Why test IgG for food sensitivity?

Multiple studies suggest that the removal of high IgG reactivity foods corresponds to reduced symptoms such as gastrointestinal issues, skin conditions, or migraines, as well as other symptoms people experience as a result of consuming certain foods. IgG is a food sensitivity test and is not an allergy test. IgG results should be correlated with symptoms and used solely as a tool to guide clinical decision making.

Here is a list of peer-reviewed studies on IgG food testing and elimination diets

1. Coucke F. Food intolerance in patients with manifest autoimmunity. Observational study. Autoimmun Rev. 2018;17(11):1078-1080. doi: 10.1016/j.autrev.2018.05.011. Epub 2018 Sep 11.

2. Tay S, Clark A, Deighton J, King Y, et al. Patterns of immunoglobulin G responses to egg and peanut allergens are distinct: ovalbumin‐specific immunoglobulin responses are ubiquitous, but peanut‐specific immunoglobulin responses are up‐regulated in peanut allergy. Clin Exp Allergy. 2007;37(10):1512-1518.

3. Rajendran N, Kumar D. Food‐specific IgG4‐guided exclusion diets improve symptoms in Crohn’s disease: a pilot study. Colorectal Disease. 2011;13:1009-1013. doi:10.1111/j.1463-1318.2010.02373.

4. Wright BL, Kulis M, Guo R, et al. Food-specific IgG4 is associated with eosinophilic esophagitis. J Allergy Clin Immunol. 2016;138(4):1190-1192.e3. doi:10.1016/j.jaci.2016.02.024.

5. Weidlich S, Nennstiel S, Jesinghaus M, Brockow K, et al. IgG4 is Elevated in Eosinophilic Esophagitis but Not in Gastroesophageal Reflux Disease Patients. J Clin Gastroenterol.  2020;54(1):43-49. doi: 10.1097/MCG.0000000000001154.

6. Schuyler AJ, Wilson JM, Tripathi A, et al. Specific IgG4 antibodies to cow’s milk proteins in pediatric patients with eosinophilic esophagitis. J Allergy Clin Immunol. 2018;142(1):139-148.e12. doi:10.1016/j.jaci.2018.02.049.

7. Bernardi D, Borghesan F, Faggian D, Bianchi FC, et al. Time to reconsider the clinical value of immunoglobulin G4 to foods? Clin Chem Lab Med. 2008;46(5):687-690. doi:10.1515/CCLM.2008.131.

8. Main J, McKenzie H, Yeaman GR, et al. Antibody to Saccharomyces cerevisiae (bakers' yeast) in Crohn's disease. BMJ. 1988;297(6656):1105-1106. doi:10.1136/bmj.297.6656.1105

9. Fritscher-Ravens A, Pflaum T, Mösinger M, et al. Many Patients With Irritable Bowel Syndrome Have Atypical Food Allergies Not Associated With Immunoglobulin E. Gastroenterology. 2019;157(1):109-118.

10. Atkinson W, Sheldon TA, Shaath N, et al. Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial. Gut. 2004;53:1459-1464.

11. Zar S, Benson MJ, Kumar D. Food-specific serum IgG4 and IgE titers to common food antigens in irritable bowel syndrome. Am J Gastroenterol. 2005;100(7):1550-1557.

12. Lee HS, Lee KJ. Alterations of Food-specific Serum IgG4 Titers to Common Food Antigens in Patients With Irritable Bowel Syndrome. J Neurogastroenterol Motil. 2017;23(4):578-584. doi:10.5056/jnm17054.

13. Zuo XL, Li YQ, Li WJ, Guo YT, et al. Alterations of food antigen‐specific serum immunoglobulins G and E antibodies in patients with irritable bowel syndrome and functional dyspepsia. Clin Exp Allergy. 2007;37:823-830. doi:10.1111/j.1365-2222.2007.02727.

14. Karakula-Juchnowicz H, Gałęcka M, Rog J, et al. The Food-Specific Serum IgG Reactivity in Major Depressive Disorder Patients, Irritable Bowel Syndrome Patients and Healthy Controls. Nutrients. 2018;10(5):548.

15. Aydinlar EI, Dikmen PY, Tiftikci A, et al. IgG‐Based Elimination Diet in Migraine Plus Irritable Bowel Syndrome. Headache. 2013;53:514-525. doi:10.1111/j.1526-4610.2012.02296.

16. Jian L, Anqi H, Gang L, Litian W, et al. Food Exclusion Based on IgG Antibodies Alleviates Symptoms in Ulcerative Colitis: A Prospective Study. Inflamm Bowel Dis. 2018;24(9): 1918-1925.

17. Severance, E. G., Dupont, D. , Dickerson, F. B., et al. (2010), Immune activation by casein dietary antigens in bipolar disorder. Bipolar Disorders, 12: 834-842. doi:10.1111/j.1399-5618.2010.00879.

18. Alpay, K., Ertas, M., Orhan, E.K., et al. Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomised, cross-over trial. Cephalalgia. 2010;30(7):829–837. doi:10.1177/0333102410361404.

19. Mitchell N, Hewitt CE, Jayakody S. et al. Randomised controlled trial of food elimination diet based on IgG antibodies for the prevention of migraine like headaches. Nutr J. 2011;10, 85 doi:10.1186/1475-2891-10-85

20. Severance EG, Gressitt KL, Alaedini A, et al. IgG dynamics of dietary antigens point to cerebrospinal fluid barrier or flow dysfunction in first-episode schizophrenia. Brain Behav Immun. 2015;44:148-158. doi:10.1016/j.bbi.2014.09.009.

21. Kelly DL, Demyanovich HK, Rodriguez KM, et al. Randomized controlled trial of a gluten-free diet in patients with schizophrenia positive for antigliadin antibodies (AGA IgG): a pilot feasibility study. J Psychiatry Neurosci. 2019;44(4):269-276. doi:10.1503/jpn.180174.

22. SeveranceEG, DickersonFB, HallingM, et al. Subunit and whole molecule specificity of the anti-bovine casein immune response in recent onset psychosis and schizophrenia. Schizophr Res. 2010;118(1-3):240-7.doi: 10.1016/j.schres.2009.12.030. Epub 2010 Jan 13.

23. Virdee K, Musset J, Baral M, Cronin C, et al. Food-specific IgG Antibody-guided Elimination Diets Followed by Resolution of Asthma Symptoms and Reduction in Pharmacological Interventions in Two Patients: A Case Report. Glob Adv Health Med. 2015;4(1):62-66. doi:10.7453/gahmj.2014.068.

24. Carini C, Fratazzi C, Aiuti F. Immune complexes in food-induced arthralgia. Ann Allergy. 1987;59(6):422-428.

25. Hafström I, Ringertz B, Spångberg A, von Zweigbergk L, et al. A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford). 2001;40(10):1175-1179.

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