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Two Kinds of Food Allergies: Which Do You Have?
There are two kinds of food allergies: the kind conventional allergists recognize as allergies, and the kind they don't. While looking for an allergist to treat my older son's food allergies, I had a little over-the-phone interview with the nurse in this doctor's office. "My son has eczema, dark circles under his eyes, goes nuts if he eats dairy, and starts falling over if he eats wheat," I told her. The nurse was very nice but told me, "Dr. B. can certainly help your son with his eczema, but undereye circles are usually related to nasal allergies, and he would not consider the other symptoms to be food allergy-related." From what I understand, this is a pretty typical response from members of the medical community. A hundred years ago, "allergy" was considered to be anything that produced an abnormal, adverse reaction in some people, but not most others. Now, we might say that there are two kinds of food allergies. Currently, the form of food allergy most widely recognized by doctors involves a very specific set of immune responses, mediated by immunoglobulin E, or IgE, antibodies. The IgE antibodies are usually located on special immune cells called mast cells. Mast cells are mostly found in the soft tissues of our bodies. In a classical allergic response, when a food molecule is "caught" by this IgE antibody, it signals to its mast cell that the food is an "invader." The mast cell responds by releasing several kinds of chemical messengers (including histamine--as in anti-histamine drugs) that call on the body to do different things to try to get rid of the "invader." The results of these efforts are the classical allergic symptoms, which are
There are other reactions to food, though that aren't necessarily tied to IgE. Some reactions are linked to another immunoglobulin, like IgG, and with others, doctors aren't quite sure how the immune system is involved. Many people call these allergic responses food intolerances. Classical allergic reactions tend to show up quickly after a person's contact with the allergen, and may need speedier medical attention than intolerances--an inhaler for an asthma attack, an antihistamine for a drippy nose, or--worst-case scenario--a hospital visit for anaphylactic shock, when there may be so much swelling the windpipe is blocked and the person can't breathe. Intolerances, on the other hand, may create chronic conditions that can't be easily medicated to turn off the response. People with food intolerance may experience a delayed reaction--up to 48 hours after taking in the offending food--that could involve:
Unlike the classical allergies, which usually stay with people throughout their lives, intolerances can be eliminated. So, again, when we're talking about two kinds of food allergies, we might say that there are the "fixed" kind and the "fix-able" kind--although some people believe that even classical allergies can be successfully and permanently treated.
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