Show Description
In this episode of the Foundations and Functions Weekly Podcast, Dr. Jason Amick and Dr. C.J. Pabla dive into a critical—and often misunderstood—topic: the difference between food allergies and food sensitivities. As part of National Food Allergy Awareness Month, the doctors explore the science behind the immune system’s varying responses, highlighting how IgE antibodies cause immediate, potentially life-threatening reactions (think EpiPens and ER visits), while IgA and IgG antibodies trigger slower, more insidious symptoms like fatigue, bloating, joint pain, and brain fog. Using real-world examples and patient stories, they explain how something as innocent as broccoli could disrupt your life days after eating it—and why conventional allergy testing often misses the mark.
Listeners will also learn about the rise in food sensitivities, the impact of modern food production on gut health, and how to navigate confusing lab results with an elimination diet strategy. The episode is packed with practical advice, including common trigger foods, symptom tracking tips, and why working with the right practitioner is key to uncovering hidden root causes of discomfort. Whether you're battling IBS, unexplained rashes, or chronic fatigue, this episode offers a fresh, functional lens on how what you eat might be eating away at your health.
Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. The content is not a substitute for professional medical care, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
If you would like more detailed medical information, please contact Integrative Medicine through their website at https://integrativemla.com/
Show Transcript
- 3 0:00
Welcome to Foundations and Functions Weekly Podcast, where we return to when medicine actually made you better. Now, here's Dr. Jason Amick and Dr. C.J.
- 1 0:14
Pabla. Thanks everybody for taking time out to listen to our podcast. You may not have realized it, but May is actually National Food Allergy Awareness Month. So we wanted to take some time to talk a little bit about food allergies versus food sensitivity. And those are two big topics that we see in our practice quite a bit. So remember, a big goal that we have through our education and our talks here is to help
- 1 0:41
you get healthy safely. So, Dr. Pabla, real quick, let's get into what's the main difference between a food sensitivity and a food allergy?
- 2 0:54
So, when we look at the immune system, there's actually five antibodies, but we really don't talk about IGD. And really, they're mediated by different components of the immune system. So allergies are mediated by an antibody known as IgE, and food sensitivities are mediated
- 2 1:15
by the part of the immune system that deals with IgG and IgA. And that's kind of the best way to kind of describe it, and we're going to get into the details of how that presents clinically differently.
- 1 1:29
Yeah. So when I used to teach this and I've talked to people, I think I tell them, think about IGE, think emergency room, think EpiPen. That's correct. These are the real emergency, true allergies that are life-threatening. Yes. And so this is the other way that I describe it pretty colorfully is I say,
- 1 1:49
think of like your drunk cousin, Teresa, right? Where she has a little bit of wine and she's just out of control. You know, so sometimes when you have a food allergy, your immune system, your IgE, just becomes completely out of control,
- 1 2:05
completely, you know, where I say, the, her idea, the IgE's best solution to protect you and save you is to kill you.
- 10 2:14
Yeah.
- 9 2:15
Yeah.
- 2 2:17
Yeah, so, yeah, allergies can, are usually manifested fairly immediately. You'll, you can present as a skin rash and some redness all the way to something that's life-threatening, anaphylaxis. Right.
- 1 2:31
And that tends to be progressive.
- 4 2:32
Right.
- 1 2:32
Sometimes the first time you're exposed to something that activates IgE, maybe you get a small rash, maybe you don't feel so well. But as you continue to get exposed to that allergen, that protein triggers a stronger response from that IgE to the point that anaphylaxis, now, but sometimes anaphylaxis can show up immediately.
- 2 2:49
Right, yes. And it's mediated through IgE, which actually binds to the allergen and then connects with a cell called the mast cell. And the mast cell releases histamine, other chemicals, and that tends to cause the rashes, then the cardiovascular changes, and even can compromise air the rashes, then the cardiovascular changes and even can compromise airway.
- 1 3:08
Right, okay. So now, so that's allergy, everyone knows allergy. Everyone knows peanut allergy. Again, it's that someone gets exposed to that, their throat swells, their tongue swells, they've got to do the EpiPen
- 1 3:19
and they got to get to the ER right away. And again, like you said, it tends to be rapid onset and very life-threatening. Sensitivity though is a little bit different in that it's rarely life-threatening. It tends to be a little slower onset. But let's talk a little bit about how that IgA can mediate that.
