Why Food Intolerance Testing Doesn’t Work

allergytestingIf Only It Were Easy

Let’s face it: the Paleo Autoimmune Protocol is hard to do. If we could just take a test to identify our food intolerances, it would be so much easier! So, why don’t we? Unfortunately, food intolerance testing is unreliable, giving both false positive and false negative results. An elimination diet (like the AIP) is the only accurate way to test for food intolerance. It’s called the Gold Standard. This is actually one area where conventional doctors and Paleo practitioners agree.

Food Allergies vs. Food Intolerances

Food allergies are severe reactions that can even be life-threatening, sending someone to the hospital because they can’t breathe. You may know a child who has this reaction to peanuts. It’s frightening. There are two tests performed by allergists to diagnose food allergies: IgE blood test, and a skin test, both of which have proven scientific validity. Even so, allergists usually perform a food challenge in the office to confirm the diagnosis. Since allergic responses are fast and furious, the doctor is there to monitor the reaction.

Food intolerances are a different matter. They are milder, but have a cumulative effect of provoking the immune system and increasing inflammation in the body. If you have autoimmune disease, food intolerances exacerbate your symptoms, making them much worse. While there are tests sold to identify food intolerances, they haven’t held up under scientific scrutiny. And because food intolerance reactions are delayed, taking up to 72 hours to appear, a food challenge in a doctor’s office isn’t possible. Instead, an elimination diet (like the AIP) is the recommended route to diagnosis.

A Scientific Look at the Tests

ELISA and ALCAT are both blood tests that claim to identify food intolerances. They look at how your blood responds when exposed to a specific food. ELISA measures IgG antibody reactions. ALCAT measures white blood cell reactions. These sound like plausible theories, right? Antibodies and white blood cells are part of your immune system. If your immune system reacts to a food, that would obviously signify intolerance. Not so fast! The immune system is complex; if it wasn’t we’d have a cure for autoimmunity by now. It turns out that some studies show that an IgG response to a food actually indicates tolerance. And white blood cells constantly change shape and activity anyway, so if they do that in the presence of a food, that doesn’t mean the food was the trigger. Not surprisingly, both tests are notorious for inconsistent results. According to Chris Kresser, some doctors have sent in two blood samples for testing from the same person at the same time on the same day, and received different intolerance reports. That’s why allergists around the world recommend against these tests and recommend an elimination diet like the AIP instead. Here’s a thorough report summarizing the research which has shown these tests are inaccurate.

Elimination-Provocation: The Gold Standard for Testing Food Intolerance

If an elimination diet is the only way to accurately test food intolerance, how does it work? There are two phases: the elimination period (strict AIP) and the reintroduction period (also called provocation.) You follow a strict AIP diet for a minimum of 30 days (some people wait 3-12 months) until you see clear improvement in your autoimmune symptoms. This shows that healing has begun, and you can reintroduce foods one at a time, to test your body for tolerance. This process requires patience, but it’s 100% accurate and individualized to you. It’s where you learn to communicate with your body, and once you have that skill, you have it for life. It may not be easy, but it’s a powerful healing tool.

The Connection Between Leaky Gut and Food Intolerance

Food intolerances are often caused by intestinal permeability (aka leaky gut). Our intestinal lining is vital to our health. It’s designed to let needed nutrients into our bloodsteam, while keeping out everything that’s harmful to our health. Here’s the problem: leaky gut and autoimmune disease go hand in hand. You rarely find one without the other. With leaky gut, our intestinal lining becomes too permeable, letting things into our bloodstream that don’t belong there. Amino acids are a nutrient meant to be allowed through. They are the building blocks of proteins in our food, and the building blocks of cells in our bodies. They’re tiny and wonderful, and we need them. With leaky gut, our bodies let proteins through before they’ve been completely broken down into amino acids. We’re not talking big chunks of food – just molecules bigger than they should be, in a form our body can’t recognize as food. So, the body mounts a defense by activating the immune system and ramping up inflammation. Not a good situation for someone with autoimmune disease.

The Benefits of Doing the Hard Thing

The Paleo Autoimmune Protocol doesn’t just identify food intolerances. It reverses autoimmunity, allowing us to reclaim our health and our life. A lab test can’t do that. The AIP has 3 pillars of healing: the foods we remove from our diet which are inflammation triggers, the foods we add to our diet that nourish and heal, and the lifestyle changes we make that balance our hormones and reduce inflammation bodywide. It’s a lot of effort, but the rewards are priceless.

One such reward is that the AIP is designed to heal and seal our gut lining. While food allergies are permanent, food intolerances can be temporary. This is why, over time, many people are able to successfully reintroduce more and more foods.

“I’m not telling you it’s going to be easy.
I’m telling you it’s going to be worth it.”
~ Art Williams

About Eileen Laird

Eileen Laird of Phoenix Helix has been living the paleo lifestyle since June 2012, reducing her rheumatoid arthritis symptoms by 95% without any steroid or immunosuppressant medication. Merging straight talk with inspiration and information, Eileen strives to help us all live the autoimmune life well! She believes in the power of symbolism: the phoenix represents our ability to transform; the helix represents the power we have over the expression of our genes. In addition to her blog, she hosts the only paleo podcast dedicated to autoimmune healing. She also hosts a weekly AIP Recipe Roundtable, is the author of the e-book Reintroducing Foods on the AIP, and you can find her on Facebook and Pinterest.

