Food Allergy vs. Food Intolerance – What’s the Difference?

Food allergies can be a real aggravation, interfering with daily life and posing a serious health risk. Fortunately, with the right food allergy care, North Texas adults and children can manage their allergies and minimize the risk of a reaction. However, before starting treatment it is very important to understand how your body reacts to certain foods, and to determine whether you have a food allergy or a food intolerance – there is a difference. So, what are the key differences between a food allergy and a food intolerance?

A child enjoys breakfast after receiving food allergy treatment.
Image Credit – ucchie79/

Do you often struggle with deciphering between a food allergy and a food intolerance?

Well, fear no more!

What Is a Food Allergy?

A food allergy occurs when your immune system reacts to a specific food protein with a hyper-exaggerated response. This reaction can lead to symptoms such as hives, swelling, vomiting, diarrhea, coughing, and wheezing. On the other hand, a food intolerance is not directly related to your immune system and usually stems from a deficiency in your body’s digestive enzymes.

 This is caused by a special antibody called immunoglobulin E (IgE). Once this antibody Immunoglobulin E is produced it binds to an allergy cell and waits to be activated by the seemingly harmless food protein. Once these allergy cells are activated by this food protein and  chemicals and mediators such as (histamine) are released. This release of histamine and other mediators cause hives, swelling, vomiting, diarrhea, coughing and wheezing symptoms that can occur with a food allergic reaction.

What Is a Food Intolerance?

A food intolerance can be well differentiated from a food allergy as it does not even involve the immune system. A food intolerance usually stems from a deficiency in your body’s digestive enzymes.  Typical symptoms  can include  bloating, gas, diarrhea, cramps, headaches, and migraines.  A typical example of this is in the case of milk intolerance. 

The Main Differences Between Food Allergy and Food Intolerance

While a food allergy and an intolerance do share similarities, breaking down the key aspects helps to differentiate each condition. Take a look at the table below to compare everything from symptoms to reaction frequency.

Food Allergy Food Intolerance
Symptoms Hives, swelling, coughing, wheezing, throat tightness, vomiting, diarrhea, anaphylaxis Bloating, gas, diarrhea, cramping, headache, migraine, irritability
Timing Usually immediately after ingesting offending food 20 min-2 hours Several hours
Frequency Predictable and every time the offending food is ingested Inconsistently, not every single time the food is ingested
Severity Can be severe and life threatening Not life threatening
Common foods Milk, egg, wheat, soy, peanuts, tree nuts, sesame, fish and shellfish Lactose, fructose and chemicals in foods
Treatment Avoidance, Food Sublingual Immunotherapy, Oral Immunotherapy Identify the underlying cause and eliminate

Why is it important to differentiate between food allergies and a food intolerance?

It’s essential to differentiate between whether you have a food allergy vs. a food intolerance, as the testing and management required will vary depending on your diagnosis. If you’re suspected of having an allergy, your allergist may recommend skin or blood testing, whereas for an intolerance may  lead symptom diary management or an elimination diet may be suggested.

Food allergy testing (such as a skin prick test) can analyze many different allergens simultaneously, and deliver results during a single appointment with an allergist.

Do you know that an estimated 32 million Americans suffer from food allergies? In fact, allergies have become increasingly common for both adults and children  over the past decade. Allergic conditions in general have been increasing and have become the 6th most common disease in the US. 

Frequently Asked Questions About Food Allergy Management

I’ve never had a food allergic reaction. Is it possible I still have allergies?

The body’s immune response to external substances is not always obvious. Even if you have never had your eyes water in the springtime or felt the helpless feeling of your throat swelling after eating peanuts, you could still be living with allergies without knowing it. You could have a food allergy and not be aware of it, since you never ingested the offending food.

How will you determine what – if anything – I am allergic to?

If you do have symptoms, itchy watery eyes, nasal congestion, sneezing, coughing, wheezing, itchy skin etc, then it is best to schedule an appointment to be evaluated. You can schedule a virtual care appointment for a consultation to discuss or you can schedule an in-person appointment. Your allergist will take a detailed history to understand your concerns and then will determine the next best step or testing to help you with your allergic condition. Your allergist will determine if your symptoms first are related to an allergy or an intolerance. This is extremely important because food allergies may require skin and blood testing, whereas food intolerance do not require allergy skin testing.  By reviewing a patient’s symptoms and eliminating certain foods from his or her diet, we can pinpoint the allergy and create a plan for managing it.

What types of food allergy immunotherapies are available?

We offer three treatment options for food allergies: Avoidance, Oral immunotherapy (OIT) and/or Food  sublingual immunotherapy (Food SLIT). We find that many patients benefit from these treatments offerings. Food allergy management is a personalized approach as each allergy and family is different. 

Contact Us for Food Allergy Care in North Texas

If you’re confused about food allergies and intolerances, TexasAllergyMD can help. We use innovative food allergy testing and treatment solutions to help prevent reactions and manage your allergies. Call (469) 375-1525 or request an appointment today.

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