Naturopath in Burnaby and Virtual Care Across BC | Dr. Mélanie DesChâtelets, ND

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Food sensitivity, food allergy or food intolerance? Is it making you sick?

Food sensitivity, food allergy and food intolerance are often used interchangeably.  Should they be?  I’d like to suggest that they are very distinct and deserve to be addressed as such.  In addition, once you realize the simplicity of their differences you’ll have a significantly better understanding of the processes that are affecting you.  In order to clarify these differences let’s first review some  basic definitions used to describe some of the functions of the immune and digestive system.

Antibodies: It is a large Y-shaped protein produced by the immune system.  Its job is to recognize foreign protein and then neutralize it.  It’s what happens when you get a cold, the bacteria or virus is recognized and then neutralized by antibodies.

Enzymes:  In simple terms enzymes help breakdown things.  The important thing to note is that enzymes are very specific for what they break down. Therefore, your body has thousands of different enzymes in your body to efficiently break down very specific compounds.  Without the enzyme the process may not occur at all or at a very reduced rate. In the digestive system, enzymes help break down food into smaller units.

Both food allergy and food sensitivity are antibody mediated reactions against food.  The antibody recognizes a food protein as harmful and tries to neutralize it.  If this is similar then what is different?

We have different types of antibodies in our body.  Different types of antibodies react differently to neutralize the foreign invader.

Food allergy

Food allergy is mediated by an antibody called IgE.  When this type of antibody reacts with a foreign protein it immediately elicits some of of the following typical reactions.  Food allergy reactions can vary from uncomfortable to life threatening.  Skin irritation, redness, swelling are often seen.  Difficulty breathing can be ominous and represents tightening of the air passageway.  Other symptoms such as hoarseness of voice, stuffy and runny nose, itchy and red eyes as well as nausea and vomiting can been seen with food allergies.

Food sensitivity

Food sensitivity is mediated by an antibody called IgG.  IgG antibodies react very differently from IgE.  In food sensitivities, when IgG antibody react with a foreign protein, it elicits a milder, slower and non typical reaction.  The reactions vary from migraines, to increased behavioural difficulties in children with ADHD, to chronic digestive concerns, decreases in energy and other vague symptoms.  Here’s the killer news.  Unlike a food allergy, food sensitivities are very hard to diagnose.  This is because their impacts can be seen 24 to 48 hours after the ingestion of the offending food.  There are two ways that can help identify food sensitivities one is a strategic hypoallergenic diet.  The other is an IgG food sensitivity blood test.  This tests how reactive your IgG antibodies are against various foods.  The higher the reactivity the higher likelihood a food sensitivity might be present.  This test isn’t perfect but can really be a good starting point in assessing potential food sensitivity.

Food allergy & Food sensitivity:  How they react differently.  

Here’s a diagram to simplify their difference.  Imagine the pink line represents the symptom threshold- when you cross this line you have symptoms.  The star represents the ingestion of the allergic food item.

Food allergy and IgE

With a food allergy, as soon as the offending food is ingested the IgE levels rise and react quickly.  The allergic symptom threshold is always reached. Avoidance of this offending food is necessary as it can be life threatening.  The levels of IgE will also drop relatively quickly and within  5-7 days you typically no longer have any symptoms.

Food sensitivity and IgG 

With food sensitivity, the offending food is ingested and the IgG antibody levels rise slowly and linger around for up to 3 weeks.  This is what makes a food sensitivity so hard to diagnose.  You first ingest the offending food sensitivity and you are symptom free.  This is because you are still far from your symptomatic threshold.  In a few days, you ingest this same food item and again no symptoms.  What you don’t know is that your IgG antibody levels have accumulated with those of your last exposure.  Third time is a charm,  you ingest the food sensitivity and this time you get “fill in the symptom blank”: a migraine, constipation, weight gain, water retention, dermatological outbreak, general fatigue etc.  Please note in this example I used 3 days but this is for illustrative purposes and is not literal.   It’s confusing.   The symptoms don’t appear immediately, it is hard to link exposure to symptoms and you are left non strategically removing and adding foods hoping something will change.  This can be a frustrating way to figure things out.  Unlike an IgE food allergy were every single exposure is followed by symptoms, IgG food sensitivities depends on frequency and dose of the exposure.

