FREQUENTLY ASKED QUESTIONS
Everything you always wanted to know about food intolerance, allergies and ImuPro testing
Here you will find answers to the most commonly asked questions about ImuPro in general, the change in diet, contraindications and many more.
- General questions
- Possible health conflicts
- Foods and drinks: some things to watch out for
- Dairy/lactose products
- Egg and Yeast
- Reactions to foods never eaten before and cross-reactions
- Cereals, gluten vs. wheat intolerance
- Medications and Cosmetics
- Carbohydrates and energy levels
- What can happen when I change my diet?
1. General questions around ImuPro
Should I fast before having my blood sample taken?
Fasting 2-4 hours prior to the blood withdrawal is enough. It also helps our testing if you avoid fatty foods for the meal prior.
How reliable is the ImuPro test?
The test is performed using the ELISA method which is a well-established standard procedure in laboratory analysis. Our results are reliable and reproducible and are checked through regular quality controls in labs across different countries.
My general practitioner performed a standard allergy test on me. Is ImuPro still worth it?
The ImuPro test detects IgG food allergies, which a standard allergy test does not detect.
What exactly is the difference between IgG and IgE?
IgG stands for “Immunoglobulin G." Immunoglobulins are the antibodies used by the immune system to identify and neutralize foreign objects such as bacteria and viruses. Everybody has IgG antibodies in their blood but occasionally these antibodies can start to react against foods. This is what can cause food allergies or delayed-onset food allergies (food intolerance). IgE mediated allergies (type I) are completely different from IgG mediated allergies (type III). An IgE allergy is a traditional “true” allergy where symptoms occur immediately, rather than delayed in the case of IgG food allergies. IgG reactions increasingly occur in case of a disturbed intestinal flora, but decrease if the change in diet is kept to. IgE reactions occur occasionally and remain for your whole life. Type I food allergies must be considered in addition to the ImuPro results when changing your diet, since the food tested positively for IgE antibodies must always be avoided.
What are the most common allergens?
This cannot be generalized. What's good for one person may be problematic for another. Years of experience with ImuPro tests, however, have shown that milk and dairy products as well as varieties of cereals trigger immunological reactions in quite a number of people. Gluten, egg white, dairy products, and brewer’s/ baker’s yeast are very strong antigens which should be avoided if you suspect an allergy – which isn't always easy as they are often hidden in innumerable industrially manufactured food products.
I have taken the ImuPro test and have come up with a number of reactions. Is there any need to be re-tested months down the line?
No, this is not normally necessary. Even if a new test does not detect particular antibodies, this does not mean that you can recommence eating all the foods and additives to which an intolerance was detected. The immune system has a memory and reactivates the production of antibodies when it comes in contact with a food or additive which it has previously had a reaction to. However the production of antibodies is generally reduced through implementing the necessary diet changes as the antibodies are no longer created by the immune system when the diet is changed. The resumption of the natural function of the intestine is an indicator that the production of antibodies has been reduced. The test would only need to be repeated if the symptoms were to reoccur, though this would be unlikely if you are keeping to your diet and rotation plan instructions. If the test is to be repeated it is recommended that two years elapse between tests.
Some of my symptoms have not gone away, even though I followed the ImuPro diet. Why is this?
Some of your issues may be caused by something other than food intolerance. These causes cannot be detected with ImuPro. They include certain defects in the intestinal flora, enzyme defects, hormonal problems, or environmental contaminants.
I have made a mistake in my change in diet. Do I have to start all over again?
An occasional mistake in your change in diet is not too serious. If you accidentally consume something containing a prohibited hidden ingredient you might have a reaction. We all slip up, but your body will recover soon.
What about following the ImuPro diet and eating out?
Do you rarely cook for yourself, usually eating out or ordering in? This makes the change in diet a bit more complicated – but far from impossible. You usually cannot see which ingredients have been used for ready-made meals or restaurant food. But these hints help you to manage your change in diet: When eating restaurant food, avoid sauces. Grilled meat or fish with potatoes or rice, vegetables or salad normally don’t cause problems. Keep your food intolerance in mind and don't be afraid to ask your server how your meal is going to be prepared.
