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Enterolab - quantity of allergen consumed

 
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nsaidcolitis
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PostPosted: Sat Dec 21, 2013 11:39 pm    Post subject: Enterolab - quantity of allergen consumed Reply with quote

I am doing the enterolab test A + C. How much food do you have to consume for the test to be reliable? I ate some foods containing milk, soy, eggs, gluten last week (all in a brownie and some muffins) and yeah got very bloated and painful. I had real eggs like 2 months ago and real milk 3 months ago. I was wondering how long ago the food must've been ingested and how much of a food needs to be taken for the test to be reliable. Does the food need to be ingested in very small amounts like in a brownie or in huge amounts like in a whole egg.

I live in new york so I will have to travel to connecticut to have the test and pay out of pocket so I dont want to mess this up.

Should I eat some milk and eggs? I'd be happy too animated cat during it....but probably not later crying
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DJ
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Food Intolerances : gluten, dairy, eggs, soy, kidney beans (and most other legumes), nuts, especially almonds and peanuts, tapioca, xanthan gum, and chicken
Location: Upstate NY

PostPosted: Sun Dec 22, 2013 8:04 am    Post subject: Reply with quote

I'm very interested in this question too. With much trial and error, I now consider that I have been entirely GF, SF, DF. NF,and chicken free for quite a while and I'm considering Enterolab testing. When I did a very strict elimination diet about 3 years ago, I learned exactly what my biggest sensitivities are but only avoided the offending foods rather that eliminating. I had two additional foods in the maybe category - chicken and eggs - that I added back in but it seems that they would sometimes (but not always) cause increased GERD and gut churning. As you know, when there are multiple offenders, it's hard to figure things out.
I too would like to know what I need to do to get the most accurate results.
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nsaidcolitis
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PostPosted: Sun Dec 22, 2013 9:47 am    Post subject: Reply with quote

I think I'd waste money on this testing if i am not careful as my symptoms wane and fade FAST. I ate potatoes two days ago and I'm fine a few days later (not fine but the bloating and pain reduced a lot).

Now if only MC were my only problem and it was a few months ago...i'd be a happy camper Very Happy
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tex
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Food Intolerances : Gluten, casein, soy, and avenin, (avenin is the prolamin in oats, which is equivalent to the gluten in wheat), beef, grapes, peanuts, cashews, almonds, (but nut butters seem OK except for peanuts), citric acid, chocolate, and agar.
Location: Central Texas

PostPosted: Sun Dec 22, 2013 11:49 am    Post subject: Reply with quote

This is a tough question, because we are all different in our sensitivity levels, and there is no easily-defined cutoff point that defines how long we can wait after eliminating a food from our diet, and still get a reliable test result. The length of time that can elapse between the time at which we cut a food out of our diet, and the time we collect a sample for testing, and still get a reliable test result, will depend on how high our antibody level was to begin with (when we stopped eating that particular food). The longer we have been reacting, the higher our antibody levels will be. The longer we wait, the more those levels decay.

The half-life for anti-gliadin antibodies (for gluten testing) is 120 days, so gluten antibody levels are very slow to decay, and EnteroLab's anti-gliadin test can reliably detect gluten for at least a year after gluten is removed from the diet, in virtually every case. For most cases, the test will reliably detect anti-gliadin antibodies for up to 2 years after gluten is removed from the diet.

Antibodies to the other inflammatory foods have a much shorter half-life, however. Most of them have only about a 6-day half-life. That's only 1/20 the half-life of anti-gliadin antibodies. So as a rough guide, we can estimate that they may be detected only about 1/20 as long as gluten, after removal from the diet. That would suggest that antibodies to casein, soy, eggs, etc., can be reliably detected in every case for 52/20 = slightly over 2 and 1/2 weeks, and in some cases (if the initial antibody level is high) up to 5 or 6 weeks. After that, tests will show positive results only in cases where reactions have been going on for a very long time (multiple years).

Or, and this is a big OR, results will depend on the purity of one's diet. Most people are sure that they are complying with an exclusion diet much better than they actually are. But the reality is that despite our best efforts, cross-contamination is a constant threat, and many of us are eating diets that are cross-contaminated, in one way or another, especially if we eat out, or we eat any processed foods on a regular basis. The cross-contamination may occur only in trace amounts, but our diet will still be cross-contaminated sufficiently that the antibodies will show up in an EnteroLab test. And of course, that cross-contamination may be the reason why remission can be so elusive for many of us.

So, as is so often the case, the answer is, "It depends". As a practical consideration, most members here seem to get reliable results up to 2 or 3 months after removing any food (other than gluten) from their diet. IMO, if one is sensitive to gluten, an EnteroLab test will always be positive, no matter how long the GF diet has been rigorously followed. Why? Because the half-life of anti-gliadin antibodies is long enough that their longevity trumps everything else. IOW (IMO), no one is capable of eating a pure diet long enough for their anti-gliadin antibody level to decay to below the threshold for a positive test result. In this heavily cross-contaminated world, we all ingest enough gluten (in trace amounts, either regularly or sporadically) to prevent our anti-glaidin antibody level from ever decaying to normal (non-reactive) levels. That may also apply to the other inflammatory foods in some cases, depending on our diet (whether we eat processed foods, supplements, medications,etc., and whether we eat away from home).

