Your Reactions to Food—How to Tell an Allergy from a Sensitivity
Do you ever wonder if you are “allergic” to a particular food? Have you ever been tempted to grab one of those food sensitivity tests in the drug store to see if you really have a reaction to certain foods?
Don’t grab for that test quite yet. In this post, I’m going to describe the differences between true food allergies, food intolerances and food sensitivities so that if you are tested, you’ll know what the test means. I’ll also give you a reason why you would and wouldn’t run a food sensitivity test.
First, the definitions…
Food Allergies, Intolerances and Sensitivities
Which is Which?
Food Allergy: This is the food reaction that you should be most concerned about. It can be immediately dangerous. And you probably know if you have one.
A true food allergy is what you probably know as a peanut or shellfish allergy. The one that makes you break out in hives immediately. Or worse. The kind where you bring an epi-pen wherever you go.
This is the type of allergy that can be tested in a doctor’s office and confirmed with certainty, generally because of the symptoms. This is known as an IgE reaction, and we will come back to that term a bit later when we talk about an allergy vs. an intolerance.
But now it gets a bit more complex…
Food Intolerance: The definition of a food intolerance is when you can’t digest a certain food or part of a food. The classic examples are gluten and dairy.
A dairy intolerance could be an intolerance to the enzyme lactase. Lactase breaks down lactose, also known as milk sugar. Lactase is a disaccharide, meaning a two-molecule sugar/carb. When we don’t have any or enough lactase in our system, the lactose molecules don’t get broken down properly, creating “exciting” symptoms like gas, bloating, etc.…
A dairy intolerance could also mean an intolerance to casein, the protein found in milk. Some symptoms overlap with a lactose intolerance, but a casein intolerance, according to the Intolerance Lab in the UK could also produce things like:
Digestive upset including lots of bloating and abdominal cramps and pain
Stool abnormalities, diarrhea, constipation, sometimes blood in the stool.
Flatulence
Runny nose and lots of nasal congestion
Adult acne
Eczema, other itchy skin rashes
Children with behavioral issues/changes
Fatigue
Unexplained joint pains
Mental fatigue, brain fogginess
But there is such a thing as a casein allergy. And so, what’s the difference? The answer is: severity and timing.
If symptoms are immediate and (generally) serious, the reaction is an allergy, an IgE reaction as in the case of the peanut or shellfish allergy.
But if symptoms are delayed—and the symptoms could occur up to three days after ingestion (which makes this all so tricky), the issue is intolerance. The symptoms, while disturbing if you are the one who has them, are also not as serious.
Gluten is another food protein that you can form an intolerance to and is increasingly common. While difficult to detect, an intolerance could be formed from either of the two main proteins in gluten, glutenin and gliadin. Gliadin is known to be the protein to which most people react.
I’ve written about gluten intolerance in detail and why it’s so pervasive. If you are interested in more about gluten and about my journey with gluten intolerance, read up here: https://barwellness.net/blog.
As I’ve mentioned before, gluten intolerances, like casein intolerances, can produce a whole host of symptoms, including:
Bloating
Diarrhea or Constipation
Abdominal pain
Lack of Energy
Headaches
Skin Problems
Unexpected weight loss or gain
Anxiety or depression
Looks like casein intolerances, right? Yep, it’s hard to know sometimes, and I have some ideas of how to find out what foods cause an intolerance for you. Keep reading….
So a gluten intolerance, absent celiac disease, is an inability to digest the elements of gluten. Just to confuse the discussion a bit more, a small minority of people may have a wheat allergy, an IgE reaction which would be immediate and usually severe.
Food Sensitivities:
So what about your friend who swears she’s “allergic” to pineapple? Or tomatoes? That’s generally a food sensitivity, the last category of reactions to foods.
These are generally the foods you would find on that food sensitivity test you’d pick up at the drug store or get in the mail. You prick yourself and deposit a pinprick of blood, seal it and send it away to find out what foods you should avoid. Most companies test for an IgG reaction (or antibody) that is produced when your blood is exposed to the food (s) in question.
When IgG or IgA antibodies are found, the symptoms you produce are not “allergic” and immediate, like an IgE reaction. Like an intolerance, these reactions can cause symptoms for up to three days after ingesting a particular food.
So while these tests are fun to take and give you a little information about what may be troubling your digestion, (or your skin, or your headaches), there are some limitations to these types of tests. Here are some:
Most food sensitivity tests are only performed on a certain number of foods, and you will pay more to test additional foods. This is not necessarily a bad thing, but some tests may leave you with an incomplete picture of your sensitivities.
Most food sensitivity tests look for IgG reactions to foods, unfortunately, food can cause a number of reactions like an IgA reaction, or a cell mediated reaction. So you may not get a complete picture.
Sensitivities are just that—foods that you are sensitive to, at the time of the test. So what does it really mean to be sensitive to a food? It means your body is reacting in a way that makes that food symptomatic for you today. Sensitivities can come and go.
There may be different levels of food sensitivities depending on the food ingested and your body’s reaction. Not all tests differentiate the level of food sensitivity.
So what do you do if you suspect a food (or multiple foods) allergies, intolerances, or sensitivities? If you suspect a food allergy, please see your doctor immediately, as the issue could be dangerous.
If you suspect a food intolerance or sensitivity, there are a few things you could do.
The easiest thing to do is the food challenge. This is where you remove a particular food for a 30-day period. After the 30 days, you re-test yourself by consuming some of the food and wait one to three days to see if you have any negative reactions. And remember, a negative reaction could be a rash. This type of testing takes a lot of time and can be nonconclusive, however, it can also give some excellent answers.
You just need some patience to stick with removing a food you may like. It’s also important to review where that food may be as an ingredient in other foods. For example, I recently did a food sensitivity test that revealed that almonds are a current sensitivity of mine. That means no almond flour (gluten free bread), almond crackers (my fav), almond milk, my current favorite power bars or most of the sweet treats I buy from my favorite gluten-free friends at the farmer’s market.
If you don’t know what food or food are providing your symptoms, you might reach out and take a food sensitivity test. You would then know at that time what foods you could incorporate into an elimination challenge. But be ready to do your elimination right away, as food sensitivities change unless you also address the underlying issues with your digestion.
Finally, you could reach out to a trusted professional (like me!) to help you sort out your particular situation. As I noted above, food sensitivities are a direct result of other digestive issues. Food sensitivity testing can only be effective if you are addressing the other challenges you may be having with your gut. And even if it’s frequent headaches, it may be a sign of digestive issues. Our bodies can trick us.
I hope I’ve cleared up the differences between food allergies, intolerances and sensitivities.
Do reach out to barwellness@comcast.net if you have additional questions or if you’d like to schedule an appointment to see if we might work together on your particular challenges.
To Your Health!
Bev