Dr. Amy Nett: Great question because these get really expensive. If a patient is eating wheat or gluten, then I really want to run the Cyrex Array 3, so I normally start there. The minority of our patients come to the practice eating wheat or gluten, so in all honesty, I think it’s less than 20 percent of my patients who actually eating wheat and gluten that I’m running the Array 3. Of those patients, I would say, I don’t have the exact numbers, but my feeling is that probably 70 ballpark 75 percent of patients come back with some antibodies either equivocal or more frankly out of range on Array 3, and in those 70 percent of patients, I suggest Cyrex Array 4 because if you have sensitivity to one food, then I think you’re more likely to have other food sensitivities. Start with the Array 3, then Array 4 depending on what that looks like, then Array 10.
When I’m running Array 4 I do give— and even when I run Array 3, I do give patients the option of running all three at once, but again, I think you’re looking at something like $500 there. Part of my concern is that I’m also running all of those gut tests, and if somebody has small intestinal bacterial overgrowth or dysbiosis on stool testing or otherwise has leaky gut and we’re going to be going after that leaky gut by doing an antimicrobial protocol, removing toxins or whatever it may be to improve that intestinal integrity, then their food sensitivities are going to change. I’m sometimes reluctant to ask patients to spend the money on Array 4 and Array 10 if I know that we’re going to be doing things to improve their GI health and then improving their tolerance and thereby decreasing their sensitivity.
I more frequently find myself running 4 and 10 on patients who we’ve been working together for maybe a year or something, and we feel like we’ve done the treatment, the follow-up tests are looking good. We check for heavy metals, and patients are still reacting. They’re still having symptoms. That’s when I’m probably going to run Array 4 and 10 to see, “Okay, is there really a food that is just triggering you that we need to think about removing even though it’s a healthy food.” That’s going to be in more like 10 to 15 percent of my patients approximately would be my guess, so I’m not running array 10 all that much.
Sometimes when I run Array 10, what percentage of these do I find positive? I would say probably that’s closer to like a 50-50. In some of the patients, you’ll see more than three-quarters of those markers coming back positive, and again, that’s where you want to start thinking about what is going on with your immune system and again going back to some extent to Elizabetta’s question. If you see a lot of antibody markers out of range on Array 10, you know in a way, one good thing is that the immune system is reacting. You have a robust immune system there. Remember, if someone’s on steroids or otherwise has any indication of a suppressed immune response, you’re just not going to be seeing antibodies coming back positive because they’re not going to have that immune response.