79 comments

  • mvarrin says

    Thanks for the article. The two Pubmed studies you cited are both done on children. I wonder if they’re relatable to adults? Seems that the burgeoning immune system of children would be very different. As we know, lots of kids outgrow food allergies.

    • There’s another link in the article that you missed. It’s an overview of many scientific studies on people of all ages:: http://www.mm3admin.co.za/documents/docmanager/8e7be0a4-2b8d-453f-875e-cd1e5132b829/00015032.pdf

      • mvarrin says

        I did miss that. Thanks, Eileen. My Cyrex gluten cross reactive test was money well spent 2.5 years ago regardless of false negatives. It started me on the right path (I found The Paleo Mom by googling ‘nut free, egg free paleo :-)). The only downside to the eliminate and test method is that it can make me so very sick for a long time. I’m going to take the new Cyrex Array 10 (released yesterday) that tests 180 real food antigens. The licensed naturopathic doc that I see has been practicing for 20 years and healing leaky gut and autoimmunity the AIP way for that long. I totally trust her and she said Cyrex has been spot on for as long as she’s been using them.

        • Ivana says

          Have you since done the cyrex 10 test ? If positive, are these the foods you need to avoid for the rest of your life ?

      • jean morgan says

        if you don’t have any outward symptoms of a food intolerance, how would you know that you actually may be eating foods that are causing inflammation?? wouldn’t you have to do “allergy testing” to see if there are foods causing you internal trouble? should you bother having allergy testing done if you have no obvious sign of food problems?

    • Charlie says

      What about the York test?

  • Hilda says

    Thank you so much for this informative article. I have recently had an ELISA test done and I found the results to be pretty accurate with what I have been already thinkig being problem foods. Many of the foods that signaled reaction are off limits on the AIP, which further proved to me that I need to dive in and just do the AIP instead of jut paleo. I agree with the questions you raise here about accuracy though, and even wth the test done, the plan is to do the strict elimination and then provocation. Your website is very inspiring as well, thank you!

    • Using a test as a jumping-off point, rather than conclusive results, makes more sense. Best wishes with the AIP, Hilda!

    • Jane b says

      I had the same results from testing as Hilda…”reacted” to dairy, eggs, legumes, cane sugar., and I am celiac.
      Just extra confirmation that the AIP is the right route.

  • Tracy says

    Thanks for the article. I’m waiting on the results of a blood test to tell me if I have an autoimmune disease … In the meantime, I had a CYREX test done to confirm food sensitities. My doc tells me the test is completely accurate, and I’ll NEVER be able to eat the foods on my list again without risking further damage to my body. As I’ve been to a few docs over the years, I’ve learned to be cautious when doctors say words like “never;” however, I’m well aware I have plenty of work to do to heal my gut.

    Just wondering … Have you ever heard of the Cyrex test? I’ve had two doctors tell me it is the “gold standard” for sensitivity testing.

    • Hi Tracy. Which test did you get? I think their gluten sensitivity screening is pretty accurate. Their gluten cross-reactive test was shown to only be partially accurate when tested by scientists outside of Cyrex. As for their wide food sensitivity testing, like all such tests, it can have false positives and negatives. The true Gold Standard is an elimination/provocation diet like the AIP. Everything else is guesswork. You are wise to question anyone who says you can “never” eat those foods again. Even if the test was accurate, with the exception of gluten, food sensitivities can often be healed. We may not get all the foods back, but with time and effort, most of us can expand our diets. If you discover you do have an autoimmune disease, I recommend the AIP – both to identify your true intolerances, and to access the healing potential of a nutrient-dense diet.

      • Nicca says

        Hi!
        Can you heal gluten sensitivity after a long diet? Also when ones suffer from a autoimmune disease? Thanks for your answer.
        Chears, nicca

  • […] allergy tests often provide false positives – Chicago Tribune Why Food Intolerance Testing Doesn’t Work | Autoimmune Paleo op: for right now, add way more gelatin than you think you "should". it will go a very […]

  • […] I do realize that there is a fair amount of criticism about the reliability of these tests, I do believe that the results are a great guideline to get a […]

  • kathryn says

    Thank you for this. Do you have any information on the accuracy of the MRT? (Mediator ReleaseTest) I am working with a LEAP certified nutritionist who uses the MRT & I am scheduled to have blood drawn for this test tomorrow.
    Thanks.

