Food Allergies, Intolerances, and Sensitivities

Definition

Food Allergy, Food Intolerance, and Food Sensitivity are terms often used interchangeably but represent distinct health issues, each requiring its unique diagnosis and treatment approach. The long-term consumption of food allergens is particularly concerning as it may lead to behavioral and mood changes, underscoring the importance of early diagnosis and intervention.

Food Allergy represents a severe immune system response to seemingly harmless food substances. This condition can emerge at any stage in life, from childhood through to adulthood. Notably, food allergies have been increasing, especially among children. From 1997 to 2011, the incidence of food allergies in American children rose by 50 percent. Currently, about 1 in 13 children and 1 in 25 adults in the United States suffer from a potentially life-threatening food allergy. True food allergies involve the immune system producing immunoglobulin E (IgE) antibodies to specific foods, triggering reactions that can affect the skin, respiratory tract, or gastrointestinal tract. In severe cases, an allergic reaction can become life-threatening, necessitating immediate treatment with epinephrine.

Food Intolerance is even more prevalent than food allergies and is believed to affect up to 20 percent of the population in industrialized countries. Unlike food allergies, food intolerances are not IgE mediated and are often the result of specific enzyme deficiencies, impaired food absorption, or other gastrointestinal issues. Conditions such as Celiac Disease, Non-Celiac Gluten Intolerance, FODMAP Intolerance, and Lactose Intolerance fall under this category. While food intolerances typically don’t provoke the dramatic or immediate reactions seen with food allergies, they are equally significant and can lead to severe health consequences if left unmanaged.

Food Sensitivity encompasses symptoms experienced by a significant portion of the population after consuming certain foods, distinct from those caused by food intolerances or allergies. The exact biological processes involved in food sensitivity remain a topic of debate; however, exposure to specific foods appears to elicit an immune response leading to various symptoms. While these symptoms are not life-threatening, they can significantly disrupt daily life. Common food sensitivities include gluten, conventional dairy, eggs, corn, soy, nuts, and nightshades.

Each of these conditions—food allergy, food intolerance, and food sensitivity—highlights the complex relationship between our bodies and the foods we consume. Understanding and distinguishing between these issues is crucial for effective management and maintaining long-term health.

Causes/Risk factors:

*Self-Explanatory*

Signs and Symptoms:

Food Allergy

• Feeling dizzy or lightheaded
• Itchy skin or a raised rash (hives)
• Swelling of lips, face, and eyes
• Coughing, wheezing, breathlessness, noisy breathing or a hoarse voice
• Sneezing or an itchy, runny or blocked nose
• Feeling sick or being sick
• Stomach pain
• Diarrhea 

Food Intolerance

• Nausea
• Vomiting
• Respiratory problems
• Brain fogginess
• Skin reactions
• Diarrhea
• Bloating
• Rashes
• Headaches
• Nausea
• Fatigue
• Abdominal pain
• Runny nose
• Reflux
• Flushing of the skin

Food Sensitivity

• Acne
• Congestion or runny nose
• Constipation
• Depression
• Diarrhea or loose stools
• Flare of immune symptoms
• Heartburn
• Immune system impairment
• Insomnia
• Inflammatory bowel disease or IBS
• Malabsorption of vitamins and minerals
• Rashes, eczema, or swelling
• Sinus infections
• Weight gain
• Joint pain or inflammation
• Stomach pain
• Fatigue
• Rashes 
• Brain fog

Diet and Lifestyle Considerations:

In the face of increasing occurrences of allergies, intolerances, and sensitivities in recent years, it’s crucial to examine potential co-factors that may contribute to these conditions. Understanding and addressing these aspects can play a significant role in management and prevention strategies.

• Medications and Antibiotics: The widespread use of medications and antibiotics has been linked to changes in our gut flora, potentially weakening our immune system’s ability to distinguish between harmful invaders and harmless substances, including food.
• Environmental Toxins: Our daily exposure to various environmental toxins can overload our bodies’ detoxification systems, contributing to heightened immune responses to foods.
• Infections: Certain infections can trigger or exacerbate immune responses to foods, indicating the importance of maintaining a robust immune system.
• Over Sanitization: While cleanliness is crucial, over sanitization can reduce our exposure to beneficial microorganisms that help train our immune systems, leading to increased sensitivity to potential allergens.
• Processed Foods: The high consumption of processed foods, which often contain additives, preservatives, and artificial ingredients, can irritate the gut lining and immune system, increasing the risk of food-related reactions.
• Stress: Chronic stress can negatively impact gut health and immune function, making the body more susceptible to allergies, intolerances, and sensitivities.
• Chemicals: Our environment is laden with toxic chemicals, from the air we breathe to the products we use daily. While some exposures are beyond our control, opting for natural alternatives when possible can reduce the overall chemical burden on our bodies.

