vials from blood test

Mediator Release Testing

Food sensitivities can be tricky to identify. If you’re curious about how to determine if you have a food sensitivity, you can learn more by reading my recent article on the food sensitivities here. If you already know that you have food sensitivities, you’ve likely tried a variety of approaches to getting to the bottom of it. Many people try various types of elimination diets to try to identify the offending foods. Many people also get tested at their doctor’s office for food allergies and food sensitivities. The most common types of tests for these conditions include: a skin prick test, an IgE test and an IgG test. While all of these are testing a specific type of reaction, none of them will yield particularly helpful results for food sensitivities. One test, however, is useful in diagnosing food sensitivities: the Mediator Release Test (MRT). Unfortunately, this test is not widely used in mainstream medicine.

In this article, I will provide an overview of the Mediator Release Test, how it works and what you can expect in terms of booking and results. I’ll cover how it differs from other food related blood tests, how to find a practitioner and how to get started in exploring this option for yourself. 

 Summary of Food Allergic Reactions

First, we need to understand a bit about food allergies and sensitivities. Both of these types of adverse food reactions are complex immune-mediated reactions. There are 3 components to each reaction: 

  1. The type of cell involved
  2. The mechanism that triggers the reaction
  3. The mediator(s) that are responsible for effects of the reaction (signs and symptoms)

Thus, a test to diagnose either food allergy or sensitivity will need to accurately measure one of these components. For food allergies, this is fairly straightforward because these reactions follow a single pathway. The components of a food allergy reaction are as follows:

  1. Cell involved: Mast cell
  2. Triggering mechanism: IgE
  3. Reaction mediator: Histamine (and some others)

Thus, one option for food allergy testing is IgE testing. While this type of test is fairly reliable for true food allergies, it’s only about 60% accurate. Fortunately, there’s a better way! Because food allergic reactions have other reliable markers, we can use something called an oral challenge. This is when a patient ingests the suspected food allergen under medical supervision and is monitored for reaction. This works for food allergies because these types of reactions follow a few some predictable patterns: 

  1. Symptoms generally occur shortly after (often almost immediately) ingestion 
  2. Patients usually only have one or a small number of food allergies
  3. Reactions usually occur and can be observed regardless of the amount ingested

Thus, the gold standard for food allergy testing is the oral challenge, with IgE and skin prick testing as alternatives or carried out in tandem.

Summary of Food Sensitivity Reactions

Food sensitivity reactions, on the other hand, are a bit trickier to diagnose. This is because there are many pathways and reactions are often delayed and dose dependent. Not only that, but many patients have several (if not many) food sensitivities. 

Let’s break this down. The components of food sensitivities can be broken down in the same way as food allergies: 1. Cell involvement, 2. Triggering mechanism, 3. Mediators.

While the components of food allergies are always the same, food sensitivities can show up in many different ways. Let’s start with cell involvement. The cells involved can be any of the following: 

  • Neutrophils
  • Basophils
  • Macrophages
  • NK cells
  • Eosinophils
  • Monocytes
  • T Cells

Moving on to the triggering mechanism, we have another long list. Mechanisms for food sensitivities can include any of the following: 

  • IgE
  • IgG
  • Complement
  • T Cells

When it comes to the last component, mediators, there are literally hundreds of possibilities. The most common mediators involved in food sensitivity reactions are:

  • Histamine
  • Cytokines
  • Prostaglandins

As you can see, food sensitivity reactions can take many different pathways. Thus, there is no one direct test that will diagnose a food sensitivity. This is where MRT comes in! This test uses an indirect method to diagnose food sensitivities. Below, I will explain how this test works, and how it is used in the clinical setting to treat patients. 

What is the Mediator Release Test (MRT)?

Rather than measuring the starting point of the reaction, MRT measures the endpoint, which provides a measure of ALL non-IgE reactions. When a food reaction occurs, a process called degranulation occurs, in which the immune cell releases granules of the mediators mentioned above (histamines, cytokines, etc.). This process results in an increase of solids in the sample. This is quantified and represents the patient’s reactivity level to that food or food chemical.

Great, but how reliable and powerful is this test? Well, the MRT test has excellent accuracy, with a sensitivity of 94.5% and specificity of 91.7%. The reliability is also excellent, with a reproducibility level consistently above 90%. 

What is the LEAP Diet Plan?

LEAP stands for Lifestyle, Eating and Performance, and it is a dietary protocol that is designed to get maximal results from your MRT results. In order to follow this type of plan, you’ll need to work with a trained dietitian to guide you through the process. When you get your MRT results, the foods and food chemicals will be listed by food group and then by level of reactivity, using a low, moderate and high scaling system. 

What Can You Expect from MRT and a LEAP Diet Plan?

Based on your individual results, together with considerations such as lifestyle and food preferences, your dietitian will devise a dietary plan that will last about 4-6 weeks. You start out with a fairly small list of foods to eat from, and gradually introduce one more at a time. The approach is rigorous, but tends to yield good results for those who are able to follow through.

Key Take-Aways

Mediator Release Testing provides an accurate and reliable method of diagnosing and measuring food sensitivity reactions. This test is paired with a dietary approach overseen by a registered dietitian, which can provide measurable results for patients with food sensitivity related conditions and symptoms. 

If you would like to discuss who this test and dietary protocol could work for you, get in touch with MEM Nutrition & Wellness today.

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