Food reactions can be super frustrating. You know something is making you feel unwell, but figuring out what can be a guessing game! Is it an allergy or intolerance? How can you tell the difference? Or could it be something else?
And most importantly of all, what can you do about it??
There are actually 3 possibilities of what it could be. It is a food ALLERGY, food SENSITIVITY or food INTOLERANCE.
Food allergies are a response in the blood to specific foods by something called IgE (it rhymes with allergy, so you can remember it!). It is an instant immune reaction in response to only specific foods that the body has built antibodies to.
If you’ve noticed symptoms that happen directly after eating certain foods, is an almost immediate response and it’s has happened more than once, then it is a true allergic response.
The most common food allergies are Dairy, egg, Soy, Peanuts, Tree nuts, Shellfish and wheat.
Allergic reactions can differ from person to person. The most serious is an
Anaphylactic reaction, as it involves swelling and constriction of the airways. This is life threatening and needs to taken seriously.
Other allergic response includes breaking out in hives, eczema, hay fever, allergic rhinitis, sneezing, coughing, dizziness, vomiting, or asthma.
The way the IgE immune antibodies respond to allergenic substances is to mount stronger attacks each time they are exposed. This means, that allergic responses may be more intense each time, so what started out as an itchy tongue the first time, may become a swollen mouth or face the next.
IgE allergies need to be under the care of a medical specialist, as you may need to carry an epi pen with you as a precaution.
Some children with allergies will grow out of them, and some adults may develop allergies.
As a naturopath, to manage an IgE allergy, one of the ways we can help is to alter the body’s histamine response.
An allergic response to food, triggers histamine to be released. Your blood vessels dilate, causing a drop in blood pressure, which is why some people feel light headed when having an allergic reaction. As the blood vessels dilate, the permeability of the capillaries increases, releasing histamine out of the cells, causing itching, swelling and redness. This results in hives or eczema. Airways can constrict causing an asthma attack or breathing difficulties.
Allergic responses can cause a hay fever reaction by increasing mucous membrane secretion.
You can measure a difference in your heart rate after you have eaten a food that causes a histamine response. If it increases, this is an indication that food may be an issue. IgE antibodies can be found in the blood, so having a blood test can help confirm you’re allergic to a certain food.
Like food allergies, food sensitivities can also be measured in a blood test. The antibodies that are involved in food sensitivities are called IgG, IgA, and complement proteins.
We can assess from these tests the “level” of sensitivity from a rating of 1-4.
The difference between food allergy and food sensitivity is the time difference to respond. Food sensitivities cause a delayed response, that tends to be milder compared to an allergy. The symptoms are almost similar; it can involve skin rashes, eczema, hives, headaches, digestive upset, constipation or diarrhoea, hay fever and asthma.
The most common food sensitivities are exactly the same as allergies! Dairy, egg, Soy, Peanuts, Tree nuts, Shellfish and wheat. The body is just differing its response to the same offenders.
I want to note that you can have an allergy or sensitivity to ANY food; it’s not just limited to these common culprits.
Let’s recap so far:
In a nut shell, food allergies and sensitivities are IMMUNE driven reactions that can be measured in a blood test. Allergies are an IgE response, and sensitivities are either IgG or IgA.
Symptoms differ from person to person and can be as varied as hives, asthma, headaches or breathing difficulties.
The third way you can react to food is a food INTOLERANCE.
Food intolerance is where things can get tricky, as they aren’t an immune response that can be measured in a blood test. We need to rely on elimination diets and symptom pictures to pinpoint the issue.
Intolerances don’t form an immune response within the blood and are really difficult to test for. We utilise elimination and rotation diets to assess and treat most intolerances.
Intolerances can be to individual food components, like lactose from milk, things like yeasts, sulphurs, and food additives. They can be to whole groups of chemicals naturally occurring in foods like glutamates and salicylates.
FODMAPs are an example of an elimination diet used to work out what food is causing the intolerance. By removing FODMAPs and seeing if symptoms subside, and then systematically returning them to see which foods react, we work out what food (or foods) are the offenders.
