Food Sensitivity vs. Allergy - What's the difference?

Used correctly, those other tests are wonderful. I have had literally people who were very, very, very ill, and in the process of sorting out their very bad chronic illness, they did one of these other types of tests for food sensitivity, and by removing those foods from their life, it changed their life completely. I'm Dr. A, and I answer your questions. This whole channel is about answering questions that people ask, and I answer them based on many, many, many years of experience as a practicing physician and a researcher, a writer, and a teacher. So I want to just take some time to talk about this food reaction thing that goes on and all the confusing terminology that you have. Obviously, people react badly to food. We know that. Right. Now, when we say food allergy, usually the XYZ, this whole halo of things that we limit the term food allergy to, is a type of reaction where Usually you have the type 1 immunoglobulin, the immune proteins that are released in the category of immunoglobulin IgE, like Edward. IgE is associated with type 1 reactions, which is allergy through anaphylaxis, that thing that can kill you, right? If you have that type of a reaction, then we say Yeah, that's bad. That's, that's food allergy, right? So it's mediated by an immunoglobulin, a type 1 immunoglobulin reaction. What I normally would tell patients is it usually, if you have a type 1 food allergy reaction, you know about it. You might even wear a wrist bracelet that says this person's allergic to shellfish, this person's allergic to latex. There's a lot of foods that are in the latex family like avocado, or this person's allergic to whatever. They're laying on the ground not breathing well. That might be part of the problem. You die from those sometimes. So normally if you have a type 1 allergy to anything, but especially a food, you've had that sort of reaction. You were saved because maybe given epinephrine or something and you lived through it. And now you don't ever want to eat that food again. That's very wise. Don't eat those foods. That's food allergy. Is there anything else other than that XYZ of that very bad deadly disease that could be a food reaction? Yeah, like the whole rest of the world. Now if you look at the allergy and immunology research written about food reaction, gastroenterology research, they admit— because it's true and very obvious, they have to admit this— that there is this food allergy thing, but then there's a whole world of other reactions that go on. Now what they will usually do, and this is true and why the gold standard beyond the testing you do for Type 1 allergies that tell you, don't, don't eat that, you're likely to die if you eat that food. This whole other universe, what they really recommend is our gold standard, and I'm saying our by these folks and the way they write, is to do an elimination and rechallenge of the foods. Which is smart because what they say is there's all these other reasons for food reactions that are not type 1 allergy, and we understand that, and we know you get sick from eating You know, whatever it is, dairy, whatever, but it's not this kind that will kill you. So then they usually say, technically, that's not going to be a food allergy, but it's some sort of food reaction, food sensitivity. These other words are used. Now, why would an elimination of the food and then challenging again be a way to identify the whole rest of the alphabet except X, Y, Z, those deadly food allergies, right? The reason that works so well is that Because there's lots of other immune system and other ways that you react to food, and we can't test for all of them. This doesn't care what immunologic way that you react to the food. It just says, I eliminated— let's say, for example, you know, you are concerned about dairy and grains. You do a diet that has none of that stuff in it, and then you'll try them one at a time, just on one day. Okay. If you haven't had any chicken for, you know, 6 weeks to 12 weeks, let's say, and then you eat some and then you get some kind of— you break out in hives or you throw up or whatever your reaction is, you've got a problem with chicken. Okay, we didn't— it didn't say why you have the problem. It just means that's not good for you. You shouldn't eat it. Now, that is considered a food reaction or a food sensitivity. Very important. It's Not going to kill you if it— let's say you do the testing for the type 1 allergic response, okay? That's usually either a blood test to check for the IgE levels, might be like a skin test, a scratch test, something like that. If it's not that though and it didn't— chicken didn't come up there but you eat it after an elimination period and you get really sick, chicken's not good for you for some reason. That could be another immunoglobulin. It could be a histamine response. It could be a bunch of stuff. The bottom line is that although it's not a life-threatening allergy, it's