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Food Allergy Testing
 
 


One man’s meat is another man’s poison
Finding out which foods are right and which are wrong for you is the key to health and performance.
By Roger D. Deutsch
Eating healthful food is one thing, but eating in accordance with your own, unique, genetically determined biochemical makeup is quite another.
Foods compatible with your makeup will increase your strength and energy, while consumption of foods or added chemicals that your body perceives as harmful will result in intolerance reactions.
Food intolerance induces the excessive generation of toxic-free radicals and inflammatory chemicals. The damage can result in a wide range of health problems.
In contrast with “true” allergy — whereby a few molecules of peanut may, for example, induce anaphylaxis — the sheer magnitude of exposures to intolerogenic foods, despite it’s less dramatic flare (pun intended), render food intolerance far more common.
Allergy vs. intolerance
The biological cause of true allergy has been known since 1967. An immune system structure called IgE plays a central role. A small amount of allergen interacting with IgE can trigger the release of chemicals that create allergic symptoms. Many people react to animals, pollens, and, in rare unfortunate cases, foods.
Food allergy symptoms are quite dramatic, and intentionally so, as this pathway represents the body’s natural defense against large parasites, such as helminths.
Unlike other pathogens (i.e., viruses, bacterium), these parasitic worms are significantly larger than the cells that protect against them. Hence, the body’s immune defense against them must be very strong, which is why an allergy produces such dramatic symptoms.
In contrast, intolerances to foods follow different pathways, and symptoms are dose related, chronic, and delayed. Consequently, most people are unaware of their food intolerances.
Offending food may be tolerable until such time as a chemical naturally occurring within the food, or that has been added, exceeds a certain threshold. Many athletes consume energy bars that are complex.
In general, the modern diet is very complex and certainly not what our ancestors have been exposed to for a sufficient enough time for us to adapt. Hence, even “normal” foods may be simply unfamiliar to us from a genetic point of view and aggravate the immune system.
Another consequence of the modern diet is the nutritional cofactors required for hepatic biotransformation are lower in commercially grown produce. When chemicals in foods (naturally occurring or otherwise) cannot be adequately detoxified by the liver, the immune system is called to action.
This “total load” is further impacted by the integrity of the gut membrane, which under normal circumstances forms a natural barrier. Infection, an imbalance in gut flora, antibiotics, cortisone (exogenous or endogenously produced by excessive stress), and hormones used in birth control compromise the gut barrier.
Classical, or IgE allergy to food, has been recognized for centuries. The first recorded anaphylactic reaction to egg occurred in the 16th century1 and fish-induced allergy was reported in the 17th century.2
However, the more recent development of other nonallergic adverse reactions to foods, including food intolerance, only began receiving recognition following the work of Chicago-based allergist Theron Randolf in the 1950s.3
Modern agriculture causes modern diseases — inflammation
The link between food intolerance, chemical sensitivity, and the dramatic increase in degenerative diseases seems to coincide with the consumption of junk food. When low-quality and noncompatible foods are avoided, inflammation resolves, weight normalizes, and a number of other inflammatory-based health problems subside.
As seen from this necessarily simplified analysis, adverse food reactions may be toxic or nontoxic reactions. Toxic reactions occur in anyone, given sufficient exposure. Nontoxic reactions occur in susceptible individuals and may result from chemicals occurring in items such as aged

