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Food Allergies vs Food Sensitivities vs Food Intolerance... what's the difference?

7/16/2014

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When most of us picture a food reaction, we think of the classic peanut allergy: one whiff of the stuff with the Teddy bear (or Squirrel, depending on your family's preference) and that one kid in class would break out in hives, have difficulty breathing and someone would dig out the epi-pen. 

That's why I often have to explain to my patients that not all food reactions are like that. Here's why.


Food can be the perfect medicine... or the best poison.

Our body does the best it can and can only run off the fuel we give it. While most of us try to eat healthily the majority of the time, sometimes the "good" foods we are regularly recommended can make us feel ill. If we are taking in foods that don't agree with us, regardless of which Food Guide or expert recommends them, our body will mount a reaction in order to tell us that we shouldn't eat it. If we continue to consume these foods, the body turns up the dial until we have to listen.

Your Cheat Sheet to Food Reactions:

Food Allergy (IgE)

  • an IgE-type reaction - immediate hypersensitivity
  • Reactions generally occur within minutes of eating reactive food and can be life-threatening
  • Body has initial exposure to the allergen, fights it off, and keeps those weapons ready on hand for the next encounter 
  • eg. Peanut or shell-fish allergy

Food Sensitivity (IgG)

  • an IgG-type reaction - delayed hypersensitivity
  • Reactions can take hours or days (or even longer) to develop
  • Body attacks the allergen, forming an immune complex that when present in large enough numbers, become difficult for the body to remove, If enough complexes accumulate, they can deposit in various parts of the body and release inflammatory chemicals that contribute to a variety of symptoms and conditions
  • eg. gluten, dairy sensitvity causing eczema

Food Intolerance

  • thought to be non-immune mediated (unlike food allergies or sensitivities) and the body reacts to a different part of the food molecule
  • can cause immediate or delayed reaction, depending on the food and the person
  • eg. lactose intolerance, MSG reactions

Timing is everything

One reason it can be so difficult to identify a food reaction is that we may react hours, days or even weeks after ingesting the food in question. If you tend to eat a highly varied diet or eat the same foods over and over, pin-pointing that one meal can be a challenge, particularly if you started to feel crummy a few days later.

Trust your gut..but look for other clues.

The gut is the gateway to the rest of the body. If a food reacts in our gut, it impacts not only our digestive function, but the rest of our body as well. In particular, the immune system, neurological and reproductive systems get involved.

Symptoms of a food sensitivity can include:
  • Digestive disturbances: gas, bloating, diarrhea, constipation, blood in the stool, heartburn/reflux, difficulty swallowing, ulcers, Irritable Bowel Syndrome
  • Headaches: migraine, cluster and/or tension
  • Neurological: numbness, tingling sensations
  • Mood: anxiety, depression, mood swings, autism, ADHD
  • Fatigue, low energy, no motivation, insomnia
  • Skin issues: acne, eczema, psoriasis, swelling
  • Joint pain
  • Muscle aches
  • Weight gain
  • Hair loss
  • Hormonal: fertility issues, PMS, menstrual cramps, low sex drive

Your symptoms may evolve over time as well. 

For example, I notice with myself that when I eat gluten I start to feel very sleepy and have an immediate-onset brain fog. If I continue to ignore my body and eat more - I am the first to admit I am very human and not immune to a fresh slice of bread from time to time - I get some pretty intense stomach cramps and constipation. Since I so seldom eat it, I notice this right away. When I was in university on a tight student's budget, I tended to a lot of pasta (it was cheap, quick and filling) I suffered from debilitating sleep attacks plus all those digestive symptoms, weight gain around the middle and acne. Eventually I realized from trial and error that it was worth spending a few extra bucks, saving the gluten/starch binges for a very occasional treat in order to be more productive, focused, energetic and healthy.

As you can see, it certainly goes beyond the digestive system!

So how do I know if there's a problem... and what can I do about it?

If you're asking yourself this, you've come to the right place! 

Working with your family doctor or allergist, standard allergy testing is often recommended to test for IgE-type reactions. Treatment then involves taking an antihistamine (Reactine, Benedryl etc.), epinephrine (eg. carrying an Epi-pen) and/or complete avoidance.

However, by now you will realize that IgE reactions are just a small part of the picture. 

