The Difference Between Food Sensitivity and True Allergy


Editor’s Note: This video is part of the ongoing allergy series in partnership with Columbia Allergy. To learn more about allergies, eczema, and related topics, please refer to our Allergy Guide!

Do you or your loved ones get a stomach ache after eating certain foods like pasta or ice cream? Or perhaps you’ve been avoiding certain foods because you believe you are allergic to them? Not sure whether you have food sensitivity/intolerance or a full-blown allergy? We recently spoke with Dr. Jain from Columbia Allergy about allergies of all forms and what it means to have a “true allergy”.

How do allergies, eczema, and asthma correlate to one another?

Allergies (food and environmental), asthma, and eczema are all classified under the category of atopic conditions. Atopy is the genetic tendency to develop allergic diseases due to a heightened immune response to common food and environmental allergens. The exact mechanism for how these conditions develop is unknown, but studies have shown that family members with these allergic diseases increase your personal risk of also having them, and having one of these conditions can also increase the personal risk of developing another atopic condition.

What is a “true allergy”? What is the difference between a sensitivity and a true allergy?

A “true allergy” involves the activation of a response from the immune system. A “true allergy” will cause the immune system to produce IgE antibodies to protect itself in response to exposure to a food allergen that the body has identified as foreign. Symptoms of an allergic reaction can include hives, vomiting or stomach cramps, wheezing, cough, or shortness of breath, swelling in your tongue or mouth, tight and hoarse throat, dizziness, weak pulse, and anaphylaxis (typically at least 2 symptoms from 2 different body systems). A food intolerance only takes place in the digestive system and does not elicit an antibody response from the immune system. Food sensitivities take place when the digestive system is unable to properly break down the food and result in gastrointestinal discomfort with symptoms like bloating, abdominal pain, and diarrhea.

Should I take an at-home food sensitivity test instead of going in for allergy testing?

Most at-home food sensitivity tests screen for IgG antibodies to a specified list of foods. In comparison, allergists are screening for IgE antibodies to make the diagnosis of a food allergy. There are 4 types of hypersensitivity reactions, and a “true food allergy” falls under the category of Type I reactions, that are mediated by IgE antibodies. This means that the body develops IgE antibodies for a specific substance such as peanuts and uses this antibody to protect itself against exposure to the substance. The at-home food sensitivity tests are unable to detect a true food allergy since it does not screen for IgE antibodies to the foods. The American Academy of Allergy Asthma & Immunology emphasizes that research has not proven that the removal of foods that had a positive IgG response will reduce any symptoms of food sensitivity or allergies. Therefore, if you want to determine whether or not you have a food allergy, the most accurate and scientifically tested option is to obtain testing through an allergist.



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