At-Home Food Intolerance Tests: A Functional Medicine Perspective | Dr. Will Cole
by Dr. Will Cole
Are you reacting to what you eat? Are those sniffles, skin problems, bloating, cramping, heartburn, diarrhea or constipation related to some particular food sensitivity, or is it caused by something else? Many of my patients want to know if there are particular foods they should avoid due to food allergies, intolerances, or sensitivities, and as a functional medicine practitioner, I know firsthand how powerful food can be for a person’s health. Not only can food pull you further into the depths of disease, but it can also be your most powerful medicine and help alleviate ongoing symptoms—that is, if you are eating the food that is optimal for your body. The question is: Which foods are doing what in your body?
We are all alive because of brilliant biochemistry, each with our own unique makeup. What works for one person doesn’t always work for the next, even among those with the same set of health problems. That is why, if you are trying to optimize your health with good food medicine, it can be beneficial to know whether you have any reactions to particular foods. You might be surprised to learn that even foods generally considered to be healthy—foods that are healthy for some people—may not be so for you. This information can help you to make the right decisions with your diet. To really understand the relationship between food and health problems, let’s look at the three main types of food reactivities. Some people use these terms interchangeably but there are differences:
If you have a food allergy, your immune system responds immediately and often drastically to the presence of food in your system, typically with reactions such as rashes, swelling, hives, and difficulty breathing. If you have a food allergy, you can’t “fix” it. Common food allergies include peanuts, tree nuts, shellfish, fish, soy, wheat, eggs, and strawberries.
If you have a food intolerance, this is likely due to deficiencies in enzymes that help to digest that particular food. They do not directly involve the immune system, but occur when your digestive system is irritated by particular foods. Common symptoms are bloating, gas, diarrhea, stomach cramps, nausea, or vomiting. Examples of foods to which many people have intolerances are dairy products, gluten, caffeine, and histamines (in many foods, especially preserved and fermented foods).
If you have food sensitivities, your reactions may not be as obvious or immediate. This is a catch-all term for when the exact reason for the reaction is more difficult to pinpoint. It may have an immune component but if you are sensitive to a particular food, you may be able to eat a little of it and only experience symptoms if you have too much. When symptoms do occur, they could happen hours or even a few days after eating the food. However, the symptoms can be serious, such as brain fog, chronic inflammation, and migraines. Food sensitivities can also cause bloating and digestive distress.
Whether your symptoms are severe and long-lasting or short-lived and easily ignored, you can’t fully optimize your health if you keep aggravating your system with foods that your body doesn’t like. The next question, of course, is how can you tell which foods are a problem for you, and which foods are fine? One of the most definitive ways to clinically look at this question is through lab testing.
As more people become educated about the importance of health, do-it-yourself wellness has risen in popularity, and lab testing is one important way to figure out the cause of health issues on your own. In the age of Amazon and instant access to almost anything from the convenience of your home, lab tests offer a multitude of at-home food sensitivity tests, each one claiming to shed light on your individual food sensitivities with one simple test—they advertise no doctor’s visit or complicated elimination diet needed. However, food reactivity testing is a mixed bag and not all tests are the same—also, your results may not be as straightforward as they seem.
How at-home testing works
When you find a test you want to try, place your order. A kit will be delivered straight to your home. Each kit will vary slightly, but generally they contain detailed instructions and the necessary instruments to complete the test. These results are gained through blood analysis, so a finger prick is required to conduct the tests. By looking at your levels of IgG antibodies to particular foods (immune reaction or reactivity), these tests are able to detect even low levels of IgG activity to determine which foods could be causing problems for you. These are the most common tests on the market.
Food Intolerance Test ($380): This test looks at your response to 200 foods, making it one of the most comprehensive at-home kits on the market.
Food Sensitivity Test ($159): This test is less comprehensive than the Pinner Test as it looks at your response to only 96 foods but it is also less expensive. You do have the option to upgrade to the Food Sensitivity Expansion Test, which will test an additional 88 foods.
