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Food Allergy Testing for Migraine Triggers

Is food allergy testing a good way to test for migraine triggers? This is a common question when people are overwhelmed by the details of an elimination diet. The answer is: it’s complicated. Food allergies usually cause some sort of reaction every time the trigger food is eaten, though the symptoms may vary from one reaction to the next, according to the American College of Allergy, Asthma, and Immunology.1 Food-related migraine triggers are notorious for sometimes causing a reaction and other times not (this is one reason finding migraine triggers can be so frustrating).

It’s far more common for a food intolerance—not an actual allergy—to be a migraine trigger. There’s no accurate test for food intolerance. There are so many different reasons a person could have a food intolerance (reactions can be immunological, physiological, or biochemical in origin) that it’s impossible to create a test to assess all of these factors, many of which cannot be tested.2 An allergist I consulted said that food intolerances are a mystery. They enter your digestive tract and some magical alchemy that’s unique to your own body happens. And there’s no way to see what, exactly, is happening. My dietician backed this up and added that food intolerances aren’t well-studied because there is no funding from pharmaceutical companies for the research.

Even testing for food allergies is not as straightforward as it may seem. Allergists test for food-specific immunoglobulin E (IgE) antibodies in a patient’s body. Their presence indicates an allergy, though 50% to 60% of blood and skin tests for food allergies result in false positives.3 Food challenges, where a person is given increased amounts of a food and assessed to see if a reaction occurs, are considered the best way to test for food allergies.1 True food allergies can cause anaphylactic shock. If you suspect an allergy, rather than an intolerance, please see an doctor for testing and guidance.


Some food allergy tests also look for IgG or IgA antibodies. Professional organizations of allergists say that these are tests are inaccurate and unreliable for testing food allergies.4-7 However, a couple studies published in migraine-related journals have found that eliminating foods that provoke IgG responses reduced migraine attacks in participants.8-9 IgG responses may also be connected to irritable bowel syndrome, which is a condition that’s comorbid with migraine.10-12 Additionally, celiac disease is associated with IgA and IgG antibodies.

In short, allergy testing might help you determine what your food-related migraine triggers are, but it might not. Your insurance is far more likely to cover IgE testing than IgG or IgA tests, unless celiac disease is suspected. You can see a traditional allergist for IgE testing, but will most likely need to find a naturopath to do IgG or IgA testing for anything other than celiac disease. The tests generally cost between $X and $X.