not good for you for some other reason. So a lot of times we will define those as a food sensitivity or food reaction or food sensitivity reaction. Now, can I test for those? A lot of people say, I don't want to do elimination. That sounds like a pain. I'm going to take, you know, dairy and grains and chicken and You know, the whole list of things out of my diet. I'm going to be eating a hypoallergenic diet for, you know, 6 weeks to 12 weeks, and then I'm going to rechallenge those foods? No, not doing that. Well, that's what elimination diet is. Yes, there are ways to check other things, but what you want to be sure that you think about with respect to checking other things is there are great tests that test for histamine response because it's a different type of immunologic response. I've used those a lot. The histamine response testing. Those are really wonderful. They cannot relate to deadly allergy, but they can make you really sick nonetheless. Then we have other immunoglobulins. You got like IgA, like alpha. IgA is the immunoglobulin in your mucous membranes, like your digestive tract, et cetera. Well, if you have an IgA response to a food, it may not kill you, but it might make you feel sick. There's also a couple of kinds of IgG. G like George. So not E, the potentially deadly one, but IgG. So you can test for those. Well, those are just other little chunks, and there's a few other tests as well that you can look at with foods and food responses. But the thing you want to remember is, and this is something clinically, you know, sometimes people say, well, why don't you do more of these other food tests with people? And I certainly would, okay? I would always, you know, look for the deadly ones, and then I would look for other allergies with people, but a lot of times I wouldn't jump right to these other tests because I would like to see if there's other functional reasons why you just don't react to that food very well, or if you would do an elimination challenge. Why? Because these other tests test very specific laser-focused types of other allergies or sensitivities, but they don't test the whole rest of the reason why you might react to food. Now, I have had doctors come back and say, well, you're saying you don't like these other tests. No, no, that's not what I'm saying. Used correctly, those other tests are wonderful. I have had literally people who were very, very, very ill, and in the process of sorting out their very bad chronic illness, they did one of these other types of tests for food sensitivity, and by removing those foods from their life, it changed their life completely. They were miraculously better, like 75%. So I've seen these things really work. But what if you get that test and you're testing over here and then your problem's up here? Okay, the test is great, but it misses, it misses where your problem is. And that's why really the immunology community, allergy community, they really like the elimination challenge test. So they say, we're going to test you for the big, bad, deadly reactions, and if it's not on there and you're still reacting to foods, we're going to do an elimination and rechallenge test. So a couple of things to wrap up here. A lot of people will call everything that you react to a food allergy, and it may or may not be a food allergy. Food allergy tends to be limited to the XYZ group of things that are very bad for you, might kill you, allergy anaphylaxis that we find through IgE testing or scratch testing or something. That doesn't mean that there's not 100 other reasons that you react to food, and we normally then call those a food sensitivity, a food reaction, a food sensitivity reaction, sometimes put it all together. Etc. It's still a problem. It's not good for you, right? It's not going to kill you, probably, but it's not good for you. It creates inflammation, makes you sick, makes you throw up, whatever the problem is. So there's 2 kinds of big reactions you can have to food. Neither is exclusive of the other. Just because it doesn't kill you doesn't mean it's good for you, okay? And just because maybe it's a non-life-threatening food reaction doesn't mean it's not worth Maybe not eating that food or doing whatever else you do. So this is to try and clear that up. And the way you— the best way to weed those out is an elimination challenge. But there are other tests. You just need to know that every test has its limits. It's not going to pick up everything. It will pick up some things, and sometimes they're wonderful and they really, really help with your case. All right. Well, I'm Dr. A answering a question around food sensitivity versus food allergy. Please keep these questions coming in. If you haven't subscribed and you like this content, I do a lot of these questions answer videos. Like, share, subscribe, hit the notification bell. It's been really, really fun, uh, doing these. I'm gonna do a lot more. Thanks again. I'll see you all on the next video.