FOOD INTOLERANCE TESTING - PowerPoint Presentation

1. FOOD INTOLERANCE TESTING

2. TOPICS Terminology Mechanisms of food intolerance Symptoms of food intolerance CNS food intolerance tests Test principles Alternative test methods Managing food intolerances Support documentation

3. “What is food to one man, may be fierce poison to another”Lucretius circa 75BC

4. TERMINOLOGY

5. ADVERSE REACTION TO FOODIgEType I AllergyIgGType III AllergyEnzyme DeficiencyPharmacological EffectChemical EffectIMMUNE MEDIATEDNON–IMMUNE MEDIATEDClassic ‘Allergic’Reaction‘Food Intolerance’ Food IntoleranceCOMMON TERMINOLOGY

6. 1. IMMUNE-MEDIATED REACTIONSFOODALLERGY(Type I)?FOODINTOLERANCE(Type III)?

7. FOOD ALLERGYImmune system responseProduction of IgE antibodies

8. ‘Foreign’ food particles (antigens) cause immediate immune reaction Rapid release of histamineAllergic reaction (anaphylaxis) can cause breathing problems and low blood pressureSymptoms include tingling mouth, hives, swelling of the lips, face, tongue and throatSymptoms can be severe or life-threateningAvoid the offending food for lifeFOOD ALLERGY

9. FOOD INTOLERANCE (IgG)Immune system responseProduction of IgG antibodies

10. “45% of the population suffer from a food intolerance”Non-specific / multiple symptomsMost people are undiagnosedMany clients will be affectedFOOD INTOLERANCE (IgG)

11. Delayed reaction to ‘foreign’ food (antigen) - hours/days after consumptionBody produces IgG antibodies to neutralise antigenForm a complex with antigen: Ag/Ab complex Immune complexFOOD INTOLERANCE (IgG)

12. Complexes deposited in tissues around the bodyTriggers complement cascadeRelease of inflammatory mediatorsFOOD INTOLERANCE (IgG)

13. Leads to chronic inflammation and gradual appearance of symptomsSymptoms can persist for many days, but are not life-threateningSymptoms can be reversed by elimination of foodsRe-introduce small amounts of the offending foodCommon to be intolerant to several different foodsMultiple symptoms are common – difficult to diagnose FIFOOD INTOLERANCE (IgG)

14. CHEMICAL &PHARMACOLOGICAL2. NON IMMUNE-MEDIATED REACTIONSENZYMEDEFICIENCY----------------------- FOOD INTOLERANCE ---------------------

15. Enzyme deficiencies can cause symptoms because foods cannot be digestedLACTOSE INTOLERANCECaused by a deficiency of lactase (needed to digest lactose)Cannot pass through gut wall, so remains in the gutCauses intoleranceSymptoms: bloating, diarrhoea, abdominal painENZYME DEFICIENCY / INSUFFICIENCY

16. HISTAMINE INTOLERANCECaused by a deficiency or inhibition of diamine oxidase (DAO)Needed to break down histamine in foodsAggravated by foods high in histamine: red wine, cheese and tuna fishFoods low in histamine can also trigger the release of histamine in the body: citrus foods, bananas, tomatoes, chocolateSymptoms include: migraines, dizziness, bowel/stomach problems, rhinitis, depression, irritation, reddening of the skinENZYME DEFICIENCY / INSUFFICIENCY

17. MSG in restaurant / take-away food (headaches, sweating, dizziness)Sulphites in dried fruits and vegetables, wine, beer (asthma)Vasoactive amines such as phenylethylamine in chocolate, citrus fruits (migraines)Natural / artificial additives used to colour, preserve and flavour food (sweating, itching, abdominal pain, nausea/vomiting, diarrhoea)Create biochemical side effects in susceptible individualsCHEMICAL / PHARMACOLOGICAL

