Food Allergy testing

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(img thanks to commons.wikimedia.org)

The Standard Food Allergy Profile test takes the guesswork out of treating your condition and saves you a great deal of time, effort, and discomfort.

If by chance your test happens to be negative, you can quickly move on to other potential causes of your problem without spending valuable time on an unsuccessful elimination diet and then wondering if you actually did it correctly.

Food allergy testing is a highly specialized procedure performed only by doctors trained in recognizing and treating non-anaphylactic food allergies, and only in laboratories especially equipped to handle the sophisticated testing required.

In order to give you an accurate result, this test must be a blood test, and must include both IgE and IgG antibodies.

If it does not evaluate both antibodies, there is a strong possibility that the testing will miss your food allergy. The procedure is neither complex nor difficult.

This blood test measures reactions to approximately 100 common foods, including dairy, eggs, corn, soy, almonds, peanuts, wheat, seafood, and many others. You are not required to fast or to change your diet in any way prior to blood collection. In fact, it is recommended that you not do so.

(However, steroidal anti-inflammatory medications such as prednisone and corticosteroids may affect the results, so talk to your medical practitioner about these medications prior to testing.)

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Dr. Stephen Wangen of the IBS Treatment Center.
Dr. Stephen Wangen of the IBS Treatment Center.

Reason #1

One major obstacle to figuring out which foods are problematic is that, even on an elimination diet, you may not have truly eliminated all of your allergenic foods.

Assumptions are often made about which foods are allergenic and which foods are not. These assumptions are often wrong. Even on an elimination diet you may still be eating something that will trigger your IBS, even if you are eating foods that you normally don’t eat.

In order to solve your IBS, you may need to stay away from entire food groups, not just one or two foods.

Food groups are much more difficult to avoid than you might think. One in particular that commonly causes problems for IBS sufferers is dairy. But dairy is not just milk.

Dairy includes cheese, butter, sour cream, cream cheese, ice cream, and yogurt. It’s found in many baked goods such as muffins, breads, and cookies, as well as in many cream soups, some salad dressings, and milk chocolate. Coffee and lattes are another common source of dairy. Even margarine contains dairy. The list goes on and on.

Two key components of dairy are whey and casein, which many people cannot tolerate. These are used as additives in a great variety of foods, even those you wouldn’t consider to be dairy foods. Look at the labels on the packaged or processed foods you buy. Even non-dairy coffee creamer contains casein, for instance.

This example demonstrates how complicated it can be to avoid entire food groups in order to assess the dietary trigger of your symptoms. Many other food groups are just as complicated. If you remove only one part of a food group from your diet, you won’t really know if that group actually causes your symptoms. You need a great deal of information about the foods you eat and what they contain in order to understand which foods trigger your symptoms.

Reason #2

Another problem is that you may react to more than one food. In fact, most people with IBS are sensitive to more than one food or food group. You may suspect that your symptoms are caused by a certain food, but find that, even after you eliminate that food, your symptoms remain. This may lead you to mistakenly see the eliminated food as not part of the problem.
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For decades, skin testing has been the standard way to test for allergies.

The potential allergen is injected under or scratched into the skin, and any resulting inflammation (also known as wheal) is measured. The size of the wheal supposedly determines whether or not an allergy is diagnosed. This technique leaves a lot to be desired because we don’t inject food into our skin when we eat, nor do we necessarily get a red bump when we have a food allergy. This is also a subjective test. There is no scientific standard for the amount of swelling required for a positive result.

Equally important, this test can measure only an IgE antibody reaction. And even so, it often is negative, missing elevated IgE levels that are evident with a blood test. The IgG antibody is not tested for at all.

Many people are incorrectly told after skin testing that they do not have a particular food allergy. Others seem to react to everything that is tested.

Skin testing is probably relevant only for life threatening (anaphylactic) types of food allergies, but in these cases the patient often already knows that he or she has the food allergy.

A more accurate way to detect most food allergies is through ELISA (ee-LIE-za) testing of the blood. This test measures the actual amount of both IgE and IgG in the blood. ELISA stands for Enzyme Linked Immunosorbent Assay, a big fancy phrase for a laboratory procedure in which antibodies are detected and measured. This very specialized procedure is performed only by doctors trained in recognizing and treating food allergies. It is run only by specialized labs equipped to handle such sophisticated testing.

QUESTIONS? Feel free to ask in our comments section (below) or contact our office.

