rma fst - everybody has a story...a sample rma fst™ report appears at right. foods with green...

On exposure to foods, the immune system can react by releasing proteins called antibodies. Foods that cause antibodies to be released are called antigens or allergens. Two types of antibodies are commonly produced in response to foods: IgE (immunoglobulin E) and IgG (immunoglobulin G). Food allergies and food sensitivities differ by the type of antibody produced and the speed of the reaction. Food allergy is an immediate reaction caused by the production of IgE antibodies, while food sensitivity is a delayed reaction caused by the production of IgG antibodies to specific foods.

Food Allergy IgE Reactions - ImmediateIgE reactions generally occur within minutes of eating a reactive food and can, on rare occasions, be life-threatening (e.g. peanut allergies). Skin eruptions (hives, eczema), breathing and digestive problems are also common IgE reactions. After first time exposure to an allergen, the body remembers what the allergen “looks like” and keeps a supply

of IgE ready for immediate release if it “sees” that allergen again. Referral to a specialist is recommended in the case of serious food allergies (i.e. difficulty breathing, anaphylaxis).

Food Sensitivity IgG Reactions - DelayedIgG reactions take hours or days to develop, making it difficult to determine the food cause without testing. In an IgG reaction, the IgG antibodies attach themselves to the antigen and create an antibody-antigen complex. These complexes are normally removed by special cells called macrophages. However, if the complexes are present in large numbers and the food antigen is still being consumed, the macrophages are unable to remove all the complexes. The antigen-antibody complexes accumulate and can be deposited in body tissues. Once deposited in tissue, these complexes may cause inflammation, which can contribute to a variety of health conditions.

Food Allergy or Food Sensitivity ?

RMA FSTIgG FOOD SENSITIVITY TEST

Delayed food reactions are IgG antibody reactions (food sensitivities) that occur hours to days after a food is consumed. The inflammatory reaction triggered by antibody-antigen complexes may have the following effects:

Systemic

Fever, fatigue, chills, sweating and feeling weak, puffiness.

Skin

Itching, redness, swelling, and rashes.

Brain

Mood and memory disturbances, behavioural problems.

Lungs

Food-induced bronchitis and asthma symptoms.

Musculoskeletal

Joint pain, muscle stiffness and swelling.

Digestive tract

Nausea & vomiting, diarrhea, abdominal pain, gas, and bloating.

Delayed Food Reactions Digestive disorders: Conditions like irritable bowel syndrome (IBS) and Crohn’s disease have been linked to IgG food reactions. Research has shown that elimination of IgG reactive foods can alleviate IBS symptoms.

Migraines: A 2007 research study found that 43/65 patients with migraine headaches had complete remission of headaches after one month of eliminating reactive foods. Another study in 2010 found a significant reduction in the number of headache days and migraine attacks with elimination of reactive foods.

Mood/attention deficit disorders: Deposition of antibody-antigen complexes

in nervous system tissues may contribute to hyperactivity, depression, anxiety, inability to concentrate and other mood disorders. There is some evidence that eliminating IgG reactive foods can improve attentiveness in children.

Weight gain: Antibody-antigen complexes in tissue cause inflammation, which leads to fluid retention and weight gain. To fight inflammation, the body releases a chemical called ghrelin, which also happens to be an appetite stimulant. Thus, IgG food reactions may contribute to weight gain in two ways: fluid retention and increased appetite.

Conditions Associated with Food Sensitivities

Because hours or days can pass between the time a reactive food is consumed and occurrence of symptoms, testing is often the only way to determine which foods are responsible for the reaction.

• IgG reactions frequently occur to commonly consumed foods such as dairy, wheat, eggs, yeast, pork and soy.

• Elimination diets (remove suspect foods for a period of time and then reintroduce and check for reactions) are difficult to follow and can take months to complete.

Why Test Food Sensitivities? Information is for educational purposes only. It is not meant as

medical advice and any treatment decisions

should be made with the knowledge or consent

of your healthcare professional

www.rmalab.com | [email protected] | 403.241.4500

TAKE THE GUESSWORK OUT OF YOUR DIET

Food Reactions

Test Results

A sample RMA FST™ report appears at right. Foods with green boxes next to them are considered normal, or non-reactive, while foods with orange boxes are borderline, or close to being reactive. The red shaded box food results are considered reactive. Thus, it is easy to see at a glance which foods are problematic for you. The RMA FST™ also lists results by reactivity, so that all your reactive foods are grouped together. Knowing which foods you react to is an important first step to achieving better health. Your healthcare professional is best qualified to help you interpret the meaning of your results.

Eliminating Reactive Foods

Once you receive your results, your healthcare professional will help you formulate a plan to eliminate the problem foods from your diet. Most people see improvement of symptoms within a few weeks of eliminating the reactive foods. However, it is important to understand that symptom improvement make take some time, and results vary from individual to individual. Removing reactive foods from the diet can sometimes result in withdrawal symptoms like headaches, tiredness, irritability and hunger.

Good health has a lot to do with maintaining balance; the right balance of work and play, the right balance of nutrients in the diet, and the right kinds of foods.

