Healthy Living: Allergy or Intolerance


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Though justified, all the attention on food allergies can sometimes lead to confusion over what a food allergy is. For instance, many food intolerances such as a lactose intolerance are referred to as allergies. But there’s an important distinction: although intolerances can cause extreme discomfort, they are not life-threatening.

Generally, food allergies come on suddenly, can be triggered by small amounts of food, occur every time a person with the allergy eats the food in question and can be life-threatening. Symptoms can include rash, hives or itchy skin, shortness of breath, chest pain and a sudden drop in blood pressure.

Food intolerances tend to come on gradually, and may only happen when a lot of the particular food is ingested by the person with the intolerance, or if the food is eaten often.
The shared symptoms of both intolerance and allergies include nausea, stomach pain, diarrhea and vomiting.

Properly diagnosing food allergies and intolerance can be difficult. There are few reliable tests for food intolerance and although food allergy tests have more accuracy, they can also be unreliable and can give false-negative or false-positive results. Because of these testing limits, identifying which food group is causing an allergy or intolerance often requires some medical detective work, says Srinivasan. “We have patients keep a strict diet diary, and monitor it very closely. That becomes the way we can test,” he says. “We monitor it over a week, and then monitor it over a two-week period to see what the symptoms are. If every time you have a dairy product then two or three days later you have a headache, we’ll eliminate dairy completely over a two-week period and see if you feel better.”

In attempts to definitively solve the food-reaction cases of his patients, Adelsberg often uses what’s called a food challenge. During a food challenge, patients will be given various food groups in the medical office and their reactions/or lack of reactions will then be observed.

Adelsberg also offers his patients an easier method.

“I tend to be very practical about what people tell me about things they tolerate and they don’t,” he says. “If someone comes in and says, ‘Every time I eat this food, something bad happens to me,’ the very first reaction one ought to have is ‘Well, don’t eat it.’ It doesn’t really matter what kind of physiological process is occurring, if you do something that makes you feel uncomfortable, don’t do it. The problem is people will go ‘But I want to do it.’ That’s when you have to get into finding whether or not it’s actually a problem.”

Mary Beth Green is a registered dietitian (RD) and certified dietitian nutritionist (CDN) who works at Norwich’s Backus Hospital, which is part of Hartford HealthCare. She warns that even if you feel better after dropping out a certain food group such as gluten or dairy, it does not necessarily mean you have an intolerance to that food.

“Sometimes it’s hard to piece together what’s actually going on,” she says. “When you stop eating wheat products, as a result you’re not eating cookies anymore, you’re not eating doughnuts, and people might actually be eating a more healthy diet as a result of that, because they’ve stopped eating those less healthy foods.”

Green cautions that just cutting out food groups doesn’t actually make you healthier. She advises consulting with medical professionals before taking any long-term action. “You don’t want to go willy-nilly dropping whole food groups, that can do more harm than good, you want to get a diagnosis,” she says.

Green adds if you have been diagnosed with an allergy or food intolerance and have been advised to stop eating certain foods, you’ll want to make sure your new diet is well thought-out.

“Seeing a registered dietitian is a really good idea because when you’re cutting out whole groups of food you might be cutting out essential nutrients, things like calcium and fiber,” she says. “It’s a really good idea to see a professional instead of relying on the Internet. There’s a lot of misinformation out there.”                            

Healthy Living: Allergy or Intolerance

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