I was very pleased to be contacted by this important health information portal. I hope that people affected can find helpful information here about the foundations of holistic diagnosis and treatment of food intolerances.
The holistic treatment of food intolerances is characterized by a detailed medical history, broad-based diagnostics, and a long-term, individualized therapy plan that requires patience and active participation. A symptom diary can be very helpful. An elimination diet is considered the gold standard for identifying intolerances. Other diagnostic methods such as breath tests, blood tests, or stool analyses can complement the evaluation. Factors such as stress or emotional strain can further intensify symptoms and should also be investigated.
Dr. Aschenbrenner: In principle, the holistic view of food intolerances differs from the conventional medical approach through a much more comprehensive strategy — including a very detailed and time-intensive medical history, broad diagnostics, and longer-term treatment that requires patience, careful observation, and active cooperation from both patient and physician.
Dr. Aschenbrenner: People who observe themselves carefully often already suspect which foods they do not tolerate well. Whenever a certain food is eaten, specific symptoms may appear — either immediately or with delay. Symptoms can vary widely, for example headaches, bloating, diarrhea, constipation, abdominal pain, hives, redness, skin rashes, palpitations, and much more. These should be recorded in a diary.
The simplest, best — but for many also the most difficult — method to identify intolerable foods is to completely avoid specific foods for a longer period (while observing whether symptoms improve) and then gradually reintroduce them step by step after a few weeks. If symptoms reappear when a food is reintroduced, a current intolerance can be assumed. This is considered the gold standard and is called an elimination diet. It should always be supervised by an experienced therapist, because it sounds easier than it is in practice. A physician should also determine in advance whether such a diet is appropriate.
There are also many other diagnostic options available. For example, certain breath tests can measure lactose or fructose intolerance. Specific blood markers can also be tested. This allows diagnosis of classic food allergies (such as peanut allergy) as well as delayed-type food intolerances (such as gluten sensitivity).
There are also histamine intolerance and Mast Cell Activation Syndrome (MCAS), in which many and very different food reactions can occur. These can be diagnosed through a detailed history and laboratory analysis of blood and urine.
Celiac disease — an absolute gluten intolerance — can be diagnosed through blood tests and/or endoscopy of the stomach and intestines. Stool tests can also be helpful in diagnosing food intolerances.
The simplest, best — but for many also the most difficult — method to find out which foods you do not tolerate is to completely avoid various foods for a longer period … and then gradually reintroduce them step by step after a few weeks.
Dr. Aschenbrenner: Because the causes of food intolerances can vary greatly, it is important to diagnose them — since management and treatment can differ accordingly. It is important to understand that continuous consumption of intolerable foods can trigger inflammatory reactions in the gut. This can lead to what is known as leaky gut (“increased intestinal permeability”), which in turn may contribute to the development of autoimmune diseases. To prevent disease in the long term, food intolerances should be identified and the triggering foods avoided.
Dr. Aschenbrenner: In my experience, this is often because the evaluation is not broad enough and not individualized enough. Time constraints are a major factor. In a typical German medical practice, patient consultations last only a few minutes on average. Based on my clinical experience, many food intolerances can at least be suspected through a thorough patient interview.
However, this requires time and many detailed questions — about dietary habits, symptoms, bowel patterns, long-term development, previous findings and examinations, and more. A comprehensive diagnostic workup follows the initial history. As mentioned, there are many possible methods. Not all physicians are familiar with them, and they require specialized knowledge.
In addition, many of these services are not covered by health insurance. This is difficult to understand, because undiagnosed food intolerances can lead to chronic disease and therefore higher long-term costs. If further diagnostics are currently not available or affordable, I recommend at least keeping a nutrition and symptom diary, ideally supervised by a physician or qualified nutrition specialist.
In a typical German medical practice, patient consultations last only a few minutes on average.
Dr. Aschenbrenner: The easiest to address are those that can be clearly identified and then avoided without causing other problems. Intolerances that occur secondarily — meaning they are caused by another underlying condition — can also often be treated successfully. Once the primary cause is resolved, the food is often tolerated again.
It becomes more difficult when multiple food intolerances are present or when conditions such as Mast Cell Activation Syndrome (MCAS) or histamine intolerance are involved. In these cases, patients often react to many different foods and additional triggers (such as fragrances or cosmetics), which can severely restrict the diet. Medication may then also be necessary to ensure adequate and healthy nutrition.
Dr. Aschenbrenner: The tests used in holistic treatment are scientifically based and evaluated methods. They could just as well be used in conventional medicine.
Part 2 of the interview will follow in the next blog post.
The content of this blog/newsletter is provided for general informational purposes only and does not replace personal medical advice, diagnosis, or treatment. The information presented here should therefore not be used as the sole basis for making health-related decisions. If you experience any medical complaints, you should in any case seek professional medical advice.
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Holistic physician and author Dr. Katja Aschenbrenner, MD, shares valuable insights from her clinical practice on functional medicine, gut health, hormones, Ayurveda, and everything that keeps us truly alive — for anyone who wants to understand their health and achieve vital longevity.
I am Dr. Katja Aschenbrenner. When no one else can find the root cause, my work begins. I support people with persistent exhaustion, unclear symptoms, or chronic illnesses using an integrative and functional medicine approach.
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