18. MECHANISMS OFFOOD INTOLERANCE

19. HEALTHY gastrointestinal tract and HEALTHY immune system:Foods digested and broken down to glucose, amino acids and fatty acidsAbsorbed through the gut liningPartially digested foods will also pass between cells into bloodstreamAntibodies produced against these partially digested foodsForm antigen / antibody complexes (normal)Efficient immune system will clear these complexesMECHANISMS OF FOOD INTOLERANCE (1)No symptoms despite an immune response occurring

20. NORMAL RESPONSE TO FOODFoodHealthy GutNo symptomsLow level ofAb/Ag complexesComplexes removed by macrophagesHealthyImmune System

21. HEALTHY gastrointestinal tract, but COMPROMISED immune system:Partially digested foods pass through the gut liningAntibodies produced against these partially digested foodsAb/Ag complexes form (normal)Compromised immune system - insufficient macrophages producedAb/Ag complexes not cleared and circulate in bloodstreamDeposited in tissues – causes inflammationMECHANISMS OF FOOD INTOLERANCE (2)

22. FoodHealthy GutSymptomsLow level of Ag/Ab complexesexcess complexes deposited in tissuesCOMPROMISED IMMUNE SYSTEMCompromised Immune System

23. LEAKY gastrointestinal tract, but HEALTHY immune system:Gut wall becomes more permeableTight junctions in epithelial layer open upIncreased number of partially digested foods enter bloodstream Ag/Ab complexes form – immune system becomes overloadedComplexes cannot be cleared and are deposited in tissuesMECHANISMS OF FOOD INTOLERANCE (3)

24. FoodLeaky GutSymptomsHigh level of Ag/Ab complexesexcess complexes deposited in tissuesLEAKY GUTNormalImmune System

25. AntibioticsMedication/Drugs Candida overgrowthParasitesIntestinal bacterial/viral infectionGlutamine insufficiencyAlcoholPoor dietStressLow stomach acidLow pancreatic enzymesFACTORS LINKED TO LEAKY GUTHeal gut with supplements and diet

26. SYMPTOMS OFFOOD INTOLERANCE

27. SYMPTOMS OF FOOD INTOLERANCERespiratory: Asthma, rhinitis, sinusitis, persistent cough, catarrhGastrointestinal: IBS, Crohn's disease, abdominal pain, diarrhoea, constipation, bloating, flatulenceSkin: Eczema, rashes, spotsCNS: Headache, migraine, hyperactivity (ADHD)Cardiovascular: Heart palpitationsMusculoskeletal: Joint pain, rheumatoid arthritis, muscle pain, fibromyalgiaPsychiatric: Chronic fatigue, insomnia, ME, anxiety, depressionMetabolic: Weight gain

28. Many symptoms – difficult to identify the cause (e.g. fatigue)IgG testing can be useful – diagnose / eliminateSYMPTOMS OF FOOD INTOLERANCE

29. CNS FOOD INTOLERANCE TESTS

30. CNS FOOD INTOLERANCE TESTSFood Detective™FoodPrint ®Food Microplate ELISA

31. World’s first rapid test kit for detecting food IgG antibodies

32. Detects antibodies to 59 common foodsRapid assay format – results in 40 minutesPositive and negative controls includedClear and concise instructionsColour coded reagentsFinger-prick blood sampleFEATURES

33. Only home-test kit on the marketNo specialised equipment neededNo waiting for laboratory resultsAct on results immediatelyWebsite supported: www.camnutri.comBENEFITS

34. CONTENTSSterile wipeSafety lancet x 2Plaster x 2Blood collection tubeSample diluent (A)Antibody detector (B)Developer (C)Wash solution (D)Reaction trayIFUResult cardDietary support guide

35. EASY TO FOLLOW INSTRUCTIONSFood Detective instructional video

36. TEST PROCEDURESterilise finger with wipePrick finger with lancetMassage finger to obtain bloodFill the capillary tube (50μl)

