The truth about food “allergies”
In this article I reveal the differences between food allergies, food intolerances, and food sensitivities. Why does it matter? The testing and treatment plan will depend on what kind of reaction you are having. Ever wonder why you react to some foods only some of the time? Do you feel like you are reacting to everything? Wondering if food allergies might be causing your heartburn, headaches or other symptoms? This article should shed some light.
First, a caveat of sorts. I want to highlight the fact that food reactions vary from person to person. For some, eating wheat might cause hives, while other might get constipation, or diarrhea…or migraines…and the list goes on. This is one of the reasons identifying adverse food reactions can be so challenging on your own. I use either an elimination diet or testing - or sometimes both with my patients. Feel free to schedule a free discovery call to learn more.
Food allergies
True allergic reactions occur in response to a substance that the body deems as a threat. The body reacts by releasing IgE antibodies. Antibodies (aka immunoglobins) are a part of our immune response and contribute to fighting anything deemed foreign, including bacteria and viruses and sometimes, certain food particles.
IgE antibodies stimulate mast cells to release histamine, which can cause itchy, red and swollen skin. These reactions can vary in severity, from a hive or two, to life-threatening. With severe reactions, the bronchial tubes can swell and constrict breathing (anaphylaxis). People with severe allergies are usually well aware and carry an epi-pen (adrenaline injection) to use in cases of accidental contact with the allergen. (1)
This reaction is repeatable, immediate (the reaction usually occurs from seconds to hours after contact).
How to identify? Elimination diet, Skin prick testing & IgE blood tests.
What to do? Avoid the food.
Food sensitivities
Like food allergies, food sensitivities are immune-modulated. They can either cause the release of other antibodies (IgG, IgA, IgM, and IgD, and IgG instead of IgE) or they are mediated by another type of inflammatory immune response, such as increased secretion of prostaglandins in irritable bowel syndrome.
Food sensitivities are dose-dependent (the more you eat the worse the reaction) and delayed (taking between 3-72 hours to show symptoms). Symptoms can vary in severity and are diverse, and can include:
Abdominal pain & cramping
Acid reflux/Heartburn
Acne
Anxiety
Bloating / Gas
Brain fog
Constipation
Dark circles under the eyes
Depression
Diarrhea
Fatigue
Headaches & migraines
Hyperactivity
Joint aches
Memory issues
Mood changes
Nausea
Skin issues
How to identify? Elimination diet, ELISA (enzyme linked immunosorbent assay) serum tests for IgA, IgE, IgG and IgG4, with compliment C3d. The gold standard is the elimination diet and reintroduction challenge.
What to do if you have food sensitivities? Identify and remove offending food, heal the gut, and then carefully reintroduce that food.
Food intolerances
The inability to digest or tolerate certain substances or food groups, like lactose (in dairy) is called an intolerance. The inability to make lactase (the enzyme that helps digest lactose) is due to genetic variation and can be inherited. Other food intolerances include salicylates, oxalates, high histamine foods and for some, the nightshade family.
Generally, food intolerances do not stimulate an immune response. However, continuing to eat those foods can cause inflammation, damage the digestive lining, and degrade to the point that undigested food particles can "leak out" and enter the bloodstream which then triggers an immune response. This response increases inflammation which can impact digestion, cause joint pain and and other health issues. For a deeper dive into gut issues check Gut Issues? Start Here. Or download my Free Better Digestion EBook.
Ok, back to food intolerances, like food sensitivities, intolerances can be dose-dependent and have a delayed reaction. For example, you might be able to eat a small amount and not notice a reaction, but if you eat a large amount you might break out in hives….a few days later. Yep, yet another confounder that makes it really challenging to identify offending foods. Symptoms are diverse and include:
Abdominal cramping
Bloating and gas
Blocked or runny nose
Brain fog
Constipation
Diarrhea
Eczema
Skin rashes
Hives
Itchy nose/eyes
Sinusitis
How to identify? Elimination diet, hydrogen breath test (lactose), skin prick test (histamine) and a variety of blood tests.
What to do? This one is a little more complicated, depending on the intolerance. For example, if you are lactose intolerant, you’ll want to avoid dairy that contains lactose (not all of it does!), and for some, taking lactase enzymes allows them to continue eating lactose. Some intolerances, however, like histamine or oxalate, may have developed as a result of poor liver function, genetic variations, microbiome imbalances or even chronic stress, so understanding the underlying cause will inform your treatment plan.
A note on wheat
This topic deserves an article of its own. And I will write one, but until then, in a nutshell:
Celiac Disease is an inherited autoimmune disease that results in immune cells attacking the intestine when gluten is eaten. It can be tested for, but gluten must have been eaten for valid results. Gluten, even small amounts (eg. using a knife that touched bread) must be avoided for life.
Non-Celiac Gluten Sensitivity is a label for people who do not test positive for celiac but have symptoms and damaged gut lining after eating gluten. The cause is not yet fully understood. Gluten avoidance is recommended, reductions have been known to help some, and small amounts don't elicit the extreme response it does with celiacs.
Wheat Allergy elicits an immediate response, can develop over time or be due to chronic occupational exposure.
All three can result in a wide range of gastrointestinal and other body system symptoms, including headaches, respiratory issues, pain and more.
Most of my recipes are gluten free, including my Buckwheat Crepes and Creamy Cauliflower Soup. My Gut-Healing Meal Plan is also gluten free and packed with gut-happy recipes.
So, in summary:
Food sensitivities and intolerances can be helped with dietary changes and/or gut healing, but the underlying cause should be identified before treatment.
Reactive foods can be identified via the elimination diet and reintroduction challenge (gold standard) or testing.
Understanding which foods or food groups you are reacting to is necessary for the healing process to begin.
Remember, one-on-one professional guidance is just a click away, book your free discovery call here.
You deserve to be well!
Yours in health,
Camille Hoffman
Naturopath, Nutritionist & Medical Herbalist
Book Your Free Discovery Call Here
The views and nutrition, naturopathic and herbal recommendations expressed by Camille Hoffman and Hoffman Natural Health’s programs, website, publications and newsletters, do not constitute a practitioner-patient relationship, are not intended to be a substitute for conventional medical service and are for informational purposes only. The statements and content found in these programs, website, publications and newsletters have not been evaluated by the Food and Drug Administration. The treatments described may have known and unknown side effects and health hazards. Each user is solely responsible for their own healthcare choices and decisions. Camille Hoffman advises the website user to discuss these ideas with a healthcare professional or physician before trying them. Camille Hoffman does not accept any responsibility for any positive or adverse effects a person claims to experience, directly or indirectly, from the ideas and contents of this website.
SOURCES
Elli, L. et al. (2015). Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity. World journal of gastroenterology, 21(23), 7110. doi:https://doi.org/10.3748/wjg.v21.i23.7110
Tuck, C. et al. (2019). Food Intolerances. Nutrients, 11(7). doi:https://doi.org/10.3390/nu11071684
Vasquez, A. (2016). Textbook of clinical nutrition and functional medicine, Volume 2, fouth edition