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Muscle testing is the act of holding a substance (a food) and then having a practitioner pull down on your outstretched arm to determine your ability to resist their pressure. The theory is that your strength will weaken if the substance does not mesh with your energy field.

This technique was developed by practitioners who could not draw blood nor run other types of testing, but who apparently saw a connection between food and health. There is no scientific reasoning supporting this procedure, and it really is as strange as it sounds. However, many people claim to have been helped through muscle energy testing, and the number of people who practice this type of testing is significant.

If there is something to the theory that your energy is being affected by a particular substance, this methodology is still very dependent on the practitioner (the person pulling on your arm). There may have been a time when this was better than no testing at all and, maybe there is something to the idea that our energy is affected by various substances, but there are now better tools available with which to detect food allergies.

QUESTIONS? Contact our office at the IBS Treatment Center.
COMMENTS? Feel free to add your thoughts below.

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Food allergies and food allergy testing are some of the most misunderstood issues in medicine.

Many people seem to have an opinion about allergies and allergy testing, yet most people don’t understand how different one test is from the next. We have summarized the key strengths and weaknesses of each test so that you can impress your friends and even your doctors with your knowledge. Today we continue with ALCAT testing.

ALCAT and Signet/LEAP/MRT aka LRA or ELISA/ACT

*PLEASE NOTE: ELISA/ACT testing (above), and ELISA testing (following blog article) are not the same thing.

This is a blood test which has been around for quite some time. It is widely marketed and gives the impression that it is highly scientific, but the scientific theory behind it has never been proven.

The theory is that the size of your white blood cells can be affected by the introduction of food into your blood. When this is done in the lab, changes in the size of your white blood cells are hypothesized to represent an immune reaction to the food. That is an interesting hypothesis, but that is all it is. There is no precedent for this type of testing, and the hypothesis has never been proven.

However, that is not the most concerning issue with this type of testing. In both published and clinical reproducibility studies, ALCAT had very poor reproducibility when sent split samples of the same blood.

What this means is that identical samples from the same patient on the same day returned different results.

If you can’t trust the results, then whatever theory being used to support the results is irrelevant. This technology may have potential, but it hasn’t been reached yet.

QUESTIONS? Contact our office at the IBS Treatment Center.
COMMENTS? Feel free to add your thoughts below.


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The immune system functions like a sentinel standing guard against foreign invaders. In the case of an allergy, the invaders are called allergens. The primary weapon that it uses against invaders is the production of antibodies. The antibodies cause reactions that result in the offending allergens being removed from the body. In many people, foods act as allergens rather than nutrition. This can result in the symptoms of IBS.

The immune system produces numerous kinds of antibodies, called immunoglobulins. IgE and IgG are acronyms for the two different kinds of antibodies produced by the immune system in allergic reactions to food.

You might be asking why you need to know this. Conventional allergy testing looks for IgE reactions only.

These types of reactions typically occur immediately after contact with or ingestion of the allergen, and in some cases can cause serious, even fatal, health problems. Potential IgE reactions include swelling of the lips and tongue, hives, bloating, abdominal pain, or sudden diarrhea. These are the reactions that people usually think of when they hear the word allergy. However, IgE reactions can also lead to many other symptoms not traditionally recognized as being caused by food allergies.

The problem with this type of testing is that most food allergies are not IgE reactions, but are rather IgG reactions, which usually show up hours or even days after ingestion of the allergen. They are generally not nearly as dramatic as the more severe IgE reactions, and usually result in “mere” constipation, diarrhea, bloating, gas and abdominal pain. Both antibodies are important, and food allergy testing should include both or the cause of IBS may be missed.

For more information about this subject refer to The Irritable Bowel Syndrome Solution.

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Get Your Lab Results!

(img thanks to wikimedia/creative commons)
(img thanks to wikimedia/creative commons)

Have you ever been to the doctor and had blood taken for laboratory tests?

Do you always get your lab results? Do you even hear back at all from the doctor?

All too often in medicine people have lab tests run and then never learn the outcome of those tests. It’s tempting to assume that no news is good news and therefore everything is normal, but we all know what can happen when you assume things.

You may be surprised to learn that it is quite common for patients to be unaware of positive lab results from tests run by their doctors. This isn’t usually the case with regard to procedures such as colonoscopies, endoscopies, and biopsies, but patients are more likely to be uninformed of the results of blood tests.

