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Allergies Allergy Basics

When is a "Food Allergy" Really an Allergy?

Food allergies are often misunderstood. Oftentimes, what is at first thought to be a food allergy turns out to be something else. For example, many people think they are allergic to a food when in fact they have a food intolerance, a much more common cause of symptoms such as nausea, cramps and bloating. The difference is that intolerance symptoms are not triggered by an immune system reaction, as is the case with allergies. People with lactose intolerance, for example, lack an enzyme needed to digest the sugar (lactose) in milk. A closer look at the basics of food allergy may help clear up the confusion surrounding the problem.

The Classic Food Allergy
Let's look first at "true," or "classic," food allergies and how to prevent and treat them. An allergy is caused by an immune system reaction to an allergen (any substance that causes an allergic response, in this case proteins in certain foods). The immune system produces antibodies to these food proteins, so that the body recognizes the food as a foreign invader. If you have a food allergy, any time you eat the offending food, your body will launch a defense, releasing chemicals, such as histamine, that trigger your symptoms. Classic food allergies include reactions to milk, soy, egg whites, shellfish and peanuts. Peanut allergy is a good example to examine, since it is one of the most widely known food allergies and is becoming more common. It is also the food allergy most likely to be fatal. Food allergy symptoms can range from hives and itchy skin to potentially deadly reactions such as airway constriction.

One question frequently asked of me is whether people can outgrow their food allergies. The answer is both yes and no. Between 6 and 8 percent of children younger than 3 will experience a food allergy, yet many will out grow them by the age of 10. While I see this frequently with egg and milk allergies (about 80 percent to 85 percent of the time), it is much less common with nut allergies, Only about 20 percent of children will lose their allergy to peanuts.

Food Allergy Reactions
Reactions that may indicate a food allergy are itchy mouth, "fullness" in the throat, difficulty breathing, an intense, itchy rash all over the body, and vomiting. In a worst-case scenario, a food allergy can result in anaphylaxis, a serious, sometimes life-threatening, reaction that may include airway constriction, a drop in blood pressure and loss of consciousness. Although severe reactions do occur, milder food reactions are more typical. Common mild reactions would include hives or red, itchy skin (eczema). Some of my patients with mild food allergies have also complained of fatigue or increased nasal irritation.

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