Food Sensitivities Test

By Fernando Bernall, DOM, CFMP

Imagine your favorite dish, but every time you eat it, you feel sick; your stomach hurts, or you feel exhausted. Maybe you wake up with a headache – It doesn’t happen often, but now and then your day starts with your head pounding – perhaps it’s my blood pressure – you think.

Imagine developing sinus congestion around bedtime, diarrhea around noon, or maybe suddenly breaking up into hives. You start asking yourself, “Is it something I ate? – But I’ve eaten this before and nothing happened – maybe I’m developing an allergy.”

It has happened to all of us. And the first thing we think – its something I ate. And 80 to 90% of the time, we would be right.. The question is: is it something I just ate? Or ate this morning, or perhaps yesterday? It’s not possible that it could be something I ate three days ago. Would it? The challenge is, how do we know?

And as usual, the answer is: we test, we don’t guess!

We can put the above symptoms into three possibilities: food allergies; food intolerance, and food sensitivities. I go into more detail on the differences between these reactions to food in this clip from the masterclass here. I have included in that page the narration to that clip so that you can read about it and follow along. So I won’t repeat myself here.

The important part to understand about the differences between food allergies; food sensitivities, and food intolerance, is that the first two involve the immune system while food intolerance involves the lack of enzymes needed to digest a particular food, for example in lactose intolerance when your small intestine doesn’t produce enough of an enzyme (lactase) to digest milk sugar (lactose).

While the symptoms of food intolerance are bothersome, they are not as severe as those from food allergies and food sensitivities. Food allergies being more severe and potentially deadly, while the symptoms of food sensitivities being more inflammatory in nature.

Another difference between food allergies and sensitivities, is the timing of symptoms. Symptoms from food allergies are usually immediate or happen within one to two hours. Most people know when they are allergic to a food because of the timing of the symptoms. On the other hand, food sensitivities symptoms may take much longer to appear. Sometimes it may take up to 72 hours before you react to a specific food. And that’s a problem. Why? Because, to be frank, I can’t remember what I ate yesterday much less two or three days ago. Unless I went to a special event, I may associate the food with the event. Otherwise, its forgotten. So this morning’s headache, may just be the nachos I ate a couple of nights ago.

That’s why a food sensitivity test is important when dealing with digestive disorders: it takes the guessing out of the game. It can help us isolate the foods to which our bodies may be reacting. Even when the reaction is delayed. Furthermore, a food sensitivity test, and this is important, helps us tailor an anti-inflammatory diet that is specific to the patient. Rather than doing a blanket, one size fits all inflammatory diet, we can include into the protocol the exclusion of foods to which the test shows we are sensitive, tolerant, or allergic. It is a real game changer – there’s no guess work – and I like that…

What is The P88-DIY Dietary Antigen Test?

The P88-DIY Dietary Antigent test is a “do it yourself” at home blood test. With a single prick of one of your fingers, enough blood is released to run 352 independent tests on 88 foods and looks at 4 different ways the body reacts to foods.

As I said earlier, food allergies and food sensitivities are mediated through the immune system and not the result of enzyme deficiencies. As such, the P88 test detects the antibodies at play in such reactions..

How Does the P88-DIY Dietary Antigen Test Work?

Every time I think of the immune system, I’m filled with a strange sense of awe and wonder; the wisdom and knowledge that resides within this aspect of our physiology boggles my mind.

To understand at a basic level the test results of the P88- Dietary Antigent Test, it is necessary to have a rudimentary grasp of how the immune system reacts to that which it perceives as foreign. To that end, I will make a humble attempt to explain the key players through which the immune system stays vigilant, never sleeps, and remains the faithful sentinel that guards our cells, and responds to that which it perceives as harmful.

The Role of IgE, IgG, IgG4, and C3d in Food Sensitivities and Allergies

Let’s first define some of the key terms used in the P88 Test; this will help us understand the results and encourage compliance to the dietary recommendations. The following is a short list of terms and definitions pertinent to this discusssion:

