Food Allergy or Intolerance?

Are food ‘allergies’ or a food ‘intolerance’ the same thing? Keep reading to find out what the differences and the similarities look like in a topic that often results in confusion.  Let us begin with the hypersensitivity, commonly known as a food intolerance.

The Food Intolerance…

The outstanding characteristic of a basic food intolerance is difficulty with digestion, although it may exist for a variety of reasons.  For instance, a dairy-based lactose intolerance is common throughout the world affecting up to 70 percent of people.[1]  This is the result of the lack of a specific enzyme called lactase which is not produced in the small intestine of certain people.  Without the enzyme lactase, the body simply cannot digest milk sugars which are the carbohydrates called “lactose”.

The milk sugar molecules (lactose) remain too large without the proper enzymatic function, therefore the small intestine cannot absorb it and these particles remain in the GI tract.  Due to this increased transit time, the gut microbes work to ferment the milk sugars.  Lactose reaches the colon still in the process of fermenting, and produces gasses such as carbon dioxide, methane, and hydrogen.  These are what cause the pain and discomfort of bloating which can further produce nausea or vomiting, especially in younger children.

Other symptoms of lactose intolerance are diarrhea, flatulence (generally with no odor), and constipation due to the production of methane that slows down the elimination process.  Constipation, although not commonly associated with lactose intolerance, has also been reported as a symptom.[1]  Still more symptoms may include: headaches, fatigue, loss of concentration, muscle and joint pain, mouth ulcers, and eczema. [1]

Various other different types of food intolerances are caused by chemicals such as caffeine and the amines that are in some cheeses; toxins, such as the aflatoxins in undercooked beans; natural food histamines like those in fish, fermented and cured foods, and in mushrooms; and salicylates that are often found in processed foods and food additives like artificial sweeteners, preservatives (nitrates and nitrites), flavorings, or colorings.[2]

The Food Allergy…

While a food intolerance causes digestive distress, a food allergy may cause a similar symptom set or in some instances can cause a much more concerning immune system reaction known as anaphylaxis.

Food allergies are an immune system reaction to specific proteins in food. This is why symptoms can be chronic or severe. What happens is that antibodies produced by the immune system, called Immunoglobulin epsilon (IgE) overreact to an allergen and in turn release chemicals causing an allergic reaction. More frequently the immune system’s reaction appears as “coughing, shortness of breath, itchy skin, hives, sneezing, systemic leaking of blood vessels that causes swelling and potential asphyxia, vomiting, and diarrhea. In severe reactions, blood pressure drops, draining vital organs and causing the heart to stop.”[3]

“Anaphylaxis is a type of allergic reaction, in which the immune system responds to otherwise harmless substances from the environment. Unlike other allergic reactions, however, anaphylaxis can kill. Reaction may begin within minutes or even seconds of exposure, and rapidly progress to cause airway constriction, skin and intestinal irritation, and altered heart rhythms. In severe cases, it can result in complete airway obstruction, shock, and death.”[4]

ANAPHYLAXIS
A severe, potentially life-threatening immune system reaction to otherwise harmless substances from the environment.

The severe reaction of anaphylaxis occurs most frequently as a result of allergens found in foods, drugs, and insect venom. The following list of possible causes of anaphylaxis is provided by thefreedictionary.com:

• Fish, shellfish, and mollusks
• Nuts and seeds
• Stings of bees, wasps, or hornets
• Papain from meat tenderizers
• Vaccines, including flu and measles vaccines
• Penicillin
• Cephalosporins
• Streptomycin
• Gamma globulin
• Insulin
• Hormones (ACTH, thyroid-stimulating hormone)
• Aspirin and other NSAIDs
• Latex, from exam gloves or condoms, for example
• Exposure to cold or exercise (in certain individuals)

While most allergic reactions to food do not lead to anaphylaxis, we have ‘become so used to the prevalence of food allergies that it’s easy to forget that forty years ago, food allergies were nearly unheard of. The wave of serious allergies didn’t appear until the 80s, and a sudden spike in life-threatening food allergies began in the mid-1990s. In fact, food allergies increased by an astounding 377 percent between 2007 and 2017!”[5]

“Among specifically identified foods causing anaphylaxis, the most common were peanuts (26 percent), followed closely by tree nuts and seeds (18 percent). Egg allergies, crustacean allergies (e.g., allergies to shrimp or lobster) and dairy allergies were also common, making up, respectively, 7 percent, 6 percent and 5 percent of the anaphylactic food reaction claim lines.”[6]

