Difference Between Food Allergies and Intolerances

Have you ever eaten something and experienced troubling symptoms a short while later? Have you had a severe reaction to a food that landed you in the ER or at urgent care? You’re not alone.

Food Allergy Research & Education reports that 33 million Americans have food allergies. Of those people, 10% are adults and almost 8% are children. More concerning, over half of adults with food allergies have had a severe reaction, and 42% of children have. That’s just allergies.

An estimated 20% of Americans have at least one food intolerance. It’s led to awareness of FODMAP sensitivities, gluten and wheat sensitivities, and more alarming intolerances to food additives and food chemicals. Food intolerances can be even harder to fully diagnose because so many things can trigger symptoms. 

The Difference Between Food Sensitivities, Intolerances, and Allergies

When you have food sensitivities or intolerances, you’re not experiencing a true allergic reaction. Food allergies involve the immune system. The body sees the food item as an invader and launches an attack. Symptoms vary from mild to severe.

Intolerances and sensitivities are similar. Intolerances usually occur in the digestive system. You ate the food and now your body is having a harder time digesting it correctly. Severity depends on how much of that food you ingested, and the symptoms are often delayed and occur after digestion starts. Sensitivities differ in that your body reacts to the food, but it isn’t a normal immune response. Symptoms instead lean more towards fatigue, headaches, and skin issues.

The key differences are best summed up as:

• Food Allergies – Immune system response, often with IgE antibodies involved
• Food Intolerance – Digestive system response, often with enzyme deficiencies 
• Food Sensitivity – Harder to diagnose as sensitivities can present with exhaustion and headaches

As any food hypersensitivity, including food allergies and food intolerances, can be dangerous, it’s important to see an allergy doctor for a professional diagnosis. Even if there isn’t an immediate reaction like throat swelling, gastrointestinal issues can lead to malnutrition, which is also dangerous. You need to work with a food allergy specialist.

Common Food Allergies and How They’re Diagnosed

There are nine main food allergies in the U.S. They include:

• Eggs
• Fish
• Milk
• Peanuts (legumes rather than a tree nut)
• Sesame
• Shellfish
• Soy
• Tree nuts
• Wheat

When you have one of these food allergies, you may experience mild symptoms like itching and hives. Digestive issues like nausea are possible. Swelling of the face, lips, and tongue are also common.

If you reach a point where you’re experiencing swelling, it’s imperative to see a doctor. You do not want your throat to swell and block your airways. Any severe symptoms like difficulty breathing, dizziness, a sudden drop in blood pressure, and throat tingling and tightening are dangerous and a sign that you have a severe allergy.

At an allergy doctor’s office, you will discuss your medical history from as far back as you can go. You’ll undergo an allergy test. That test might be a blood test that measures IgE antibodies. These antibodies are produced by the immune system when an allergen enters the body. High levels of IgE are a sign of an allergic reaction.

A skin prick test may be used to determine the allergy. A small portion of the food is rubbed or placed on the skin, and a small needle pricks the skin. A red welt indicates an allergy.

With some food allergies, it’s better to undergo an oral food challenge. You eat a small portion of the food and the doctor monitors your response. 

Once you’re diagnosed, avoidance of that food is one treatment option. It can be hard to fully eliminate some foods, however. Other treatment options may help, but you always need to be aware of the foods you eat by reading labels and asking what’s in a food someone has prepared. If you’re not certain, avoid it.

Common Food Intolerances and How They’re Diagnosed

Intolerances are often tied to a shortage of specific enzymes necessary for the digestive system to break down foods. Because it’s tied to digestion, bloating, nausea, abdominal cramps, constipation, and diarrhea are key indicators of a food intolerance. Common food intolerances include:

• FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols carbohydrates like fructans, fructose, glucose, lactose, mannitol, and sorbitol)
• Food chemicals (Artificial sweeteners, MSG, and sulfites)
• Gluten (Different from celiac disease, but it’s barley, rye, and wheat proteins that trigger the intolerance)
• Histamine (Food in aged cheeses, cured meats, and fermented food like sauerkraut)
• Lactose (Milk sugar)

Diagnosing food intolerances is harder. Most doctors use the elimination diet approach. After determining possible trigger foods, you stop eating them. They’re reintroduced to your diet one by one until the symptoms return. Once the symptoms are back, you know that’s the food to avoid.

Your allergy doctor will ask you to keep a food diary to find patterns between your symptoms and the foods you ate. If you had macaroni and cheese and then felt bloated and experienced abdominal pain, you might have a problem with the cheese, or it could be gluten. You need to start looking for patterns by using a food diary.

Earlier we mentioned that wheat intolerance isn’t the same as celiac disease. Celiac disease is an autoimmune disease that causes serious problems with damage to the intestinal walls. If you eat gluten, your immune system damages the lining and makes it hard for the body to absorb nutrients. You can end up with anemia and osteoporosis. It’s not the same as a food intolerance or allergy and requires immediate medical care and maintenance of a gluten-free diet.

Common Food Sensitivities and How They’re Diagnosed

Food sensitivities are closer to intolerances than allergies, but there are still differences. With food sensitivities, it can be very hard to diagnose them as the symptoms may not appear for a while and they aren’t typical. Food sensitivities include headaches, fatigue, and even brain fogs. 

A gluten sensitivity is one of the more common ones, but again, it’s different to celiac disease. Other triggers of food sensitivities include:

• Food additives (Artificial sweeteners, food coloring, MSG, and sulfites)
• Histamines (Aged cheeses, alcohol, chocolate, cured meats, shellfish, and vegetables like spinach and tomatoes)
• Salicylates (Natural chemicals found in aspirin, fruits like apricots, pineapple, and strawberries, and vegetables like avocado)

Like food intolerances, sensitivities are hard to pinpoint. An elimination diet is the best chance, but symptoms like lack of energy and headaches can be triggered by many other health conditions. It takes time to work out if it’s food sensitivity or something else.

When Should You See an Allergy Doctor?

Don’t try to self-diagnose your symptoms. Allergies can become life-threatening. If you find certain foods make you feel poorly or unusual, see an allergy doctor. Premium Allergy specializes in food allergies and intolerances and has solutions that help you go through your day without fear that you might consume food that makes you feel sick. Make an appointment and work with an expert in allergies and treatment options.