, DOM, DPT, DNP, APRN, PA etc.) will have the most extensive education with regard to being trained as a healthcare provider.
3. Functional Medicine Training. There are several organizations that train functional medicine providers as certifications or training programs.
These three have been around the longest and offer comprehensive training in Functional Medicine:
- Institute for Functional Medicine
- Functional Medicine University
These organizations teach specific versions of Functional Medicine
- Kalish Institute
- Kresser Institute
Many other organizations offer specialty training in hormones, immune function, environmental medicine, autism, etc. This is all great too! It means your practitioner cares enough to keep pursuing more knowledge to help people heal.
- Bonus Experience. Here is where a little extra digging might help you out. You never know what experiences someone might have that would make them and even better practitioner. Teaching, research, counseling, or even having rescued themselves from the corporate world might be to your benefit. There are many life experiences or jobs that might make a practitioner more well-rounded. One-on-one mentorships with experts are also a bonus.
5. Years Practicing Functional Medicine. This one is pretty obvious :). Experience is important. Ask the practitioner how long they’ve been practicing functional medicine. Really, FIND out how long they’ve been practicing!!! I’ve been burned by referring clients to new practitioners that really didn’t know what they were doing but their website made it seem otherwise.
In our practice, Dr. Tammy and I have over 30 combined years of clinical practice, and over 20 combined years of Functional Medicine practice. We’ve trained with the IFM, Kalish Mentorship, Seeking Health Educational Institute, and 1000’s of hours of continuing education courses and seminars on topics from gut health and autoimmunity, to hormone balancing and environmental toxins. Dr. Tammy also did a hormone mentorship program for several years.
1. Personality. Above all else, and almost as important as experience and training is personality. If the functional medicine practitioner you choose doesn’t resonate with your personality…RUN. You’ll serve yourself best if you find somebody you jive with. Your communications and outcomes will typically be better.
Think about it, would you marry someone you didn’t get along with?? This is an important relationship, much like a marriage.
2. Exploratory Call or Free Consult. This is your golden opportunity to learn more about the practitioners and the practice! You can find answers to the questions laid out above, as well as many other details that important to you. If you call or email a practice and they aren’t willing to give you any information, that might be a red flag. They should be willing to share some information with you.
Many practitioners do anywhere from 10 to 20 minute consults now so that you can see if they are a good fit or you, and likewise, you for them. An honest practitioner will tell you if they can’t help you or if your case doesn’t fit their practice.
We offer free 15-minute consults for this reason (click here if you’re interested).
Pro Tip: Write your list of questions out before you contact any providers you’re interviewing so you can compare all of their answers and find who is best for you.
Wishing you the best of luck on your journey!
Understanding an eczema outbreak is really complex. And like a child learning language, you have to understand the alphabet and sounds first before you can talk. Same goes for eczema.
To really understand an eczema outbreak, you have to first understand the difference between the way functional medicine and conventional medicine views it.
Why Functional Medicine?
Functional medicine (FM) is a “systems” way of thinking. And when we say “systems,” it’s not like conventional medicine that views the body as a group of isolated systems where you have a cardiologist for the heart, an endocrinologist for hormones, etc. In FM, we view the systems, or areas of the body, as operating as a whole response to the environment (kind of like the operating system of a computer).
It makes perfect sense because each area influences the others.
A good analogy to help you understand functional medicine versus conventional medicine is to think about a tree. Visualize the entire tree with its roots, trunk, branches, and leaves. Conventional medicine looks at one branch, whereas functional medicine views all of the branches, trunk, and roots. It’s going to look at the leaves and even further in-depth because we really want to understand what’s going on in the entire person.
When we do this, we take a really detailed history and look for root causes. It’s interesting that we look for root causes and use the tree analogy, because the goal is to find out what is foundationally disrupted in your body to figure out what’s causing the eczema flare.
Conventional medicine really tends to see eczema as something that doesn’t truly have a cause yet. When I was told that I had eczema the doctor said, “You’ve got eczema. There’s no known cure. See you later.” However, in functional medicine—and now even in the medical literature (check it out here)—they’re starting to talk about it as an autoimmune condition and starting to identify some causes of it. And that’s what we’re going to get into here a little bit later.
This is why taking a FM approach to looking at eczema really can help you get down to why things are happening.