cheese and chocolate and may involve either immune mechanisms (allergy or hypersensitivity) or nonimmune mechanisms. The former are referred to as “hypersensitivities,” the latter “intolerances.”
Food intolerances are most common and most likely caused by pharmacologic activities of chemicals that naturally occur in or are added to food.
However, some intolerances result from inherited enzyme deficiencies and thus remain fixed. Some reactions are exacerbated by poor digestion related to intestinal disorders or the overwhelming of specific detoxification pathways that are rate limited.4 Hence, addressing these underlying issues can result in tolerance of moderate quantities of the food.
Because numerous and varied mechanisms play a role in the pathogenesis of adverse reactions to foods, definitive identification of offending foods relies upon provocation of symptoms following oral challenge under double-blind conditions — not always a convenient option.
Various serum tests exist, but are of questionable value. Whereas testing serum levels of allergen specific IgE is a useful test for classical allergy, it is of limited value for identification of foods and chemicals associated with intolerances that are not IgE mediated.
Rather, a useful test for intolerances would have to measure the direct effect of the food substance on the very immune system cells responsible for these intolerances. It should show a good correlation with clinical symptoms, as confirmed by double-blinded oral challenges.
Other manifestations
Previously, childhood diabetes was exclusively of the type 1, autoimmune-based type. The consequence: high blood sugar levels and tissue degeneration.  Now, due to overactivation of the innate immune system and food intolerances, so called “adult onset” diabetes occurs even in children.
Adult onset diabetes is not autoimmune per se, but occurs when insulin receptors on muscle, the liver, and the brain lose effectiveness. Insulin resistance is the hallmark of metabolic syndrome.
Initially, insulin is produced, but it cannot sufficiently facilitate the uptake of glucose because of the insensitivity of the insulin receptors. The pancreas then produces increasing quantities of, but lower quality, insulin and blood sugar levels increase.
Interleukin 6 and tumor necrosis factor alpha block insulin receptors. Glucose is stored in adipocytes (fat cells), which in turn produce these very same mediators perpetuating the cycle of inflammation, muscle degeneration, and inefficient metabolism.
Solutions
The foremost approach to achieving health, leanness, and improved energy and strength should be dietary — emphasizing healthy, natural, nutritious food along with exercise, stress management, intestinal health, and adequate nutrition.
Foods that act as triggers require proper identification and avoidance. Testing of white blood cell reactions is the best approach. It reflects pathological responses to foods mediated by immunologic, nonimmunologic, and pharmacologic, as well as toxic pathways.
A nutrition response test is a scientifically validated approach that exhibits the highest degree of correlation with blinded challenges and is the most accurate.5 Symptom resolution, normalization of weight, and broad clinical correlation affirm this as a most beneficial tool to be added to any health and sports regimen.6
Roger D. Deutsch, president and CEO of Cell Science Systems Corp., is co-developer of the ALCAT Test and has performed pioneering research in the field of food and chemical sensitivity testing for more than 24 years. He can be reached at  800-872-5228 or info@alcat.com.
**To read some food intolerance effects that may be of interest to athletes, visit www.ChiroEco.com/intolerance


Measurement of cellular reactivity to foreign substances
The short-term efficacy of the ALCAT Test of food sensitivities to facilitate changes in body composition and self-reported disease symptoms: a randomized controlled study
Gilbert R. Kaats, Director, Health and Medical Research Foundation, San Antonio; Dennis Pulliri, Executive Director, Baylor Sports Medicine Institute, Houston, TX; Larry K. Parker, MD, Women’s Total Health Care Angleton, TX. Published in American Journal of Bariatric Medicine, Spring, 1996.
To examine the efficacy of providing dieters  with information on food sensitivities ential food allergies, 100 subjects completed a beginning and ending ALCAT food sensitivity blood test, an underwater test (displacement method) for assessing body composition, and a disease symptom inventory (DSI) self- report at the beginning and end of a four-week test period.
After completion of the initial test, subjects were randomly divided into either a control or an experimental group. Subjects in the control group were asked to pursue a weight loss program of their own choosing, while subjects in the experimental group were provided with the results of their ALCAT Test listing foods to which they were most and least likely to have a food sensitivity or allergic-like reaction.
Subjects in the experimental group were also provided with dietary guidance on foods that could be substituted for those to which they were likely to have sensitivity.
Analysis of the pre-study data revealed that there were no significant differences between the experimental and control group on any of the parameters of the test battery. However, as compared to the control group, the group following the ALCAT group plan lost significantly more scale weight, percent body fat, and fat weight; had greater improvements in body composition; and had greater increases in fat-free mass.
When compared to the control group, the ALCAT group reported improvements in all 20 items on the DSI, 18 of which were significant at the p=.06 to <.001 levels.
It was concluded that, as compared to participants following a weight control plan of their own choosing, following the ALCAT Test and diet plan resulted in highly significant improvements in body composition and self-reported disease symptoms.