I have read that there is a lot of criticism of IgG tests, even from doctors. Critics say, for example, that not all foods tested positively lead to a symptom and so IgG tests deliver “false positive” results. How do I know that this criticism is not justified?
Just because there is no visible symptom caused by IgG antibodies, it doesn’t mean there is no reaction at all. If the immune system builds IgG antibodies to attack a certain food you have eaten, this will lead to an inflammation, but this inflammation might not be visible from the outside. Secondly, ImuPro doesn’t claim to show a connection between a food and a certain symptom. It is a first step in finding foods that might cause you problems. ImuPro detects IgG antibodies against food, i.e. delayed food allergies. Our plan eliminates these foods from your diet so that the inflammation is stopped and your body can recover. Then the eliminated foods are reintroduced to your diet. This provocation is done one food at a time, and helps to identify specific foods which cause problems.
Critics argue that IgG tests lead to malnutrition. How can I be sure that this doesn’t happen when I implement the results of the ImuPro test?
Malnutrition doesn’t occur with ImuPro for two reasons: rotation and reintroduction. Having used the ImuPro test to identify your possible trigger foods, a diet plan is created that removes those foods and rotates allowable foods on a 4/ 5 day basis. This maintains variety and nutrition and ensures that your body is supplied with everything it needs. After the provocation phase, certain foods may possibly be reintroduced to your diet. This means you will have even more foods to rotate, guaranteeing a diversified and balanced diet.
Does the ImuPro test have any certification?
The ImuPro tests and antigens are manufactured by the German company R-Biopharm under strict quality management ISO 9001 and ISO 13485 systems that have been accredited by the DQS according to the international standards ISO 9001 and EN 46001 (medical devices). In 2003, the company gained ISO 13485 quality management accreditation. All of the reagents used in the test have CE approval. Due to the fact that ImuPro tests are processed in more than 20 laboratories worldwide, each run by specialists in this field, we are even able to conduct inter-laboratory trials on a yearly basis to ensure the consistency and quality in every test.
2. Possible health conflicts with ImuPro
Can children or babies take the test?
Children over 12 months old can take the test. If the child is under 12 months old we would recommend that the mother is tested, as she has passed her antibodies on to the child during pregnancy.
Can I have the test done if I am on a restricted diet?
Yes, you can still take the test if you are on a restricted diet. However, your reactions to the foods that you have been avoiding will be much lower than if you were on an unrestricted diet so you just need to be aware of this. If you have avoided certain foods for more than 6 months, expect the result to be negative as the antibodies we’re testing disappear when that food is not consumed.
I am on antibiotics. Will this affect my results?
Provided you are not taking immunosuppressant drugs, your results will not be affected by being on a short course of antibiotics. A long course of antibiotics, however, can compromise the intestinal flora and may cause a higher number of reactions to be detected. If you are currently taking any medication you should advise the ImuPro team and your doctor, just to be certain.
Which medication can affect my test results?
Certain medications can affect the results of the ImuPro test, so if in doubt, the patient should check with the ImuPro team. A long course of antibiotics can interfere with the results. If you are taking, or have taken, a long course of immunosuppressant medication such as cortisone, steroids, prednisone etc., this may also affect the results. You should let the ImuPro team know your concerns prior to ordering the test so that the team can advise you of whether it will be a problem.
I use steroid based inhalers regularly. Can I still have an ImuPro test?
The concentration of steroids in these inhalers is usually so low that they don’t affect the results of the ImuPro test.
Could a cortisone cream affect the results?
The cortisone cream should not interfere with the test if the concentrations are low and the effect is local. If the patient doesn’t take tablets, she should do the ImuPro test. To be absolutely sure, we recommend determining the total IgG value in serum. If it is not decreased below the reference range, no negative impact on the ImuPro result should occur.
I have a cold and/or high temperature. Is it okay to have my ImuPro test?