The ATM Model
One of the foundational principles of understanding functional medicine is the concept of antecedents, triggers and mediators. We call it the ATM model. These are how a functional medicine practitioner frames an understanding of your entire life history and contributing factors to your condition. We’re looking at all of that to figure out how you got to where you are today.
Let’s start off with the antecedents, which are the predisposing factors. Those are things like genetics and family history, lifestyle, past illness, and exposures (occupational, home, or environmental), and are the underlying or precipitating cause of illness.
A key point regarding genetics and family history is that they aren’t life sentences. A lot of people think, “Oh, there’s cancer in my family. I’m going to get cancer.” That’s not necessarily the case. There are so many modifiable factors here that can prevent you from actually having that illness even though you might be very prone to having it. Great news!!
To recap: Genetics are largely modifiable. NOT your destiny. **Note, in a future post I’ll address genetic concerns such as the filaggrin protein and common SNPs (single nucleotide polymorphisms) that matter to eczema suffers.
Triggers are what provoke the signs and symptoms of illness. Those are along the lines of infections, allergens, toxins, radiation, surgery, social conditions, and things of that nature. They’re going to combine with the antecedents to actually cause more signs and symptoms.
Last, the mediators perpetuate the illness. You can think about these on a biochemical or psychosocial level. Biochemically speaking, the hormones, neurotransmitters, metabolites, free radicals, and inflammatory chemicals are what perpetuate what’s going on. Once you have that genetic factors, plus the triggers, these mediators keep that cycle going. In the case of eczema, it’s going to cause the flare to continue.
The psychosocial factors—stress, thoughts, beliefs, community- are extraordinarily important in this model, but also in eczema. Stress is often the primary trigger and tipping point for most people (***remember stress can be emotional or physiological like trauma or infection…regardless of the source, it causes systemic biochemical changes that are bad if they continue for a prolonged period of time).
Genetics, family history, lifestyle, past illness, and environmental exposures are key antecedents for everyone. For example, if you have certain historical factors like a family history of autoimmunity or allergies, asthma, and eczema (the allergic triad) you’re much more likely to get eczema than the rest of the population.
The most common triggers I see in practice are infections, allergens, toxins, diet, and dysbiosis (an imbalance in the microorganisms in your body—not just in your gut, but all over your body). In eczema, skin dysbiosis can be an important piece of the puzzle too.
The primary mediators of eczema are (without getting too crazy science-y):
- Hormone imbalances (especially from stress and sex hormones). Cortisol, DHEA, estrogen, progesterone, and testosterone imbalances can perpetuate inflammation and make eczema flares worse.
- Depleted Nutrients. In practice it’s usually omega 3 fatty acids, vitamin D, antioxidants such as vitamin C and selenium, and minerals such as zinc and magnesium. Protein malabsorption can be an issue too since you need the amino acids to make collagen and skin tissue.
- Inflammatory chemicals. Histamine, cytokines, and free radicals are major contributors here, though there’s a long list of players in this biochemical pool.
- Impaired liver function. If you’re liver can’t function optimally, you can’t clear metabolic waste, toxins or hormones efficiently which are essential for a healthy gut and skin. This is often one of the key places we address first.
- Leaky gut. This occurs when many of the above factors cause increased intestinal permeability allowing things into the bloodstream (like bacteria, toxins, proteins, etc.) that shouldn’t be there. This causes inflammation and immune system activation driving the eczema cycle.
I find for most of the clients we see in our virtual clinic is that stress is often the most significant factor, either as a trigger or as something that’s perpetuating, or both. We work on addressing it in its many forms, in many different ways.
To recap- if you’re having an eczema flare or a flare-up of any autoimmune condition- you’re looking at: antecedents + the triggers + the mediators= cause of flare.
It’s a cyclical process that self-perpetuates until you identify the triggers and the root causes to stop this cycle. You must eliminate the root cause imbalances such as infections, hormone and nutrient imbalances, allergens, foods, etc., to get this cycle to stop. Then you actually need to take the proper steps to heal it (replacing nutrients, healing leaky gut, balancing hormones, improving liver function, etc.).
Real Life Eczema Example
I’m going to use myself as an example. I’m not necessarily proud of this, but we’re all human 😉
I was driving home from my sister’s this past Halloween. I had just thought to myself that I was so excited because I didn’t have any Halloween candy…. but then I did.
About an hour later, it triggered a flare. And for me, the area where my eczema always, always, always starts is my left wrist and my left hand. They started itching like mad. I was scratching for four hours.
