Many women report an association between gut symptoms such as bloating and altered bowel habits with eating. As a result, it is not uncommon for women to go down the route of trying to identify triggers for their symptoms. In clinic, we see women who have tried food intolerance tests as a way of managing these symptoms but more often than not, this results in more confusion or a very restricted diet that the are unable to sustain. In this article we will be discussing food intolerance tests, if they work, and how to manage food intolerances and how to manage food intolerances in menopause.

What is a Food Intolerance?

The term “food intolerance” describes unpleasant symptoms that occur each time a specific food is eaten. It differs from a food allergy as allergies are related to the immune system and present the risk of severe and sometimes life-threatening allergic reactions, also known as anaphylaxis. 

There are many different types of food intolerances, and the symptoms can vary between individuals, with various severities and onset times. The most common intolerances are as follows:

• Lactose intolerance
  • Occurs when you have too little or no lactase, the enzyme that helps to digest lactose, the sugar found in dairy products.
• Histamine intolerance
  • A reaction to vaso-active amines, naturally occurring products found in foods such as red wine, blue cheese, tuna, pork products, tomatoes, and other preserved foods.
• Gluten intolerance
  • A reaction to the proteins found in wheat, barley, and rye.
  • Differs from coeliac disease.
• Salicylate sensitivity
  • A substance chemically similar to aspirin.
  • Found in some fruits, vegetables, nuts, herbs, and spices.

What are the symptoms of food intolerances?

Symptoms of food commonly effect the digestive, skin, and respiratory systems:

• Skin symptoms can include urticaria (raised red, itchy rash), flushing of the skin, eczema flare ups, and angioedema (swelling of the tissue).
• Digestive symptoms including abdominal pain, diarrhoea, bloating, stomach cramps, and constipation. May be the result of irritable bowel syndrome. 
• Respiratory symptoms can include breathing difficulties, wheezing, and rhinitis (nasal congestion, runny nose, sneezing, and itching).
• Some people also experience other symptoms like headaches and palpitations [1].

Are food intolerances a problem in menopause?

Researchers have identified a higher prevalence of IBS symptoms and/or greater symptom severity in women. Multiple biological, surgical, psychosocial, and behavioural factors may influence the gastrointestinal health of midlife women. Women in the menopause transition commonly reported digestive disturbances, both new symptoms or worsening existing symptoms.  The connection between sex hormones and digestive disturbances is well-known.[2]

A study amongst peri-menopausal and post-menopausal women found that perimenopausal and postmenopausal women had a high prevalence (38% vs 14% for premenopausal women) of self-reported altered bowel function. The prevalence (36%) of IBS-type complaints peaked in the aged 40 to 49 group. [3]

To learn more about gut health and menopause, read our blog article on the topic here.

What are Food Intolerance Tests?

Food intolerance tests have become more popular over recent years with companies using tests such as hair and blood samples to identify the presence of intolerances. 

Do not confuse these food intolerance tests with conventional allergy testing, which regulated health professionals perform and are based on evidence. Common food allergy tests are as follows:

• Skin prick test
  • The procedure involves placing a small amount of the suspected allergen onto the skin and then pricking the skin.
  • Monitor the skin for any lumps, and if the findings align with a person’s clinical history, diagnose an IgE-mediated food allergy.
• Blood tests
  • Eat the suspected food, and use a blood test to measure the amount of IgE antibodies in the blood.
  • IgE antibodies are seen in higher levels when the body is having an allergic reaction.
• Food challenges
  • The food will be eaten in small amounts, gradually increasing.
  • A clinician will check to see if any symptoms are shown at each stage.
• Food exclusion and reintroduction
  • This method involves removing the suspect food from the diet and recording symptoms.
  • The food is then reintroduced and if symptoms return this indicates that an allergy may be present.

However, various commercially available tests are now marketed to diagnose food intolerances. Some commercially available tests include:

• IgG blood test
  • This blood test looks at IgG antibodies in the blood related to specific foods.
• Hair analysis
  • A hair sample is tested by scanning energy fields in the hair and comparing to a database [4]. 

Do food intolerance tests work?

Conventional allergy testing is scientific based and performed by professionals, therefore they are the gold standard for diagnosing an allergy. A food allergy involves the immune system, distinguishing it from a food intolerance. Commercially available food intolerance tests are not based in scientific evidence therefore can be a waste of money and incorrectly diagnose food intolerances.

In terms of IgG blood tests, they claim that an increase in IgG to a certain food indicates an intolerance to that food. However, research shows that an increase in IgG antibodies is seen in all healthy adults and children, with and without symptoms. This indicates that IgG is not an accurate diagnostic tool but part of a normal immune response to food [5].

Hair analysis is another popular commercially available intolerance test. While hair analysis can identify factors like recreational drug use, lead, and mercury poisoning, its application in allergy testing lacks proven efficacy [6]. 

These food intolerance tests pose a primary risk of unnecessarily excluding a long list of foods from the diet. Doing this could put you at risk of nutritional deficiencies, malnutrition and reduce overall quality of life.

Managing Food Intolerances in Menopause

So, what is the gold standard for testing for food intolerances? 

If you suspect that you have a food intolerance, it is important to visit a healthcare professional for advice. They will collect a detailed clinical history and decide the best course of action for treatment. At present, clinicians do not use tests, such as blood tests, to diagnose food intolerance; hence, the primary course of treatment is elimination diets.

Elimination diets involve avoiding the suspected intolerance from the diet for 2-6 weeks, as advised by a healthcare professional. During this time, maintain a food diary to ensure adequate avoidance of the food, and keep a symptom diary to monitor symptoms throughout the elimination phase.

After eliminating the food, reintroduce it into the diet to observe if symptoms return. If symptoms do reappear, the clinician can diagnose food intolerance. Seeking guidance from a dietitian at this point may also prove useful to determine whether any adjustments are necessary in the diet to prevent nutritional deficiencies during the elimination process. [1].

Summary

Food intolerances can cause uncomfortable symptoms for many. Tests advertised as methods to diagnose intolerances exist; however, research indicates that tests such as blood and hair samples cannot diagnose intolerances. Seeking advice from a healthcare professional and following an elimination diet is currently the best course of action for identifying food intolerances.

If you would like support with managing a food intolerance, please book a free 15 minute call with me here.