Sorry, I wish that there were a clear-cut answer. That said, if you want to maximize your chances of obtaining accurate and reliable results on the EnteroLab tests, here are my thoughts on how to go about it. I wouldn't worry about a false-negative gluten result. Unless you're eating the purest diet in the world, if you're sensitive to gluten, it's going to show up in the EnteroLab test results as a positive result (based on the reasons cited in the last paragraph).

For the other foods, if I hadn't eaten them within the last 6 to 8 weeks before taking a sample, then before taking a sample, I would eat at least a small (significant) amount, each day, for at least 4 or 5 days in a row. I would then wait approximately 5 days (to maximize immune system sensitivity), and then I would eat at least a small amount of the food/s. The next day I would take a sample. That should optimize your chances of getting accurate test results if you haven't eaten certain foods for a long period of time. Incidentally, if you aren't reacting on the day that you take the sample (or the previous day), then you are almost surely not sensitive to that food (or to those foods), because this is how one confirms a subtle food sensitivity that is difficult to ferret out.

Tex
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DJ
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Food Intolerances : gluten, dairy, eggs, soy, kidney beans (and most other legumes), nuts, especially almonds and peanuts, tapioca, xanthan gum, and chicken
Location: Upstate NY

PostPosted: Sun Dec 22, 2013 9:14 pm    Post subject: Reply with quote

Thanks, Tex. I feel very certain about gluten, soy, dairy, and nuts but if I get a negative test result it may change my psychological resolve to remain free from what made me so sick. I'd like to know about chicken and eggs. I'm betting they will come back positive. I omitted chicken a while back and recently went from eating eggs nearly daily to using them only for baking.

I wonder how harmful it would be to a gut that's had years of pummeling to eat a little of all offenders but gluten for the tests.
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tex
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Food Intolerances : Gluten, casein, soy, and avenin, (avenin is the prolamin in oats, which is equivalent to the gluten in wheat), beef, grapes, peanuts, cashews, almonds, (but nut butters seem OK except for peanuts), citric acid, chocolate, and agar.
Location: Central Texas

PostPosted: Sun Dec 22, 2013 10:08 pm    Post subject: Reply with quote

In general, gluten causes much more severe damage, that takes much longer to heal, when compared with the other inflammatory foods. I would think that reactions due to a short-term exposure to those other foods should pose little risk of long-term damage, but I'm only guessing, since this type of damage has never been explored in an organized study. I certainly wouldn't want to go on record as encouraging anyone to do that, since we can't be sure of the outcome.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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DJ
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Food Intolerances : gluten, dairy, eggs, soy, kidney beans (and most other legumes), nuts, especially almonds and peanuts, tapioca, xanthan gum, and chicken
Location: Upstate NY

PostPosted: Mon Dec 23, 2013 6:44 pm    Post subject: Reply with quote

Yes, it's a big decision, Tex. I've made a lot of progress not only with my gut but with reduction in body pain. At first I though the reduced pain level was Entocort alone because the improvement came so suddenly but I'm beginning to believe that it's also diet/food sensitivity. Amazing, absolutely amazing.
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DJ
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Food Intolerances : gluten, dairy, eggs, soy, kidney beans (and most other legumes), nuts, especially almonds and peanuts, tapioca, xanthan gum, and chicken
Location: Upstate NY

PostPosted: Sat Dec 28, 2013 11:20 pm    Post subject: Reply with quote

Quote:
For the other foods, if I hadn't eaten them within the last 6 to 8 weeks before taking a sample, then before taking a sample, I would eat at least a small (significant) amount, each day, for at least 4 or 5 days in a row. I would then wait approximately 5 days (to maximize immune system sensitivity), and then I would eat at least a small amount of the food/s. The next day I would take a sample. That should optimize your chances of getting accurate test results if you haven't eaten certain foods for a long period of time. Incidentally, if you aren't reacting on the day that you take the sample (or the previous day), then you are almost surely not sensitive to that food (or to those foods), because this is how one confirms a subtle food sensitivity that is difficult to ferret out.


Tex, I'm considering Enterolab testing. I'm certain about my biggest sensitivities but I'm interested in testing eggs, oats, chicken. What is a small significant amount? A tablespoon of oatmeal per day? A cup of oatmeal? A tablespoon of chicken per day? One half egg per day? I know I have problems with peanuts and almonds but I would test walnuts if I could eat just 1/2 nut per day and get results. I understand that you don't have an exact answer but any "ballpark" would help.

Thanks.
DJ
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tex
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Food Intolerances : Gluten, casein, soy, and avenin, (avenin is the prolamin in oats, which is equivalent to the gluten in wheat), beef, grapes, peanuts, cashews, almonds, (but nut butters seem OK except for peanuts), citric acid, chocolate, and agar.
Location: Central Texas

PostPosted: Sun Dec 29, 2013 9:28 am    Post subject: Reply with quote

When I wrote that, I wrote it as if I were seriously considering doing those food challenges. Really, though, I'm not at all sure that I would do that unless I were pretty sure that the reactions would be relatively minor. For one thing, if the reactions were likely to be major, then obviously I should be able to prove a sensitivity simply by doing the challenges themselves, one at a time.