    • Jenny says

      I did the LEAP MRT test last month. So far, I do believe it has been helpful. I have a unique situation, though – a combination of Hashimoto’s Thyroiditis and IBS-C as a result of some type of hemolytic e-coli infection and a yeast overgrowth (both found by Genova Diagnostics CDSA 2.0). I stuck faithfully to AIP elimination diet for several months, but was still having digestive problems! LEAP MRT showed that my body was sensitive to some AIP-legal foods such as beef and coconut, and eating the ‘lowest’-reactive foods for the most part has been helpful with my IBS-C. So far, what I’ve found the test doesn’t predict, though, is what other types of reactions I might get from a food, even those on the ‘lower’-reactive lists. For example, cucumber and shrimp (also both AIP legal) are on my lower (not lowest)-reactive list and both ‘fog’ me – I don’t know if this is because eating the really low-reactive foods has calmed the inflammation so much that the next level-foods affect me that way; it’s really mysterious, but it’s a process and a place to start and for me to help my IBS-C. So far, as long as I am eating my lowest reactive foods and avoiding the others, I am able to go to the bathroom comfortably. But, due to my AIP knowledge, I’ve been really careful on my low-reactive list before trying any nightshades, nuts, etc. Basically, I try to keep the AIP principles in mind and sort of combine them with what the test told me. I also had Spectracell Micronutrient Testing done through my nutritionist and am taking supplements to correct deficiencies–this has already made a huge difference in my overall energy and feeling of well-being. I think AIP is great, but I also think sometimes these tests can pick up on the little idiosyncracies in our bodies that AIP alone cannot (beef, coconut, even watermelon!!!). These tests have helped me, and I would do them again! According to the research that I was given, LEAP MRT is also 90% reproducible as compared to the ALCAT which was only 60%. Again, it’s not everything, and AIP is still really important, but I did find the LEAP MRT to be helpful.

      • Jenny, it sounds like you are reviewing the MRT results very thoughtfully, with self-experimentation to confirm or void the results, which is very wise. Our bodies really do know best. I do want to comment on the 90% statistic that is often shared on MRT websites. That was a study done in Poland 18 years ago that isn’t available in English, so unfortunately, we have no way of knowing if it was a quality study or not. There hasn’t been another study with those results since.

    • Stacy says

      I was wondering your thoughts on this one as well. I had it done in November and after already going through leaky gut healing and a 4 month round of AIP with successful food reintroduction. I was surprised to see a long list of foods I wouldn’t have considered (cinnamon, oregano, mint, orange, strawberry, coconut, vanilla, and more) and only took it in the first place because I was having a bad reaction to some estrogen/progesterone support my naturopath had me on so he wanted to see if there was a weird ingredient trigger..

    • susie says

      I did the MRT (mediator release test) and LEAP diet for 9-10 months — it was AMAZING. I did this under the guidance of a Registered Dietician. i had NO IDEA that a side-effect would be — GOODBYE DIGESTION problems/pains etc. What is funny, is that during this time — which really I was 97%-100% compliant — I would say really more like 99.9% compliant — except for the 3 day rotation in phase six — I stuck to the foods but not the rotation — I’m telling you that digestively speaking I felt great! I met another woman who lives near me who is doing this. She is doing it for other reasons so we talk — & when she is on the diet – no diahrhea — when she’s off the diet — hello problems — so it has really been amazing. Please note that under the care of a dietician, we’re able to determine — the “other” foods that are showing symptoms that didn’t show up on the test. So for example rule #1 — NO SOY NO COW MILK and NO GLUTEN for autoimmune — across the board. So no matter what the test says — this is the rule so those foods are out (but not cheese for example, as the molecules are different than the molecules in a glass of cow milk, unless of course, cheese is a problem for you on test). SO… This explained why I just couldn’t feel good on AIP — because CHICKEN was my HIGHEST reaction!! That meant no chicken products for me… There were other things too that are on the AIP that are allowed such as avocados — which I have loved and eaten all my life… Yet — hello, no avocados for me to start – due to tyrosine issues. No foods 3 days or older because of tyrosine issues — and on and on — I must MUST say – that this MRT/LEAP testing UNDER THE GUIDANCE of a SKILLED REGISTERED DIETICIAN is simply amazing. Now the time is here in which I’m testing some of my foods of highest sensitivity — WANTING them to work out… Hello digestive ache… (not always but sometimes) I even tried gluten free oats – I used to eat these nearly every morning with blueberries and cinnamon — but yikes wow — not for me. Quinoa — Yikes ouch not for me… So on and so forth. As soon as I ate oats — hello phlegm… Hello not feeling so great. I eat nearly all “WHOLE FOODS” and have been doing so for nearly the entire year (and on and off for years before this) and once again — the MRT/LEAP test (updated ALCAT) is just amazing. It is also a NEWER test just of recent years — so something mentioned about a 19 year old Poland study below — is not related to the current MRT test. Sensitivity testing this way? YES DEFINITELY! AMAZING!

  • Alexandra says

    What if you have a histamine intolerance? Many of the AIP approved foods are problems for those with this particular issue. I was told by a nutritionist, that while the AIP elimination is a start, it doesn’t necessarily remove all problem foods since i have the histamine issues. They said that the MRT test would help determine exactly what I should eliminate for the elimination phase. What are your thoughts on this?

    • Mickey Trescott says

      Hi Alexandra,
      I’ve got a form of histamine intolerance, and I layer those modifications with AIP. I don’t believe there is a test you can do to figure out which foods cause you a histamine reaction, but usually you will know the culprits after eating them–for me it’s cured or smoked meats canned fish, and fermented fish. The other “high histamine” foods don’t seem to bother me.

      I suggest doing an additional histamine elimination for a week or so and then reintroducing those foods in order to assess tolerance. You don’t need to avoid these foods for very long, maybe a week or two so it is a much quicker process than treating them like regular AIP reintroductions. Hope it helps!

      Mickey

      • Alexandra says

        Thanks! I will definitely try that out to see if it helps. I definitely seemed overwhelming to remove the histamine foods as that made the list even smaller. Thanks for getting back to me.

