Food Allergy v. Food Intolerance

You may be one of the more than 12 million Americans suffering from food allergies, or you may be one who just thinks they’re allergic.

There’s a big difference between a food allergy and a food intolerance, and it’s a really important difference to know.

“Basically, with a food allergy it’s a cascade of reaction that can be life-threatening, whereas intolerance is just the inability to digest your food,” said Dr. Jackie Eghrari-Sabet, of Family Allergy & Asthma Care in Gaithersburg, Md.

Food allergy has been called a disability that you can’t see, and it’s becoming more prevalent in younger generations. Allergies to peanuts and shellfish are two of the most common. Allergic reactions can range from mild cases of hives or lip-swelling to severe cases of throat-swelling, difficulty breathing, unconsciousness and death.

“You will never die from a food intolerance,” said Dr. Jackie. “It’s really just limited to GI problems and tummy upset, and the most common offenders in this category are lactose and gluten."

There are three steps to a getting a proper diagnosis. The first step is to get a blood test known as an immunoCAP.

“You need to ask for it by name. It’s a specific blood test to a specific food,” according to Dr. Jackie.  “If you think you are allergic to a certain food and you haven’t had this test, or if you’ve had the older form of this test, you really need to get the new test."

The second step is component testing.

“If the blood test results show you are allergic to a certain food, there are sometimes different components that may be cross reactive,” Dr. Jackie said. “That’s particularly true for people who think they’re allergic to something that grows on a tree or to vegetables or shellfish. Component testing will determine whether you are really allergic to that food or to a piece of the food.”

If the component testing proves negative, doctors can perform a food challenge to further gauge your sensitivity. This involves eating small portions of the suspect food under strict doctor’s supervision in the doctor’s office. Once you’ve completed these tests, you’ll know for sure whether a specific food will cause you to react.

But here’s the good news! Allergies don’t have to last for life. There is a lot of new research.

“For one, we now have the ability with some foods to help people outgrow their allergies by doing what’s called  tolerance building,” Dr. Jackie said. “This, too, is only done in the doctor’s office.  Patients get small amounts of foods, such as milk and egg product, until they are able to eat it without reacting at all.

Unfortunately, there is no treatment for a food intolerance, other than avoiding it.

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