About the kiweno food intolerance test

The topic of food intolerances covers a broad, complex spectrum of manifestations. Many of our clients suffered for a long time from sometimes diffuse symptoms such as digestive problems, headaches, dizziness or similar, without having found a cause and solution for them in the existing health care system.

Our intolerance test (only available in Austria) based on IgG4 antibodies was finally able to provide clarity in countless cases and offer a solution approach that could sustainably increase the well-being of our customers.

Since the IgG4 analysis is nevertheless always under discussion and the scientific situation is not clear, we would like to make an enlightening contribution with the information below.

IgG4 as basis for food intolerance tests

In the kiweno intolerance test, the blood sample is tested for elevated food-specific antibody titers (immunoglobulins of the IgG4 subtype) using the ELISA technique (enzyme linked immunosorbent assay). This type of screening for potential food intolerances is a simple and quick test for the benefit of the client.

Testing for specific IgG4 antibodies in food intolerances is based on recent studies indicating clinical relevance:

In the publication by Bernardi et. al. published in June 2008, 68 persons with clinical symptoms of food intolerance were examined – as well as 22 control subjects. The sensitivity of the IgG4 ELISA test was 81%, the specificity 87%. The test procedure showed good diagnostic accuracy. After an elimination diet regarding specifically elevated IgG4 antibodies, 78.5% showed significant symptom relief after 2 months. Of 19 individuals who underwent control testing at 2 months, 89.5% showed a significant reduction in specific IgG-4 antibody levels compared with baseline (Bernardi, et al, Time to reconsider the clinical value of immunoglobulin G4 to foods., 2008, Clin Chem Lab Med 2008;46(5):687-690. doi: 10.1515/CCLM.2008.131)
Atkinson et. al. published a randomized double-blind study in Gut. 150 patients with IBS were tested for 29 food proteins. This was followed by a 12-week elimination diet based on specific IgG4 test results compared to a control diet group. Thereby, the elimination diet group showed significant symptom reduction compared to the control group. (Atkinson, et al, Irritable bowel syndrome, Food elimination based on IgG antibodies in irritable bowel syndrome: a randomized controlled trial., 2004, Gut 2004;53:1459-1464. doi: 10.1136/gut.2003.037697)

We are aware that the IgG4 based food intolerance test is under discussion. However, we are convinced – based on many years of medical practice, a lot of positive feedback and our own personal involvement – that taking our test results into account has a positive impact on health and well-being.

With reference to the allergy guideline, we would like to state that it does not take into account all the available data and that noteworthy current study results remain unmentioned. We would also like to refer to statements regarding IgG4 testing by German laboratories, such as Ganz Immun Diagnostics AG (“Statement: IgG-/IgG4- tests for the clarification of food intolerances” from 2009) or the Labor Dr. Bayer.

The criticism that elimination diets can lead to malnutrition is not appropriate in our view, as long as nutritionally sound alternatives are considered as nutrient sources.

The current discussion clearly shows that the clinical symptoms of food intolerances suffered by patients are multidisciplinary, include skin, stomach, intestinal problems, migraine, depression, etc. and should ideally be brought to a sustainable solution through multidisciplinary cooperation. The challenge lies precisely in this closing of ranks, and this is where kiweno sees itself as a link.

The topic of IgG4-based food intolerance testing will continue to be a lively topic of discussion, and further studies will appear.

Statement
Dr. Roland Fuschelberger

General practitioner & specialist for internal medicine
Medical director at kiweno

“The claim is often made that IgG antibodies against food allergens represent a physiological reaction and have no medical relevance. If this were the case, all people would have to have antibodies against milk, eggs, wheat, gluten, yeast, etc.”. But this is not the case. There are people with negative test results (no IgG/IgG4 antibody formation). This contradicts the statement that IgG antibodies represent a physiological reaction. It can be concluded that the appearance of antibodies in high concentrations is not a physiological reaction.

Nowadays, when for various reasons digestion (breaking down of food) is less effective and the intestinal mucosa or wall becomes increasingly permeable to larger protein molecules, this lays the foundation for the development of food intolerances. The primary immune reaction leads to the formation of IgG antibodies. There are four subclasses here. IgG1 are the initial antibodies produced against new foods (antigens). The immune complexes formed are rapidly destroyed by macrophages (phagocytes). With continued antigen stimulation, there is a switch from IgG1 to IgG4 antibodies. These immune complexes are small and can again function as antigens per se. In contrast, IgG1 is now produced again and a new cycle can be initiated. The immune complexes become larger and larger. The large immune complexes activate the complement system and initiate an inflammatory response in the body. It is this inflammatory response against food that is thought to be the cause of intolerance reactions. IgG/IgG4 antibodies appear to be a clinically relevant marker for chronic food immune reactions (food intolerances). (Prof. PhD RS Lord, JA Bralley, Laboratory evaluations for integrative and functional medicine)

From my many years of daily practice, I can also refer to many other physicians who work with the tests and report countless positive results in their use, based on many years of clinical experience for the benefit of patients. In the spirit of an open discussion, it seems reasonable and fair to acknowledge these arguments as well. There is certainly a need for more research in the field and a differentiated discussion of the topic in the interest of the people concerned. In my view, one-sided dogmatic guidelines are not sensible.”

Classic allergy vs. food intolerance

For the sake of completeness, we would like to point out that intolerances and allergies – in the conventional sense – are to be distinguished.

In the medical context, intolerances are so-called type 3 allergies. These are attenuated, delayed reactions. In the vernacular, allergy is the classic type 1 allergy with immediate reaction in the minute range, which can result in symptoms such as swelling, rashes or redness.

In contrast, symptoms of intolerance usually manifest themselves 6 to 48 (sometimes up to 72) hours after consumption. It is precisely this fact that makes the determination of intolerant foods so difficult or even impossible without testing, since the reaction cannot be directly traced back to the food consumed.