  • Debra says

    Like Hilda, I’m debating on doing the blood testing as a starting point for elimination and provocation testing. I’ve been reacting to many of my meals, and I haven’t been able to track down the cuprit(s), despite keeping a detailed food journal. There hasn’t been a single food family in common with my problem meals. I’m experiencing chest congestion, coughing, and runny nose within 1 hour of eating, which takes up to 3 hours to clear up. AIP alone hasn’t cleared up all my problems, so I’m suspecting I may be reacting to food(s) allowed on AIP. I’m not sure what my best options are at this point. Thanks for writing this article. It’s important to understand the tests’ limitations.

    • Mickey Trescott says

      Hi Debra,
      A couple things I would look into in your situation–doing a trial of a low-histamine or low-FODMAP approach, in addition to AIP, for a week or two to see if it changes anything. Especially the runny nose sounds like histamine, so I would be interested to see if anything changed there. If it does, then I would get tested for SIBO, which causes symptoms when FODMAPs are eaten and can also be an underlying cause of histamine intolerance. Or if you want to skip the trial and error, you can just ask your doctor for a lactulose breath test to see if you have SIBO.

      Additionally, a comprehensive stool test would be a good bet to pinpoint a root cause if you are not feeling better on AIP. Hope it helps!

      Mickey

  • MaryK Humber says

    Question: I’ve done strict AIP for 6 months. SOMETHING is STILL bothering me!! How do I find out of MEATS I eat consistently are problematic without risking being too low in protein if I remove chicken, pork and beef from my diet for 30 days?? I was thinking ALCAT might help me figure out what AIP compliant foods I might be struggling with!! Any help is appreciated!! 🙂

    • Mickey Trescott says

      Hi Mary,
      While some people do react to different proteins, it is not especially common. What is more likely is an underlying cause in the gut–pathogenic bacteria, overgrowth of yeast, parasites, etc. I would recommend finding a functional medicine doc to get some comprehensive gut testing to rule those things out before doing something as drastic as removing all proteins. A LOT of food reactions can be caused by imbalances in the gut.

      Mickey

      • Hey Mickey, Given your restorative approach to healing, I’m wondering whether you choose to treat parasites as per your naturopathic friends e.g. fairly harsh herbal protocols. Do you think these are a necessary evil or do you think that parasites are a side-effect of other imbalances?

        Cheers
        Josh

        • Mickey Trescott says

          Hi Josh! I was actually treated by a naturopath for my parasite, who prescribed a prescription medication to take care of them (and she was right–I only took two doses, two weeks apart and they were gone). She thought the herbal protocol would be harder on my system. This is when it is really helpful to have a qualified practitioner to help make those conventional vs. natural medical decisions. Hope it helps!

  • Stacy says

    I already commented above asking your thoughts also on the MRT test, but I also was wondering if you know the date of the South Africa Allergy Position Statement? Science is definitely not my strong suit and it’s overwhelming trying to read through both sides of the arguments and know what information to trust. That position report is very intriguing, but their most current source was from 2007. I wonder what’s changed in the research since then unless this paper was written recently. I imagine some science works slow while others advance quickly. I’m not sure where allergy research falls in that 🙂

    • Stacy, one of the reasons these tests are often inaccurate is that there are countless ways a body can have an inflammatory response to a food. There is no test that covers all the reactions. Simultaneously, these tests measure response in a lab environment and try to draw a correlation with what’s happening in your body. Your body is a totally different (and more complex) environment, hence the “false positives.” I know you said above that you took the MRT test and it had some surprising results. You can test those results yourself by doing elimination/provocation on that list. Remove those foods from your diet for 30 days, and then reintroduce them one at a time, following the same careful steps you followed with AIP reintroductions. You can trust your body to tell you if you really need to avoid those foods. My guess is that you’ll be able to reintroduce many of them successfully.

  • Sabina says

    I concur with these theories. I have a child with an anaphylactic response to most of a food type, and even in the traditional western, non-functional med world, the only way they say to be sure is to do a food challenge after a long period of abstinence. Also, a family member worked for years in pediatric food allergy research, and it’s common knowledge that if you took 6 random people off the street and tested their blood for an allergy to almonds, 5 would come back with RAST markers in their blood for an allergy, but never have symptoms when consuming the food.

  • Heather Burkhardt says

    Cyrex Labs has recently released a 180 food panel. Array 10. Your statements are in direct opposition to Dr. Aristo Voljdani’s.
    Some of our best functional medicine doctors really respect his work. I know every time I hear him speak, I am very impressed with his research. I think through his work we are getting closer to healing autoimmune disease. I want to bring up an point he made in one of the lectures I listened too. I am so sorry I do not remember the specific protien and the details of the study (mice vs human) BUT, he said that people/mice who had antibodies to this one protein, developed a condition where their own tissue was destroyed through pure molecular mimicry. The protein and the protein in their bodies were so similar that antibodies to the protein alone were just as damaging as an autoantibody to the tissue. This is highly significant. I believe it was in his lecture in the Autoimmune Summit by Amy Meyers that he spoke about this study.
    I beleive the idea of ‘never’ consuming a food again is a very hard thing to confront. I do not know if Cyrex’s Array 10 is 100% accurate, and exactly what antibody reactions to foods mean for us, BUT, I do beleive that Cyrex Labs are the best antibody testing lab we have and I am going to do Array 10. I know that I am way better off after cutting out the foods I reacted to on the gluten cross-reactivity panel. I also think that we can have immune reactivity to foods without feeling overt symptoms from them. Making the our current ‘gold standard’ very, very weak. I am all for the AIP and have eaten this way for nearly 2 years. I am also anxiously awaitng my lactulose breath test and rechecking on all other gut pathogens. But I am definitely doing Cyrex’s Array 10 and hoping for better health, longevity and lasting remission.

