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Why Elimination Diets and Food Journals Typically Don't Identify All Food Sensitivities: The 3-Week Problem Explained
Elimination diets operate on a critical assumption: that you'll notice a reaction shortly after reintroducing a food. This works for food allergies (IgE reactions) that occur within minutes to hours. However, food sensitivities (IgG and Immune Complex/Complement (C3d)) can take up to three weeks to manifest – by then, you've reintroduced multiple foods, making it extremely difficult to identify the true trigger(s).
Dr. Paul Deglmann, a functional medicine practitioner with over 20 years of experience, has seen this scenario countless times. In his guide, he explains why traditional elimination diets and food journals often fail to catch delayed food sensitivities. Dr. Paul also educates us on the testing methods that can finally provide the answers you've been searching for!
Video: Why so many are suddenly reacting to so many foods?
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Understanding Food Sensitivities:
Why Adults Develop New Food Reactions | A Comprehensive Guide
Nearly 20% of adults believe they have food allergies, though only about half have confirmed allergies. The rest likely experience food intolerances or sensitivities. Additionally, up to 20% of the global population is estimated to have some form of food intolerance.
Why the following article and video from Dr. Paul matter?
- The Problem: Elimination diets assume almost all reactions happen within 24-72 hours
- The Reality: Food sensitivities can take 3 hours to 3 weeks to manifest
- The Challenge: By the time symptoms appear, you've eaten several other foods
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The Solution: Understanding why testing may succeed where diets fail
Many adults experience a puzzling phenomenon: suddenly reacting to foods they've eaten their whole life. Understanding the difference between food allergies and sensitivities can help explain these changes. Dr. Paul Deglmann, a functional medicine practitioner in Minneapolis-St. Paul with over 20 years of experience, shares insights into why these reactions develop and how proper testing may help identify them. Research suggests that approximately 20% of adults may develop new food sensitivities as adults. This phenomenon raises important questions about digestive health and immune function. Dr. Paul explains...
Food Sensitivities
Food Allergy Vs Food Sensitivities: Understanding the Differences...
Food Allergies: Immediate Immune Responses
Food allergies involve IgE-mediated immune responses that typically occur within minutes to three hours of exposure. Studies indicate these affect approximately 4% of adults.
Typical symptoms may include:
- Hives or skin reactions
- Respiratory Symptoms
- In severe cases, anaphylactic reactions
Common examples include reactions to peanuts and shellfish, where responses are typically immediate and identifiable.
Food Sensitivities: Delayed Reactions!
Food sensitivities, which may affect a significant portion of the population, involve IgG-mediated responses that can manifest anywhere from three hours to three weeks after consumption. This delayed timeline makes identification challenging through conventional methods.
Possible symptoms include:
- Cognitive effects (brain fog)
- Headaches
- Digestive discomfort
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Fatigue
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Joint discomfort
Food Allergy Vs Food Sensitivity Comparison
Why Adults Develop New Food Reactions: Three Primary Pathways
According to functional medicine principles, new food reactions typically develop through three main mechanisms:
1. Gradual Intestinal Changes
The intestinal barrier may experience gradual changes over time, similar to normal wear and tear. Since approximately 70% of immune activity occurs in the gut, these changes can eventually affect food tolerance.
2. Post-Infectious Changes
Some individuals report changes in food tolerance following infections. Gastrointestinal infections, influenza, or other illnesses may alter digestive function and immune responses.
3. Genetic and Environmental Factors
Genetic predispositions to certain sensitivities may remain dormant until environmental factors – such as stress, environmental exposures, or lifestyle changes – influence gene expression. Research in epigenetics suggests that environmental modifications can influence these genetic expressions.
The Role of Intestinal Permeability - "Leaky Gut"
Intestinal permeability, sometimes referred to as "leaky gut" in functional medicine, describes a condition where the intestinal barrier function is compromised. When tight junctions between intestinal cells don't function optimally, various substances may cross the intestinal barrier, potentially triggering immune responses!
Distinguishing Food Reactions from Other Digestive Issues
Understanding Different Causes of Digestive Discomfort
It's important to note that not all digestive symptoms indicate food allergies or sensitivities.
Other potential causes include:
- Digestive insufficiency: Low stomach acid, low digestive enzyme production and/or poor gallbladder function/bile flow
- Microbiome imbalances: Dysbiosis affecting digestion
- Mechanical issues: Eating too quickly or inadequate chewing
The Role of Testing in Identifying Food Reactions
Why elimination diets and food journals often can't identify all food sensitivities:
If elimination diets worked for everyone, you wouldn't be reading this. But here's the truth: they fail for millions of people with food sensitivities, and it's not because you're doing them wrong.