Immediately, I went downstairs and took some anti-inflammatory nutrients because I knew I had to get at that flare before it became a full-blown outbreak. Yes, it is possible to dampen the effect of a flare once you have your eczema under control.
But for me, I had a major flare. My last major flare was 1.5- 2 years ago. I hadn’t had anything go on since then until I was pregnant recently and had a few minor flares (due to hormones) that went away quickly.
Let’s also review my ATM’s.
My major antecedent is the allergic triad in myself and family members. As I mentioned above, the allergic triad is allergies, asthma and eczema. Most of that manifests in childhood, but not always. I only had allergies in childhood. Eczema started in my 30’s! If you have any of those, you’re also going to be more prone to autoimmunity as an adult.
And, eczema often accompanies other autoimmune conditions, not just in and of itself.
So I have 2 of the allergic triad, and a family history of autoimmunity and inflammation conditions. There’s lots of cardiovascular disease and diabetes in my family. Historically, I was bottle fed and was around smokers growing up which are also key antecedents in developing eczema.
My main trigger for this flare was hormone imbalance and dysbiosis that developed during pregnancy. In the gut, when your hormones such as progesterone are high, it slows things down in pregnancy. It sets the stage for things like leaky gut and dysbiosis to occur. This was something that I had experienced quite a bit of during my pregnancy (even though I tried my hardest to prevent it since I know what I know!!).
Diet was also a key trigger (especially the candy). I kept a clean, organic diet for the most part. However, after the birth, my diet has not been quite as tight. I’m gluten-free and try to be in the realm of Paleo/Autoimmune Paleo. But sometimes I have corn or dairy or beans. And those things have crept into my diet more frequently now that I’ve had the baby.
The candy just happened to be the breaking point for me… that little bit put me over the edge!
My primary mediators were hormone and nutrient imbalances from pregnancy and breastfeeding, leaky gut, and STRESS.
I’m going to reiterate stress here… I’ve got a new baby. I’ve got a 5 year old. I’ve got work. I’ve got life. Everybody’s got stress. But I currently feel like I have a lot on my plate. That’s the main mediator perpetuating the cycle for me.
And for me, stress is probably the number one factor that contributes to my flares every single time. When my stress levels get high, I can get a flare super easily. And I know that’s true for many of the people we work with in the clinic as well.
Another less obvious mediator is lack of sleep. Lack of sleep is a major contributor to manifesting any autoimmune condition, especially something like eczema. We heal and regenerate when we sleep. If you’re not sleeping well, it’s not happening.
Lastly, there’s the issue of support and community, or a lack thereof. When you first have a baby, everyone comes and sees you for the first couple of weeks. And then it’s suddenly, it’s gone. This can leave you with a sense of feeling like you’re lacking community or lacking support. I won’t say that I feel that tremendously, but I feel it a little bit.
All of these things added up and resulted in my eczema flare.
If you’re looking for more support in healing your eczema and understanding your root causes, you can always book a free 15-minute consult with our clinic: http://drstephaniedavis.com/consultation/.
Do you know you’re root causes or ATM’s? Leave a comment below if you do!
This article originally appeared on Healevate.
Nothing says good morning quite like pooping into a toilet hat and transferring part of that specimen, using a spoon, into a test tube. While this might sound a little gross on the surface, it can tell you a lot about your health.
The condition of your gut and how well you can absorb, utilize, and eliminate nutrients represents the foundation of health in your body. Digestive symptoms manifest as anything from brain fog, fatigue and acne, to diarrhea, gas, and bloating. The symptoms are vast and can be confusing, so clearly knowing what you’re looking for helps.
Symptoms of Digestive Problems
Understanding your symptoms can be a useful guide for choosing the correct test.
GI: Gas, bloating, belching, stomach pain, constipation, diarrhea, undigested food particles or fat in stool, gurgling in stomach, acid reflux, malabsorption, cankers, altered motility or gastroparesis, and food sensitivities or allergies.
Immune: Allergies, asthma, chronic sinus infections, frequent infections such as urinary tract infections, Candida overgrowth, and autoimmune conditions.
Liver: Poor detoxification, recirculation of toxins and hormones from bacterial deconjugation, increased or decreased bile production, and pain under the lower right ribs.
Skin: Itching, hives, acne, rosacea, rashes, eczema, psoriasis, and dermatitis.
