I'm considering MRT testing but can't find anything at pubmed to back it up. What studies show that its effective? I'm deficient in all immunoglobulins so IgE or IgA dependent tests won't work for me.
Thanks
Mike
Is MRT reliable? Where's the evidence?
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Hi Mike,
For someone with selective IgA deficiency, and/or other immunoglobulin irregularities, testing for food sensitivities is much more tenuous. As far as I am aware, the mechanism on which the MRT is based hasn't been independently verified, nor published in any peer-reviewed medical journal. Rather than to spend a lot of time trying to rephrase the information I have on this, I'll just quote my thoughts on MRT from my book (pp 149-150):
Tex
For someone with selective IgA deficiency, and/or other immunoglobulin irregularities, testing for food sensitivities is much more tenuous. As far as I am aware, the mechanism on which the MRT is based hasn't been independently verified, nor published in any peer-reviewed medical journal. Rather than to spend a lot of time trying to rephrase the information I have on this, I'll just quote my thoughts on MRT from my book (pp 149-150):
It's definitely better than trial and error, but according to the experience of the members here, as I mentioned in the quote above, the method is notorious for missing the most significant sensitivities, such as gluten and casein. It's very beneficial for ferreting out the less obvious sensitivities that we sometimes overlook, though. Remember that just because it hasn't been published in a prestigious peer-reviewed medical journal, doesn't mean that it doesn't have merit.Unfortunately, outside of the tests offered by EnteroLab, not many other tests are available that have been shown to be helpful with this disease. Some people find it helpful to order testing such as mediator release testing (MRT) and then they experiment with modifying their diet based on their test results, under the guidance of a dietician who has been certified to work with the program. The dietician will recommend a simple elimination diet followed by a testing program that introduces foods that have been shown by the test results to be non-reactive, or minimally-reactive, one at a time in an attempt to determine tolerance. This is known as the MRT/LEAP program.8
Most people can accomplish the same goal and save the not-insignificant cost of that program if they are willing to carefully follow an elimination diet until they reach remission. Then they can test various foods, one at a time, to determine their suitability. This is best done in conjunction with the use of a food diary where every item ingested is recorded, along with any reactions, symptoms, bowel movements, and general impressions. For someone with MC, foods should be introduced at a rate no faster than approximately one food item every three days or so, in order to allow for the possibility of a delayed reaction.
The primary problems with the MRT program seem to be a lack of specificity and a lack of repeatability. The test does not measure any specific antibodies, nor does it quantify changes in the numbers of any other specific inflammation modulators. Instead, the results are based on an indirect method that is claimed to determine a relative level of sensitivity to various foods and chemicals by measuring an increase in the ratio of liquids to solids in a blood sample that has been exposed to a given allergen.
Regardless of how the test results are determined, and regardless of the details of the actual test results, all foods that are rated as safe in the MRT results still have to be tested in the diet by trial and error to verify tolerance or reactivity. In some instances, the ratings do not necessarily coordinate very well with actual tolerance or intolerance. Also, experience shows that test results can change dramatically from one sample to another, for the same patient, especially if a significant amount of time passes between the occasions when the respective samples are drawn. The test also seems to be notorious for missing various foods that cause gluten-related reactions, such as wheat, rye, and barley. Still, many people find the test and the associated LEAP program to be helpful for ferreting out difficult-to-detect food sensitivities that they haven’t been able to track down by other methods.
Tex
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.
Thanks Tex. That sounds very fair.
I was doing a gluten-dairy free, low fodmap/low fructose diet (just meat, certain veges, butter from grass-fed cows, rice, bananas and boiled sweet potatoes), but haven't noticed a difference. I don't know if:
a) I have to give it more time, because my gut is so messed up (either inflammation, SIBO, leaky gut, dysbiosis)
b) all my supplement pills are causing gut/motility stress (colostrum, VSL#3, Udo's oil, HCL/enzymes, magnesium, hydrolyzed whey, various vitamins/minerals, etc.), or
c) if I'm sensitive to beef, chicken, or sweet potatoes.
getting scoped soon because I'm impatient and willing to go on budesonide short term, while I work out a diet that will work for me.