- 1 3:39
So here's the pop quiz. Where is IgA found?
- 2 3:43
Yeah, so IgA and IgG are the ones that tend to mediate food sensitivity. IgA tends to be in more mucosal surfaces, sinus cavity, vaginal mucosa, GI tract. And 80% of our lymph nodes are essentially in our GI tract, you know, in the lower portion of your small bowel.
- 2 4:05
And so, you know, they're kind of sampling what I say when I tell patients it's inflammation. So when these antibodies and immune cells are activated, they tend to cause more insidious type symptoms that aren't necessarily immediate, but can be delayed by hours, days, and it's sometimes real hard
- 8 4:26
to figure it out.
- 1 4:27
And that's one of the things we talk about is sometimes you could be sensitive to something, food for example. You know, you eat some broccoli on Tuesday, and you might not have a symptom until Thursday or Friday. Right. And so it's hard to track that back to say, oh, it was because of something that happened
- 1 4:44
to me days ago. And so that's why you mentioned the IGA, we find a lot of mucosal tissue, including our GI tract. That's why a lot of food sensitivities manifest with some sort of GI presentation.
- 7 4:58
That's correct, yeah.
- 1 4:59
So we'll talk about bloating and abdominal pain later on. So some of the key facts we talk about with food sensitivities, 20% of the world population have some sort of food sensitivity. In the United States, one in 13 children have some form of food sensitivity.
- 1 5:16
And in the last couple decades, the incidence has just gone up, right? So we're seeing more and more of these foods. Now, we might do a whole nother podcast about why that is, but the short answer is our food supply is just different. It's different today than it was
- 1 5:35
when our parents were young, and of course when their parents were younger. So the mass production of food, and the alterations of our crops have really fed into that. So let's touch a little bit about some of the most common food sensitivities or foods that cause either allergy or sensitivities.
- 2 5:57
Yeah, so you've got dairy, wheat, and everybody kind of classically talks about gluten and celiac disease, which is an enteropathy or inflammation, which is a type of food sensitivity. Soy, eggs, peanuts, tree nuts, those are the big ones that can cause sensitivities. Obviously any food can cause a sensitivity based on the reaction of your immune system, but those are the classic ones.
- 1 6:25
Yeah, and so we know that, again, I'll tell patients, go do a deep dive in your refrigerator. Look at all your sauces. Everything that's in the door of your refrigerator, finding dairy, wheat, gluten, soy, it's ubiquitous.
- 2 6:40
Yes, it's in everything, absolutely. And it's hard to avoid. And you've got flowers now that have higher gluten concentrations. So that's, as you mentioned before, the food supplies change, our gut biome has changed. All of that has mixed together to increase our food sensitivities and our reactions to the foods that we eat currently.
- 1 7:03
Yeah. And so one of the main strategies, obviously, with these food sensitivities is really just avoidance, right? Trying to either dramatically reduce or remove these irritants from your food supply. So we talk about keeping a food diary, and that goes back to what we talked about, that sometimes these things show up days later, you know, once you actually ingest them
- 1 7:25
or get exposed to them. So, but let's talk about some of the symptoms, right? There are some common symptoms that we see. Patients come see us in our practice and say, gosh, you know, I've got all these weird symptoms going on. So what do you think is the most common thing
- 1 7:40
that we see from patients?
- 2 7:41
Right, so food sensitivities present obviously in the gastrointestinal tract, so the simplest ones are a lot of bloating, sometimes you get constipation, diarrhea, abdominal cramping, but then you get some systemic symptoms too, such as fatigue, joint pain, and that's because your immune response, right, your immune system is in your GI tract. And these white blood cells are living in these lymph nodes and they're sampling this inflammation and then releasing chemokines and cytokines,
- 2 8:12
which can cause systemic symptoms as well. So you might get some joint pain with that, muscle aches, skin rashes, brain fog, migraine headaches, beyond the classic gastrointestinal symptoms.
