What is the difference between intolerance and allergy?
One gets itchy from a strawberry, the other gets a stomach ache from milk. Many people have food allergies or a food intolerance. But what’s the difference?
There are proteins in almost all foods. For example, there are proteins in milk, nuts, meat, cheese, legumes and fish. Those proteins normally do no harm. The body actually needs protein.
food allergy
In some people, however, the immune system reacts very strongly to certain proteins: an allergic reaction occurs. The proteins that cause a reaction are called allergens. For example, peanut protein can be an allergen. If someone with a peanut allergy ingests (sometimes even a very small amount) peanut protein, the immune system starts fighting those peanut proteins. The body then makes antibodies (IgE) and histamine is released. And the latter substance is responsible for the allergic symptoms.
Allergic complaints
The complaints can manifest themselves through the skin (redness, hives, itching, eczema), but there can also be eye complaints (itching, tears), respiratory complaints (stuffy nose, sneezing, tightness, wheezing), the gastrointestinal tract (nausea, abdominal pain, diarrhoea, vomiting) and cardiovascular complaints (sweating, dizziness, low blood pressure). You can also suffer from angioedema. The latter are local fluid accumulations that mainly occur in the face. A swelling in the neck can be life-threatening.
The diagnose
There are several ways to diagnose food allergies. Often a combination of studies is used. For example, to make the diagnosis, blood tests are used to detect antibodies. In the skin prick test, drops of an allergen are placed on the skin. It is punctured through and after about 15 minutes it is checked whether the skin reacts allergically at the puncture site. The best diagnosis is made through a double-blind placebo-controlled food challenge (DBPGVP). Such a test is performed double-blind. This means that both the patient and the researcher or doctor do not know what the allergen is and in what quantity. During the study, the patient is given a food containing the allergen or a food containing a placebo. An IgE allergy can be hereditary.
food intolerance
An intolerance is a non-allergic reaction to food. The immune system has no or an insignificant role in this. An intolerance can be caused by a deficiency of a certain enzyme, such as lactose intolerance. In this case, someone makes too little lactase (an enzyme that ensures the digestion of milk sugar) and not all lactose in the body is digested. This causes complaints such as flatulence, diarrhea and abdominal pain. An intolerance can also be caused by substances that are already present in the diet, such as histamine or tyramine. The foods that cause intolerance symptoms are not called allergens but ‘triggers’.
Complaints that can occur with a food intolerance are nausea and vomiting, abdominal pain, diarrhea or constipation.
Do in case of intolerance or allergy:
- Do you suspect that you have an allergy or intolerance? See your doctor or a dietitian and get a test done.
- If you have an allergy or intolerance, adjust your diet with the help of a dietician. This way you avoid a one-sided power supply. Read labels. Also from products in which you do not expect allergens. For example, toothpaste can contain the allergen gluten and baby food can also contain allergens.
- At the risk of a rapid, life-threatening reaction (anaphylactic shock) you will be prescribed an adrenaline pen. This is an injection pen filled with adrenaline. Always keep this pen with you and that people close to you know how the pen works.
