4 False Food Allergy Beliefs: Allergy and Intolerance are not the same

False food allergy beliefs are extremely common. The word allergy refers to a specific reaction of the immune system and medical treatments are directed toward blocking this reaction. False food allergy beliefs drive many people to over treat and aggressively manage symptoms. This over-treatment occurs out of fear that a progressive food allergy reaction may happen.

Food intolerances may mimic food allergies. Many people spend excessive amounts of time eliminating foods, and taking supplements and medications to avoid worsening symptoms. False food allergy beliefs place a heavy burden families and significantly impact social interactions.

A food intolerance occurs when a food, drink or additive is eaten and a reaction happens. Symptoms are usually related to digestive symptoms; however, other reactions are possible. Food intolerances do not progress to urgent life threatening reactions, but they can have chronic or intermittent symptoms.

A true food allergy occurs  when food is eaten, touched or even inhaled. The food then triggers the immune system to mount a reaction which can affect many organs in the body; consequently, severe or life-threatening reactions may occur. These are the food reactions most people fear. Allergy is a true disease.

Food allergies are extremely common with 1 in 13 children showing some degree of food allergy. I plan to discuss different aspects of allergic disease in future posts; however, it is important to fully understand the difference between a true allergy and an intolerance.

The most severe forms of food allergies show immediate symptoms, and  no doubt exists about the presence of an allergy. Mild to moderate food allergies, where reactions are delayed or intermittent, remain more difficult to diagnose. An allergy specialist should be consulted.

4 false food allergy beliefs

1. Food allergies can always be determined by history

A complete history remains the best method to assess allergies. I am a Pediatric Ear Nose Throat (ENT) and Allergy specialist and find that children often provide incomplete symptom history. We must rely on what parents notice.

My own daughter had obvious nasal allergies and asthma. When her symptoms became difficult to control, she underwent allergy skin testing.  Not only did I find her severe pollen allergies, but I found unsuspected severe food allergies!

When questioned directly, she admitted that some foods made her mouth itch and caused her gums to swell; however, she kept eating the foods because she liked them. Some kids report the foods that bother them, others simply are labeled ‘picky eaters’ because they cannot explain how the foods make them feel. Yet others, like my child, never complain or stop eating the foods despite clear symptoms.

2. I cannot eat foods that I am allergic to

Many people carry a diagnosis of food allergies but eat the offending foods with no obvious symptoms. Practitioners routinely report that these foods are not true allergies. I disagree. These reactions represent mild allergies that may not have obvious clinical significance, but overtime, they can cause the chronic problems that I treat  every day as an ENT  surgeon.

 Most people simply need to “reduce and rotate” but not completely eliminate these offending foods. Your physician should discuss this plan with you.

3. Allergy blood tests are all the same

One of the most common tests to screen for allergies is a blood test. However there are many types of tests which do not measure the same thing.

Often a food intolerance test reveals 50-100 reactions! First of all….just NO. Second of all…just NO.

Ask your doctor exactly what the test is measuring. Tests that measure IgG, show results for food intolerances.  IgG measures a different immune reaction in the body. Tests that measure IgE show results for true food allergies. We often look for specific IgE to specific foods and not just the total amount of IgE in the body. Each measurement tells us different information.

After blood test results are obtained, your physician will determine if skin testing is needed. Tests combined with clinical history provide the best treatment plans.

4. My child will outgrow the allergies

Allergy evaluations occur based on reported problems; therefore, if no symptoms are reported, an allergy evaluation does not occur.

Many children outgrow their allergy symptoms.  When parents request an allergy test to insure the allergy no longer exists, I frequently find ongoing allergy reactions.  The allergy reaction may continue to exist, however, it is no longer significant.

Other children fail to improve their allergy symptoms, and they make up a large part of my practice!

The best approach to diagnosing food allergies is to obtain a history, perform an exam, perform allergy blood and/or skin testing, and modify the diet. New information about introducing infants to peanuts early in life has provided significant hope for severe food allergy reduction in the future.