An Intolerance to Allergies: Common Allergies and Food Intolerances

by Dr Donna Robinson

How many times have you eaten something and thought ‘could I be allergic to that?’ It’s not surprising that this is a common worry of ours as allergies are indeed really quite common and considered to be on the rise. It’s not exactly known what might be causing the rise in allergies around the world – it may be that we are less exposed to germs as children or it could just be that, with better food packaging, we are more easily able to identify what might have caused us to feel unwell after eating something.

Nevertheless, eating foods that you are unknowingly allergic to can leave you feeling generally unwell, can affect your concentration and mood and, in some cases, can lead to more serious long-term consequences. It’s also really quite important from a medical perspective to distinguish whether you are allergic to something or whether you just have an intolerance to it. Knowing which one of these two health impacts will determine how you can best avoid any immediate symptoms and long-term consequences.

So what is an allergy?

An allergy is when our body has an inappropriate or exaggerated response to any particle (usually to a certain food or a certain air particle). Our body thinks that the ‘particle’ is something that definitely shouldn’t be inside us and as a result, rejects it. As your body rejects the ‘particle’, you may feel symptoms such as:

• Sneezing • Runny nose • Reddened, itchy, watery eyes • Wheezing and coughing • Difficulty breathing (in the case of an anaphylactic reaction) • Red, itchy rashes • Exacerbation of eczema or asthma symptoms

What’s the difference between an allergy and food intolerance?

The key difference is that with a food intolerance, your body is not actually rejecting the food/particle. Instead, your body does not know how to deal with the food once it’s inside your gut. Usually, when we eat food, our digestive system breaks food down into smaller pieces so that we can absorb nutrients. If you have a food intolerance, your digestive system might just not have the correct ‘tools’ (i.e. enzymes) to break this particular food down into smaller pieces and the undigested food leaves you feeling unwell. You may have symptoms of:

• Bloating • Migraines/headaches • Feeling under the weather • Stomachache • Irritable bowel So the symptoms of an allergic reaction and a food intolerance are really quite similar. The one difference is that being exposed to one tiny drop of something that you allergic to could immediately trigger all of the symptoms above. With a food intolerance, it’s usually the more of the food you eat, the more unwell you feel. Generally speaking, the symptoms of a food intolerance appear with slower onset after eating the food (i.e. about 1-4 hours after consumption).

How do you develop allergies?

You can either be born with allergies or you can develop allergies at any given point in your life. Allergies are more often first discovered in young children but it is not uncommon for adults to develop them and be ‘diagnosed’ with a certain allergy later in life. The reason that we allof-a-sudden can develop allergies during adulthood is not exactly known – it’s thought to be because our immune systems gradually begin to weaken. If you were previously allergic to something as a child or teenager and ‘outgrew’ this allergy, you are greater risk of developing an allergy again later in life.

Common allergies include:

• Pollen from grass and trees, also known as ‘hay fever’ • Dust mites • Animal dander/dandruff • Food – particularly nuts, dairy products, shellfish, and eggs • Insect bites and stings • Medication; e.g. Ibuprofen, aspirin, penicillin, and various antibiotics • Latex • Mould • Household chemicals such as detergents and hair dyes

How do you develop food intolerances?

Food intolerances are mostly explained by when our body lacks that certain ‘tool’ to break down food that we discussed earlier. Lactose intolerance is the perfect example of this – a person is lactose intolerant if they do not have lactase, the enzyme that breaks lactose down. However, sometimes, it can be caused by a condition called ‘Irritable Bowel Syndrome’, a chronic condition where our bowel just doesn’t ‘agree’ with certain foods.

So do I have an allergy or an intolerance?

If an exclusion diet does not alleviate your symptoms or if you receive a negative allergy screening test, you should consider consulting a doctor to exclude any more serious causes of regular stomach cramping/pain and stomach upset. Sometimes stress and other environmental factors can cause symptoms similar to a food allergy or food intolerance.

Do I have an allergy or intolerance?

I am experiencing symptoms such as abdominal bloating and pain, excess gas, diarrhoea/ constipation regularly.

