Explore the cell’s role in mediating adverse reactions: a scientific discussion on metabolic, immunologic and pharmacologic mediators

Moderator

Thank you for joining us for tonight’s live event titled “Explore the cell’s role in mediating adverse reactions.” A quick note about tonight’s broadcast. Broadcast quality is determined by the strength of your internet connection. You may adjust video quality in the bottom right section of the player. Be sure to participate in the live chat, as we’ll be answering questions at the end of tonight’s event. Presenting tonight are Amy Pieczarka, RDN, Dr. Craig Koniver, MD, and Roger Deutsch.

 

Roger Davis Deutsch, Founder & CEO

Thank you very much. So, just a little bit about me. I’ve been involved and the CEO of Cell Science Systems that sponsoring this event. And I’ve been in the field of testing for food and chemical sensitivities since 1986, when I was brought in to help commercialize the Alcat Test. And it’s been a fascinating ride for me prior to that. I had been in the industry, in business and was successful in the finance field, but found that the activity was wholly unrewarding, just doing a job for the sake of making money. And when I was presented with the opportunity to get into this particular field, I jumped at it.

And ever since then, I’ve had a lot of fun watching the evolution of this process. Today, many people accept, I think everybody accepts that foods can cause disease. When I first started, there was a lot of resistance to that very basic concept, which today would seem quite surprising. I had people get quite alarmed when I proposed that food can cause disease, and they would challenge me, and so forth. But nowadays, it’s been quite an evolution. And I’ve been involved entirely with the development of the Alcat Test, which we’ll talk about today.

We’ll talk a little bit about the methodology and we’ll answer some questions that came in that are focused on the difference between the Alcat Test and IgG testing, because everyone knows that IgG testing is still used quite widely. The question is, I think every day I hear that question, what is the difference? So hopefully, I’ll be able to, and Dr. Koniver and Amy will help clarify what the difference is, because it is quite striking actually. In one case we’re talking about an antibody, which is a molecule, which can have different functions. And there are essentially five different types of antibodies.

 

And on the other hand, we’re looking at Alcat, which is a cellular test, which is actually a biological response test, real-time, how the live leucocytes respond to a challenge ex vivo with a food or chemical. And that type of testing actually has been around. We’ve been doing it for 30 years. But the idea actually came out in the ’30s when people realized that leucocytes can be damaged by foods. And the technology in those days was very crude, so there was a matter of taking a person’s blood, counting their white blood cells, having them eat a food, taking their blood again, and counting the white blood cells again.

This was the leukocytopenic index and seeing if the ingestion of the food caused lysis or death, apoptosis or degranulation to occur, and a reduced number of white cells to occur, which would then indicate a reaction. And in 1957, an allergist in El Paso named Black applied microscopic observations to white cell responses to both food and airborne allergens. And his work was continued by a couple in St. Louis at Washington University, William and Miriam Brian, who were ENT allergists. And they published several papers.

And they called the test, at that point, the cytotoxic test. And it was around for quite a while and there were a lot of people very enthusiastic about it. Except, I think, people became too enthusiastic about it and a lot of the mainstream members of the medical establishment were unhappy about the claims that were being made for the successes achieved through the cytotoxic test, and possibly even felt a little bit threatened in their allergy practice in more conventional, using more conventional type of technologies.

So it was attacked and it was criticized. And basically, the criticism was aimed at the fact that it wasn’t an objective measurement. It required subjective evaluation of changes in cells by a technician. And you can imagine looking at 100 microscope slides to look at the response to 100 different foods would be tedious. And if you did that every day, all day long, maybe you would miss some very subtle changes that occur in the cell size, which is an antecedent to the cell actually internalizing particles that may lead to the death of a cell and the spewing out of toxic mediators, and the generation or free radicals, and ensuing symptoms.

And if it’s chronic and long-term it could ultimately attack and degrade tissues, even degrade DNA, and lead to a lot of disease. And it can also cause the release of DNA from the cell into the surrounding milieu where it might become immunogenic if it’s not neutralized. If the monocyte macrophage system is overwhelmed and there’s too much of it, it could generate autoimmune disease. And this has been identified now and linked clearly to lupus and arthritis, and probably many others have that as a base.

So the Alcat Test essentially took that concept and found a way to perform the analysis of the cellular responses through an electronic analyzer coupled with computer algorithms that can determine even very subtle changes in the cells. So with that background, I’d like to begin and speak about how Alcat is different from other tests on the market. That’s what the most often asked question, I think, is. But when we consider this area, it’s very complex. There’s no way we’re going to even go further than scratching the surface of the topic.

Food sensitivity, we learn more every day. But as we’ll see, the immune system is very smart, hopefully, and can tell us and guide us what exposures are potentially harmful and what are compatible and what might even be good. The question is what do we look for in the immune system? Many people talk about looking for antibodies. We talk about looking at how the cell responds. Remember, the cell makes many responses and engulfs the particles, it neutralizes them.

It may, if necessary, generate antibodies to help in the process of opsonizing particles so that they can be phagocytized. It can also be used to clear excess antigen from the circulation by the monocyte macrophage system without inducing any immunological response. It can be immunologically silent. It doesn’t go on. It’s quite a natural process that occurs whenever there’s exposure. That’s why immunological tests are used to determine exposure to certain pathogens. They just tell us that they’re there.

So with that in mind, let’s begin. Firstly, we can’t entertain a discussion about how we respond to food without looking at the environment. In this care, the environment, there’s the gut microflora. And it’s so important, even back at…this paper that I’d like to talk about for a few moments, from the Journal of Allergy and Clinical Immunology was published back in 2001. Looking at the difference in the microflora of neonatals who later on became atopic, meaning they became atypical, displaying features of allergy, versus children who do not. And there was a striking difference between the population of clostridia in the microflora of infants that later on became atopic.

There’s three times as much clostridia as compared to the normal population. However, there was also an equally exaggerated deficiency in the existence of bifidobacteria in the gut. So there’s one-third as much bifidobacteria. So we’ve seen this over the years. A number of studies have come out showing that there are profiles of lean microbiota, so to speak, characterized by a lot of bacteriorities. And there is also a profile that is associated with metabolic syndrome, vermicides [SP], that is associated with obesity and metabolic symptoms.