Undiagnosed food sensitivities may contribute to symptoms and biochemical changes that result in illness.

Rocky Mountain Analytical is committed to offering tests that identify food reactions and other imbalances - so they can be corrected before disease develops!

Why Test?

How “Leaky Gut” Contributes to Food Reactions

Leaky gut syndrome is caused by inflammation in the gut lining. Inflammation can be caused by food allergies or sensitivities, abnormal gut flora, stress, certain drugs, and alcohol. An inflamed gut lining causes more food particles to leak into the bloodstream where they may come in

contact with food-specific immunoglobulins. Therefore, a test report that shows multiple food reactions to foods regularly eaten may be an indication of leaky gut. If so, your healthcare professional may suggest treatments for your digestive system in addition to dietary changes.

Unexpected Results

• If you have not eaten a particular food for many months, you are less likely to have circulating antibodies to that food. In that case, a lack of reaction is most probably due to lack of exposure and does not necessarily mean the food is non-reactive.

• Sometimes reactions appear for foods seldom or never eaten. For example: a child reacting to coffee. This may be due to cross- sensitivity with a related food, or may result from inadvertent exposure to that food (hidden ingredient in packaged food item or sauce). Elevated IgG may also have a role in protecting against more serious IgE reactions. It’s important to understand that having elevated IgG antibodies is not a concern if the reactive food is rarely eaten.

• Non-immune food reactions: Food reactions can also arise from a lack of digestive enzymes or stomach acid, chemicals naturally present in food and artificial additives. For example: lactose intolerance is due to lactase enzyme deficiency; histamine is found in wine, cheese, spinach and tomatoes; and MSG is an additive that can produce symptoms in some people. These are not immune reactions, and therefore will not result in antibody production.

• Food reactions can also arise from previous negative experiences with a specific food (e.g. food poisoning), in that physical reactions to subsequent exposures are possible.

Rocky Mountain Analytical®

Clinical Information for Professionals

IgG Food SensitivityIg

G F

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IgG Food Sensitivity

IgG delayed onset reactions can contribute

to a variety of health

problems.

Circulating IgG antibodies form immune complexes with allergen/antigen (Ag). This is considered a Type III delayed hypersensitivity reaction, and typically occurs over several hours to several days.

Formation of the complexes activates the complement pathway and releases inflammatory mediators.

The IgG-Ag immune complexes are usually cleared by macrophages but, in the presence of excess antigen, macrophages may saturate their capacity to remove immune complexes, causing the excess to be deposited in tissue. Deposition of IgG-Ag complexes causes inflammation and tissue damage, which may contribute to specific health issues.

There are four subclasses of IgG: IgG1, IgG2 , IgG3 and IgG4. All subclasses activate the classical complement pathway except for IgG4. Our IgG test measures all four subclasses, and reports the result as total IgG.

IgG Type III Delayed Hypersensitivity Reactions

Clinical Relevance

Although still controversial in mainstream medicine, IgG food sensitivity testing is starting to accumulate research in support of its clinical utility. For example, 125 patients, identified by an allergist as likely having food allergies, were given blood tests for IgG food reactions. All positive foods were removed for a 6 month period. The allergist considered the treatment a success when a minimum 75% improvement in symptoms occurred. Of the 80 patients who completed the full course, 71% were successfully treated. In particular, there were 11 patients who had positive allergy symptoms, but had negative IgE test results. These patients were all successfully treated by eliminating the IgG food allergens. The allergist concluded that blood tests for IgG reactions to food were clinically useful and much more palatable to patients than the traditional skin prick and oral challenge tests.

Although he acknowledged that the lack of blinding and randomization meant the results could be considered anecdotal, the allergist concluded that eliminating reactive foods was useful clinically.1

IgG testing for food is not considered diagnostic for food reactions because a direct cause-effect relationship has not been established. Elevated levels of IgG have not yet been proven to cause patient symptoms, however, more studies are emerging to show a correlation between elevated IgG reactions and a variety of conditions.

+

food

antibody

food antigen

Deposition of antibody-allergen complex into tissue

causes inflammation

Antibody-allergen complex

September 2017© Rocky Mountain Analytical

Rocky Mountain Analytical®Changing lives, one test at a time

Conditions Related to Elevated IgG Levels

Irritable Bowel Syndrome A double-blind 2004 British study randomized 150 patients to receive either a sham diet or true diet. The true diet group eliminated all IgG reactive foods, and the sham diet group excluded the same number of foods as showed up reactive, but not the actual reactive foods. The severity of IBS symptoms, non-IBS related symptoms, anxiety/depression and quality of life scores were obtained at the start and again after three months on either diet. At the end of the study, the true diet group had significantly reduced severity of IBS symptoms and overall symptoms compared to the sham diet group.2

MigraineA 2004 study looked at the relationship between IgG food reactions and migraine attacks. In the study, 61 people were tested via IgG ELISA for 113 foods. About 90% of participants eliminated some or all of the reactive foods from their diet. At 1 month, 30% reported marked improvement, and at 2 months 40% reported benefit. Reintroduction of the reactive foods into the diet resulted in return of migraine for 60% of these patients. This study suggests that IgG reactions to food may play a role in the etiology and/or treatment of migraine attacks.3

