“Are you Sensitive to Non-Gluten Grains?”

Understanding Cyrex Labs Array #4 – Gluten cross-reactivity and Food Sensitivity Panel

I had an opportunity to speak with Dr. Ari Vojdani, the head of Cyrex Labs and the #1 Immunonologist in the world (He discovered H. Pylori antibodies and was instrumental in developing IgE Allergy treatments way back when) about their Array #4, Guten Cross-Reactivity and Food Sensitivity panel which many of my patients have to go on. While the Cyrex Labs Array #4 test is a cross-reactivity and sensitivity test, Nnt all of the the items tested are cross reactions. Some are sensitivity reactions caused by the fact that the patient has a leaky gut. Cyrex Labs Array #2 helps us identify if the patient has leaky gut syndrome and how much of an issue intestinal permeability (LGS) will be in causing food sensitivities. This helps us evaluate better what the results mean.

Some of the interesting items that I understood from Dr. Vojdani are listed below for all of my patients and followers:

1. Dr. Vojdani shared that on Array #4 “Gluten-Associated Cross-Reactive Foods and Foods Sensitivity,” only thirteen of the 24 foods are cross-reactive with gluten. Cross-reactive means the amino acid sequences are so similar that the immune system can react as if the patient is still eating gluten.

The other eleven foods are ones that are eaten frequently on a gluten-free diet or are often introduced only after a patient begins a gluten-free diet. Foods that are not introduced as an infant or toddler often don’t pass the immune system’s oral tolerance test. This means we can react to them the first time we eat them, even if there is not a permanent sensitivity reaction.

For the many chocaholics of the world, the most exciting revelation was that chocolate by itself is NOT cross-reactive with gluten. Dr. Vojdani said it is the milk in chocolate, not the cocoa, and that Cyrex will soon be changing the labeling on Array #4 to “Milk Chocolate.”

Dr. Vojdani said the thirteen foods commonly cross-reactive with gluten are: cow’s milk, alpha-casein and beta-casein, casomorphin, milk butyrophilin, American cheese, milk chocolate, rye, barley, spelt, kamut (polish wheat), yeast, oats, and coffee. In other words, If you are gluten sensitive, you are likely dairy-sensitive, oat-sensitive, coffee-sensitive and often have yeast problems. (there is gluten in rye and barley so we’re just going to eliminate those no matter what if you are gluten-sensitive)

The eleven foods not cross-reactive, but that patients on a gluten-free diet are frequently sensitive to are: sesame, hemp, buckwheat, sorghum, millet, amaranth, quinoa, tapioca, corn, rice, and potato (does not include sweet potatoes).

2. Reaction to Glutamine / RepairVite: A patient with significant inflammation in the gut may react badly to glutamine or products containing high amounts of glutamine, such as RepairVite(K60), said Dr. Tom O’Brien. The reaction is usually GI related such as abdominal discomfort, diarrhea, etc.

In such cases, he recommended discontinuing glutamine/RepairVite for about two weeks, while using vitamin D (we use Emulsi-D3 from DFH), fish oil (Lemon Drop Smoothie or Omega Ultra from DFH), and curcumin to calm the inflammatory cascade. When the inflammation is reduced, the glutamine or RepairVite can be reintroduced without causing a reaction.

3. Can we Reintroduce Cross-Reactive Foods? Bad News…If it is one of the cross-reactive foods, it should be eliminated forever. If it is one of the eleven, it can be reintroduced in rotation once the gut is healed.

4. There is a Large Number of Undiagnosed Celiac Cases: According to a study published in Gut in 2006, there are 8 undiagnosed celiac cases for every diagnosed case.

5. Gluten-Free Is Not Enough: A paper published in 2010 in Digestive Diseases and Sciences studied celiac patients who had been on a gluten-free diet for a mean 9.7 years. It found that less than half of them did show complete normalization of intestinal biopsies, intestinal permeability and antibody levels.

My note: interventions beyond a gluten-free diet are needed for many patients –interventions such as directly addressing increased intestinal permeability, reducing gut inflammation and identifying and avoiding cross-reactive foods.

Hope this helps.

Akiba Green, DC