Food Allergy Vs. Food Sensitivity: What’s The Difference?

By this point, you probably understand that food can cause reactions in our bodies.

Since every human body is different, these reactions can vary from person to person.  Maybe you develop a rash after eating shrimp, experience migraines every couple of days, or get bloated and uncomfortable after you eat dairy products. How can you determine the difference between a food allergy, food sensitivity, or food intolerance? Let’s discuss below.

Food Allergy:

A food allergy is the result of your body’s immune system attacking the protein in a certain food. Food allergies affect about 4% of adults and 8% of children in America. Your body releases powerful immune chemicals (like histamine) as a result of eating a food allergen. These chemicals cause the common allergy symptoms such as redness, swelling/anaphylaxis, and hives.

The top 8 most common IgE food allergies are milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat.

There are multiple ways to diagnose a food allergy.

Skin Prick Test: This test, done in a doctor’s office, pricks a tiny amount of various food proteins and awaits response from your skin indicating an allergic response (i.e. a wheal/flare formation causing redness and swelling).

ELISA IgE: This is a blood test, designed to detect IgE antibodies in response to various food proteins.

Food Challenge: An incremental dose of food protein vs placebo is given at 20-minute intervals while waiting for signs/symptoms of food allergy. This test is not commonly ordered, because there are many pitfalls, such as the risk of severe reactions.

Food allergies usually require lifelong avoidance; however, research has shown that some children may outgrow milk, soy, and egg allergies.


Food allergies and sensitivities are different. The symptoms can vary for each person. Food Farmacist RD breaks it down to help you figure out if you are experiencing an adverse food reaction.


Food Sensitivity:

Unlike allergies, food sensitivity reactions may not occur right away and can happen up to 72 hours after consumption.  This is why it is SO hard to determine what may be causing your symptoms by only doing a typical elimination diet. The food that may be triggering your eczema, for example, may be something that you ate nearly two days ago!

Also unlike allergies, food sensitivities are triggered by multiple pathways of the immune system and do NOT involve the typical allergy IgE antibodies. Traditional allergy testing does not work for food sensitivities, because food sensitivities are not controlled by IgE antibodies. Instead, they can be mediated by different antibodies such as IgG, IgM, or immune cells like T-cells, neutrophils, and more.

What do all of these food sensitivity pathways have in common?

The endpoint of ALL of these pathways is the production of inflammatory chemicals (mediators). Did you know food sensitivities are often the culprit for migraines? For example, this study found high levels of a chemical called Interleukin-5 in 84% of patients suffering from migraines.

By measuring these chemicals via your cells response to various foods, we can identify which foods may be causing your symptoms.

There is only one food and chemical sensitivity test that accounts for all of the non-IgE pathways, the Mediator Release Test (MRT). By measuring your blood’s inflammatory response to certain foods and chemicals, we are able to classify these foods as reactive (highly likely to cause symptoms), moderately reactive (may cause symptoms), or non-reactive (safe- will not cause symptoms). You can read more about the patented Mediator Release Test here.

Most other food sensitivity panels only test your body’s IgG antibody reaction to certain foods. The problem with this is that IgG reactions may not all be bad. Sometimes, a high IgG reaction to foods can simply indicate that we recently ate those particular foods. The MRT blood panel is different from other food sensitivity tests because it accounts for all of the possible food sensitivity immune pathways. This is why Food Farmacist RD utilizes the MRT test as a starting point to identify food triggers for your symptoms. By eating the foods that are calming to our body, we are able to create a state of balance and healing with food.

Do you have to avoid your food sensitivities forever?

Not necessarily. Food sensitivities are typically not permanent, and once the gut is healed, the negative response may decrease. Many people can eventually resume eating some of the foods they were once sensitive to, even if only in small doses. Over time, food sensitivity reactions may change, depending on lifestyle, diet, medications etc. Let’s recap food sensitivities versus food allergies before moving on.


Food allergies and sensitivities are different. On this table, Food Farmacist RD breaks down the basics of comparison between the two. Click to read more about which food reaction might be happening to you.


Food Intolerance

Food intolerances do not involve the immune system at all.

Instead, food intolerances occur because of the way your body processes the food or components in the food. Take for instance: lactose intolerance. In this case, the body does not have the enzyme lactase to digest the milk sugar called lactose. As a result, the bacteria in the colon feed off of the undigested lactose. BOOM – hello GI distress (bloating, diarrhea, gas etc.).

How can we test for food intolerances?

Some food intolerances can be tested through your breath. For the above example, a person who suspects lactose intolerance could undergo a Hydrogen Breath Test. This test is relatively simple. The person will need to fast the night before and will start the test by drinking lactose containing substance . Then, the person will give breath samples every 15 minutes for about two hours. The breath samples are analyzed for hydrogen content. If a high amount of hydrogen is detected, this may indicate that your body is unable to digest lactose. So, the bacteria in your gut will breakdown the lactose instead, which then causes hydrogen release and GI symptoms.

Most times, people who have food intolerances do not do a Hydrogen Breath Test. This is because most food intolerances occur in the following hours after eating that particular food product. By eliminating that food product, many people are able to resolve their GI symptoms. Note: if you cannot resolve your symptom with eliminating lactose, for example, you may also have underlying food sensitivities.

How can we treat food intolerances?

You can treat intolerances by avoiding the food, taking appropriate digestive enzymes to help digest the food, or consuming foods with the pre-digested form (ex: Lactaid milk).


So, you might be super overwhelmed, or not quite sure where to begin assessing your OWN food reactions. As a reminder, there are three different types of food reactions that can occur in your body. A food allergy usually occurs immediately and can be life-threatening. Food sensitivity can occur at any time up to 72 hours past consumption. The only food sensitivity test that accounts for all of the food sensitivity pathways is the Mediator Release Test. Lastly, a food intolerance does not involve the immune system and is usually a result of your body’s inability to break down certain foods.

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