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What is the difference between food allergy and food sensitivity?
Help me understand whether this could be a food sensitivity or a food allergy:
tl;dr: I get joint pain in my wrists, a rash on my hands, and a red, itchy neck when I eat gluten. I tested negative for celiac disease, but it and thyroid disease run in my family. I’ve been eating gluten-free for almost two years. I recently developed the same neck and wrist symptoms when I eat dairy, so I’ve given that up as well. Is this a food allergy, or a food sensitivity? And I should probably be worried about leaky gut, right? What are the chances I'll continue to lose more and more food groups?
Background:
My mom was diagnosed with celiac in 2021 or 2022 in her late 50s or early 60s. At least one cousin and aunt also have celiac and thyroid diagnoses.
I thought I had dodged all the problems until late 2022. I started getting a red, itchy neck. I also had some issues with runny stools and urgent bowel movements. I read that many first degree relatives can have asymptomatic celiac disease, so I decided to get tested eventually. However, I didn’t have a primary care doctor at the time and was too busy.
February-May of 2023 was probably the most stressful period of my life, as my workplace was undergoing a hostile takeover, I was one of the last members of leadership left, and I was job searching and moving halfway across the country.
The itching was getting worse, but I knew if I stopped eating gluten before getting tested, the test would not be accurate. Then, during the worst of the stress, my wrists started hurting. For a week it got worse and worse, then the pain started traveling up my arms. At that point, I went to Lab Corp and got the celiac test. It came back negative, I cut out gluten, the wrist pain was gone within days, and my mild digestive issues went away. When I ate gluten for a day, and the symptoms immediately returned.
Since then I figured I have Non-Celiac Gluten Sensitivity, but I haven’t pursued a diagnosis, and sometimes I wonder if the test was accurate, since I wasn’t eating that much gluten at the time.
When I have had gluten by accident, I get small red dots all over the backs of my hands, my wrists hurt, and/or my neck itches and turns red. Once I thought, “maybe I’m not sensitive anymore” and ate a breadstick, and my hands had the red rash for a week.
Recently I started to notice my neck itching again. This was the first symptom I noticed with gluten. I didn’t think I was getting glutened by mistake.
I cut out dairy as an experiment, and the itching went away within a few days. When I had some dairy, the itching came back and my wrists started hurting. This happened even with gluten-free cornbread containing a little buttermilk.
I’ve now cut out dairy, but I’m concerned that I might have ongoing gut issues or “leaky gut,” and that other food groups might be next. I’m also concerned about eventually developing celiac disease—if I don’t already have it—or other autoimmune diseases.
I’m also confused about what to call this, and I haven’t found much online. Some reputable sources say that a food allergy is very dangerous, involves the immune system, and can cause anaphylaxis. I’ve never come close to having breathing problems from food that doesn’t seem to fit. But the websites said a food sensitivity or intolerance mainly involves the digestive system, like lactose intolerance, which doesn’t seem to fit either since I have symptoms in my skin and joint pain.
What do you think is happening, and would it be considered a food allergy? I don’t think my primary care physician is very knowledgeable about this, since she told me I could be tested for celiac without eating gluten.
Appreciate any input!
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Allergies of any type requires they be life threatening reactions. Mainly hives. Simply said, if you react, your are sensitive, if you have hives or other life threatening reactions then it is an allergy. Avoidance maybe the only solution for many sensitivities and allergies. I am allergic to aspirin and all non steroidal antiinflammatories NSAIDs. Avoidance is the only solution. I am also allergic to a few foods and again avoidance is the solution. Hope this helps you understand allergies vs. sensitivities.
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1 ReactionThank you! I guess I'm also wondering what causes food sensitivities. If the trouble isn't confined to my digestive tract, then what else is going on in the body? Do you have any recommended books or websites you've found helpful?
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1 Reaction@jabrown0407
Several years ago, I started listing cinnamon as an allergy. It was based on extreme headaches, sinus irritation, coughing, when I came in contact with it (mostly smelling it). If I smelled it immediately the headache, sinus irritation, coughing started.
Are you saying it is a sensitivity not an allergy?
@jenlemon - this Mayo Clinic article might be useful:
- Food allergy vs. food intolerance: What's the difference?
https://www.mayoclinic.org/diseases-conditions/food-allergy/expert-answers/food-allergy/faq-20058538
What does your doctor think is going on, jenlemon?
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1 ReactionTechnically yes, avoidance is the solution for both for most foods. Realistically I would not split that hair, however medical professionals often use the differentiation to classify the reactions.
No, I'm not saying that. That's what I'm wondering---what is the difference?
I read an article from the American Academy of Allergy, Asthma & Immunology called Food Intolerance v. Food Allergy.
It said that a food intolerance "takes place in the digestive system" while "A food allergic reaction involves the immune system" and can lead to dangerous reactions.
Maybe I'm just overly focused on the anaphylaxis. It also says, "Symptoms of allergic reactions to foods are generally seen on the skin (hives, itchiness, swelling of the skin). Gastrointestinal symptoms may include vomiting and diarrhea. Respiratory symptoms may accompany skin and gastrointestinal symptoms, but don’t usually occur alone" which would seem to fit both of our cases.
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3 ReactionsThanks! My doctor didn't seem very interested or curious about the gluten issue. I have an annual appointment coming up in a few weeks, so I'm trying to decide how to bring it up again, now that I'm reacting to dairy too, esp. whether there are any tests I should get. I've resigned myself to cutting out dairy, but I'm concerned it might keep happening-- this year dairy, next year eggs.
So, a sensitivity involves the immune system but isn't life threatening. An allergy could be life threatening by causing anaphylaxis. And a food intolerance involves the digestive system, like lactose intolerance.
Do I have that right?
Intolerance can have other effects as well digestive, such as joint pain, outbreaks of canker or cold sores, acne, headaches.
The trick is to figure out if you have an allergy, an intolerance (which can be just as miserable) or both.
Or do what I do and just quit the offenders when they are foods. Medications can be a little more difficult because sometimes you have to suck up the side effects and take the drug if nothing else works.
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4 Reactions@jenlemon
My Mayo doctors don't question my listing cinammin only kind of laugh about it with me. So many products have it so kind of hard to stay away from it. My wife loves cinanamin but when she buys a product I can smell it immediately and start coughing, headache, sore throat, sinus irritation.
I have another allergy to a medicine. When I took it I have every serious side affect listed. So Mayo doctor changed the prescription and listed it as an allergy.
I have tremendous issuse with sinuses, sneezing, coughing at times. My PCP says he sees a lot of patient with these symptoms caused by pine allergies. I live in Florida when the most abundant tree is pine trees. You can imagine how much we are exposed to pine pollen. Problem is when you have (according to my PCP) allergy testing at Mayo Jacksonville they do not test for pine pollen.
Where I live in Jacksonville area you can see the pine tree pollen on everything. It cakes up on your mailbox, on top of your car. When the wind blows hard that is when everyone who is allergic to it really suffers.
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