Is it a Food Allergy or Intolerance?

Seems like lately, every patient walking through my doors complains that they’re allergic to something. Anything from the typical dairy, dog hair and gluten to Handy Andy and chamomile tea. One patient complains of a stomach ache if they eat bread; another’s has a life-threatening reaction to nuts. Both call it an allergy. Unfortunately the term “allergy” has become a generic term used to describe allergies and intolerances, but there is a clear clinical difference between them – that being your bodies immune response.

And with the media trying  to use every buzz word possible to hook you into buying R50 loaves of bread because of your ‘allergy’,  it’s important to know the differences between an allergy or intolerance.


When you have a food allergy, your immune system will illicit a response by releasing antibodies to ‘fight off’ the allergen. Symptoms will show fairly quickly after eating & could include difficulty breathing, wheezing; skin reactions like hives & swelling; dizziness; swelling of the tongue, mouth or face.

The most common foods that cause allergic reactions are:

  • Peanuts & tree nuts
  • Shellfish
  • Cow’s milk
  • Wheat

Allergies can be life-threatening and shouldn’t be taken lightly. Your doctor will be able to specifically test for allergies with a skin-prick test.


Food intolerances occur when your body doesn’t have the right enzymes to properly break down the food in your gut. There is NO immune response but your body will show uncomfortable gut symptoms. The most common words I hear are “It just doesn’t agree with me”.

A really good example of this is lactose (from milk). People who are lactose intolerant, don’t have the enzymes to break down lactose properly so when it is ingested and reaches the large intestine, the bacteria break it down releasing gas, bloating, pain and diarrhoea. The symptoms take longer to show & other symptoms could be headaches, nausea, nervousness, heartburn and vomiting.

Foods that can cause intolerances can vary greatly but commonly include:

  • Wheat
  • Caffeine
  • Dairy
  • Food additives & artificial flavourants (like MSG)

Elimination diets under the guidance of a practitioner are the most useful in isolating the culprit foods.

In Closing

Food allergies and intolerances actually fairly uncommon and your symptoms could be caused by a number of other factors such as stress, hormonal changes or a different digestive disease. They can also be quite difficult to tell apart because of how symptoms overlap so greatly. If you suspect that you may have an allergy or an intolerance, I urge you to see a registered health practitioner so that you can be properly diagnosed and treated under their supervision.


A side note on gluten

Gluten seems to be a favourite word with the media at the moment. It’s found in most grains like wheat, rye and barley & can be the cause of both an intolerance or an allergy, depending on the structure of the gut & microbiome. 

Many people have an intolerance to gluten and will have quite a bit of discomfort when they eat foods that contain it. But gluten intolerance isn’t very common and not everybody needs to be eliminating gluten from their diet like we’re told in the media. 

Now, for some individuals, it is critical that they avoid gluten. These individuals have an autoimmune disease called Coeliac’s. The body has a completely abnormal immune response to gluten that causes damage to the villi in the small intestine (the finger-like structures in our gut that help with absorption of nutrients). It’s not entirely clear what causes the immune system to act in this way, but a combination of genetics and the environment appear to play a part. This damage creates gaps between the villi which means toxins are able to enter the blood stream and can be fatal if left untreated. 

So my ‘side note’ about gluten is clearly becoming its own blog post & I promise to write a more in-depth post in the near future on this.