So I think we have to always keep in mind that everybody is different and two people might have antibodies, but the bottom line essentially is whether or not biologically we’re reacting to it. And the gold standard has always been a challenge. In mainstream medicine, if you wanted to determine if someone has an adverse reaction to a food, you feed it to them. But you do it under certain rigorous conditions, double-blind. You do it spaced out in time so that the one challenge is not impacted by carryover from the previous challenge as the symptoms can be delayed.

And although we’re not going to get into that because of time constraints, there have been a number of studies looking at both serological approaches and the cellular approaches. And there’s also a sharp difference there. The cellular responses that we see with the Alcat correlate very well with double-blind oral challenges. And we don’t see that with other approaches. One group that reported out, this is a study reported on the open access public library online service in late ’14.

Looked at different patterns of the expression of IgG and IgA against food and microbes in the serum and the feces of patients with inflammatory bowel disease, which means all sorts of colitis and Crohn’s disease. And we’ll just touch on this because this could be a lecture in itself. It’s a very interesting piece of work. And it sheds light, a little bit, on how the specific immune system plays a role in or doesn’t play a role with these gut disorders. So they made an investigation of levels of antibodies in patients who were symptomatic and also normal controls.

 

And here’s some of their findings, which I think are very interesting. The anti-food antibodies and antimicrobial IgG and IgA are seen here plotted on the graph. These on the top, on the north end of this graph, are the IgG in the serum antibodies against ovi albumen from egg, wheat, milk, saccharomyces cerevisiae, anti-saccharomyces cerevisiae antibodies, antibodies against E. coli, and B. fragilis. I’m going to focus primarily on these four.

There’s a big difference in the antibodies against saccharomyces cerevisiae amongst the Crohn’s disease patients who had the stronger presentation of disease. They had penetration, meaning perforation, and stricturing, means obstruction in the gut versus controls. So clearly, and this is consistent with earlier findings, saccharomyces cerevisiae seems to play a role in the pathology of IBD. To some extent, we see this same thing in the more severe expression of the disease, but not the less, more moderate expression of the disease. There we see, actually, lower titles of specific IgG against E. coli.

So this, we think, based on this and other studies, is diagnostic. In fact, we include this marker, particularly for that reason, into our gut health panel, which consists of, of course, a number of Alcat determinations. Candida, which plays a role, and in fact, it’s been shown that there is course reactivity between ASCA and candida, that ASCA antibodies will often bind with candida albicans. And of course, we include in that panel genetic markers for Celiac, because it’s important to rule out whether or not a person has that risk, in which case it’s very necessary that they avoid gluten.

So that’s a good panel. But looking at the food, and again, we’re talking about serological tests right now. We’ll get into the cellular in a moment. The food doesn’t show much difference or any difference in any of these groups, except slightly with the very severe Crohn’s disease patients. The normals have the same levels of IgG, at least against these foods, which are major foods. With IgA, it’s more or less the same thing. IgA also plays a protective role. There’s serological IgA. There’s also secretory IgA in the gut that excludes antigen. So it’s not surprising to see that in some cases.

That’s even higher amongst normals than it is on people who have a moderate form of disease. So there summarizing the results such that saccharomyces cerevisiae antibodies and the others were increased in Crohn’s disease. Not so with E.coli. And food allergens were not significantly different within the patients groups. And again, they summarize that and they characterize an important finding of the study is that they didn’t find any correlation between food, specific antibodies, and clinical symptoms.

So the data does not support the idea that measurements of anti-food specific IgG or IgA is of any clinical relevance, at least for patients with Crohn’s or ulcerative colitis. Now, as I mentioned earlier, I’ve been doing this for about 30 years so I remember a lot of things from the early times. And there was a lot of buzz about food intolerance and in vitro testing for it when I first got involved in this area. And in fact, 3M Diagnostics made a multi-million dollar; it was about a $35 million investment in a company that developed a new methodology, a fluorescent test for identification of allergen-specific IgG antibodies for foods.

So after paying $35 million for that company and that technology they, I don’t know, I think they probably put the cart before the horse, but then they began some research studies. And I was actually quite well aware of this because the company had approached me for joint venture activities. And one of the researchers, Joseph Bellanti from Georgetown University, and he’s still at Georgetown as Professor of Immunology and Molecular Biology, was involved along with the scientists from 3M in looking carefully at correlations between IgG4 against foods in patients who were confirmed sensitive by oral challenge.

And they found it was only correlated about 36%. So 3M being a big company, were able to renounce that investment and walk away. And I was actually at the allergy meeting where they announced that they were going to not…they weren’t going to be in business anymore. They closed that business. They didn’t think the test worked, except it was a good test for monitoring compliance because the antibodies were correlated with exposure but not with pathology. And that wasn’t enough to justify a business model so they walked away from that.

So there are many other occurrences that were extant in that day, but will have to wait for another time. But I think the IgG has kind of lingered on in people’s minds because there are some benefits from it. But people get the right answer for the wrong reason sometimes. But the test lacks in specificity, so people are avoiding on the foods that they’re exposed to. And no doubt, when you avoid everything you’re exposed to, included in that is the subset of foods that you may actually have indirectly become sensitized to. But then it’s not sensitive, but…excuse me, it’s not specific.

Now, as far as the sensitivity of it is concerned, there are a number of chemicals in food, and Amy will be speaking about that in a few moments, which can cause adverse reactions via a non-immunological pathway. In fact, these chemicals are natural constituents of foods, and she’ll elaborate on that, that can be harmful but they’re too small to actually even generate an antibody. But they can, through pharmacological pathway, trigger adverse reactions. The cells that recognize dangers have danger associated molecular patterns on their surface and can respond to small chemicals that are not proteins. So we’re not talking about allergy, but adverse reactions that can occur from pharmacological mechanisms.