37. Place in SOLUTION A(Sample Diluent)Pour into trayLeave for 20 minutesTEST PROCEDURE

38. SOLUTION D (Wash Solution)Repeat x 3SOLUTION B(Antibody Detector)Leave for 10 minutesTEST PROCEDURE

39. SOLUTION D(Wash Solution)Repeat x 3SOLUTION C(Developer)Leave for 2 minutesWash ONCETEST PROCEDURE

40. RESULT INTERPRETATIONVisually read resultsIf specific-food IgG antibody is present, well is BLUEDetermine strength of colour

41. NEGATIVEWEAK POSITIVEPOSITIVESTRONG POSITIVEWhitePale blueMid blueDark blueIgGIgGIgGIgGRESULT INTERPRETATION

42. Ring / haloINVALIDNegative Controlmust be WHITEPositive Controlmust be BLUERESULT INTERPRETATION

43. Identify reactive foods from IFURESULT INTERPRETATIONRecord on Results Card

44. FOODS TESTEDDAIRY / EGGSCow’s milkWhole eggFISH / SEAFOODWhite fix mixFreshwater mixTunaShellfish mixFRUITAppleBlackcurrantGrapefruitMelon mixOliveOrange and LemonStrawberryTomatoGRAINSOat WheatRiceCornRyeDurum WheatGlutenHERBS / SPICESGarlicGingerMEATBeefChickenLambPorkNUTS / SEEDSAlmondBrazil NutCashewPeanutWalnutVEGETABLESBroccoliCabbageCarrotCeleryCucumberLeekLegume mixMushroomPeppersPotatoSoya BeanOTHERCocoa BeanTeaYeast

45. Microarray Food Intolerance Test

46. FOODPRINT® LABORATORY TESTSINDICATORFOOD PANELSSPECIALISED

47. Food extracts ‘printed’ onto nitrocellulose padsTEST FORMAT

48. Finger-prick sample Send to lab FoodPrint microarrayFOODPRINT® TESTING PROCESS

49. Hi-res optical scan Data conversion Test ReportFOODPRINT® TESTING PROCESS

50. FOODPRINT® TEST REPORTSFood GroupsOrder of Reactivity

51. FOODPRINT® REPORTSIgG concentration (U/ml)Traffic light system:ELEVATED (≥30 U/ml)BORDERLINE (29-24 U/ml)NORMAL (≤23 U/ml)

52. INTERPRETATION OF RESULTSELEVATED – high level of antibody detectedEliminate food from diet for at least 3 monthsBORDERLINE – moderate level of antibody detectedReduce or rotate food for at least 3 monthsNORMAL – low level of antibody detectedFood can be eaten freely

53. NEW PATIENT REPORTTest Reports + Patient Guidebook

54. FOODPRINT® BLOOD COLLECTION VIDEO

55.

56. PRODUCT RANGE

57. FEATURESKits available for 5, 40, 93 or 109 foods25µl serum or plasmaAssay time <90 minutes96 well plate assay, strip format

58. BENEFITSIdeal for small–moderate sample numbersReady-to-use reagentsShort incubation stepsReliable resultsCE-marked kitsCertified to ISO 9001 & 13458

59. Assay ProcedureTEST PROCEDUREIncubate30 minutesIncubate30 minutesWash Plate x 3100µl conjugate into each wellIncubate10 minutesWash Plate x 3100µl TMB substrate into each well100µl Stop solution into each wellRead 450nmDispense samples, standards and controls25µl sample into10ml diluent

60. PERFORMANCE CHARACTERISTICSReproducibility: Intra-assay 5.1-11.9%Sensitivity: 0.4U/mlInterferences: Grossly haemolysed, icteric or lipaemic samples should be avoidedStability: 18 months

61. TEST PRINCIPLES

62. TEST PRINCIPLESEnzyme-Linked Immunosorbent Assay (ELISA)Standard laboratory method to detect antibodies and antigensMICROPLATE ELISAPlateFOODPRINTMicroarray PadFOOD DETECTIVEReaction Tray