A 2010 randomized, double-blind, crossover trial also showed a statistically significant drop in the number of headache days, and the number of headaches during the six week period when IgG reactive foods were eliminated from the diet.4

Weight Gain / Atherosclerosis A paper published in 2008 reported that obese children have significantly higher IgG antibodies to food antigens than normal weight children. They also found that anti-food IgG antibody concentrations are strongly associated with low grade systemic inflammation and with increased intima media thickness of the common carotid arteries. The study concluded that: “These findings raise the possibility that anti-food IgG is pathogenically involved in the development of obesity and atherosclerosis.”5

Atopy Allergic individuals and those with atopy achieved 70% reduction of symptoms with elimination of IgG reactive foods.6 In addition, atopic children (with or without eczema) were shown to have higher IgG levels to specific foods than non-atopic children. In children without eczema, higher levels of IgG were still significantly associated with atopy, with elevated IgG most prominently to egg white, orange and cow’s milk.7

Rheumatoid ArthritisSome rheumatoid arthritis patients have shown improvement in symptoms when reactive foods were eliminated from the diet. It has been hypothesized that patients with occasional rheumatitis may experience delayed hypersensitivity food reactions.8

ADHDAlthough no studies directly correlate elevated IgG levels to specific foods with hyperactivity in children, a few studies have shown improvement in attentiveness and temperament when common food allergens (e.g. wheat, dairy, oranges) were eliminated.

About IgG Testing for Food Sensitivity

Procedure: The RMA FST™ measures levels of IgG antibodies to up to 222 different foods. Antibodies are highly specialized proteins that bind to specific antigens. All foods have antigen molecules on them, and sometimes these food antigens can trigger the production of antibodies. The exact reason why food antigens trigger the release of IgG antibodies is not known.

Antibody levels are measured via an ELISA (Enzyme-Linked Immunosorbent Assay) microarray method. For an ELISA test, food antigens must first be chemically bonded to a site within a gel pad. Each of these sites has the antigens of one specific food. More than 220 foods can be tested on a single gel pad for any given patient. A measured amount of the patient’s blood serum is placed on the pad and then treated with a series of chemical solutions. Eventually a colour develops at each site and the intensity of the color is measured by a high resolution scanner. The intensity of the colour is proportionate to the amount of antibody in the blood specific to that food antigen.

Source of Food Antigens: Foods and extract material are sourced from pre-approved vendors in Europe and North America and are assayed for total protein content. Quality control procedures ensure the protein source is correct and that no other contaminants are detectable. Proteins are de-fatted (where applicable), freeze-dried (lyophilized) as necessary and stored at less than 0ºC (the lyophilization process involves rapidly freezing the food source then subjecting it to a high vacuum which removes ice by sublimation). A particular antigen is only considered suitable for use if there is significant stock. Lot-to-lot analysis is done using the extract..

Accuracy: The patient ‘unknown’ response is compared to the response of a known standard. Positive and negative controls are also run on each gel pad. All foods standards and controls are run in duplicate.

Regardless of the laboratory or testing method used, results perceived to be ‘false’ negatives or positives may occur.

September 2017An Accredited Medical Laboratory

False Positives• Cross-reactivity: False positives may occur as a result of

cross-reactivity with other foods or proteins. This can occur when the proteins are not identical, but similar enough that the immune system reacts to them. For example, a reaction to bananas may also produce a reaction to latex or vice versa.

There is an antibody pattern (either IgE or IgG) seen in a small subpopulation that has elevated antibodies to vegetables, fruits and grains. In these individuals, the high antibody levels to plant glycoproteins do not appear to be clinically relevant. Nevertheless, the practitioner must use his/her professional judgement to ascertain the significance of the results relative to the patient’s clinical picture.9

• Leaky Gut: When the gut lining is inflamed, food particles can leak through and be considered foreign bodies. This can lead to elevated IgG levels for all the foods the patient normally eats. Leaky gut may originate with one or more food allergies, or may be a result of stress or prescription drug or alcohol consumption.10

False Negatives • No Exposure: If the food antigen was consumed very

infrequently or not at all for several weeks or months prior to testing for IgG, the antibody levels may have decreased to the point that no significant food reaction is apparent. However, there are no studies that demonstrate the precise impact of food avoidance on antibody levels. Individual variability in antibody level decline is also likely a factor. Ideally the patient should consume a regular-sized serving of the food at least twice a week for two or three weeks prior to testing.11 Foods that are not consumed regularly may not give accurate results.

• Alteration: The form of allergen being tested is not the same as what the patient reacts to. For example, whey protein is altered by high heat, so someone with a whey allergy may have no reaction to heat-altered milk products. Similarly, raw eggs may show no reaction, but cooked eggs may be a problem.

• Non-Immune: Enzyme deficiencies, toxins and chemicals found in foods may mimic the symptoms of a food allergy. See chart below.

