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October 30, 2019
Food Allergy or Food Sensitivity: What’s the Difference?
When I travel, I always carry food with me. My family knows this and they usually travel empty-handed because they know I have the “goods” with me: It’s usually some sort of gluten-free crackers or chips, some smoked salmon or good quality jerky, olives, nuts, raw veggies and dip, as well as cut up fruit and dark chocolate. This is a habit I developed during my years as a medical sales rep having to travel on a weekly basis. It’s my way of being sure I always have food on hand that I can digest and that will help me stay sharp and full of energy. I have food sensitivities that leave me feeling “off” when I don’t heed them. For many years, however, I didn’t even know what a food sensitivity was and I struggled with lots of unexplained symptoms.
As a kid, I grew up with an angry rash inside the crease of my arms and on the backs of my legs. It didn’t matter what my mother put on it or what pills she had me swallow; the rash was to remain with me until my college years.
I saw the same rash appear on my son’s hands when he was in grade school. We attributed it to the soap we were using, the laundry detergent, and the fact that he washed his hands constantly. We didn’t do much about it. At age ten, however, he had a pretty serious encounter with a cashew nut that left him itchy, swollen, wheezing and almost unable to speak. The paramedics were called and this is how we became very well acquainted with anaphylaxis and epi-pens and the difference between a life threatening food allergy and a food sensitivity.
A food allergy is an immune reaction that causes chemicals called cytokines to react to a food as a life-threatening condition. This is called an anaphylactic reaction. During this type of reaction we see the hallmark of inflammation: Swelling (tongue, throat, lips), redness (itchy skin), heat (may not be noticeable), pain (may not be noticeable but usually occurs in the throat area). This happens fast and it requires a fast intervention, usually in the form of an epinephrine injection.
A food sensitivity, however, may manifest as digestion issues, skin conditions, malaise, brain fog, intestinal permeability, microbial shifts like candida or fungal infections, mood disorders, IBS, anxiety, or depression. A food sensitivity is the inability of the body to digest and utilize a food to the best of its ability, which leaves partially broken down food particles trying to cross the gut barrier into the bloodstream. Food sensitivities may lead to a condition called “intestinal permeability” or “leaky gut”. In this instance the immune system reacts by increasing low grade inflammation in the body and we see digestive issues, skin rashes or systemic symptoms like brain fog or joint pain.
Food intolerances, on the other hand, are not the same as food sensitivities: A food intolerance may be caused by the lack of an enzyme, as is the case with lactose intolerance. Once the enzyme lactase is made available, then the person is able to digest lactose and enjoy dairy products.
Since most of the immune system is in the gut, and the gut mucosa is affected by food that is not digested properly, it follows that the gut-immune connection is pretty important for our well-being. Serotonin is also created in the gut, as well as melatonin. You can start to see how our brain health and our sleep are also affected by the condition of that gut barrier. It is important to note that the cell barrier at the gut level is only 50 microns thick; this is as thin as half of one of our hairs. Although the gut barrier is microscopic, it is designed to be extremely resilient, until it’s not. Once that resilient gut barrier is compromised, the body starts reacting and that's when we see all the above symptoms.
We now know that food can affect pretty much every system in the body, causing inflammation. We also know that inflammation is at the root of pretty much every chronic condition, including weight loss resistance, thyroid conditions, diabetes, Alzheimers, cardiovascular disease, autoimmunity, even cancer! Doesn't it make sense to try to remove the source of that inflammation? The best way to do this is by removing the most commonly offending foods for a period of time, usually 30-60 days, and re-introducing them slowly to assess the effect on said symptoms.
As a dietitian and holistic care practitioner, I’ve seen many patients with pretty serious gut issues and some who just want to improve their digestive or overall health. The most important solution I can give them is to help them learn to pay attention to the symptoms they experience day in and day out. These symptoms hold the answer to the question: “what’s going on in there?” and documenting them helps your practitioners figure out how to help you resolve all kinds of conditions.
Our bodies are usually whispering, speaking, or screaming at us. The question is, are we listening? The symptoms you’re experiencing may show up in your brain, your skin, your gut or your joints. You can have non-digestive symptoms such as joint pain, brain fog, or fatigue and these may be driven by a digestive problem.
In the last ten years, researchers have been able to figure out there is a gut-skin connection, there is also a gut-brain connection, there is a gut-immune connection and a gut-weight connection, among many others. It is safe to say there is a gut-everything connection! If the gut has a connection to every system in the body, doesn’t it make sense to look at the effect of the most common foods we eat on the symptoms we are experiencing?
Primary healthcare providers don't usually look for food sensitivities. This is not a place of focus for them in our healthcare system. However, you can either request a food sensitivity test from an alternative practitioner like a naturopath or a functional medicine practitioner or if you suspect food sensitivities you can do an elimination diet yourself at home.
A good place to start is with a period of time where you remove the foods that you think may be causing you symptoms. Usually it’s gluten, dairy, sugar, processed foods, soy, or anything that leaves you drained, crampy, gassy, or just feeling bad. Doing it yourself takes a lot of discipline and dedication and although it’s not easy, it’s possible.
Most people like to do it in a group or with a friend. This is why I created the “Nourished Cleanses”. If this is your first time doing a cleanse or a detox, a 21-day program is perfect for you. It helps you get started in a gentle way, being supported by a practitioner and a community. Doing an organized cleanse also helps you get a lot of information you can put to use right away. A well-designed cleanse will provide you with well-curated recipes that address the major foods that cause a reaction in most people. After the cleanse you can decide whether to continue the elimination period for up to 30-60 days or to gradually introduce foods again.
It's important to note that just removing the offending foods will not suffice to resolve your issues. In most cases, if there are other issues, you will need a gut-healing protocol and some other treatments that a good functional practitioner can provide. It would be my honor to guide you through this process. Please go to www.nourishedfn.com to find more information on my programs and how I can help you find relief and peace of mind.
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Yours in wellness,
Monica Paz, MS, CN, FNLP
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