63. Antigens (food) attached to well

64. YYDiluted blood sample:Specific food IgG antibodiesBinds to food antigensY

65. YYYDetector solution / conjugate: Contains enzyme (HRP) linked anti-human IgGBinds to food-specific IgG antibodies

66. Developer solution / TMB substrateEnzyme HRP causes oxidation of substrate: Change from colourless to blueYYY

67. ALTERNATIVE TEST METHODS

68. IgG4 ELISAWhite Blood Cell

69. IgG4 ELISADetects IgG4 antibodies associated with food allergies

70. IgG SUBCLASSESSUBCLASSABUNDANCEIgG166%IgG223%IgG37%IgG44%

71. IgG SUBCLASS PROPERTIESNEUTRALISATIONAbility of antibodies to neutralise the pathogenic effects of antigens:– block and inhibit biological effectsCOMPLEMENT ACTIVATIONAbility of antibodies to activate complement cascade:consists of a group of 30 serum proteinsdestroy foreign cells by phagocytosis and lysis of cell membranescreates inflammation

72. OPSONISATIONAbility of antibodies to ‘flag’ foreign cells/antigens for destruction:cells / antigens are destroyed by phagocytosis (macrophages and neutrophils)phagocytes need a ‘marker’ to identify what to destroymarkers are antibodies and complement proteins (called opsonins)installation of opsonins enables phagocytosisBINDING TO PHAGOCYTESAbility of opsonin antibodies to bind to macrophages and neutrophilsIgG SUBCLASS PROPERTIES

73. PROPERTYIgG1IgG2IgG3IgG4Neutralisation++++++++Activation of complement pathway++++++Opsonisation++++++Binding to macrophages++++++++Binding to neutrophils++ IgG1 and IgG3 have strong pro-inflammatory properties IgG4 has protective, anti-inflammatory propertiesIgG SUBCLASS PROPERTIES

74. IgG4 FUNCTIONActs as a ‘blocking agent’ against the actions of IgECatches and neutralises the (food) antigen before IgE can bind to itIgG4 acts to prevent acute allergic reactions (Type I allergy) from occurringNo involvement with Type III (IgG-mediated) food intoleranceImpossible to detect ‘delayed-onset’ food intolerance by IgG4 testing!No complement activation and no opsonising capacities

75. Testing for IgG4 against foods is not recommended as a diagnostic tool. S. Stapel, R. Asero, B. K. Ballmer-Weber, E. F. Knol, S. Strobel, S. Vieths, J. Kleine-Tebbe.Allergy 2008: 63: 793–796PUBLICATIONS AGAINST IgG4 TESTINGConclusion: food-specific IgG4 does not indicate (imminent) food allergy or intolerance, but rather a physiological response of the immune system after exposure to food components. Testing of IgG4 to foods is considered as irrelevant for the laboratory work-up of food allergy or intolerance and should not be performed in case of food-related complaints.

76. All controlled studies for “food intolerance” are performed with total IgGNo controlled clinical trials have been performed with IgG4PUBLICATIONS AGAINST IgG4 TESTING

77. WHITE BLOOD CELL TESTTests for cellular responses to foreign substances in-vitro

78. (Activated Neutrophil Test and Cytotoxic Test)WHITE BLOOD CELL TEST Incubation Activation of immune response in cellWhite Blood Cells (separated or EDTA blood) are exposed to antigens:Principle: the diameter of white blood cells (leukocytes) change after being challenged with foods, moulds, additives, environmental chemicals, dyes and antibiotics.Primary reactive leukocyte fraction consists of: Neutrophils

79. NEUTROPHIL DEGRANULATIONFood antigens bind to antibodies which are attached to surface of a neutrophil.Creates a “cross-linking” which induces a process known as degranulation.Neutrophil

80. Damaging to pathogens but also damaging to host tissuesGenerates highly toxic reactive oxygen and nitrogen speciesRelease powerful proteolytic enzymes / histamine / chemokines / heparinNEUTROPHIL DEGRANULATION

