Eating certain foods before EnteroLab testing

Discussions can be posted here about stool testing for food sensitivities, as offered by Enterolab.

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JMArnold
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Eating certain foods before EnteroLab testing

Post by JMArnold »

I recently read Tex's book (much kudos-very helpful), and identified that I want to do the EnteroLab testing. I am preparing to do Panels A & C so as to test a wide range of foods. There are a number of items that I rarely eat, but am willing to eat them for now in preparation for the test.

I have been off gluten for a decade, and I won't reintroduce that--back then, I did a SiGA-based saliva test that showed I have anti-gliadin antibodies. But I hardly ever eat soy - I am willing to eat a small amount for now (I avoid primarily because of being hypothyroid-Hashimotos). I only occasionally eat tuna, as I want to avoid the mercury. I rarely eat almonds or walnuts because of the high oxalates. I don't eat oats, but am willing to eat them for now, for the test. Until recently, I was mostly off starches, so I just reintroduced more potatoes, corn, rice within the last month or so.

I emailed the lab and asked: "In preparation for the food sensitivity testing - what quantities of the tested foods need to be included in the diet? For how long prior to the test should I be eating foods that I don't normally eat (or normally only eat very small amounts)?"

Phyllis replied: "Dear Jean, Per Dr. Fine's instructions included in your kit, we ask that you collect your specimen while on your current diet. He prefers that you not reintroduce any foods into the diet that you have already eliminated, as there is no concrete rule as to how long a person must consume a particular food in order to spike an IgA antibody count. Everyone produces IgA at different rates, so it may take weeks for one person and months for another."

Phyllis is saying it can take at least weeks -- if not months -- of eating the test foods, in order to affect IgA levels. I might be willing to eat these foods several times over a couple weeks of preparation, but probably not more than that, unless there were compelling reason to do so. What is the experience of others here in regards to reintroducing foods for a brief time period prior? Have sensitivities still been detected?

I will be doing the blood test for SiGA level prior, because in the past always tested low for secretory IgA in saliva tests.

Thank you,
Jean
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tex
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Post by tex »

Hi Jean,

Welcome to our internet family. Most members don't make any significant changes in their diet before taking a test sample, unless they order a fat malabsorption test. In that situation, if they have been taking a fish oil supplement, they would stop taking it for approximately a week immediately prior to the test. And of course, anyone who has been taking Entocort EC for longer than a few weeks might need to discontinue taking it, since it can suppress antibody levels and confound the test results, especially for individuals who have an above-normal sensitivity to it, and/or those who have initial relatively low antibody levels that barely exceed the minimum threshold required for a positive result. In general, the longer we react, the higher our antibody levels.

Phyllis is quite correct about the length of time required to build up our antibody level to a "new" food that is introduced into our diet. That time varies not only by the individual, but many other factors also influence it. A few years ago I did an oat challenge after avoiding oats for roughly 5 years. Eating gluten-free oats twice a week, it took 6 weeks before I began to react, and then it took another 6 weeks for the D to subside after I cut it back out of my diet.

Dr. Fine's guidelines assume that we are more or less eating our usual/preferred diet when we submit a sample for testing, implying that foods not in the diet would be pretty much irrelevant, anyway. For most people, even if they have been avoiding certain foods, they will almost surely ingest trace amounts of those foods from time to time, and those trace amounts are usually enough to maintain some level of antibody production in our body, if we are sensitive to those foods.

In your current situation, it seems to me that the most expedient way to go about testing would be to take the tests based on your current diet, and if certain foods that are not currently in your diet show negative results, and you would like to add them to your diet later, a simple challenge involving eating that food for 3 days in a row will promptly tell you whether or not that food is safe to add to our diet. But — experiment with adding foods only after you are in stable remission, otherwise your test results could be confounded by other issues.

Thank you for the kind words about the book.

Again, welcome to the board, and please feel free to ask anything.

Tex (Wayne)
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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JMArnold
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Post by JMArnold »

Thank you, that is helpful & interesting. If it is typical that a three-day challenge will yield results, then is your 6-week experiment more unusual?

I am also starting to understand that when something triggers a flare, the flare can last for a good while, as you are describing with the oats. So a current bout of D could have to do with something eaten a while back, rather than the prior day's food choices.
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tex
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Post by tex »

Jean wrote:Thank you, that is helpful & interesting. If it is typical that a three-day challenge will yield results, then is your 6-week experiment more unusual?
Well, yes, but those are 2 totally different situations. The 3-day challenge works for foods that we have been avoiding for only a year or so (or less), while we have been eating a restricted diet in order to reach remission (but we ate them prior to changing our diet as part of our recovery program).

If we have never eaten a food previously, or if we have been totally avoiding a food for 5 or 6 years or more (except for gluten), then the odds are fairly high that we will no longer have any antibodies in circulation connected with that food. In that case we may have to eat the food for an extended period before we build up an antibody level that is sufficient to trigger a reaction.

Even after we totally remove inflammatory foods from our diet, the immune system continues to produce antibodies to inflammatory foods for a few years, just in case any of those foods ever show up again in the diet. But if we totally avoid a food for enough years, any residual antibodies to that food will slowly fade away until eventually none remain in the bloodstream. As long as we have even just a few antibodies to a food remaining in circulation, the immune system is programmed to look out for the food that produces those antibodies, and it will remain on high alert. If those particular antibodies completely disappear from circulation however, if the food is reintroduced later, then the immune system will have to recognize and "relearn" that it is sensitive to that food, and that process usually takes weeks or months, rather than days.

Gluten is an exception because while the half-life of most antibodies caused by food sensitivities is approximately 6 days, the half-life of anti-gliadin antibodies is 120 days. So those antibodies are much, much more persistent in the bloodstream. The alpha gliadin peptide, as you probably know, is the primary peptide in wheat that causes celiac-type reactions to gluten.
Jean wrote:So a current bout of D could have to do with something eaten a while back, rather than the prior day's food choices.
Flares caused by exposure to an inflammatory food can continue for weeks (or longer), but a "new" reaction, or episode, that occurs during remission is almost surely caused by a recent exposure to an antigenic food. IOW, if we are having regular reaction symptoms, with an occasional "good" day thrown in the mix, then a renewal of symptoms the following day is probably due to the same issue that was previously causing symptoms. If we seem to be in remission though, and we suddenly have a relapse, then the relapse is most likely due to food eaten anywhere from a few hours to a few days prior to the reaction.

I hope I haven't just confused the issue with my attempted explanations.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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JMArnold
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Post by JMArnold »

Your explanations were clear for me - I was able to follow what you are saying. Thank you so much!

So the three-day challenge (after avoiding certain foods a good while & achieving improvement) is appropriate:

1. If someone decides not to do the EnteroLab test or the MRT test.

2. If someone wants to test foods that are not included on either test.

Jean
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tex
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Post by tex »

"Yes", to both scenarios. Just be sure to allow a few extra days of recovery time before trying the next food, if you have a reaction to the previous test food.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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