Reliability of ELISA test

[Deleted]

I just got my results back from an IgG ELISA test from US BioTek...(for some reason, the IgE wasn't on the result sheet) and the results were quite surprising and contrary to my own experiences with food selection and composition:

I can tolerate oatmeal, grains and wheat just fine! Which is strange because I stopped eating all of these about a year ago, and dropped a lot of bloat/water retention and increased my energy levels almost immediately.

I had a very high or extremely high reaction to the following:

Almonds, Honey, my beloved Pineapple (damn), eggs, and then for the grand finale: milk, whey, cottage cheese and yoghurt!


Moderate reaction to the following foods, which implies that I should only eat it once every 2-4 days or so and rotate them - correct?

Casein, bakers yeast, coconut (does this apply to extra virgin coconut oil?), peanuts, walnuts, potato (white), and tomato.

Do you know if the "treated" milk proteins (isolates, CFM, hydrolyzation etc) in protein supplements yield the same IgG reaction as the untreated proteins found in milk and cottage cheese?


All meats, veggies, fish/shellfish and fruits were low to no reaction. Spices and herbs weren't included although I requested those, which leaves out a huge part of the puzzle since I spice my foods quite literally.

As you have mentioned before, the ELISA test is considered 1 out of 4 pieces of a puzzle, with the Signet MRT test giving the final 3 pieces. Hopefully, the testing kits for Europe will be ready next week.

Now – the question until then is - how consistent with the MRT test have you found the IgG ELISA to be? Do the same foods show up as high reactivity?

I've read that the ELISA IgG could show a high reactivity to foods I eat every day, simply by virtue of being exposed to them all the time, and not necessarily an immune reaction?

Which would explain a low to no reaction to wheat, grains and oats because I haven’t eaten them in about a year?

Thanks for your input.

[robwhite]

On the US BioTek website it seems to indicate that the finger prick test is an IgG - only antibody test, therefore you will not get IgE data with that test. However, Eric's site suggests there is also some IgE data that comes with the test. Maybe Eric can clarify this?

That fact that you cut out grains some time back has probably reduced your immune response to foods from that group - therefore when you had the test done and your antibody reaction was tested, i can understand it might be quite low. If all of a sudden you started eating significant amounts of grains again daily, i would think the scale of your antibody reaction to it would go up. I think you are probably correct in the assumption that any foods you eat all of the time will trigger elevated antibody responses as time goes on. This is why i think food rotation is a good idea to limit this. However, some foods are likely to trigger much greater responses in certain individuals that others.

What blood type are you? Dr Laura Power's research indicated that Type O's typically show highly elevated immune and lectin responses to dairy and eggs.

Did you only go for the 96 General Food Panel? From what i gather looking here, www.usbiotek.com/Services-Antibody.htm that panel does not include Herbs & Spices, which is an addtional Panel in itself that you would need to pay extra for.

The Signet MRT-150 tests herbs & spices, and covers non-immunoglobin mediated, delayed reactions to foods, so you might want to consider that when it becomes available.

[Deleted]

I'm type 0 and I've read Power's site, hope she will release that book of hers soon

I took the test at a clinic and said I wanted both the 96 General Food Panel as well as the herbs and spice panel, but I guess they either didn't listen or didn't care

I was told that the MRT specimen testing kits will be ready tomorrow, Tuesday 9th, from the lab in Poland, so looking forward to that.

This is why I was asking if people who had taken both the BioTek ELISA and the Signet MRT found them to be in agreement on reactive foods.

And if anyone has taken another IgG or MRT test after some time without a reactive food in their diet to see if that made a difference?

[erictalmant]

Jun 8, 2009 6:10:47 GMT -5 robwhite said:

On the US BioTek website it seems to indicate that the finger prick test is an IgG - only antibody test, therefore you will not get IgE data with that test. However, Eric's site suggests there is also some IgE data that comes with the test. Maybe Eric can clarify this?

That fact that you cut out grains some time back has probably reduced your immune response to foods from that group - therefore when you had the test done and your antibody reaction was tested, i can understand it might be quite low. If all of a sudden you started eating significant amounts of grains again daily, i would think the scale of your antibody reaction to it would go up. I think you are probably correct in the assumption that any foods you eat all of the time will trigger elevated antibody responses as time goes on. This is why i think food rotation is a good idea to limit this. However, some foods are likely to trigger much greater responses in certain individuals that others.

What blood type are you? Dr Laura Power's research indicated that Type O's typically show highly elevated immune and lectin responses to dairy and eggs.

Did you only go for the 96 General Food Panel? From what i gather looking here, www.usbiotek.com/Services-Antibody.htm that panel does not include Herbs & Spices, which is an addtional Panel in itself that you would need to pay extra for.

The Signet MRT-150 tests herbs & spices, and covers non-immunoglobin mediated, delayed reactions to foods, so you might want to consider that when it becomes available.

Excellent post, Rob!

Generically, the foods that show up as moderate or highly reactive on the BioTek IgG test (I thought they did an IgE as well, but that also did not show up on my test) are usually reactions that we are "genetically prone" to; if that makes any sense.

The Signet MRT test is the one that is a bit more volatile and relies upon many variables. I have seen test results change on the MRT over time; but not so much with the BioTek IgG test.

Personally, I avoid the moderate and highly reactive foods on my BioTek IgG test like the plague. I then do my best to avoid the foods that I am reactive to on my Signet MRT Test. I do have some foods that I am highly reactive to on both tests; but for the most part I am reactive to them on one test and not as much on the other.

