Food Allergy vs Food Intolerance?

by THOMAS on May 2, 2012 • 7:42 pm

There is a lot of confusion amongst the public as to the difference between food allergy and food sensitivity. With an increasing focus on the importance of food in general, there is a real need to distinguish between

the two. Food allergy occurs in only about two (2) percent of Americans, whereas food intolerance occurs in a whopping 70% of the population! Food allergies are the bodies reaction to food proteins, which are perceived by the bodies immune system to be invaders. In contrast, a food intolerance is a delayed, negative reaction to a food, beverage, or food additive often due to insufficient levels of a specific enzyme.


The four primary types of food intolerance are to lactose, gluten, fructose, and histamine. Lactose intolerance is often identified as a food allergy but is actually due to a deficiency in the enzyme lactase. This deficiency allows undigested lactose to enter the intestines where bacteria process the mil sugar and release gas. This results in bloating, abdominal pain and diarrhea, typical of a food intolerance.


Gluten intolerance is the inability to digest gluten. This can range from mild gluten sensitivity to full blown celiac disease. Fructose intolerance is sensitivity fructose, a natural sugar found in fruits, nuts, and honey. This intolerance can be mild or serious. The more serious form is hereditary fructose intolerance, a rare genetic disorder. People with this condition lack an enzyme necessary needed to break down fructose during digestion, and this can result in liver and kidney damage. The mild form of this disorder is call “fructose malabsorption”. Symptoms include bloating, abdominal cramps, gas and diarrhea.


One of the most common food intolerances, but not widely reported, is histamine intolerance. Again this is due to inadequate activity of an enzyme and I this case diamine oxidase(DAO). Histamine levels are usually very high in “guilty pleasure” foods such as pizza, beer, red wine, cured and smoked meats and fish, and many types of cheeses and nuts. As foods lose their freshness, the histamine levels rise. Unfortunately, few folks have the very high levels of DAO necessary to process these very high levels of histamine.


So how to tell the difference between a food allergy versus a food intolerance or sensitivity? You need to ask yourself when do the symptoms occur? If they are present within minutes, it is likely an allergy. If symptoms

occur a half hour or later, it is likely food intolerance. The following is a list of symptoms associated with food intolerance and allergies.


- Itching or tingling in and around the mouth

- Swelling in the mouth or a narrowing or closing of the throat

- Rashes, blotches or redness on the skin anywhere on the body

- Irritated or tearing of the eyes, or runny nose

- Wheezing or difficulty breathing

- Feeling of acute sickness, nausea, or vomiting


A YES answer to any of the above immediately after eating would indicate a potential food allergy.


- Bloating or pain in the stomach or abdomen

- A rumbling in the abdomen and or gas

- Constipation or diarrhea

-Tiredness and weakness

- Headache or migraine


A YES answer to any of the above within half an hour to an hour after eating would indicate a likely food intolerance or sensitivity.


If you have a concern about a possible allergy or food intolerance, I would advise you to consider an elimination diet. This can be very helpful in isolating the suspected foods. The most likely suspects that have been previously mentioned in this article would be the place to start. Often times a sensitivity to food will arise if the particular food item is consumed too often. In this case a temporary removal of the item from the diet will often allow the food to be reintroduced at a later date without incident.


Be well


Dr. T