High correlation of the ALCAT Test results with double-blind challenge (DBC) in food  sensitivity
Peter I. Fell, MD, Director, Oxford Allergy Centre, London; Jonathon Brostoff, MA, DM, USc, FRCP, FRCPath, Dept. ofImmunology, University College & Middlesex School of Medicine, London; Mark Pasula, PhD, Research Director,AMTL, Miami, FL; Presented at the 45th Annual congress of the American college of Allergy and Immunology, Los
Angeles, CA: November 12-16, 1988. Published in Annals of Allergy.
The ALCAT Test reproducibly measures volumetric shifts in the white blood cells upon incu-bation with antigens. This study was designed to assess the degree of corre- lation between ALCAT and the results of oral DBC with the same foods.
Nineteen symptomatic patients (IBS, atopic eczema, allergic rhinitis, or migraine headaches) with evidence of food sensitivity were ALCAT tested to each of 50 food extracts. Each subject was given diary cards to score (zero to four) symptoms daily over an eight- week period.
In the first two weeks, all ALCAT positive foods plus three ALCAT- negative foods were eliminated from the diet to determine the degree of symp- tom remission possible. In each of the subsequent six weeks, a new food was introduced randomly in DBC, several portions eaten daily for the week; three of the foods were ALCAT-positive and three were ALCAT-negative.
Symptom scores for each week were averaged and compared; any increase exceeding 40 percent over the second baseline week or the preceding DBC week was considered a positive food challenge. For the 58 ALCAT-positive foods selected from the 19 subjects, 46 were positive on DBC (79.3 percent) and 12 were negative.
For the 56 ALCAT-negative foods, 49 were also negative by DBC (87.5 percent) and seven were positive.
Overall correlation between ALCAT and DBC was 83.4 percent. This suggests that the ALCAT Test was quite reliable in identifying unsafe foods in these sensitive subjects.

Food intolerance in patients with angioedema and chronic urticaria: an investigation by rast and ALCAT Test
Lene Hoj MD, Copenhagen, Denmark Presented at the Xvl European Congress of Allergotogy and Clinical Immunology Madrid, Spain: June 25.30,1995. Published - European Journal of Allergy and clinical Immunology Supplement. Number 26, Vol. 50. 1995.
The aetiology of the atopic conditions angioedema (AE) and chronic urticaria (Cu) has hitherto been obscure with suggestions to allergy or other hypersensitivity as the cause. The aim of this study was to test the hypothesis of food intolerance being associated with AE and CU. Fifty-two patients, 39 females and 13 males, with a median age of 48 years (range: 6-83) and a median duration of disease of 6 years (range 1-6 1) were included.
The patients, none of them deficient of C1- esterase inhibitor had oropharyngeal symptoms at least twice a month and classical skin eruptions at least twice a week. Follow-up (nm5l) was at least six months.

For more research, visit www.ChiroEco.com/research.
This research was provided by Cell Science Systems.
800-872-5228 • www.alcat.com

Nutritional guidelines complete answers
This is in reference to the article "Nutritional guidelines," which appeared in Issue 16, 2010. The following are each nutrition companies answers in their entirety.
Michelle Mohamed, marketing coordinator for Cell Science Systems Corp./The ALCAT Laboratory, www.alcat.com
“Optimal Wellness through Customized Nutrition”
Cell Science Systems, Corp., developed The ALCAT Test to measure personalized nutrition at the cellular level. The core technology is a blood test that measures the body’s cellular response to challenges from a wide array of substances including various foods, additives, colorings and chemicals. The individual’s cellular reactivity after exposure of the blood to the various test agents, versus the person’s own baseline control, tells the healthcare provider which substances may be causing a sensitivity-related response in the body. Following testing, a 4-Day Rotational Diet is recommended to the patient.
The ALCAT Test Results (elimination diet)
The ALCAT Test results are presented in an easy to understand, color-coded format. They highlight each patient’s incompatible foods and the level of each reaction (severe, moderate or mild). The ALCAT Test results also clearly identify the foods which are non-reactive or “safe” foods by putting them in the green section of the results and organizing them by food groups.
Rotational Diet
Strategic approaches and knowledge to be compliant with the ALCAT test results (meal plan, rotation diet, consulting and six month compliance program)
Leaky gut protocol (helps heal gut; a platform for everything else that you want to do)
Detoxification program (get liver functioning optimally; detoxify heavy metals coming out of fat)
How does your nutritional protocol benefit a chiropractic practice and patients?
For over 24 years The ALCAT Test has provided healthcare professionals and their patients with a tool for managing a wide variety of conditions linked to chronic activation of the immune system, such as: weight gain, inability to lose weight, obesity, IBS, chronic fatigue, migraine headaches and many more…
Improve patient wellness
One simple blood test, scientifically proven, that tells you which foods may be a problem for you.
Reduce symptoms of chronic diseases by following the meal plan
Financial benefits
Natural way of healing patients in an economically viable manner
Increase additional revenue strain for practice and provide customized meal plan unique to each individual’s chemistry

Food factors and athletic performance
By Roger D. Deutsch

Eating healthful food is one thing, but eating in accordance with your own, unique, genetically determined biochemical makeup, is quite another thing.

