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Do You Have A Food Allergy? with Gary E. Eddey, MD, MPH

July 18, 2022
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Do you know the difference between a food allergy and a food intolerance? Most people confuse the two, but the distinction might save your life.

A food intolerance is something that does not agree with you and might cause an uncomfortable condition. You might have an intolerance to a food dye or lactose, for instance. An infant might have an intolerance to something their mother is eating, and that could cause them to be fussy. The way to avoid the condition is to avoid the food that has that ingredient.

A food allergy, on the other hand, is based in immunology. You are allergic to a specific protein in a food. Your immune system sees that protein as a foreign object and overreacts to it. A food allergy means that your immune system is not working properly, and the ensuing allergy could be life threatening.

A food allergy can lead to hives, anaphylaxis, which is also known as oral anaphylaxis. Anaphylaxis is when your immune system releases a flood of chemicals in reaction to something you have eaten that can cause you to go into shock. Your blood pressure will drop suddenly, and the airways will narrow, blocking your breathing. Other signs and symptoms include a rapid and weak pulse, a skin rash, and nausea and vomiting.

Anaphylaxis requires immediate treatment. You should call 911 right away. You will need a shot of epinephrine, or adrenaline, to open the airways so you can breathe. An EpiPen is a disposable, pre-filled injection device that administers epinephrine in the event of a severe allergic reaction. People with food allergies commonly carry one with them in case of an allergic reaction, but EMTs will have one if you must call 911.

Foods that people are commonly allergic to include:

• Peanuts and other tree nuts

• Seafood, especially shellfish like lobster and shrimp, and swordfish

• Eggs, cow milk, sesame, and soy

Is it possible to outgrow a food allergy? Yes, but it depends on the type of food you’re allergic to and the severity of the allergy. According to the Mayo Clinic, about 80 percent of kids outgrow milk and egg allergies by age 16. By contrast, only about 20 percent of kids with peanut allergies outgrow them.

If your child experiences generalized anaphylaxis or oral anaphylaxis, your physician may consider having a team of allergists perform an inpatient or outpatient oral challenge test. Severe Immunoglobulin E (IgE) allergies must be taken very seriously.

If your child experiences milder forms of reactions then one can readily use three common methods of allergy skin testing: a skin prick test, an intradermal test, and a patch test.

The skin prick test involves:

  • Placing a small number of substances that may be causing your symptoms on the skin, most often on the forearm, upper arm, or back.
  • The skin is then pricked so the allergen goes under the skin's surface.
  • The health care provider closely watches the skin for swelling and redness or other signs of a reaction. Results are usually seen within 15 to 20 minutes.
  • Several allergens can be tested at the same time. Allergens are substances that cause an allergic reaction.

The intradermal skin test involves:

  • Injecting a small amount of allergen into the skin.
  • The provider then watches for a reaction at the site.
  • This test is more likely to be used to find out if you are allergic to bee venom or penicillin. Or it may be used if the skin prick test was negative, and the provider still thinks that you are allergic to the allergen.

Patch testing is a method to diagnose the cause of skin reactions that occur after the substance touches the skin:

  • Possible allergens are taped to the skin for 48 hours.
  • The provider will look at the area in 72 to 96 hours.

In addition to intervening after a food allergy has been identified, your pediatrician and/or allergist can discuss with you the value of introducing common allergenic foods early in life – around 6 months of age. This will prevent the overwhelming majority of food allergies.


If you have concerns about food allergies or food intolerance, discuss it with your Ryan Health provider. To book your appointment, use our Online Scheduler.