Musculoskeletal: Joint pain, muscle pain, and fibromyalgia.
Brain and Mood: Headache, fatigue, neuropathy, brain fog, inability to focus, irritability, anxiety, depression, ADD/ADHD, lack of coordination or balance, and poor memory.
Hormones: Fatigue, poor temperature control, weight gain or weight loss, poor sleep quality, food cravings, poor blood sugar regulation, and hormone imbalances.
Which Test Do I Choose for Digestive Problems?
Choosing digestive tests can be a daunting task, especially when the symptoms seem to be coming from everywhere in your body. Starting off with the basics and expanding from there is always a good way to proceed when doing any testing.
The first thing to consider is if the symptoms suggest an acute infection, such as parasites or food poisoning. If this is the case, then testing to identify the organism is best. This usually involves a stool test and/or blood testing.
If your symptoms are chronic or more vague, then approaching tests with a broader scope can more easily pinpoint the root causes (there are often many). Dysbiosis, malabsorption, nutrient depletion, and GI dysfunctions like increased or decreased transit time often occur together.
When using this approach, the first goal is to identify and eliminate all pathogens, because if they’re present, you’ll have dysbiosis. Next, identifying the composition of the gut flora and checking immune and gut function will help direct treatment in the healing and rebuilding phases.
Occasionally, things don’t go like you want them to and further testing is warranted. Some companies offer specialty tests for food sensitivities or allergies (like celiac), detoxification, specific toxin testing, and hidden infections. We’ll get to these types of tests later on.
General tests can be completed by lab companies such as LabCorp or Quest, as well as specialty labs:
- Stool testing (1- or 3-day)
- Serum blood testing for infections such as bacteria or yeast
- Antibody or antigen testing for certain bacteria, yeast, or viral infections
Functional tests are more in-depth than standard digestive tests. They’re provided by specialty labs and often require a practitioner to request them for you:
- Organic acids dysbiosis profile
- Comprehensive digestive stool analysis (CDSA)
- Intestinal permeability
- Lactose intolerance breath testing
- SIBO (small intestinal bacterial overgrowth) breath testing
Stool testing is just what it sounds like—an examination of your stool for good and bad organisms, toxins, and the presence of blood.
Typically, stool tests incorporate a stool culture of common bacteria, microscopic analysis for yeast, fungi, parasites, and blood cells, and sometimes testing for toxins that organisms excrete, such as the Shiga toxins (E. coli) or Clostridium difficile toxins A and B.
Additionally, most of the functional/specialty labs do antibody tests for hard-to-identify organisms, such as Giardia lamblia, Cryptosporidium parvum, Entamoeba histolytica, and Helicobacter pylori as a part of their normal stool testing.
One of the big differences is that some labs offer one-day tests while others offer three-day tests. The benefit to three days’ worth of samples is that there’s a greater chance of identifying elusive GI organisms.
That’s not the whole story, though. While most labs rely on traditional methods to identify organisms, some labs offer PCR-based testing, which means they’re using DNA to identify and only require one sample.
Standard stool testing is offered by traditional lab companies. Expanded stool testing is offered by specialty labs such as BioHealth Laboratory, Genova Diagnostics, and Doctor’s Data. DRG Laboratory offers PCR-based stool testing.
Serum Testing for Infections
Serum testing requires a blood draw, and the sample will be used to identify any organisms in your bloodstream. This may happen if you’ve had a systemic illness that may have spread from another area, such as the digestive or urinary tracts.
Bacteria, yeast, and other fungi are often identified in this manner. Yeast is especially important to consider here, because it’s opportunistic and will go beyond the limits of the GI tract in people with compromised immune function or co-infections.
This test is most likely to be conducted through a standard lab, at a hospital, or through your doctor’s office. It’s not something offered through specialty labs.
Antibody or Antigen Testing for Infections
Antibody testing is similar to serum testing in that it offers another means of identifying sometimes hard-to-locate organisms. Antibody testing can be done on blood or stool. When you have an infection, your body mounts an immune attack and creates antibodies against that specific organism’s antigen (the protein your body identifies as foreign).
Antibody tests measure your body’s immune response to an organism. This type of testing lets you know that there was an organism present at some moment in time, but it won’t necessarily tell you if it’s active, since antibodies can remain elevated even after the intruder is eliminated.