- 1 8:27
I think some of those, so we'll see a lot of patients that come in, you know, gosh, and they say, man, every time I eat, every time I eat, within minutes of eating, I am uncomfortable. I have significant bloating. You know, there's always kind of the joke, you know,
- 1 8:44
at the family gatherings, the Christmas or Thanksgiving of wearing the spandex pants or the loose pants, but this is different than that. This is a daily battle that people have where they have very uncomfortable bloating. We saw a picture recently of someone,
- 1 8:59
of a young lady who within 20, 30 minutes of eating looks like she's six, seven, eight months pregnant. I mean, she just has that much and it's very painful.
- 4 9:07
Right.
- 2 9:08
And, you know, and we're going to talk about this in our other podcast, but there could be a subset of that called SIBO where you actually have bacteria that overgrows in your small bowel that can cause more immediate bloating. But the bloating related to this tends to be more delayed, but absolutely can be immediate as well. But we'll subset that out and talk about that
- 2 9:33
at a different time. SIBO standing for small intestinal bacterial overgrowth.
- 1 9:38
Yeah, that's a whole podcast.
- 2 9:40
Whole nother podcast, but definitely foods exacerbate that as well.
- 1 9:47
And so, again, one of the things we talk about is, is your gut killing you, right? Are you having a lot of GI symptoms from the foods that you're eating? They're disrupting your daily life.
- 2 9:59
You might come in with the term irritable bowel syndrome, right? What does that mean? I think that's kind of a basket term catch-all, a clinical diagnosis of, you know, chronicity, of bloating, sometimes alternating constipation, diarrhea, but how much of that could be just related to food sensitivities? Obviously, there's other pathologies that kind of merge under that umbrella of IBS, but we try to stay away from that term.
- 2 10:26
We understand that term, it's a clinical diagnosis, but we try to really find the root cause of that. This might be one of the root causes of irritable bowel syndrome.
- 1 10:36
And that's where, you know what, what we do when we look at things from a functional lens and we pull those together, a lot of these can be kind of vague symptoms and they don't always show up at the same time. You might have some nausea and maybe some diarrhea
- 1 10:48
and then next time you don't, you just have the joint pain. And so they kind of can be really vague and often patients have really good, reasonable explanation for them. You know, well, of course I'm fatigued. I'm busy at work.
- 1 11:00
I've got a lot of stress with some deadlines coming up, or I just moved, or fatigue, brain fog is another one. Well, maybe I'm just getting older, that's why I'm a little confused more often. And so pulling all of those symptoms together and looking at it from a wider lens helps us really get down to what are some of the issues. I talk a lot about skin and skin reactions, you know, whether that's acne or rosacea
- 1 11:27
or some sort of inflammatory response from just at the skin level. And we think, well, someone might come and see us go, I have a skin issue. No, you have a gut issue.
- 6 11:36
Right, right.
- 1 11:37
You have a gut issue. That's showing up as a skin problem.
- 2 11:41
But this is really more of a gut issue. Yeah, and one of the caveats is there's a lot of companies that do these tests, and we like to correlate this data clinically. There tends to be a lot of false positives in these food sensitivity panels, so how we manage that is once we kind of determine your level of reaction, we essentially will do elimination diet, and then usually six weeks or so,
- 2 12:12
six to eight weeks to get the inflammation down, and then we can do a reintroduction to verify the data. So just because you have a food sensitivity panel that's positive, is it true positive, right?
- 5 12:24
And Dr. Emick and positive, is it true positive, right?
- 2 12:25
And we're, Dr. Amick and I, we really want to, you know, you don't necessarily just treat labs, you treat patients. So we want to verify that data and just want to put that out there. There tends to be a lot of false positives with these tests, so you've got to be with
- 1 12:39
the right provider that understands that and then can help you verify that data. And on the flip side, we've seen kind of what I would call maybe some false negatives where patients don't understand what we talked about before was the IgE versus Ig. If you've had a, if you've gone to a dermatologist or an immunologist and you've had the skin prick test, most likely that is an IgE food allergy.
- 1 13:01
So some patients might say, well I had a food allergy test and it was negative. Well, it was negative for the IgE, the anaphylaxis, but did they really test the IgG, IgA, IgM? And then the other side of that is you and I get pretty fussy about the quality of testing and how the lab is actually testing.
