Do you think what you're eating might be causing you discomfort?
If you’ve ever felt bloated, gassy, or had an upset stomach after eating, you may be wondering if you have a reaction to a particular food.
Food allergy, intolerance and sensitivity, are words often used interchangeably to describe a reaction to a food. In this article, we’ll explore the Functional Medicine approach to food intolerances, sensitivities, and allergies.
We’ll use the term ‘food reaction’ to include all three types of reactions.
While different types of food reactions can result in either subtle, or more severe symptoms, the mechanism of action, i.e. how the food causes those symptoms, is unique to whether it’s a food allergy, sensitivity, or intolerance.
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Food reaction rates are rising, and food intolerances and sensitivities are far more common than allergies.
Food intolerances and sensitivities are estimated to affect up to 45% of the population, and food allergies up to 10% of people worldwide.
What’s the difference between a food intolerance, a food sensitivity and a food allergy?
A food intolerance usually occurs when your body has difficulty digesting a certain type of food.
This can often lead to symptoms such as bloating, flatulence, abdominal pain or diarrhoea.
A food sensitivity is the result of a food triggering an immune response.
And, to make it a little more confusing, both food intolerances and sensitivities are commonly (but incorrectly) collectively referred to as food intolerances.
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The immune response produced in food sensitivities, is different to the immune response produced in a food allergy (more on this later).
A food allergy is the result of a food triggering an immune response to a certain protein in a food, and often results in more severe symptoms such as hives, itching, swelling, and even anaphylaxis (a life-threatening reaction).
What are food allergies?
A food allergy is a reaction of the body to a foreign substance, called an allergen.
When you have a food allergy, your immune system mistakes a protein in the food as a threat.
The body mistakes the food (or allergen) for something harmful and produces antibodies to protect itself. When you’re exposed to even a small amount of the allergen, these antibodies are released, which causes the allergic reaction.
In food allergies, the antibodies produced are called Immunoglobin E (IgE), which are specific to a particular trigger food.
After you consume a food you’re allergic to, symptoms usually occur quickly — usually within minutes, but can be up to two hours.
If for example, you’re allergic to peanuts or soy, ingesting even a small amount may lead to a rapid, severe reaction called anaphylaxis, which in extreme cases can be life-threatening.
Symptoms of food allergies
The symptoms of food allergies can include:
- Rash or hives
- Difficulty swallowing
- Swelling of the lips, tongue or throat
- Wheezing or trouble breathing
Eight types of food account for about 90% of all food allergies:
- Eggs
- Fish
- Milk
- Peanuts
- Shellfish
- Soy
- Tree nuts, like cashews and walnuts
- Wheat
What are food intolerances?
Food intolerances do not involve the immune system and occur when your body reacts to a food because it’s unable to digest or break it down effectively.
Food intolerances do not involve IgE antibodies.
The severity of the food intolerance reaction may also vary depending on the quality and quantity of the food consumed.
Food intolerances are caused by:
- Specific enzyme deficiencies, e.g. lack of lactase enzyme, resulting in a lactose intolerance
- Impaired food absorption
- Gut dysbiosis (imbalance in bacterial communities in the microbiome)
- Histamine sensitivity
- Sulphite sensitivity
Due to the diverse nature of the root causes of food intolerances, even with a Functional Medicine approach to food intolerances, they can be difficult to identify.
What are food sensitivities?
Food sensitivities are often referred to as food intolerances, and while many people use the two terms interchangeably, they’re not the same.
Food sensitivities do involve an immune response, but rather than the immune system producing IgE antibodies, the immune system produces (mostly) IgG antibodies.
Tests marketed as Food Intolerance tests, that have become so popular, are tests measuring IgG antibody levels to different foods, so they’re actually testing food sensitivities, not food intolerances.
Despite food sensitivities being so common worldwide, the diagnosis is often not straightforward.
This is because symptoms can develop anywhere between a few hours to a few days after the exposure to the food causing the problem, which is called an IgG-mediated delayed hypersensitivity.
Symptoms of food sensitivities
Common food sensitivity symptoms can include:
- Brain fog
- IBS symptoms
- Bloating
- Joint pain
- Eczema
- Asthma
- Fatigue
- and anxiety
If unmanaged, food sensitivities can have serious health consequences.
If you don’t know you have a food sensitivity and keep eating the offending food(s), it is possible to increase your risk of developing an autoimmune disease, neurological disorders, and more.
The conventional medicine approach to food reactions
In conventional medicine, food allergies are diagnosed with a blood or skin prick test and are treated by avoiding the problematic food.
In some cases, oral immunotherapy is offered which involves gradually increasing the amount of the food allergen given, under medical supervision.
This is frequently offered to children who have food allergies.
It is believed that there is a genetic component to developing food allergies, and therefore the food allergy is unlikely to change.
This means that once someone develops a food allergy, they are likely to have that allergy for life (although children sometimes can “outgrow” allergies to milk, egg, wheat, or soy, perhaps due to better / more mature gut health).
It’s important to be 100% aware of what foods may contain the allergen, as there is a high risk of a severe attack.
