Allergies vs. Intolerance; What’s the Difference?

You often hear of people talking about their food/environmental conditions. Sometimes they use the word allergies, sometimes sensitivities, sometimes intolerance. So what is the difference? Sometimes they speak of an allergy but add a caveat, such as “but not anaphylactic” or “only in big amounts.” Does that count as an allergy or an intolerance or sensitivity?

Here are some definitions and some differentiations to help you understand the difference when it comes to food allergies, sensitivities and intolerances.

Intolerance: An adverse reaction to food that does not involve the immune system. Lactose intolerance is one example. Often the digestive system is involved, but it is not a systemic reaction. Symptoms may include gas, bloating and sometimes headache, fatigue or feeling “foggy.” Hives, shortness of breath, itchy throat, swelling, and anaphylaxis are not symptoms of food intolerances.

Sometimes an intolerance is also referred to as sensitivity. Antihistamines have no effect on food intolerances because there is no histamine reaction taking place. Individuals with intolerances can sometimes have small amounts of the food. For instance, those with lactose intolerance may be able to have small amounts every so often, but not glasses of milk or ice cream every day.

Allergy: A reaction that occurs when the immune system responds defensively to a specific food protein when ingested. There can be a wide array of symptoms from itchiness in the mouth and throat to hives to anaphylactic shock. Sometimes the term hypersensitivity is used in place of allergy. Allergies are usually more severe than intolerances and the food has to be avoided altogether. Even touching something that has residual oils can cause an adverse reaction to those with allergies. Antihistamines do help with allergies, but sometimes an injection of epinephrine is required along with hospitalization.

With an intolerance, the body lacks the enzymes required to break down  a certain product in food, like lactose. Therefore the symptoms, like gas and bloating arise. It is uncomfortable but not life threatening. An allergy, on the other hand, is when your body sees a certain food, like peanuts, as a harmful threat, therefore sends out immunoglobulin E (IgE) antibodies to fight the specific food or food component. If you eat even the smallest amount of that food again, the IgE antibodies sense it and signal your immune system to release histamine and other chemicals into your bloodstream. That is why each time you ingest the food your symptoms may get worse.

It’s important to distinguish food intolerance from food allergy. If you have a food allergy, you need to completely avoid the food. You also need an emergency plan in case you do come in contact with it. On the other hand, a food intolerance is less severe; you usually can eat small amounts of the food without a reaction. If your symptoms are very uncomfortable, you probably do want to avoid that food, though, as well.

– Heather Legg

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