Food allergies and sensitivities are quite common in the general population, but they are even more common in those with Adrenal Fatigue.
Adrenal Fatigue and the concurrent suppression of the body’s digestive and immune systems create the perfect environment for the development of food allergies. Adrenal Fatigue may not be the only cause of food allergies, but it is a major one, for sure. Even though the food allergies my patients develop are a result and not the cause of the Adrenal Fatigue, once present, we must deal with them before they become a stressor in and of themselves.
The reason that people with Adrenal Fatigue are especially at risk for developing food allergies and sensitivities over time is that if there is enough chronic stress to weaken the adrenals, then there have been enough stress to adequately suppress the immune system as well as the digestive system. This occurs because these organs are primarily strong and in balance during times of rest. Conversely, during times of stress or fight or flight, when the organs of the sympathetic nervous system are active, the organs of the parasympathetic nervous system are suppressed. As we just discussed, this shift in the immune system leads to increased immune system sampling which leads to an increased potential for mistakes and an increased tendency to antibody production. There is yet another variable that, when thrown into this mix, increases the potential for food allergies even more so…. digestive suppression. This combination of out of balance immune system and suppressed digestive processes is a perfect environment to develop food allergies and sensitivities.
Theoretically, we have ultimate control over what we put on our fork and into our mouths, so this should be one “stress” we do have control over. In a world where it is difficult to control all the various stressors that come up, it is wise to deal with those we can identify and manage.
Symptoms of food allergies
More subtle types of food reactions often do not cause any digestive symptoms at all. While this is rather counter-intuitive, it has repeatedly proven to be true in practice. These “delayed-onset” food reactions take longer, sometimes days, to develop and generate more systemic symptoms than digestive symptoms. This delay makes them much more difficult to identify without more sensitive testing. Some symptoms that can develop from these types of reactions include fatigue, congestion, ear infection, headaches, heartburn, eczema, asthma, joint pain, palpitations, and even blood pressure elevation.
Suppressed digestion from chronic stress leads to low stomach acid production and hence undigested food in the stomach. This undigested food is then, at some point, dumped into the small intestine where it causes irritation to the sensitive digestive lining. These undigested foods will also appear “foreign” to the immune system and hence more likely to be sampled by the immune system. This sampling process discussed earlier, then leads to the increased likelihood of mistakes and then antibody production to the undigested food sampled.
This process is made even worse by the irritation in the lining of the digestive tract that is created by the undigested food. Couple this with the fact that stress hormones deteriorate the protective outer mucin lining in the digestive tract and you create a very vulnerable situation. Combined, this situation creates damage and inflammation that leads to intestinal permeability or “leaky gut.” Leaky gut acts just like it sounds; the lining of the gut becomes permeable to larger bits of protein allowing them to enter the bloodstream. Once these proteins enter the bloodstream, they are even more likely to be identified as foreign by the immune system, leading to further immune sampling and increased antibody production.
“IgE, IgG, or IgA testing? What’s the difference?”
Food allergy management begins with assessment through proper testing. This is a crucial point, as there are several different mechanisms through which we can develop food allergies.
The majority of allergists do not test for food allergies beyond those that cause extreme or anaphylactic reactions. Foods that cause severe anaphylactic reactions are referred to as IgE-mediated allergies. IgE is a specific class of immune molecule or “immunoglobulin.” You have heard of and perhaps know someone who has had an anaphylactic reaction to peanuts, strawberries, or shellfish, for instance. Those reactions are sudden and severe and are commonly identified at a young age.
As it turns out, anaphylactic reactions account for a rather small percentage of the total number of adverse reactions to food that exist. One has to look more deeply into the immune system, especially at IgG or even IgA types of reactions to find the more common and subtle food allergies and sensitivities that plague those with Adrenal Fatigue. Like IgE, IgG and IgA are both a specific class of immune molecules or “immunoglobulins”. IgA is associated with mucosal membranes. IgG is associated with the blood and is said to be the most abundant immunoglobulin. IgG is often tested to identify delayed or “hidden” food allergies or sensitivities.
If there is suspicion of possible food allergies or sensitivities, we will engage in assessment through IgG ELISA testing first, and then work in the direction of healing the digestive and immune system (while healing the Adrenal Fatigue, of course).