I have symptoms within 1 hour of eating this food.

Food intolerance I roughly know what food might be causing my symptoms.

Food allergy I know what food might be causing my symptoms.

If you’re unsure, start by excluding the more common foods that people have intolerances to (i.e. gluten, lactose etc.) and observe how you feel.

Start by trying to exclude this food from your diet for at least 2 weeks. Re-introduce the food after 2 weeks and see if your symptoms come and go.

food Allergy Panel Screening (i.e.g all shellfish)

Specific IgE Food Allergy Test for i.e. prawns OR Skin Prick Test

Allergy testing

The allergy evaluation begins with a thorough history to look for possible triggers of the symptoms that you are experiencing or have experienced. In cases in which there is no clear trigger, allergy testing for multiple foods or allergens can be preformed. There are two main ways that you can have allergy testing done – the skin prick test or by one simple blood test. A skin prick test involves placing a small drop of a protein extract (the ‘allergen’) on the skin (usually the forearm) and a small prick is made in the skin through the drop.

The size of the swelling (the ‘wheal’) is measured after 10-15 minutes. Skin prick tests can be slightly uncomfortable (itchy) but are usually well tolerated, even by small children. Local itch and swelling normally subside within 1-2 hours. The skin prick test is considered to be more convenient and you can get the results in 20 minutes, but if a severe reaction to an allergen such as peanuts then blood testing is safer. The second option is allergy testing by one simple blood test. You can either select an allergy test for one specific food, for a group of similar foods (i.e. seafood) or opt for 20 common foods allergy (IgE) panel test or 20 common food and 20 common inhaled allergens panel test (IgE). This involves taking a small blood sample which is sent to a laboratory. Then you just need to wait for the result which you will receive by email shortly after. This is recommended for more serious allergies.

What can I do If I am allergic or intolerant to something?

Allergies and food intolerances can be quite an annoyance. Avoiding allergies and food intolerances, or the symptoms, can be achieved by various means. The simplest way is to avoid contact or exposure to the specific food as much as possible. However, this can be very difficult at times! When the actual allergen cannot be avoided, Dr Donna notes that the symptoms of allergies can also be mitigated through the use of anti-allergy medication, also known as antihistamines, which work by calming your body’s immune system’s response to the allergen and therefore lessen the symptoms they cause.

Two common antihistamine/ anti-allergy medications that are usually available over the counter are Zyrtec and Claritin (Loratidine). Both have similar effects and are considered relatively safe to use.

If you have any questions at all, please do not hesitate to contact Dr Donna or her staff at MedConsult Clinic who will always be pleased to help or provide advice.

Allergy test Typical cost (Baht)

Allergy Test for 1 Specific Food or Inhaled Allergen (i.e. for peanuts, for tuna, etc.)
900.00 – 1,800.00

Allergy Test for a Food Group Panel (i.e. for Seafood Panel: Tuna, Prawns, White Fish, etc.)
1,500.00 – 3,000.00

Allergy Test (IgE Test) for 20-panel Common Foods: Egg White, Egg Yolk, Milk, Wheat Flour, Rice, Sesame, Soya Bean, Peanuts, Hazelnuts, Beef, Pork, Chicken, Shellfish Mix, Fish Mix, Crab, Shrimp, Lobster, Blue Crab, Chocolate, Glutamate

Allergy Test (IgE) for 20-panel Common Foods and 20-panel Common Inhaled Allergens: Egg White, Egg Yolk, Milk, Wheat Flour, Rice, Sesame, Soya Bean, Peanuts, Hazelnuts, Beef, Pork, Chicken, Shellfish Mix, Fish Mix, Crab, Shrimp, Lobster, Blue Crab, Chocolate, Glutamate Tree Mix, Beefwood, Acacia, Oilpalm, Mixed Grasses, House Dust Mites Mix, Cockroach, Cat, Dog, Cage birds, Guinea pig, Mouse, Rabbit, Hamster, Mould Mix1, Mould Mix2, Candida 4,500.00

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