So, I start with my basic food list. I then cross out IgG reactive foods and then cross out MRT sensitive foods and end up with my personal food list. I have limited experience on those that have taken multiple IgG and/or MRT tests because they are somewhat cost prohibitive. I plan on doing a MRT retest soon, and when I do I will report back.

In the meantime, if you would search for Ethan DeMitchell's audio interview that we posted here on the site I am sure it would answer many of your questions.

[erictalmant]

Jun 6, 2009 20:55:33 GMT -5 @borgef said:

I just got my results back from an IgG ELISA test from US BioTek...(for some reason, the IgE wasn't on the result sheet) and the results were quite surprising and contrary to my own experiences with food selection and composition:

I can tolerate oatmeal, grains and wheat just fine! Which is strange because I stopped eating all of these about a year ago, and dropped a lot of bloat/water retention and increased my energy levels almost immediately.

I had a very high or extremely high reaction to the following:

Almonds, Honey, my beloved Pineapple (damn), eggs, and then for the grand finale: milk, whey, cottage cheese and yoghurt!


Moderate reaction to the following foods, which implies that I should only eat it once every 2-4 days or so and rotate them - correct?

Casein, bakers yeast, coconut (does this apply to extra virgin coconut oil?), peanuts, walnuts, potato (white), and tomato.

Do you know if the "treated" milk proteins (isolates, CFM, hydrolyzation etc) in protein supplements yield the same IgG reaction as the untreated proteins found in milk and cottage cheese?


All meats, veggies, fish/shellfish and fruits were low to no reaction. Spices and herbs weren't included although I requested those, which leaves out a huge part of the puzzle since I spice my foods quite literally.

As you have mentioned before, the ELISA test is considered 1 out of 4 pieces of a puzzle, with the Signet MRT test giving the final 3 pieces. Hopefully, the testing kits for Europe will be ready next week.

Now – the question until then is - how consistent with the MRT test have you found the IgG ELISA to be? Do the same foods show up as high reactivity?

I've read that the ELISA IgG could show a high reactivity to foods I eat every day, simply by virtue of being exposed to them all the time, and not necessarily an immune reaction?

Which would explain a low to no reaction to wheat, grains and oats because I haven’t eaten them in about a year?

Thanks for your input.

I advise clients to avoid protein powders that come from cow's milk if they have anything other than a low reaction to ANY cow product.

You could very well be sensitive to oatmeal, grains, wheat, etc. via the Signet MRT test.

I have found the opposite to be true: that those foods that someone eats quite often show up on the MRT test and not as much the IgG test.

Always keep in mind that NONE of these things are exact sciences. We have to use them as tools and then apply them while always being aware of what our bodies are telling us.

[erictalmant]

