Food Allergies and What You Can Do About Them

Dr. Andrea Klemes, Chief Medical Officer MDVIP
By Dr. Andrea Klemes , MDVIP
May 7, 2023
Food Allergies and What You Can Do About Them

When I was in school growing up in New York, hardly anybody had food allergies. Nobody sat alone at an allergy table, and peanut butter was practically cuisine du jour. A lot has changed.

Today, food allergies affect a growing number of American adults – about 2 percent. They cause 30,000 emergency room visits and 2,000 hospitalizations each year, according to the Food and Drug Administration.

These ER visits and hospitalizations are usually caused by extreme allergies, ones likely to cause anaphylaxis, a severe allergic reaction which occurs within minutes of coming in contact with an allergen like shellfish or peanut butter. When this happens, our body’s immune system overreacts to the allergen and makes it difficult to breathe or causes swelling and other dangerous symptoms.

This is different from a food sensitivity or a food intolerance. A food sensitivity is also an immune system response — like a milder allergy, with lesser symptoms. A food intolerance – like lactose intolerance — usually means your body can’t digest a certain food. They typically cause gastrointestinal issues, like:

  • Tummy aches
  • Bloating
  • Flatulence
  • Diarrhea

Sometimes they can cause more substantial symptoms like irritable bowel syndrome.

These three terms, allergies, sensitivities and intolerances are often used interchangeably; however, they are different due to how our bodies react. While allergies may result in more severe issues, food intolerances and sensitivities affect a bigger population, up to 20 percent of Americans, by some estimates.

The most common foods that people can’t digest easily include:

  • Wheat bread
  • Cabbage
  • Onions Peas or beans
  • Milk
  • Hot spices
  • Fatty/deep fried foods
  • Coffee.

Food sensitivities typically include those foods people are commonly allergic to or intolerant of as well as things like food colorings and preservatives.  

The saying in my extended family is that you have the “Klemes Stomach.” My father always had stomach issues. He was diagnosed with Irritable Bowel Syndrome in his 60’s. I have suffered for years never really knowing why. Several years ago, my symptoms got so bad I knew I had to do something about it. I researched several companies doing testing and consulted with experts and other MDVIP affiliates.

After taking the ALCAT food sensitivity test, I found out that I had sensitivities to lobster, white potatoes, soy, gluten and many others. I removed the worst offenders from my diet and my world changed. I still get symptoms every so often, but the repercussions are minimal now.

Why are there so many food allergies now versus when we were growing up? We don’t exactly know, but we have excellent theories.

The most popular theory is the Hygiene Hypothesis. Adherents of this theory believe that we are exposed to fewer allergens, viruses and bacteria in our modern environment than our parents and their parents. There’s about 30 years of science underpinning this theory.

A good example: In 2016, researchers compared children of Amish farmers to the children of Hutterite farmers, who use mechanized equipment in farming. They discovered the Amish children, who were exposed in their traditional farming community to more airborne allergens, animal dander and fecal matter, had fewer allergies and generally stronger immune systems, despite the two groups sharing genetic ancestry.

In short, the dirtier the environment, the fewer the allergies. But researchers have struggled to understand this hypothesis and figure out what to do with it to prevent rising allergies.

The second most prevalent theory is called exposure timing. When we are infants, our immune system is still developing. The earlier we’re exposed to a food, the less likely we’ll be allergic to it. This may seem counterintuitive because we’re often encouraged to avoid introducing babies to foods that can potentially cause an anaphylactic reaction, but studies now show infants exposed to peanuts earlier tend to develop fewer allergies.

There are other theories about the rise of food allergies — vitamin D deficiencies as well as genetics, come to mind — but none answer the question satisfactorily. They also don’t answer how adults can develop food allergies. Researchers think adult-onset are likely the result of changes in our immune system. 

Theories around the rise in food sensitivities and intolerances also abound — from the increase in industrialized food to the prevalence of medications to stress to better testing — and are equally unsatisfying.

The reason probably doesn’t matter if eating certain foods make you feel bad – or worse. What can we do about food allergies and sensitivities?

First, if you’ve experienced an allergic reaction to a food, it’s important to share this with your doctor — no matter how mild. Allergic reactions can intensify over time. Your doctor may prescribe you an epinephrine injector to carry and refer you to an allergist.
What does an allergic reaction to food look like? Symptoms include: 

  • Tingling or itching in the mouth
  • Itchy skin and hives
  • Breathing difficulty
  • Swelling of tongue, face, lips or throat (any part of the body that came into contact with food)
  • Abdominal pain, vomiting or diarrhea
  • Dizziness

Long-term skin rashes or eczema can also be a sign of food allergies.