False Positives / False Negatives

Non-Immune Mediated Reactions

Implicated Substance Associated Foods Possible Symptoms

Enzymeslactase deficiency lactose in dairy products

nausea, diarrhea, gas, bloating, and abdominal cramps

alpha-galactosidase insufficiency cruciferous vegetables, legumes gas, bloating

Chemicals

histamine fish, sauerkraut, cheeseheadaches, rashes, itching, diarrhea, vomiting and/or abdominal pain

methylxanthine cola, coffee, chocolate, tea anxiety, panic disorders

tyramine cheese, pickled herring headache, palpitations, nausea, vomiting

tryptaminefermented foods (soy sauce), Acacia species (incl. beans)

restlessness, agitation, gastrointestinal distress, muscle tension, may be hallucinogenic

Toxins

aflatoxin peanuts, cereal grains chronic exposure: liver disease, increased risk of liver cancer

saxitoxin shellfish inhalation: numbness & tingling of lips, tongue, and fingertips, followed by numbness of the neck and extremities and motor incoordination. Other symptoms may include light-headedness, dizziness, weakness, confusion, memory loss, and headache

ergot cereal grains numbness, tingling & burning in limbs, feeble pulse,restlessness, stupor, delerium

cyanogenic glycosides cassava, stone fruits (e.g. peach, apricot)

chronic exposure may lead to thyroid and neurological disorders

This information is provided for educational purposes only. Rocky Mountain Analytical does not diagnose, treat or prescribe for any health condition. IgG testing is considered to be an investigational and research tool. Clinical data is not considered conclusive for the diagnosis of food allergies. Testing is conducted for investigational and research purposes only. © 2017

September 2017An Accredited Medical Laboratory

Clinical Phases of IgG Reactions

I Hidden Phase Small amounts of the reactive food are eaten. Antibody-allergen complexes form, but are removed by macrophages. Patient is asymptomatic.

II Symptomatic PhaseReactive food is eaten in large quantities and regularly. Large numbers of antibody-allergen complexes form and cannot be completely cleared by macrophages. Patient suffers chronic symptoms.

III Trial Avoidance Phase Patient removes reactive foods from diet. Levels of IgG antibodies to reactive foods remain high.

IV Challenge PhaseFour or five days after reactive food antigens have been removed from diet, the food antigens have cleared but IgG antibody levels remain high. Patient consumes a large amount of the reactive food and experiences exacerbation of symptoms.

V Elimination Phase Reactive food is eliminated for 4 to 6 months. IgG levels to the reactive food(s) drop to non-reactive levels.

VI Reintroduction Phase

After avoiding for 6 months, the reactive food is reintroduced. Patient to consume only modest amounts every fifth day. IgG levels rise when reactive food is consumed but because levels are already low, the elevation in IgG is usually insufficient to induce symptoms. Patient may consume modest amounts of the reactive food once every 5 days. Note that it is not always possible to reintroduce reactive foods into the diet without symptoms reappearing. In some cases, it may be necessary for the patient to permanently avoid the reactive food(s).

The chart below highlights the clinical picture for the various phases of IgG food sensitivity reactions [Adapted from Dixon and Trevino. Food Allergy. 1997. Thieme Medical Publishing].

September 2017© Rocky Mountain Analytical

References

1. Otolaryngol Head Neck Surg. 2000 ;123(1 Pt 1): 48-542. Gut. 2004 Oct ; 53(10):1459-63. Headache Care. 2004; 2(1):11-14 4. Cephalalgia. 2010 ; 30(7) : 829-375. Exp Clin Endocrinol Diabetes. 2008; 116: 241-456. Ann Allergy. 1987 Nov;59(5 Pt 2):137-40

7. Clin Exp Allergy. 1999 May;29(5):604-108. Food Allergy. 1997. American Academy of Otolaryngic Allergy9. Allergy. 1998 ; 53(S 46): 58-6110. Alt Med Rev. 1997 ; 2(5) : 330-4511. Food Allergy. 1997. Thieme Medical Publishing

Category RMA FST™ Basic RMA FST™ EnhancedEverything in the Basic panel, plus

Dairy/Eggs

Alpha-lactalbumin Egg White Milk (Goat) Milk (Buffalo)

Beta-lactoglobulin Egg Yolk Milk (Sheep)

Casein Milk (Cow)

Grains

Barley Oat Wheat Couscous Spelt

Durum Wheat Rye Wheat Bran Malt

Gliadin

Grains(Gluten-free)

Buckwheat Millet Amaranth Tapioca

Corn Rice Polenta


RMA FST™ Enhanced

Over 220 Food Antigens

Cover all of your bases with our most comprehensive panel, the RMA FST™ Enhanced. It has all of the foods tested in the RMA FST™ Basic panel, plus over 80 more!

The RMA FST™ Enhanced panel includes some additional popular foods consumed in the North American diet, such as:

BlueberryChamomileChickpeaCouscous

Flax SeedHoneyMangoPeppermint

QuinoaRaisinRosemarySquash

Sweet PotatoTangerineWatermelon...and many more!

