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

Did you know that only 4-5% of the adult American population has true allergies? Although many people suspect that they are allergic to something, it is more likely that what they suffer 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, leaving you feeling unwell, bloated and having digestive problems a day after eating something your body can’t tolerate, preventing you from losing weight or having the energy you’d like . have, but will not send you to the emergency services.

Allergies to tree nuts and shellfish are known to cause such severe allergic reactions that death can result from simply kissing someone who has recently eaten the offending food or from touching a table that has not been properly cleaned. This has resulted in “nut-free” classrooms, federal regulations on food labeling and some restaurants catering to people with allergies. One important 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 can get worse with each exposure. Anaphylactic shock can cause death if not treated quickly with an Epi-pen or similar medication to counteract the reaction. Other, sometimes severe, symptoms include wheezing, asthma and hives.

An intolerance to food, a food additive, environmental chemical, antibiotic or mold may not cause a reaction for hours or even days, but when the body tries to process the substance, symptoms appear. It is not life-threatening, but can be very uncomfortable. Up to 80-90% of Americans suffer from food intolerances and most are unaware 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 no, lactase, the enzyme that breaks down the lactose in dairy products. This intolerance usually develops over time, so adults may not have a reaction to milk products until they are in their 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 start producing gluten-free foods. An intolerance can 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.

Allergies cause the immune system to react and many are less severe than peanut allergies or bee sting allergies. Pollen and other allergies can be mild and respond well to antihistamines that reduce the body’s immune response to the trigger. The level of reaction varies from person to person, but one important 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 cannot process that substance, whether it is gluten, preservatives found in many foods, or certain antibiotics, fungi 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 in which people should treat the intolerance. Sensations 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 certain substance also depends on the amount of the substance and can vary from situation to situation.

The increase in those with allergies has been researched and documented, specifically in children, prompting the change in lunch menus and cafeteria rules. Although it is possible to work with your allergist to gradually reduce your reaction to an allergen with immunotherapy, it is often not used for severe allergies. Allergy shots, especially for hard-to-prevent environmental toxins like pollen, have been used for years and have 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 be done for severe allergies. For some severe allergies, it is best to avoid the allergen completely.

Intolerances have been recognized for decades, but it has taken time to help those who suffer and recognize the range of substances that can cause a reaction. People cannot link the frequent, or even constant, bloating and discomfort they feel for a while to their diet because the response is not immediate. Drinking a milkshake, if you’ve been doing it all your life, and then suddenly have bowel problems that night or the next day it can take some time to reconnect with the milkshake.

Testing for both allergies and intolerances and sensitivities has come a long way. Keeping a food and symptom diary and testing can provide a path to wellness, as most reactions are due to intolerances that cause 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 response to specific allergens. Testing for intolerances or sensitivities to food and environmental substances can also be done with a simple blood test that allows people to know which foods to completely avoid and which to reduce in their diet. Eliminating factors that cause bloating and inflammation can relieve symptoms and lead to feeling healthy and energetic. Better health may only be a blood test away!

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