It was even found that IgA probably mediates gut homeostasis and have an anti-inflammatory effect. And that’s consistent with other findings as well. In summary, the study reveals that these Crohn’s and ulcerative colitis and acute gastroenteritis patients, as well as non-inflammatory controls do have distinct, different patterns. However, food-specific antibodies have not yet been proven to be a valuable biomarker. Looking at cells, on the other hand, it’s a different phenomenon.

They’re both food sensitivity tests, but one is looking at antibodies and the other is looking at cells. And a cell, an antibody producing cell, a plasma cell spews out millions of antibodies, but that’s only one thing that they can do. And then if the antibodies are promoting pathology or if they’re just binding and opsonizing particles so that a cell can take care of it, which may or may not induce, which may be immunologically silent or not, are whole other questions. And I think those are fascinating areas, but the cell only responds if there’s really a need to…the cell is the final…in other words, a cell is a final common pathway of a lot of different mechanisms.

In the response of the cell, if it’s dramatic enough, on the one hand indicates that the substance is a danger, and on the other hand it also, in the process of neutralizing particles, produces toxic mediators and reactive oxygen species that produce the symptoms that we see that are so extent to these days. The inflammatory mediators block insulin receptors, they’re involved in metabolic syndrome, they oxidize particles, they damage DNA, they oxidize cholesterol, which can help form plaques. So the cell is kind of sitting and in the innate immune system, cells particularly are sitting sort of at the center of a lot of the chronic inflammatory and degenerative conditions that we see today.

 

What came out from Harvard, from Fasano’s group, is this study working with people from the NIH Lymphocyte Biology Labs and Immunology Labs was the demonstration that PT-gliadin or pepsin trypsin gliadin, which is pre-digestion in that way in order to mimic gliadin that we ingest, induces an immediate and substantial recruitment of neutrophils in the lumen of the gut. And increased intestinal permeability, of course, favors the access of gliadin right into the lamina propria where other cells get involved. And if we’re programmed accordingly, with the genetics, it will then send that information to T-helper 2 cells, which will cause damage we know is associated with celiac disease.

But even celiac disease, being an autoimmune disease which is a function of the specific immune system, is first signaled by the efforts of the innate immune system, particularly the neutrophils to neutralize the particle. And in fact, what we’re doing in our ex vivo Alcat Test is looking at activation of the neutrophils. Now, I’ll let him present his findings in his own words. It’s very interesting to look at this video.

Dr. Alessio Fasano

What you see here is the cross-section of this core of the villus. This black stuff here are the capillaries. And this green dots that you will see a little bit better are the soldiers, are neutrophils, they are particularly treated in this transgenic animals with the fruit fly gene that makes them to be fluorescent. So what you’re going to see now is on the left, these are the villi of a mouse that has been exposed to another protein, BSA. This is the mouse that has been gavaged with gluten.

And this pretty much what you going to see there. So see how many of this soldiers are stuck on the wall of the capillaries here and then eventually start to move out and get out, and got into the external part, what we call the lamina propria while this guy here they keep troubling, and they stay in the lumen. So in the animals that was exposed to gluten, gluten is attracting the soldiers outside of the capillary and they start to really get on the battlefield, where gluten and God knows, again, what else is sitting in there, because it been absorbed through this breach in the barrier.

While these guys, they keep going. Again, who is close by may see that. But even if you are not that close, you see the mess that is happening here, and this is all due to the simple difference that here you have bulbi serum albumin and here you have gluten. That’s all.

Roger Davis Deutsch

So, from that study, they also showed human cells. And here we see, on these different chambers, and what’s called an easy taxis…sorry about that, chemotaxis assay. We see cells that are exposed to a control, phosphate-buffered saline, and we see cells exposed to fMLP, which is used experimentally because it’s the same structure as a peptide sequence on the cell wall of bacteria and it always activates neutrophils, and then gluten. And so we can see how the control doesn’t do it, so the effect that we’re seeing from the gluten is the same active migration of the cells.

And they’re moving at about 10 microns per second, which is pretty fast. They’re capable of a little bit more than that. Again, the controls are not moving. And this is mimicking what happens in vivo when there’s signals sent to the neutrophil of injury or presence of a pathogen. These cells actually get activated and start to migrate out of the vasculature. They upregulate selecting on their membranes and the endothelial cells in the capillaries express inhesion molecule. And then they separate and the cells go out and enter into the tissue to fight against the pathogen. A

And in the process, of course, there could be collateral damage. So with that in mind, let’s look at just a few instances. There could be actually hundreds of instances cited here from studies that are recent showing how leucocyte activation damages various parts of the body. And the mechanism is how that is done. But we’ll just look at a couple, just to get an idea. Today, many couples are infertile and we see many women who are unable to conceive follow the Alcat for three months and they’re then able to conceive. They become pregnant.

And it’s believed that the inflammation causes this swelling of the fallopian tube and the eggs cannot reach the uterus. But it can also be the man’s fault. And what’s seen in this study, and the citations may be too small for you to see, but this, you can download this presentation after we give it and you can look these up. The semen has the potential to…sorry, the leucocytes are present within the semen and mostly the population of leucocytes that are present are neutrophils, which we’ve spoken about, and the macrophages.

 

And they have the ability to damage the gametes, to damage the sperm via the generation of free radicals species, toxic mediators, proteases, and then the induction of apoptosis. And again, when apoptosis occurs, you have this dead cell which does release its DNA and that DNA is itself pro-inflammatory and can also be immunogenic and trigger autoimmunity. In this study, they were able to confirm for the first time that seminal plasma does indeed contain neopterin and that high levels of this macrophage activity marker are threefold higher in infertile men than in fertile men.

So there you have it. But in another very recent study from the Inserm in Paris, they speak about these mechanisms. And they say that it’s difficult to discriminate between the consequence of the activation of resident macrophages and the activation of infiltrating neutrophils because both cells secrete similar panels of molecules and antimicrobial products. Now, someone who’s very alert would say, “Well, look. In the Alcat Test you’re not testing macrophages because they’re only in the tissue.” But we’re testing all of the peripheral leucocytes with contain also not only the neutrophils but monocytes, which are the precursors of macrophages.