RMA FST™ Vegetarian


Not worried about fish, seafood and meat? This panel is for you. The RMA FST™ Vegetarian panel has all of the vegetarian foods tested in the RMA FST™ Enhanced panel, including those listed under Dairy/Eggs.

Excludes the foods listed in the Fish/Seafood and Meat categories, but includes over 50 vegetarian foods not provided in the RMA FST™ Basic panel.

RMA FST™ Basic


Undiagnosed food sensitivities can affect quality of life. Take back control of your health with the RMA FST™ Basic panel, a personalized report of over 125 foods.

TA K E T H E G U E S S W O R K O U T O F Y O U R D I E T

RMA FST™ Panel Options

RMA FST™ Antigen List(Continued on Second Side)

Rocky Mountain Analytical®


Fruit

Apple Grape Orange Blueberry Mango Redcurrant

Apricot Grapefruit Peach Date Mulberry Rhubarb

Avocado Kiwi Pear Fig Papaya Tangerine

Banana Lemon Pineapple Guava Pomegranate Watermelon

Blackberry Lime Plum Lychee Raisin

Blackcurrant Melon (Honeydew) Raspberry

Cherry Nectarine Strawberry

Cranberry Olive

Vegetables

Asparagus Cauliflower Onion Artichoke Quinoa Sweet Potato

Beet Celery Potato Arugula Radish Turnip

Bell Peppers Chicory Soy Bean Cabbage (Red) Shallot Watercress

Broccoli Cucumber Spinach Chard Squash (Butternut) Yucca

Brussel Sprout Eggplant Tomato Fennel (Leaf ) Squash (Summer)

Cabbage (Savoy/White)Carrot

Leek

Lettuce

Herbs/Spices

Basil Dill Nutmeg Aniseed Ginkgo Peppermint

Chilli (Red) Garlic Parsley Bayleaf Ginseng Rosemary

Cinnamon Ginger Peppercorn (Black/White) Camomile Liquorice Saffron

Clove Hops Sage Cayenne Marjoram Tarragon

Coriander (Leaf ) Mint Thyme Curry Nettle

Cumin Mustard Seed Vanilla

Nuts/Seeds

Almond Canola Peanut Bean (Broad) Flax Seed Pine Nut

Bean (Green) Coconut Pistachio Chickpea Macadamia Nut Tiger Nut

Bean (Red Kidney) Hazelnut Sesame Seed

Bean (White Haricot) Lentil Sunflower Seed

Brazil Nut Pea Walnut

Cashew Nut

Miscellaneous

Cane Sugar Coffee Tea (Green) Agar Agar Chestnut Honey

Carob Mushroom Yeast (Baker’s) Aloe Vera Cola Nut Transglutaminase

Cocoa Bean Tea (Black) Yeast (Brewer’s) Caper


Fish/Seafood

Cod Mussel Sole Anchovy Cuttlefish Sardine

Crab Oyster Swordfish Barnacle Eel Sea Bream (Gilthead)

Haddock Plaice Trout Bass Espaguette Sea Bream (Red)

Herring Salmon Tuna Carp Hake Snail (Winkle)

Lobster Scallop Turbot Caviar Monkfish Spirulina

Mackerel Shrimp/Prawn Clam Octopus Squid

Clam (Razor) Perch Wakame

Cockle Pike

Meat

Beef Lamb Veal Goat Ox Rabbit

Chicken Pork Venison Horse Partridge Wild Boar

Duck Turkey Ostrich Quail

NO

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A FS

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* Rocky Mountain Analytical reserves the right to substitute/change allergens without notice.

October 2018

RMA FST™ BasicOver 125 foods

RMA FST™ VegetarianOver 160 foods

RMA FST™ EnhancedOver 220 foods


There are three panel options available to meet your needs:

TA K E T H E G U E S S W O R K

O U T O F Y O U R D I E T

Which RMA FST™ Panel Is Right for You?

When to Select RMA FST™ EnhancedBelow is a list of foods included in the RMA FST™ Enhanced panel only. If your diet includes four* or more foods, the RMA FST™ Enhanced panel is the best option of you. Note: This is a condensed list. See the Antigen List for the full list of foods.

Learn more at: rmalab.com/RMAFST

Grainsc Quinoa c Couscousc Beer or Whiskey (often has Malt)c Spelt or Amaranth (flours commonly used to replace wheat)c Gluten-Free Breads (often has Tapioca)

Meatc Goat c Rabbit c Ox

Herbs/Spicesc Herbal teas: Peppermint or Camomile (also spelled Chamomile)c Rosemaryc Ginseng c Cayenne c Curryc Ginkgo

Miscellaneousc Honey c Jams, Jellies or Canned Soup (often has Agar Agar)c Deli Meats or Chicken Nuggets (often has Transglutaminase)

Fruitc Blueberry c Mango c Pomegranate c Raisin c Tangerine c Watermelon c Date c Fig c Papaya

Vegetablesc Sweet Potato c Shallot c Arugula c Zucchini (also known as Summer Squash) c Butternut Squashc Red Cabbagec Radishc Chard

Nuts/Seedsc Flax Seed c Chickpea (commonly used in hummus and falafel)c Macadamia Nutc Fava Bean (also known as Broad Bean)

Fish/Seafoodc Anchovy (commonly found in caesar dressing) c Squid (used for calamari)c Wakame (commonly used in miso soup)c Spirulina

* Each of these antigens are available to order by your Healthcare Provider through Rocky Mountain Analytical, as an add-on to the Basic and Vegetarian panels. They are a minimum of $25 each.

