Food allergies are tricky: Sometimes they hide or work in combination with other allergies; sometimes they aren’t allergies at all but food intolerance.

Many people say they have an allergy when they don’t because they don’t understand or they think other people won’t understand.

“Unfortunately, the term ‘allergy’ is sometimes used by the public or health care providers to describe any unpleasant experience patients have with eating food, including ‘feeling bad,’” explained Mar Reidl, MD, MS, assistant professor of medicine at the University of California at Los Angeles David Geffen School of Medicine.

Feeling sick doesn’t mean you are allergic

A food allergy is a specific immune system response to a protein which involves either immunoglobulin E (IgE) or T-cells. An IgE response will happen within a few short minutes of allergen protein ingestion. For a sensitive allergy, the IgE response may happen after touching or smelling the food protein.

The presence of the protein triggers the immune system to see the protein as harmful. Histamine is released by the body to protect itself, and this causes symptoms which include wheezing, trouble breathing, itching, hives, swelling and, rarely, anaphylaxis.

Every year 30,000 Americans go to the emergency room for help with an allergic response to food. According to the Food and Allergy Network, as many as 200 die.

There are not different types of allergic responses to the same allergen

A non-IgE immune system response can take a few hours to be recognized. It is often mistakenly identified as a food insensitivity or food poisoning.

“The biggest misunderstanding is that there are different types of food allergies,” Burks explained. “You can’t eat cheese, feel sick, and claim a food allergy, but then turn around and enjoy ice cream and feel OK. With a true food allergy, the trigger does not change and the trigger will always set off the same immune system response.”

What is a food intolerance?

Unlike the immune system response of a food allergy, a food tolerance means your body lacks a particular enzyme to digest that food. Lactose intolerance and celiac disease are both autoimmune disorders where the body cannot process gluten.

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