From our experience there are no problems with patients having a cold or even having a high temperature. It is more of a precaution. If a patient has a temperature we advise patients to wait until after their fever has gone away before having their blood sample drawn.
I have been taking a TNF blocker (e.g. Infliximab, Humira, etc.). Can I still have an ImuPro test?
TNF blockers have not shown to have any adverse effect on results from an ImuPro test. To ensure that this is the case we would advise determining the total IgG antibody levels in a sample first and if the levels are in the normal acceptable range, then you can proceed with the test .
3. Foods and drinks: some things to watch out for
Is alcohol allowed while following the ImuPro guidelines?
Alcoholic beverages are semi-luxuries and should be avoided during the first stage when the immune system is stabilized. Later on in the dietary change, you may allow yourself a glass of dry or sparkling wine now and then. The ImuPro tests do not analyze the beverages themselves, but rather their ingredients, such as grapes, cereals, yeast, and malt. If you have increased quantities of IgG antibodies to one of these ingredients, you will have to do completely without the beverages during the avoidance period.
Can I drink coffee while following the ImuPro recommendations?
Coffee is not recommended. In particular the roasting substances contained in the coffee have an irritating effect on the intestinal mucosa. This increases the permeability of the intestine. The stimulating effect of caffeine can be obtained by drinking black or green tea as well – it should, however, be drunk in rotation and not every day. Another alternative for caffeine is guarana, a tropical plant.
How about vegetable and fruit juices or smoothies – am I allowed to drink them?
Vegetable and fruit juices or smoothies are actually not really drinks, but rather liquid food, since very large amounts of fruit or vegetables are necessary for a glass of squeezed juice. If you still want to drink a glass of fruit or vegetable juice now and then, dilute the juice with water and buy juice with 100% fruit content without added sugar. Only fruit and vegetables that you showed no reaction to would be recommended.
If a patient is intolerant to coffee beans should they avoid caffeine altogether?
Caffeine is an ingredient in coffee beans. We test coffee beans as a whole so we can’t distinguish between coffee and caffeine in the test. It could be that you react to both elements or only one of them. At the start avoid coffee and caffeine. Wait for at least 3 weeks, or until your symptoms have stabilized before consuming caffeine.
If I'm intolerant to wheat, oat, rye, and barley, should I be avoiding spirits made from these grains and others?
All fermented drinks made from gluten containing grains must be avoided, such as beer, but also malt drinks. Check the ingredients list for premade smoothies and milk shakes. All spirits are gluten free unless gluten was added after distillation (cocktails). Malt whiskeys are gluten free, as nothing was added after distillation, just maturation in barrels.
4. Dairy/lactose products
Is there a risk of developing an under supply of calcium when I have to do completely without dairy products?
No, there is not. Most milk alternatives are calcium-enriched. If you stick to the rotation, an under supply of calcium is not to be expected. Broccoli for example contains high amounts of calcium.
A patient has reactions to milk. Is it OK for him to take lactose or casein free milk?
No. With ImuPro, we are testing antibodies to specific proteins of the concerned food. Lactose is not tested in our test, because lactose is not a protein but a sugar which cannot lead to antibody production. Lactose intolerance is an enzyme deficiency, either genetic or acquired. It is the inability to digest this sugar. Lactose-free milk contains the same proteins as normal milk. Milk contains up to 30 major proteins. While casein is the major protein in milk, we don’t differentiate in our test which protein has caused a reaction. We see that when we test milk-positive patients for casein, a significant percentage of them do not react to casein, but to some other ingredients. So, if the patient consumes casein-free milk, they might be able to tolerate it, but we cannot predict this.
What does ‘milk, cooked’ mean? Is this the same as pasteurized milk?
