Food Sensitivities vs Food Allergies: Key Differences Explained

Following a meal, some people may experience symptoms such as bloating, fatigue, or cognitive cloudiness several hours or even days later. While it may be clear that these symptoms are adverse reactions to food, the kind of adverse reaction they are is another question. This article considers the distinction between food sensitivity and allergy.

Both conditions are immune-mediated food reactions, but they are not exactly identical. Food allergies involve an immune response, typically mediated by immunoglobulin E (IgE) antibodies, which can lead to severe and sometimes life-threatening symptoms. In contrast, food sensitivities are non-IgE-mediated reactions that trigger symptoms through different, often less understood, immunological pathways.

The clinical presentation also differs. Food allergies commonly produce acute symptoms affecting the skin, respiratory tract, and cardiovascular system, usually within minutes of exposure. However, food sensitivities tend to manifest gradually and primarily affect the gastrointestinal system, skin, and energy levels. Both conditions also differ in their causative agents and diagnostic approaches. 

Understanding the differences between these food allergies and sensitivities is essential for effective management. Find out more in this article.

What Is the Difference Between Food Sensitivity and Food Allergy?

Food allergies typically involve immunoglobulin E (IgE) antibodies, cause faster and more severe reactions, and have specific diagnostic tests. On the other hand, food sensitivities do not involve IgE, tend to have delayed and milder symptoms, and lack specific diagnostic tests. 

Below is a breakdown of their differences by mechanism, prevalence, symptoms, food causes, diagnosis, and natural treatments.

Mechanisms

Food allergies are adverse reactions that arise from a specific immune response that occurs reproducibly upon exposure to a given food, according to the National Institute of Allergy and Infectious Diseases (NIAID). The components of foods (usually proteins) responsible for the immune response are known as allergens.

Food allergies can be further classified based on the immune mechanisms involved:

• IgE-mediated reactions: These involve immunoglobulin E (IgE), an antibody that is responsible for immediate allergic reactions
• Non-IgE-mediated reactions: These involve other parts of the immune system and not IgE antibodies
• Mixed IgE/non-IgE reactions: These involve both IgE antibodies and other immune responses

Food sensitivities, on the other hand, are adverse reactions to foods caused by immune mechanisms that do not involve IgE antibodies. These reactions typically occur through cell-mediated mechanisms and are not as well understood as IgE-mediated food adverse food reactions.

Understanding what’s triggering your symptoms can help you feel better day to day. Schedule a personalized food sensitivity assessment today with our Functional medicine doctor at Bay Clinic of Chiropractic.

Prevalence

According to study estimates from the Northwestern University Feinberg School of Medicine in Chicago, Illinois, food allergies affect around 11% of US adults, although up to 19% of adults believe that they are food allergic. Food allergies are more common in children, affecting at least 7.6% of US children, and possibly as much as 11%.

Food sensitivity prevalence rates are less readily available due to a lower research interest. Still, it is a consensus that food sensitivities are less common than classic food allergies. FPIAP is estimated to have an overall incidence of around 7%, making it the most frequently observed of the different food sensitivity types. FPIES has an incidence rate between 0.3 and 0.7%.

Symptoms

Here are some food allergy and sensitivity symptoms.

Food Allergy Symptoms

Food allergy symptoms include:

• Skin reactions: Redness, itching, hives, rashes, and swelling
• Ocular problems: Tearing, redness, itching, and puffy eyes
• Respiratory issues: Sneezing, rhinitis, nasal congestion, cough, chest tightness, wheezing, and shortness of breath
• Gastrointestinal symptoms: Nausea, vomiting, diarrhea, abdominal pain
• Cardiovascular symptoms: Low blood pressure, fast heart rate, and dizziness

Food Sensitivity Symptoms

The symptoms of food sensitivities include:

• Gastrointestinal issues: Vomiting, diarrhea, blood or mucus in stool, abdominal bloating, pain, cramps
• Skin reactions: Rashes, blisters, itchiness, swelling, and eczema
• Musculoskeletal symptoms: Fatigue and joint pain
• Neurological symptoms: Headaches and brain fog
• Cardiovascular problems: Anemia, hemorrhage, and low blood pressure

Factors like the amount of food ingested and individual differences dictate the exact symptoms and their severity for both food sensitivities and allergies. There may be an overlap of symptoms between food sensitivities and allergies, making it difficult to rely on just symptoms for differentiating them.