81. WHITE BLOOD CELL TESTHealthy cell Mild reactionStrong reaction

82. AdvantagesDisadvantagesErrors eliminated due to computerised measurementNeutrophils are unstable - high risk of incorrect test resultsMorphologically change immediately after blood is drawnReliable test results only if tested within 6 hoursNo possibility to send sample by mailNeutrophils are highly sensitive to drug intake and infections - risk of incorrect resultsNeed an automated system to count cellsWHITE BLOOD CELL TEST

83. MANAGING FOOD INTOLERANCES

84. Identify foods producing elevated IgG responseCOMMON PROBLEM FOODS (data collated by CNS)MANAGING FOOD INTOLERANCES

85. Remove or reduce reactive foods from dietPLAN THE DIET:Reduce “allergenic load”Compliance important for best resultsPlan / shop in advanceKnow your “problem” foodsRead ingredients labelsSubstitute with similar alternativesConcentrate on NORMAL foodsVariety – nutrients & intoleranceMANAGING FOOD INTOLERANCES

86. Remove or reduce reactive foods from dietFoods to avoid, include, recipes, menus, websitesMANAGING FOOD INTOLERANCES

87. Remove or reduce reactive foods from dietPOINTS TO NOTE:Food must be included in diet before testing- no IgG reaction if food is not consumed!Avoid known allergenic foods – negative in IgG testSome clients may feel worse after elimination of reactive foodsImmunosuppressantsMANAGING FOOD INTOLERANCES

88. Remove or reduce reactive foods from dietADVICE FOR NUMEROUS ELEVATED RESULTS:Leaky Gut?Prioritise - 4 to 6 most reactive foods (reduce allergenic load)Rotate / reduce the remaining foodsWork with symptoms and resultsMANAGING FOOD INTOLERANCES

89. Repair Leaky Gut / boost immune systemRe-populate gut with beneficial gut floraStrengthen the immune systemRe-introduction of foodsAvoid elevated foods for 3-6 monthsStill symptoms – probably not food intoleranceRe-introduce foods – graduallyMonitor symptomsAvoid for longer if necessaryEat in moderation and vary the dietMANAGING FOOD INTOLERANCES

90. Eliminate foods with strong reaction (ELEVATED foods)Reduce / rotate foods with moderate reaction (BORDERLINE foods)Eat foods freely from the NORMAL groupReplace foods with a similar food from that food groupEat a varied dietRepair leaky gutSupport immune systemSUMMARY OF ADVICE

91. SUPPORT DOCUMENTATION

92. Scientific PublicationsPatient Experiences

93. ADHDAnti-AgingAutismFertilityGastrointestinalSCIENTIFIC PUBLICATIONSRheumatoidArthritisMigraineGeneralSkinConditionsWeight Loss

94. GENERAL (GN1)Toward an understanding of allergy and in-vitro testingMary James N.D. Great Smokies Diagnostic Laboratory

95. GENERAL (GN1)Toward an understanding of allergy and in-vitro testingMary James N.D. Great Smokies Diagnostic LaboratoryExcellent overview of:Immune systemFood terminology – hypersensitivity and allergyImmune tolerance and overloadDiagnosisElimination dietsLeaky gut

96. GENERAL (GN13)Testing for food reactions: the good, the bad, and the uglyMullin GE, Swift KM, Lipski L, Turnbull LK, Rampertab SDNutr Clin Pract 2010 Apr; 25(2):192-8

97. GENERAL (GN13)Testing for food reactions: the good, the bad, and the uglyMullin GE, Swift KM, Lipski L, Turnbull LK, Rampertab SDNutr Clin Pract 2010 Apr; 25(2):192-8Literature reviewEvaluating the validity of tests used to assess food reactionsFood hypersensitivity, food allergy, food sensitivity, food intolerance testing and adverse food reactionsIgE–mediated food allergy testing was best represented in PubMedIgG–based testing showed promise, with clinically meaningful resultsProven useful as a guide for elimination dietsFurther investigation into the clinical application is required

