IgG antibody test - worth getting?
#367830 - 07/18/12 09:14 AM
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Hi all,
I recently started seeing an MD who practices integrative medicine.
He wants me to have a comprehensive IgG food panel (for 184 foods) done to test for food sensitivities.
Unfortunately my insurance isn't covering this and it is going to be quite expensive. Also, my GP just told me that he doesn't believe in this test and I've subsequently come across this viewpoint from other sources after doing some research online.
My question is whether anyone on this list has had an IgG test performed and whether the results were helpful in terms of highlighting trigger foods?
Thanks for any feedback!
Chris
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The IgG is popular in the alternative medicine community. Your doctor and your research is correct. The medical community has little faith in the IgG tests. This is likely the reason your insurance will not pay for the test. In summary, there isn't any strong clinical evidence to support the use of IgG test for food allergies or sensitivities. Elimination diets are still the best.
You might find Allergy Diagnostic Testing: An Updated Practice prepared by the The American Academy of Allergy, Asthma and Immunology (AAAAI)and the American College of Allergy, Asthma and Immunology (ACAAI). Here are a few of the quotes:
"Specific IgG/IgG4 results do not correlate with oral food challenges and are not recommended for the diagnosis of food allergy."
"IgG and IgG subclass antibody tests for food allergy do not have clinical relevance, are not validated, lack sufficient quality control, and should not be performed."
"No studies have convincingly demonstrated a relationship between the presence of food specific IgG antibodies and allergic disease"
"IgG antibodies to allergens such as foods can be detected and quantified by Unicap or ELISA techniques. The presence of IgG antibodies, however, does not indicate allergy to these environmental substances. Detection of IgG antibodies, IgG subclasses, or IgG/IgG4 antibody ratios were discredited as reliable diagnostic tools. IgG antibodies to common foods can be detected in health and disease. This reflects the likelihood that circulating immune complexes to foods occur in most normal individuals, particularly after a meal that would be considered a normal physiologic finding. It was therefore concluded that food specific IgG or IgG subclasses should not be used in the diagnostic evaluation of food allergy."
Also the article Testing for IgG4 against foods is not recommended as a diagnostic tool prepared by The European Academy of Allergy and Clinical Immunology maybe of interest too. They say "In conclusion, food-specific IgG4 does not indicate (imminent) food allergy or intolerance, but rather a physiological response of the immune system after exposition to food components. Therefore, testing of IgG4 to foods is considered as irrelevant for the laboratory work-up of food allergy or intolerance and should not be performed in case of food-related complaints."
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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In your view, what is a good food allergy test covered by insurance?
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IgE blood is good for specific kinds of food allergies such as diary proteins, peanuts, etc. Skin prick tests are used some times. I believe the best test for food sensitivity is an elimination diet.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Hi Syl,
Wow, thanks so much for the very useful information! This is going to save me a lot of money.
A couple more questions if you don't mind:
This doctor also ordered a candida profile and a celiac disease profile. The former involves testing for candida immunoglobulins and candida immune complex, while the later entails testing for IgG/IgA to gluten, reticulin antibodies, tissue transglutamionase (tTG) and antibody A.
Would what you said about the IgG test apply to these texts as well? The thing is, I was already tested a couple of years ago for celiac (came back negative), but this particular doctor is insisting that I be tested again from the lab that he uses.
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Because I'm on a tight budget, I'm also realizing that the elimination diet route is the best way to go. However, in the past I've struggled in trying to devise my own elimination diets. In short, I never feel like I reach a stable enough of a baseline to determine whether adding/removing foods has helped.
I've tried eliminating all of the obvious culprits, but with no success. However, one thing I haven't tried is the FODMAPS approach, so I'd like to start there. Can you recommend any good literature about how to actually carry out this elimination diet?
For example, I'm looking for specific recommendations on not just which foods to avoid, but how long to avoid them, how to reintroduce them, etc.
Thanks again for all of the helpful info!
Chris
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Testing for candida overgrowth is another favorite test of alternative medicine practitioners. A link has never been clinically shown between candida overgrowth and IBS. You can read about it in this post.
If your have had a blood tested for celiac disease and it was negative then there is no reason to have the test again. If you wanted to definitively know if you have celiac disease then ask your GP or GI doctor about an endoscopy which is the gold standard method for determining if you have celiac disease.
You can read about the FODMAP approach in the first link in my signature. Or you might get Patsy Catsos's book IBS-Free at Last! Second Edition.
The best approach is to blend Heather's diet with the FODMAP diet which does not deal with triggers like caffeine, fat, alcohol, insoluble fiber, etc which Heather's deals with exceptionally well.
With the FODMAP approach if you find a food category that is a problem you don't usually reintroduce it you eliminate it or eat it in very small amounts 
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Thanks so much for the info!
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One more question:
What's your take on the lactulose hydrogen breath test (as a way of diagnosing small intestinal bacterial overgrowth)? And how about the h.pylori test?
Do you feel that these are legitimate tests that would allow me to potentially hone in on what is causing my symptoms and/or give me helpful info. for conducting an elimination diet?
Thanks!
Chris
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The h.pylori test is a legitimate test if given by a certified lab. This test is specific test for ulcer causing bacteria. Your GP should be able to it request it if deemed necessary and it will likely be covered by insurance.
I believe lactulose has been replace with glucose in the hydrogen breath test for the SIBO. The lactulose test gave too many false positive results. Again it is likely covered by insurance if you GP or GI doctor requests it.
Neither of these tests will help with an elimination diet. And the role of SIBO in IBS is still controversial. In the US is treatment for SIBO is a prescription of non-absorbable antibiotics.
--------------------
STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Thanks Syl.
I'll probably just jump straight into the elimination. I've never been able to have my symptoms resolve by just eliminating a short list of food or a certain food group. The only major relief I get from my symptoms is to eat an extremely restricted diet. So I'll probably start there and then gradually do the food challenges.
As mentioned, I've never been successful in doing this before. I came to the conclusion that my dimensioned symptoms were probably just a matter of eating overall much less usual. And the problems came back when I simply started eating more.
Anyway, it's worth another try.
Chris
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