Peanuts

“Private insurance claim lines with
diagnoses of anaphylactic
food reactions increased 377 percent from 2007 to 2016!”[5]

So what is causing this dramatic increase? Here we may find a clue: Although “the proven allergenicity of vaccines is widely acknowledged, medical literature carefully avoids the question of what kinds of allergies vaccines can and do create to substances that are coincidentally or subsequently inhaled, ingested or injected. One exception to this unwritten rule was an unusual admission by Japanese doctors that an outbreak of gelatin allergy in children starting in 1988 and continuing through the 1990s was caused by pediatric vaccination. In that year, changes to the vaccination schedule in Japan meant that the DTP was replaced by an acellular version containing gelatin, the age at which it was administered to children was dropped from two years to three months, and this new vaccine was given before the live virus MMR vaccine that also contained gelatin. When children began reacting with anaphylaxis to the MMR vaccine as well as gelatin-containing foods (yogurt, Jell-O, etc.), doctors investigated. Finally, they concluded that the aluminum adjuvant in the DTaP had helped sensitize children to the “minute amounts” of proteins in the refined gelatin in the vaccine. Removal of gelatin from the DTaP vaccines was “an ultimate solution for vaccine-related gelatin allergy.” Subsequently, new cases of gelatin allergy in Japanese children dropped.”[3]

What does this have to do with peanut allergies? Consider this: “The fact that refined peanut oil was a documented vaccine ingredient in the past is a subject of concern equal to the potential of sensitization to body tissues or even of cross-reactivity between dietary peanut and homologous injected proteins. These cross-reactive proteins may include those in the Hib cellular membrane or legume oil in a popular brand of the vitamin K1 prophylaxis. Cross-reactivity explains why a person who is allergic to peanuts, legumes like soy and castor beans, may also react to nuts or citrus seeds, which belong to different plant families—their proteins have similar molecular weights and structures. …Few parents realize that by design immunization provokes both the desired immune response and allergy at the same time. These natural defenses are inseparable and the more potent the vaccine, the more powerful the two responses. This is an outcome of vaccination the medical community has understood at least since Charles Richet won the Nobel Prize (1913) for his research on anaphylaxis.”[3]

“In the past, some vaccines have actually contained peanut oil—and, even today, vaccine manufacturers are not required to list the exact ingredients of certain vaccine additives, including oils used as adjuvants or surfactants. In addition to the fact that peanut oil might be lurking in vaccines, other ingredients are similar enough to the proteins in peanuts and tree nuts that they can cause sensitivities in children that later result in serious allergic reactions. For example, a child who is allergic to peanuts may also be allergic to legumes and soy—the similar structure shared by these proteins can trigger a deadly reaction. Some vaccines given in early childhood contain soy peptone, which could trigger both soy and peanut allergies.”[5]

Here we see that it is possible that some proteins bypass the digestive system through injection whether it occurs through a needle and syringe or even by a natural insect sting. Honey bee venom contains a complex mixture of proteins which include phospholipase and melittin. The chemical makeup of the venom of different insects vary.

Babies are not born with a fully functioning microbiome in their digestive system. As a baby passes through the birth canal, it is “seeded” by the mother’s beneficial bacteria, that is, if she has healthy gut bacteria. Balanced microflora are indeed found in other areas of the body. While no evidence suggests that probiotic bacteria are in mother’s milk, there is an interesting study that indicates that probiotics flow through the mother’s immune cells via the “entero-mammary pathway to influence neonatal gut colonization and maturation of the immune system.” Read about it here.

However, when a child is born non-vaginally, is not breastfed, or the mother does not have her own healthy microflora the child will not get this benefit. Unfortunately, without supplementation their gut ecosystem will remain fragile. Couple this with the introduction of soy or cow’s milk formulas (along with their difficult-to-digest proteins, vaccinations (as described above), antibiotics, and being offered milk products too early and likely you will find a child who easily succumbs to an allergic state.

Milk

Milk allergy occurs when the person has an autoimmune reaction to the protein (generally casein) in milk.  These proteins are found in both raw and pasteurized milk.  While raw milk has many health benefits, the bodies of those with milk allergies simply cannot tolerate it.

