Food Allergies, Sensitivities, and Intolerances: What are the Differences?
Ever eat something and minutes to hours later your body is saying "thanks, but no thanks"? You begin to question, is this an allergy? Am I lactose intolerant? Sometimes I eat yogurt and feel fine and other times it feels like I have a boulder in my stomach. What does this mean? It can be a confusing issue to navigate.
Allergies have become a major issue and often minimized as being a minor nuisance. While over 12 million Americans suffer from food allergies and allergic disease being the 5th leading chronic disease in the U.S., this is no small issue at all1. (American Academy of Allergy, Asthma, & Immunology).
The U.S. Department of Agriculture reports that 15% of the population has food allergies or sensitivities. Why is this such a big deal? According to James Braly, M.D., medical director of Immuno Laboratories in Fort Lauderdale, Florida, food sensitivities and allergies can be the underlying cause or a contributing factor in close to 80 medical conditions. Chemical sensitivities are also on the rise and many people exposed to small amounts of chemicals will experience symptoms such as hives, headaches, muscle spasms, brain fog, and other skin irritations.
Allergy? Sensitivity? Intolerance? What is the difference?
Most people tend to think any type of reaction to food or a substance is an allergy, when in fact most people are actually experience something less serious, while still very frustrating.
Allergy: refers to the immune system’s hypersensitivity upon re-exposure to a sensitizing agent, which results in the release of inflammatory chemicals and development of various symptoms (Immunoglobulin E, IgE, is a traditional marker)
Sensitivity: refers to adverse reaction in the body upon exposure to a sensitizing agent in the environment. It does NOT involve antibodies, although it can involve other immunological processes. Most food and chemical reactions are actually sensitivities
Intolerance: refers to the absence of a particular chemical or physiological process needed to digest a food substance. For example, the lack of digestive enzymes lactase results in the inability to digest dairy. Gastrointestinal upset is often a sign of an intolerance. This is not a true allergy.
Types of Allergic Responses
Type I: Immediate Response
This type of response happens immediately after exposure and is considered a “true allergy,” and can be caused from exposure to inhalants, topical applications, and common food triggers such as wheat, dairy, eggs, corn, chocolate, strawberries, nuts, and peanuts. This is an IgE response, meaning an immune response.
This type of allergy is triggered by the proteins in food such as gluten (breads, crackers, cereals), casein (dairy), and albumin (eggs). While type II allergies are caused by the chemicals in foods such as MSG (cheese, soy protein, yeast extract) , acids (citris acids, wine, nightshades), sweeteners (aspartame), and sugars (sucralose).
Can you develop a reaction over time?
There can be stages to developing a reaction to a food. For example, the first time an allergen enters your system, you may experience no symptoms. However, antibodies are being formed that are specific to this allergen or food. The allergen then attaches to B lymphocytes, which create the antibodies to that allergen. These specific antibodies then attach the mast cells, which release histamine and other cytokines and results in the reaction. The immune system becomes sensitized and creates a “memory,” for that allergen. So let’s say, this specific allergen is eggs. You eat eggs and few times and feel fine. Slowly your body starts to create antibodies whenever eggs are introduced into your system and before you know it, the next time you eat eggs, your body goes into alert mode as the immune system now has a scripted code to attack when it sees eggs! This is now an immune response every time you re-expose yourself to this food.
Symptoms of this type of response (aka IgE-mediated allergies)
Red itchy eyes
While food allergies are active by the immune system, food sensitivities may or may not be caused by an immune response. Unlike a true allergy, a food sensitivity may be immediate or delayed.
Common symptoms include:
(Symptoms may change upon each food exposure)
There is also a cyclical action in which there may be symptoms one time and none at other times, making it difficult to figure out if you are indeed sensitive to the food or not.
There may be multiple symptoms and it can take several exposures for a food reaction to occur. There is a significant increase in inflammation as other chemicals are also released from this type of response.
Why are you developing food intolerances?
One of the most common reasons why I see people develop a loss of oral tolerance to food is due to enzyme deficiency, meaning that there are not enough enzymes to help break down your food properly. This in combination with low stomach acid causes food not to be digested properly resulting in harmful bacteria making it through your system and larger food particles not being absorbed and assimilated. This type of imbalance over a long period of time results in leaky gut.
Additional nutrient deficiencies can also be the culprit such as low vitamin C, D, and A; antioxidants, zinc, selenium.
Lastly, reactions to chemicals in foods can also trigger an intolerance such as pesticides, food additives, and preservatives.
Reasons for food intolerances:
Chronic exposure to certain foods
Weakened immune system
Early exposure to certain foods
How do I diagnose my allergies?
Skin prick test
IgG1 and IgG4 (foods)
Anti-gliadin IgG and IgA
Provocation with Neutralization (PN)
How do I treat my allergies?
The goal is to cut back on releasing the histamines and inflammatory chemicals and ultimately reduce your symptoms. The first step is to identify the root cause and triggers. You can do this by allergy testing or by seeing what foods are causing these symptoms and then eliminate them for a few weeks and re-introduce them and see if the symptoms come back.
Autoimmune Paleo Diet (AIP)
Whole foods and spices
Emphasize bioflavanoid, antioxidant, and immune enhancers
Heavily sprayed foods
Peanuts, bell peppers, citris, apples, non-organic spiniach
Tomatoes, potatoes, eggplant, peppers, tobacco
Herbs: stinging nettle, feverfew, demulcent herbs, boswellia, perilla seed
Bioflavanoids: quercetin, rutin, hesperidin
Vitamins: A, B, C, D
Minerals: zinc, selenium, magnesium
Immune enhancers: mushroom extracts
Enzymes: bromelain (pineapple), papain (papaya), protease, trypsin, chymotrypsin
Niacin flush (500 mg) this will increase circulation to the liver and histamines will be released and lowers toxic load