The Critical Flaw? Timing. Elimination diets assume your body will react to problem foods within three days of eating them. This works perfectly for immediate food allergic reactions (IgE responses) that show up within hours. But food sensitivities (IgG and Immune Complex/Complement (C3d)) play by different rules entirely – they can take anywhere from three hours to three weeks to cause symptoms.
Think about what this means: You eat dairy on Monday, feel fine all week, then develop brain fog the following Tuesday. By then, you've reintroduced wheat, eggs, and soy. Your carefully kept food journal can become useless and confusing.
When elimination diets and food journals don't provide clear answers, functional lab testing may offer additional insights. Dr. Paul often utilizes:
- IgE antibody testing for identifying allergic responses
- IgG and Immune Complex/Complement (C3d) testing for identifying potential sensitivities
- Comprehensive digestive analysis to understand gut health
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Intestinal permeability testing to assess barrier function
A Functional Medicine Approach to Food Sensitivities
Functional medicine seeks to identify and address root causes rather than just managing symptoms. This approach involves comprehensive assessment and individualized protocols based on each person's unique situation.
Testing Methods for Food Sensitivities
Functional medicine takes a comprehensive approach to identify both immediate and delayed food reactions that conventional testing often misses:
Core Functional Medicine Tests
1. IgG and Immune Complex/Complement (C3d) Food Antibody Panel (32-176 foods)
- Identifies delayed immune reactions (3 hours to 3 weeks post-consumption)
- Shows severity levels: mild, moderate, severe reactions
- Catches hidden triggers that elimination diets miss
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Reveals foods causing chronic inflammation
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Most useful for: fatigue, headaches, brain fog, digestive issues, joint pain, skin issues or chronic/unexplained symptoms
2. Intestinal Permeability Assessment (Leaky Gut Test)
- Measures zonulin levels (gut barrier protein)
- Gut Barrier Panel tests for leaky gut syndrome by measuring IgG and IgA antibodies against four key markers (Candida, Zonulin, Occludin, and LPS), with positive results indicating potential gut permeability issues that may require a gut healing protocol
- Identifies root cause of why sensitivities developed
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Determines healing protocol intensity needed
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Guides supplement selection (L-glutamine, zinc carnosine, omega 3s/fish oils, vitamin A and DGL)
3. Microbiome Mapping
- DNA analysis of gut bacteria diversity
- Identifies missing beneficial bacteria
- Rules out overgrowth of H. Pylori, opportunistic bacteria, yeast/candida and parasites
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Guides targeted probiotic therapy
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Measures several immune and gut-specific inflammatory markers
Advanced Functional Testing
4. Organic Acids Test (OAT)
- Shows yeast/bacterial overgrowth markers
- Identifies oxalate issues (kidney stones, joint pain)
- Reveals mitochondrial dysfunction
- Indicates neurotransmitter imbalances
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Can help explain food cravings and reactions
5. Histamine/DAO Assessment
- Measures histamine levels and degrading enzymes
- Explains reactions to fermented/aged foods
- Not a true allergy but causes allergy-like symptoms
- Guides low-histamine diet protocol
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Often overlooked cause of food reactions
6. Microbiome Mapping
- Reveals dysbiosis and bacterial imbalances
- Identifies candida, parasites, pathogenic bacteria
- Measures inflammation markers (calprotectin, lactoferrin)
- Shows digestive enzyme production
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Assesses short-chain fatty acid production
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Critical for understanding WHY reactions occur
7. Cyrex Arrays (Specialized Panels)
- Array 3: Wheat/gluten proteome reactivity
- Array 4: Gluten-associated cross-reactive foods
- Array 10: Multiple food immune reactivity screen
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Most comprehensive for gluten-related disorders
- Identifies molecular mimicry reactions
Key Differences from Conventional Approach:
Dr. Paul's approach is very different from conventional approach. His approach:
- Tests for delayed reactions, not just immediate
- Identifies subclinical reactions before disease develops
- Focuses on barrier function and root causes
- Includes assessment of gut ecosystem
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Addresses inflammation at cellular level
Unlike conventional scratch tests that only detect immediate IgE allergies (affecting only 2-5% of adults), functional medicine testing captures the full spectrum of food-immune interactions, allowing practitioners to create targeted healing protocols that address root causes rather than just managing symptoms indefinitely.
Book a free phone consultation with Dr. Paul
For those experiencing unexplained food reactions or digestive symptoms, Dr. Paul Deglmann offers complimentary 15-minute educational consultations to discuss gut health concerns and explain testing options.