Any substance that causes the body to have an allergic response to an antigen (described below) by way of IgE antibodies.
Any substance that causes the body to make an immune response against that substance. Antigens include toxins, chemicals, bacteria, viruses, or other substances that come from outside the body. Body tissues and cells, including cancer cells, also have antigens on them that can cause an immune response. In short, an antigent is any substance that creates an antibody2
An antibody is a protein component of the immune system that circulates in the blood (humoral immunity by way of body fluids), recognizes foreign substances like bacteria and viruses, and neutralizes them. After exposure to a foreign substance, called an antigen, antibodies continue to circulate in the blood, providing protection against future exposures to that antigen. 3
B Cells
A type of white blood cell that makes antibodies. B cells are part of the immune system and develop from stem cells in the bone marrow. Also called B lymphocyte. B cells are able to differentiate9 into two different types of cells known as B Memory cells, which remember previous pathogens, and into plasma cells that in turn produce antibodies.4
Complement is a system of over 30 plasma proteins that can be activated directly by pathogens or indirectly by pathogen-bound antibody, leading to a cascade of reactions that occurs on the surface of pathogens and generates active components with various effector functions. Your body’s complement system gets its name because it “complements” or enhances your body’s infection-fighting cells.56
C3d is one of over 30 proteins within the complement system. It is a fragment of C3 which is broken down into four separate segments or fragments each with a unique function within the immune response to antigens and allergens. To stay within the scope of this article, C3d’s main function is to amplify the immune function of IgG by as much as 1000 to 10,000-fold. As we shall see later, it is opposite to that of the IgG4’s blunting of IgE allergic reactions to foods. This biomarkers and their interaction with each other, is what makes the P88 Dietary Antigen Test a valuable tool in the design of an exclusion diet that is unique to each patient.15
humoral immunity
Humoral immunity is the aspect of immunity that is mediated by macromolecules – including secreted antibodies, complement proteins, and certain antimicrobial peptides – located in extracellular fluids (fluids outside the cells). Humoral immunity is named so because it involves substances found in the humors, or body fluids (blood, lymph). It contrasts with cell-mediated immunity. Humoral immunity is also referred to as antibody-mediated immunity. 7
An immunoglobulin is the same as an antibody. The word “immunoglobulin is a portmanteau8 made up of the words immune and globulin.
Globulin are proteins with a spherical or globular shape. Three types of globulins have been identified: Alpha, Beta, and Gamma. The first two are made by the liver and act primarily as transport proteins hormones, lipids, cholesterol, and copper. Gamma globulins are produced by lymphocytes and plasma cells in lymphoid tissue and function as antibodies namely: IgG, IgA, IgE, IgM, IgD. I will briefly describe the antibodies that are included in the P88 Test.

IgE is the first antibody we see in the P88 table. This antibody is produced by the immune system and is known for its involvement in the allergic responses. It is produced in the blood in response to a food allergen. It is an important antibody in fighting off parasites. Our interest in this antibody is as it relates to food allergies.
Of all five immunoglobulins, IgG is the most abundant and accounts for around 75% of all antibodies. There are four subclasses of this antibody numbered from IgG1 to IgG4. IgG1 and IgG3 antibodies are preferentially elicited by protein antigens, these being sugars on the surface of cells such as viruses or bacteria. IgG2 subclass usually bind to polysaccharide antigens. For clarification, on the surface of antigens, there are clusters of proteins and other substances made up of several (poly) sugars (saccharides) which the immune system antibodies will recognize as foreign or not self.13 Some of these substances on the surface of bacteria are called LPS or Lipopolysaccharides or Endotoxins and consist of a lipid (lipo), poly (several or many), saccharides (sugars).14

Unlike IgG1, which binds with C3d leading to an amplification of immune reaction, IgG4 does not bind with complement and it is not so inflammatory and blocks the effects of IgE. IgG4 antibodies are often formed following repeated or long-term exposure to antigen in a non-infectious setting.11 IgG4 has a unique set of properties compared with the other IgG subclasses that has led to IgG4 being widely regarded as an anti-inflammatory, ‘benign’ antibody that may have beneficial functions in allergic disease. IgG4, the least abundant of the immunoglobulins has an affinity toward food allergen and its importance in the P88 Antigen test is its ability to block or buffer the effects of IgE in allergic reactions. Long term induction of IgG4 from repeated exposure to food antigen leads to food tolerance.1012

Plasma Cells
When B cells are activated by an antigen, they convert into plasma cells which release large quantities of antibodies into circulation.

Putting it all together

The P88 report is divided into two categories: Allergies and Sensitivities. This image only shows a few of the 88 foods that are tested in the P88 test.

Each section shows the antibodies involved in allergies and sensitivities respectively, with complement C3d at the far right.

The middle column shows if the body has developed tolerance to a food, indicated by whether IgG4 is greater than IgE.(IgG4 > IgE Abs). If greater, as in Milk, then the patient does not have a severe reaction to milk and has developed tolerance to milk due to higher levels of IgG4 which has blunted the effects of IgE. However, following to the sensitivity section we see that there’s an IgG reaction. Since C3d is not attached to the IgG antibody, the reaction to milk is moderate.


This image shows that the patient has a reaction to Cacao, and because C3d of the complement system is bound to IgG the sensitivity symptoms are magnified.

From the data gathered, a list of foods the patient can eat without limitations is listed on the left. Foods that had IgG moderate sensitivities are rotated while those with high levels of sensitivities with C3d bound to IgG are removed.

It should be understood that the elimination of the offending foods is often temporary. The exclusion of these foods aim to taper the immune system down.