There is casein in goat and sheep milk as well, but nowhere near as much as in cow’s milk.  Unfortunately, they do contain a different allergenic protein called beta lactoglobulin at similar levels to cows’ milk.  Because of this, some may use milk from other animal sources, while others cannot.

Dairy allergy is one of the most common allergies, and is especially high in children.  Symptoms include: abdominal distention[7], bloody/mucous stools[7], diarrhea[7], edema[7] , failure to thrive[7], gastroesophageal reflux[8], hypoalbuminemia[7], low-grade fever[7], mild to severe rashes, mucus production[9], nausea, regurgitation/vomiting[7], stomach pain, trouble breathing, loss of consciousness, and swelling of the lips or throat.

As the casein protein breaks down in the colon, casomorphin (an opioid protein fragment) is produced.  This stimulates the opioid receptors within colon and triggers the opioid receptors in the respiratory tract to respond to this trigger by secreting mucus. 

The association between milk and mucus cannot be explained using the conventional paradigm for diagnosing allergies, however, there is medical evidence that shows cause.  As the casein protein breaks down in the colon, casomorphin (an opioid protein fragment) is produced.  This stimulates the opioid receptors within colon and triggers the opioid receptors in the respiratory tract to respond to this trigger by secreting mucus.  “This association may not necessarily be simply cause and effect as the person has to be consuming A1 milk, β-CM-7 [casomorphin] must pass into the systemic circulation and the tissues have to be actively inflamed. These prerequisites could explain why only a subgroup of the population, who have increased respiratory tract mucus production, find that many of their symptoms, including asthma, improve on a dairy elimination diet.”[9]  [my clarification]

“These prerequisites could explain why only a subgroup of the population, who have increased respiratory tract mucus production, find that many of their symptoms, including asthma, improve on a dairy elimination diet.”[9]

Based upon the previous study it is interesting to note that in a subsequent study, cows’ milk has been also found to cause inflammation in the intestines that cause failure to thrive in children with cystic fibrosis.[10]

“Milk protein intolerance can cause inflammation in the large intestine and rectum, resulting in blood-tinged stools. This condition is called proctitis or proctocolitis and predominately occurs in infants, according to Dr. Alan M. Lake, associate professor of pediatrics at Johns Hopkins University School of Medicine. Lake states that this symptom typically manifests between 2 and 8 weeks of age and resolves within three days of eliminating the milk protein exposure.”[11]

In a Turkish review of evidence pertaining to infants and children and their relationship to cow’s milk protein allergy, the consensus is that ” Exclusive breastfeeding for 4-6 months (17-27 weeks) is recommended as the best method of infant allergy prevention.”[12] While a cow’s milk allergy may be outgrown, few children will “outgrow” a tree nut allergy. Also, take note that soy is the most common allergen for infants.

“A variety of disorders, including autism, schizophrenia, and postpartum psychosis, were thought to be due to an inability to process gluten and casein adequately. These products of inadequate digestion, ‘gliadorphin’ and ‘casomorphin’, can be measured in the urine and cerebrospinal fluid of autistic patients. They theoretically cross both the gut and brain barriers, and then bind with endogenous opioid receptors, causing ‘interference of signal transmission’. It has been proposed that ‘gliadorphin’ and ‘casomorphin’ have negative pharmacological effects on attention, learning, social interactions, and brain maturation.^”[13] Celiac disease or gluten intolerance is not considered a food allergy, but does signify GI distress.

Theoretically, gluten and casein “cross both the gut and brain barriers, and then bind with endogenous opioid receptors, causing ‘interference of signal transmission.”[13]

Similar to a baby’s underdeveloped digestive system, another way proteins can enter the blood is through a “leaky” gut. It is estimated that 80 percent of the human immune system is found in the gut which includes, not only the physical structure but the whole microbiome (beneficial bacteria, enzymes, and all).

Additionally, it may not be beneficial to switch cows milk for almond milk in an allergic individual. This can turn into merely swapping out one allergen for another. Almost 50 percent of people allergic to peanuts are allergic to tree nuts such as almonds.