One example of this is anemia. Several times per year, while reviewing lab records that patients have brought with them, we will notice the presence of an anemia (iron deficiency) that had not been disclosed to the patient. Upon asking, “Did you know you were anemic?” or “How did you treat your anemia?” they will respond with disbelief, or “What anemia?”

Why does this happen? That is an excellent question.

Maybe it was overlooked. Maybe it wasn’t seen as all that important. Neither answer is acceptable, but unfortunately it is not the standard of practice for all medical professionals to review all lab work with patients. This is the opposite of our standard at the IBS Treatment Center.
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Reason #1

One major obstacle to figuring out which foods are problematic is that, even on an elimination diet, you may not have truly eliminated all of your allergenic foods. Assumptions are often made about which foods are allergenic and which foods are not. These assumptions are often wrong. Even on an elimination diet you may still be eating something that will trigger your IBS, even if you are eating foods that you normally don’t eat.

In order to solve your IBS you may need to stay away from entire food groups, not just one or two foods.

Food groups are much more difficult to avoid than you might think. One food group that commonly causes problems for IBS sufferers is dairy. Dairy is not just milk. Dairy includes cheese, butter, sour cream, cream cheese, ice cream, and yogurt. It’s found in many baked goods such as muffins, breads, and cookies, as well as in many cream soups, some salad dressings, and milk chocolate. Coffee and lattes are another common source of dairy. Even margarine contains dairy. The list goes on and on.

Two key components of dairy are whey and casein, which many people cannot tolerate. These are used as additives in a great variety of foods, even those you wouldn’t consider to be dairy foods. Look at the labels on the packaged or processed foods you buy. Even non-dairy coffee creamer contains casein, for instance.

This example demonstrates how complicated it can be to avoid entire food groups in order to assess the dietary trigger of your symptoms. Many other food groups are just as complicated. If you remove only one part of a food group from your diet, you won’t really know if that group actually causes your symptoms. You need a great deal of information about the foods you eat and what they contain in order to understand which foods trigger your symptoms.

(more…)

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Irritable Bowel Syndrome (IBS) has been conventionally defined not by what it is, but by what it is not.

Successfully discovering the cause of IBS has been impossible, because the cause was thought to be unknown. It’s really been nothing more than a guessing game, and you get to be the guinea pig.

Fortunately that has now all changed.

Now we can define the cause of your IBS, and therefore treat it. IBS symptoms are almost always caused by either food allergies, bacterial imbalances, yeast, or parasites. And there are three tests available for determining the specific foods and spices that you are allergic to.

  1. The Standard Food Allergy Panel (96 foods)
  2. Vegetarian Food Allergy Panel
  3. Herbs & Spices Allergy Panel

 

Today we’re going to highlight what is included in the Herb & Spices Panel.

Foods Included in the 24 Herbs and 24 Spices Additional Food Allergy Panel

Spices: Allspice, Basil, Bay Leaf, Cinnamon, Cloves, Cumin Seed, Curry, Dill, Fennel, Ginger, Horseradish, Marjoram, Mustard, Nutmeg, Oregano, Paprika, Parsley, Pepper (black), Pepper (cayenne), Peppermint, Rosemary, Sage, Thyme, Vanilla Bean

Herbs: Aloe Vera, Angelica sinensis (Dong Quai), Arctostaphylos uva-ursi (Uva ursi), Astragalus membranaceus (Astragalus), Camellia sinensis (Green Tea), Cimicifuga racemosa (Black Cohosh), Dioscorea villosa (Wild Yam), Echinacea augustifolia (Echinacea), Eleutherococcus senticosus (Siberian Ginseng), Glycyrrhiza glabra (Licorice), Grape Seed, Gymnema sylvestre (Gymnema), Hydrastis canadensis (Goldenseal); Hypericum perforatum (St. John’s Wort), Matricaria chamomilla (Chamomile), Plantago ovata (Psyllium), Rosa canina (Rose Hips), Serenoa serrulata (Saw Palmetto), Silybum marianum (Milk Thistle), Spirulina, Taraxacum officinale (Dandelion), Vaccinum myrtillus (Bilberry), Valeriana officinalis (Valerian), Withania somnifera (Ashwaganda)

More information on food allergy detection available here.

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Acne may be one of the most common conditions known to humans. It can be embarrassing, frustrating, and downright unfair.
Fortunately, most of the time, it is also avoidable.