Frequently Asked Questions About Food Sensitivities
Q: How long after eating might food sensitivity symptoms appear?
Research suggests food sensitivities may manifest anywhere from 3 hours to 3 weeks after consumption, unlike allergic reactions which typically appear within minutes to 3 hours.
Q: Can adults develop new food sensitivities?
Yes, adults frequently develop new food sensitivities. Research shows approximately 80% of self-reported food hypersensitivity in adults develops at or after age 15, and among adults with confirmed food allergies, 48% developed at least one as an adult.
Q: Why Adult-Onset Food Sensitivities Happen?
The development of food sensitivity is directly related to increased permeability of the intestinal barrier - commonly called "leaky gut." This allows undigested food particles to escape the intestine, triggering immune responses that develop into chronic food intolerances.
Here is a common scenario by age:
- In our 20s: Strong gut barrier, diverse microbiome, efficient digestion
- In our 30s-40s: Accumulated stress, dietary choices, and medications start wearing down gut integrity
- In our 40s-50s: Hormonal changes and chronic stress accelerate gut barrier breakdown
- From 50s+: Decreased stomach acid and enzyme production affect digestion
Common Triggers Include:
- Infections: Post-gastroenteritis changes to gut barrier
- Antibiotics: Often reported as triggering sudden food intolerances by disrupting the gut microbiome
- Chronic stress: Stress hormones induce changes that alter the gut microbiome and increase intestinal permeability
- Pregnancy: Hormonal changes affect gut permeability
- Processed foods: Can alter gut microbiota and intestinal barrier, increasing susceptibility to sensitization
The Microbiome Connection: Your gut microbiome plays a key role in developing both allergies and intolerances. Microbial imbalance (dysbiosis) often occurs before food allergies develop.
Key Difference from Childhood Allergies: Unlike childhood allergies, adult food sensitivities typically develop from gut damage accumulating over months or years, encouraging inflammation and interfering with digestion.
The Good News: Food sensitivities are often reversible. Normal gut permeability can usually be restored once causative factors are identified and corrected through gut healing, microbiome restoration, and dietary modifications.
** References:
1. Lam HCY et al. European Journal of Clinical Nutrition. 2023;77:833-840
2. Gupta RS et al. JAMA Network Open. 2019;2(1):e185630
3. Multiple peer-reviewed sources on gut health and food sensitivities (2019-2024)
Q: What testing methods are used for food sensitivities?
The most effective approach combines multiple tests to get the complete picture:
1. IgG and Immune Complex/Complement (C3d) Food Antibody Panel (32-176 foods)
- Identifies which foods your immune system is actively fighting
- Shows severity levels (mild, moderate, severe reactions)
- Catches those delayed reactions that elimination diets commonly miss
2. Intestinal Permeability Test ("Leaky Gut" Assessment)
- Measures if your gut barrier is compromised
- Can explain WHY you developed food sensitivities in the first place
- Guides how aggressive your healing protocol needs to be
3. Microbiome Mapping
- Reveals dysbiosis, inflammation, and digestive function
- Identifies parasites, yeast, or bacterial overgrowth
- Shows if you're properly breaking down foods
4. Genetic Testing (Optional)
- Checks for gluten sensitivity and Celiac genetic predisposition genes (HLA-DQ1, HLA-DQ3, HLA-DQ2 and HLA-DQ8)
- Helps predict which sensitivities might be permanent vs. temporary
Unlike the spin prick or RAST skin tests at allergies (which only detect immediate IgE reactions), these tests can catch the delayed, hidden reactions commonly contributing to your chronic symptoms. Once available, Dr. Paul goes over these results in detail with his patients and develops a personalized protocol specifically for them.
Q: Are food sensitivities reversible?
Research shows that most food sensitivities can be reversed by addressing their root cause – intestinal permeability (leaky gut). This is one of the most encouraging aspects of functional medicine. Unlike true food allergies (IgE reactions), which tend to be permanent, food sensitivities (IgG and Immune Complex/Complement (C3d) reactions) often develop due to reversible factors like leaky gut, dysbiosis, or inflammation. When the gut barrier heals, the immune system stops encountering undigested food particles, and IgG antibody production decreases.
When you heal the gut barrier and address the root cause, your immune system often stops reacting to those foods. Dr. Deglmann has seen patients successfully reintroduce foods they couldn't tolerate for years. The key is understanding that food sensitivities are usually symptoms of underlying gut dysfunction, not permanent conditions. Healing typically involves a 3-6 month protocol of gut repair, though some people see improvements within weeks.
Even genetic predispositions aren't destiny – through epigenetics, changing your environment and healing your gut can actually modify how your genes express themselves.