If you can afford the testing and aren’t ready to commit to a complicated and restrictive migraine elimination diet, food allergy testing might be a good place to start. If you do eliminate foods based on the test results and have an improvement in your migraine frequency or severity, talk to your doctor about an oral challenge of foods on the list. Even if your test results say you’re allergic to 12 foods, you might find that only two are actually problematic for you. (Only do this with your doctor’s supervision.) If eliminating the foods doesn’t help and you’re still convinced foods are a trigger for you, then an elimination diet is probably the next step.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Food Allergies. American College of Allergy, Asthma, and Immunology. Retrieved on Mar. 31, 2015 from http://acaai.org/allergies/types/food-allergies.
  2. Joneja, J. M. (1998). Food Allergy Testing: Problems in Identification of Allergenic Foods. Canadian journal of dietetic practice and research: a publication of Dietitians of Canada= Revue canadienne de la pratique et de la recherche en dietetique: une publication des Dietetistes du Canada, 60(4), 222-230.
  3. About Food Allergies: Diagnosis and Testing. Food Allergy Research & Education. Retrieved on Mar. 31, 2015 from http://www.foodallergy.org/diagnosis-and-testing/blood-tests.
  4. Panel, N. S. E. (2010). Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel.Journal of Allergy and Clinical Immunology, 126(6), S1-S58.
  5. Stapel, S. O., Asero, R., Ballmer‐Weber, B. K., Knol, E. F., Strobel, S., Vieths, S., & Kleine‐Tebbe, J. (2008). Testing for IgG4 against foods is not recommended as a diagnostic tool: EAACI Task Force Report*. Allergy, 63(7), 793-796.
  6. Australasian Society of Clinical Immunology and Allergy. Unorthodox Testing and Treatment for Allergic Disorders. Retrieved on Mar. 31, 2015 http://www.allergy.org.au/patients/about-allergy/65-aer/general/261-unorthodox-testing-and-treatment-for-allergic-disorders
  7. Position Statement: ALCAT and IgG Allergy & Intolerance Tests. Allergy Society of South Africa. Retrieved on Mar. 31, 2015 from http://www.mm3admin.co.za/documents/docmanager/8e7be0a4-2b8d-453f-875e-cd1e5132b829/00015032.pdf.
  8. Alpay, K., Ertaş, M., Orhan, E. K., Üstay, D. K., Lieners, C., & Baykan, B. (2010). Diet restriction in migraine, based on IgG against foods: A clinical double-blind, randomised, cross-over trial. Cephalalgia, 30(7), 829-837.
  9. Aydinlar, E. I., Dikmen, P. Y., Tiftikci, A., Saruc, M., Aksu, M., Gunsoy, H. G., & Tozun, N. (2013). IgG‐Based Elimination Diet in Migraine Plus Irritable Bowel Syndrome. Headache: The Journal of Head and Face Pain, 53(3), 514-525.
  10. Zuo, X. L., Li, Y. Q., Li, W. J., Guo, Y. T., Lu, X. F., Li, J. M., & Desmond, P. V. (2007). Alterations of food antigen‐specific serum immunoglobulins G and E antibodies in patients with irritable bowel syndrome and functional dyspepsia.Clinical & Experimental Allergy, 37(6), 823-830.
  11. Atkinson, W., Sheldon, T. A., Shaath, N., & Whorwell, P. J. (2004). Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial. Gut, 53(10), 1459-1464.
  12. Guo, H., Jiang, T., Wang, J., Chang, Y., Guo, H., & Zhang, W. (2012). The value of eliminating foods according to food-specific immunoglobulin G antibodies in irritable bowel syndrome with diarrhoea. Journal of International Medical Research, 40(1), 204-210.

Comments

  • 27cqtxa
    4 years ago

    I suffer from both migraines and irritable bowel syndrome. I’ve been aware for a number of years of studies relating IgG testing to improvement in both migraines and IBS and have asked several doctors (neurologists, gastroenterologists, and 1 internist) about doing an IgG test to see if it will work for me. The neuros and gastros all dismissed it without further thought, and the internist steered me to an ALCAT test that showed I was sensitive to a vast number of foods, including soy, gluten, wheat, and high-fructose corn syrup. After 6 months of sticking to a very restricted diet, and with at best some slight improvement in the headaches and no improvement in the IBS, I gave up on the diet.

    Has anyone actually had IgG testing and would be willing to share their experience?

  • Luna
    4 years ago

    Check out my comment below about the LRA by ELISA/ACT test. My biggest trigger is odors so nothing else really seems to matter. I eat a very clean diet anyway.

  • Dsukie
    4 years ago

    I have not had food allergy tests done, but kept a food diary for several months at my doctor’s suggestion.
    Found a few foods that are instant triggers… Pork, chocolate, cold cuts, anything with aspartame or MSG.
    Not sure what test are available in Canada!

  • Luna
    4 years ago

    FYI – There is a different blood test available called LRA.
    It analyzes the lymphocytes, the body’s long lived, memory-carrying white blood cells that indicate health and disease in the body. It tests all three types of delayed sensitivity reactions through lymphocyte activation:
    * Reactive antibody (IgA, IgM, and IgG)
    * Immune complexes
    * T cell direct activation
    I had it 10 years ago. Can’t say that it helped me. They test for food, mold, toxic minerals, food additives and preservatives, food colorings, and environmental chemicals.

  • Luna
    4 years ago

    I shouldn’t say it hasn’t helped. It showed that I am affected by xylene which is in petroleum. It is used widely in many things so it did help me understand my reaction to so many environmental factors.

  • Poll