But nevertheless, they continue, the severity of immune complex induced inflammation is closely linked to the extent of neutrophil infiltration. So activation of neutrophils, which is the precursor of infiltration, is underlying a lot of chronic disease and inflammatory processes. So, this cell type is responsible for most of the observed symptoms. Circulating neutrophils adhere to cardio myocytes and they cause injury. So, reperfusion injury, after an ischemic event, that injury is mediated by the neutrophils. These are the guys that are troublemakers, but we need them, of course.

MPO, which we’ll hear about it more and there are some studies underway, and I think we’ll talk a little bit about MPO, stands for myeloperoxidase. It’s produced by neutrophils. It’s a better marker for inflammation predicting cardiovascular events than is LDL. In fact, LDL is not maybe as big a problem as we’ve been led to believe. It becomes a problem when it gets oxidized and it gets oxidized from free radicals that come from neutrophils. Also, in a very interesting paper from some years ago that identified chronic activation of the innate immune system, which of course we’re talking about neutrophils, underlies metabolic syndrome.

And a further impact of this, which relates to aging or premature aging, is that the constant deluge of pro-inflammatory cytokines are a major stimulant to the HPA axis because the body is trying to produce more cortisone to neutralize this inflammation, which means that there’s less sex hormone production. So that’s a hallmark of aging. So aging is a function of chronic activation of the innate immune system. And no wonder, in so many people, there’s a lot of chronic, low-grade inflammation.

And again, we can go on and on, but just another example is that atherosclerosis is associated with an increase level of circulating neutrophils. And more recently, a med analysis of a number of studies shows that low-grade, chronic inflammation is associated with the pathophysiology of metabolic syndrome. And we can get into the weeds on that at another time. But I think that gives you the background and the flavor. And I would like to turn this over to Amy to speak a little bit more about how cellular testing can help with different kinds of foods.

Amy Pieczarka, RD/RDN

Thank you, Roger. It was fascinating and thank you for sharing that. It’s just amazing how food sensitivities…that response can…and inflammation that results from it can impact any organ system in the body. I am a registered dietician and a certified clinical nutritionist. And I’ve been counseling people, giving nutrition guidance for over 30 years in a hospital setting and also in private practice. And I started using the Alcat Test probably about 15 years ago, after I felt that I was kind of spinning my wheels with people, feeling I really wasn’t helping to get to the underlying causes, underlying reasons, what’s impacting their health and interfering with their efforts to feel better and to get well.

And it’s just added so much. I think it’s such a valuable tool, valuable information to have for just about anyone, actually. And now I’m very happy to be managing PreviMedica. We are a tele-health company and we are focused on nutrition and behavior change. I have a wonderful group of professionals, nutritionists and exercise specialists who are seeing people all over the country to guide them with regard to promoting optimal health. One of the unique features of our services, though, also is that we provide culinary guidance.

 

We have professional chefs that are working with patients and they’re seeing patients from our demo kitchen. And it’s just very effective to help patients to be able to put into practice their nutrition plans. So I’m really happy to be here with Roger and Dr. Koniver. Famous biologist Philip Regal had it right when he described plants as little biochemical factories that manufacture loads of bioactive substances. And these really, what they act as is protectants to the plant. They protect the plants from microbes and fungus and insects and UV light.

And there’s hundreds and hundreds of them that have been identified in plants. And some of them actually, well we call them phytonutrients or phytochemicals. Some of them are actually very helpful, not only to the plant but very helpful to humans as well, giving us some health benefit. Some of them have actually been used to manufacture pharmaceuticals. Some of them actually, though, are considered anti-nutrients where they will interfere with the absorption of vitamins and minerals. And then they, unfortunately, can also be triggers.

Triggering, as Roger mentioned, a pharmacoactive response within patients and triggering symptoms such as migraines and other symptoms of inflammation. So what most practitioners will think of, again, there are hundreds of them that have been identified, but the most common ones that we think of promoting symptoms in patients would be the -amines: tyramine and tryptamine, for example, in wines and aged cheeses, beer. They very often have been suspected in patients with migraines, the suspected culprit. So a lot of times migraine patients will remove them and they do see a benefit. Some do not, however.

Another example of one of these naturally occurring chemicals would be solanine, in nightshade vegetables. And very often, practitioners might tell their patients with arthritis, remove all the nightshade vegetables, the potato family, peppers, and potatoes, and tomato, and eggplant, for example. Tobacco is also a source of solanine. And another, salicylates, naturally occurring salicylates in fruits and vegetables. Very often, practitioners will suggest that patients with attention issues get rid of the salicylates in their pattern of eating.

So what I’ve always thought about that, and what happens is when you use that approach, some people see the benefit and others do not. And when they study that approach as well, some study subjects see benefit and others do not. And why is that? Well, because some people got lucky and they identified the right culprits, whereas others didn’t identify the right culprits, or that was one culprit but not all of them so they didn’t avoid all the things that made them symptomatic. So it’s wonderful that we have testing that actually can take that guesswork out of the picture for us.

Peter Fell, who’s a physician from England, actually a clinical pharmacologist, he conducted a study back in the early ’90s. He was very interested in this topic because he’s a clinical pharmacologist. Roger, is there anything else you want to say about Dr. Fell?

Roger Davis Deutsch

Well, Dr. Fell became interested because he was tasked, in his position as Medical Director of Fisons, to bring the disodium cromoglycate products in through the U.S. FDA. And that’s into a long… And these things had a direct pharmacologic…they didn’t actually know the mechanism but they knew it had a direct pharmacologically mediated reaction on cell membranes, particularly mass cell membranes. So they prescribed these products, even today to some extent, for asthma and GI problems.

So he was interested in looking at pharmacological mechanisms that may be in play here that the cells as responses as measured by the Alcat Test were indicating. And so he wanted to drill down into that, looked at these particular naturally occurring pharmacological substances. And I’ll let you go on, but he looked at people who had these reactions. And what he found was quite interesting, I think.

Amy Pieczarka, RD/RDN

Right, particularly because the immune connection was already established, so they wanted to see if there was a pharmacoactive response that the Alcat Test could capture and that was the objective of the test. They test was actually separated into three different parts. The first part, they determined what concentration of these naturally occurring chemicals to test the blood against. The second part involved determine a reproducibility of the test. They used duplicated samples. So after they did that, then they actually compared patients who were struggling with migraines to healthy volunteers who reported no symptoms whatsoever.

