What’s the Difference between a Food Allergy and a Food Sensitivity? An Interview with Sezelle Gereau, MD

There’s a lot of buzz these days about food allergies and sensitivities. There’s a lot of confusion too. We spoke with our resident expert, Sezelle Gereau, MD, to learn the difference between the two and why it matters.

What is the difference between a food allergy and a food sensitivity?
When one is allergic to a food the body recognizes it as a pathogen, and goes through a set of immunologic responses to attack and contain it.  They can be life threatening, as we recognize with children and peanut allergy.  While sensitivities can be uncomfortable, they do not trigger the immune system in the same way.  So, one can be either allergic or sensitive to a food, although the two are often confused.  For example, one can have a true allergy to milk, or a lactose intolerance, which is more of a sensitivity and not a true allergy.

If a food sensitivity does not trigger the immune system in the same way as a food allergy then why are they so uncomfortable?
Sensitivities are different, both in their symptoms and their underlying mechanisms. Most commonly one will present with gastrointestinal symptoms such as gas, cramps, bloating, heartburn, headaches, or irritability. Some will complain of brain fog and fatigue. The most common food sensitivity is lactose.  Sulfites and alcohol are other frequent offenders.

What about gluten?
Common, but not as much as generally thought by the public, is gluten sensitivity – you can be allergic to wheat, or have a sensitivity to gluten. A gluten sensitivity is not a true allergy, but can trigger a set of responses that feel like an allergy.  Celiac disease is an autoimmune disease also related to sensitivity to gluten, but again, not an allergy. It is important to know if one has gluten sensitivity, as it can lead to issues in other parts of the body, such as your thyroid gland.

Do we outgrow allergies and sensitivities?
One can outgrow food allergies. Many children have food allergies early in life, and they commonly outgrow them by about age 8.  Food sensitivities are idiosyncratic, and there is no specific pattern.  The best way to train your body to outgrow both allergies and sensitivities is to eliminate the food completely.  Sometimes foods can be re-introduced on occasion without adverse effect, but if one has a severe reaction it is recommended that you completely eliminate these foods from your diet for good.

How do I know if I have an allergy or a sensitivity?
There are a number of ways to test for food allergies, including blood tests such as IgE or IgG.  You may have heard of the ALCAT or MRT testing.  Your doctor may choose to do any one of a number of these, and each has its pros and cons – but the best way to understand if one is allergic or sensitive is to eliminate the food strictly for 3-6 weeks and then reintroduce it in small amounts, one by one over a series of days and observe for reactivity.

When should I call a doctor?
Many times a functional medicine doctor, such as one of our doctors at Blum Digital, LLC, can help you sort out these issues.  They can help you start to grapple with your reactions and relationship to foods.  A comprehensive history with some additional testing can help one to understand if this is truly reactivity to foods, or if something else is out of balance in the body.

What’s new and exciting?
An exciting new treatment available for food allergy is allergy drops – which offers a way to eliminate the allergy entirely, not just control symptoms.  It is safe and effective for both adults and children. Come in for a visit if you’d like to learn more.