© All Rights Reserved, LifeLabs LP, 2019. RMA FST™ is a trademark of LifeLabs LP.

You want to choose a panel that best reflects you and your eating habits, and is the best value for money. Don’t eat meat, fish or seafood? Try the Vegetarian panel. Mainly interested in your reactivity to the most common food sensitivities? Perhaps the Basic panel will do. Wondering if you should select the Enhanced panel? To make a confident choice, it is important to consider all of the foods that you consume on a regular basis.

TA K E T H E G U E S S W O R K

O U T O F Y O U R D I E T

• Remove the foods that are reactive, following your Healthcare Provider’s guidance and advice. • Track your symptoms, and if they have improved, you may want to test yourself for reactions by slowly reintroducing

foods into your diet. Consult with your Healthcare Provider before doing this.• Choose one test food to reintroduce into your diet at a time. • Using the tracker below, take detailed notes on how you feel, and make a point to notice everything you’re feeling.

Day 1 Day 2 Day 3 Day 4 Day 5Time

Food

Digestion/Bowel Function

Joint/Muscle Aches

Headache/Pressure

Nasal or Chest Congestion

Kidney/Bladder Function

Skin

Energy Level

Sleep

Other Symptoms

Food Reintroduction - Symptoms Tracker

© All Rights Reserved, LifeLabs LP, 2019. RMA FST™ is a trademark of LifeLabs LP.


Accession: 111111

E: [email protected]: 403-241-4500F: 403-241-4501www.rmalab.com

12:00AM2017/09/27

Reported On:Date of Receipt:

Time of Collection:Date of Collection:

Healthcare ProfessionalDr. John Smith1234 Imagination Road Calgary, AB T3G 1X1

P: 403-555-1234 F:

PatientSally Thomson

Gender:Date of Birth:Age:

Female1985/12/20

2017/09/292017/10/18

31

RMA FST Basic

NORMAL

BORDERLINE

ELEVATEDFOOD GROUP Report

RESULT STATUS

The upper limit for assigning Normal status varies by antigen.

The lower limit for assigning Elevated status varies by antigen.

The upper and lower limits for assigning Borderline status varyby antigen.

NOTE: The limits assigned to individual antigens are basedon a statistical analysis of a Canadian population

Dairy / Egg

0 Alpha-Lactalbumin (whey) 0 Beta-Lactoglobulin (whey) 67 Casein

72 Egg White 8 Egg Yolk 91 Milk (Cow)

32 Milk (Goat) 31 Milk (Sheep)

Grains

47 Barley 29 Durum Wheat 87 Gliadin

9 Oat 25 Rye 54 Wheat

22 Wheat Bran

Grains (Gluten-Free)

1 Buckwheat 48 Corn 0 Millet

50 Rice

Fruit

3 Apple 1 Apricot 3 Avocado

4 Banana 6 Black Currant 8 Blackberry

7 Cherry 9 Cranberry 5 Grape (Black/Red/White)

6 Grapefruit 3 Kiwi 3 Lemon

15 Lime 4 Melon (Galia/Honeydew) 1 Nectarine

3 Olive 14 Orange 3 Peach

5 Pear 2 Pineapple 25 Plum

10 Raspberry 4 Strawberry

Vegetables

0 Asparagus 1 Beet 5 Bell Peppers

7 Broccoli 7 Brussels Sprout 23 Cabbage (Savoy/White)

CPSA Accreditation # L0154200

A division of LifeLabs LPCo-Signing Physician:Clare Westmacott, MDCalgary, ABPhone (403) 278-1405

Vegetables

15 Carrot 1 Cauliflower 11 Celery

2 Chicory 7 Cucumber 1 Eggplant

2 Leek 2 Lettuce 4 Onion

42 Potato 3 Spinach 1 Tomato

Fish / Seafood

5 Cod 3 Crab 10 Haddock

5 Herring 3 Lobster 2 Mackerel

22 Mussel 53 Oyster 4 Plaice

1 Salmon 22 Scallop 3 Shrimp/Prawn

4 Sole 0 Swordfish 1 Trout

8 Tuna 0 Turbot

Meat

3 Beef 2 Chicken 0 Duck

3 Lamb 3 Pork 0 Turkey

4 Veal 3 Venison

Herbs / Spices

3 Basil 2 Cinnamon 0 Clove

0 Coriander (Leaf) 0 Cumin 2 Dill

4 Garlic 7 Ginger 5 Hops

1 Mint 16 Mustard Seed 11 Nutmeg

0 Parsley 0 Peppercorn (Black/White) 6 Red Chili Pepper

1 Sage 0 Thyme 0 Vanilla

Nuts / Seeds / Legumes

38 Almond 1 Bean (Green) 25 Bean (Red Kidney)

9 Bean (White Haricot) 16 Brazil Nut 0 Canola

16 Cashew Nut 1 Coconut 21 Hazelnut

5 Lentil 40 Pea 22 Peanut

33 Pistachio 0 Sesame Seed 4 Soy Bean

14 Sunflower Seed 8 Walnut

Miscellaneous

5 Cane Sugar 3 Carob 3 Cocoa Bean

3 Coffee 2 Mushroom 2 Tea (Black)

0 Tea (Green) 59 Yeast (Baker's) 58 Yeast (Brewer's)

Accession Number: 111111 Page 2 of 7

Status:

