Allergy or Intolerance?
The identification of food allergies, sensitivities and intolerances is an area in which complementary medical practitioners (CM) play a pivotal role. It has been the CM Practitioners over the past 30 years who have appreciated the scope of Food Intolerance and developed clinical guidelines for the successful management of a very wide range of disorders. It is also a complex and challenging part of modern clinical practice.
Currently there is a great deal of interest in identifying Food Intolerance and the baffling array of symptoms such reactions can cause, in fact Food Intolerance may well be present in the majority of clinical disease states if great care is taken to identify its presence. There are a number of conditions associated with food reactions, including fatigue, migraine headache, irritable bowel syndrome, inflammatory bowel disease, gallbladder disease, arthritis, asthma, rhinitis, attention deficit-hyperactivity disorder (ADHD), enuresis, epilepsy, eczema, psoriasis, aphthous ulcers, otitis media and recurrent infections.  In fact, many conditions that involve pain and inflammation may be aggravated by food Intolerance. Many if not most patients suffering from psychological symptoms or psychiatric disorders will respond to an elimination diet and the correction of specific nutritional deficiencies.
Type I immediate hypersensitivity reactions are mediated by IgE antibodies, and are characterized by the release of histamine and other chemical mediators upon exposure to an allergen. Type I reactions are responsible for “immediate-onset” allergies, such as eczema, allergic rhinitis and acute asthma. The exposure to the antigen triggers mast cell degranulation and release of several mediators, including histamine, platelet-activating factor, leukotrienes and prostaglandins, which evoke allergic reactions. In its most extreme form, this type of response can result in anaphylaxis, which can be life threatening and most often requires an emergency intervention with injectable adrenalin. The foods which most commonly cause anaphylactic reactions are cow’s milk, hen’s eggs, nuts, fish, seafood and pollen-related fresh fruits and vegetables.  According to the current medical literature, immune mediated food allergy accounts for as little as 2 – 5% prevalence in adults and 5 – 10% prevalence in children, whilst non-immune mediated food intolerances account for 15 – 20 % of all cases. 
Food intolerance is best characterised as Type III immune-complex delayed hypersensitivity reaction. As the term conveys, food intolerance characteristically has a more delayed response following exposure to a particular dietary antigen. Type III reactions are mediated by mixed immunoglobulins — primarily IgG. Complexes composed of antigen and antibody activate complement and cytokines in the body, resulting in an inflammatory response. Symptoms are delayed because of the time required for the formation of complexes to occur. “Although not life threatening like food allergy, food intolerance should never be underestimated as its impact on sufferers can be significant, severely impacting on their ability to live normal healthy lives.” 
In those with a family history of allergies (such as asthma, eczema or migraines), hyper-sensitive reactions are often set in train by ingestion of whole foods – most commonly dairy products, gulten and wheat, corn, cereals and caffeine (in chocolate, cola drinks, tea and coffee).
With an immune system that tends to over-react, a second round of sensitivities can develop towards the naturally-occurring chemical constituents of foods – the main ones being amines, MSG, phenolics and salicylates.
A third class of triggers for food sensitivities are artificial additives, such as colourings and preservatives.
Inhalation allergens are any inhaled substance which triggers a hypersensitive reaction. Exposure can occur at home or in the work place. In both locations, exposure is often chronic with repeated contact over a prolonged period often leading to acquired sensitivities. Asthma, hay fever and sinusitis are common outcomes.
The main inhalation allergens include animal hair and epithelia, chemicals – especially aerosols, pesticides – dust mites, fungi, pollen, grasses, trees and flowering plants. Other environmental allergens include insect bites and stings, latex and jewellery.
Mention any allergy issues you may have when booking your appointment on 0468 774 633.
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2. Isolauri, E., S. Rautava, and M. Kalliomaki, Food allergy in irritable bowel syndrome: new facts and old fallacies. Gut, 2004. 53(10): p. 1391-3.
3. Herman, P. and L. Drost, Evaluating the Clinical Relevance of Food Sensitivity Tests: A Single-Subject Experiment. Alternative Medicine Review 2004. 9(2).
4. Zopf, Y., et al., The differential diagnosis of food intolerance. Dtsch Arztebl. Int., 2009. 106: p. 359-369.