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Allergies

Food allergy vs. food intolerance

Reactions to certain foods are more often than not caused by a food intolerance rather than a food allergy. And while people can confuse the two, they are different even though some symptoms may overlap.

This at-a-glance chart can help you know the difference between a food allergy and intolerance:

Food allergy Food intolerance
Involves your immune system. Your immune system identifies a substance in a food (usually a protein) as harmful and responds by releasing antibodies and chemicals (like histamine) to fight it. The release of histamine is what can cause very serious symptoms. (See list below.)
  • A food intolerance doesn’t involve your immune system.
  • Symptoms usually happen because you can’t digest a certain food or ingredient in a food.
Can be fatal. It’s important to manage a food allergy properly. They can be life-threatening otherwise. Are not fatal and while unpleasant are less serious or dangerous than a food allergy.
Has an immediate reaction. Symptoms usually develop gradually.
You can react to even a very small amount.
  • It usually takes a normal sized portion of the food to cause symptoms.
  • You may be able to eat a small amount of the food without trouble.
  • May happen when you eat too much of the food, or have it too often.
Symptoms: Symptoms can include your respiratory system, gastrointestinal tract, skin or cardiovascular system.

Typical reactions include:

  • Breathing difficulties — like wheezing
  • Vomiting
  • Diarrhea
  • Skin problems — rashes or hives

 

Severe reactions (anaphylaxis) can be life-threatening:

  • Trouble speaking
  • Trouble swallowing
  • Difficulty breathing
  • Drop in blood pressure
  • Rapid heart rate/palpitations
  • Unconsciousness

 

Symptoms normally involve just your gastrointestinal tract.

Symptoms:

  • Abdominal pain
  • Bloating
  • Diarrhea
  • Loose stools
  • Gas
  • Cramps
  • Heartburn
  • Headaches

Common food allergens:

  • Peanuts
  • Tree nuts (like almonds, cashews, walnuts and hazelnuts)
  • Sesame seeds
  • Fish and shellfish (like shrimp, crab or lobster)
  • Eggs
  • Milk
  • Mustard
  • Soy
  • Wheat

Common food intolerances:

  • Lactose — a sugar found in milk and milk products
  • Gluten — intolerance or allergy (see celiac disease below)
  • Sulphites — which can trigger asthma attacks
  • Food additives

Celiac disease vs. gluten intolerance

Celiac disease is a disorder that has a genetic component. It’s not a food allergy but is considered an autoimmune disorder because the body damages its own tissues. Eating gluten (a protein found in wheat, rye and other grains) is the trigger and the damage is such that it prevents your body from absorbing nutrients. Generally, symptoms are limited to gastrointestinal problems and there’s no risk of anaphylaxis. There is no cure and can only be treated by avoiding gluten.

How do you know if you have it? If a blood test comes back positive for celiac disease, an intestinal biopsy and upper endoscopy confirm whether or not you have it.

Those who test negative may be gluten intolerant or gluten sensitive. And while they don’t have intestinal damage, they may have symptoms after eating gluten.

For more information and support, search “allergy” in Find Support for organizations in your area.

Food allergy vs. food intolerance
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