Similarly, antigen testing can identify the presence of an organism. Performing a stool antigen test for H. pylori is a preferred method, as it’s less invasive than other methods and is both sensitive and specific for active infection.
Antibody and antigen testing can be run through standard labs, as well as via BioHealth Laboratory, Genova Diagnostics, Doctor’s Data, and DRG Laboratory.
Organic Acids Dysbiosis Profile
Urinary organic acids measure the byproducts of your metabolic processes. Specifically, it’s measuring the metabolites produced by the bacteria and yeast living in your gut. This is a simple and non-invasive test, since it requires only a urine sample.
Intestinal bacterial overgrowth and yeast infections will cause elevated metabolites, and they’re also useful in assessing carbohydrate and protein malabsorption.
Urinary organic acid testing is available through Great Plains Laboratories and Genova Diagnostics.
Comprehensive Digestive Stool Analysis (CDSA)
Comprehensive digestive stool analysis is another way to evaluate the health of the GI tract. Using microbial growth-based cultures, biochemical assays, and microscopic evaluation, this thorough test assesses the status of beneficial and pathogenic microorganisms, including aerobic and anaerobic bacteria, yeast, and parasites. Specific analysis includes:
- Identification of pathogenic bacteria, parasites, and fungi, and levels of beneficial bacteria
- Protein, carbohydrate, and fat absorption via elastase and chymotrypsin levels, as well as the presence of meat and vegetable fibers and fats
- Inflammatory markers including lactoferrin, lysozyme, eosinophil protein x, calprotectin, and the presence of mucus or blood cells
- Immune function via sIgA levels (secretory IgA)
Many of these markers can also be tested as smaller profiles or individual tests. The full test is offered by Genova Diagnostics and Doctor’s Data, while DRG Laboratories can do a pared-down version with their stool PCR testing.
Intestinal Permeability Testing
This test provides a method for verifying the presence of increased intestinal permeability, also called leaky gut. Leaky gut allows food particles, toxins, and products of dysbiosis to enter the bloodstream, where an immune response mounts and inflammation is produced. It’s implicated in many conditions, from IBS to autoimmunity.
One version of the test, the Lactulose-Mannitol test, requires you to drink a solution of the sugars lactulose and mannitol. The degree of permeability is assessed by the amount of sugar recovered in urine.
An updated version of permeability testing called Intestinal Antigenic Permeability Screening assesses IgA, IgM, and IgG antibody reactions to bacterial endotoxins (LPS) that have entered the bloodstream. It also measures the tight junction proteins zonulin and occludin that break down in leaky gut, as well as a cell structure component called actomyosin. This test may more specifically show the route of gut barrier damage.
Genova Diagnostics and Doctor’s Data offer Lactulose-Mannitol testing. Cyrex Labs has the Array 2: Intestinal Antigenic Permeability Screening.
Lactose Intolerance Breath Testing
Lactose intolerance is one of the most common food intolerances in the US. Consumption of dairy that causes gas, bloating, diarrhea, and abdominal pain is an indication for this type of test. Inability to break down the dairy sugar lactose because of a lack of the digestive enzyme lactase or intestinal irritation results in lactose malabsorption and digestive symptoms.
This test requires you to drink a lactose solution and then take breath samples over a period of several hours. It measures the amount of hydrogen and methane produced when undigested and absorbed lactose is fermented by gut bacteria.
Genova Diagnostics offers this test.
SIBO Breath Testing
Small intestinal bacterial overgrowth (SIBO) occurs when large amounts of bacteria are present in the small intestine, where there are normally very few. The small intestine is where absorption largely takes place, so there’s little need of bacteria.
The symptoms are similar to lactose intolerance, because the bacteria are fermenting undigested foods (especially carbohydrates) and producing methane or hydrogen. Bloating, gas, abdominal pain, diarrhea, and constipation are classic symptoms.
During this test, you consume solution of glucose or lactulose, and then breath samples are taken over a period of 2-3 hours. The test measures the amount of hydrogen and methane produced when undigested and unabsorbed lactose is fermented by gut bacteria. High methane is associated with constipation, and high hydrogen levels correlate with diarrhea.
Genova Diagnostic and Commonwealth Labs both offer this test.
There’s certainly no shortage of digestive testing for you to explore. If you don’t get answers from basic tests, perhaps it could be time to consider more functional testing. Many of the tests referenced above can be ordered through Direct Labs, and can shed much light on the root causes of your health symptoms- and like G.I. Joe used to say, knowing is half the battle.