The Traditional View of Acne and Its Treatment 


Most people assume that getting acne is a normal part of life. But why do some people get acne when others do not? And why do certain people have such bad cases of acne? Commercial treatments for acne focus on keeping the skin clean and clearing clogged pores. This sounds reasonable, but again, why do some people have to obsessively clean their skin when others do not? And why do some people cleanse, exfoliate, deep clean and still get acne?



What’s Wrong with this Approach to Acne? 


The real problem with this approach to acne is that acne develops from inside the body, not outside. The skin is an organ, and it is an organ of elimination. We eliminate waste products through our skin, just as we loose minerals when we sweat. 
Too many toxins inside the body can lead to inflammation in the skin resulting in clogged pores and acne. In order to treat the cause of the acne we must first remove the toxins.

Why Do Antibiotics Help, but Only Temporarily?

The inflamed and clogged pores of acne become infected. This is what causes puss. Antibiotics may help treat this infection. Unfortunately, acne comes back when the antibiotics are discontinued because the underlying cause that leads to inflammation and clogged pores, toxins in the body, still exists.
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A recent news article titled, “When it comes to allergies, newer blood tests show that many children are misdiagnosed” explores the accuracy of allergy testing and especially, desensitization. This is predicated on an understanding of allergies as only those reactions that produce the classic allergy symptoms.  While it is important and valuable to enable those who are allergic, and whose reactions are potentially life threatening and immediate, to consume foods common in our society without dying, it is important to remember that this does not end the allergy – it just reduces the severity of the symptoms.

This information is important to you for obvious reasons, but also because only you are ultimately responsible for your health. And as such, it’s important that you educate yourself so that you can look at all of this information on the web in context.

An excerpt from Boston.com:

While it’s a promising start, “we’d like to get better results,” said study coauthor Dr. Wayne Shreffler, director of the food allergy center at Massachusetts General Hospital. More than two-thirds of the children weren’t cured. And 4 of the 40 children who were treated withdrew from the study after experiencing mild allergic reactions such as hives or itchy throat. None had severe reactions, but the study didn’t include anyone who had life-threatening allergic reactions to eggs in the past.

“We still have a lot of unanswered questions about the safety of this technique,” said study coauthor Dr. Marshall Plaut, an allergy research administrator at the National Institute of Allergy and Infectious Diseases. But researchers are pressing ahead, with federal funding, to study the technique for treating peanut allergies, which are more frequently associated with serious allergic reactions. Only 20 percent of children outgrow peanut allergies — compared with 80 percent who outgrow other food allergies.

 

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There have been many studies demonstrating that IgG antibodies to foods indicate an allergy that can produce a wide variety of symptoms, including IBS. (img thanks to leavedebtbehind.com)

Definitions to understand for this study:

Antibody – also known as an immunoglobulin (Ig), is a large Y-shaped protein produced by B-cells that is used by the immune system to identify and neutralize foreign objects such as bacteria and viruses.

Immunoglobulin G (IgG) and Immunoglobulin E (IgE) are both antibody isotypes.
____

The opinion (unsupported by research) of many doctors, particularly allergists, has been that allergies can only be caused by immunoglobulin type E antibodies (IgE).  It has even been stated as commentary in research papers (again, not based on hard evidence) that the presence of IgG antibodies indicates that the patient is tolerant of the food. 

This does not make sense when you consider that  tolerance is when your body makes NO antibodies to the food.  Your body does not waste precious energy and resources making antibodies to things it tolerates. 

There have been many studies demonstrating that IgG antibodies to foods indicate an allergy that can produce a wide variety of symptoms, including IBS.  Now we have a study that shows that IgG antibodies are associated with conventional peanut allergy as well. Again, it’s associated with the peanut allergy – not as a tolerance. 

There are links both on the IBS Treatment Center References page and on the Food Allergy and Intolerance Foundation website.

The study from National Institutes of Health:

Peanut sensitization during the first 5 yr of life is associated with elevated levels of peanut-specific IgG.

BACKGROUND:
Allergen-specific IgE antibodies are implicated in allergic diseases while allergen-specific IgG antibodies have been proposed to prevent allergic reactions. The objective for this study was to study whether the immune response (IgG and IgG4) to peanut differs in IgE-sensitized and non-sensitized young children.

