Food Allergies and Food Intolerances, Understanding the Differences

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Our daily lives are incomplete without food. It provides nourishment, enjoyment, and sustenance. Certain foods can cause adverse reactions in some people. Food allergies and intolerances are two of the most common types of reactions. Although they may have some similarities in symptoms, their underlying mechanisms and treatment differs significantly. This comprehensive guide will explore the differences between food intolerances and allergies, their symptoms, diagnosis and treatment.

Allergies to Food

Food allergies are immune system reactions to specific proteins found in food. Even tiny amounts of allergenic foods can trigger these immune reactions, which can cause a variety of symptoms. Some of them can even be life-threatening. The “big eight” food allergens are the most common.


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Food Allergies: Mechanism and Treatment

A person with food allergies mistakenly believes that certain proteins are harmful when they consume the allergenic food. The body responds by releasing a flood of chemicals including histamines. This leads to an array of allergic reactions.

Food Allergies Symptoms

Food allergies can lead to a variety of symptoms including:

Hives or skin rash

Lips, tongue or throat swelling

Watery or itchy eyes

Nasal congestion

Coughing or wheezing

Gastrointestinal symptoms such as nausea, vomiting diarrhea or abdominal pain

Anaphylaxis is a severe reaction, which can be life-threatening. It can cause difficulty breathing, low blood pressure and even loss of consciousness.

Food allergies can occur at any age. Even trace amounts of allergenic foods can cause a reaction for some people.

Diagnosis and Treatment of Food Allergies

Food allergies are diagnosed by combining a medical history with a physical exam and specialized tests. Food allergies can be diagnosed using the following methods:

Skin Prick Test – A tiny amount of allergenic food extract is applied to the skin and then a small prick is made. This allows the substance into the skin. A raised bump or rash is indicative of a food allergy.

Blood Tests – These tests determine the level of specific antibodies, like immunoglobulin E antibodies (IgE antibodies), in the blood. A high IgE level to a specific food could indicate an allergy.

Oral Food Challenge (OFC): The individual is monitored by a doctor as they consume increasing amounts of suspected allergenic foods to see if there are any reactions.

Elimination diet: This involves gradually reintroducing the suspected food while monitoring symptoms.

Patch Test: The patch contains the allergenic substance and is applied on the skin. Any skin reactions are then observed.

Food Allergies: Management and Prevention

Food allergies are not curable at this time. The management of food allergies involves avoiding the allergenic foods and being prepared for possible reactions. Food allergy sufferers should:

Be sure to read food labels carefully. Look for allergen statements, and be alert to hidden allergen sources.

Inform food service providers and restaurants: If you are dining out, make sure to inform the staff of your allergies and that they understand how important it is to avoid cross-contamination.

Bring epinephrine with you: A life-saving epinephrine injector can be used for severe allergic reactions. Food allergy sufferers should always carry an epinephrine auto-injector.

Family and friends should be educated: Make sure that your family and close friends are aware of any food allergies you may have and the importance of avoiding foods with allergens.

Food Intolerances

Food intolerances can be defined as adverse reactions that are not immune-mediated. These reactions are usually caused by the digestive system not being able to properly process and metabolize certain compounds. Food intolerances tend to be less severe than allergies, and they do not cause life-threatening reactions.

Mechanism of Food Intolerance

There are many reasons why food intolerances occur, including:

Enzyme Deficiency – Some people lack the enzymes necessary to properly digest certain foods. Lactose intolerance, for example, occurs when the body does not have the enzyme lactase. This is needed to break down the lactose sugar in milk.

Food Additives Sensitivity: Some people can have adverse reactions to additives such as sulfites which are used in wine and dried fruits to preserve them.

Chemical Sensitivity – Sensitivity towards naturally occurring compounds, such as histamine and tyramine in food, can cause intolerance reactions. Histamine intolerance, for example, can cause symptoms such as headaches and skin irritation.

Food intolerance symptoms

Food intolerance symptoms can be varied but include:

Symptoms of the digestive tract: Gas, stomach cramps, or bloating.

Nausea or vomiting


Hives, eczema or other skin rashes.

Respiratory symptoms include wheezing and nasal congestion.

Migraines and headaches

Food intolerances are not as severe as food allergies. Symptoms usually do not appear immediately after eating the food that is causing the problem.

Diagnosis and Treatment of Food Intolerances

Food intolerances are more difficult to diagnose than allergies, because there is no definitive test. Diagnosis usually involves:

Food Diary: Keep a detailed log of the foods you eat and any symptoms that you experience. This can help to identify possible intolerances.

Elimination diet: Remove the suspected food and monitor for improvement in symptoms. Gradual reintroduction may help confirm intolerance.

Breath tests: These tests are used to identify intolerances such as lactose and fructose by measuring the gasses released in the breath following the consumption of certain substances.

Blood Tests. Specific tests are available to determine lactose and fructose tolerance by measuring the blood glucose level after consumption of the problematic substance.

Management of Food Allergies

In order to manage food intolerances, it is important to identify and avoid the food or substance that causes the reaction. It may be necessary to make dietary changes and pay attention to the labels of ingredients. Enzyme supplements can help people with enzyme deficiencies to process certain foods better.

What are the differences between food allergies and food intolerances?

It is important to distinguish between food allergies and intolerances for accurate diagnosis and management.

Immune System: Food intolerances and allergies are not related to the immune system.

Food intolerances and allergies are usually less severe than food allergies.

Food intolerances and allergies can have different onset times.

Diagnostic Tests** Skin prick tests or blood tests can confirm food allergies. Food intolerances can be diagnosed by elimination diets or food diaries.

Management:** The main management of food allergies is to avoid the allergen, carry epinephrine and educate yourself about it. Food intolerances can be managed by avoiding specific foods or substances that cause the intolerance.

The conclusion of the article is:

Food intolerances and allergies are two different things. Food allergies can be severe and cause immediate reactions. However, food intolerances tend to be less severe. They are caused by the body’s inability to process certain food components. You should consult a medical professional if you think you may have a food intolerance or allergy. This will ensure that you are well and that you can enjoy your diet.

Credit:  Saray Clinic & Anberry Hospital

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