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

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.