The Mediator Release Test (MRT)
Q. Is MRT accurate?
A. A blinded peer reviewed scientific study showed MRT to have the highest level of accuracy of
any food sensitivity blood test (94.5% sensitivity and 91.8% specificity).
Q. What’s the difference between MRT and other tests for food sensitivities?
A. There are a few different tests available that are intended to identify sensitive foods. They are
IgG (ELISA or RAST), ALCAT, and LRA by Elisa-Act (not to be confused with ELISA IgG). Without
understanding some basics, it’s impossible to understand how one is superior to the others and how
they compare.
The Basics:
Food sensitivities make a person feel sick because the immune system reacts to foods and causes
the release of chemicals called mediators (such as histamine, prostaglandins, cytokines, etc.) from
white blood cells. It’s the mediators that cause the inflammation, pain, and other symptoms associated
with food sensitivities. In fact, food sensitivity is a very complex reaction by our immune system. There
are many different cells that have different profiles of mediators, many mechanisms that cause
mediators to be released, and of course, many different mediators. The thing that makes food
sensitivities complicated is that there are various ways the immune system can respond in
hypersensitivity. Because there are different ways the immune system can respond, there are
different approaches researchers have tried to identify reactive foods and chemicals.
ELISA IgG: This test quantifies how much IgG you are producing to a specific food, with the
assumption that high levels of IgG are only a bad thing. There is a specific type of immune reaction
called Type 3 Hypersensitivity that can involve IgG or another antibody called IgM. When IgG is
involved in triggering mediator release, this testing will be very helpful. Unfortunately, there are three
very serious limitations of IgG testing:
1. High levels of IgG can be either good (suppressing of an immune response) or bad (causing
an immune response). But you cannot tell which is good IgG or which is bad IgG through this
testing. Having a high level may actually be good -- not bad.
2. IgG only plays a minor role in IBS, migraine, and fibromyalgia. Instead, research shows that
Type 4 Hypersensitivity is the primary type of reaction. Type 4 Hypersensitivity doesn’t involve
IgG or any other antibodies.
3. IgG testing cannot identify reactions to chemicals like food additives. It’s clearly documented
that food chemicals play a very important role in provoking symptoms in many conditions. If
you cannot identify these reactions, you could very well be missing very important information
that can impact your health.
How MRT Compares to IgG: There are a number of advantages of MRT over any form of IgG testing.
MRT is an endpoint test, meaning that all the immune based adverse reactions end up causing
mediator release. So MRT tests for the release of mediators without caring about the mechanism. In
fact, by testing for mediators which are the endpoint of immune reactions, MRT is able to take into
account the actions of all mechanisms, whether they are antibodies or other, because all of them
ultimately cause white blood cells to release mediators. MRT is able to account for a much wider array
of reactions than the relatively simple IgG testing. In addition, MRT is able to identify reactions to
chemicals. Overall, MRT is more accurate and useful clinically.
The ALCAT Test: The ALCAT Test was invented and patented by the same person who invented and
patented MRT, Dr. Mark Pasula. The two technologies are similar, yet separately patented, which
means there is a unique difference. The main difference between the two tests is in terms of accuracy and reliability. Side by side studies have shown MRT to be more accurate (higher sensitivity and
specificity) and to have higher split sample reproducibility than ALCAT. It is a good, but older method
that has been replaced by the newer, better technology used in MRT.
LRA by ELISA-Act: This test is somewhat of a mystery as to what it actually measures and how that
correlates with mediator release and with an involvement in IBS, migraine, fibromyalgia, or other foodsensitivity-
related conditions. The company that invented it makes claims about its accuracy,
reproducibility, and validity, but in fact there are no actual third party studies that confirm any of their
claims. Nor have their own studies related to the same been published. In other words, there are no
published studies that support their claims. In addition, the actual methodology is not described or
validated in any peer reviewed publications, yet they claim that it is. Therefore it’s not possible to
assess and compare its strengths and weaknesses to MRT.
MRT: The main difference between MRT and ELISA-Act is that of scientific validation. There are
studies published on MRT that clearly show the methodology, accuracy, ability to discriminate
between healthy and sick populations, etc. They clearly tie the relationship of what MRT is measuring
to the physiological basis of adverse food reactions in IBS, migraine, fibromyalgia, and other foodsensitivity-
related conditions.
Q. How does MRT work?
A. MRT is an indirect method of accurately measuring mediator release. MRT does this by
measuring changes in the liquids to solids ratio of your blood after your blood has been exposed and
incubated with the test substance. It accounts for all reactions by your immune cells. This is done as
an indicator that your immune cells have released chemical mediators such as histamines and others.
Significant reactions are broken into either Reactive (Red), or Moderately Reactive (Yellow) categories
and insignificant reactions (Green) are placed in the Low-Reactive category. All measurements are
made using the most accurate method of measurement (Ribbon technology) currently available.
Q. How come the test shows I’m reactive to something I have never eaten?
A. There are 4 possible explanations as to why the test would show reactivity to an infrequently or
never-consumed food:
1. Genetics. It has been shown that immune-based food reactions can have a genetic component
and can be passed on from generation to generation.
2. Cross reactivity. Your immune system identifies and differentiates antigenic substances based
upon their molecular structure. Foods from the same food families often share similar protein
structures and can sometimes cross-react if tested. Another situation that can contribute to cross
reactivity is when a reactive chemical binds with a non-reactive food and causes that food to be
identified immunologically as a reactive substance.
3. Hidden source of the food. Many foods can be found as additives under different names. For
example, monosodium glutamate (MSG) can be found in an ingredient list as monosodium glutamate,
MSG, natural flavoring, or hydrolyzed vegetable protein (HVP). It is common for these items to be
hidden in prepared foods. The report sections on Hidden Sources of Test Substances, and Chemicals
and Additives can help reveal hidden forms of the items you need to avoid.
4. False positive test result. Even the most accurate laboratory tests can give some false
readings. The overall accuracy of MRT as determined in a peer reviewed blinded study is roughly 93%
leaving a small margin of potential error in the reading, that can show up as either false negatives
(which means a substance is actually reactive, but the test says its non-reactive), or false positives
(which means the test says its reactive, but it is really not).