    • Heather, you are right that Cyrex is a well-respected lab in the functional medicine community. That doesn’t make it infallible, though. For example, when an outside lab tried to confirm Cyrex’s gluten cross-reactivity results, it found that only 1/2 the list of foods on the array had the potential to cross-react, and most of those were grains and dairy, which are automatically eliminated on paleo anyway. When it comes to the Array 10, there hasn’t yet been an outside lab testing those results. If you feel you need more information than an elimination diet has provided, by all means, follow your instincts. You are the expert on your own body. My recommendation, though, is to use such a test as a starting point for further exploration, rather than putting your faith in it completely. I don’t recommend avoiding a food for life based on a lab test.

      • Heather Burkhardt says

        Thank you for your reply Eileen. Yeah, I do feel like I need to confirm some suspected intolerances. I also want to make sure the food I am eating regularly is not causing me problems. I like the idea of further exploration, to see how I feel/function after cutting out the foods I have antibodies/immune reactivity to.. I certainly do not relish cutting my diet down further. I guess I am hoping I really can eat coconut after all, and which nuts are healthy for me and I want to find out if bananas are strange for me solely because of a blood sugar reason or do I have acutal immune reactivity to them….I have a lot of questions….and hoping Array 10 will help guide me in the right direction. I will keep a skeptical view of it all, but to date, Cyrex Labs has done right by me. I realize I probably have a big positive bias towards them, so I thank you for your point of view and will keep it in mind as I proceed.

      • Katie says

        My understanding is that Array 4 is for both Cross Reactivity AND Food Sensitivity. In fact – that is what the panel is called. It isn’t just called a Cross Reactivity panel! It doesn’t claim that all of the foods on the panel are cross reacting with gluten! Just those down to yeast. Therefore it isn’t surprising at all that an outside lab also found this.

        I don’t imagine that Cyrex Array 10 or Array 4 are 100% correct but I think it is now time for us all to start being clearer about the differences between Array 10 and older methods of IgG food intolerance testing so that the info we are spreading out to our community is accurate and up-to-date.

        Chris Kresser is held up as a leading authority several times in this article, but the page on his site that is linked to is from 2012, before Array 10 came out. Array 10 is mentioned positively in at least two different articles on his site from 2015. There may well be more. I also read somewhere recently that he uses Array 10 but does think that there should be more research done into it……I can’t remember where I read that now. So it isn’t as though he is completely endorsing it.

        http://chriskresser.com/5-steps-to-personalizing-your-autoimmune-paleo-protocol/
        http://chriskresser.com/which-lab-tests-are-essential/

        People are using Array 10 (often in combination with Array 4) and if they have had this test then they have questions – for example what do they do if they are reacting to lots of fruits and meats but not any legumes or dairy? It would be great to be able to support these people as well and answer the questions that come up for them. I know I would really appreciate being able to read more about that.

  • Jenn B says

    I wholeheartedly agree with this post. I have a very dramatic story of healing through this type of elimination diet that you write about.. I got the ALCAT test done and after following their menu protocol became the sickest (almost died) from the leaky gut that I had and the foods I was still ingesting because they tested “safe” for me with ALCAT. It was incredible once I removed the foods how, within two days, my symptoms began to go away. I have Hashimotos and eliminating trigger foods (for MY body), repairing my gut, and reintroduction was the key to healing – not food sensitivity testing that I had through ALCAT. Following their recommendation actually made me far worse. You can read about my complete (with pictures) health and healing journey with Hashimotos, Asthma, Sever Eczema and Miscarriages here: http://feastingonjoy.com/about/my-health-journey/

  • This thread is starting to fill with questions about other brands of food intolerance testing, such as York, MRT, and the Cyrex array 10. My guess is there will be dozens more added by the time this discussion is complete. We understand the appeal of believing there is a test out there that works – one that we have simply haven’t yet mentioned – that will provide you with accurate answers. I’m sorry – the science simply doesn’t support it. As I said above in another comment, there are countless ways a body can have an inflammatory response to a food. There is no test that covers all the reactions. Simultaneously, these tests measure responses in a lab environment and try to draw a correlation with what’s happening in your body. Your body is a totally different (and more complex) environment, hence the “false positives.” Our recommendation remains the same – do an elimination diet correctly (with very careful reintroductions), and trust your body to tell you which foods are inflammatory for you. If you’ve done the AIP, and are looking for more information, you can try one of these tests above, but then follow it with an elimination protocol to test those results.

    • Eileen Laird says

      P.S. I also support Mickey’s advice above that other tests might prove much more useful when you’ve hit a roadblock – such as tests for gut dysbiosis, SIBO, nutrient deficiencies, a comprehensive blood panel, urine organic acids test, MTHFR, etc. There are many conditions that can affect our inflammation levels, and our ability to tolerate foods. The tests I just listed help uncover the root cause.

