“Leaky Gut” and the Confusion of Food Allergies and Sensitivities

Believe it or not, food allergies are rare. Studies estimate these to affect less than 10% of the population. But twice as many American adults report “food allergies” and they seem to come up all the time in the news.

Often what people are really experiencing are food sensitivities. Certain foods, usually at certain times, offend. These cause symptoms ranging from stomach aches to wheezing to headaches and joint pains.

Understanding the difference requires a quick understanding of common immunoglobulins, the antibodies that respond to invaders in our body.

• IgM – These antibodies are like the marines. They are the first responder to any threatening invader to our system. They are general. Our body immediately sends them no matter what and then waits for back up. Often they get the job done before that even happens. Hoo rah.
• IgG – While the IgM marines are fighting the first wave, they send a spy back to the immune system. This spy reports exact details of the invader, and our bodies make the exact opposite – terminators called IgG antibody. IgG antibodies are highly specific. They respond in 10-14 days to neutralize the threat. When the threat is over, IgG antibodies go back home and lay in wait for the invader to come back – known as a a reactivation. If you had the Influenza B in 2003, and you get it again in 2023, those flu antibodies respond immediately and get rid of it, often before we even feel sick. This is one of the ways we stay well. I’ll be back!
• IgA – This is the native immune system that lines the inside the “pipe” – or mucosa -- of our intestines. If you ate some bacteria, say, on a street taco, that didn’t belong in our system, our body has a signaling system to the brain to say “get it out” (often a “flood”: vomit or diarrhea). IgA also responds and gets to work knocking it out.
• IgE – These are the “allergies” everyone talks about when they say they’re allergic. Every sneeze when trees and flowers bloom in the spring? IgE. Ever get a bee sting? And a big red welt appears? IgE. What about a kid with a peanut allergy who situation becomes an emergency when her throat swells up? That’s IgE. That is a massive histamine response for which we give antihistamines – such as Benadryl (diphenhydramine).

So what do antibodies have in common with the gut? Or even a leaky gut?

First, a fun fact: the barrier of our gut is 1 cell width wide – that’s infinitesimally small! And strong! But is it an any wonder it can possibly leak?

Ok then, what is “leaky gut”?

Leaky gut, scientifically referred to as increased intestinal permeability, is a condition where the lining of the intestines open up more than normal, generally in response to prolonged inflammation. This allows substances like toxins, undigested food particles, and bacteria to leak through the intestinal barrier and enter the bloodstream. In a healthy gut, the intestinal lining acts as a barrier, selectively allowing nutrients to pass into the bloodstream while preventing harmful substances from entering.

When the integrity of the gut barrier is compromised, various health issues can arise. These may include inflammation, autoimmune reactions, food sensitivities, joint pain and digestive problems. Some factors

that can contribute to leaky gut include chronic stress, poor diet, excessive alcohol consumption, certain medications, infections, and imbalances in the gut microbiota.

And what’s behind out gut? Toll Like Receptors (TLRs). These are essentially buckets of – what for it – histamines! This is the bodies last ditch response – a histamine response -- to degrade what’s leaking through to the bloodstream while sounding the alarm to the rest of the system that there’s an invader.

Leaky gut and histamine response are both related to your gut health and can have significant implications for overall well-being.

What is a histamine response?

As mentioned, histamine is a naturally occurring compound in the body that plays a role in the immune response, regulation of stomach acid, and neurotransmitter function. Histamine is also found in various foods and is released in response to allergies or inflammatory reactions (IgE!).

Some people can have a heightened sensitivity to histamine, and they may experience symptoms when exposed to foods or other triggers that release histamine.

Histamine intolerance – or more like, an overwhelm -- is a condition in which the body has difficulty breaking down histamine, leading to an excessive accumulation of histamine in the body. This can result in symptoms such as headaches, hives, digestive issues, nasal congestion, and more. Certain foods that are high in histamine or trigger the release of histamine (e.g., fermented foods, aged cheeses, alcohol) can exacerbate these symptoms in sensitive individuals.

