I received this email recently from a patient, prior to his visit to our clinic. In it, he references an AARP bulletin that warns of “medical procedures that you don’t need”. We always appreciate these emails from patients (and potential patients) and I wanted to share it with our readers. Please feel free to comment!
Hello Dr. Wangen -
The following was in AARP Bulletin May 2012, Vol. 53, No. 4. I transcribed this verbatim.
If you have a moment, I’d like to know what your opinion is on this information and if I need to do anything to avoid false positives prior to my visit, if that is even possible?
Title of Article: 7 Medical Procedures You Don’t Need
6. Dubious diagnostic tests for suspected allergies.
American Academy of Allergy, Asthma and Immunology
Some 35 million Americans suffer from seasonal allergies. And millions of Americans increasingly blame a food allergy or sensitivity – from gluten to milk – for their health woes. Some doctors or health workers now perform a blood test, called an IgG, for food allergies. But Linda Cox, M.D., of the allergy academy says the test simply doesn’t work. A positive result in an IgG test is the sign of a normal immune system, not a food allergy. “It leads to a lot of confusion, ” Cox says. If you’ve been eating any kind of food, there’s a good chance you will develop an IgG antibody, she says. “And that has nothing to do with allergy.” For seasonal allergies, many doctors run a battery of blood and skin tests dubbed IgE, when just a few specific tests would do. By asking patients when and where they have symptoms, doctors can pinpoint what tests to run.
Dangers: The superfluous use of medications; an overly restricted, unbalanced diet.
Dear Mr. XXXXXX,
Thanks for writing and expressing your concern. I certainly understand it.
The problem is this: The AAAAI has redefined allergy to suite their own purposes. Their new definition (as opposed to the definition that has been in medical dictionaries for years) states that only IgE reactions that produce the typical allergy symptoms (eczema, hives, asthma, itchy eyes, anaphylaxis, etc.) are allergies.
The text you cite also has statements about IgG reactions that fly in the face of reason and the published research. Some of these statements are just wrong. For example: ” Some doctors or health workers now perform a blood test, called an IgG, for food allergies.” There is no test called an IgG. There is a test method called enzyme linked immunosorbent assay (ELISA) that has been adapted to detect IgG antibodies in human blood. Another example: “If you’ve been eating any kind of food, there’s a good chance you will develop an IgG antibody,”. We have run literally thousands of tests for IgG antibodies. The vast majority do not show reactions to many of the foods that are most common in the specific patient’s diet. My own test, for example did not show any reaction to many foods common in my diet, such as eggs, pork, beef, peanuts, etc. These kinds of statements have no scientific basis.
First – your body does not randomly make antibodies. If a substance in your body is not causing a problem your body will not generally make antibodies to it. However, once the immune system starts to create antibodies to a substance the biochemistry is set – exposure to the substance will result in the antibody binding to the substance, and the cascade of immune response is initiated. This is not a choice – it is chemistry. The way in which the immune system manifests the chemical changes that happen when antibodies are binding varies significantly. But antibodies necessarily initiate this chemical reaction. Antibodies are made to initiate the immune response. And they do, because they are chemicals, not intelligent beings.
Second – here below is a list of published studies that have found that IgG reactions can produce symptoms – outside of the typical symptoms usually thought of as allergies. This list is by no means exhaustive, but you get the idea – there is plenty of published medical research that demonstrates the value of IgG antibody testing.
Alpay et. al. (2010). Diet restriction in migraine, based on IgG against foods: A clinical double-blind, randomised, cross-over trial. Cephalalgia. 2010 July; 30(7): 829–837.doi: 10.1177/0333102410361404. [Full Text]
Arroyave Hernández et. al. (2008). Food allergy mediated by IgG antibodies associated with migraine in adults. Rev Alerg Mex. 2007 Sep-Oct;54(5):162-8.
Drisko et. al.(2006). Treating Irritable Bowel Syndrome with a Food Elimination Diet Followed by Food Challenge and Probiotics. Journal of the American College of Nutrition, Vol. 25, No. 6, 514-522
Yang and Li (2007). [The therapeutic effects of eliminating allergic foods according to food-specific IgG antibodies in irritable bowel syndrome][Article in Chinese]. Zhonghua Nei Ke Za Zhi. 2007 Aug;46(8):641-3.
Ou-Yang, et. al. (2008). [Application of food allergens specific IgG antibody detection in chronic diarrhea in children.] [Article in Chinese]. Zhongguo Dang Dai Er Ke Za Zhi. 2008 Feb;10(1):21-4.
Wilders-Truschnig et. al. (2008). IgG antibodies against food antigens are correlated with inflammation and intima media thickness in obese juveniles. Exp Clin Endocrinol Diabetes. 2008 Apr;116(4):241-5. Epub 2007 Dec 10.
Zuo, et. al.(2007). Alterations of food antigen-specific serum immunoglobulins G and E antibodies in patients with irritable bowel syndrome and functional dyspepsia. Clinical & Experimental Allergy 37 (6), 823–830.
And Third: You can read my blog response to this push by the AAAAI to limit their responsibilities:
You can also read this blog response by a doctor in Toronto who got really mad when she saw this stuff about allergies:
Please let me know if you have any questions, or find a study that proves non-IgE antibody reactions don’t usually have a deleterious effect on health.
Article Courtesy: Dr. Stephen Wangen
Image thanks to marsdd.com
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