We receive A LOT of questions regarding the differences between food allergies and food intolerance (often called food sensitivities). This question is typically complicated by conventional medicine (at least in Ontario) where no distinction is ever made – you’re either allergic to something or you’re not. And while diagnosing true allergies IS very straightforward as your medical doctor or allergy specialist will insist, there is yet another category of food issues that often goes completely unrecognized and ultimately no treatment or strategy is offered to patients. Well, I’m here to tell you that such black and white categorization is not only wrong – it’s scientifically wrong. (That’s REAL wrong).

In fact, from a clinical perspective we have A LOT of patients that routinely report significant improvement to their health when they address food intolerances. Children in particular seem to be the most reactive to a variety of food intolerances and display a wide range of symptoms – everything from eczema and rashes to earaches, hyperactivity and mood disorders. What is most remarkable is just how fast changes can occur when food intolerances are addressed. We once had a mother call us 3 days after implementing dietary changes following her daughter’s food intolerance test to let us know that she “literally had a new kid”. Remarkably, the expediency of results upon addressing food intolerances is also quite clear in adults as well.

Let’s take a closer look at the distinction between food allergies and food intolerances. We’re all familiar with allergies, and in the case offood allergies, what we’re referring to is an immediate reaction to food proteins (called antigens) by a specific part of our immune system called IgE antibodies. In a nutshell, we eat food, we digest food, we absorb food proteins, and our IgE antibodies incorrectly identify the food proteins as harmful intruders. Ultimately, the immune system then rallies its troops to attack the antigens tagged by our IgE antibodies and a cascade of often deadly health effects occur very quickly. Symptoms can range from as mild as dermatitis and gastrointestinal distress such as numbing of the lips, to life threatening anaphylaxis which causes swelling in the throat and can lead to asphyxiation. In most cases, because of the immediacy between eating the food and the onset of symptoms, there is normally little question as to whether a particular food may have been the culprit. Common foods that fit into this category are peanuts, strawberries, fish, shell-fish, tree-nuts, eggs, milk, and wheat (in the case of celiac disease).

There isn’t really any known cure for food allergies other than steps that can be done to reduce your immune system’s reaction. Most allergies are treated by abstinence of the offending foods, while symptoms are managed with antihistamines, steroids, and epinephrine (the epi-pen). 

Food intolerances on the other hand not only have a much wider range of possible triggers, but typically illicit more subtle symptoms often with a much greater delay in the onset of symptoms after eating leading to chronically rooted symptoms. Most intolerances that we deal with as nutritionists and naturopaths take the shape of non-IgE –mediated immune responses; that is to say, the immune system still misidentifies a food protein and mounts a response, but not through the normal mechanism that can categorize itself as a true allergy. Lack of a specific enzyme or chemical is often the case with conditions such as lactose intolerance or fructose intolerance. Other possibilities include malabsorption issues, and intolerances that are not immune-mediated at all. The key with most intolerances is that they have a greater number of causes, produce milder symptoms than a true allergy, and quite often have a delayed reaction – all of which make them harder to determine.

Common symptoms of food intolerances often include fatigue, skin problems such as eczema and rashes, sinusitis, nasal congestion, asthma, throat irritations, dry cough, mouth ulcers, cramps, nausea, gas, diarrhea, constipation, and IBS symptoms. While there are a number of ways to identify suspected foods, we commonly use a method called the IgG antibody ELISA test (short for enzyme-linked immunosorbent assay) which involves a small blood sample taken via finger-prick. The sample is then sent to an accredited lab that then divides the blood sample into 96 smaller samples and reacts each one with 96 different food antigens by default. Blood samples that produce abnormal IgG reactivity are flagged as intolerances and much like food allergies, the only recourse is either partial or complete abstinence of the food(s), or various techniques to minimize the body’s immune reactivity – a process called immunomodulation.

Identifying food allergies and intolerances can make a remarkable difference to your health and wellbeing, and its lack of exposure in the conventional medical system is something that needs to be addressed (and it sells a lot of drugs). Until next time; Happy Health.