Cooked milk is milk boiled for at least 30 minutes, cooled down and the developed skin is removed. During boiling, the proteins of the milk are degraded and most of the antigenic structures are destroyed. In most cases, patients with a reaction to cow’s milk can tolerate boiled cow’s milk. Only if the reaction to cow’s milk is directed against a heat stable antigen does the intolerance also remain for boiled milk. If you boil the milk for 30 minutes and remove the skin, you should be able to drink it. Cooked milk contains the same amount of calcium as raw milk. Pasteurized milk is only heated for 15 seconds at 75°C. UHT milk is heated for 1-2 seconds to 135°C; this is to decontaminate the milk from infectious agents. The quality of the proteins of UHT milk is not altered. In other words, pasteurized milk and UHT milk are to be considered raw milk (with regard to ImuPro).
Can I use cow's milk alternatives such as buffalo milk if I have a dairy allergy?
No, it is not a different food group. Buffalo milk and its derived products are to be considered cow milk or dairy. In a former version of ImuPro, we had buffalo milk in the test, but the results were 99% identical to cow’s milk. Therefore we changed buffalo milk for another food, as it was not worthwhile to test it separately.
I have had a reaction to rennet cheese (cow). Does that mean I can have cheese that doesn’t contain rennet?
As both forms of cheese still contain the proteins from the cow’s milk used to make the cheese we would advise you not to.
Will the ImuPro test detect if I am lactose intolerant?
Lactose intolerance is different to having an IgG food allergy to milk or dairy products.
Lactose intolerance is the body’s inability to digest lactose (the sugar present in milk) due to a lack of the required enzyme. ImuPro does not look for enzyme activity in the body. It looks for the production of IgG antibodies to a particular food protein. You might have a type III food allergy to dairy products, but this does not necessarily mean you are lactose intolerant and vice versa.
If I have reactions to dairy products, should I avoid lotions and other non-food items?
We know that antigens can also be absorbed by the skin. Pay attention to the ingredients in soaps, shampoos, and conditioners.
If I have reactions to dairy products, should I avoid lotions and other non-food items?
Halloumi is a cheese made from sheep’s and goat’s milk. Why is this kind of cheese tested individually, if ImuPro also has goat’s and sheep’s milk tested individually?
Halloumi is a special cheese, because the milk used for its production has been cooked in several steps for a longer time up to 90°C. During this process, the milk used (even cow’s milk) will lose some of its antigenicity which makes this cheese more tolerable for people with a milk allergy. We decided to test for Halloumi in order to offer a possible additional alternative to patients with a milk allergy.
5. Egg and Yeast
What should I avoid in case of a reaction to egg protein?
All products containing egg white. Egg white proteins may be hidden behind the following names: yolk egg white, ovalbumin, livetin, albumin, lysozyme, E 1105, globulin, ovomucoid, lecithin, E233.
If you have to avoid egg white, you can replace the binding effect by mixing 1 tablespoon of soybean flour with 2 tablespoons of water to a paste. In case of soybean incompatibility, the soybean flour may be replaced by maize flour and potato flour by rice flour. Be aware that wine can contain egg white.
If I have reactions to yeast, should I still avoid sourdough bread?
Pure sourdough fermentation is mainly done by lactobaccilli, a bacterial strain, and hardly any yeast. So if the baker doesn’t add yeast on purpose, sourdough bread should not contain high quantities of yeast. For vinegar it is similar, the final fermentation of vinegar is done by bacteria, acetic acid bacteria mostly from high percentage alcohol, not yeast. Industrially produced vinegar hardly contains any yeast; some hand-made vinegar might contain higher amounts of yeast. Sourdough can be an exception for some people, but it’s advised you follow our testing methods to determine if that’s the case.
I react to lemon. Do I have to avoid all citric acid?
No, citric acid is a single molecule produced chemically. You likely reacted to the proteins contained in lemon.
I react to vanilla. Do I have to avoid vanillin?
No, you do not. Vanillin is a chemically produced flavor and has a different composition.
What should I do in case of a sudden craving for a particular food?
The relation between allergy and craving is known. When you feel a sudden craving for a certain food, try to hold out. These episodes of craving normally subside after three to five days. Distraction might be helpful: try some pleasant scents from a fragrance lamp or essential oil for the skin.
May I eat sweets?