Food intolerance

Food intolerance represent an enzyme deficiency.  Our body can’t break it down and it typically causes digestive concerns.  The most infamous example is that of a lactase enzyme deficiency.  This enzyme is important in breaking down lactose found in dairy products.  The lack of this enzymes results in gas, diarrhea and discomfort.

I work with many individuals strategically to figure out potential food sensitivity reactions.  The goal isn’t to eliminate a food for the rest of your life although significant avoidance for a period of time is sometimes necessary.  Following the 4R GI restoration program we can in most cases improve the integrity of the gut lining so that you can once again tolerate the offending food.  The reality is when you figure out what’s bugging you and you understand the symptoms it generously provides it makes avoiding it much easier.

PS:  If you learned a thing or two please share this article via facebook, retweet, or google+ it. If you would like future articles delivered into your email box sign up for email updates on your right.

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What does choosing a dog and choosing a probiotic have in common?

In the last few decades, research on probiotics has grown exponentially. Our understanding of how they can influence our gut health as well as how they influence seemingly unrelated systems such as the immune system has been greatly refined. Unfortunately, as research creates buzz, so does the marketing world and our shelves are popping up with probiotic labels everywhere. Now, we have a dilemma- how to decide which probiotics give you the bang for your buck. This current article builds on my last article explaining some of the research and the benefits of probiotics. If you haven’t read it you can check it out here.
Are all probiotics created equal?

Saying I take probiotics is as vague as saying I take vitamins. Just as different vitamins play differing roles in the body, we also know that different probiotics with different genus, species and strains do not have the same effects.
If you currently take probiotics take a look at the label now.

What do you see? Can you find the Genus, species and strain of the probiotic?

Some of the lower quality probiotics only specify the genus and species and not the strain. This is because identifying strains take an additional level of evaluation. This step however is proving to be extremely important as we are learning that probiotics with the same genus and species but different strain can play different roles in your health and do not all confer the same benefits.

To conceptualize, consider that all dogs have the same genus and species- Canis lupus. Within this genus and species we have various types of dog breeds. Visually it is evident that different breeds have very different characteristics. For example, some are great hunter dogs others are better sled dogs while some are hypoallergenic dogs. Having a probiotic that doesn’t specify strain is like looking for a hunting dog but blindly buying a dog without knowing the breed.

If you own a dog you very likely chose a specific breed of dog to suit your lifestyle. In the same way, there may be a specific probiotic strain that is indicated for the outcome you are looking for.

Take home message: Top 5 things to know before choosing your probiotic

1. Know your probiotic strain

Look for a known probiotic strain that has been tested in humans and known to confer the specific outcome you are looking for.

2. Know the colony forming unit (CFU)

CFU indicates the amount of live microbes in the supplement. Recommending a dose is very difficult as it depends on the probiotic strain and the outcome you are looking for. Doses range from 50 million to 1 trillion CFU a day.

3. Know the probiotic strain’s tolerability to digestion.

Digestion provides a rough journey for some of these living microbes. Some strains are tough naturally and others aren’t. Has the strain you are taking been studied to assess its tolerability to the gastric acid of your stomach, the bile salts of your gallbladder and the digestives enzymes of your pancreas? Some strains are tolerant; some are not. The ones that aren’t need to be formulated in capsule that will only dissolve in the lower gastrointestinal track.

4. Know your manufacturer: 3 questions to ask.

Does this manufacturer ensure that strain-identification has been done, a process that ensures you have the strain of probiotic you are looking for?  Is the manufacturer diligent about the entire process ensuring that if a probiotic needs to be refrigerated it is from the moment it leaves their hands, through shipment and until the time it gets to your home?  Have they studied the probiotic to ensure it has a stable shelf life until expiry?

