Food Allergies, Intolerances & Sensitivities: What's the Difference?

Good food translates to good health. This is common wisdom. However, sometimes even good whole foods can make a person sick. When fresh strawberries cause hives, a glass of milk causes stomach cramps and diarrhea, or daily bread products cause fatigue and bloating; then it is time to talk to your health care provider to determine whether an ordinary food may be causing your health problems.

In my clinical practice I spend a lot of time with each and every one of my patients reviewing their diet, encouraging balanced diets rich in whole foods, and when needed testing for food sensitivities and allergies. This article will outline the difference between food sensitivities, intolerances and allergies, common symptoms related with these food reactions, and what to expect with food sensitivity and allergy testing.

What’s the difference between food allergies, intolerances, and sensitivities?

Food allergies are IgE mediated immune reactions that cause immediate and sometimes life threatening reactions in the body. Breathing difficulties, anaphylaxis, skin eruptions such as hives, and digestive problems are common IgE reactions.

Food sensitivities and intolerances are not life threatening and are delayed reactions that contribute to chronic health concerns. These reactions are typically divided further into digestive and immune concerns.

Food intolerances are digestive in origin and typically refer to the inability of the body to break down the offending foods. Digestive intolerance symptoms often include cramping, bloating, and diarrhea. The most common digestive intolerance is lactose intolerance, where digesting diary becomes a problem. Most people with digestive intolerances can correlate symptoms to the ingestion of the offending foods, and testing is not necessary. Some people will benefit from taking digestive enzymes with every meal. However, if this doesn’t help, I would recommend seeing a naturopathic doctor for additional support.

Food sensitivities are delayed IgG mediated immune reactions. Symptoms take hours or days to develop, making it difficult to determine the food cause without testing. With food sensitivities, symptoms are incredibly individual, and each person will manifest them differently. However, common food sensitivity symptoms include fatigue, digestive disturbances, chronic skin rashes, weight gain, headaches, joint pain, mood and memory disturbances, and behavioral problems.

Can you develop food intolerances and sensitivities later on in life?

Food intolerances and sensitivities can develop at any point in life. A person who has never had any problems with food, may develop food reaction symptoms later on in life. Food intolerances and sensitivities can be triggered by many different factors. These factors include overconsumption of a particular food, genetic predisposition, poor digestion, environmental factors, and stress.

How can I get tested for food allergies and sensitivities?

An allergist typically tests for food allergies, however here in BC naturopathic doctors are also licensed to test for these immediate immune reactions. To get an appointment with an allergist you will need a referral from your family doctor. An allergist will test for food allergies through a scratch test or blood test, which is covered through MSP. A naturopathic doctor on the other hand, uses blood testing only for food allergies, which may be covered through your extended health insurance.

Naturopathic physicians are the go-to health care providers for food sensitivity testing. The test involves a finger prick or blood draw. Once the blood sample is taken, the sample is sent to the lab for testing, and your naturopathic doctor (ND) will receive your results within 10-14 days. At this time you will be called to book a follow-up visit with your ND to discuss your results.

What happens after I get my food sensitivity results?

If you test positive for any food, taking those reactive foods out of your diet for 3-6 months is recommended. In my practice I give detailed handouts on alternatives to your food sensitivities to ensure that proper nutrition is maintained. I also recommend starting a probiotic to help heel the gut from damage created from years of eating those food culprits.

Overtime it is common that the foods that a person was once sensitive to become less reactive. At the 3-6 month mark, re-introduction of these foods will determine whether or not you will need to continue avoiding them, or are able to eat these foods in small amounts. This is different from a food allergy, where the offending food will have to be avoided long term (sometimes indefinitely).

What about celiac disease?

Celiac disease is an autoimmune disorder of the small intestine caused by eating gluten, a protein found in wheat, barley, rye, spelt, and kamut. Overtime, this immune reaction produces inflammation and damages the small intestinal cells which causes malabsorption of nutrients. The intestinal damage can cause weight loss, bloating and sometimes diarrhea. Anemia, loss of bone density, headaches and fatigue, joint pain, numbness and tingling, acid reflux and an itchy blistery skin rash (dermatitis herpetiformis) are other common symptoms. In children, malabsorption can affect growth and development. The intestinal irritation can cause stomach pain, especially after eating.

Your naturopathic physician or family doctor can test you for celiac disease. The blood test ordered is called tissue transglutaminase (ttg). If you have a positive ttg test, your doctor may refer you for a small intestinal biopsy to confirm the disease. The management of celiac disease involves strict life-long avoidance of gluten, and nutritional supplementation to heal the damaged intestinal lining.

In health and happiness,

Dr. Meghan van Drimmelen | Naturopath Victoria BC