The Difference Between a Food Allergy, Intolerance and Sensitivity
Updated: Apr 15
In my practice I do a lot of food sensitivity testing. It's a simple blood test and can make a huge difference when I'm working with someone on almost any condition. The gut is home to 70% of our immune cells so controlling inflammation at this level is so important.
I always ask my patients about how well they are digesting their foods to get a sense of how well they are absorbing what they eat, if they are eliminating well and if further testing would be useful. I find that using testing to figure out food sensitivities can be very useful and take the guesswork out of this part of treatment.
The Difference Between Allergy, Intolerance and Sensitivity
The terms "food allergy," "food intolerance," and "food sensitivity" get thrown around a lot and used interchangeably, but what is the difference between these terms when it comes to knowing what to do for treatment?
Food allergy - When we are exposed to a food or environmental substance there are a few different reactions that can happen in our body. The most serious reaction is an allergy where a person goes into anaphylaxis and their throat closes up and they can't breathe. People with these types of reactions may need to carry around an Epi-Pen. Common food allergies include tree nuts, peanuts, shellfish and eggs.
Food Intolerance - A food intolerance is when you are unable to digest and break down a food. This type of reaction doesn't cause an immune response like an allergy or sensitivity. Symptoms of an intolerance are usually limited to the digestive tract and can include stomachache, diarrhea and bloating. An example of a food intolerance is lactose intolerance in people who don't produce the enzyme lactase.
Food sensitivity - The third type of reaction is a food sensitivity and this is what food panels are testing for and are more common than you might think. This type of reaction can be more confusing to figure out because it may not be immediate like a food allergy. It may take days for a reaction to show symptoms, making it hard to pinpoint what the food culprit is unless you track what you eat. A food sensitivity can also have many different symptoms both inside or outside the digestive tract. Symptoms can be broad and include brain fog, fatigue, anxiety, depression, insomnia, rash, joint pain, PMS, bloating, cramping, diarrhea, or constipation.
A food sensitivity causes an immune reaction leading to leaky gut or gut permeability. Your gut lining becomes "leaky" and lets substances through and into your blood stream that wouldn't usually be there. This can cause a body-wide reaction and is why you can have symptoms that seem unrelated to your digestive system.
Elimination-Rechallenge Diet and Gut Healing
Because symptoms can be broad and take days to show themselves, a food sensitivity test can be very useful to pinpoint which foods are causing issues. Once you know which foods to take out of your diet, the next step is an elimination-rechallenge diet for at least 6-8 weeks. Removing the foods for that long helps to start the gut healing process and resolve symptoms. If you've had symptoms or eaten a food for a long time it may be beneficial to remove the food for 3-6 months before re-introducing it back into your diet.
It's important to know that an elimination diet is temporary. You're not meant to stay on this type of a restrictive diet forever. It's a tool to help you and your healthcare provider identify which foods are causing symptoms. After an elimination diet you can re-introduce foods one by one to see if you have a reaction and how severe that reaction is.
Changing the diet is part of the plan but gut healing is also an important step in the healing process. For this part I like to recommend digestive enzymes, probiotics, L-glutamine and soothing herbs like licorice, marshmallow, slippery elm and aloe.
If you want to learn more about how to do an Elimination Diet check out my Elimination Diet Guide with a sample meal plan and recipes!
Testing can be helpful for determining whether someone has an allergy, intolerance or sensitivity. These terms get thrown around a lot and I wanted to shed some light on what they mean. A food allergy is a serious medical condition and common allergens include shellfish, eggs, and nuts. A food intolerance is when you are unable to break down food due to lacking an enzyme like lactase. A food sensitivity can cause many symptoms and causes an immune reaction that can lead to leaky gut or gut permeability. An elimination diet is temporary and done for 6-8 weeks, but may need to be up to 6 months depending on symptoms. Gut healing is done with digestive enzymes, probiotics, L-glutamine and herbs.
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This website is not intended for the purpose of providing medical advice. All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.
Brazier, Yvette. “Food Intolerance: Causes, Types, Symptoms, and Diagnosis.” Medical News Today, MediLexicon International, 20 Dec. 2017, www.medicalnewstoday.com/articles/263965.php#diagnosis.
Olsen, Natalie. “Food Allergy vs. Sensitivity: What’s the Difference?” Healthline, 2018, www.healthline.com/health/allergies/food-allergy-sensitivity-difference.