However, food sensitivity symptoms are usually delayed from hours to days and weeks, while food allergy symptoms typically occur within minutes to hours of food ingestion. Food allergy symptoms also tend to be more serious and can cause anaphylaxis, a life-threatening condition that causes itching, hives, wheezing, breathing problems, and low blood pressure.

Food Causes

Below are common food causes of food allergies and sensitivities.

What Foods Trigger Food Allergy?

More than 170 foods have been associated with food allergies in the United States, but 90% of all food allergy cases are attributed to 9 foods, commonly called the “Big 9.” According to the FDA, the 9 major food allergens are: 

• Milk 
• Eggs 
• Fish 
• Crustacean shellfish (such as crabs, shrimps, and lobsters) 
• Tree nuts (such as almonds, walnuts, and pecans) 
• Peanuts 
• Wheat 
• Soybean 
• Sesame

Peanut allergy (around 66% of all cases) is the most common food allergy and the leading cause of food allergy-related deaths. Tree nut allergy (61%) is the next most common allergy, followed by egg (43%), milk (37%), soy (20%), seeds (20%), and shellfish (20%). Most food allergies (around 8 in 10) are caused by accidental exposures. 

What Foods Trigger Food Sensitivity?

Food sensitivities are mostly triggered by cow milk and soy, with both foods responsible for up to 60% of all food sensitivity cases. Solid foods may also trigger food sensitivity symptoms. Here are the common triggers of food sensitivities:

• Cow milk
• Soy
• Grains (rice, wheat, barley, corn, and oats)
• Vegetables (sweet potatoes and squash)
• Fruits (commonly bananas and avocados)
• Poultry meat (chicken and turkey)
• Eggs
• Fish

Diagnosis

Here are the respective diagnosis approaches for food allergies and sensitivities.

How Food Allergies Are Diagnosed

Food allergy diagnosis begins with a thorough assessment of the patient’s clinical and dietary history. Healthcare providers typically follow the EATERS pattern:

• Exposure: Details about the food, amount, preparation, and relevant factors
• Allergen: Identify suspected foods
• Timing: Assessing how long it takes symptoms to appear after exposure
• Environment: Consider the surrounding environment during exposure 
• Reproducibility: Check if reactions consistently occur with subsequent exposure.
• Symptoms: Describe the severity and duration of symptoms

After this initial evaluation, diagnostic tests are needed to confirm the allergy:

• Skin Prick Tests (SPTs): Help detect IgE antibodies, confirming an allergy
• Serum-specific IgE (sIgE) Tests: Measure specific IgE antibodies in the blood, providing additional insight into the immune response

While these tests can confirm IgE involvement, they cannot differentiate between allergy types and may produce false positives (incorrect positive results). Therefore, healthcare providers often proceed with:

• Elimination Diets: These diets last 2 to 4 weeks, during which suspected foods are removed and symptoms are monitored. However, they carry risks like malnutrition, weight changes, and reduced quality of life.
• Oral Food Challenge (OFC): This is the gold standard of food allergy diagnosis. It involves the controlled oral administration of a suspected allergen, gradually increasing food amounts to accurately confirm a food allergy diagnosis. While reliable, OFCs require highly trained personnel and may cause severe allergic reactions, so they are only used when needed.

How Food Sensitivities Are Diagnosed

Food sensitivity diagnosis follows a similar path to food allergies, but lacks specific diagnostic tests, as no biomarkers exist for non-IgE-mediated reactions. The process typically includes:

• Clinical and Dietary History: A detailed assessment of symptoms and possible food triggers
• Symptom Evaluation: Identifying whether symptoms align with food sensitivities
• Elimination Diets: Removing suspected foods and monitoring symptoms
• Oral Food Challenge: Specifically designed to confirm food sensitivities 
• Endoscopy: This is a test that looks inside the gut, and may assist in diagnosing food sensitivities

If you need a diagnosis of your food sensitivity in Panama City, Florida, contact us at the Bay Clinic of Chiropractic at (850) 785-9372 or info@thebaydoctor.com. Dr Tony Salamay, the lead health practitioner and experienced in food sensitivity testing and different food allergies, and he can help you with your food allergy and sensitivity diagnosis, as well.

Natural Treatments

Here are the natural treatment approaches for food sensitivities and allergies.