You may. You should, however, attune your sweets to the rotation plan. Choose for example sweet maize biscuits if you use maize on that day or spelt crackers on your “spelt day”. However, you should avoid industrially produced sweets such as chocolate or cake.
What is the "honey mixture" for which ImuPro is testing?
Honey mixture means that ImuPro doesn’t test for a specific honey produced from just one kind of flower. You can get numerous specific honeys, mostly locally. So we opted for the “general honey” you can buy in the supermarket. These honeys are from pooled nectar from different bee colonies harvesting on different flowers. Users should avoid any honey for the recommended period of time.
I have a positive result for tannins. What foods do I have to avoid?
The tannin used in our test is synthetic tannic acid. The word tannin covers a large group of substances and is not uniform from one food or plant to another. As tannins have reduced water solubility, the amount of tannins in our food extracts is not high and the amount varies with the ripeness of the fruit. So you cannot relate or correlate reaction to tannin to the proper reaction of a tannin containing food. Sensitization to tannic acid is more likely due to exposure to added tannic acid in either drugs, creams, or transformed food. The advice is to reduce tannic rich food. The risk for adverse reaction in this patient is probably more to added tannic acids in products rather than in naturally complex tannin containing foods.
Is there a method to eliminating Aspergillus Niger fungus from my food?
Aspergillus is a mold; it forms spores. These are extremely resistant to heat, cold, dryness. They can survive a long time and under extremely harsh conditions. Freezing doesn’t achieve anything, it makes it even worse. Heating to boiling point for at least 30 minutes can kill all living form but not the spores. After cooling the spores would germinate. To kill them you have to sterilize them, meaning at 125°C at high pressure. It would be easier to avoid the concerned food.
7. Reactions to foods never eaten before and cross-reactions
Is there any link between the intake of omega-3 and intolerances to fish?
No, there is no link between omega-3 fatty acids and reactions to fish. As omega-3 is a fatty acid and separated from the proteins, there are no proteins in omega-3 capsules.
My ImuPro results displayed a wide range of intolerances to fish, with the exception of trout. How can I explain such a result?
This is a matter of cross-reactivity. It depends on what specific protein(s) your antibodies are directed toward. Many patients can eat certain fish, whereas they react (severely) to others. There are no definitive data regarding cross-reactivity that we can apply to fish in order to guide patients in their choices. Unfortunately, cross-allergenicity between fish is quite complex and has not, to our knowledge, been conclusively defined. However, the fact that they are in separate families does not rule out potential cross-reactivity, and there are no definitive data which would allow you to predict with accuracy whether or not clinical cross-reactivity would occur. Additionally you should also be aware that fish proteins are found in a lot of processed foods, where you wouldn’t expect them, for example in Caesar salad and Caesar dressing, Worcestershire sauce, bouillabaisse, imitation or artificial fish or shellfish (surimi, also known as “sea legs” or “sea sticks,” is one example), meatloaf, barbecue sauce or caponata, a Sicilian aubergine relish.
I have had a reaction to crayfish. Does this mean that I can't eat crab?
Crayfish, crabs, shrimps and lobsters are all crustaceans. Where individual results are offered for any of these foods then go by that result. If you get a positive result for one or two of them but the others are not covered due to the size of test you have chosen then it is best to initially stay away from all of the foods for which you have no result. This is because they share some of the same proteins. Once your symptoms have settled down try introducing them one at a time into your diet. If you don’t feel any adverse effects then include them in your rotation diet.
I have a reaction to bananas and pineapples. I have never eaten a banana before! How can this be?
They are present in a lot of flavored milks, yogurts, and fruit juices. It is also possible to have a cross-reaction to both. Bananas and pineapples have common allergenic structures with latex. If you are allergic or sensitive to latex, a cross-reaction with bananas is possible. You can absolutely react to bananas without ever having eaten one. The indoor plant Benjamin’s fig is another possible source for this allergen. If you are sensitive to the plant, you shouldn’t have it in your house. There may also be cross-reactions with avocados and melons.
8. Cereals, gluten vs. wheat intolerance
Which is the antigen used in wheat or kamut?
