Millions of Americans experience negative reactions to certain foods, be they from a food allergy or a food intolerance. Specialized diets aimed at minimizing these reactions have been en vogue over the past couple of years, but food allergies and food intolerances are medical conditions that may require professional intervention.

“I see a lot of patients who have tried to self-diagnose allergies, and that’s a mistake. Many of those people may be restricting nutritious foods from their diets unnecessarily, and others may be unknowingly doing their bodies harm by continuing to eat damaging foods,” said Ryon Parker, M.D., Chief Medical Officer at Parker Medical and internal medicine physician at Southern Hills Hospital and Medical Center.

Knowing the difference between these conditions and being able to identify whether there’s a problem is integral to health and well-being.

Food allergy

“A true food allergy triggers an immune system response. Essentially, your immune system goes into overdrive attempting to fight the allergen,” Parker said. Because of this, food allergies come on suddenly, and even a small amount of the food can cause a reaction. Food allergies can cause mild to severe, even life-threatening, symptoms.

Possible symptoms:

  • Anaphylaxis
  • Vomiting and/or stomach cramps
  • Hives
  • Shortness of breath, wheezing or coughing
  • Trouble swallowing
  • Swelling of the tongue
  • Weak pulse
  • Pale or blue coloring of the skin
  • Dizziness and/or feeling faint

Usually, symptoms begin within minutes of exposure to the allergen, though a reaction can occur up to two hours after eating. In rare cases, some patients may experience a delayed reaction to the allergen, not presenting any symptoms for four to six hours.

Most common food allergies

“While every patient is different, and any food can cause an allergic response, 90 percent of food allergies are caused by eight specific foods,” Parker said. They are: Tree nuts, shellfish and fish, wheat, soy, milk, eggs and peanuts.

Treating and living with a food allergy

People with food allergies must avoid contact with that food. Allergies can evolve and change; sometimes, exposure to the allergen can elicit a mild response and other times it can cause a severe reaction. Because symptoms can vary so greatly, it’s important for anyone with a known food allergy to avoid the food and have an Epipen on hand in case a reaction occurs.

“Patients need to be very careful when reading food labels, and always be sure to talk to their server when dining out to ask questions about the menu. Don’t just ask about the ingredients, either; ask about how the food is prepared,” Parker said.

He also notes that allergens can lurk in hidden places, such as condiments and seasoning.

Food intolerance

Unlike a food allergy, which causes a response in the immune system, a food intolerance, or sensitivity, occurs when food causes a reaction in the digestive tract.

Some patients may not have the enzymes needed to properly digest certain foods, whereas other patients may be reacting to toxins in the food, such as different preservatives. “Intolerances aren’t life-threatening like allergies can be, but they can cause lots of discomfort for patients,” Parker said.

Symptoms of food intolerance:

  • Bloating
  • Gas
  • Diarrhea
  • Cramping and stomach pain
  • Nausea
  • Constipation
  • Long-term side effects include:
  • Weight gain, or difficulty losing weight
  • Low energy/fatigue
  • Skin problems
  • Insomnia/trouble falling asleep or staying asleep
  • Hormonal imbalance

Treating and living with a food intolerance

A reaction to a food intolerance can occur based on the amount of the irritant consumed and how often it’s consumed. “For example, people with a dairy intolerance may be able to eat cheese once or twice a week without issue. However, if they eat a large amount of cheese, or eat cheese every day, they may see symptoms then. Other patients may need to avoid it entirely,” Parker said.

Watching what you eat, the amount eaten and the frequency of eating such foods are necessary for people with food intolerances. Parker recommends paying attention to your body and how it reacts after eating certain foods to help decipher what you’re able to tolerate.

Most common food intolerances

Parker notes that lactose/dairy is the most common food intolerance. Other common intolerances include gluten, yeast, alcohol and histamines (found in coffee, chocolate, fermented foods and drinks, cured meat and some fruits).

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