January 10, 2022

The Difference Between Food Allergies and Sensitivities

Many people use the phrases “food allergies,” “food intolerance,” and “food sensitivity” interchangeably.

Medically, however, there is a big difference. What is that difference, and what can you do about them?

Difference between food allergies and food intolerance

The primary difference between a food intolerance (or sensitivity) and a food allergy is in the reaction. A food intolerance primarily involves the digestive system, while a food allergy involves the immune system.

Reaction time and symptoms also may differ. Food allergies typically trigger reactions more quickly than sensitivities.

Definition of food intolerance

Food intolerance, or food sensitivity, occurs in people who cannot properly digest a kind of food. The cause may be food additives, or an enzyme deficiency that makes it difficult to break down the food (as in lactose intolerance).

Most people with an intolerance can eat small amounts of the food without problems. Many people with lactose intolerance can take an enzyme that allows them to eat dairy.

While uncomfortable, the symptoms of a food intolerance are not life-threatening. Symptoms may include:

● Nausea

● Gas

● Cramps or abdominal pain

● Diarrhea

● Irritability or nervousness

● Headaches

Definition of food allergies

With a food allergy, the immune system reacts to a food as if it were a harmful invader. The

immune system produces antibodies called Immunoglobulin E (IgE), which travel to cells that

release chemicals and create an allergic reaction.

For example, a person’s immune system may produce IgE to fight a protein in cow’s milk. This is a different type of reaction than if the person only lacked the enzyme to digest milk.

Food allergy symptoms can be (but aren’t always) life-threatening. Symptoms may resemble a food intolerance, or may include:

● Difficulty breathing

● Throat tightening

● Hoarse voice

● Coughing

● Vomiting

● Swelling or puffy skin

● Itching or hives

● Drop in blood pressure

● Anaphylaxis

How to test for food allergies

At Aspire Allergy & Sinus, we can test and treat common food allergies in children as young as 4 months. We have three different options for food allergy testing:

1. Skin testing

Skin tests involve lightly pricking the patient’s skin with a tiny drop of a liquid form of the food allergen. We then check the results by measuring the reaction on the skin.

The presence and severity of allergies determines what the reaction looks like. There may be just a little redness, or a raised bump that looks like a mosquito bite. A raised bump usually means there is an allergic reaction.

2. Blood testing

A blood test for food allergies detects and measures the amount of allergen-specific antibodies in your blood. We send your blood sample to an outside lab for testing, which usually takes 1-2 weeks. The lab then sends results to your specialists at Aspire Allergy & Sinus.

3. Oral Food Challenge

If a skin or blood test is inconclusive, we may recommend an oral food challenge. This test involves eating or drinking small portions of a food in increasing amounts. A doctor supervises

this process to watch for an allergic reaction.

Oral food challenges are considered the gold standard for diagnosing food allergies.

The oral food challenge method of food allergy testing may sound scary, but all food challenges at Aspire Allergy & Sinus clinics are performed with three important elements:

1. Supervision by a board-certified physician.

2. Safety, with emergency medications ready for use if necessary.

3. Incremental doses of the allergen, given under close observation. If no symptoms develop after 20 minutes, the test proceeds with a slightly larger amount of food. This process is repeated over the course of 3-4 hours, with the goal of reaching a full serving size of the allergen food.

How to treat food allergies

Many people have found success in treating food allergies with oral immunotherapy (OIT). More than 80 percent of patients are able to eat foods that formerly threatened their health within 6 months of OIT treatment.

Much like the oral food challenge, an OIT patient receives small amounts of a food to decrease their sensitivity. This dose gradually increases over about 6 months.

Because OIT involves the use of allergenic foods, there is a risk of anaphylaxis. Our staff carefully supervises all OIT patients, and all treatments and test are overseen by a board-certified allergist.

The OIT process involves four phases:

1. Initial dosing: Patients receive seven to 13 doses in a single day over a 4-6 hour time period, under physician supervision.

2. Build-up dosing: This dose is increased incrementally every 1-2 weeks under observation until the maintenance dose is reached. This process usually takes about 6 months.

3. Maintenance dosing: Based on physician recommendation, doses are taken daily for years.

4. With the maintenance doses, patients get long-term resistance and the ability to consume foods that previously threatened their health.

What food allergies does OIT include?

Aspire Allergy & Sinus offers oral immunotherapy treatment for the following foods:

● Egg

● Milk

● Peanut

● Almond

● Cashew

● Macadamia Nut

● Hazelnut

● Pecan

● Pistachio

● Walnut

● Wheat

● Soy

OIT can help your family enjoy a healthier, less stressful life. Read about our patient success stories to learn how we can help you build food allergy tolerance.

About The Author:

Stacy Silvers, MD