Natural Treatments of Food Allergies

The natural treatments of food allergies aim at reducing the body’s allergic response to the trigger food. However, these treatments are not effective in severe symptoms, like anaphylaxis, and urgent and more invasive treatments like epinephrine injections are needed. 

Here are natural treatment options for food allergies.

• Avoidance of allergens: This is the primary method for managing food allergies is to completely avoid allergens that trigger an immune response. This is done by reading food labels carefully and confirming ingredient safety with manufacturers or marketers when unsure. 
• Oral Immunotherapy (OIT): This involves gradually increasing exposure to an allergen to desensitize the immune system. OIT is most effective when started early, but requires long-term commitment to the plan.
• Probiotics: Found in fermented foods like yogurt, kefir, and sauerkraut, probiotics can help manage allergies by improving the gut microbiome and balancing immune responses. They are particularly effective for peanut and milk allergies.

Natural Treatments of Food Sensitivities

The natural treatment of food sensitivity is not as stringent as food allergy treatments, especially because symptoms tend to be milder with food sensitivity. The main treatment approaches for naturally treating food sensitivities are:

• Elimination Diet: A diet that identifies and eliminates suspected trigger foods from the diet is the primary method for managing food sensitivity. It can be a bottom-up approach (removes suspected trigger foods while maintaining most of the regular diet) or a top-down approach (removes a broader range of foods initially before gradually reintroducing them).
• Nutritional Support: Proper nutritional support is crucial to prevent deficiencies during an elimination diet. A personalized support plan created by a qualified health practitioner ensures that nutritional needs are met while avoiding triggers.
• Supplements: Supplementation can help in nutritional support and also help modulate the gut and balance immune responses (as in the case of probiotics). Always ensure you contact your healthcare provider before using any supplement. 

Frequently Asked Questions

Do Food Allergies Ever Go Away?

Yes, food allergies may go away over time. There is no way to accurately predict whether a food allergy will go away, but the severity of symptoms provides valuable information. The more severe the food allergy symptoms, the lower the chances of the allergy going away. 

Another useful indicator of whether an allergy will go away is when it first develops. Food allergies that are present in childhood have a better chance of going away, as the body learns to tolerate these foods. On the other hand, food allergies that first arise in adulthood are likely lifelong.  

Typical examples of allergies that go away with time are milk, wheat, and soy allergies, while fish, seafood, and nut allergies tend to last a long time. Strategies like early introduction to the allergen can prevent some allergies from developing, like peanut allergy.

Are Food Allergies Curable?

No, food allergies are not curable. However, some children can outgrow certain food allergies (especially to milk, wheat, and soy) with time, as their bodies develop a tolerance to the antigens in these foods. Similarly, some people may become less sensitive to allergens over time and be able to withstand higher amounts, even if they are not fully tolerant of the allergen.

What Is the Difference Between Food Allergies and Food Intolerances?

The primary difference between food allergies and intolerances is the involvement of the immune system. Food allergies are adverse food reactions that involve the immune system, while food intolerances do not. Instead of immunological mechanisms, food intolerances include metabolic, toxic, pharmacologic, and undefined mechanisms.

Food allergies are also typically more severe than food intolerances, with life-threatening symptoms like anaphylaxis. IgE-mediated food allergies usually present with symptoms as early as a few minutes after ingestion, while food intolerances take longer before symptom onset. 

Can a Person Have Both Food Allergy and Food Sensitivity?

Yes, a person can have both food allergies and food sensitivities. People with food allergies are usually allergic to 1 to 3 different foods, and these allergies can be independent of one another. Therefore, it is possible to have a food allergy to peanuts and a food sensitivity to cow milk or soy at the same time. In cases where a person has both food allergies and food sensitivities, diagnosis is to be done differently, and the treatment approach should also be in line with the specific adverse food reaction.

Conclusion

Food sensitivities and allergies are both immune-related adverse food reactions. However, food allergies are often IgE-mediated, causing immediate and severe reactions like anaphylaxis. On the other hand, food sensitivities are non-IgE-mediated, less understood, and cause delayed symptoms affecting the gut, skin, and nervous system. Diagnosis of food allergies involves defined tests like IgE testing and oral food challenges, while food sensitivities rely on elimination diets and symptom tracking due to the lack of biomarkers. 

Accurate diagnosis and personalized management are essential to reduce risks and improve your quality of life. You can get both these services from the Bay Clinic of Chiropractic, Panama City, Florida. Contact us at (850) 785-9372 or info@thebaydoctor.com 

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