Q. I know that I am allergic to a particular food but MRT said I wasn’t. Why?
A. MRT identifies foods and food substances involved in food sensitivities, and is the most
comprehensive blood test for these types of reactions. If you know that you are allergic to a particular
food, it most likely won’t show up on MRT because mast cells, the main cells involved in allergic
reactions are found in tissue, not in the circulation. MRT measures the circulating cells which tend to
be involved in sensitivities.
If your “allergy” is not really an allergy, but rather a food intolerance, that also will probably not show
up on your MRT results because the symptoms are not triggered by an immune system reaction. In
any case, if you know a particular food does not agree with you, the best thing to do is avoid it.
Q. How can I be reactive to this food; I eat it all the time and it’s a healthy food?
A. One of the problems with food sensitivities is that any food or food substance that you
consume can potentially be a culprit. Foods that you eat regularly are even more likely to be causing a
problem.
Food sensitivities often develop over time in a gradual manner, and this causes you to become
accustomed to a certain amount of suffering which you experience as “normal”. When you eat
reactive substances in this situation, it may not cause a dramatic reaction, relatively speaking.
However, if you avoid your reactive foods for a while and then reintroduce them, you may experience
a very pronounced reaction. Then you know that food is not good for you, no matter what the other
health benefits of the food may be.
Foods such as garlic, fresh vegetables, or fresh fish, provide important nutrients and under normal
circumstances promote health. However, any food that triggers your immune system to react against
your body is not healthy for you, even if it contains some health benefits for others.
Q. Why are milk, cottage cheese, and yogurt different in reactivity?
A. While milk, cottage cheese, yogurt, and other cheese are all in the same food family (dairy),
the antigenic protein structure varies considerably as the milk changes into a new product. That is why
some people cannot tolerate milk, but can tolerate yogurt or certain cheeses. However, a good rule of
thumb is that if you are reactive to two or more foods from the same food family, you should avoid the
entire family.
Food Sensitivities
Q. What is the difference between food allergy, food sensitivity, and food intolerance?
A. Food allergies, food sensitivities, and food intolerance are often used interchangeably and
inappropriately. In fact, there is active debate in scientific and medical circles as to how to define and
use these three terms. The general consensus is that food allergy can be defined as any adverse
reaction to food that involves our immune system. This further breaks down into two kinds of
reactions, food allergy, and food sensitivity. Food intolerance does not involve the immune system.
Food Allergy
Perhaps the best-known example of food allergy is also its least common – and most dangerous.
Anaphylactic shock is a severe hyper-reaction of the immune system caused by a massive release of
histamine and other chemical mediators from certain types of white blood cells called mast cells and
basophils. Not everyone with food allergies experiences anaphylaxis though. The immunological
triggering mechanism that causes the mast cells (and basophils) to release their chemicals is called
IgE and is a very well understood phenomenon. This underlying mechanism is considerably different
from the triggering mechanisms found in food sensitivities. The most common foods implicated in food allergy are peanuts, other nuts, shellfish, or foods containing sulfites. People with anaphylaxis can die
within minutes if they ingest even one molecule of their allergic food.
Food allergy affects about 1-2% of the population and accounts for only a small percentage of all
adverse food reactions. Most immediate reactions are not life threatening but do produce
uncomfortable symptoms. People suffering from food allergy can usually identify what foods they are
allergic to without the help of a doctor or testing. This is because the reaction occurs every time and
shortly after they eat their allergic food.
Food Sensitivity
Food sensitivity (also known as delayed food allergy) is quite another story. Delayed reactions
manifest in many different ways as they can affect any organ system in the body and can take from
45 minutes to several days for symptoms to become apparent. The delayed onset of symptoms and
complex physiological mechanisms involved in food sensitivities make them an especially difficult
puzzle to try to solve either on your own or with most laboratory serum tests. In fact, food sensitivities
often go undiagnosed or misdiagnosed. The treatments prescribed usually provide only temporary
relief that mask the symptoms instead of addressing the root cause of the problem.
The differences between the two kinds of immune-mediated adverse food reactions are summarized
in the table below.
Item Compared Food Sensitivities Food Allergies
Body organs involved
Any organ system in the body
can be affected
Usually limited to airways,
skin, gastrointestinal tract
Symptom onset occurs
From 45 minutes up to 3 days
after ingestion
From seconds to 1 hour
after ingestion
Are symptoms acute or
chronic?
Usually chronic, sometimes
acute
Usually acute, rarely
chronic
Percentage of population
affected
Est. 20 - 30% 1 - 2%
Immunologic mechanisms
White blood cells
Antibodies:
IgG (and subclasses)
IgM
C3, C4
IgE
Non-immunologic mechanisms
Toxic
Pharmacologic
None
How much food is needed to
trigger the allergy?
From small amount to large
amount; often dosage
dependent
1 molecule of allergic food
needed to trigger reaction
Food Intolerance
Food intolerance can produce some digestive symptoms that are similar to food sensitivity but it
doesn’t involve the immune system. Instead, when the food in question is consumed, it is not properly
digested and begins to ferment inside the gut. The best example of food intolerance is lactose
intolerance. This condition is characterized by bloating, loose stools or diarrhea, and gas. Lactose
intolerance is caused by an inability of the body to produce enough of the enzyme lactase, which
breaks down lactose, the primary sugar found in milk. Avoiding milk products or supplementing the
diet with lactase enzyme is the best way for a person with lactose intolerance to overcome the
problem.

Q. Why do I have food sensitivities; how did I get them?
A. Researchers do not have all the answers to this question and there is still much to be learned
about how food sensitivities develop. The following are the most widely accepted factors that can help
cause food sensitivities.
1. Poor digestion.
2. Unbalanced gut flora
3. Chronic stress/severe trauma
4. Immune system overload
5. Genetics
6. Toxic-induced loss of oral tolerance (overexposure to chemicals)
Q. How do food sensitivities cause symptoms?
A. The symptoms that result when we have food sensitivities are caused by the release of toxic
chemicals such as histamine from immune cells. The table below describes the sequence of events
involved in developing symptoms from food sensitivities.
Step 1
Identification
Step 2
Call in the Troops
Step 3
Chemical Warfare
Step 4
Symptoms
Immune system
identifies foods and
food substances as
foreign
Immune & non-immune
mechanisms (IgG, IgA,
IgM, etc.) trigger
immune cells to attack
Chemicals such as
histamine are released
from immune cells to
destroy invaders
Tissue inflammation
and damage occurs
leading to symptoms

Copyright 2008 Signet Diagnostic Corporation

[erictalmant]

Here is an EXCELLENT exchange between a MT advisor and the main guy at Signet, Ethan DeMitchell:



Hi Ethan,
I hope you don't mind answering a question that's been on my mind for a long time.
I've always wondered if it's possible to have issues with gluten that aren't indicated by MRT results and I finally had a client ask about it.

I know that intolerance is different from sensitivity in that intolerance involves incomplete digestion. The MRT guide explains that an immune response isn't involved with intolerance. However, with gluten, the undigested proteins often do cause an immune response.



The answer is definitely yes, and particularly in the case of the most well-known reaction to gluten, celiac disease (CD). MRT will never be a good test for celiac disease because the reaction is against the tissue specifically and not the gluten. Celiac disease is called a "gluten intolerance" and it most definitely is, as people with CD don't tolerate gluten containing grains at all. But don't be confused by the definitions I use when discussing allergies, sensitivities and intolerances, as there is no medical consensus about terminology. So some will use intolerance to denote any kind of adverse food reaction, others will use it for non-immune reactions, and still others will use it any way they see fit, etc., etc..

