Did you know that there’s a difference between these two? Well, if not, you are certainly not alone. I can’t even tell you how often I get people asking all manner of questions about food sensitivities and allergies. The problem is that its all very confusing, but everyone keeps hearing about them. Everyone’s heard one or another of the terrible, terrible stories that go something like: “..there was a girl who had a peanut allergy and kissed a boy who had eaten peanut butter like 3 days ago, and then her throat swelled up and…” and everyone knows someone these days with a gluten intolerance. It seems like every third person can’t digest gluten these days!
So the question is: “How did we come to this?”
And I’ll tell you– I don’t know. Truthfully, nobody really knows– but there are theories. First though, let me do what I promised. Let me explain the difference between allergies and sensitivities. I think we all know about seasonal allergies. The more heated problem these days, though, is food allergies. The most common perpetrators are peantuts, nuts and shellfish, and in children– eggs and dairy. So what happens when you eat something that you’re allergic to? Well, usually you’d suffer a predominantly histamine mediated reaction. Histamine is a molecule released by white blood cells that triggers your immune system to react in the presence of a foreign substance. Most of the reaction tends to appear as an itchy rash on the skin or as an itchy, uncomfortable feeling in the mouth. Other, lesser known molecules that are also released by white blood cells contribute symptoms such as runny nose, mucous production, and in the worst of cases, anaphylaxis or anaphylactic shock. Anaphylaxis is the name of the extremely dangerous syndrome in which the body is stimulated in the presence of a very specific allergen to both constrict the bronchial tubes (sometimes to the point of asphyxiation) and to cause a reduction in blood pressure by the blood vessels as they dilate and literally leak blood into the body’s tissues. This can sometimes lead to shock and even death. It’s terrible and frightening, and can happen very quickly. That being said, the occurrence of anaphylaxis is relatively rare. Most people have symptoms that are more in the “itchy and annoying rash” category. So that’s allergies– you’re probably pretty well acquainted with those (ah-choo!)
So then, sensitivities are a little different and they tend to be far more elusive. My patients with sensitivities are those that come in complaining of IBS (constipation or diarrhea, bloating, painful indigestion) or heart burn and reflux. They also tend to have symptoms of general tiredness and discomfort. I’ve even had patients that have entirely bizarre symptoms like throwing up/coughing up of blood or general aches and pains; symptoms that could not be explained by the full gamut of tests that they have inevitably been put through by the time they come to see me. It is these people that I usually begin on a food elimination diet to see if they experience any improvement after a week of not eating specific foods. Sensitivities do not show up on allergy tests because the mechanism by which they occur is completely different than allergies. Food sensitivities are usually due to a person’s inability to properly absorb a specific nutrient or chemical. A very well known example of a food sensitivity is lactose intolerance. In this case, some people can’t properly absorb the dairy sugar lactose because they don’t have the proper enzyme (lactase) to break it down into a form that the gut can properly absorb. The result of which can be… traumatic and annoying.
Another common sensitivity is to the protein gluten, which is found in wheat, barley, rye, and other related grains. It seems like just about everyone has gluten intolerance these days! Why is that? Well, of course, nobody really knows. There are some educated guesses out there, though. For example, it has been theorized that since, as humans, our diet originally consisted predominantly of those foods which go along with a hunter/gatherer lifestyle (ie fish, meat, fruits, nuts, and vegetables), we simply aren’t as well equipped to digest the foods that were added into our diet later on when we began to cultivate our own foods. Perhaps. Perhaps its more a result of the cultural mixing that has occurred in the past few hundred years– some cultures are simply less inclined towards the glutinous grains. Why are diagnosed cases on the rise in the past, say, 5 years? The jury’s still out, but it seems to this humble acupuncturist that prior to this period their sure were a whole lot of non-specific IBS diagnoses out there. People are just really starting to look towards food intolerances more than ever in the past– and there’s still a lot of resistance out there!
Interestingly, in comparing the proper treatment of food allergies and sensitivities, current thinking stipulates that they be treated in significantly different methods. In the case of allergies, lessening exposure to an allergen is both good and bad. This is because the less a person is exposed to a specific allergen, the worse an allergy will likely, in time, become. Yet, if the allergy is intense, then avoiding the allergen is extremely important to avoid anaphylaxis. So, the treatment is somewhat case by case. If, for instance, a young child has a peanut allergy wherein the reaction is relatively mild, an allergist will likely recommend that the child still be given some exposure to peanuts to avoid having the allergy become hypersensitive and dangerous. If, however, the allergy is already hypersensitive, treatment in this fashion is difficult. Although research has shown that low dosage immunotherapy of this sort (similar to allergy shots– in which an extremely small amount of allergen is injected) can be effective, in the case of hypersensitive allergies the patient’s reaction to the therapy has to be controlled and carefully watched to avoid anaphylaxis. So, doctors aren’t doing it yet. Hopefully sometime in the near future this kind of therapy will emerge. In the meantime, perhaps the best treatment is preventative. Make sure your little little ones have some conservative exposure to the common allergens— because it has been shown that in countries that expose their infants/toddlers to things like peanut butter early, the percentage of older children with that allergy is greatly reduced. Furthermore, it seems that the number of people with peanut allergies has only increased since parents began to be instructed to avoid common allergens in their childrens’ baby food.
Treatment of food sensitivities, on the other hand, is simple. Well, or maybe not so simple. You simply have to completely avoid that food. In the case of dairy or gluten, this can be very difficult, as they seem to be in everything! The additional problem is that, once you avoid it, you actually become a bit more sensitive to it– so, you will actually react more to smaller amounts of it. This means that just reducing the amounts you eat doesn’t really work if you are having major, system-wide problems. It simply all must go– and that is no small deal! That’s huge! We humans have a very deep, emotional relationship with our food. Sometimes, however, it simply all MUST go. Your body doesn’t get “used to” foods its sensitive to as it can in the case of allergies, because in the case of sensitivities, your body lacks the proper mechanism to digest the food, and it likely always will. These don’t tend to come and go in the same way that allergies can.
So there it is. Enjoy your food– unless, of course, you’re getting rashes, sniffly, bloaty, acidy, or constipated. Because in these cases, I’m probably going to have to sit you down and have a little heart to heart with you, and I might end up telling you something you really don’t want to hear…!