Am I reacting to foods I’m eating?
Do I have a food allergy?
Or a food sensitivity?
Or an food intolerance?
I often hear people using these terms interchangeably but they describe different responses that the body has to food. The symptoms can be the same which can make it hard to tell which one you might have. But treatment varies, so knowing which one you have is important.
The symptoms of can be vague and located anywhere in the body which makes it particularly difficult to diagnose. The most common symptoms are centered around the digestive tract: nausea, vomiting, diarrhea, constipation, heartburn, or gas. I’ve also seen skin reactions like acne or eczema, headaches, increased PMS cramping, and fatigue. The list of symptoms of food sensitivities could go on and on.
What is a Food Allergy?
The term allergy describes a specific type of immune response. People can be allergic to pets, pollens, grasses, foods, etc. The most common foods that trigger a true allergic reaction are peanuts and shellfish. The allergic response can be serious and even life threatening. That’s why people with allergies might carry an epi-pen and why many elementary schools are completely peanut-free. For a child with a peanut allergy even touching a table where a peanut butter sandwich had been lying could be enough to trigger a serious response.
An allergy is a specific immune response that involves specific types of immune cells. We think we understand allergies pretty well. The first time someone is exposed to a food they create white blood cells that don’t like that food, then every time they eat that food (or touch that dog, or inhale that pollen) later those white blood cells trigger an immune response that causes symptoms like runny nose, itchy eyes, throat swelling, etc. This reaction happens fast, within just a few minutes. Allergist use blood and skin prick tests to diagnose allergies.
A food intolerance is not an immune response at all. Instead it’s when the body is can’t digest a type of food because it is missing an enzyme specific for that food. For example people who are intolerant to dairy do not have lactase, the enzyme that breaks down the lactose protein found in milk. People can be missing enyzmes causing them to be intolerant to fructose, histamine, sulfites, etc.
A food sensitivity involves the immune system, but it is different from an allergy. There are different white blood cells involved that trigger a different type of response. It is not immediate, like an allergy, but can be delayed up to 72 hours. This makes it particularly difficult to pinpoint which food might be causing the symptoms. Nine out of ten people with a food sensitivity will be sensitive to dairy, eggs, soy, gluten, or corn.
The best way to identify a food intolerance or sensitivity is to avoid the probable foods for a period of time and then eat them again and note any symptoms. The symptoms might not appear until 2-3 days after the food is eaten. In my practice I recommend an elimination/reintroduction diet to help people identify food intolerances and sensitivities.
For a true food allergy, one should avoid the food they are allergic to forever.
For a food intolerance, in general it’s best to avoid those foods. It can be okay to eat a little bit occasionally, as long as you take appropriate digestive enzymes at the same time to help your body digest the food. I prefer 100% plant-based enzymes.
Identifying a food sensitivity is just the first step in a longer process of gut repair. Since a sensitivity is often caused by some sort of “leaky gut” that allowed the food proteins to come into contact with the immune system too soon, we want to strengthen the gut. The gut repair process can take months to years. My gut repair protocol uses 4 R’s. Remove the offending food completely from your diet. Restore proper function (this is individual and would address specific symptoms like constipation, heartburn or acne). Repopulate the gut with good bacteria. And last but most importantly, repair the lining of the small intestine.