CD is definitely an immune-mediated reaction, but it is actually not a reaction against the gluten. Rather it is an autoimmune reaction against the villi in the gut when gluten is present in the GI tract. That's why the only sure diagnostic test for celiac disease is the genetic test. That will most definitely tell you if you have CD although it won't tell you if it is active. The active state of CD is of course the most damaging and hazardous. The next best test that is used is Tissue Transglutaminase (TTG) which determines if antibodies are being produced against the tissue, which denotes the autoimmune response. But this is not as sensitive as the genetic test. Then they may take tissue samples and look to see damage of the villi. But this is also not the best because they could take a clean section.

Other tests, like IgA or IgG against gluten are not valid but are marketed and hence confuse the people of the etiology of CD. Still, the treatment is strict avoidance of gluten containing grains. For celiacs, even a minute amount of gluten can be disastrous.

There are other types of gluten enteropathies, but really there is no proven reliable diagnostic test for them. The reactions in gluten intolerance are most definitely inflammatory. But IgA produced against gluten does not mean inflammatory response as IgA is not an inflammatory antibody. IgG produced against gluten also does not mean inflammatory response as IgG can be anti-inflammatory, or just a normal consequence of exposure. So there is little to be gained from IgA or IgG to gluten.

When someone has any kind of reaction in the gut, gluten or otherwise, it is most often NOT isolated, meaning there are reactions to many other antigens as well simultaneously. It's all part of the process of losing oral tolerance. These reactions then can lead to developing sensitivities to other food or food chemical antigens. So a test like MRT is very helpful in the big picture.

Much of the research that has been done on gluten intolerances have not looked at co-morbid reactions of other antigens, and the studies tend to jump to conclusions without understanding the big picture. A great example of this is that many celiac proponents/researchers postulate that the gluten reaction causes many non-GI symptoms and conditions, i.e. that the other symptoms are also a gluten reaction. Often the conclusion is gernated just because the markers for celiac disease are present. If you just look at the destroyed villi, which is the barrier between the inner body and gut, and the fact that the gut is now much more porous, it is easy to see how new sensitivities can occur, and how the constant breach can lead to other illnesses.

As such, how likely is it that such a response wouldn't be picked up by the MRT? I would expect that if someone is reactive to gluten that all gluten containing grains would show as sensitivities on the MRT, but this doesn't seem to be the case. Do you have an explanation for this?



From what I have seen over the years, MRT is pretty good at showing patterns of reactions, even with the gluten containing grains. The assumption is often to point the finger at gluten, as everyone (media, practitioners and patients) talks almost exclusively about gluten. So the expectation is that gluten should always be the culprit. But the incidence of celiac disease and other gluten enteropathies is way less than the number of people with food sensitivities (from 0.05% - 2% of the population vs. 15-40% of the population for sensitivities).

And foods and food reactions are very complex. Even wheat has a number of antigens other than gluten that are unique to wheat. All foods are like that. I remember attending a medical conference (American Academy of Otolryngic Allergy) many years ago where they were talking about standardization of food antigen extracts so that allergy testing (RAST, ELISA, SET) would be more reliable. Of course it would be ideal if it were possible, but as the speaker pointed out, milk has as many as 60 different antigenic components. So which ones are you going to isolate and standardize? Focusing on just one would miss the others. And they may be the important ones.

MRT will show important reactions with a high degree of reliability. However, MRT is not perfect and may show some and miss some of the gluten containing grain reactions. Therefore if you suspect gluten as a problem, then take your patient off all gluten containing grains, in addition to their MRT test reactive foods. Be a little more conservative in the beginning. Then you can challenge some of the gluten containing foods that tested non-reactive and see for yourself if they were playing a symptom-provoking role. Make sense? I appreciate the question. -Ethan

[Deleted]

So I just got the results from the MRT. They had computer problems earlier in the day, but Dr Dorota Kurek actually called me personally and told me they had technicians working on it and they would do their best to resolve the issue. She kept me updated all day Friday and sent me the test results by e-mail at close to 10pm! Now that's customer service! Very impressed!

For the test results I'm having a few questions. After the ELISA IgG I eliminated all milk products, egg, almonds and pineapple. All the moderate reaction foods were rarely or never eaten.

I did try eating oatmeal a few times, but every time it made me sleepy and like clockwork had me running to the bathroom with stomach pains two hours later...

The MRT showed me highly reactive to:

BEEF! - which I've been eating on a daily basis, and I ordered 10lbs of TP's beef protein isolate since I couldn't use any milk based protein supplements.
Coffee (oh well...I have my green tea), pork, and most importantly kamut and wheat (which had low reaction on the IgG)

MSG was moderately reactive...

Interestingly - there was low or no reaction to:

- Whey, yoghurt, cottage cheese (so I can start back on whey protein isolates? Or perhaps not since it can be a source of MSG)
- Eggs (although lecithin in yolks was borderline green/yellow)
- Pineapple
- Almonds

So how do you usually go about reconciling these results?


I know you said earlier that any highly reactive foods on the IgG were eliminated and the MRT reactive foods you did your best to reduce, but I also know that not eating a food for a few weeks could reduce the reaction to it, so maybe that's why the foods that were previously highly reactive on the IgG showed low reaction on the MRT?