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The Standard Food Allergy Profile test takes the guesswork out of treating your condition and saves you a great deal of time, effort, and discomfort. And if by chance your test happens to be negative, you can quickly move on to other potential causes of your problem without spending valuable time on an unsuccessful elimination diet and then wondering if you actually did it correctly.

Food allergy testing is a highly specialized procedure performed only by doctors trained in recognizing and treating non-anaphylactic food allergies, and only in laboratories especially equipped to handle the sophisticated testing required. In order to give you an accurate result, this test must be a blood test, and must include both IgE and IgG antibodies. If it does not evaluate both antibodies, there is a strong possibility that the testing will miss your food allergy.

Foods Included in the Standard Food Allergy Panel – 96 foods

Dairy: Cow’s milk, whey, casein, mozzarella cheese, cheddar cheese, cottage cheese, yogurt, goat’s milk.

Meat and Poultry: beef, chicken, lamb, pork, chicken, eggs white (chicken), egg yolk (chicken), whole egg (duck), turkey.

Grains: amaranth, barley, buckwheat, corn, gliadin (wheat), gluten (wheat), oat, rice (white), rye, spelt, whole wheat.

Seafoods: lobster, clam, cod, crab, halibut, scallop, salmon, shrimp, red snapper, sole, tuna

Vegetables: avocado, broccoli, beet, bell pepper (green), cabbage (white), carrot, cauliflower, celery, cucumber, garlic, lettuce, mushroom, olive (black), onion (white), potato (white), pumpkin, radish, spinach, sweet potato, tomato, zucchini squash.

Nuts: almond, coconut, hazelnut, peanut, pecan, sesame seed, sunflower seed, walnut

Legumes: green pea, kidney bean, lentil, lima bean, peanut, pinto bean, string bean, soy bean.

Fruits: apple, apricot, banana, blueberry, cherry, grape (red), grapefruit, lemon, orange, papaya, peach, pear, pineapple, plum, raspberry, strawberry.

Miscellaneous: coffee bean, cocoa (chocolate) bean, honey, baker’s yeast, brewer’s yeast, sugar cane.

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We encourage your questions. Keep 'em coming! (image thanks to marsdd.com)

I received this email recently from a patient, prior to his visit to our clinic. In it, he references an AARP bulletin that warns of “medical procedures that you don’t need”. We always appreciate these emails from patients (and potential patients) and I wanted to share it with our readers. Please feel free to comment!

Hello Dr. Wangen –

The following was in AARP Bulletin May 2012, Vol. 53, No. 4. I transcribed this verbatim.
If you have a moment, I’d like to know what your opinion is on this information and if I need to do anything to avoid false positives prior to my visit, if that is even possible?

Thanks,
XXX

————————————————————————

Title of Article: 7 Medical Procedures You Don’t Need

Text:

6. Dubious diagnostic tests for suspected allergies.
American Academy of Allergy, Asthma and Immunology

Some 35 million Americans suffer from seasonal allergies. And millions of Americans increasingly blame a food allergy or sensitivity – from gluten to milk – for their health woes. Some doctors or health workers now perform a blood test, called an IgG, for food allergies. But Linda Cox, M.D., of the allergy academy says the test simply doesn’t work. A positive result in an IgG test is the sign of a normal immune system, not a food allergy. “It leads to a lot of confusion, ” Cox says. If you’ve been eating any kind of food, there’s a good chance you will develop an IgG antibody, she says. “And that has nothing to do with allergy.” For seasonal allergies, many doctors run a battery of blood and skin tests dubbed IgE, when just a few specific tests would do. By asking patients when and where they have symptoms, doctors can pinpoint what tests to run.

Dangers: The superfluous use of medications; an overly restricted, unbalanced diet.

Dear Mr. XXXXXX,

Thanks for writing and expressing your concern.  I certainly understand it.

The problem is this: The AAAAI has redefined allergy to suite their own purposes.  Their new definition (as opposed to the definition that has been in medical dictionaries for years) states that only IgE reactions that produce the typical allergy symptoms (eczema, hives, asthma, itchy eyes, anaphylaxis, etc.) are allergies.  