Eggs

Most egg allergies are outgrown before a child reaches 16 years old but can occur in infancy. Common symptoms to egg allergens (the proteins in either the whites or in the yolks) are skin rashes, hives, wheezing weak pulse, dizziness, confusion, congestion of the nasal passages, stomach pain and digestive issues, as well as nausea and vomiting. Fortunately, an anaphylactic response is uncommon.[14]

Tree Nuts

Allergies to tree nuts include: almonds, Brazil nuts, cashews,hazelnuts, lychee nuts, macadamias, pecans, pine nuts, pistachios, and walnuts. A tree nut allergy is a common, and generally lifelong condition. Allergy to one type of tree nut increases the risk of developing an allergy to other tree nuts.

Allergy symptoms include: Abdominal cramps, upset stomach, nausea, vomiting, diarrhea, itching eyes/hands/other areas of the body, itching of the mouth or throat, difficulty swallowing, difficulty breathing or shortness of breath, wheezing, nasal congestion, and/or a runny nose.

The immune system overreacts to harmless allergens in an allergy. “Interestingly, this is the same type of response that expels viruses, parasites, and bacteria from the body.”[15]

The risk of anaphylaxis is much higher with tree nuts than some other food allergens. Tree nut allergies cause approximately 50 percent of anaphylaxis-related deaths.

Soy

Soy allergies can be triggered a few different ways. Soy peptones are part of certain vaccines. Peptones are water-soluble protein fragments. As we discussed before, inoculated proteins are not broken down by digestion, instead they enter the blood supply where there is potential for the immune system to tag them as “invaders”, rallying an autoimmune response. Soy is a legume, as are peanuts, navy, kidney, string, black, pinto, chickpeas, lentils, carob, and licorice. Yes, carob and licorice are legumes. Soy/legume proteins are similar, tree nut proteins are also very much like soy and peanut protein. The likelihood of cross-reaction among allergens in this instance is very high. Sensitivity to one legume commonly indicates potential for sensitivity to another.

Soy is found in a myriad of places from most off-the-shelf prepared foods, to spice mixes, breads, pastas, sauces, baby formulas, sausages/hot dogs, “vegetable protein”, milk substitutes, candies, fudge, margarine and substitutes for butter, natural flavoring, vegetable broth, hydrolyzed soy protein, restaurant foods, etc.

“The likelihood of cross-reaction among allergens is very high. Sensitivity to one commonly indicates potential for sensitivity to another.”

Other common food allergens include fish and shellfish, wheat, fruit, rice, etc. While it is generally a protein found in the food that is the problem, nutrient deficiencies can play a part, as can toxicity. Tests for food-specific IgE antibodies are available to help pinpoint the cause.

An elimination diet is often used to remove suspected allergens, seal the gut and stabilize the body, and then reintroduce the previous offending food(s) slowly and in small amounts to check for a (hopefully) proper autoimmune response.

References & Resources:
1. 5 Signs and Symptoms of Lactose Intolerance by Elise Mandl, BSc, APD
2. What is a food intolerance?
3. The Peanut Allergy Epidemic: What’s Causing It and How to Stop It
4. Anaphylaxis
5. The Connection Between Food Allergies and Vaccinations by Vaccines Revealed F
6. Food Allergies: New Data on a Growing Health Issue by Robin Gelburd
7. Yang M, Geng L, Xu Z, et al. Severe Food Protein-Induced Enterocolitis Synd
8. Iacono G, Carroccio A, Cavataio F, et al. Gastroesophageal reflux and cow’s milk allergy in infants: a prospective study. J Allergy Clin Immunol. 1996;97(3):822–827. doi:10.1016/s0091-6749(96)80160-6
9. Jim Bartley, Susan Read McGlashan, Does milk increase mucus production? Medical Hypotheses Volume 74, Issue 4, April 2010, Pages 732-734
10. S M Hill, A D Phillips, M Mearns, and J A Walker-Smith Cows’ milk sensitive enteropathy in cystic fibrosis Arch Dis Child. 1989 Sep; 64(9): 1251–1255. doi: 10.1136/adc.64.9.1251
11. Milk Protein Intolerance Symptoms by Cindy Haskin-Popp
12. Kansu A, Yüce A, Dalgıç B, Şekerel BE, Çullu-Çokuğraş F, Çokuğraş H. Consensus statement on diagnosis, treatment and follow-up of cow’s milk protein allergy among infants and children in Turkey. Turk J Pediatr. 2016;58(1):1–11. doi:10.24953/turkjped.2016.01.001
13. Immunologic Reactions to Wheat by Micheele Pietzak
14. Egg Allergy
15. Connecting the Dots Between Allergies and Autoimmune Disease