One man’s meat is another man’s poison.  Finding out what foods are right (and which are wrong) for you, is the key to health and performance.  

Foods that are compatible with your make up will increase your strength and energy.  Consumption of foods or added chemicals that YOUR body perceives as harmful will result in intolerance reactions.  Food intolerance induces the excessive generation of toxic free radicals and inflammatory chemicals. The damage can result in a wide range of health problems.  The following are some of the effects of food intolerance that are of strong interest to athletes:

1. Direct damage to the mitochondria in our cells.  The mitochondria are the site where energy is produced.  The wrong food activates the immune system and free radicals and attacking molecules produced can cause damage to the DNA, and other structures within the mitochondria, resulting in lower energy production.  This is of special significance to athletes because intense exercise alone will generate damaging free radicals from normal metabolic process speed up somewhat by the intensity of the exercise.  Usually this is not a problem if your anti-oxidant enzymes and nutritional anti-oxidants are sufficient.  Complicate it with food intolerance and the generation of free radicals will overload your systems.

2. Related in some ways to this is that inflammation will also cause a shortening of the ends of the strands of your DNA called telomeres.  Telomeres are like the plastic pieces at the end of a shoe lace, holding the DNA strands together.  Whenever the cell divides, and immune cells divide frequently, the telomeres are shortened.  When they become too short the cell can no longer reproduce; becomes old and dies.  This could explain cancer and generalized weakened immunity in old age.  Avoid this by avoiding inflammation.  We can choose what we eat.

3. Auto-immunity can also arise from too much inflammation.  How, some immune cells die in the process of trying to neutralize a food.  The DNA from the dead cells release their own genetic material, which, if it is too great may become itself perceive as a “foreign” body the immune system must attack.  However, this time you are attacking the blueprint for you own bodily proteins (structures) and auto-immune reacts may occur.  Again, it’s better to avoid this if you can.

4.  Certain immune chemicals with names like Interleukin 6, and tumor necrosis factor alpha, will block insulin receptors on your muscle (and brain and liver) cells.  This is a recently discovered finding made by medical scientists which explains why food intolerance makes people fat.  The muscles cells are starved of  important energy material which is instead stored as fat in fat cells.

5. Food intolerance can cause inflammation in the gut.  An extreme form is celiac disease.  This reduces the absorption of nutrients that are needed for proper energy production as well as all other biologically processes.  It also consumes serotonin in the gut.  Serotonin deficits are related to sugar craving.

6. Toxic immune chemicals – such as elastase- damage muscle tissue.

7. Food intolerance can cause inflammation in the upper and lower airways.  Decreased air intake limits aerobic metabolic function.

8. Chronic inflammation also makes you fatigued.  Ever wonder why you feel so tired when you get the flu?  It’s because the same immune chemicals that are intended to fight viruses cause fatigue so that you are forced to rest when you are sick.  Your body wants you to rest, not exercise, so that your energy can be used to fight the invader.  The immune system that’s inappropriately activated by the wrong food will thus cause you to be chronically fatigued to a lesser or greater extent.  The immune system is now mistaking a food particle for a virus or bacterium.

In contrast with, “True” allergy, whereby, a few molecules of peanut may, for example, induce anaphylaxis, the sheer magnitude of exposures to intolerogenic foods, despite it’s less dramatic flare (pun intended) render FOOD INTOLERANCE FAR MORE COMMON.

Allergy vs. Intolerance
The biological cause of true allergy has been known since 1967.  An immune system structure called, IgE, plays a central role.  A small amount of allergen, interacting with IgE, can trigger the release of chemicals that create allergic symptoms.  Many people react to animals, pollens; and, in rare, unfortunate cases, foods.