Here is how I treat food reactions:

  1. Review. The first step is examining your eating habits. I have all of my patients complete a diet and lifestyle diary for several days to get a baseline for their diet and habits relating to how they feel. In our visit, we discuss these and make recommendations based on what I see (inevitably, it is someone's birthday during that time and I hear "I don't usually eat like this!!!"). 
  2. Identify. If it is appropriate, I may recommend cutting out some foods entirely for a few weeks to see if their symptoms improve.
  3. Test. Alternately, we can run a Food Sensitivity Panel testing for food allergies (IgE) and/or food sensitivities (IgG). This is a great way of determining which foods you are reacting to right now and how much of a reaction your body is mounting. 
  4. Heal the Gut. Once the offending foods are identified, we begin a process of eliminating them in order to allow the gut to heal and give your body a break. There are several supplements that I regularly use that help your body to heal as well.
  5. Reintroduction. This is the exciting part, where we reintroduce the foods one by one in order to see how your body uniquely responds. Sometimes there is a very clear reaction (migraine headaches, worsening of skin or mood symptoms for example). Other times, it can be difficult to tell (hair loss in particular is tricky because it can takes months to see a difference).
  6. Reinforcement. With a tailored supplement protocol, good stress management and a diet specific for you, you may not react to the same foods in time.

If you or someone you know is suspects that a food reaction might be contributing to feeling unwell, I would like to offer you a complimentary 15 minute consultation with me to discuss your concerns. 
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Don't bother me, I'm eating!

11/18/2013

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There was a running joke in our family growing up: Don't mess with a German Sheppard while it's eating. By German Sheppard, we meant me. 

I don't mean to say that I was particularly clumsy with my utensils - on the contrary, my mother was very adamant about us knowing exactly which fork to use, how to use chopsticks, a la Emily Post.  Nor that I was the perfect family pet. 

The joke was that I am very serious with my food. I wake up excited about all of the delicious things that I want to eat in the day, my husband and I are addicts of Gordon Ramsay's Ultimate Cookery Course, and I am happiest puttering around the kitchen making food for my family. 

Also, that one might be taking their life into their hands by coming between me and my plate. 

My father actually called me "Spike" as a kid, and my uncle DID teach me to growl as a toddler... just capitalizing on my hungry dog status.  I digress.

In Chinese Medicine, there is the concept of "Digestive Fire" which is essential for us to be able to process the foods we take into our body, extract the nutrients and in turn be nourished. In me the Digestive Fire was quite strong. In fact, I would diagnose myself as having Stomach Fire, which can show up as extreme hunger, canker sores, lots of burping, and unquenchable thirst. Add to that a family propensity for hypoglycemia and not enough vegetables, and we had a recipe for a kennel full of hangry (hungry + angry, fyi) puppies at our house. 

That is, until I adopted a more Primal or WAPF way of eating. I used to go from craving starch, and carbs, and salt, and sugar... and did you just say cupcake???? ALL THE TIME to only having minimal food cravings and feeling more satisfied.  My secret? 

Chew the fat. 

Yes, you can discuss your day at the dinner table. What I really mean is that by increasing healthy fats in my diet I no longer am in danger of causing bodily harm to my loved ones in public because someone just wanted a bite (probably of my steak). Fats act to slow the digestion and absorption of sugar into your blood stream which means that you will feel more stable, energetic and full longer.  

Sugar is essentially a drug - we crave it because it gives us a high, and when the effect wears off, we feel a low. We get miserable, hungry, tired and generally unpleasant. And we are craving another fix.  I see a lot of people that get that 3pm slump where they could use a nap, or coffee and chocolate because they feel so tired! The first place to start, therefore, is with breakfast and lunch.  If you are consuming a lot of sugars in isolation with little protein and fats (think the classic TV commercial breakfast of a bowl of cereal, skim milk, a banana and orange juice) you will be experiencing this guaranteed. The same goes for my smoothie-loving friends out there that just have frozen fruit and OJ blended up with nothing else for breakfast.  Junkies, all of you! 

I can't judge, however, because I was there.  Since re-evaluating my food patterns this is no longer a problem.  My favorite go-to fat and protein snacks are almond/cashew/sunflower butter, nuts, coconut oil, avocados, bacon (make sure it is good quality), salmon, kippered herring, sardines, olive oil and of course... meat. 

Since then my Digestive Fire has gone from a burning inferno to gently simmering.  

Stay tuned for more Optimizing Your Digestion Tips!

Yours in health,

Dr. Roesner

p.s. Check out these awesome Cereal commercials!

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    Dr. Keila Roesner is a Naturopathic Doctor. When not treating patients she is also an enthusiastic barefoot-strolling, music-loving, yoga-doing kitchen wiz - who also happens to be a wrestling fan.

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