In order to build up an antibody level adequate to yield a valid test result, one must ingest an inflammatory food for a significant period of time, because with continued regular exposure to an antigen, antibody levels continue to slowly increase for an indefinite period of time. That implies a significant number of days of reactions, before an adequate antibody level is attained (one that's capable of reliably triggering a positive test result). By comparison, a trial and error testing program requires only a single exposure to an antigen (and possibly a follow-up repeat exposure, in order to verify the result).

When there are multiple minor food sensitivities however, then combinations of inflammatory foods tend to cause a reaction even though the individual foods by themselves, may seem to be well-tolerated. Or dosages may matter. In those situations, obviously the EnteroLab tests should hold a huge advantage over trial and error testing.

Since you recognize that developing a reliable challenge program is pretty much guess work, here are my thoughts:

For an ordinary gluten challenge, doctors recommend the equivalent of 1 or 2 slices of wheat bread, daily, for at least several months. Those who don't understand how insensitive the blood tests actually are, mistakenly recommend as little as a few weeks or so, while those who recognize how difficult it can be to get a positive result on a celiac blood test, tend to recommend a much longer challenge (such as 5 or 6 months or so). But this is because the blood tests are so insensitive and unreliable.

In view of the fact that the EnteroLab stool tests are at least several orders of magnitude more sensitive (and more reliable) than the blood tests, IMO a gluten challenge that lasted for 1 week would probably provide a reliable test result for most people, and a challenge that lasted for 10 days to 2 weeks should provide a reliable test result for even cases where gluten sensitivity is still a minor problem. IMO, the approximate minimum amount of antigen ingested can probably be far less than the equivalent of 1 or 2 slices of wheat bread. After all, most of us are capable of reacting to a few crumbs of bread, so in view of that, just a decent sized morsel should work. An ordinary cracker, for example, should be adequate, IMO. It should certainly be adequate to prepare one for a stool test, at any rate.

The same guideline should work for any other food sensitivities. Since the half-life of most food antibodies is only 1/20 that of gluten (gliadin), it's tempting to think that one could prepare for a stool test by eating the food for only 1/20 the amount of time (which would be less than a day). But as any engineer familiar with designing models can tell you, it doesn't necessarily work that way. Models are affected differently by virtually all of the physical influences of various parameters when compared with full-size objects, and that probably applies in this case, also, even though we're not actually talking about physical models here.

Anyway, with that in mind, I'm inclined to believe that somewhere between 1 and 2 weeks of food challenges, using approximately (at least) tablespoon-size dosages, should be adequate for preparing for an EnteroLab stool test in situations where the food being tested hasn't been eaten in a (relatively) long time. A single dose each day might be adequate, but an additional daily dose or 2 would probably help to boost the antibody level for a more definitive test result.

Or, I could be all wet. shrug

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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DJ
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Food Intolerances : gluten, dairy, eggs, soy, kidney beans (and most other legumes), nuts, especially almonds and peanuts, tapioca, xanthan gum, and chicken
Location: Upstate NY

PostPosted: Sun Dec 29, 2013 11:45 am    Post subject: Reply with quote

Thank you, Tex. I would not dare with gluten, soy or peanuts or almonds but I might with eggs, oats, chicken and walnuts. Your opinion on this helps me to think it through. I am likely dealing with a bit of denial here. Like chicken, eggs have bothered me intermittently over time. With gluten and soy, I know the correct amount for me is zero but I'm wondering if avoiding large quantities of egg, such as quiche or a plate of eggs, and having eggs only in baked goods, for example, might still allow me to fully heal. I don't want to give up any ground concerning my health yet I want the most livable diet. On the other hand, I'm willing to do a lot to avoid diarrhea and body pain.
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tex
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Food Intolerances : Gluten, casein, soy, and avenin, (avenin is the prolamin in oats, which is equivalent to the gluten in wheat), beef, grapes, peanuts, cashews, almonds, (but nut butters seem OK except for peanuts), citric acid, chocolate, and agar.
Location: Central Texas

PostPosted: Sun Dec 29, 2013 1:57 pm    Post subject: Reply with quote

Yes, I see your point. The beauty of the EnteroLab panel C, is that it ranks the food sensitivities, so that it becomes easier to rank the relative threats imposed by various foods. This can also make it easier to organize a rotation diet plan (or a rotation plan for certain specific foods), if that's on the agenda.

Keep in mind that if you challenge certain foods, but not others, that may cause them to rank higher in the results. That shouldn't be a deal-breaker though, because quite often the foods that we consider to be the biggest problems, are. It's just something to keep in mind, when comparing the test results.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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ldubois7
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Food Intolerances : Gluten, dairy, eggs, soy
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PostPosted: Mon Dec 30, 2013 8:22 pm    Post subject: Reply with quote

Just to throw in my 2 cents ....I never eat beef, but I ate chicken about 6X per week for years. On my Enterolab test both chicken & beef were a 3+ result! I thought that was odd.
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