According to the MRT FAQ, IgG can show a high reaction to a food by virtue of regular ingestion of it, not because you have an immune response, and that the MRT is more reliable and won't give false positives.

So based on that I should be able to rotate in eggs, whey, almonds and pineapple to my diet.

Or do you combine results from both tests and eliminate foods highly reactive on the IgG and the MRT, even though the MRT showed a low reaction?

Ok, I basically just want you to tell me that I can eat whey protein, pineapple and eggs again

Although I can't imagine a life without a juicy steak every day, I should be able to work around the limited availability and higher cost of wild game meat...

[robwhite]

Whey protein is not a source of MSG - the glutamine and glutamic acid in whey does not necessarily get co nverted into glutamate, and if it does its will be because the regulatory mechanisms in your metabolism demand so (a certain amount of endogenously-produced glutamate is perfectly natural and healthy). If you show no signs of reactions to whey, i would go ahead and use it every few days. It is good stuff and has lots of health-promoting compounds in it (avoid acid-washed whey if you want these to remaiun intact)

You could rotate consumption of the odd steak once every 5 days. Do you live in the UK? For decent game meats at a good price, try www.gribblesbutchers.co.uk/. I have used them in the past, and their game minces are exceptional value and taste great.

[robwhite]

Jun 15, 2009 8:42:31 GMT -5 erictalmant said:

Q. How does MRT work?
A. MRT is an indirect method of accurately measuring mediator release. MRT does this by
measuring changes in the liquids to solids ratio of your blood after your blood has been exposed and
incubated with the test substance. It accounts for all reactions by your immune cells. This is done as
an indicator that your immune cells have released chemical mediators such as histamines and others.
Significant reactions are broken into either Reactive (Red), or Moderately Reactive (Yellow) categories
and insignificant reactions (Green) are placed in the Low-Reactive category. All measurements are
made using the most accurate method of measurement (Ribbon technology) currently available.

Hi Eric, thanks for this excellent Q&A on the MRT. With reference the bit i have quoted here, this prompted me to post somethin Dr Power emailedme a while back:

"Here's my take on the MRT. MRT purports to measure inflammation by measuring volume changes in serum. Hence it is only an "indirect measure" of a response, not a direct measure such as an antibody or T-cell or lectin. Furthermore, serum volume can also be affected by electrolytes (sodium, potassium, chloride), protein, pH and carbonates. In addition, immune cytokines cause vascular permeability and fluid leakage out of the blood vessels and into the tissues, lowering blood volume, not raising it. Finally, the only patent for MRT is for monoclonal antibodies, if memory serves correctly, not for food allergies -- according to my fiance, who is a senior examiner at the patent office (USPTO). Therefore, I am skeptical of the assumptions of MRT."

If this is true, and MRT only looks at increases in blood volue as a measure of mediator response, then this may cause validity problems for the test ...?

[Deleted]

Thanks Rob, unfortunately I don't live in the UK - I live in Norway but the season for deer and moose is not far away. I sell my own line of supplements, so high quality whey isn't a problem.

Pineapple is known for it's anti-inflammatory effect, so could it be that it has a high IgG response from being suppressive to the immune system (in a good way)?

FWIW, after dropping the beef and only eating chicken w one salmon meal per day, my stomach has been more upset, I don't get as full (although I add oil or nuts to the chicken), and my energy level is slightly less (could be too early to tell, though)...

Dropping cow's milk (and eggs) after the IgG test showed some noticeable improvements in several areas, though. That was 7 weeks ago.

I also e-mailed Ethan DeMitchell but no response yet.

Eagerly awaiting Eric's feedback, I guess we'll have to wait until Wednesday

[Deleted]

Got a very interesting response from Ethan DeMitchell, I'll just paste the relevant parts here:

"mediator release = inflammatory process which leads to subclinical and clinical effects
the greater the quantity of key mediators released = the greater the inflammatory process leading to greater negative physiologic effects significant volumetric changes in white blood cells after exposure to antigen = good overall picture of degree of mediator release as the mediators are stored within white cells.

So MRT has a sound physiologic basis.

IgG:
High levels of IgG do not correlate well with elevated levels of inflammatory mediators
There is no correlation established in any research studies between levels of IgG and mediators or IgG levels and symptoms. IgG is not a good indicator of food hypersensitivity. If it were, the whole conservative medical world would have embraced it just like they embraced IgE.

So when you look at your MRT results you have a pretty good picture of the degree of reactivity of every tested antigen and that correlates well physiologically. IgG doesn't.

MRT is also subject to false positives and false negatives - just not nearly as subject as IgG or any other type of food sensitivity blood test. The reactions MRT measures are more clinically relevant as they measure the endpoint of all delayed food reactions inflammatory.

I would say follow the results as outlined by LEAP. Would I exclude any of the IgG foods that showed a reaction? Only if you experienced benefit by avoiding them in the first place. Then, after a period of around 30 days of avoiding everything that was reactive before MRT you can introduce it into your diet one at a time on a 3 day basis and see how you respond. If it doesn't cause any subtle or gross problems, then it's fine to rotate in."

- Ethan DeMitchell




From another source, as quoted by Ethan:

"Please everyone take note of the following findings in this study as it will not be found touted in the literature of laboratories promoting food specific IgG4 as an indicator of HYPERSENSITIVITY to food antigens.

