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Food Allergies vs Food Intolerances

Aug 22, 2022

When you hear the words "food allergy”, does it trigger images of hives, stomach cramps, and vomiting? How about food intolerance? Again, most people immediately think of skin and digestive issues.

While it’s true both can occur upon exposure to offending foods, some symptoms of food allergies and intolerances can be more subtle—especially when it comes to a food intolerance.

Food allergies

In a food allergy, the body mistakes an ingredient in food—usually a protein—as harmful. In response, the immune system produces a protein called Immunoglobulin E (IgE)—an antibody—to fight it. These antibodies attach to cells in the skin, lungs and gastrointestinal tract, causing any number of the following symptoms:

  • Hives, rash, or itching
  • Swelling
  • Wheezing or shortness of breath
  • Chest pain
  • Nausea or vomiting
  • Diarrhea
  • Cramping/stomach pain

You’ve probably also heard of more severe reactions to food (i.e. peanuts) where the allergen causes a potentially life-threatening reaction called anaphylaxis.

The most common food allergies include: fish, shellfish, tree nuts, eggs, peanuts, wheat, soy, and cow’s milk.

Those with diagnosed food allergies are advised to avoid the offending food completely, as symptoms can be triggered by even a small amount of the food and will occur every time it is eaten.


Food intolerances

More common than food allergies, food intolerances are a digestive response to a food rather than an immune response. They are thought to be caused by enzyme deficiencies, impaired food absorption, and other gastrointestinal issues.

Potential symptoms of a food intolerance include: nausea, vomiting, respiratory problems, brain fog, and skin conditions (i.e. eczema).

Unlike food allergies, those with food intolerances may not have symptoms unless they eat a large portion of the food or if they eat it frequently. Because of this, some people may choose to continue eating the problem food, rationalizing it with statements like:

“It’s just a little digestive upset! I’m willing to pay the price.”


The problem is, if left unmanaged food intolerances can increase the risk of developing neurological disorders and autoimmune disease—a condition where the body essentially attacks itself. Two examples of autoimmune disease are inflammatory bowel disease (Crohn’s disease and ulcerative colitis) and psoriasis.

So you see, just like food allergies, intolerances can be equally (if not more) detrimental to long-term health.

The four most common food intolerances are:

  1. Celiac disease
  2. Non-Celiac Gluten Sensitivity
  3. FODMAP intolerance
  4. Lactose intolerance


Celiac disease

Celiac disease is an inherited autoimmune disorder affecting the digestive process of the small intestine. When a gluten-containing food is eaten, the immune system launches an attack against the gluten, mistakenly damaging healthy cells lining the small intestine in the process. Gluten is a protein found in wheat, rye and barley.

Contrary to popular belief, Celiac disease is not the same as a wheat allergy. Remember, a food allergy triggers the immune system to overreact to a particular food, causing potentially serious side effects shortly after ingestion. A food allergy is an immune reaction, not an autoimmune reaction.

Non-Celiac Gluten Sensitivity (NCGS)

Non-Celiac Gluten Sensitivity—also known as gluten sensitivity—is neither an allergic nor autoimmune response. Symptoms often overlap with those of celiac disease and improve when gluten is eliminated from the diet. The difference is, the individual doesn’t test positive for the disease.

FODMAP intolerance

Gluten sensitivity can be confused with an intolerance to FODMAPs, which stands for: fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are all carbohydrates found in common foods like:

  • Wheat-based products: crackers, bread, cereal
  • High-fructose fruits: apples, dried fruit, watermelon, peaches, pears
  • Vegetables: garlic, onions, asparagus, Brussels sprouts, cauliflower
  • Beans: black, kidney, lima, soy
  • Dairy products: cow, sheep, and goat’s milk, yogurt, ice cream, cream cheese
  • Sweeteners: agave, high fructose corn syrup, honey, sugar alcohols (i.e. sorbitol and xylitol)

In FODMAP intolerance, the GI tract isn’t fully digesting and absorbing these carbohydrates. In some cases, the carbs become fermented by pathogenic bacteria in the small intestine. Excessive gas, abdominal pain, inconsistent or excessive bowel movements occur as a result, allowing for an increase of uncontrolled gut bacteria. This is often referred to as small intestinal bacterial overgrowth, or SIBO.

In other cases, individuals may lack adequate enzymes to break down and absorb the fermentable sugars.

Lactose intolerance

Also known as milk sugar, lactose is the carbohydrate-portion of animal-based dairy products like milk, yogurt, ice cream and cheese. Individuals who are lactose intolerant, have trouble digesting lactose due to a decrease in production and/or functionality of the enzyme lactase. Side effects can include:

  • Bloating
  • Diarrhea
  • Gas
  • Nausea
  • Stomach pain

Lactose intolerance tends to run in families, but can also be the result of intestinal damage caused by certain health conditions or treatments, such as celiac disease, certain cancer treatments, and gastrointestinal surgery.

In my next post I'll share helpful tips for managing these four food intolerances. Stay tuned! 🤗


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