    • Katie says

      So – if somebody has already invested in Array 10 and it suggests that they are reacting to lots of meats and fruits, are you advising that they ignore these results and do the normal AIP programme instead?

  • Lisa says

    Great article. Also, what are your thoughts on Kinesiology as a valid form testing? Kinesiologists have been testing me for food sensitivities and I’m unsure about the ‘science’ behind it.

  • Claire B says

    Hi Eileen, Mickey and Angie,

    Great post and lots of good discussion. I’d like to share my experience with food testing.
    I have taken different IGG food tests over the years and decided at one point I would never do it again, due to the inaccuracies of the testing. I relented recently during a prolonged exacerbation of “IBS” symptoms. The most highly reactive food was potato. (This is before I went AIP) I had already suspected potato wasn’t a good food, but was still eating it in gluten free foods. Cutting this food out made a big difference. Also, the foods I was eating all the time had become more reactive for me, including chicken and olive oil (AIP approved). The only way to know if the test results were accurate was to do an elimination/provocation challenge on my own; sure enough chicken and olive oil cause immediate GI distress. The bottom line is, these tests can be helpful, but I agree that elimination/challenge is the most accurate way to determine food sensitivities even if you decide to take an IGG test.

    Now that I’m 26 days into AIP and have had some positive results working with both the IGG test and AIP. Some days are very hard because of all the restrictions. Also, I was eating too low carb in the beginning and this was stressful on my body and caused rapid, unwanted weight loss which set me back quite a bit. In spite of the set back, I can see that healing is taking place and a number of symptoms have improved. AIP is a good starting place, but each person’s ideal diet will be a little different.

    • Thanks so much for sharing your experience, Claire – both the positives and the negatives. The one advice I have (which it sounds like you are already working on) is being sure you eat enough while combining the AIP with IGG testing. It’s so easy to get undernourished when our diet is very restricted. Expand your diet as soon as you can, and in the meantime, focus heavily on nutrient density.

      • LauraLC says

        Hi Eileen,

        Thanks for this information source and all your helpful advice.
        I have been on (and still am) on an elimination diet and am also on a rotation diet because there are so few foods I can eat (only some vegetables and oils). I am reactive to all proteins (plant & animal), beans, all grains (including wheat , corn, rice, etc.), dairy, nuts, seed, fructose (under 15 g/meal is tolerated), soy, and caffeine. I was diagnosed with IBS-C 16 yrs ago (intolerant to caffeine , beads, cabbage) then wheat, dairy, soy etc. progressively starting 4 yrs ago. I have not eaten protein for 3 months. An MD friend of mine said I will starve to death without protein. I have been to several doctors and Mayo Clinic found nothing wrong with me.
        Is there a couple of functional doctors or naturopaths in the Chicagoland area you could recommend?

        Thank you!

  • Gita says

    Through elimination, I’ve discovered my daughter is at least sensitive to gluten, milk, salicylates, sulfites, corn and potatoes. She’s had a worsening rash for a 1 1/2 years that I am just now gaining ground on after figuring out the sulfite issue. I have celiac, no gallbladder, and have been treating autoimmune symptoms for eight years which autoimmune paleo has really helped the last year. I also tested positive for h. Pylori and imagine she has it. The only thing that doesn’t make her react is grass-fed beef and venison. I’m still nursing her and my younger daughter, who seems to have at least a dairy sensitivity (which I don’t eat on purpose, but I have to try everything because there’s almost nothing we can eat.), so I can’t eat much either. Has anyone run across any of this? We’re taking mastic gum with success but she doesn’t take it consistently. I’ve been to a dermatologist – very unhelpful- and a functional doctor, also unhelpful. I’ve rad h. Pylori can cause widespread food sensitivities.

    • Mickey Trescott says

      Hi Gita,
      I am sorry to hear of you and your daughter’s food sensitivities–boy that can be a challenge with multiple family members! I have successfully treated H. Pylori myself under the care of a doctor using Mastic Gum. It took a long time, maybe three months of twice daily doses. I didn’t notice a change in my food allergies post treating it–I had already been on AIP for awhile at that point. Hope my experience helps somehow!

      Mickey

  • I think there really is no one answer to health. And AIP isn’t for everyone either. I think everyone has to find their own way down their path to health. I have tried multiple diets and most failed because I hadn’t yet found the key list of foods I was intolerant to. May of these diets, including AIP and GAPS recommended I eat food that was actually causing a problem for me which I later determined through an intolerance test.. So, I believe that there is a place for these intolerance tests, which have been pretty accurate for my son and I, in combination with a diet like AIP or in working with a naturopath to heal your body in additional ways. To say the intolerance tests are not worthwhile, doesn’t seem fair. There is a place for them. While they may not be accurate all the time, neither is true of IgE allergy testing. It’s best to eliminate the intolerant foods from your diet and then reintroduce them slowly to see which ones were accurate and which were not. My son and I were able to uncover many foods that had been causing trouble for us via an intolerance test that we never would have figured out on our own – foods like bananas, black pepper, olives/olive oil, etc.

