Saul Marcus, ND - Naturopathic Doctor

257 West 39th street, 10th floor - New York, NY 10001

Phone:(646)330-0388 | Email:

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The following is an overview of nutritional issues that regularly come up with clients. It is not mean to be inclusive of all nutritional factors and scope is limited. However, this does cover some simple concepts that are at the core of many health issue people struggle with.

One diet for everyone?

There are many different dietary theories, many of which come with their own books and gurus.

Due to tremendous variability between people (genetic, lifestyle, age, toxicity, stress, etc ... ) I do not know of any one size fits all diet. There are basic guidelines that are true for everyone:

What works, is at the very least, a whole diet, free of artificial chemicals and over-cooking. Everyone is different, some feel better with more carbs, some with more protein. Self awareness and modifying diet according to what works for you may help much more than following some diet simply because an expert says it what worked for him/her.

Allergenic foods

There are varying definitions for what is a food allergy. In lay terms it often means a food that someone responds poorly to and gets symptoms. To be more percise, it indicates an immune system response to food.

Something that makes this complicated is that there are so many different possible type of immune system reactions. Often theses are explained in terms of type of immunoglobulin response.


An immediate immune system response. This can be to environmental allergens (dust, mold, pollen) or to foods. The allergic response happens quickly. IgE is what causes anaphylactic responses to foods such as peanuts or bee stings.


IgG immunoglobulins are in the blood. In terms of food allergies these can cause delayed responses (an allergic response to food a few hours or days after exposure).


IgA is secreted across the mucous membranes of the digestive tract (from mouth all the way down) and respiratory system. It's job it to come into contact with allergens before they enter the body and trigger an appropriate immune system response.

Confusion over testing

It's possible to have one type of immunoglobulin response and not another.

In conventional medicine emphasis is often put on IgE response. If you've ever had an skin prick tests, that's looking for IgE. But that is not a rule out for IgG, or IgA. This can be problematic when someone gets an allergy tests and it told it is OK to eat a certain food, when it is not.

Aside from the conventional tests, there are smaller labs that offer IgG and IgA lab tests. These tests can be good, but also costly. Currently New York State has restrictions which prohibits having many of these tests done in NY (such restrictions do not exist in other states - but New York State politicians seemed to believe it is in the best interest of their constituents to pass laws prohibiting them from having access to medical tests available to the rest of the country).

Some problems with functional tests for food allergies:

My response to this, considering both New York state laws, expense of testing and results people often get is this:

Celiac disease and gluten sensitivity

Cereal grains have been introduced into the human diet relatively recently (about 10,000 years ago). We have not evolved with these as part of our diet. In our culture gluten sensitivity is particularly important - because we eat so much wheat and it is so many different foods.

Gluten sensitivity can be understood as an immunological sensitivity to gliadins (a protein in wheat). Gluten sensitivity can cause many illnesses. One of which is celiac disease. However, it is very possible for someone to have gluten sensitivity which presents in symptoms other than celiac disease.

The list of illnesses associated with gluten sensitivity is numerous, but includes:

Endomysial and transglutaminase antibodies

Common blood test to screen for gluten sensitivity. Unfortunately many patients are given the impression that these are definitive tests to know if it is appropriate to have gluten. These tests can be used to screen for reaction, however should not be used to absolutely rule gluten sensitivity out.

Gluten sensitivity can remain a problem despite negative tests result.

Veganism and Vegetarianism

There are very healthy people who eat animal products as well as healthy people who do not. As a naturopathic doctor my job is to help people make the best choices for their health - and is certainly not to dictate ethical decisions. If someone wishes to abstain from animal products, that is their right and they should not be bullied by health care practitioners to go against their ethics (which is common - in conventional and natural health for this to happen).

Nonetheless, poor health advice may circulate among vegans - as it's spread in order to convince other people to be vegan and not necessarily healthy. If veganism is your individual choice, then that is fine. If you don't feel well (especially after several months), then work may be needed to adapt the diet to you - even if you have been told otherwise my vegan experts.

Also, be aware that many vegan alternatives at the health food store may contain very questionable ingredients. This is especially true for fake meat products that have various forms of things such as "soy protein," or "texturized vegetable protein."