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Allergy or intolerance: what's the difference?

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allergy or intolerance?

This is usually asked in the context of food allergies, but it can and does pop up in regard to the products we use every day at home. While in some respects allergies and intolerances produce similar reactions, they are distinctly different.

The main difference is that an allergy directly involves the immune system which in turn affects the other organs within the body. In severe cases, an allergic reaction can be life threatening (i.e. anaphylaxis, even death). Those who have allergies triggering reactions of this level of severity should carry an EpiPen or similar at all times for emergency self-treatment.

On the other hand, an intolerance will just make you miserable. It is overall a less-severe issue as it is a matter of being unable to fully digest a particular food. You may be able to tolerate exposure to small amounts of a trigger, but larger amounts may cause a proportionally larger reaction. It may be possible to circumvent reactions in some cases. Someone who is lactose intolerant may be able to take a supplementary enzyme to aid in digestion of lactose containing products. A preventive antihistamine can lessen or even prevent hay fever on a high-pollen day. A skin protectant may be able to prevent that itchy rash which results from exposure to certain materials.

Allergens

Intolerances

Tip: Please see this article on antihistamines if you are intolerant, sensitive, or otherwise reactive to certain foods.

Elimination diet how-to and tips

If you suspect that you might be allergic to, intolerant of, or otherwise reacting to a particular food, the best way to determine the problem is with an elimination diet. This means restricting your food intake to a limited set of safe foods to which you have no discernible reaction for a set period of time (usually several weeks) before "challenging" anything that potentially causes a reaction.

These challenges should be done one food at a time, allowing several days between re-introductions. During the challenge period, record any changes in your daily health. Keep a spreadsheet to record your results, and assess aberrations after each food is re-introduced. In the event of a severe reaction, cease attempts to re-introduce the offending food while you rest for several days before moving to the next food on the list.

By the time you have completed your challenged foods list, your data should show some indications of the "problem foods" in the patterns of your symptoms. If you consistently get reflux as a result of eating wheat, for example, there is a wheat issue. If you have gastrointestinal distress from dairy, there is a dairy issue. If chickpeas trap you in the restroom within an hour of eating them, chickpeas should be removed from your diet.

The goal here is to not only have a list of "problem foods" but also to confirm that your safe foods are indeed safe for you. Many people are reactive to several foods or food groups, so this may require a repetition of the elimination diet protocol until you can be reasonably sure you have found everything.

Safe shopping

Once you have your "safe foods" list, you will be able to shift your focus from foods you cannot eat to foods you can eat. This will allow you to plan menus with your safe foods, which will in turn allow you to go grocery shopping with a firm safe food list in hand. For general tips on safe grocery shopping while highly allergic, please see the following articles on allergen free grocery shopping and how to read labels for allergens.

This article on non-food allergen sources may prove useful for other products such as personal care products and cleaning products.

If you aren’t still sure about a particular product, I recommend contacting the manufacturer of the product to confirm the product’s allergen status. They can probably give you better information you better than I can about product allergens. For tips and a sample letter, please see the article about how to contact companies about allergens.

If the product in question is a medication, you may need to have your medication compounded specially by a compounding pharmacy.

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