The text you cite also has statements about IgG reactions that fly in the face of reason and the published research.  Some of these statements are just wrong.  For example: ” Some doctors or health workers now perform a blood test, called an IgG, for food allergies.”  There is no test called an IgG.  There is a test method called enzyme linked immunosorbent assay (ELISA) that has been adapted to detect IgG antibodies in human blood.  Another example: “If you’ve been eating any kind of food, there’s a good chance you will develop an IgG antibody,”.  We have run literally thousands of tests for IgG antibodies.  The vast majority do not show reactions to many of the foods that are most common in the specific patient’s diet.  My own test, for example did not show any reaction to many foods common in my diet, such as eggs, pork, beef, peanuts, etc.  These kinds of statements have no scientific basis.  

First – your body does not randomly make antibodies.  If a substance in your body is not causing a problem your body will not generally make antibodies to it.  However, once the immune system starts to create antibodies to a substance the biochemistry is set – exposure to the substance will result in the antibody binding to the substance, and the cascade of immune response is initiated.  This is not a choice – it is chemistry.  The way in which the immune system manifests the chemical changes that happen when antibodies are binding varies significantly.  But antibodies necessarily initiate this chemical reaction.  Antibodies are made to initiate the immune response.  And they do, because they are chemicals, not intelligent beings.
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Foods Included in the Standard Food Allergy Panel – 96 foods

Dairy: Cow’s milk, whey, casein, mozzarella cheese, cheddar cheese, cottage cheese, yogurt, goat’s milk.

Meat and Poultry: beef, chicken, lamb, pork, chicken, eggs white (chicken), egg yolk (chicken), whole egg (duck), turkey.

Grains: amaranth, barley, buckwheat, corn, gliadin (wheat), gluten (wheat), oat, rice (white), rye, spelt, whole wheat.

Seafoods: lobster, clam, cod, crab, halibut, scallop, salmon, shrimp, red snapper, sole, tuna

Vegetables: avocado, broccoli, beet, bell pepper (green), cabbage (white), carrot, cauliflower, celery, cucumber, garlic, lettuce, mushroom, olive (black), onion (white), potato (white), pumpkin, radish, spinach, sweet potato, tomato, zucchini squash.

Nuts: almond, coconut, hazelnut, peanut, pecan, sesame seed, sunflower seed, walnut

Legumes: green pea, kidney bean, lentil, lima bean, peanut, pinto bean, string bean, soy bean.

Fruits: apple, apricot, banana, blueberry, cherry, grape (red), grapefruit, lemon, orange, papaya, peach, pear, pineapple, plum, raspberry, strawberry.

Miscellaneous: coffee bean, cocoa (chocolate) bean, honey, baker’s yeast, brewer’s yeast, sugar cane.

Foods Included in the 16 ‘Vegetarian’ Additional Food Allergy Panel

Vegetables: Artichoke, Bean Sprout, Eggplant, Chili Pepper, Black Pepper

Grains: Flaxseed, Kamut, Millet, Quinoa, Brown Rice

Legumes/Nuts: Navy Bean, Cashew Nut, Pistachio Nut

Fruits: Cantaloupe, Cherry, Watermelon

Foods Included in the 24 Herbs and 24 Spices Additional Food Allergy Panel

Spices: Allspice, Basil, Bay Leaf, Cinnamon, Cloves, Cumin Seed, Curry, Dill, Fennel, Ginger, Horseradish, Marjoram, Mustard, Nutmeg, Oregano, Paprika, Parsley, Pepper (black), Pepper (cayenne), Peppermint, Rosemary, Sage,Thyme, Vanilla Bean

Herbs: Aloe Vera, Angelica sinensis (Dong Quai), Arctostaphylos uva-ursi (Uva ursi), Astragalus membranaceus (Astragalus), Camellia sinensis (Green Tea), Cimicifuga racemosa (Black Cohosh), Dioscorea villosa (Wild Yam), Echinacea augustifolia (Echinacea), Eleutherococcus senticosus (Siberian Ginseng), Glycyrrhiza glabra (Licorice), Grape Seed, Gymnema sylvestre (Gymnema), Hydrastis canadensis (Goldenseal); Hypericum perforatum (St. John’s Wort), Matricaria chamomilla (Chamomile), Plantago ovata (Psyllium), Rosa canina (Rose Hips), Serenoa serrulata (Saw Palmetto), Silybum marianum (Milk Thistle), Spirulina, Taraxacum officinale (Dandelion), Vaccinum myrtillus (Bilberry), Valeriana officinalis (Valerian), Withania somnifera (Ashwaganda

Information on being tested for food allergies at IBSTreatmentCenter.com

Image thanks to upenn.edu

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