What is the treatment?
Treatment involves a combination of elimination and avoidance as well as treatments targeted at healing the gut and calming the immune system. All of this though must be addressed in addition to quieting and healing the stress response system since it is this over-activated system that is “telling” the digestive and immune systems to behave this way.
Once we uncover any hidden or not-so-hidden food allergies in our patients, we can begin the treatment. We start with gentle and progressive elimination, avoidance or restriction of food sensitivities.
Essential to the long-term success of the treatment, as mentioned above, is the healing of the Adrenal Fatigue. The Adrenal Fatigue creates the physiological state that creates food allergies and this must be corrected. It is only as this occurs that any effort targeted at digestive mucosal healing and balancing the immune system can be effective.
I generally recommend avoidance of the offending foods for a temporary time. I tell my patients that even though it’s temporary it is a long temporary. Typically, the avoidance period lasts 6-12 months. During this time, we encourage you to explore options to replace the offending foods and to focus on what you can have, while keeping as much variety in your diet as possible.
The most common question I get: “Why didn’t I test positive through my allergist?”
Assessment of food allergies has proven to be quite confusing for many. To understand this confusion, you have to think back to the variety of immunoglobulins that I discussed previously. Antibodies to foods and the environment are typically found in the IgE, IgG, or IgA subclasses. When a doctor tests for food allergies he has to choose one of the subclasses to test. Traditional allergists only pay attention to and only test for the most severe of allergic reactions, which is an IgE mediated reaction. This means that if you’re reacting with a different class of antibody, like IgG or IgA, and you’ve only been tested for IgE, then you won’t test positive.
The majority of allergists do not feel that reactions on an IgG or IgA level are “clinically significant.” This means that these reactions do not cause significant enough disease to warrant assessment and treatment. My clinical experience is quite different. I have seen many patients experience, not only symptomatic relief from the identification and treatment of IgG-mediated food sensitivities but the relief of a major stressor on their adrenal systems that have enabled them to heal on a deeper level faster than if we had ignored these reactions.
To assess for food allergies we recommend testing for IgG antibodies, although you can test for IgA or IgE as well. I don’t generally test for IgE antibodies because if a person were reacting on this level they generally know, because the symptoms are so severe and often immediate. I generally don’t test for IgA because in my experience when a person is reacting with the IgA antibody, they are also reacting with the IgG antibody. So, it is often unnecessary to test for both. IgG antibody testing is a simple, readily available, cost-effective test that can now even be done in the comfort of your own home with a simple finger-prick.
To be complete, I want to mention another method of assessment of allergies that is somewhat difficult to find anymore, but nonetheless, quite possibly the best testing available today. Formerly known as SET (serial endpoint titration) and referred to now as EPT (evocation, provocation testing), this is a test quite similar in process to the traditional “skin-prick” testing with which you may be familiar. It differs from traditional testing mainly in that this testing is far more sensitive than the traditional test method. Also, the immunotherapy that is done as a treatment based on the results of the testing is much more individualized to the patient, and hence more effective. The challenge with this form of testing is finding a lab or clinic that will still offer it. Some allergists (specifically EENTs) still perform this method of testing. There are also physicians trained by the American Academy of Environmental Medicine (AAEM) that may offer this form of testing as well. We are incredibly fortunate to have just this arrangement with our sister clinic, Woodlands Healing Research Center, and will refer to them when this form of testing is warranted.
Tips for success when eliminating allergic foods
Think about the foods you can eat rather than the ones you can’t. Focus on meats, any meats, fish, veggies, and fruits, and minimal starches like rice, corn, and potato.
Simplify your meals. You do not have to be a professional chef to manage this diet.
Be cautious with gluten-free (GF) options since they are going to be all carb, and thus be converted to sugar quite easily. These are to be reduced to control blood sugar in the hypoglycemic diet.
Throw out the idea of breakfast, lunch, and dinner and just think of these meals as 3 meals per day. You can eat anything at any meal. The only reason that we think of breakfast foods like cereal, toast, yogurt, orange juice, waffles, eggs, etc. is because of marketing and advertising.
Open yourself to the idea that you can eat anything at any time. It takes getting used to, but it helps.