The development of TOLERANCE to food antigens is indicated, among other things, by the decreasing sizes of skin prick test wheals (mast cell stability...IgE not binding the altered antigen AND INCREASING LEVELS OF SPECIFIC IgG4.. Immunoprotective function....in how many tests then are elevated IgG4 levels indicative NOT of a hypersensitivity to the food but of DOSE TOLERANCE to the food...the diametric OPPOSITE of what the test result is claimed to indicate? Also keep in mind that the tolerance to a food, or conversely its allergenicity, is not solely a function of proteins!!!! How much research has to be published in this regard before people get it?

Anyway....if tolerance is indicated by increased levels of IgG4 what the hell is being sold?

what is funny is that a major "food allergy testing lab" places on its own website editorials which call into question, nay, counsel against the use of its own testing....an example

www.betterhealthusa.com/public/282.cfm

"At this time, after extensive literature searches and interviews with various companies offering this test, we at Bastyr are unaware of any peer-reviewed published study examining the positive predictive values of IgG for the diagnosis of food allergy or the association of this test with food allergy signs and symptoms. Only one company, (in Florida) of all we interviewed, reports that a study examining correlation of "food" IgG levels and elimination diets is currently underway (n=50). Therefore, with regard to high serum levels of IgG and the aforementioned in vitro work on basophils, mast cells and complement, it is a large extrapolation that IgG to food antigens is correlated to signs and symptoms of food allergy. Furthermore, the clinical meaning of elevated IgG levels in atopic individuals has caused much debate of late, including the premise of IgG as a blocking antibody."

further

"In addition to the lack of documented correlation between IgG and food allergy, it is uncertain if numerous companies doing this assay are even measuring what they think they are..."

"In conclusion, food allergy testing by IgG ELISA/EIA panels is a convenient and easy way to diagnose food allergies in a patient. It is, however, a testing method that is questionable in both its theory and validity. It is also costly and may not be reliable, depending on which laboratory you use."

Here's the abstract of the study:

Curr Opin Allergy Clin Immunol. 2009 Jun;9(3):234-7.

Rare, medium, or well done? The effect of heating and food matrix on food protein allergenicity.

Nowak-Wegrzyn A, Fiocchi A.

Jaffe Food Allergy Institute and Department of Pediatrics, Mount Sinai School of Medicine, New York, New York, USA. [e-mail]

PURPOSE OF REVIEW: To review recent advances in the area of food allergen processing and the effect on protein allergenicity. RECENT FINDINGS: Heating generally decreases protein allergenicity by destroying conformational epitopes. In peanut and shrimp, heat-induced Maillard reaction (glycation) may increase allergenicity. The majority of milk and egg-allergic children tolerate extensively heated (baked with wheat matrix) milk and egg. Introduction of extensively heated milk and egg proteins is associated with decreasing sizes of skin prick test wheals and increasing serum food-specific IgG4 levels.

SUMMARY: Heating and other methods of food processing have different effects on food allergens, even those contained in the same complex food. Structural homology does not reliably predict the effect of processing on allergenicity, and individual food allergens have to be tested. Interactions with other proteins, fat, and carbohydrates in the food matrix are complex and poorly understood. Introduction of extensively heated milk and egg proteins into the diet of allergic children may represent an alternative approach to oral tolerance induction. Better characterization of these aspects of food allergy is critical for elucidation of food protein interactions with the gut-associated lymphoid tissue, the ability to induce IgE sensitization, the potential to trigger hypersensitivity reactions, and different clinical phenotypes of food allergy with regard to severity and persistence.

[robwhite]

Jul 8, 2009 1:28:46 GMT -5 @borgef said:

"mediator release = inflammatory process which leads to subclinical and clinical effects
the greater the quantity of key mediators released = the greater the inflammatory process leading to greater negative physiologic effects significant volumetric changes in white blood cells after exposure to antigen = good overall picture of degree of mediator release as the mediators are stored within white cells.

So MRT has a sound physiologic basis.

So where Ethan says 'significant volumentric changes', is he talking about increases AND decreases in serum volume? If the MRT test doesnt take account for both, i'm skeptical, because of the reasons Laura Power stated in my quote from her that i posted a few posts previously (i.e. because immune cytokines can increase vascular permeability and fluid leakage out of the blood vessels and into the tissues, lowering blood volume, not raising it).

[Deleted]

Ethan sent me a very enlightening e-mail along with some documents and studies, but I am awaiting his approval before posting a response. From what I can tell, the underlying science and methodology is sound and there are inaccuracies in Powers' claims that will be addressed.

[Deleted]

This is the response from Signet Labs:

Dear Dr. Power,
Being somewhat familiar with your work on lectins and blood typing, and using more classic markers for assessing specific elements of oral tolerance I could not help but take the opportunity to respond to your remarks about Mediator Release Testing (aka “MRT”). There are several areas where I think the information available may not have been very clear concerning the technology and the method of assessing oral tolerance via MRT. Perhaps in this way I can help make you a bit more comfortable with a test which is actually not a fad but has gained quite a bit of credibility for its clinical utility in specific disease states.

While it is true that MRT testing does not measure an antibody, for example, as we know there are multiple mechanisms and multiple pathways involved in the oral tolerance process. Several of these pathways do not involve antibodies which correlate well with the common end point of all pathways to an inflammatory reaction: excess mediator release. Cytokines, for example, have been clearly implicated as the mediators associated with symptom generation in a number of common conditions heretofore unrecognized as inflammatory in nature such as IBS and fibromyalgia and in many, such as migraine and rheumatoid arthritis, where inflammatory processes have been demonstrated for many years. (Irritable Bowel Syndrome, for example, has been shown repeatedly by full thickness biopsy of the upper bowel to be characterized by lymphocyte aggregates at the root ganglia of the myenteric plexus with accompanying neuronal degeneration).

