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What is the difference between food allergy, food sensitivity and food intolerance?

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What are the chances that you or someone you know have had an adverse reaction to something you ate? According to the numbers, the chances are reasonably high.

Studies published in 2018 and 2019 indicate that about 32 million Americans are living with some type of food allergy. Add to this figure the individuals who have found themselves with some form of food sensitivity or intolerance, and the number of those whose digestive capabilities limit their diets only continues to rise.

Though the term “food allergy” is often used as a catchall culprit for the symptoms experienced when the body negatively reacts to food, food sensitivities and intolerances are classified as entirely different cases.

So, what’s the difference?

What is a food allergy?

A food allergy occurs when the body’s immune system incorrectly identifies food that has entered the body as a threat. The body then triggers a harmful immune response to attack proteins in the food and “protect” the body.

Unlike the reaction from a sensitivity or intolerance, the effects of a genuine allergic reaction are wide-reaching and can affect multiple organs and systems throughout the body of the affected person. These include the respiratory and gastrointestinal tracts, as well as the cardiovascular system. Symptoms of an allergic reaction can widely vary, ranging from more mild reactions, such as a rash or itch, to severe and life-threatening as with anaphylaxis

Food allergies also differ from food sensitivities and intolerances in the amount of irritant required to trigger an individual. Allergic reactions can occur from the ingestion of even the slightest bit of the culprit food.  (ACAAI) lists the following as the foods most commonly responsible for food-related allergies: milk, eggs, peanuts, tree nuts, soy, wheat, fish,       shellfish and sesame.

While the FDA hasn’t approved a formal treatment for food allergies, food oral immunotherapy has become a viable option and can be done by experienced board-certified allergists.

What is a food intolerance?

For those navigating life with a food intolerance, the bodily effects of an intolerance response are restricted to the digestive system.

The development of a food intolerance is due to an issue with one’s inability to break down a specific type of food properly. Because of this, the symptoms of an intolerance are not as wide-reaching as those of an allergic reaction.

Causes behind food intolerances can include a sensitivity to food additives, enzyme deficiencies or reactions to naturally occurring chemicals in certain foods.

Unlike individuals with a food allergy, those with a food intolerance can often eat small amounts of culprit foods without experiencing any side effects or complications. While this is the case, keeping clear from trouble foods is still recommended.

Some of the most common causes for food intolerances include, but are not limited to, dairy, gluten, caffeine, FODMAPs and more.

What is a food sensitivity?

While a large portion of the population does not suffer from food allergies or intolerances, they may still react poorly to certain foods. In these cases, it may be a food sensitivity that is causing the affected to experience symptoms.

Similar to an allergic reaction, the symptoms of a sensitivity result from an immune response in the body to a specific type of food, though typically not as severe. Digestive issues can also plague those living with a sensitivity.

Though not life-threatening, those living with a food sensitivity may find their symptoms disruptive to daily life if not adequately monitored: common complaints include joint and stomach pain, fatigue, rashes and brain fog. Many individuals who believe they may be experiencing food intolerance can start to identify the causes through the practice of keeping a food diary to track symptoms following the ingestion of certain foods.

How do I know if I have an allergy, intolerance, or sensitivity?

Testing methods have been developed to assist in discovering the root cause of your symptoms. Along with making a record of your medical history, a board-certified allergist is also trained in the analysis and administration of several allergy testing methods.

The skin-prick test is widely considered to be the most reliable of allergy tests. To perform this test, your allergist will prick or scratch a small sample of the suspected allergen on the skin’s surface. If allergic, a small area of swelling and redness will develop at the administration site. Not only is this test the most accurate, it is also quick and results in little to no pain. Patients will typically receive test results within minutes.

Blood tests may also be conducted to narrow down the cause of an allergy. These tests are used to measure the number of antibodies present to the specific food being tested. While skin prick tests are the top standard for identifying issues, blood tests are often helpful in conjunction with skin prick tests when doctors need more information. 

If you are experiencing any symptoms of an allergy, intolerance or sensitivity, reach out to your local, board-certified allergist today to discuss your symptoms and see if an allergy test may be right for you.

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