Food Allergy, Intolerance or Sensitivity?

I was recently asked to participate on a panel of health-care providers discussing digestive health. It was a great event and one of the questions I was asked was the difference between food allergies, intolerances and sensitivities.

A food allergy reaction is the result of the immune system identifying a food a foreign entity and then launching a response against it. The body will immune cells called Immunoglobulin E (IgE), Immunoglobulin G (IgG) and histamine. Common food allergies include peanuts, tree nuts, seafood (fish or shellfish), milk/dairy, soy, eggs, corn and sugar. The symptoms may be immediate or rapid onset (IgE) or delayed with onset in hours to days later (IgG) which makes it difficult to identify their source. Common symptoms include the following:

Pruritis (itchy skin)
Angioedema (swelling around the lips or eyes)
Shortness of breath
Abdominal pain
Chest pain

A food intolerance reaction is a result of being unable to adequately digest a food. It causes chronic inflammation and irritation in the gut. A very common example is lactose intolerance. This is not an immune response but may be a result of enzyme deficiencies or other physiological factors.  Such symptoms may include:

Gas, bloating, abdominal pain
Brain fog, anxiety or depression
Inflammatory symptoms (eg. joint pain)
Difficulty losing weight (Check out my post on Food Allergies and Weight Gain)

It is important to be aware of how your body responds to foods. A good way to develop this awareness is to keep a diet log or diary which documents foods you eat and your physical and mental responses to them. This is often all you need to do to identify offending foods. Once identified, you may choose to begin an Elimination or Allergy Avoidance Diet where the suspected foods are removed for a period of time to see if your symptoms resolve. The foods may then be slowly re-introduced to confirm your suspicions.

If your diet diary is not definitive, you may want to pursue food allergy testing that will measure the levels of immune cells in your blood to various foods. You may also test for other inflammatory markers in specialized intolerance/sensitivity tests. This helps you understand your body’s reactivity and equips you with the information you need to take the next steps in your diet and lifestyle to optimize your health and well-being. What could be better that that?? I offer these tests in my practice and, when indicated,  find them incredibly helpful in resolving the chronic health issues listed above.

I recommend speaking with your primary care doctor regarding any changes in your diet and for supervision and guidance when investigating food allergies or intolerances.

For more information, check out this great article on the Allergy Avoidance Diet.

Here’s to your health,
Dr. Mead

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