- 1 13:20
We had one lab quite a while, when we first opened the practice, and they were using the crab, remember that? They were using the crab shell, right? As their source of sensitivity. Well, who eats the crab shell?
- 1 13:32
No one eats the crab shell. But it was cheap, it was easy to get to, and so we're like, well, you gotta be careful of what test you're choosing in the lab
- 2 13:40
and how they validate those tests. So there's a lot of disparity between those. And foods can have multiple different components. Like milk can have multiple different components of proteins in them, right? So how do you prepare that when you do your analysis? How well are you digesting it? Are you breaking it down to X amount of amino acids?
- 2 13:59
And so that changes the test, how you're actually preparing the sample. So, we take that all with a grain of salt, but it's a starting point, right? It gets us a rough idea, then you can do an elimination and then reintroduce that food one at a time and verify, oh, yes, I reintroduced, let's say, pineapple, and now I broke out in a rash and I felt more bloated.
- 2 14:23
And now your clinical symptoms correlate with the lab that validates the test, right? So you just, you know, you might get your food sensitivity panel back. You did it in the mail and say, oh my gosh, I'm allergic to all these foods or excuse me,
- 2 14:38
intolerant to all these foods. That's not necessarily true. You got to verify that.
- 1 14:43
And I think a lot of folks get intimidated when they hear elimination diet, because they'll say, gosh, well, what am I supposed to eat? I can't eat anything. And so helping folks understand which are the crossover sensitivities,
- 1 14:55
which are true allergies, true sensitivities, and then again, that whole process of going through, reintroducing some foods at some time, and then understanding what your tolerance level is for that
- 2 15:06
Can be really important and and we're gonna talk more about gluten sensitivity and and then celiac But you know, these antibody tests are all indirect. The gold standard is a duodenal biopsy So I just want to put that out there but we're gonna talk specifically about a type of sensitivity called gluten sensitivity or celiac and that once again that'll be another podcast.
- 1 15:28
Right, and then the other thing we can talk about another podcast, keying that up, would be histamine intolerance. Yes. What does that mean? And so a lot of folks suffer from that where we have to remind them that, listen, your body makes histamine naturally and there are some foods that just naturally
- 1 15:45
are high in histamine. So if you're either making too much histamine or you're ingesting too much histamine, you can definitely have some symptoms from that. So those are coming down later on in our podcast journey. So I think kind of recapping a lot of this,
- 1 16:03
the first things we talk about is food allergy and food sensitivity are different beasts. There are different body responses to them. One is true immunological, IgE mediated and could potentially be life-threatening. Sensitivities tend to be-
- 2 16:22
More insidious.
- 1 16:23
Yeah, more insidious, not necessarily life-threatening, but very life-disruptive.
- 4 16:27
Right.
- 1 16:28
Yeah, so timing and onset are issues. Allergies tend to be more rapid. Sensitivities tend to be more slower onset, like you said, insidious there. And then the type of reactions that we get. And then the plethora of symptoms.
- 1 16:44
Again, I think that the ones we see mostly are the abdominal pain, bloating, migraines, fatigue, skin rashes, brain fog, even kind of nasal congestion, like, oh, I just have some hay fever, some allergy. It could actually be a food sensitivity issue. So if any of that connects with you, if you feel like that might be something that has been kind of elusive to you, certainly reach out.
- 1 17:09
We're happy to help and see you for that and get you some testing and help you interpret that testing so that you can wrap your hands around your health. If any of those symptoms seem like things that you deal with on a regular basis, we want you to reach out. Our office can help get you scheduled. We can work through that allergy testing and sensitivity testing and really help educate
- 1 17:35
you about what's going on inside your body. Because remember, we want to return to when medicine actually made you better. And a big part of that is helping you understand how your body works.
- 3 17:50
The information provided in this podcast is for educational and information purposes only, and is not intended as medical advice. The content is not a substitute for professional medical care, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. If you would like more detailed information, please contact Dr. Amick or Dr. Pablo at Integrative Medicine through their website at Amick or Dr. Pablo at Integrative Medicine through their website at IntegrativeMLA.com
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