 

And it’s important to note that the patients with migraines actually had previous food sensitivity testing and saw good results when they avoided their reactive foods and consumed a variety of their non-reactive foods, but they still were struggling with migraines, severe migraines occasionally. So they compared those patients. And remember, typically, it was the -amines that a lot of these migraine patients prior to not having this kind of test available, a patient would be just kind of given that blanket recommendation to avoid them.

But what they found was the patients struggling with migraines had a significant amount more reactions to these naturally occurring chemicals than the healthy patients. In particular, tryptamine, gluten…in this particular study, tryptamine, gluten, chlorogenic acid, dopamine, octopamine, and I believe, yeah, those were the most common, or those are the most reactive in those migraine patients. So, it did establish the fact that yes, the white cell changes were captured by the Alcat Test.

So what Dr. Fell concluded, and what he stated in his study was, it’s highly unlikely that there’s any immune mechanism, as Roger mentioned, too small for that to happen. They’re not testing the proteins. Highly unlikely that there’s any immune mechanism playing a part in these results. And the pharmacological reaction of these substances is well-known, so it showed that the white cell can act as a model of activity by either a toxic or a pharmacological effect. So they determined that the Alcat Test can actually capture that.

So, I have a few…well, I have a lot of positive outcomes that I could share because, as I said, I’ve been doing this for a long time. But there’s one significant…well, one I think of quite often, and that’s a 14-year old boy that I had worked with years ago who came to me. The family was referred to me by their doctor. The father was a pharmacist who was just fed up with what he described as a cocktail of medicine this boy had been taking since he was six years and then they adjusted the medication throughout the years. But he was diagnosed with ADD at the age of six, and since then was taking medication for it, not seeing results.

And also was struggling with migraines, two to three a week he reported. So, father was fed up. He wanted to see what they could do nutritionally. And when they were making their appointment I had said to them, I just kind of gave them an idea of what sort of thing I might be suggesting that they’ll do as we’re working together, so of the testing I might suggest to uncover the nutritional reasons, what was holding him back. And I had mentioned food sensitivity testing, food and chemical sensitivity testing might be something that we want to investigate because it could be a big piece of the puzzle, among other things.

So he was very interested in that and he said, “Well, before we even come see you, let’s just do the test.” So we did. And I had not met this teenager yet. And I got the results to the testing. He had everything that the Alcat Test offered at the time, everything tested, which by the way, I think it’s very, very important that when patients get tested that we test as much as you possibly can to leave no stone really unturned because the more foods that are not tested, we don’t know if they’re reactive. So to manage food sensitivities properly, we would say, “Don’t consume those foods if they’re not tested,” because we don’t know if they’re reactive.

So he got tested for everything including the pharmacoactive agents, and he had really, really significant results with regard to how many foods he reacted to. And I first saw them, I thought, “There’s no way this 14-year old, he’s a teenager, there’s no way he’s going to want to,” I assumed that he wouldn’t want to implement this. So I figured I was going to have to be very gradual with how we put this in practice. And when I met him for the appointment, I showed him the results, and I was very surprised to hear him say, “I want to do it. I want to do everything that you suggest because I’m so sick and tired of feeling like this.”

And he had reacted to gluten and peanuts and some other nuts that he was consuming, and tomatoes. But with the pharmacoactive agents he reacted to tyramine and solanine. So had I not had that information, I probably wouldn’t have automatically removed one of his favorite foods, or suggested that he avoid one of his favorite foods, which was cheese. He was eating quite a bit of cheese. So he didn’t react to the dairy, but he reacted to the tyramine. So I needed that information. I said, “Well, let’s take it out for six weeks. It could be possible that you might be able to tolerate some cheese later on. It might be a dose dependent situation.”

So, as I said, he followed my advice to the letter and within three weeks he was off all of his ADD medicine. He reported one migraine in the three weeks. One that wasn’t as severe, he reported it was a headache, which was down from two to three. After six weeks, he decided to reintroduce the cheese on his own. And then he reported feeling that he was kind of losing a grip on things. He started feeling like he was headachy again, so he cut it out himself.

So I think it’s important to know that, again, there’s these naturally occurring chemicals in foods that can have this impact on cellular response. And it’s a great thing to look at. And again, had I not had that information we might have been spinning our wheels and he might have abandoned the plan because he wouldn’t have been seeing results. So it’s important information. So, I’m happy to be here with Dr. Koniver, and I’ll turn it over to you to present your interesting case studies.

Dr. Koniver

Thank you. So I have a practice in Charleston, South Carolina, which I’ve maintained for 10 years now, since 2006. And I’ve been using the Alcat Test very successfully with patients for about that 10 years, maybe a little bit less. And I’m going to talk to you about some clinical cases and my experience using Alcat, and kind of put that clinical spectrum of how all this science translates to how you can utilize it practically with patients. I first want to say though, personally, one of the first Alcat Tests I ran was on myself.

I get migraines since I was a teenager, and since I was 13, 14, I’ve tried lots of pharmaceuticals. I stay away from the migraine-provoking foods: aged cheese, red wine. But there was a time, it was again, probably nine years ago, I was getting a flurry of migraines and so I ran the Alcat Test and my top three severe foods were watermelon, blueberries, and mint. And while I don’t eat a lot of watermelon, I was eating a lot of blueberries, super brain food. I like mint. I eliminated those two things and my migraines changed dramatically.

And that really sold me, really beyond, again, the science, just how this test is very applicable to really lots of inflammatory disorders and lots of things we don’t necessarily think of as just gastrointestinal. So again, the Alcat Test is really not just for gastrointestinal issues. It certainly is very helpful, and I’ll also get into why it’s very helpful with patients with autoimmune disease, why it’s very helpful. But you can also use the Alcat Test successfully, not just with patients who have symptoms but patients who are trying to optimize their health.

