Food Allergies VS Hypersensitivities VS Intolerances
A RANGE OF REACTIONS
How you manage a food sensitivity depends on the type and severity of the reaction.
Severity can range from minor stomach discomfort to dangerous anaphylactic shock.
CAN I JUST TAKE A FOOD SENSITIVITY PANEL?
A food hypersensitivity test provides a snapshot of how your body is responding to the foods you are eating at that time.
It can be helpful for identifying trigger foods, managing symptoms, and allowing the body to heal, but should not be the only thing to guide eating decisions.
HYPERSENSITIVITY
IMMUNE REACTION: Th1 (same reaction to bacteria & viruses)
ANTIBODIES & CYTOKINES: IgG, INFgamma
IMMUNE FACTORS: histamine, leukotrienes, prostaglandins, inflammatory cytokines, etc
RESULT: inflammation & oxidative stress
SYMPTOMS: GI issues, headaches, brain fog, skin issues, sinus pressure, etc
RESPONSE TIME: hours to days
FOOD TRIGGERS: strawberries, corn, soy, chocolate, dairy, gluten, etc
ENVIRONMENTAL TRIGGERS: latex, poison ivy, nickle, etc
TESTING: blood IgG, MRT panel
MANAGEMENT: diversify diet, heal gut, slowly reintroduce if possible
ALLERGY
IMMUNE REACTION: Th2 (same reaction to worms)
ANTIBODIES & CYTOKINES: IgE, IL-4, IL-5, IL-15
IMMUNE FACTORS: histamine, enzymes, mucus
RESULT: swelling & histamine release
SYMPTOMS: hives, diarrhea, swelling of lips/eyes/ears, anaphylaxis
RESPONSE TIME: immediate
FOOD TRIGGERS: peanuts, nuts, fish, shellfish, eggs, soy, sesame, wheat, whey
ENVIRONMENTAL TRIGGERS: pollen, bee stings, animals, etc
TESTING: oral food challenge, blood IgE, skin-prick
MANAGEMENT: limit exposure (if severe, complete avoidance)
INTOLERANCE
REACTION: not immune, but digestive
PHYSIOLOGY: poor absorption from intestinal injury, dysbiosis, or insufficient enzyme production
RESULT: bacterial fermentation
SYMPTOMS: gas, bloating, intestinal pain, diarrhea, etc
RESPONSE TIME: usually 15-90 minutes
FOOD TRIGGERS: lactose in dairy, fructose in fruit/honey/HFCS, fats & oils
TESTING: oral food challenge, breath tests
MANAGEMENT:
dairy: increase consumption to increase lactase production
fructose: temporarily decrease consumption & support gut healing
fats & oils: consume with more fiber, improve quality, support liver/gallbladder function
A Th1 (hypersensitivity) and Th2 (allergy) reaction occur in balance with one another, like a teeter-totter. The ideal reaction to a food is tolerance, when neither hypersensitivity nor allergy is triggered.
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References
Venter C. (2012). Food hypersensitivity: diagnosing and managing food allergies and intolerances. Journal of allergy, 2012, 576017. https://doi.org/10.1155/2012/576017
Valenta, R., Hochwallner, H., Linhart, B., & Pahr, S. (2015). Food allergies: the basics. Gastroenterology, 148(6), 1120–31.e4. https://doi.org/10.1053/j.gastro.2015.02.006
Yu, W., Freeland, D., & Nadeau, K. C. (2016). Food allergy: immune mechanisms, diagnosis and immunotherapy. Nature reviews. Immunology, 16(12), 751–765. https://doi.org/10.1038/nri.2016.111
Gargano, D., Appanna, R., Santonicola, A., De Bartolomeis, F., Stellato, C., Cianferoni, A., Casolaro, V., & Iovino, P. (2021). Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns. Nutrients, 13(5), 1638. https://doi.org/10.3390/nu13051638