One of the most common scenarios in my office is a client who comes in asking for help to find out their food allergies. It's always a bittersweet situation, because in many cases they probably don't have an actual food allergy but may have multiple food sensitivities and/or intolerances. Many clients are disappointed to hear that the reason for their symptoms isn't as simple as an allergy; however it can be a good thing for several reasons which differentiate allergies and sensitivities.

The main differences between a Food Allergy, Sensitivity, and Intolerance are:

• Timing /onset of symptoms
• Visibility of inflammation
• Dose dependent vs. dose-independent
• Mechanism by which the body responds

For one, allergies usually produce an immediate and often severe reaction such as hives, throat/mouth swelling, or vomiting/diarrhea within hours of exposure. These symptoms can be scary and even life-threatening if not treated promptly. Food sensitivity symptoms may not appear for days, but usually within 24-96 hours.

Allergies usually have a more visible response such as the symptoms mentioned above, whereas food sensitivities produce a more low-grade inflammation which may contribute to several minor (and perhaps seemingly unrelated) symptoms vs. one obvious response.

An allergic reaction can occur from even the smallest amount of ingested or exposed material, such as in the case of cross-contamination or even airborne particles in some cases. Food sensitivities, however, tend to build up based on the DOSE and FREQUENCY in which they're eaten, so symptoms take longer to develop, may not seem to relate directly back to one particular food, and may not be triggered consistently.

The Science Breakdown

These differences are due to how the body responds to a food or chemical substance. Immune particles called IgE antibodies govern an allergic response, but food sensitivities are mediated by non-IgE inflammatory messengers in the body such as cytokines, leukotrienes, and prostaglandins. These molecules still produce an inflammatory response, but not through the same channels as an allergy, hence the difference in reaction. Intolerances, which we haven't mentioned yet, are yet another reaction which are mediated by more of a mechanical response in the body where certain enzymes or a disruption in gut flora makes physically breaking down a food difficult (such as in the case of lactose intolerance).

Usually allergies are a longer-term or more permanent condition that can only be managed--not always reversed (although I have seen this happen in adults who develop sudden food allergies due to intestinal damage which then improves as the gut heals; or in children who "grow out" of an allergy).

Typically, there also is a much higher level of care that must be taken in order to prevent exposure via cross-contamination and airborne particles. So be glad you don't have an allergy if that's the case! The downside is food sensitivities can be trickier to figure out, because it may not be one thing but a combination of things that over time and in certain doses, all contribute to inflammation which eventually triggers symptoms. This is where testing (I personally like MRT as it detects chemical as well as food sensitivities and measures an inflammatory response, not just an antibody reaction). If you can't afford testing, a really thorough food journal can be helpful.

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