Sensitivities and Intolerances: Distinguishing and Supporting

Introduction

Adverse reactions to food and environment affect a growing proportion of the population. An estimated 20% of adults report adverse food reactions, although actual IgE-mediated food allergy prevalence is only 2-4% in adults.

Definitions and Mechanisms

Allergy (IgE-Mediated)

A disproportionate immune reaction. Mechanism: sensitization then IgE-mediated mast cell degranulation releasing histamine. Symptoms within minutes: urticaria, edema, bronchospasm, potentially anaphylaxis.

Intolerance (Non-Immune)

Non-immune reaction, usually enzymatic deficiency. Example: lactose intolerance (lactase deficiency). Dose-dependent, delayed symptoms. Histamine intolerance (DAO deficiency) is another common form.

Non-Celiac Gluten Sensitivity

Digestive and extra-digestive symptoms after gluten ingestion without celiac disease or wheat allergy. Mechanism may involve innate immunity and/or fructan (FODMAP) reaction.

Diagnostic Tools

• IgE allergies: prick tests and specific IgE (RAST).
• Celiac disease: anti-transglutaminase antibodies + duodenal biopsy.
• Lactose intolerance: hydrogen breath test.
• IgG food tests: commercially available but not scientifically validated. EAACI advises against diagnostic use.
• Elimination-reintroduction diet: gold standard for food sensitivities.

Integrative Support

• Intestinal barrier restoration: glutamine, zinc, vitamin A, specific probiotics.
• Microbiome support: prebiotics, probiotics, fermented foods.
• Liver support: artichoke, milk thistle, desmodium, black radish.
• Histamine management: low-histamine diet, DAO supplementation, vitamin C.
• Psycho-emotional support: multiple food restrictions impact quality of life.

Disclaimer

This article is for informational purposes only. Any suspected food allergy must be evaluated by an allergist. Never undertake extensive elimination diets without professional supervision.