98. GENERAL (W1)Dietary advice based on food specific IgG resultsGeoffrey Hardman, Gillian Hart. Nutrition and food science Vol 37 No 1 2007 pp 16-23

99. GENERAL (W1)Dietary advice based on food specific IgG resultsGeoffrey Hardman, Gillian Hart. Nutrition and food science Vol 37 No 1 2007 pp 16-23 Provide evidence that elimination diet based on food-specific IgG testing is an effective, reliable and valid aid in the management of chronic illnessPostal survey commissioned by Allergy UK – 5286 participantsQuestionnaire sent 3 months after IgG food test76% reported a significant improvement in their condition68% noticed a benefit within 3 weeksThose with more than 1 condition more likely to report noticeable improvement92% reported a return of symptoms on reintroduction of offending foods

100. GASTROINTESTINAL (GA1)Food elimination based on IgG antibodies in Irritable Bowel Syndrome: a randomised controlled trialW Atkinson, T A Sheldon, N Shaath, PJ Whorwell Gut 2004:53 1459-1464

101. GASTROINTESTINAL (GA1)Food elimination based on IgG antibodies in Irritable Bowel Syndrome: a randomised controlled trialW Atkinson, T A Sheldon, N Shaath, PJ Whorwell Gut 2004:53 1459-1464To assess the therapeutic potential of dietary elimination based on presence of IgG antibodies to food150 outpatients with IBS - 3 month studyDiet excluding all foods to which they had raised IgG antibodies or a sham diet excluding the same number of foods but not those to which they had antibodiesOutcome measures - change in IBS symptom severity and global rating scoresTrue diet resulted in 26% greater reduction in symptom score than sham dietRelaxing the diet led to 24% greater deterioration in symptomsFood elimination based on IgG antibodies effective in reducing IBS symptoms

102. GASTROINTESTINAL (GA5)Clinical relevance of IgG antibodies against food antigens in Crohn’s Disease: a double-blind cross-over diet intervention studyBentz, Hausmann, Piberger, Kellermeier, Paul, Held, Falk, Obermeier, Fried, Schölmerich, Rogler Digestion 2010;81:252–264

103. GASTROINTESTINAL (GA5)Clinical relevance of IgG antibodies against food antigens in Crohn’s Disease: a double-blind cross-over diet intervention studyBentz, Hausmann, Piberger, Kellermeier, Paul, Held, Falk, Obermeier, Fried, Schölmerich, Rogler Digestion 2010;81:252–264Immune responses against food antigens may be a reason for the perpetuation of inflammation associated with Crohn’s Disease (CD)79 CD patients and 20 healthy controls were tested for food IgG antibodiesBased on the IgG antibodies, a nutritional intervention was planned84% patients had IgG antibodies against processed cheese and yeastDaily stool frequency decreased by 11% Abdominal pain reduced and general well-being improved

104. GASTROINTESTINAL (GA6)Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probioticsDrisko, Bischoff, Hall, McCallum. Journal of the American College of Nutrition, Vol. 25, No. 6, 514–522 (2006)

105. GASTROINTESTINAL (GA6)Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probioticsDrisko, Bischoff, Hall, McCallum. Journal of the American College of Nutrition, Vol. 25, No. 6, 514–522 (2006)Goal was to investigate the role of food intolerance in IBS patients20 patients with IBS who had failed standard medical therapiesBaseline IgE and IgG food/mould panels and stool analysis were performedPatients underwent food elimination diets based on their resultsElevated serum IgG food/mould levels detected in 100% participantsSignificant improvement after food elimination and rotation dietIdentifying food sensitivity in IBS impacts on overall well being and quality of life

106. MIGRAINE (M2)Food allergy mediated by IgG antibodies associated with migraine in adultsHernández, Pinto, Montiel. Revista Alergia México 2007;54(5):162-8

