Food allergies and intolerances

Many people mistakenly tend to confuse allergies with food intolerances : the concepts, however, are very different, despite the fact that the related symptoms are, in some ways, overlapping.
In this article we will try to shed light on the meaning of “allergy” and “intolerance”, analyzing the causes that trigger them, the underlying mechanism, the symptoms and possible remedies.

Food allergy

Allergy is an exaggerated reaction of the immune system , which is triggered in response to an antigen . Rather than “antigen”, however, when considering a food allergy it would be more correct to speak of “allergen”, which is perceived as a foreign element by the body, and therefore as a possible source of damage. The antibody system provokes an immune response: it is the food itself with its allergens (more precisely the proteins contained in it) that causes this disproportionate response, which can also lead to very harmful consequences for the organism.

Food intolerance

For intolerance, however, the concept is different: the immune system is not involved, therefore an immune response is not triggered.
The etymology of the term “intolerance” already indicates the inability to endure, to tolerate: following an abundant intake of a certain food, the organism “rebels” because it cannot digest it properly. This is the reason why intolerance is a toxic reaction of the organism, unlike allergy (non-toxic reaction) which does not depend on the dose taken.

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Food allergies or intolerance?

To simplify the concepts, an example is given: the immune system of a person allergic to strawberries reacts in an exaggerated way even if the person eats only one fruit, which means that even a single strawberry is perceived as a “foreign and potentially dangerous element” for the organism, which is defended by causing a first alarm bell ( itching and irritation in the skin). If, on the other hand, a person is intolerant to strawberries and takes a very small amount (one or two strawberries), there will be no skin reaction. However, when the subject eats a large dose of these fruits, the food is no longer able to be digested: consequently there will be effects on the skin.

Still other factors can be highlighted that distinguish allergies and intolerances: allergies are classified according to the antibodies involved in the reaction (IgE-mediated and IgE-non-mediated), while intolerances, not involving the antibody system, are divided into “enzymatic” and “pharmacological”.
By “enzymatic” we mean an intolerance determined by the lack, or deficiency, of an enzyme involved in digestion : the enzyme is unable to digest food. This is the case, for example, of lactose intolerance , the characteristic sugar of milk , due to the lack of lactase , the enzyme responsible for the digestion of lactose..
By “pharmacological” we mean an intolerance in which the subject is sensitive to some substances found in the food. This is the case, for example, of foods rich in tyramine and their effects in subjects hypersensitive to this substance.

The only factor that unites, even if only in part, allergies to intolerances is the symptoms: in fact, the effects that occur after an allergic reaction or food intolerance are common: abdominal pain , diarrhea , nausea , bloating at the stomach , itching and redness of the skin are the symptoms found in both problems. Certainly, however, the symptoms that occur in an allergy can be greater than the same ones that occur in an intolerance: allergic manifestations can in fact also lead to respiratory and cardiorespiratory problems, up to the most severe form ofanaphylactic shock which, if not treated immediately with specific drugs, can cause coma and even death.

It is good to remember that sometimes forms of food intolerance can occur that can be confused with an allergy, because they are characterized by elements that are found in both disorders: for this reason, we speak of “pseudo-allergies”. These particular problems, included in the category of pharmacological intolerances, are intolerances defined as a sort of allergy due to the production of histamine following the ingestion of a food. For example, shellfish , chocolate , tomatoes , canned fish are all foods defined as “histamine-releasing substances”.

Regarding the remedies that can be adopted to avoid allergies and intolerances, if that particular food is completely eliminated from the diet of an allergic subject, it will no longer have any type of manifestation (exclusion diet). If a person is intolerant, however, he can still continue to take that food, but in small doses; sometimes total abstention is suggested for short periods, in order to recreate the enzymatic heritage necessary for the digestion of the food.

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