Food Sensitivity+ ($249.99): This option not only looks at your body’s response to different foods, but it takes it a step further and looks at the relationship your DNA has to your ability to digest certain foods such as caffeine.
Food Sensitivity Test ($199): Like EverlyWell, this test looks at 96 foods.
Do home tests work?
Each test presents the results in its own way, but in general, you will receive a list of foods that the test has determined are causing some level of reactivity in your system. You could just quit eating the foods on the list, but many people want a professional to help them with what to do next, especially when the list of reactive foods is long. When prospective patients send me their at-home food sensitivity lab results and I see numerous food reactivities, it often tells me that the problem isn’t necessarily a legitimate sensitivity to every single food on the list, but an overall lack of gut health and an overreaction of the immune system to many foods that may not be a problem when your body is less inflamed and aggravated.
In my experience, when patients retake these tests months later, they may get different results because labs are snapshots in time. If your health and lifestyle have changed, your results are likely to change, too. The results for any lab, food sensitivity labs included, are looking at the specific day and time that the lab specimen was collected. Life and health are dynamic, so on any given day, your immune system could be behaving differently and reacting differently to different foods. And in the case of someone with multiple food sensitivities, their immune system is even more likely to have ups, downs, twists, and turns, depending on the day in the short term, and changes in health over the long term.
So what do you do if your results reveal many food sensitivities? This is when I recommend rotating the foods you eat, to keep your immune system more calmed and balanced by avoiding eating one food too often. My goal as a functional medicine practitioner is not to have patients just avoid every food that shows a positive reaction in a test, but to treat the underlying issues causing the sensitivities to flare up. Depending on how many foods are positive, I may have patients limit or avoid those foods for a time while actively working on healing the underlying gut-immune problems that are causing the reactions in the first place. Also, I recommend actively working on improving your gut health – this is generally a good idea anyway, but it can certainly help to reduce immune system reactivity. Later, when health improves, chances are good that many of the foods on that long list can be successfully re-introduced.
Another thing to consider is how you will respond to your test results. If you see that you have numerous food sensitivities detected by an at-home test kit, will this lead to more stress and anxiety for you? Will you worry that you can’t eat anything but air and ice cubes? Stress and anxiety are not good for gut health, or health in general! For some people, labs like these without a qualified functional medicine doctor or coach can fuel food anxiety and eating problems like orthorexia, so if this feels like something you’d be predisposed to, I’d recommend avoiding them.
Who should take these at-home tests?
DIY food testing labs can provide you with a good, base-level window into how your immune system is reacting to foods. If you can’t or don’t want to work with a functional medicine practitioner right now, I see these labs as beneficial for people who have tried healing their guts on their own but feel like they aren’t getting anywhere or are stuck at a plateau, or for people who have already cleaned up their diets but are still having some symptoms. Information about specific foods to avoid for a while can jumpstart your healing. A direct-to-consumer microbiome test like Viome can add further information. Together with food tests, they can give you a good overall look at the landscape of microbiome.
Bottom line: These tests can still give you enough information to start cleaning up your diet, even if you aren’t yet ready to consult a professional.
But what if you don’t want to pay the price? There is another option that may give you even more specific and accurate advice…and it’s free! It is an elimination diet. This temporary diet strategy can help anyone who wants to kick off their gut-healing journey by finding food sensitivities on their own. Just about anyone can do an elimination diet. Explore for yourself how foods make you feel by giving your body some time away from the most common inflammatory foods. When you eat nothing but gut-healing, anti-inflammatory foods for a period of time, then slowly reintroduce potentially problematic foods one by one to see how you feel eating them again, you may find that the results are clear and directly coincide with your actual symptoms. It may take a little more effort than taking a blood sample and mailing an envelope, but it’s an investment in your health that almost always pays off.
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