By assessing the net in vitro response to antigen or chemical challenges (something which cannot be done by any antibody assessment) through the common end point (quantitative assessment of cellular volume change in response to antigen or chemical challenge) compared to both PATIENT SPECIFIC negative control challenges and the entire spectrum of cellular response to all foods and chemicals challenged, we isolate those responses which lay well outside the normal cellular reactions associated with antigen priming, beginning of the inflammatory response via proinflammatory mediator release, and the down-regulation of inflammatory response via anti-inflammatory mediator release. This range of specific responses measured with great volumetric precision gives us an excellent snapshot of the net total cellular response to antigen and/or chemical presentation in vitro (which is an approximation of the in vivo process) and allows MRT to account for mediator release at both clinical and sub-clinical levels, both of which are clinically significant.

An example of how closely the plasma levels of cytokines are linked to dietary changes based on the results of testing for excessive mediator release by this method were presented by our Medical Director, a Board Certified Gastroenterologist, at the 2005 Annual Scientific Meeting of the American College of Gastroenterology.
The following chart is an excerpt from that presentation showing the results of our experiments at measuring the plasma levels of specific cytokines before and after MRT testing, with test positive food removed from the diet. The results correlate directly with the patients’ symptomologic remission and quantify why the patients’ symptoms cease and reappear as the diet is altered to exclude or include foods that the MRT test showed were outside the normal range of volumetric change in response to antigen presentation.
A complete discussion of the specific relationships between specific elevated cytokines and specific symptoms, or the impact of altered ratios of plasma values of various pro and anti-inflammatory cytokines which regulate normal oral tolerance or dysregulate oral tolerance is beyond the scope of this communication. However, the fact is that the wide use of MRT based dietary therapy among medical nutrition/dietary therapists, physicians, and our own verification of the changes in mediator levels and symptoms in response to the dietary changes made based on this common end point approach to assessing oral tolerance, we believe shows that the methodology and physiology are both sound. We believe this is the basis for the excellent clinical utility reported by dietitians and others who use this testing in their daily practices. This chart is typical of a patient with symptom inducing food sensitivities detected by MRT and diet adjusted accordingly.





While there is no doubt that the methods used to detect (4) specific paths to what might be classically termed “food allergies” have stood a test of time, we have developed and patented another testing method which encompasses some of these and other mechanisms which lead to mediator release. While there is debate in the world immunology community over whether we now “know” of 6 or 7 or even 9 mechanisms, that will become more clear over time as work in this area progresses.

The MRT method of assessing oral tolerance is based on the extensive work of a number of European allergy and immunology centers regarding additional and alternative pathways to reduced oral tolerance and excessive inflammatory response to antigens and chemicals, which are not easily detected by methods in present use. In this way we can broaden the scope of our views of altered oral tolerance and expand the clinical tools available to those who do nutritional and dietary therapies.

MRT has been in clinical use since 1997, so we have a good decade under our belts so far and better than 20,000 patients tested and treated by care givers of various types. Those who have been working with us since the beginning continue to do so and they too believe MRT has so far stood the test of both time and clinical utility, and its relation to mediator release and symptomology is well established. In the coming (2) years further new developments will indeed ensure that MRT is not seen as a fad but as a new standard and essential adjunct to classic tests for antibody-mediated hypersensitivity reactions. We look forward to a synergistic clinical relationship with the methods you presently use to great effect.
In addition, our own internal research comprising 5 years and over 2500 patients has given us valuable insight into what our own experience has shown is a highly effective method of building a diet for each specific patient based on the MRT results and patient history. Perhaps this is an area where incorporation of some of your principles would further improve outcomes.

Just as a note there is not a patent for MRT for monoclonal antibodies. The patents for MRT are :

U.S. Patent # 6,114,174: “IN VITRO DETECTION OF REACTIONS IN BLOOD TO FOREIGN SUBSTANCES” issued September 5, 2000.

U.S. Patent # 6,200,815: “METHOD OF MEASURING THE VOLUME OF LIQUID AND/OR SOLID IN A SUSPENSION” issued March 13, 2001.

Canadian Patent No. 2,250,125: “IN VITRO DETECTION OF REACTIONS IN BLOOD TO FOREIGN SUBSTANCES”.

[robwhite]

Wow, thanks for that Borgef. That certainly is a comprehensive response, and IMO answers many of Dr Powers concerns. However, i'm still curious to know, when Ethan states measuring 'volumetric changes' in plasma, whether he is referring to decreases AND increases in plasma volume. My assumption is that he is, because technically a volumetric change would encompass any change in plasma volume either way.

[erictalmant]

First of all, many thanks to Borge for posting all of this great information on MRT!

You guys do your homework, and that benefits all of us that come to this forum! I really appreciate that!

Here are two more things that would be beneficial for the topic(s) at hand:

www.erictalmant.com/Signet.html - you will want to click on the "Click here to download or open the full document" link at either the top or the bottom of the page. Please be warned that it does take some time to download, but that it is there and the link should not be broken.

I also think that Ethan's interview with Sean Croxton is quite valuable in this discussion, and that can be found here:

www.blogtalkradio.com/UndergroundWellness/2009/03/04/Food-Sensitivities-Is-Your-Food-Making-You-Sick

Give both of these resources some investigation, and then post back with clear an concise questions that still remain-if there are any.