I was doing a gluten-dairy free, low fodmap/low fructose diet (just meat, certain veges, butter from grass-fed cows, rice, bananas and boiled sweet potatoes), but haven't noticed a difference. I don't know if:
a) I have to give it more time, because my gut is so messed up (either inflammation, SIBO, leaky gut, dysbiosis)
b) all my supplement pills are causing gut/motility stress (colostrum, VSL#3, Udo's oil, HCL/enzymes, magnesium, hydrolyzed whey, various vitamins/minerals, etc.), or
c) if I'm sensitive to beef, chicken, or sweet potatoes.
getting scoped soon because I'm impatient and willing to go on budesonide short term, while I work out a diet that will work for me.
Mike,
It's possible for any of the possibilities you mentioned to prevent achieving remission. The half-lie of anti-gliadin antibodies (gluten antibodies) is 120 days, so it can take a long time for us to stop reacting to gluten after it is removed from the diet. Usually months, and for some of us, a year or more. Younger people heal faster, and those who have less damage usually heal faster. Supplements and prescription medications often contain ingredients that we react to.
You appear to have the right idea with your diet, except that most of us are sensitive to the primary protein in all dairy products, casein. Butter is loaded with casein, and hydrolyzed whey may contain enough residual casein (or something) to cause many/most of us to react. Either of those might be preventing you from getting your symptoms under control. Many of us cannot take any probiotic without reacting, but for those who can tolerate it, VSL#3 is one of the better choices.
Good luck with your treatment program.
Tex
It's possible for any of the possibilities you mentioned to prevent achieving remission. The half-lie of anti-gliadin antibodies (gluten antibodies) is 120 days, so it can take a long time for us to stop reacting to gluten after it is removed from the diet. Usually months, and for some of us, a year or more. Younger people heal faster, and those who have less damage usually heal faster. Supplements and prescription medications often contain ingredients that we react to.
You appear to have the right idea with your diet, except that most of us are sensitive to the primary protein in all dairy products, casein. Butter is loaded with casein, and hydrolyzed whey may contain enough residual casein (or something) to cause many/most of us to react. Either of those might be preventing you from getting your symptoms under control. Many of us cannot take any probiotic without reacting, but for those who can tolerate it, VSL#3 is one of the better choices.
Good luck with your treatment program.
Tex
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.
Hi Mike,
Welcome!
Early on folks seem to do better with coconut oil, extra virgin olive oil, earth balance soy free spread (in margarine section) rather than butter. I'm now ok using ghee (clarified butter)-- that has the casein removed.
Tex is right, I"d eliminate the whey.
Also supplements can be problematic for us particularly early on. Before I was diagnosed and found this site I eliminated all supplements and after 8 weeks was able to get to "softserve". At that point I added back in calcium/magnesium, then about 3 weeks later I added back vitamin D, then about 3 weeks later I added in a B multvitamin. I didn't feel good about eliminating supplements, i.e. felt like I'd get scurvy or something but I'm doing well and have been able to add things back. Make sure your supplements are G, D and S free and don't have a lot of miscellaneous items in them.
Regards, Brandy
Welcome!
Early on folks seem to do better with coconut oil, extra virgin olive oil, earth balance soy free spread (in margarine section) rather than butter. I'm now ok using ghee (clarified butter)-- that has the casein removed.
Tex is right, I"d eliminate the whey.
Also supplements can be problematic for us particularly early on. Before I was diagnosed and found this site I eliminated all supplements and after 8 weeks was able to get to "softserve". At that point I added back in calcium/magnesium, then about 3 weeks later I added back vitamin D, then about 3 weeks later I added in a B multvitamin. I didn't feel good about eliminating supplements, i.e. felt like I'd get scurvy or something but I'm doing well and have been able to add things back. Make sure your supplements are G, D and S free and don't have a lot of miscellaneous items in them.
Regards, Brandy