In food sensitivities and intolerances, the conventional medicine advice is to avoid the food for a period of time, then to try re-introducing it in small quantities.
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The Functional Medicine approach to food intolerances, food sensitivities, and food allergies
In some cases of food allergies, improvement in symptoms has been reported once gut health has improved (more on this coming up).
So even if a food allergy is something you’ll experience for life, the severity of symptoms can be reduced, which day to day, can make a remarkable difference by reducing the risk of life-threatening allergic reactions.
In food intolerances and sensitivities, the underlying cause of the food reaction can often be addressed, meaning that long term avoidance of the problematic food(s) is not necessary.
This is where a Functional Medicine approach to food intolerances and sensitivities can really help.
And actually, by correcting the underlying imbalance, other areas of health may also improve.
For example, modulating the immune system and improving a histamine sensitivity, not only means that high histamine foods can be better tolerated, but also that other symptoms relating to high histamine, can also be avoided, such as:
- Headaches
- Rashes
- Flushing
- Itching
- Swelling
- Runny nose
- Painful menstrual periods
- Nausea
So you can see, it’s much better to address the underlying reason for a food sensitivity or intolerance, rather than avoid a problematic food indefinitely.
Food intolerances and sensitivities can be reversed, whereas food allergies often can’t be reversed.
With food allergies, symptom severity can be reduced.
The Functional Medicine approach: gastrointestinal health and food reactions
In the Functional Medicine approach to food intolerances, sensitivities, and allergies, these food reactions often circle back to compromised gut health.
In most cases, a food isn’t being digested properly and/or or food molecules are getting past the gut lining when they shouldn’t be able to.
Cases are thought to be caused by:
- Specific enzyme deficiencies
- Impaired food absorption
- Bacterial dysbiosis
- Increased intestinal permeability (‘leaky gut’)
- and other gastrointestinal issues
Once any problem foods are identified, Coho Health practitioners will put a personalised plan together for you, which will support the digestive system, particularly the intestinal lining, by:
- Optimising stomach acid levels
- Optimising digestive enzyme levels
- Optimising bile production and flow
- Reducing inflammation
- Improving the microbiome
- Increasing specific nutrients to support the intestinal mucosal lining (and to support the repair of a leaky gut / increased intestinal permeability
- Modulating the immune system
- Reducing stress
Depending on your symptoms we may also recommend to try the following, temporarily, while the gut healing process is being carried out:
- Lactose free diet
- Gluten free diet
- Dairy free diet
- Low histamine diet
- SIBO specific diet
- Elimination diet
- Low FODMAP diet
With food allergies, we may recommend the following:
- IgE Food Allergy test
- Avoiding the allergen and cross-reactive foods to environmental allergens
- Supporting intestinal barrier health (‘leaky gut’) to reduce the IgE antibody count
- A comprehensive stool test to assess gastrointestinal function, bacteria, yeast and parasites
With food sensitivities, we may recommend the following:
- Food sensitivity testing – IgG (or IgA, IgG4, or C3d) testing
- Support the intestinal barrier health in order to reduce IgG levels
- A comprehensive stool test to assess gastrointestinal function, bacteria, yeast and parasites
- An Elimination Diet may be recommended, which is the gold-standard for helping to identify food reactions
During a 3 or 4 week Elimination Diet, the most common food reactions are avoided, and then carefully re-introduced one at a time, and symptoms closely observed.
An Elimination Diet is a great way to identify food intolerances and sensitivities, and clients also report unexpected ‘side effects’ such as:
- Improved energy levels
- Reduced joint pain
- Better mental focus
- Clarity
- Better sleep
- Improved mood
It’s important to note that the benefits may not just be attributed to the avoidance of food reactions, but likely also to an overall improvement in nutrient intake during this period.
With an Elimination Diet, the goal is to reintroduce foods successfully to ensure a full range of nutrients for optimal health.
Ultimately, a nutritionally diverse diet is crucial for gut health – reducing digestive issues, and supporting a healthy microbiome.
Improving the structure and function of the intestinal barrier (improving increased intestinal permeability (‘leaky gut’)), means better digestion, absorption, gut motility, gut bacteria balance, and reduced inflammation – all of which feed into reduced food reactions.
Supplements and/or herbs can be useful to restore and support gut health.
Often after the above has been successfully carried out, supervised food reintroduction is performed and any symptoms monitored.
Any foods that continue to cause negative symptoms (physical or mental) can then be further avoided for a period of three to six months whilst the gastrointestinal and immune systems are further supported, and then re-assessed.
Book your free 15 minute Discovery Call with Dee Brereton-Patel now
The wrap...
Food reactions are a huge and growing problem globally, and symptoms can range from being mild and hardly noticeable (or even completely hidden), to life threatening.
A Functional Medicine approach to food intolerances, food sensitivities, and food allergies, with an in-depth, root cause analysis and exploration of your personal triggers, can offer success in taking back control of your health and living a better, healthier life.
To your optimised, healthy future,
Dee & the Coho Health team
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