So what the Alcat Test provides you is information, specific information, which is really good, that tells patients exactly how to eat for their body, how they’re going to respond and react. And for someone who’s an athlete, for someone who just wants to age more gracefully, not develop chronic disease, this is a wonderful tool. And so, just as a reminder, everything we interact with in our life, and all of us eat, it all affects our biochemistry. I also want to point out that I use a lot of different specialty labs in my practice.

And no test is perfect. So we can’t have these unrealistic expectations that all the results are going to be perfect. They’re not. This reminds me of a story. I have a patient. This was years ago. She called me on a Saturday and she said she was eating out and she started developing, she called and said, “I’m developing hives. I’m short of breath. My throat is closing.” I told her to call an ambulance, so she did. She went to the hospital. She got epinephrine, steroids, antihistamines.

I referred her to an allergist because clearly she was having an anaphylactic reaction. Well, the allergist did the traditional IgE immunoglobulin testing. And when she went in for the results, he told her, “They’re all negative. This is all in your head.” So that’s ridiculous.

Amy

It’s an IgE test.

Dr. Koniver

Yeah, it’s an IgE test. And he said, “It’s all made up. There’s nothing positive here.” So just keep that in mind. No test is perfect, so have some realistic expectations about that. What I want to also point out is that we’re a society now that has so much chronic disease. Greater than 50% of adults now are tired, they’re depressed, they’re obese. Greater than 50% of adults now take more than one prescription medicine. And this all makes sense. The conventional model of medicine is about pharmaceuticals.

A patient comes in, has this symptom or this diagnosis, and we prescribe a medicine. But I also want to point out that 100% of all these people eat food. And we eat food all throughout the day. Food is obviously nutritious for us. We need food to live. And so one of the problems with the medical model, the pharmaceutical model that we currently, the paradigm is that we’re thinking of medicines when we should be thinking about food. Food is at the heart of what we all do.

So don’t just think of food as being healthy. Food can be absolutely inflammatory. And once you start recognizing that and understanding that, you can apply that not just to people with gastrointestinal issues but people with migraines, and people with attention deficit, people with weight gain, people with joint pain, people with MS, neurological disorders. What we eat absolutely impacts our health, as well, in our society, we’re accepting more and more toxic things.

We have many more chemicals than we’ve ever had: pesticides and antifreeze and plastics and pharmaceuticals. So as humans, we all have to absorb and, in a way, detoxify from all this toxic mess. And it’s becoming increasingly more difficult. And so it’s not just food, although food is really important, but it’s the chemicals, too. I like this quote. It says, “In diagnosis, think of the easy first.” And to me, that rings true when you think about food. We all eat food.

It starts there. That’s how, if you think about most of chronic disease, like diabetes, for the most part, Type 2 diabetes is preventable is we could figure out what people should and shouldn’t be eating. But we don’t. We instead think, someone has high blood sugar, they have diabetes, they need to be medicated. And most doctors are used to telling people, “Change your diet and exercise,” really, non-specific, generic advice.

What’s great about the Alcat Test is it’s the most specific test that you can then relay and create a program for your patient to tell them exactly what to eat on what day. It doesn’t get better than that. I like this picture because when we think about health and we think about our risk of developing chronic disease or getting sick, there’s lots of factors. Obviously, one factor is our genes. We’re born with a certain genetic code.

We have an ability or inability to detoxify from our environment. And then our environment, which includes the things we think about, includes chemicals, and includes food, put that all together and we get to make us and how we progress through life. So I have three quick case studies. One is about a chemically sensitive patient, a patient with gastrointestinal health issue, and one patient with a metabolic issue.

But before that, I’m reminded of a patient. This was several years ago. He wanted to get off high blood pressure medicine. He was on Lisinopril. One of the things we did was the Alcat Test. And got him the results, got off the medicine, but his blood pressure was still high. And one of his red foods, one of his severe foods was garlic. And he told me, he said, “Doctor, I’m Italian. There’s no way I’m coming off garlic. It’s just not going to happen. I eat garlic every day. It’s super healthy for me.”

Well I said, “Maybe try it. See what happens.” He came back three months later and his blood pressure was normal. And he said, “I did it. I came off garlic.” And it really is surprising and I could tell you story after story. Actually, the first patient I ever did Alcat Testing on, he was a young guy in his mid-30s. He was a runner and he had a lot of joint pain and this rash on his hands. I remember getting the results.

And again, this is the first Alcat Test I ever did. And his only severe food was olive. And I thought to myself going into the room, I thought, “This is crazy. He’s going to laugh at me.” And I went in there and I told him, I went over the results. He said, “Aha.” He said, “I’ve been eating a ton of olives. I cook with olive oil.” A month later, he’d eliminated olive oil, olives, he had no more joint pain, back to running, the rash was gone. So there’s so many utilities for this test.

So the chemically sensitive patient, her initials are J.S. She’s a 53-year old female and she had about a year history of mouth sores, joint pain, feeling fatigue. She was referred to me by another doctor because she also had a lot of sinus infections, allergies. And they tried her on multiple antibiotics, trying different things, steroids, whatnot, but they couldn’t get to the root cause. So we ran the full Alcat Test panel. And what I want to show you is, on her chemical side, she had a moderate intolerance to fluoride and a mild intolerance to naproxen, or Aleve.

Now, fluoride obviously is ubiquitous. It’s in our water. It’s in our soil now. It’s in the food we eat. But for most people, it’s also heavily concentrated in their toothpaste. And when I pointed this out to her, this was enlightening. Again, she had mouth sores, these chronic ulcers in her mouth. Well, she changed her toothpaste. She also had been taking a lot of Aleve, an NSAID, for her joint pain and she eliminated that.

It took a little while. It took a good three to four months, but her mouth sores are gone. Her joint pain is gone. She doesn’t have to rely on antibiotics, steroids, and whatnot. And I never, ever could have helped her if I hadn’t done this test. So I think that’s an important point. The second patient is a patient with gastrointestinal issues. His initials, T.S. He’s a 43-year old male. He really had no significant medical problems. He wasn’t taking any medicine.