Negative

Candida IgG

Note: The College of Physicians and Surgeons of Alberta considers some forms of testing for food reactions tobe complementary medicine. Specific IgG quantification has been utilized in research settings to assess andinvestigate Type I and Type III allergies respectively. However, the assessment of human IgG antibodiesspecific for individual food antigens is not a recognized diagnostic indicator of allergy. Rocky MountainAnalytical does not diagnose or make treatment recommendations. Data is provided for research andeducational purposes only.

George Gillson MD, PhDMedical Director


Interpretation Accession Number: 111111

IgG FOOD REACTIONS VS IgE FOOD ALLERGIES: IgG food reactions differ significantly from classic IgE foodallergies. IgE food allergies are immediate reactions that occur within minutes or hours of consuming a food andmay include serious reactions like hives, difficulty breathing and anaphylaxis. In contrast, an IgG food sensitivity isa delayed reaction that occurs hours to days after the food is consumed, with symptoms that may not appear fordays or months. Lack of an IgG antibody response to a specific food does not rule out the possibility that the foodmay elicit an IgE reaction (food allergy). Patients should continue to avoid foods to which they have a known IgEfood allergy. Conversely, elevated IgG to a specific food is not diagnostic of IgE food allergy. If symptoms (e.g.hives, difficult breathing) are suggestive of food allergy, the patient should be referred to an Allergist Specialist forspecific IgE testing via ImmunoCAP.

IgG REACTIONS: IgG reactions are food sensitivities, not food allergies. When a reactive food is consumed, theIgG antibody forms a complex with the food antigen. Normally, the body is able to eliminate theseantibody-antigen complexes, but with excess antigen, small complexes tend to deposit in blood vessel wallswhere they can cause tissue injury via the release of inflammatory mediators [Brantzaeg 1997]. Over time, thistissue injury may contribute to the development of a variety of health conditions. Research has shown thatelimination of IgG reactive foods from the diet improves a variety of health conditions including irritable bowelsyndrome and migraine headaches [Atkinson, Alpay]. Eliminating IgG reactive foods has also been reported tohelp with eczema, mood disturbances, weight gain and other digestive disturbances [Mullin, Lewis, Bentz].

NORMAL REACTIONS: A normal reaction to a food antigen may indicate lack of recent exposure to that food.Therefore, under circumstances of complete avoidance, it is impossible to determine whether the food(s) avoidedwould elicit a reaction if consumed recently. It is important to note that a normal reaction to a specific food doesnot mean it can be safely consumed by someone who has previously had a serious reaction to that specific food.Serious reactions to foods (e.g. anaphylaxis or hives) are caused by IgE antibodies, not IgG. Therefore, a normalIgG reaction to a known food allergen is not an indication the tested food is safe to consume.

PATIENT HAS A REACTION TO ONE OR MORE FOOD ANTIGENS NOT CONSUMED REGULARLY: It ispossible to have elevated IgG to foods not recently consumed, or to foods that have been specifically avoided (i.e.due to serious previous IgE reaction). Elevated IgG in this circumstance may be due to panallergen reactions[refer to the RMA FST Food Sensitivities and Cross-Reactions document], or to an abundance of the IgG4 subtypeantibody, which acts on mast cells and may have a protective effect for IgE reactions and antibodies may remain incirculation for 18 months even with no exposure [Mullin].

GOAT'S MILK AND/OR SHEEP'S MILK ARE BORDERLINE OR ELEVATED but patient may have neverconsumed: In vitro studies have shown extensive cross reactivity between milks from ruminant species. Significantamino acid sequence homology between milk from cows, goats and sheep mean cross-reactivity is highly probable[URL: www.uptodate.com/contents/milk-allergy-management. Accessed June 11, 2016]. Clinical research hasfound that a significant percentage of cow's milk allergic patients also react to goat and sheep milks [Pediatr AllergyImmunol. 2012 Mar;23(2):128-32].

WHEAT IS BORDERLINE OR ELEVATED AND WHEAT BRAN IS NORMAL: Wheat is a 42 chromosome memberof the Triticum genus that is comprised of the whole cereal grain; endosperm, aleruone and pericarp. Wheat branis the hard exterior coating of the wheat grain (aleurone and pericarp) that contains a high percentage of fibre andfatty acids. The difference in reactivity between wheat and wheat bran may be explained by the presence ofallergenic proteins in the endosperm of whole wheat [Clin Exp Allergy. 1990;20(5):501-509], versus fibre and fattyacids found in the exterior shell of the wheat bran.

