Intolerances deserve attention too

[Note: this was originally part of the post titled Allergy: I do not think that word means what you think it means. I've moved it into a separate section to make the original post more manageable.]

"True" IgE-regulated allergies are often thought to be more important and more deserving of attention and research than non-IgE regulated adverse reactions. I think the current approach is a bit unbalanced, and here's why:

###################

It's often said that intolerances are usually milder than allergies, and that allergies can occur to trace amounts of foods while intolerances are usually dose-related. But that's not necessarily true.

For instance, gluten intolerance can be triggered by extremely trace amounts of gluten, such as cross-contamination from foods processed on the same equipment as items containing gluten. Corn intolerance is another "non-allergy" in which it seems particularly common for trace amounts of highly refined corn derivatives to cause severe reactions even in people who test negative for corn allergy. That's certainly the case with Baby E and many others on The Avoiding Corn Forum.

There's a misconception that intolerances only cause minor symptoms such as indigestion. But non-IgE food reactions can have all the same symptoms as an allergy, or others just as uncomfortable.

The consequences of an IgE-regulated allergy can range from mildly annoying symptoms such as an itchy mouth, mild rash or runny nose to a severe, multi-systemic debilitating or even life-threatening reaction. Likewise, non-IgE reactions can range from mild to severe. A person may just get a stomach ache when they eat too much of a certain food (as is the case with many intolerances), or they may experience symptoms such as severe vomiting/cramping/diarrhea, internal bleeding, itching, rashes, headaches, difficulty breathing, changes in heartrate or blood pressure, malabsorption, failure to thrive, or even anaphylactoid reactions.

A truly life-threatening adverse food reaction is rare with both an allergy and an intolerance. An intolerance may be less likely to kill you, but a fatal anaphylactoid reaction will kill you just as dead as fatal anaphlyaxis will. Untreated autoimmune or metabolic food intolerances can certainly be fatal.

Intolerances may be mild more often than allergies, but a moderate to severe intolerance can make life just as difficult and uncomfortable as a moderate to severe allergy can. A severe intolerance can be more debilitating and difficult to manage than a mild allergy. Intolerances can be especially difficult to manage since some of the most common intolerance triggers, such as corn and MSG, are less well-regulated and labeled than the top 8 allergens are.

A lot of people get up in arms about people lumping together food allergies and other adverse food reactions. How dare anyone think an intolerance could be in the same class as a REAL allergy? It's touted frequently that, while maybe 15-30% or more of people experience some sort of food intolerance, only a very small percent (somewhere between 1% and 8%, depending on the reporting source and the age range) have "true food allergies." Food labeling laws and other policies are largely based only on the IgE-regulated reactions.

Intolerances are harder to study than allergies, but they affect far more people than allergies do, and their consequences can be severe.

Things like research, accurate labeling, education, and effective treatments are important for all types of adverse food reactions. For both allergies and intolerances, the primary treament is to avoid the foods triggering the symptoms. Pinpointing the trigger foods and being able to avoid them is equally important for managing moderate to severe reactions, whether technically they are allergies or not.