What causes allergies, sensitivities and intolerances??
The leading theory is known as the hygiene hypothesis. It basically says we have cleaned ourselves out of a diverse range of bacteria and left the bad guys room to flourish. Using antibiotics in our foods, during pregnancy, and early in an infants life, leads to changes in the microbiome. Lack of exposure to soil microbes plays a role.
Researchers agree that there must be something in our environment that is contributing to the rise in allergies. It’s toxins in our air, pesticides on our food, chemicals in vaccines, mould exposure and multiple chemicals that we come into contact with everyday. They all agree that it comes from our environment, but they can’t pin point it to just one thing. It seems like it is a cumulative impact of all of these 21st century things that contribute to our immune systems acting differently to our forefathers.
So what is happening with the immune system??
Basically, our immune systems job is to differentiate between what things are US and what is NOT. It determines US from OUTSIDE invaders.
We can create antibodies to anything the body thinks is an invader. The way I like to think of them is little mini soldiers running around our blood stream taking out the bad guys. Now the bad guys that they should be taking out are viruses and bacteria. However, sometimes they attack food molecules instead.
When it comes to food reactions the TYPE of antibodies determine whether it is an allergy or intolerance. As we discussed earlier, IgE is allergy, and IgG, IgA plus complement give us a great picture of sensitivities.
Food intolerance reactions don’t create antibodies, but there are testing options for intolerances. If we suspect you are reacting to glutamates or amines, we can check in your urine and use a neuro-amine test. FODMAPs are linked in with having SIBO, which is Small Intestinal Bacterial Overgrowth. And there’s a breath test to see if you may have SIBO or not.
You know some friends are not your friends, WHERE TO NOW??
If you come into clinic to have a chat to one of our Newcastle naturopaths about reactions to foods then we will do our utmost to help you.
We work through the following processes with you:
- REGULATE- Utilising testing (if warranted), symptom pictures and clinical experience, we will regulate your diet and determine the triggers and root causes.
- REMOVE- Balancing out your nutritional intake to ensure you are meeting your needs while removing any triggers for set periods of time to reduce inflammation and responses.
- REPAIR- Rebuild and rectify gut integrity, immune function, histamine response and whatever else needs a bit more recovery. Here, we utilise herbal or nutritional medicine to assist recovery.
- REPLENISH- Replenish the good gut microbiome to assist in a more positive immune response in the future. Using food as medicine or probiotic therapy, we can improve gut function and immune response.
- RE-INTRODUCE. This is where we are the experts at support. We will work together to form a clear timeline of re-introduction when appropriate and safe to do so in a systematic fashion.
It is a process, working out what is triggering responses, particularly if it is more than one food! We will help you do that with relevant and evidence based testing, supported elimination diets and re-introductions and working systematically to help you discover what it is that you are reacting to!
With a lot of intolerances or sensitivities, if you can work on the underlying issue, then you may be able to re-introduce foods in the future. However, there’s no guarantee. Treatment options involve working on different body functions, like liver function, methylation, microbiome, and neurotransmitter function.
We can help you adjust to any changes you need to make, whether it is short term, longer time, or lifetime avoidance.
There are a few key things we need to remember when removing foods thought to be a culprit.
We will work to ensure you are still meeting your nutritional needs, and replacing any foods that you need to remove with safe foods. We can help you work out how to cook meals for your family with your adjusted ingredients.
When we work with you to see what food is not your friend, it’s important that this is a sustainable exercise. Based on your symptom picture, we will recommend foods to exclude. What’s important is that it’s not too much and not too little. So, a highly restricted diet is not viable long term and can be very difficult to manage with re-introductions. On the flip side, if you think you are reacting to wheat, but don’t want to trial 100% gluten free, then it may not be a successful removal. When it comes to gluten free, it can be 100% or nothing.
Finding out which foods are not your friends can be a big process, but it’s important to do so. Let us help you figure out what foods are YOUR friends!