Allergies, Sensitivities and Intolerances: What’s the Difference?

Wang Yan
Wang Yan

Global Courant

Did you know that only 4-5% of the adult US population has true allergies? Although many people suspect they are allergic to something, it is more likely that what they are suffering from is an intolerance or a sensitivity. The distinction may not seem important, but knowing the difference, especially for severe reactions, can be critical. True food allergies can be life-threatening, while feeling unwell, bloated and having digestive problems as much as a day after you have eaten something that your body can’t tolerate could be preventing you from losing weight or having the energy you would like to have, but will not send you to the emergency room.

Allergies to tree nuts and shellfish have been known to cause such severe allergic reactions that death can result from merely kissing someone who has recently eaten the offending food or from touching a table that hasn’t been cleaned thoroughly. This has resulted in “nut-free” classrooms, federal regulations on food labeling and some restaurants catering to those with allergies. One significant characteristic of a food allergy is that the onset of symptoms is immediate and with some allergies such as peanuts or bee stings the allergic reaction may get worse with each exposure. Anaphylactic shock can cause death if not treated quickly with an Epi-pen or similar medication to counter the reaction. Other, sometimes severe, symptoms include wheezing, asthma and hives.

An intolerance to food, a food additive, environmental chemical, antibiotics or mold may not cause a reaction for hours or even days, but when the body tries to process the substance symptoms show up. It is not life-threatening but can be very uncomfortable. Up to 80-90% of Americans suffer from food intolerances and most are not aware of it. Two food intolerances that most people have heard of are lactose intolerance and gluten intolerance. With a lactose intolerance, the body does not produce enough, or even any, lactase, the enzyme that breaks down the lactose found in dairy products. This intolerance usually develops over time so adults may not have any reaction to milk products until they are in the 40s. A gluten intolerance is the inability to process gluten, a component of many foods such as wheat, rye and barley and is found in many processed foods. The increased awareness of gluten intolerance has caused many food companies to begin producing gluten free foods. An intolerance may cause symptoms such as weight gain, eczema, irritable bowel syndrome, fatigue, excess gas, bloating and swelling of some body parts, such as hands or feet. It is important to distinguish between a gluten intolerance, a gluten allergy or Celiac disease, an auto-immune disease in which the body reacts similar to an allergy and can cause weight loss.

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Allergies cause the immune system to react and many are less severe than the peanut allergies or bee sting allergies. Pollen and other allergies can be mild and respond well to antihistamines which reduce the body’s immune response to the trigger. The level of reaction varies from person to person, but one key factor in identifying an allergy is that a specific person’s reaction is the same every time they are exposed to that allergen, regardless of the amount. Intolerances do not provoke an immune response but cause discomfort and health problems because the body can’t process that substance, be it gluten, preservatives found in many foods, or certain antibiotics, molds or environmental chemicals. The reaction to an intolerance varies from person to person, but also varies depending on how much of the substance the person is exposed to. Some people with gluten intolerance can ingest a small amount and not have a reaction, resulting in different levels of intolerance and different ways people should handle the intolerance. Sensitivities are less well understood and generally cause symptoms such as acid reflux, nausea or abdominal cramps but, as with intolerances, do not involve the immune system. Someone’s reaction to a particular substance is also dependent on the amount of the substance and may vary from situation to situation.

The increase in those with allergies has been researched and documented, specifically in children, giving rise to the change in lunch menus and cafeteria rules. Although it is possible to work with your allergist to slowly lower your reaction to an allergen with immunotherapy, it is frequently not used for severe allergies. Allergy shots, especially for environmental toxins that are hard to avoid, such as pollen, have been used for years and been shown to reduce allergic reactions over time. Research is being done to find ways to build resistance to allergens, but there is still a lot of work to do for severe allergies. For some severe allergies it is best to completely avoid the allergen.

Intolerances have been recognized for decades but it has taken time to help those who suffer and to recognize the range of substances that can cause a reaction. People may not link the frequent, or even constant, bloating and discomfort that they feel to their diet for quite some time because the reaction isn’t immediate. Drinking a milkshake, when you’ve done it all your life, and then having sudden intestinal issues that night or the next day may take some time to connect back to the milkshake.

Testing for both allergies and intolerances or sensitivities has come a long way. Keeping a food and symptom diary and getting tested can provide a path to wellness since most reactions are due to intolerances that are causing the discomfort. Allergy testing no longer requires multiple skin pricks but can be done with one simple blood draw that measures the immune system’s reaction to specific allergens. Testing for intolerances or sensitivities to food and environmental substances can also be done with a simple blood test that will let people know which foods they should avoid completely and which to reduce in their diet. Eliminating factors that are causing bloating and inflammation can relieve symptoms and lead to feeling healthy and energetic. Better health may only be a blood test away!

Allergies, Sensitivities and Intolerances: What’s the Difference?

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