Is there a leaky gut-histamine connection?

There is a potential connection between leaky gut and histamine intolerance. When the gut barrier is compromised and becomes leaky, it can allow larger molecules, including histamines from food and TLRs, to pass through into the bloodstream. This can contribute to an increased histamine load in the body, potentially exacerbating histamine intolerance symptoms in individuals who are already sensitive.

Moreover, certain compounds in the gut microbiota can influence histamine production and breakdown. Dysbiosis (imbalanced gut microbiota) or overgrowth of certain bacteria can lead to increased histamine production, adding to the overall histamine load in the body.

What about IgM and IgG?

Meanwhile, those food particles each cause an IgM – and ultimately – when the body has seen them before -- an IgG reaction.

So food can reactivate our immune system – a lot. A single meal can leak through many constituents or pieces of food. And then the immune system has to deal with a dozen “invaders” instead of say, one, if it were a food allergy. When stress continues to inflame our gut and the immune system has to deal with lots of invaders leaking through for a long time we experience symptoms such as stomach aches, increase gas, bloating, and often severe fatigue.

How do you know if you have a food allergy or food sensitivity?

We can test.

Western doctors often run to IgE allergy tests. And these are great for environmental allergies. (Ask us about SLIT testing!)

IgE tests also can inform food allergies. That said, someone with a food allergy who’s had to go to Urgent Care or ER KNOWS they have a food allergy and unfortunately, that is the “best” way that many find out. Absent that kind of response when it happens, few likely have food allergies. The test is then about simply knowing vs. actually diagnosing or healing something.

What has more utility for leaky gut is IgG AND IgA testing. Many practitioners – including many naturopaths -- only run IgG – the thought being that we can identify the foods that the body has seen before or is reacting to right this minute. The protocol is that we have the patient eliminate all the foods on the list for 6 weeks, allow the gut to heal from the absence of these offenders, then reintroduce them one by one, testing to see if they cause symptoms again.

What tests for a leaky gut?

First, we can also test for zonulin, the “rivets” or “elastic bands” that hold the gut together that comes apart when the gut “leaks”. We can gather from either blood or stool tests. Diagnostic but slightly less important.

I think that in addition to IgG, it also is critical to test IgA, the” inside the pipe” immune system. What’s upsetting that too? That – combined with IgG -- can help us pinpoint specific foods triggering our immune system. We can run a blood test with that combination.

HELP! Everything came up on my Food Sensitivity test! What am I supposed to eat?!

When a patient returns a long list of foods on an IgG/IgA, they’re not allergic or sensitive to them genetically or long term – they are sensitive right this minute – and probably not to most of those – only what’s recently leaked through and been responded to by the immune system.

For that reason, when we see “everything” come up on Food Sensitivity Panel, it’s almost always it’s leaky gut. (And we can always confirm with zonulin test).

We cannot eliminate ALL of those foods and reasonably and expect someone to have a robust, nutritious diet. Food restriction causes other downstream problems to our microflora – many important microbiota stop getting “fed” and die off, causing “dysbiosis” -- an upset of the harmony of the species in our gut microbiome.

We can group foods into categories (gluten, dairy, legumes etc) for elimination, thereby reducing the confusion and restriction.

And, we can identify the worst offenders since we have BOTH IgG and IgA irritation. We start there and proceed in a practical way that nourishes the body, heals gut inflammation, and enables the overactive immune system to stand down (giving us a much needed break from symptoms).

Now what? Where do I start?

Addressing leaky gut through dietary and lifestyle changes, along with proper medical guidance, may help reduce inflammation and improve gut barrier function, potentially alleviating histamine intolerance and other immune response symptoms. It's important to note that leaky gut can be a complex condition with individual variations, so consulting a naturopathic doctor with backgrounds in gut health and nutrition is advisable if you suspect you have these issues. The physicians at Chambers Clinic can provide personalized guidance and recommendations based on your specific situation.

Contact us today for more information.