Here is a typical comprehensive healing gut protocol timeline:
Phase 1 (0-3 months): Remove triggers, reduce inflammation
Phase 2 (3-6 months): Repair gut lining, restore microbiome
Phase 3 (6+ months): Gradual food reintroduction
Important note: Success rates vary significantly based on individual factors including the severity of gut dysfunction, compliance with protocols, underlying conditions, and the specific foods involved. Working with an experienced functional medicine practitioner can optimize your chances of successful food reintroduction.
Remember: The key difference - food allergies (immediate IgE reactions) are typically permanent, while food sensitivities (IgG and Immune Complex/Complement (C3d)) are often temporary manifestations of gut dysfunction that can improve with proper treatment.
Q: Why might someone develop food reactions later in life?
Our gut at 25 is like a brand new filter-everything typically works well. By 45, it's commonly like a coffee filter that's been used too many times – full of holes. Here's what creates those holes:
The Decade-by-Decade Breakdown:
Mechanical Wear (happens to everyone):
- Stomach acid decreases 1-2% per year after 30
- Digestive enzymes drop 10% per decade
- Intestinal cell turnover slows from every 3 days to every 5-7 days
- Beneficial bacteria species decline from 1000+ to less than 300
Lifestyle Accumulation (the variables):
- Antibiotics: Average adult has taken 17 courses by age 40
- Stress: 15+ years of elevated cortisol degrades gut lining
- Medications: NSAIDs, PPIs, etc. affect gut integrity
- Diet: 30 years of processed foods depletes microbiome
- Alcohol: Social drinking for decades irritates intestinal walls
The Triggering Event (the final straw):
- Major stress (divorce, job loss, death in family)
- Illness (food poisoning, flu, surgery)
Result: Our gut barrier fails, food proteins can leak through, immune system reacts, and suddenly we have sensitivities to foods we've eaten for 40 years. The foods didn't change – our ability to process them did.
For those experiencing unexplained food reactions or digestive symptoms, educational consultations are available. Dr. Paul Deglmann offers complimentary 15-minute educational consultations to discuss gut health concerns and explain testing options.
"What can I expect in working with Restorative Health Solutions?"
At Restorative Health Solutions, we strive to get to the root cause of the symptoms/condition and help patients finally reach their optimal health. We also guarantee to replace the 'one-size-fits-all' approach with a personalized plan for you!
How we dramatically lower the recurrence of your symptoms:
1. Our comprehensive initial assessment with you to ensure we're a good fit in partnering to take back control of your health and quality of life.
2. We take the time to educate our patients on what's really going on, to make our patients more empowered in their health journey.
3. State-of-the-art testing used strategically, to eliminate the guessing and finally get to the root cause of your symptoms.
4. Our functional medicine approach, combined with many years of experience in functional neurology, is comprehensive and gets to the root cause(s) of the problem. The result of this approach is that our patients have a better chance at being healthier long-term with much lower recurrence rates of the problem.
If you or a loved one are having any strange GI symptoms, or interested in getting a thorough and complete work-up, we’d be happy to help. Please don't hesitate to ask us questions and get a second opinion with us at Restorative Health Solutions.
We look forward to helping you Restore Your Gut Health, and your quality of life!
Sincerely,
Dr. Paul Deglmann, DC, DACNB, FACFN and Dr. Kyle Warren, DC, CFMP
Owners at Restorative Health Solutions- Edina, MN
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FAQs:
Do you offer virtual consultations?
At Restorative Health Solutions we offer both in-person and virtual consultations. Feel free to share your preference with our front desk when you reach out. *We do not work with patients that live outside of the United States.
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Typically how long are the appointments?
The initial appointment after the first phone call is around 90 minutes on average. Follow-up visits are usually 30 minutes.
How many visits will I need?
This of course, depends on your unique situation and plan for recovery! Typically, our follow-up visits are every 3-6 weeks in the initial phase of the protocol and every 3-6 months for maintenance or wellness visits. Telehealth options are also available.
Do I need a doctor referral to come see you?
No, you do not! We see people referred by doctors, friends and family, and those that are taking charge of their own health.
I am already taking supplements or antibiotics? Can what you do still help me?
Yes, absolutely. Managing your gut microbiome while on Antibiotics is crucial! Please note: taking back control of your health is difficult to do by taking supplements on your own, without clinical guidance. Taking the right supplements, with proper dosage dosing and sequence is crucial for long-term improvement. On our intake form, our patients list any supplements they're already taking to give Dr. Paul a heads up. Supplements taken with proper guidance, can be more effective and help patients to avoid long-term use.
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