This article originally appeared on Healevate.
If you’re experiencing a variety of health symptoms and have no known food allergies or sensitivities, you might wonder why you’d need to test yourself for them. You may believe that simply cleaning up your diet and eliminating soda, baked goods, sugar, and processed foods is enough. And while that’s certainly a good start, it’s not nearly enough to eliminate the immune and inflammatory processes that food reactions can cause.
Since eating is such an automatic process for most of us, we never stop to consider whether the symptoms we’re experiencing are related to food unless the reaction occurs while we’re actually eating or very soon thereafter.
If you have brain fog, fatigue, congestion, rashes, joint pain, or headaches, there’s a pretty good chance that your body is reacting to something you’re eating.
For many people, food is the most inflammatory substance they encounter on a daily basis. Because we eat multiple times a day, and because we’re creatures of habit, we tend to consume the same things, giving the immune system the opportunity to react.
Symptoms of Food Allergies and Sensitivities
The symptoms of food intolerance can manifest quickly, as with a swollen tongue or anaphylaxis, but quite often the symptoms are delayed. This makes them hard to pick up on, as well as attribute to a certain food.
Immune/inflammation: Allergies, asthma, runny nose, post nasal drip, unresolved infections, autoimmunity, swelling, wheezing, coughing, anaphylaxis, throat closing.
Skin/hair/nails: Dermatitis, eczema, acne, rashes, scaly skin patches, hives, photosensitivity (sun sensitivity), hair loss, nail pitting, dry eyes, skin, and mouth.
Gastrointestinal: Stomach pain, GERD (acid reflux), IBS, gas, bloating, nausea, diarrhea, constipation, gastroparesis (delayed stomach emptying), canker sores.
Brain and mood: Headaches, brain fog, inability to focus or concentrate, double vision, blurred vision, poor memory, depression, anxiety, irritability, fatigue, lethargy, dementia, insomnia.
Nerves: Tingling, pins and needles, numbness, paresthesia.
Hormones: High or low blood sugar, weight gain or loss, excessive sweating.
Musculoskeletal: Joint and muscle pain, muscle weakness, fibromyalgia.
Liver: Poor detoxification, chemical sensitivity.
Cardiovascular: Low blood pressure, rapid heart rate, palpitations.
The First Food Allergy or Sensitivity Test To Perform
The first method of screening isn’t a lab test at all. It’s an elimination diet. Eliminating the most common sources of food intolerances is a great way to find out if you have an issue.
Removing gluten, dairy, corn, soy, eggs, and nuts from your diet for 4 weeks, then adding them back one single food (not food group) at a time over a period of 3 days should tell you whether your body is reacting to something.
If you have a known autoimmune condition, you may also want to include the nightshade vegetables, such as tomatoes, potatoes, sweet and hot peppers, eggplant, and spices made from these, as well as gluten cross-reactive foods like coffee, chocolate, and the gluten-free grains.
If any of the previously mentioned symptoms appear during that 72-hour window, you should avoid that food for at least 6 months to give your immune system a break and let the inflammation go down.
This method can you help you to identify the source of your food troubles, but for some, reactions can occur to even the healthiest foods, such as blueberries or spinach, especially if they have a leaky gut. To further complicate matters, not only do the foods themselves cause a response, but the additives, colorings and gum resins (binders used in gluten-free foods) do as well. This is where testing can be valuable.
Food Allergies vs Food Sensitivities
Food allergies and sensitivities are very different issues. A food allergy occurs when the immune system identifies a food as a foreign substance and attacks it. This response occurs on a spectrum and can be anything from a swollen tongue to anaphylaxis, which is a potentially life-threatening reaction.
Food allergies are tested by measuring antibodies in the blood against particular foods. IgE and IgG are commonly measured. If you have an obvious response to a food, you can confirm it with this type of testing.
Food sensitivities are the more common and elusive form of food intolerance. They’re more vague than allergies and are considered to be any toxic or inflammatory response to food. Quite often they’re mediated by a lack of enzymes, stomach acid, and/or a leaky gut. Celiac disease is a perfect example, where a severe intolerance to gluten causes the destruction of the surface of the small intestine.
Testing for food sensitivities offers a variety of options; antibody and mediator release testing (MRT) are two of the better ones available. No matter what test you choose, be aware that if you have a leaky gut, there’s a good chance you’ll be reacting to many of the foods you eat.