5. Are you having a double rainbow “what does it mean” moment?

I know, I’m sorry but it was a bit of the point of this article. I see so many patients taking probiotics but they have no idea what strain or for what outcome. Next time you see the word probiotic I hope you can see through some of the hype of what might be good marketing versus some of the benefits the best of science has to offer today. For overall intestinal and systemic health, the most basic recommendation in adults would be the periodic use of 15-30 billion of Lactobacillus acidophilus NCFM® (talk to your primary care giver). This strain was first isolated from the human gut and has been well researched. It is known to have digestive tolerability and been shown to adhere to the human intestinal wall. It is one of the most common probiotics in the gut and one with a very good safety record. There are over 6o studies on this specific strain demonstrating various beneficial outcomes for certain conditions.
Are you looking for specific outcomes, do you have irritable bowel syndrome or disease? If so, talking to someone who is well versed in the different strains of probiotics can get you inline with the research ensuring it has the best chance at improving the outcomes you are looking for.
If you would like more info, the International Scientific Association for Probiotics and Prebiotics (ISAPP) has been created to demystify some of complexities of this ever growing and expanding body of research. Hope you’ll have a more critical eye next time you see the word probiotic.

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The scoop about your poop

Imagine the euphoria of observing a beautiful brown foot long sinker with all its majestic substance contrasting the beautiful white backdrop of the porcelain bowl.  The pursuit of the perfect poop is not always an easy one but is certainly one worth the mighty effort.

I am here today to start a poop movement!  The topic of poop needs to move from the nuisances of our lives to a front row Hollywood show.  Poops everywhere are here to speak up.  They have been trying to tell you something for years but have you been listening?

Let’s open the bathroom doors and liberate the knowledge of learning a new language: poop reading.

Brown poop. Yes that is normal.  Big surprise!  Ever wonder about these others colours?

Black poop may be a red flag!  When you have a digestive bleed originating in the stomach or esophagus it mixes with the acid of the stomach to make tarry black stools.  Other less worrisome causes are iron supplements and bismuth compounds such as pepto bismol.

Red poop may be a red flag!  When you have a digestive bleed originating below the stomach it will be red.  This can be a sign of colon cancer and thus should be taken with a great level of attention!  Irritable bowel diseases are also associated with bloody stools as are fissures or  hemorrhoids- you should be checked out.  The only time you can take a deep breath and relax about it is if you consumed some red beats!  Beats have a magical way of making your poop a colourful experience.  If this is the case enjoy the show.

White/Gray poop can be a sign of a bile duct blockage or liver disease.  This is also not a colour to kid about.

Green poop can be OK or a pain in the butt.  Don’t worry you will know the difference.  Fever, abdominal pain and some diarrhea likely infectious in nature.  I feel great but my poop is a tinge green?  That’s great you are probably consuming quite a bit of spinach.  As long as it’s digested there’s no need to worry.  If it’s not digested then you may benefit from a little naturopathic digestive tune-up.

Yellow poop can be a sign of pancreatic disease.  The pancreas produces enzymes critical for the proper digestion of fat.  Sub-par functioning of the pancreas can lead to yellow poop.

Floaters- once in a while floaters are no big deal.  Fat in the stool or gas can give your stool that little extra buoyancy.  Nonetheless,  if this is a consistent occurrence it can be a sign of chronic pancreatic insufficiency which means not enough enzymes are produced to break down the fat.

Sinkers– Yay, woohoo, great job!  Keep it up!

Marble poop is due to poop glue deficiency! Poop glue?!?!  Well when you ingest fiber it is fermented by bacteria that reside in your colon and it produces beautiful poop glue and lubrication.  This keeps poop from breaking into pieces.  For a lubricated and bulkier experience increase your dietary sources of fiber and water.

Soft poop not yet diarrhea but certainly not the hulk of poops either.  This tends to be indicative of malabsorption.  Some of the most common offenders are due to fructose, sorbitol, lactose in dairy, gluten in wheat or even more generalized food sensitivities.  Removing the offending culprit is key.

Thin and windy poop may be a red flag!  Progressively narrowing stool can be indicative of colon cancer!  It may also be a simple sign of excessive straining.  Go ahead relax and enjoy your poop experience- let it fall out instead of pushing it out.

Poop jam the most common cause is a simple case of dietary fiber and water “under consumption”.  If that doesn’t do the trick, perhaps a hypoallergenic diet should be considered.

Diarrhea can be caused by a GI infection, malabsorption or food sensitivity.

Our poop is a great indicator to the health of our digestive system.  Our digestive system is one of the most fundamental systems to our health, influencing seemingly unrelated systems such as the immune system, respiratory health, skin health and joint health.  Just remember we are giant walking tubes from our mouth to our anus.  The digestive track is a major system in which we interact with the outside world.  It’s important we have it working as best we can!  I wish you daily successes along your pursuit of perfect poos.