But he came to see me last fall with a nine-month history of gas, bloating, constipation. He also had a strange-looking, erythematous, red rash on his lower extremities. So we started with running the 200 food panel. After a month of following, and he was really good. He’s one of these patients who’s really good about following both the elimination, rotational component. He came back after one month and said his symptoms were 90% better. Ninety percent at one month is phenomenal and you don’t hear that very much.

I want to point out to you, on the Alcat Test, which I think they do the best job presenting the results, color-coding the intolerances: severe, moderate, mild. So he didn’t have that many intolerances. He had one severe intolerance, which was squash, three moderate intolerances, and he definitely had some mild intolerances. What I’m used to seeing is most patients have about five or six severe intolerances, more than that moderate, and a whole, long list of mild intolerances. He didn’t and that’s interesting.

He also, in the blue sections, the blue sections are the most frequent and severe classifications of food that are tested. So he had a mild reaction to candida, and a mild reaction to gliadin or gluten, and no reaction to casein or whey. Again, it doesn’t have to be that he had all of these severe things. What was good is that he followed it and we have the information, after one month, he was 90% better. That’s phenomenal.

And then the last patient, her initials are C.B. She saw me just a couple months ago, actually. She’s 56 years old. She had a lot of fatigue, inability to lose weight. She had diabetes, she was on multiple medicines. And she finally said, “Hey, I’m sick of taking all this medicine. It’s not working. I need another option.” So we ran this test. And literally three weeks after changing her diet, she told me, she emailed me and said her normal fasting morning glucose was 86, which I thought was phenomenal.

Well, maybe that a fluke. Well, this was followed by several in the 90s and then several back in the 80s. Her normal was the 120s. So again, she had already tried the whole medication route. She had done everything the conventional doctors did, and it didn’t work. Now, when we actually changed her diet…and here is her results. And what I want to point out is she didn’t have a ton of common foods. Her most severe intolerance was watercress. She probably wasn’t even eating that.

And in the blue category, she had none. And so she didn’t have any reaction to candida, gluten, or casein, or whey. So sometimes we think that in this fad of, it’s almost like a fad of gluten intolerance where everyone has to be gluten-free now and it’s all about gluten or people think about dairy, and it doesn’t have to be. And I’ve told you several examples here, it can be minor things. For me, it was blueberries and mint. For the other patient, it was garlic. One patient it was olives.

It’s impossible to figure this out unless you do a test like this. And when you start thinking about how you really want to help your patients and really want to help them move past their health hurdles, figuring out what they should eat should always be included. I just have one final thing to say about autoimmune disease. We got a question before this webinar about how does inflammation relate to autoimmune disorders? I want to point out that there’s more people now with autoimmune disease than cancer and heart disease combined in this country.

So we should be on the lookout more for autoimmune than anything. And there’s a direct relationship between inflammation and autoimmune disease. And in my experience, you can’t get a better test than this test to help someone get past an autoimmune disorder. While there’s a number of them like celiac disease and MS and Hashimoto’s thyroiditis, a ton of things that are considered autoimmune disease, if you can help a patient calm down their inflammation by helping them figure out what to eat, what not to eat, you will go a long way with helping them control and even possibly getting past that autoimmune process. So that’s a really important point.

Amy Pieczarka

Thank you.

Dr. Koniver

Yeah, thank you.

 

Roger Davis Deutsch

Good stuff.

Amy Pieczarka

Mm-hmm.

Roger Davis Deutsch

Should we do some questions? Are there?

Amy Pieczarka

Yeah, well there was one question, too, that I thought we could address that came in pre-webinar. And that had to do with what part of the food is actually tested? And I think that’s a really good question because then the person’s question was actually what part of the food then to avoid if the person’s reactive to it? And the answer to that question is the Alcat Test tests the part of the food that actually gets eaten. I know that there’s, with different foods, different parts of the foods get eaten.

But there’s hundreds of constituents in all foods, so they really can’t possibly test every single thing. But the point is if there’s, for example, the reaction to lemon, you would avoid everything that has to do with lemon: lemon juice, a lemon wedge, lemon rind. And if it’s something, even the part of, for another reason, even the part of the food that did not get tested, we consider that untested then. And maybe it isn’t reactive, but it’s an untested item and it would need to reactive…I’m sorry, eliminated anyway because of the fact that it was untested. So hopefully that answered that question.

Roger Davis Deutsch

I just wanted to clarify what Dr. Koniver was talking about, these blue boxes. These are reflexes. So if someone did have a cellular response to candida albicans, that box would be populated with a number of items that could promote the growth of candida, even though they didn’t have a direct sensitivity to those particular items. And with the gluten and gliadin, we’re testing gluten in a pure form. And it may be that someone did not have a strong reaction or even a moderate reaction to gluten, or to wheat, for example, or rye or barley.

 

Amy Pieczarka

Same thing that we were saying. Right.

Roger Davis Deutsch

But we would put that in there as a cautionary note. And the same thing applies to the dairy casein and whey, which means that if you have a reaction to casein or whey, well, don’t eat yogurt, don’t eat cheese, and so on and so forth. That’s just to explain that.

Dr. Koniver

Yeah, that’s a good point.

Amy Pieczarka

And that’s why they have the blue boxes, because it pulls out more than one food and it puts them in there, so yeah. And what you were saying before, Dr. Koniver, about the fact the person didn’t react to gluten or didn’t have a significant reaction to what we call the most common reactive foods, gluten and dairy. From the nutritionists’ perspective, that’s exactly what we do. When we get a set of results from the Alcat Test, the first thing we do is look at those blue boxes.

And then our first…it’s just our tendency to say, “Uh-oh.” They didn’t react to something that they’re having every single day, but they’re more than likely gluten and dairy. And then you automatically think, “Oh my gosh, is this going to help?” And then when you look and you find out, like you did about the olive and blueberries.

Dr. Koniver

It’s interesting.

Amy Pieczarka

Right.

Roger Davis Deutsch

I have an example, myself, as well like that. I always react on the test to cucumbers and to basil. And I was just observing that reaction. I’m not particular fond of either one, although you can get a pizza which has a lot of basil on it or so. And one day I was out and I grabbed a wrap and a veggie juice from a local place. I brought it back to my office and I got a large veggie juice, and I asked them to leave out the cucumber. It had a lot of other greens in it. And I noticed while I was settling down, I was kind of engrossed in my work so I just glanced over and I noticed it was kind of more translucent than I thought it should be.

