food allergies intolerance

Food allergy and food intolerance are two types of reactions that are completely different in nature. The former is a pathological response mediated by the immune system. A very small amount of exposure may induce shock or even death. The latter is mostly a non-immune reaction caused by the lack of corresponding enzymes in the digestive system or stimulation. It only causes discomfort when the intake reaches a certain amount and is rarely life-threatening. The two must not be confused, let alone blindly label yourself as "allergic".

Last week, I met a girl in the clinic. She was crying while clutching a "food intolerance test report" from an internet celebrity organization, saying that she couldn't touch more than 20 kinds of food and that she had no chance of survival in this life. I took it over and saw that even rice and cabbage were on the "mild intolerance" list. When I asked her about eating these, she didn't feel any discomfort at all. She was simply fooled by the test.

To be honest, these two concepts have been talked about interchangeably for so long that many people can’t figure out the difference. I treated a 10-year-old boy before. His grandma fed him a spoon dipped in mango juice. Within five minutes, his lips swelled into sausages and he couldn't breathe. He was given hormones in the emergency department before he recovered. This typical IgE-mediated allergy is really untouchable, and epinephrine pens must be always available at home. But I still feel uncomfortable after eating. My best friend drinks half a cup of milk and is fine. But after drinking a full cup, she feels bloated and runs to the toilet. All the allergen tests are negative. It is just a simple lack of lactase secretion, which is a typical food intolerance. Now every time she drinks milk with a lactase enzyme, there is no problem at all.

The most controversial issue in the industry right now is whether food-specific IgG testing is an IQ tax. The consensus in the traditional immunology community is very clear: food-specific IgG is the normal immune response of the human body after exposure to food. As long as there are no corresponding symptoms, there is no need to avoid foods. It is sheer nonsense to use this indicator to determine "intolerance" and to avoid foods. ； However, many researchers in the field of functional medicine believe that sustained high-titer IgG combined with chronic gastrointestinal discomfort, unexplained rashes, and fatigue can indeed be used as a reference for adjusting diet, but it must not be used as the only basis, and you cannot directly blacklist foods as soon as you see a positive.

I met a young man who was working out before. I heard on the Internet that the IgG test was accurate and found more than 20 food intolerances. Even eggs, beef, and salmon were on the list. He had been avoiding all foods for three months. His protein intake was seriously insufficient, his training status was in a mess, and he caught colds easily. Later, we gave him an oral provocation test and tried it. In fact, he only felt a little bloated after eating a whole whole wheat bread. Other so-called intolerance foods had no problem at all. Now he has added back all the meat, eggs and milk that he was forbidden to eat, and his training state has returned quickly. Occasionally, he gets a craving for whole-wheat bread and gets bloated, so he chews two tablets of digestive enzymes, which does not affect his life at all.

What’s interesting is that many parents are overly nervous about their children’s food allergies and won’t even let them touch them. Instead, they don’t take their own intolerance seriously. Drinking iced milk tea and having diarrhea every day is considered “detoxification”, which is quite double standards. In fact, when most people encounter diarrhea after drinking milk tea on a daily basis, nine times out of ten, either they are intolerant to the lactose in the milk, or they eat too much sugar substitutes such as erythritol and sorbitol, which cause the intestinal osmotic pressure to rise. There are also people who feel itchy and red spots all over their body after eating crayfish. Don’t be too busy saying that you are allergic to seafood. Sometimes the crayfish you eat is not fresh and the histamine exceeds the standard, causing an allergic reaction. It may not be a problem at all if you eat a fresh one.

There is actually no unified standard answer regarding the treatment plan. For food allergies, the traditional guideline is to strictly avoid food for 3-6 months and then review it, and then slowly try to introduce it. However, in the past two years, more and more clinical studies have shown that for people with non-severe allergies, gradual exposure to allergens in small doses under the supervision of a doctor can induce immune tolerance faster, which is better than avoiding food all the time. However, this program has not yet been widely popularized. You must listen to professional doctors whether you want to try it, and don't try it blindly at home. If it induces a serious reaction, the gain will outweigh the loss.

Over the years, I have seen too many people attribute occasional gastrointestinal discomfort to food allergies. They dare not eat this or touch that. In the end, their diet is a mess, their immunity has not improved, and they have more problems. If you really suspect that you have a problem, don't buy those messy fingertip blood or hair test kits. Go directly to the allergy department of a regular hospital to register. Check IgE first, and if necessary, do an oral food challenge test. This is the gold standard. To take a step back, even if there is an intolerance, it is mostly a matter of quantity. For example, drinking half a cup of milk is fine, but drinking only one cup will cause bloating. There is no need to stop drinking it at all. Just small amounts many times or with some lactase enzyme will be enough. You don’t have to fight against your appetite, right?