Cereal extracts only contain water soluble proteins while gluten is only soluble in alcohol – that means cereal extracts only contain cereal specific proteins and no gluten.
The consequence: If you don’t show a reaction to gluten, but react to different sorts of flour then there is an intolerance to the specific proteins of the flours. This is quite rare. If there is the case, then it means that you have to avoid the flours in question even if an intolerance to gluten hasn’t been detected.
How is it possible to have wheat intolerance but not an intolerance to gluten?
Wheat proteins consist of gluten and wheat specific proteins. As gluten is not water soluble, we have to extract gluten with alcohol and to test gluten in an extra cavity. This cavity does not contain the other water soluble proteins of wheat. Accordingly, the wheat cavity does not contain the gluten molecule. So these are two completely different tests and it is possible to be sensitized to either of them or both of them. In the first case, only one allergen (gluten or wheat) is tested positive and in the second case wheat and gluten are positive.
Why is durum wheat (grano duro) is missing from the test? This is the flour used for spaghetti and other Italian pasta.
Durum wheat reacts exactly the same way as normal wheat. The different wheat species have the same major antigens. What differs is mainly the quantity of certain proteins and enzyme or the content of starch. You can trust the result for gluten and the wheat specific proteins in the ImuPro test to also be valid for durum wheat.
9. Medications and Cosmetics
I have reactions to various foods that can also be present in cosmetics. Do I have to avoid these as well?
Yes, cosmetics containing extracts of IgG positive foods in the ImuPro test have to be avoided. The skin is also a very reactive immune organ, and the experience we have had showed us that products on the skin or even inhaled antigens like lavender have led to symptoms. We also know from our experience in environmental medicine, that if someone reacts to titanium oxide, they have to eliminate all cosmetics and tooth paste containing TiO2.
10. Carbohydrates and energy levels
I am an athlete and have reacted to all gluten containing grains. I am worried that cutting out carbohydrates will affect my energy levels and training. What should I do?
We understand your concerns, but when you are supplying your body with carbohydrates in foods you are reacting to, especially gluten, you will have a loss of energy and physical strength due to the inflammatory processes. There are still some carbohydrates which you can eat (e.g. rice, potatoes, corn, etc.) so you can get your carbohydrate intake through those. If you do not have a positive result for yeast then you can eat gluten-free breads. You may have to eat larger portions or more regularly. You could also increase protein and fat intake with high quality fats rich in omega-3. Calcium supplements are a good idea as you will lose a lot of minerals during competition. Preliminary study results with athletes show that an increase of VO2max, the reduction of lactate, contributes to better recovery and better body fat composition are achieved while adopting an ImuPro diet.
11. What can happen when I change my diet?
How long until I start to see positive changes?
That depends largely on the type of symptoms. Some changes are seen after two to three days, namely loss of around 2 kg of weight due to release of excess water. Digestive symptoms start to improve after three to five days. Generally, patients report that after three to five days, they feel much better. However, some symptoms, like arthritis or more severe immunological diseases, may take weeks to give a result.
Will my symptoms get worse initially while my body rids itself of toxins, etc.?
This is very individual. It can happen, but most of the time it doesn’t. We have seen this kind of reaction when people first stop drinking coffee, especially for heavy coffee consumers. They reported an increase in headaches during the first week, but after ten days the headaches completely disappeared.
I would like to try a food that I have not been tested for. Is that okay?
All foods and additives not included in the test analysis should be avoided during the first 8 to 10 weeks following the test. Afterwards, you should proceed as follows:
If you would like to try a food which has not been tested, you should note any health problems that occur in the following week. You should also limit yourself to reintroducing one untested food at a time into your diet so that if you do get a response you will know which food has caused it. If you do not have any adverse reactions to the food then you may continue to include it in your rotational diet. Also observe your body weight. If you experience an increase of body weight of approximately 1kg or more overnight after having introduced a non-tested food, it is likely that you react to this food. Increase of body weight overnight is a sign of an inflammatory response to the food. A consequence of an inflammatory response is the retention of water which you can see on your scale.