These days, it’s expected that servers at restaurants ask guests about food allergies before taking their order, and for good reason: Almost 20% of adults believe they have a food allergy, according to a January 2019 study in the Journal of the American Medical Association.
However, only about 10% of adults actually have a diagnosed allergy, according to the same study. While it’s still a significant number, it means half the people who think they have an allergy are still in the dark about what the issue really is. Instead of self-diagnosing, or ignoring a potential problem, here’s what you should know about food allergies, how they differ from food sensitivities and what to do if you have symptoms of either.
FOOD ALLERGY OR FOOD SENSITIVITY?
Food allergies and food sensitivities can trigger some miserable symptoms, like stomach pain and fatigue. Food sensitivities only occur within the digestive system, and while eating a food you have a sensitivity to might cause discomfort like bloating, it isn’t life-threatening. Some people may even be able to eat the food in small amounts with no symptoms, according to the American Academy of Asthma, Allergy, and Immunology (AAAAI). While this is good news overall, it can also make a food sensitivity tough to diagnose.
A food allergy, on the other hand, has consequences beyond the digestive system. If you’re allergic to a food, eating it will trigger an immune system response that causes an allergic reaction throughout the body, according to the AAAAI. The severity of an allergy can range from person to person; someone with a less severe allergy may get itchy after eating a triggering food, while someone with a more severe allergy might be at risk of anaphylactic shock (a serious condition that causes swelling and difficulty breathing) after just touching or smelling the food.
SYMPTOMS TO LOOK FOR
“Food allergy symptoms can include tingling in the mouth, hives, itching, eczema, swelling of the lips, face, tongue or throat, wheezing, congestion, trouble breathing, dizziness, lightheadedness, fainting, abdominal pain, diarrhea, nausea or vomiting,” says Amy Gorin, MS, RD. Food sensitivity symptoms, she says, include stuffy nose, fatigue, headaches and stomach pain or discomfort.
WHAT TO DO IF YOU EXPERIENCE ANY OF THESE SYMPTOMS
Make an appointment with an allergist, says Gorin. Anyone with a severe food allergy has likely already been diagnosed, since symptoms like vomiting, closing of the throat and trouble breathing can land you in the emergency room. But, it’s important to get a diagnosis from a professional even if your allergies aren’t so severe. “Eating a food that once caused a mild reaction could another time cause a severe, life-threatening reaction and it’s not worth taking a chance,” notes Gorin.
An allergist will run one or several tests to help you sniff out a food allergy. “This testing could include a skin prick test, a blood test, an oral food challenge or a trial elimination diet,” says Gorin. If the tests show evidence of an allergy, “you can manage your symptoms as well as take any necessary precautions, such as carrying an epinephrine pen if you have a risk of an anaphylactic reaction.”
WHEN IT MIGHT BE A FOOD SENSITIVITY
If allergy testing doesn’t lead to a diagnosis, it’s possible you have a food sensitivity. While the consequences aren’t as serious when compared to food allergies, it can still be a big pain. Trying to self-diagnose or following an elimination diet without the supervision of a doctor or dietitian can lead to more problems.
“An elimination diet is a short-term protocol designed to help you figure out what foods, if any, you’re sensitive to,” says Leslie J. Bonci, RD, owner of Active Eating Advice. “You really should only do one if it’s medically necessary, and you should be under the guise of a dietitian the whole time.” He or she will guide you through a process of eliminating common trigger foods, then systematically reintroducing them one at a time in order to figure out which ones might be causing problems.
Moreover, Bonci emphasizes that elimination diets aren’t meant for the long-term. “The problem with all of these popular elimination diets floating around is the fear factor,” she says. “When people restrict certain foods and still have symptoms, they often think, ‘Oh, I should restrict more,’ rather than recognizing that food may not actually be the problem.” This can lead to disordered eating habits, and even nutrient deficiencies. If a dietitian-supervised elimination protocol still doesn’t get to the root of your problems, schedule an appointment with a gastroenterologist, who may diagnose irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) or another digestive issue that can be managed with doctor-recommended lifestyle changes or prescription medication.