In addressing diet and lifestyle considerations, it’s essential to focus on whole, unprocessed foods that support gut health and immune function. Incorporating a variety of fresh fruits and vegetables, lean proteins, healthy fats, and whole grains can provide the nutrients necessary for a strong immune system. Additionally, practices such as regular exercise, adequate sleep, stress management techniques, and minimizing exposure to toxins can support overall health and reduce the likelihood of developing food-related health issues.

Integrative Treatments Overview:

Living with the discomfort of food allergies, intolerances, or sensitivities can be challenging, often leading individuals to seek temporary management solutions. However, for lasting relief and proper management, accurate diagnosis through comprehensive testing is crucial.

Testing

The first and most critical step in addressing these health issues is thorough testing, which provides a detailed look at the digestive system’s condition. Consider the following tests:

• Intestinal permeability (leaky gut)
• Calprotectin
• Pancreatic elastase 1
• Bile acid
• Cholic acid
• Chenodeoxocholic acid
• Lithocholic acid
• Acetic acid
• Butyric acid
• Propionic acid
• Valeric acid
• Total SCFAs
• SS-glucuronidase
• Bacterial species involved with SIBO, IBS, IBD
• Fungal species
• Parasites and worms
• Viruses

Treatment

Upon obtaining a comprehensive understanding of an individual’s unique health profile through testing, personalized treatment strategies can be formulated:

• Elimination Diet: This involves removing suspected allergens from one’s diet and later reintroducing them to identify the culprits.

Rotational Eating: A method to prevent overexposure to potential allergens by rotating foods, thereby reducing the likelihood of developing new sensitivities and promoting gut health.

Nutritional & Environmental Medicine Overview:

In addressing food allergies, intolerances, and sensitivities, adopting specific approaches tailored to each condition is crucial for effective management and, in some cases, can lead to significant improvement or resolution of symptoms.

It is recommended that a patient consult a certified practitioner to assess their symptoms and case history and explore their individual needs. 

Food Allergies: The primary strategy involves comprehensive allergy testing and treatment, particularly for severe symptoms such as significant rashes, faintness, facial swelling, and breathing difficulties. It’s crucial to read ingredient labels carefully to avoid allergens and carry epinephrine shots for emergencies, which can be lifesaving in cases of accidental ingestion or contact with the allergen.

Food Intolerances: Unlike allergies, which are typically lifelong, food intolerances may be addressed by improving gut health. Strategies include:

• Increasing stomach acid through supplementation and herbs to aid digestion.
• Undergoing testing and treatment for Small Intestinal Bacterial Overgrowth (SIBO) or other intestinal pathogens to restore healthy gut flora.
• Incorporating sauerkraut, fermented foods, and probiotic supplements into the diet.
• Consuming fermentable fiber for its prebiotic benefits, enhancing microbiota.
• Drinking bone broth to support gut lining repair with its gelatin, glycine, and glutamine content. A budget-friendly method to identify food intolerances involves a 30-day Paleo reset diet, eliminating common triggers and systematically reintroducing them. For severe reactions or conditions like IBD, IBS, or ulcerative colitis, the Paleo autoimmune protocol (AIP) diet may offer additional insights by removing more potential irritants, with studies showing significant clinical remission in IBD patients.

Food Sensitivities: The elimination diet remains a foundational tool for identifying food sensitivities, involving the removal of suspected foods for two to four weeks, followed by careful reintroduction and symptom monitoring. This process can pinpoint problematic foods, enhancing overall well-being. Additionally, given the dynamic nature of our bodies and immune systems, previously sensitive foods might be reintroduced over time to test for current tolerance levels.

The management of food-related health issues extends beyond simple avoidance. It encompasses a holistic approach that includes dietary adjustments, environmental changes, and, importantly, a focus on gut health. Working closely with healthcare professionals for testing, dietary planning, and monitoring can provide a structured path towards managing these conditions effectively.