  • […] false negatives, and that I should just eat more leafy greens and I’d be fine.  In fact, other people online (whose opinions I respect) agree.  However, in my case, I was having catastrophic issues with food […]

  • […] AIP/Paleo world was hailing the benefits of coconut oil. Once my symptoms abated and I started food reintroductions, I tested plain shredded coconut first. NO reaction. Hallelujah! Then coconut oil. All good! Long […]

  • […] AIP/Paleo world was hailing the benefits of coconut oil. Once my symptoms abated and I started food reintroductions, I tested plain shredded coconut first. NO reaction. Hallelujah! Then coconut oil. All good! Long […]

  • Darren says

    This article means well but is a bit deceptive. I looked at the study you cited and it mainly talks about ALCAT. I spent some time in the industry and my experience and those of others including medical doctors and naturopaths has been the same as the paper cited…its not a very good test. After talking to numerous doctors, its my understanding that many don’t believe in food intolerance testing because they don’t understand the testing itself. Many fall for marketing gimmicks vs. real science. Another factor is the labs they are using don’t really understand the food testing and offer it is an ala carte item and offer much research behind their methods.. My consensus is there are too many bogus tests out there being used by doctors therefore know one believes in it. It is not the testing itself, its the labs,

  • Jacqueline says

    The elimination diet and idea I great in theory… However what about when I’m doing it with a 3yr old. She can’t very well tell me how she feels after every different food. I did the strict elimination thing for about 8 weeks and it hard to keep up. We are not being as strict any more and I’m not sure I knotice a difference. Would the testing not give me a starting point on which foods to really watch an affect for?

    • Mickey Trescott says

      Hi Jacqueline,
      I agree this is very difficult to do with a child, I would definitely seek out advice from an experienced doctor or practitioner on this one. Good luck!

  • Required field says

    Interesting to read a reasoned criticism of fake tests like ALCAT, etc., while pushing the “leaky gut” myth. It is not a diagnosis recognized by the medical community. Intestinal permeability is a real condition that does occur with a lot of autoimmune disorders, but like candida before it, “leaky gut” is simply a catch-all fake condition used to sell diets and protocols, and often expensive supplements and books. A real doctor can test for and treat intestinal permeability, but the notion that lupus, psoriasis, and MS can be cured with diet is dangerous advice. Please inform your readers that “leaky gut” is not actually a recognized medical condition, and there are no peer-reviewed studies showing its existence.

    • Mickey Trescott says

      Hi there,
      I’d suggest you search “intestinal permeability” (aka leaky gut) on pubmed and let me know how many studies you find! 😉

  • Colleen says

    I have Hashi’s. I have dermatitis herpetiformis. I have Sjogrens symptoms at times. I have been eating paleo plus dairy for a long time and having gut issues just since March of this year. I love butter and whipping cream and never could have given those up without getting the results from the Cyrex Labs Array 4 test (my nutritionist suggested it). Now I am learning all I can about AIP, but the test results told me dairy is out as well as all of the ingredients used in gluten free flours including tapioca and oats and sorghum and rice. I am so glad I took the test because it gave me the reason to drop these foods out of my diet! (My inner child is stubborn and wants a reason for everything!)

    • LauraLC says

      Hi Colleen,

      I have similar symptoms/conditions as you. I just got back from Mayo Clinic and had negative blood tests for Sjogren’s Syndrome although I have 90% of the symptoms (I couldn’t get anyone to test me for the metabolic disorders). Were you ever tested for Sjogren’s antibodies?

  • Joyce says

    I have had gerd, esophagitis, duodenal ulcers, larngitis, chronic gastritis and was on heavy dose of nexium for a decade. Now am diagnosed with candida albicans antibodies and multiple allergies based on Immupro300 test. I dont have anything that I could eat due to allergies and candida diet. I feel weak and not eating. Even raw veg juice is a problem. My lips remain swollen for my months! Please advise!

    • Mickey Trescott says

      Joyce,
      Sorry to hear about your issues, but your query is best addressed by a medical professional familiar with treating your issues. Hoping you can seek out the help you need and start feeling better soon!

  • […] Why Food Intolerance Testing Doesn’t Work […]

  • Lolo says

    I have been suffering from alopecia areata since last Sep. and have lost almost half of my hair in the span of a few months.

    For me it came out of nowhere, as growing up I have never felt that I was allergic to any foods and ate basically anything (I have to admit as it had no apparent consequence at the time, I wasn’t a healthy eater)
    After been to many Dermatologist, they could not offer any treatment that could cure this condition. Thankfully I found your blog and info on AIP and autoimmune disease. Everything I have started the AIP diet since 3 weeks ago. I am happy that AA has triggered the motivation for healthy eating!

    However, as I never felt any discomfort when eating any common sensitive foods before, and I’m tested negative for gluten sensitivities in a blood test in Denmark, I have no idea what is going to happen when I reintroduce foods. Or as so far there is no significant change yet, I am kinda worried if I would be secretly sensitive to things allowed on AIP like coconut..
    Hence, I am hoping to do a food sensitivity test to aid my AIP diet so I have some idea what could be the problem that never occurred to me.

    I am moving to Princeton from Copenhagen Denmark next week.
    I did a search on http://www.naturopathic.org/AF_MemberDirectory.asp?version=1
    But it shows no Naturopathic Physicians in the area of autoimmune disease in the Princeton area.

    Is there any IgG test you would recommend or what is the best search term or way to find a Dr. that know about AIP approach instead of just prescribing creams?