Food Allergy and Sensitivity Tests
There are several types of testing available for identifying food allergies and sensitivities. IgE testing represents the true food allergy test. IgG testing can also identify allergies, but more commonly, it shows delayed sensitivity reactions. The rest of the testing options are for intolerances or sensitivities only.
- IgE antibody test
- IgG and IgA antibody test
- Gluten and gluten cross-reactivity tests
- MRT test
IgE Antibody Testing for Food Allergies
Antibodies are produced when your body mounts an immune attack on a substance it has identified as foreign, which in this case is food. It creates antibodies against specific proteins (antigens) in that food. Antibody tests measure your body’s immune response to a particular substance or organism.
There are several categories of antibodies. IgE antibodies are created when your body has a true allergic response to a substance, which is why traditional food allergy testing analyzes antibody levels in the blood. An IgE allergy is considered a fixed allergy in that it will almost always provoke an immune response when the food is consumed. This type of food allergy elicits an immediate response.
This test can be completed by traditional labs such as LabCorp or Quest, as well as the specialty lab companies Alletess Medical Laboratory and Great Plains Laboratory. IgE testing can easily be ordered online through Direct Labs.
IgG and IgA Antibody Testing for Food Allergies and Sensitivities
In spite of having an allergy, you can still yield a negative IgE test result. This is why it’s important to test IgG levels as well. IgG antibodies measure a delayed hypersensitivity reaction, which can take up to 72 hours to occur. These are the more difficult reactions to link to a particular food, so testing can be helpful here. IgG antibodies are the most prevalent antibodies in systemic circulation and are the most common form of immune-mediated food responses.
While some IgG responses represent true allergies, most are hypersensitivities or intolerances. Similarly, IgA antibodies also represent delayed hypersensitivities. They can take many hours or days to occur and operate in a low-and-slow manner.
Traditional labs such as LabCorp or Quest will offer this test. Genova Diagnostics offers an IgG test. Alletess Medical Laboratory offers stand-alone IgG testing, combined IgG and IgE testing, and IgA testing. Cyrex Laboratories offers the Array 10: Multiple Food Reactivity Screen that measures IgG and IgA levels. The Array 10 tests raw and cooked foods, additives, gum resins, and brewed beverages.
All of these IgG and IgA tests can be ordered online through Direct Labs.
Gluten and Gluten Cross-Reactivity Tests
If you suspect that you’re sensitive to gluten, or even have full-blown celiac disease, testing is an important piece of the puzzle. Gluten testing involves analyzing the IgG and IgA response to various components of the gluten molecule, including several gliadins, glutenins, gluteomorphins (made during the digestion of gliadin), and the intestinal enzyme transglutaminase. It’s important to note that you must consume gluten for this test to be as accurate as possible.
Once you confirm gluten intolerance or celiac disease, completing gluten cross-reactivity testing is helpful, since these foods elicit the same response from the immune system as gluten does. This means that they contain similar protein sequences as the gluten molecule (molecular mimicry). Milk, whey, chocolate, coffee, soy, potatoes, corn, eggs, and most gluten-free grains (including rice) are considered cross-reactive.
Conventional lab companies offer gluten testing and the Array 4: Gluten Associated Cross-Reactive Foods test. This test can be ordered online through Direct Labs.
Mediator Response Test (MRT)
The MRT utilizes different technology than antibody testing. It quantifies the inflammatory response to specific foods and additives. Mediator release refers to the inflammatory chemicals that are liberated from your cells in response to a sensitizing food.
Instead of measuring antibody production, this test measures your white blood cells’ chemical response to a food. It gauges the cells’ change in volume, which comes from the release of inflammatory chemicals such as histamine and cytokines. A non-reactive food will produce no change, while a reactive food will produce an increase or decrease in cell volume.
This is a blood test and is only offered by Oxford BioMedical Technologies.
The Bottom Line on Food Allergy and Sensitivity Tests
Start with the basics and conduct an elimination diet. That alone will give you new information to work with. From there, spend money only on the testing that could reveal new information that would alter your approach to food. If you’re already 100% gluten-free and are avoiding all cross-reactive foods as well, then gluten testing would be a waste of time and money.
So be smart and be proactive. Discovering hidden food allergies or sensitivities could make a huge difference in your day to day health.