Food allergy symptoms are quite dramatic, and intentionally so, as this pathway represents our natural defense against large parasites, like helminths.  Unlike other pathogens (i.e., viruses, bacterium) these parasitic worms are significantly larger than the cells that protect against them.  Hence, our immune defense against must be very strong, which is why allergy produces such dramatic symptoms.

In contrast, intolerances to foods follow different pathways, and symptoms are dose related, chronic and delayed.  Consequently, most people are unaware of their food intolerances.

Offending food may be tolerable until such time as a chemical naturally occurring within the food, or that has been added, exceeds a certain threshold.  Many athletes are consuming energy bars that are complex.  The modern diet is, in general, very complex and certainly not what our ancestors have been exposed to for sufficient time for us to adapt.  Hence, even “normal” foods may be simply unfamiliar to us, from a genetic point of view, and aggravate the immune system.  

Another consequence of the modern diet is that nutritional cofactors required for hepatic biotransformation are lower in commercially grown produce. When chemicals in foods (naturally occurring or otherwise) cannot be adequately detoxified by the liver, the immune system is called to action.

This “total load” is further impacted by the integrity of the gut membrane which, under normal circumstances,
forms a natural barrier.  Infection, an imbalance in gut flora, antibiotics, cortisone (exogenous or endogenously produced by excessive stress) and hormones used in birth control, compromise the gut barrier.   

Classical, or IgE allergy to food, has been recognized for centuries.  The first recorded anaphylactic reaction to egg occurred in the sixteenth century (1) and fish induced allergy was reported in the seventeenth century.  However, the more recent development of other non-allergic adverse reactions to foods, including food intolerance, only began receiving  recognition following the work of Chicago based allergist, Theron Randolf, in the 1950’s(3).

Modern agriculture causes modern diseases; inflammation
The link between food intolerance, chemical sensitivity and the dramatic increase in degenerative diseases is clear; coinciding, as it does, with consumption of junk food.  When low quality and non compatible foods are avoided, inflammation resolves, weight normalizes, and a number of other inflammatory based health problems subside.

As seen from this necessarily simplified analysis, adverse food reactions may be toxic or nontoxic reactions. Toxic reactions occur in anyone, given sufficient exposure. Nontoxic reactions occur in susceptible individuals and may result from chemicals occurring in aged cheese, chocolate; and may involve either immune mechanisms (allergy or hypersensitivity) or non- immune mechanisms.  The former are referred to as, “hypersensitivities” the latter, “intolerances”.

Food intolerances are the most common.  They are most likely caused by the pharmacologic activities of chemicals that naturally occur in the food; or, that are added to the food.

However, some intolerances result from inherited enzyme deficiencies, and thus remain fixed.   Some reactions are exacerbated by poor digestion related to intestinal disoders, or the overwhelming of specific detoxification pathways, that are rate limited. (4)  Hence, addressing these underlying issues can result in tolerance of moderate quantities of the food.   

Because numerous and varied mechanisms play a role in the pathogenesis of adverse reactions to foods  definitive identification of offending foods relies upon provocation of symptoms following oral challenge under double blind conditions- not always a convenient option for a training athlete. Various serum tests exist but are of questionable value.  Whereas testing serum levels of allergen specific IgE  is a useful test for classical allergy, it is of limited value for identification of foods and chemicals associated with intolerance that are not IgE mediated.  Rather, a useful test for intolerances would have to measure the direct effect of the food substance on the very immune system cells that are responsible for these intolerances.  It should show a good correlation with clinical symptoms, as confirmed by double blinded oral challenges.  The only test meeting these criteria is the Alcat test.  The Alcat test was developed by scientists working in the US in the mid ‘80’s.  It has since spread throughout the world and is now available in Germany.  It has begun to start a revolutionary breakthrough in sports and general medicine that many have not yet come to terms with.  However, it’s many benefits are well documented.

Other Manifestations
Previously, childhood diabetes was exclusively of the Type 1, auto-immune based type.  The consequence: high blood sugar levels and tissue degeneration.  Perhaps this is just the tip of the iceberg.  Now, due to over activation of the innate immune system, due to food intolerance, so called, “adult onset” diabetes occurs even in children. Adult onset diabetes is not auto-immune per se, but occurs when insulin receptors on muscle, liver and brain, lose effectiveness.  Insulin resistance is the hallmark of metabolic syndrome.  Initially, insulin is produced, but it cannot sufficiently facilitate the uptake of glucose because of the insensitivity of the insulin receptors.  The pancreas then produces increasing quantities of insulin but of lower quality. Blood sugar levels increase.   

