Food Allergy vs. Food Intolerance: Which are you?

A common question I ask my patients is, “Are there any foods that you avoid?” The answers range anywhere from “absolutely not” to a very long list. I ask this question because I find the things you put in your mouth may be affecting all of those symptoms you just described.

Fatigue? Gas and Bloating? Headaches? Constipation? Rashes? Acne? Joint pain? PMS?
Yes – they can all be food related.

As the commercials on television will tell you (and it is true) 70%-80% of your immune system lives right around your intestines. It is a smart maneuver in human design because anything you eat, breathe, swallow, and drink goes right into your gastrointestinal tract. Therefore the cereal you had for breakfast is evaluated just the same as the flu-bug you inhaled while waiting in line for coffee…then your immune system has to decide - friend or foe?

Many of us would assume the flu-bug must be destroyed and the cereal can live to see another day, right? Well, what if you put milk in your cereal and you shouldn’t have milk? What if your cereal is made up of wheat flour and you’re sensitive to wheat? What if your cereal also has soy crunchies for extra protein and soy is the enemy?
What if you didn’t know?

There are two main types of responses that can occur. One is the typical ‘food allergy.’ Most common examples are the people who eat nuts and have an anaphylactic reaction, drinking citrus juice causes their lips to swell up and dairy sends them running for the bathroom. It is an immediate response and governed by an immune antibody called, IgE.

The second type of response is non-IgE-mediated or known as IgG. This is a delayed response and may not produce a symptom for 2 hours to 48 or even 72 hours. This means if you drink a glass of milk on Monday, you may not notice any symptoms until Tuesday or Wednesday. What if you drink a glass of milk all the time? Then these symptoms could be a problem everyday because you are stringing along your delayed responses.

Remember that not all food related symptoms are intestinal problems. I commonly hear patients report no gas and bloating, no constipation and no diarrhea. Then they complain of being tired all the time, mild headaches that come and go, dry skin, bad PMS, hot flashes, chronic stuffy nose or constantly clearing their throat….this can be food related too.

A quick peak in the research shows overwhelmingly that the most common allergies (IgE) are Peanuts, Tree Nuts (cashews, almonds…etc.), Seafood, Wheat, Dairy, Egg and Soy. Interestingly enough, these are also the most common intolerances (IgG) just a slightly different order: Wheat, Dairy, Soy, Egg, Seafood, Tree Nuts, and Peanuts.

In my experience, I see smaller odd-ball foods too that produce large ‘Ah-ha!’ moments when discovered on testing. “Dr. Jones – I eat that everyday!” “Dr. Jones, I grew up on those.” “Dr. Jones, I take that as a supplement.”

So what do you do? First consider getting tested for both IgE and IgG food categories. Many doctors are familiar with the IgE testing but not with IgG testing so you may have to do some research. If you can not test then the easiest and cheapest is straight forward elimination. I recommend taking the top two, wheat and dairy, and get them out of your diet. I am not kidding. Go on a wheat-free, dairy-free diet for a full month and see how you feel. There are several resources on-line and many grocery stores now that offer a variety of options. You will not starve – I promise.

Of course the food you eat is probably not responsible for ALL of your symptoms but it could be perpetuating an unhealthy cycle. For example, allergies and intolerances might not be the only reason for your joint pain but the inflammations they produce make your pain that much worse.

If you are going to eat three meals a day anyway, then you might as well make them worth your while. Say good-bye to foods that are not benefiting your health and take note of the changes in your symptoms. You just might have an “Ah-ha” moment too.