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Is it a food allergy or food sensitivity? Talk to your doctor

Raj Srinivasan, MD

Food sensitivities and food allergies can be easily confused. Doctors are trained to help figure out which one is which—and to know when to recommend testing.

At Vancouver Clinic, we follow established national guidelines from our professional organization, the American Academy of Allergy Asthma and Immunology, to determine when food allergy testing is necessary. In general, we suggest food allergy testing when:

  • There is concern that an immediate allergic reaction, such as hives or anaphylaxis, may occur
  • An infant is at high risk for an egg or peanut allergy, usually because of the presence of severe eczema
  • An individual is diagnosed with eosinophilic esophagitis

We do not recommend food allergy testing for mouth irritation, chronic hives, migraines, abdominal pain, bloating, altered bowel habits, flushing, changes in energy levels or appetite, or as part of a general health exam. All of these are symptoms of a food sensitivity.

In general, food sensitivities are diagnosed based on a thorough history and physical exam. Because sensitivities are not driven by an allergic reaction, allergy testing is not recommended. When allergy tests are performed for food sensitivities they tend have a falsely elevated results.

A thorough assessment by your primary provider or GI specialist can help rule out gastrointestinal conditions and acid reflux, and pin down problem foods. (An intolerance to lactose is one of the most common.) Food journaling, as well as eliminating and reintroducing foods, can also help identify issues. It’s best to avoid “food sensitivity testing” and other disproven testing offered by some naturopaths and chiropractors.

Dr. Raj Srinivasan is an Allergy, Asthma & Immunology Department specialist. He enjoys being able to focus on patients, helping them control allergic problems and achieve a better quality of life.