It seems to be a modern epidemic. Dinner with a group of women in New York will immediately point to it. It seems the world (or at least NYC) is suffering from food allergies -- gluten, dairy, nightshades... the list goes on.  If fact, it’s estimated that 12 million to 15 million Americans suffer from said allergies. Common culprits include peanuts, milk, eggs, fish, shellfish, sesame, wheat and soy.  But what’s the big deal with allergies?  Are they different to food intolerances? How do we know?

What exactly are food allergies? 

The medical community strictly defines food allergies as anything that creates a specific immune response within two hours of ingestion.  Those immune responses -- either IgE antibody mediated or delayed non-IgE mediated allergies -- are reactions caused by the immune system. They are limited to hives, swelling, vomiting, diarrhea and most severe of all, anaphylaxis; any response that falls outside of these reactions are labeled as food intolerances. 

What are food intolerances?

Food intolerances are less severe than food allergies, but still troublesome. While they are not an immune-related response, symptoms can range from gas and bloating to headaches and can impact one's quality of life as much as an allergy.  However, the onset of symptoms is much slower and can take anywhere from a few hours to a few days.  While they might be limited to GI upset, they can cause chronic inflammation if left unchecked, which can then lead to disease down the line.  Even obesity, type II diabetes, eczema, psoriasis, headaches and autoimmune diseases are linked to food intolerant sensitivities.  So, they’re no joke.

How do you know for certain you have food allergies or intolerances?

If you have food allergies, you likely already know.  The symptoms are usually too severe to ignore or you’ve already gotten a food allergy test. Food intolerances, on the other hand, are a bit sneakier and can require a bit more detective work.  Here’s a few ways you can identify your triggers.

1. An IgG test: As mentioned earlier, food allergies are discovered through IgE blood tests.  However, you can also determine food sensitives through an IgG test.  These tests are used to look for antibodies usually associated with food allergies.  If the serum IgG antibodies exist, it’s likely there is a food sensitivity. 
2. An ALCAT test: An ALCAT (Antigen Leukocyte Cellular Antibody Test) test is a blood test that looks at your white blood cells and tests them against up to 450 substances in a process know as flow cytometry and cell impedance methodology. This is considered to be fairly accurate when it comes to food intolerances.
3. An ELISA test: ELISA is an abbreviation for Enzyme-linked Immunosorbent Assay and is usually less preferential than the ALCAT test. Much of the literature I’ve read, along with first-hand accounts from colleagues, points to this test being directionally accurate but not 100% correct.  The benefit is that it can be done by a nutritionist versus a doctor, as it’s a blood spot finger-prick test and not a full blood draw.
4. An Elimination Diet: The trouble with the aforementioned tests is that even if you don’t produce allergy-specific antibodies to a food your body might still react to it! How can that be, though? In some cases, people don’t have the ability to digest certain types of foods which can thereby lead to inflammation. Such is the case with people who have FODMAP sensitivities due to IBS or SIBO. Your body might not be reacting to the protein, but it is indeed having an inflammatory response.  That’s where an elimination diet would come in.  An elimination diet is one where you would remove common allergens and suspected intolerances for a period of time and then work them back in one by one to identify the actual culprits.  Read more about how to do an elimination diet here.
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Food allergies and sensitivities are serious medical ailments and we always recommend checking in with your healthcare provider before starting a new regimen.