    Thank you 🙂

    • Mickey Trescott says

      Hey Lolo! Happy you found us here. We don’t recommend IgG testing for sensitivities, just the autoimmune protocol, as it is the best way to pinpoint food allergies and sensitivities. Have you seen Stella’s site, https://wholeearthlife.wordpress.com/? She has alopecia and has had great success using AIP, I would recommend connecting with her! Primaldocs.com and paleophysiciansnetwork.com are great resources for finding practitioners in the US.

      Wishing you a safe move and good luck on your health journey.

  • Megan says

    I’ve had IgG testing an an effort to try and find out what’s causing my head to toe “eczema.” It suddenly appeared 9 months ago, with no history of allergies or skin issues. The IgG didn’t have any flags at all, and I already eat very clean. Would an elimination diet be futile after the negative result? Eliminating until symptoms are gone would be difficult to keep up if there’s never improvement, and this rash is seriously unsettling for me.

  • Beth Hooper says

    I’m a big fan of the AIP diet, but I think you are selling food sensitivity testing short. I have used the cyrex tests, very successfully in my practice and with my family. The array 2 lets you know if you have intestinal permeability – leaky gut. The array 4 is great if you have a gluten intolerance to test for cross-reactivity with other foods. And the array 10 tests for autoimmune reactions to over 100 foods, both cooked and raw. For anyone with food intolerances and leaky gut, cyrex can help provide a roadmap of what to eat and what not to eat. Done in combination with the AIP can be a very effective combination. Plus, you can re-test later to monitor what has changed.

  • Ann says

    My son started having eczema on his hands around age 3.At the time he was gluten free bc I have celiac,and we thought about the elimination diet.So,we started with dairy for a couple of weeks without any improvement,on the contrary his eczema was getting worse.We tried eggs ,tomatoes,eggplants (he was getting a bit red around his mouth) and so on.Time passed (about 1 1/2 year) and his eczema was getting worse,he was getting anxious,impatient ,sometimes violent.We finally found and md that was curing his patients with food and supplements,but mostly food.He did this test where over 300 foods were involved and my son tested highly sensitive to many foods like chicken,salmon,tilapia,eggs,tomatoes,eggplants,honey,apricots,chickpeas,cocoa,apples,pecans and a few more.At the beginning we laughed at this as we didn’t believe it,but gave it a shot.We eliminated all this foods from his diet and in 4 days (yes,4) his eczema was gone.We had tears in our eyes
    His mood was back to normal,the sweet little boy that he was before.I know that the test is accurate bc every time he eats a small amount of any of those foods,his eczema is back between his finger,moving up his hands.His mood again changes (he becomes mean),his fingers are very itchy and he gets his dark cicles.
    For us it would have been almost impossible to find all these foods.I don’t know which test he did but I’m so thankful for having my son eczema free and healthy (he almost never gets sick,like maybe once a year where there would be no antibiotics nor otc pills ).

    • LauraLC says

      Hi Anne,

      That’s a great success story! I (and I’m sure a lot of other readers) would like to know the name of the blood test that tested for 300 foods and the type of MD (maybe name and geographic location too!) you sought for help. Could you call the doctor’s office and get the name of the blood test?

      Thanks!

      • Mickey Trescott says

        Hi Laura,
        If you read the article above, you’ll see why we don’t recommend these tests as a replacement for doing the elimination diet. They can be helpful for some folks at pinpointing triggers, but they don’t test all foods in every way the immune system can react to them.

  • Duncan Green says

    I have a question. If leaky gut means our intestines are too permeable and allow things into our blood stream that should not be there, how is it that there are no blood tests to detect those foreign bodies in the blood? In the entire body of scientific research not once have food particles been detected in blood. In any case presumably this would lead to a most serious sepsis.

    It is such a seductive idea and I really want to believe it’s true. However, not only does this theory lack any scientific proof but it also lacks any slight indication from medical research anywhere that it might be true.

    • Duncan Green says

      Btw I am not questioning that people get better when they change their diet. I know there is great power in functional nutrition.

    • Mickey Trescott says

      Hi Duncan! Yes there are many studies, and even medical tests that can check for leaky gut. I recommend checking out the book The Paleo Approach by Sarah Ballantyne, which has over 2,000 scientific references.

  • […] eggs, as well as lost several other food sensitivities. There are several articles discussing the inefficiency of food sensitivity testing via bloodwork, which is another reason why NAET is a great option. If this option doesn’t […]

  • carla says

    Ive been AIP for 35 days. If I get the array #4 done, will I get accurate results since I haven’t consumed any of the foods being tested for over a month?

    • Mickey Trescott says

      Hi Carla,
      Elimination and reintroduction is the best way to tell if you are sensitive to a food. There isn’t really a way to tell if elimination for a month is going to trigger a result on the test before you do it.

  • […] remove all wheat and eliminate things you’d never identify without an MRT – though you also need more than just food intolerance testing, as this excellent Autoimmune Wellness guest post points out (click that […]

  • Carina says

    Great info, but I wish the article ended by saying “While food allergies CAN be permanent” vs “food allergies ARE permanent.” Because they aren’t always permanent. I’ve had regular food allergy testing (and food allergies) for over 20 years. Over time, many allergies subsided or went away completely, and occasionally new ones appeared. I have very few IgE food allergies now.

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