BREWER'S YEAST IS BORDERLINE OR ELEVATED: Note that Brewer's Yeast and Baker's Yeast are differentstrains of one organism, Saccharomyces cerevisiae. The Brewer's Yeast strain is slower acting and has lessafter-taste than Baker's Yeast. Food sources of Brewer's Yeast include: beer, cider, dried fruits, marmite, miso,tamari, vegemite, yeast extract, wine. Brewer's Yeast may also be added to cookies, oatmeal and yogurt toimprove nutrition. Brewer's Yeast is high in chromium and B vitamins and may be used in supplements.

BAKER'S YEAST IS ELEVATED: Note that Baker's yeast and Brewer's yeast are different strains of one organism,Saccharomyces cerevisiae. Baker's yeast must multiply quickly and under high heat, and so the appropriate strainof Saccharomyces cerevisiae is selected for rapid growth and ability to tolerate high heat. Food sources of baker'syeast include: bagels, bread, buttermilk, cheese, MSG, Oxo cubes, pizza dough, pretzels, root beer, soy sauce,soup, sourdough.


Interpretation Accession Number: 111111

REACTIVITY TO CRUSTACEA AND/OR MOLLUSCA: Reaction to Crustacea and/or Mollusca (even in theabsence of exposure to, or with strict avoidance of), may indicate cross-sensitivity to TROPOMYOSIN, anallergenic protein found in insects and arachnids. Dust mites and cockroaches are commontropomyosin-containing allergens. If the clinician determines that exposure to tropomyosin could be contributing toclinical symptoms, measures to reduce exposure to insect and arachnid antigens may be recommended. Refer tothe RMA FST Food Sensitivities and Cross-Reactions document for more information on cross-reactions.

ELEVATED REACTIONS TO FOODS: Interpretation comments are provided for certain foods. Comments appearwhen related foods give seemingly inconsistent results (e.g. casein normal and cow's milk high) and for reactivefoods that are not commonly found in the North American diet. Refer to the RMA Food Reaction Guide forcommentary on sources of individual foods or food categories.


DOB:

Client:Sally Thomson

Provider:Dr. John Smith ND

20-Dec-1985

ORDER BY REACTIVITY Report

ELEVATED FOODS

87 Gliadin 59 Yeast (Baker's) 53 Oyster

50 Rice 48 Corn 42 Potato

BORDERLINE FOODS

91 Milk (Cow) 72 Egg White 67 Casein

58 Yeast (Brewer's) 54 Wheat 47 Barley

40 Pea 38 Almond 33 Pistachio

32 Milk (Goat) 31 Milk (Sheep) 29 Durum Wheat

25 Plum 25 Rye

NORMAL FOODS

25 Bean (Red Kidney) 23 Cabbage (Savoy/White) 22 Mussel

22 Peanut 22 Scallop 22 Wheat Bran

21 Hazelnut 16 Brazil Nut 16 Cashew Nut

16 Mustard Seed 15 Carrot 15 Lime

14 Orange 14 Sunflower Seed 11 Celery

11 Nutmeg 10 Haddock 10 Raspberry

9 Bean (White Haricot) 9 Cranberry 9 Oat

8 Blackberry 8 Egg Yolk 8 Tuna

8 Walnut 7 Broccoli 7 Brussels Sprout

7 Cherry 7 Cucumber 7 Ginger

6 Black Currant 6 Grapefruit 6 Red Chili Pepper

5 Bell Peppers 5 Cane Sugar 5 Cod

5 Grape (Black/Red/White) 5 Herring 5 Hops

5 Lentil 5 Pear 4 Banana

4 Garlic 4 Melon (Galia/Honeydew) 4 Onion

4 Plaice 4 Sole 4 Soy Bean

4 Strawberry 4 Veal 3 Apple

3 Avocado 3 Basil 3 Beef

3 Carob 3 Cocoa Bean 3 Coffee

3 Crab 3 Kiwi 3 Lamb

3 Lemon 3 Lobster 3 Olive

3 Peach 3 Pork 3 Shrimp/Prawn

3 Spinach 3 Venison 2 Chicken

2 Chicory 2 Cinnamon 2 Dill

2 Leek 2 Lettuce 2 Mackerel

2 Mushroom 2 Pineapple 2 Tea (Black)

1 Apricot 1 Bean (Green) 1 Beet


NORMAL FOODS

1 Buckwheat 1 Cauliflower 1 Coconut

1 Eggplant 1 Mint 1 Nectarine

1 Sage 1 Salmon 1 Tomato

1 Trout 0 Alpha-Lactalbumin (whey) 0 Asparagus

0 Beta-Lactoglobulin (whey) 0 Canola 0 Clove

0 Coriander (Leaf) 0 Cumin 0 Duck

0 Millet 0 Parsley 0 Peppercorn (Black/White)

0 Sesame Seed 0 Swordfish 0 Tea (Green)

0 Thyme 0 Turbot 0 Turkey

0 Vanilla


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