Dr. Amy Nett: Again, this is somewhat similar to Jenny’s question. There are a couple of different approaches. I’m going to focus here on Cyrex Arrays 4 and 10. I’m going to leave gluten out of it for now. I think we addressed that. That probably needs to have a repeat Cyrex Array 3 panel. If you’ve removed foods from Cyrex Arrays 4 and 10, I would first start with looking at the other test results. Were there issues with SIBO or dysbiosis or a clear cause of immune imbalance? Once you feel like you’ve addressed those issues and the patient is ready to reintroduce foods, you can consider two approaches. One, of course, is going to be repeat testing. The other option is going to be a gradual reintroduction of those foods when the patient has a stable baseline. That’s one important thing to think about. The patient needs to be in a stable enough place where they feel like they’re going to be able to identify potential food intolerances or food reactions when they do reintroduce those. If patients are still undergoing treatments or adding new supplements, that’s not going to be the time to reintroduce foods. You want to reintroduce foods when you’re not making any other changes of their supplements or their treatments and things are otherwise stable.
In general, you want to introduce foods one at a time. The best approach is probably to take somewhere between one to two weeks between different foods because, as we know, you can have pretty delayed responses to food intolerances, which makes this difficult. That’s one of the reasons we use the Cyrex Array panels as a guideline for food intolerances. It’s a very slow and methodical approach to identifying which foods you want to reintroduce and separating those, preferably, probably up to two weeks, monitoring for any changes in symptoms, and/or consider repeat testing after you’ve addressed the underlying issues.