But I dismissed the thought because I was so preoccupied. So I drank the whole thing. And in the middle of the night I woke up with…I felt like I had a cannonball in my stomach. And I never have GI issues, really. So it’s something, I wouldn’t have connected it. Similar things with basil, I wouldn’t connect it, but then when, inadvertently, I eat basil I feel bad and then I’m informed or I inquire, find out it was mixed in with it and it was a pesto sauce or something.

Amy Pieczarka

There a question came, well it wasn’t a question, they just want a little bit more info on reintroduction. And I think that’s important, too. A lot of times patients believe that this is going to be my results are forever. And the immune system is constantly changing, so when you give your immune system a rest from these things, you could try to reintroduce them. But there are certain, like you with cucumber, it seems like that will always be an issue. And I tend to have the same thing with banana, and it seems to always come up.

But just because a person is sensitive to it now and they avoid it for a period of time and they heal the gut, which is important, work on the gut, they may be able to tolerate these things later on.

Roger Davis Deutsch

Yeah. There’s also the phenomenon of the detoxification pathways being overloaded. So sometimes, and it is a total, you alluded to that earlier, it’s a total load phenomenon. That a certain amount may be tolerated and you exceed that and then it triggers a response.

Amy Pieczarka

Right, so it’s important to support the liver’s detoxification systems while you’re doing this, as well.

 

Roger Davis Deutsch

It also explains why seasonally we might have some reactions, during a certain season, that we don’t have otherwise. Like for example, when the birch pollen is in the air, we may not be able to tolerate apples because there’s a similarity in the molecules and so forth.

Amy Pieczarka

Interesting.

Roger Davis Deutsch

So there’s still some art in terms of it’s very important for the physician or the healthcare practitioner, the dietician, to kind of understand as much as possible to help guide people through these things.

Amy Pieczarka

Very important. That’s why we do, of course, with people that we counsel, many of them have had the testing done. It’s very important because a person could be overrestricting and not nourishing the body properly. So it’s very important to get that information.

Dr. Koniver

Are there any questions from the audience?

Moderator

Certainly. We are approaching the half hour mark, so I think we’ll pick one or two questions. The first question is a…it looks like a clinical question and it reads, “Do you encounter patients who struggle with the habit changes required from food sensitivity testing? And if so, what kind of strategies do you implement to overcome that?”

Dr. Koniver

Yeah, every patient is different, so what I tell people, you just have to meet patients where they are and for some patients, if they’ve got a lot of foods to eliminate, they’re not going to be able to do it all at once. So you have to strategize and kind of come up with a game plan and tell them, “This is a long-term plan. The goal isn’t to rush to do this all in three days.” What I tell people is, “You want to warm up to this.” I tell them that it’s very important if they can, on the weekends, plan out every single meal for the entire week and get a grocery list so they know exactly what they have to eat for each meal.

Because when you start doing the rotational diet, it gets very tedious for someone who’s not organized and it’s very difficult for them to…it can be very overwhelming and they get stressed out and feel like they’re not making progress. And so you just tell them to do a little bit at a time until you get there, but what the goal is you certainly want to follow that rotational diet and elimination diet as closely as possible. I tell people, “This is not, obviously, life or death, but this is a map and the closer you follow that map, the faster you’ll get to your result.”

And so if you just take pressure off from people, it doesn’t have to be all done within three days, and just take your time, and meet with them frequently, I think then you’ll have much more success.

Amy Pieczarka

I agree. Some people need to ease into it and to ultimately be following the whole shebang, just so they can feel well. But there are others, like this 14-year old boy I talked about, who, “I’m doing it. I’m doing it now.” He felt so lousy and so he wants to feel better. And a lot of times I worry when people do it that quickly, because I think, “Is this really going to last?” It’s too much of a change too fast.

Dr. Koniver

Yeah, I had one patient who, this was years ago, she was 50 and said she needed to lose weight. She tried every diet, exercised six days a week, was really…said she maxed that out. So we did this test and she was one of these people who literally took the Alcat results everywhere she went. She came back three months later, she had lost 20 pounds and she was blown away. But she was really good.

If she went out to eat, she would say, “Here’s what I can have. It’s day two, here’s what I can have.” I don’t think most people do that, but what I like about the results, they have a wallet card you can put in your wallet so you know exactly what you shouldn’t be eating. Some people aren’t as aggressive about that. And so some people, I tell them, “Look, just work on the red food, the severe. Once you’re past that, get to the orange, and eventually we’ll get there.” But I think you just have to meet the patient where they are and feel them out.

Moderator

We have another question that asks about retesting and what’s the best way to retest, what should I consider in retesting, what interval?

Roger Davis Deutsch

In an ideal world, someone would retest every season because seasonal changes bring about different exposures to cofactors, different things are blooming. The body, in Oriental…I studied Oriental medicine so I have that past. The body changes during the season. The immune system can change as well. That might be too much. It is usually too much for people. So they can gauge it according to the other factors in their life, when they feel like it. Certainly, if they find that they’re slipping back, it’s good to re-up.

Amy Pieczarka

With regard to their symptoms.

Roger Davis Deutsch

Yeah, re-up. So I’m not sure if there’s a hard and fast. If there were a hard and fast, I’d say do it every quarter. But that’s not practical for most people.

Amy Pieczarka

We have a lot of people who will do it once a year and that seems to be practical. And with the foods, the recommendation is as foods are reintroduced they were reactive to into the pattern of eating before they retest.

Roger Davis Deutsch

That’s a good point.

Moderator

Great, thank you for those answers. As we are approaching the hour and a half mark, I believe we will conclude here for this evening. To all of our listeners, we will be providing the full transcript, slides, and video of tonight’s presentation in approximately seven days. Thank you for joining us tonight.

 

Amy Pieczarka

Thank you.

Dr. Koniver

Thank you.

Roger Davis Deutsch

Thanks.

Amy Pieczarka

Good night.