Interleukin 6 and tumor necrosis factor alpha block insulin receptors.  Glucose is stored in adipocytes (fat cells) which in turn produce these very same mediators perpetuating the cycle of inflammation, muscle degeneration, and inefficient metabolism.  

Solutions
The foremost approach to achieving health, leanness and improved energy and strength should be dietary; emphasizing healthy, natural, nutritious food along with exercise, stress management, intestinal health and adequate nutrition.

Foods that act as triggers require proper identification and avoidance. Testing of white blood cell reactions, is the best approach.  It reflects pathological responses to foods that are mediated by immunologic, non-immunologic, pharmacologic as well as toxic pathways.   The Alcat test is a scientifically validated approach that exhibits the highest degree of correlation with blinded challenges and is the most accurate. (5) Symptom resolution, normalization of weight, and broad clinical correlation, affirm this as a most beneficial tool to be added to any health and sports regimen. (6)

REFERENCES
1. Cohen SG, Saavedra-Delgado AM. Through the centuries with food and drink, for better or worse II. Allergy Proc 1989;10:363-73.

2. Harper DS. Egg?—Ugh! In: Avenberg KM, editor. Footnotes on Allergy. Uppsala: Upplands Grafiska AB; 1980. p. 52.

3. Bruijnzeel-Koomen C, Ortolani C, Aas K, et al. Adverse reactions to food. Allergy 1995;50:623-35.

4. Deutsch, R.  The Right Stuff: Use of Alcat testing for determining dietary factors effecting immune balance, health and longevity.  Anti Aging Therapeutics. Chapt. 9, Vol. 10, 2007

5. Høj  L.  Diagnostic value of ALCAT test in intolerance to food additives compared with double blind placebo controlled (DBPC) ora l challenges. Alleg Clin Immun 1996: No 1, part 3.

6. Brostoff, J., et. al., 45th An. Congress ,Am. Col. Of Allergy & Imm.

For more info contact Lee Rolnick at lrolnick@alcat.com.


It's true that we gain weight when we eat more than we can burn off. But this conventional diet wisdom does not always hold true. Weight gain can also be caused by health conditions such as hypothyroidism, food sensitivity, Cushing's syndrome, organ disease, prescription drug use, anxiety, blood sugar imbalance, and essential fatty acid deficiency. Many people respond to stress or depression by eating excessively. Sources of stress may not always be apparent, but may still affect eating habits and cause weight gain.

Reactions to foods are not always immediate. They can occur many hours later as bloating and swelling in the hands, feet, ankles, abdomen, chin and around the eyes. Much of the weight gained is fluid retention caused by inflammation and the release of certain hormones. In addition, there is fermentation of foods, particularly carbohydrates, in the intestines which can result in a swollen distended belly and gas production. Food allergies as well as food sensitivities can cause weight gain. Yes, it's possible to have no other symptoms. You can't count on seeing runny noses or sneezes with some food sensitivities. Instead, a person's body perceives the food as a poison and limits digestion of nutrients, thus causing the body to store fat.

Symptoms of food sensitivity can include headache, indigestion or heartburn, fatigue, depression, joint pain or arthritis, canker sores, chronic respiratory symptoms such as wheezing, sinus congestion or bronchitis and chronic bowel problems such as diarrhea or constipation.

The ALCAT Test differs from other food allergy or intolerance tests as it accurately and objectively measures leukocyte cellular reactivity in whole blood, which is a final common pathway of all mechanisms. The test utilizes electronic, state of the art, hematological instrumentation. Standard allergy tests, such as skin testing or RAST are not accurate for delayed type reactions to foods and chemicals. They measure only a single mechanism, such as the effect of mast cell release of histamine or the presence of allergen specific IgE molecules. Delayed reactions to foods and chemicals are NOT IgE mediated.

The ALCAT Test also differs from standard IgG tests in that they rely exclusively on one immune pathway, serum levels of immunoglobulin G (IgG). In fact, high food specific IgG titers are indicative only of exposure, not necessarily intolerance.

The ALCAT Test reproducibly measures the final common pathway of all pathogenic mechanism; whether immune, non-immune, or toxic. It is the only test shown to correlate with clinical symptoms by double blind oral challenges, the gold standard.
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