107. MIGRAINE (M2)Food allergy mediated by IgG antibodies associated with migraine in adultsHernández, Pinto, Montiel. Revista Alergia México 2007;54(5):162-8 Aim of study was to investigate allergen-specific IgG in patients with migraine56 patients with migraine, control group without migraineSerum antibodies to specific 108 food allergens were measuredSignificant differences in number of positives for IgG food allergens between patients with migraine and a controlled groupElimination diets successfully control the migraine without need of medicationsSerum IgG antibodies to common food should be investigated in patients with migraine

108. Excel LibrarySCIENTIFIC PUBLICATIONSAbstracts BookletFull Publications

109. GastrointestinalDiscomfortPATIENT EXPERIENCESMigraines& HeadachesSkin ConditionsWeight IssuesChronic FatigueAches & Pains

110. ACHES & PAINSLesley, a retired PA from Ashford, KentAching joints and muscles and flu-like symptomsSymptoms were worse after she had eaten wheat (especially bread) and dairy togetherAugust 2005, Lesley decided to do a food intolerance test (FoodPrint)Tested positive for wheat, yeast, cola nut and pineappleLesley saw an improvement in her symptoms immediatelyFound alternatives to replace the wheat and yeast in particularLesley has tried reintroducing some foods but finds that she reacts on each occasion

111. CHRONIC FATIGUETansy, a 36-year-old psychotherapist from Horncastle in Lincolnshire4 years off work with M.E. - bedridden for up to 10 days a monthTansy decided to experiment with her diet after a friend advised her to try excluding certain foodsExcluded nuts and eggs – felt slightly betterExcluded wheat and replacing it with rye – felt worseEliminating every possible food intolerance by trial and error was time consuming Decided to try Food Detective testReacted to 20 foods, including wheat, rye, dairy, soya, nuts, egg, barley and crabIronically, she reacted more to rye than wheatTansy took the offending foods out of her diet and within the first week began to feel better

112. GASTROINTESTINAL DISCOMFORTSandra, 54, from Crawley, West SussexAgonising bouts of Irritable Bowel Syndrome (IBS) - laid up in bed for days at timeOver an 18 month period, Sandra underwent numerous medical investigations: - endoscopy, CT scan and multiple blood testsEventually one doctor told her she had IBS and would just have to live with itSandra went to see a nutritionist who suspected she was suffering from a food intolerancePerformed a Food Detective testIntolerant to apples, wheat, almonds, rice, brazil nut, cashew nuts, cocoa beans, whole egg and shellfishEliminated the foods and began to feel betterWithin a few weeks her IBS symptoms disappeared

113. MIGRAINES AND HEADACHESYvonne, a 58-year-old mum from Poringland in NorfolkSuffered for 12 years from fortnightly migrainesYvonne’s GP was helpful in providing medication to manage her migrainesHe never got to the root of what was actually causing themDecided to try Food Detective™Reacted to soya bean, wheat, barley, corn, rye, cow’s milk, egg, grapefruit, almond and cashewImmediately avoided these foods and was felt better within a week

114. SKIN CONDITIONSJames, 31, from CambridgeSuffered from eczema - frustrating and difficult to function normally at workPrescribed various steroid creams and emollients but nothing addressed the cause of the eczemaStarted doing some research on the internet - link between food and eczemaDecided to try a food intolerance testReaction to cows’ milk, egg white and also grains and yeastJames eliminated all the foods he was intolerantEffect on his eczema was astounding - within a couple of days it had completely cleared upSleeping through the night and feeling much better for itOccasionally, James has a meal containing dairy foods or enjoys a couple of beers but the next day his eczema will flare up again

115. WEIGHT ISSUESTina, 41-year-old from Forest Row, East SussexGrossly overweight - BMI was dangerously high – difficulty loosing weightVisited a local nutritional therapistSuggested she may be intolerant to some foods - could be inhibiting her weight lossGiven a Food Detective test Tina tested positive to cow’s milk, citrus fruits and durum wheatStarted using nut milk on cereal and in tea and stopped eating oranges and pasta

116. Excel LibraryPATIENT EXPERIENCESBooklet

117. DEMONSTRATION VIDEOS