Symptoms of food intolerances may be harder to peg. They usually affect our gastrointestinal system (stomach aches, bloating, flatulence and diarrhea), but they can also cause:

  • Migraine
  • Headaches
  • Runny noses
  • General malaise

How do we test for allergies, sensitivities and intolerances? It starts with identifying symptoms and creating a family history of these issues. Your doctor may also do a physical examination, especially if you’re still experiencing symptoms.

There are multiple types of tests to verify. There are two classic food tests for allergies: 

  • Skin test: A small amount of allergen is introduced to a small scratch or prick in your skin. If your skin reacts, your doctor or allergist will have a better idea of what you might be allergic to. But it’s not conclusive. Sometimes our skin will react to foods we can eat safely and vice versa.
  • Blood serum test: Doctors and allergists may also perform a blood test that measures your immune system’s reaction to an allergen. Blood is drawn, sent to a lab and then tested against various foods. The tests measures immunoglobulin E, an antibody produced by your immune system.

There are other ways to determine if you might be allergic to a food. Doctors may put you on an elimination diet, where suspected foods are removed and then slowly reintroduced one at a time. Because we often eat more than one food at a time, an elimination diet can help you home in on the allergic culprit.

This may also be done in combination with an oral food challenge, which usually takes place at a doctor’s office or a medical facility. In this test, small but increasing amounts of food suspected of causing an allergic reaction are given to you. If you don’t have a reaction, that food can usually be added back to your diet.

These same approaches may be used on food sensitivities, too.

Determining if you have a food intolerance is a little different. Usually, a doctor will ask you to eliminate a suspected food like dairy or wheat from your diet for a time to see if symptoms resolve. But there are other tests as well.

For lactose intolerance, doctors can use a hydrogen breath test or a blood test to see the level of glucose in your blood. There are specialized tests for other intolerances like celiac disease, in which patients cannot digest wheat.

There are other tests on the market which can help you narrow down foods that you might be sensitive to. There are several kinds of blood tests to do this. Your MDVIP-affiliated doctor can help you determine the right approach to figuring out your food-related problem. MDVIP Affiliates offer additional testing that can help you identify the issue you’re dealing with or can help you find the right specialist to work with.

There are both immediate challenges (anaphylaxis)and long-term consequences to allergies and intolerances (digestive issues, low-grade inflammation, eczema). That’s why it’s important to talk to your doctor.

Once my physician and I were able to identify some of the foods that don’t work with me, I felt a lot better. Talking to my doctor and figuring out the foods that affected me improved my quality of life. And hopefully keeps me healthier!

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About the Author
Dr. Andrea Klemes, Chief Medical Officer MDVIP
Dr. Andrea Klemes, MDVIP

Dr. Andrea Klemes is the Chief Medical Officer of MDVIP. She also serves as the executive and organizational leader of MDVIP’s Medical Advisory Board that supports quality and innovation in the delivery of the healthcare model drawing expertise from the affiliated physicians. Dr. Klemes oversees MDVIP’s impressive outcomes data and research including hospital utilization and readmission statistics, quality of disease management in the MDVIP network and the ability to identify high-risk patients and intervene early. She is instrumental in the adoption of the Electronic Health Record use in MDVIP-affiliated practices and the creation of the data warehouse. Dr. Klemes is board certified in internal medicine and endocrinology and a fellow of the American College of Endocrinology. Dr. Klemes received her medical degree from the New York College of Osteopathic Medicine. She completed an internal medicine residency at Cabrini Medical Center in Manhattan, New York and an Endocrine and Metabolism Fellowship at the Medical College of Georgia in Augusta. Prior to joining MDVIP, Dr. Klemes worked at Procter & Gamble in the areas of personal healthcare, women’s health and digestive wellness and served as North American Medical Director for bone health. She spent 10 years in private practice specializing in endocrinology and metabolism in Tallahassee, Florida. In addition, Dr. Klemes held leadership roles with the American Medical Association, Florida Medical Association and as Medical Director of the Diabetes Center in Tallahassee and Panama City, Florida, as well as Chief of the Department of Medicine at Tallahassee Community Hospital. She has been a consultant and frequent lecturer and has completed broad clinical research in diabetes and osteoporosis and published extensively.

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