Food Allergies: Distinguishing Fact from Fiction
Allergy, intolerance or sensitivity? They're not the same.
Dr. Nadia Kouri
Allergist-Immunologist

In simple terms
True IgE-mediated food allergies affect 3 to 6% of children and 2% of adults. Knowing how to identify them can save lives.
What you need to remember
- Three Different Mechanisms — IgE-mediated allergy**: rapid immune reaction (minutes to 2 hours).
- The 14 Major Allergens — European regulations require the declaration of 14 allergens: gluten, shellfish, egg, fish, peanut, soy, milk, tree nuts, celery, mustard, sesame, sulfites, lupin, mollusks.
- Recognizing an Anaphylactic Reaction — Generalized hives, facial swelling
Food allergies are increasing in industrialized countries. However, many people confuse allergy, intolerance, and non-allergic sensitivity.
Three Different Mechanisms
- IgE-mediated allergy: rapid immune reaction (minutes to 2 hours). Can cause anaphylaxis. Common allergens: peanut, tree nuts, milk, egg, fish, shellfish.
- Intolerance: enzyme deficiency (e.g., lactase for lactose). Digestive symptoms only, dose-dependent.
- Non-allergic sensitivity: real symptoms but without an identified immune mechanism (e.g., non-celiac gluten sensitivity).
The 14 Major Allergens
European regulations require the declaration of 14 allergens: gluten, shellfish, egg, fish, peanut, soy, milk, tree nuts, celery, mustard, sesame, sulfites, lupin, mollusks.
Recognizing an Anaphylactic Reaction
- Generalized hives, facial swelling
- Difficulty breathing, wheezing
- Drop in blood pressure, malaise
- Abdominal pain, vomiting
Immediate action: self-injectable adrenaline (pen) and call 911.
Living with a Food Allergy
- Systematically read labels
- Inform family, friends, and restaurants
- Always carry your adrenaline pen
- Wear a medical identification bracelet
The words explained
Medical terms used above, in everyday language.
- Symptom
- A sign you can feel or see that something is wrong, like pain, tiredness or a rash.
- Immune system
- Your body's defence team: cells that fight germs and repair damage.
- Blood pressure
- The force of blood pushing against your artery walls. Too high, over years, damages the heart and vessels.
When should you see a doctor?
- Your symptoms last more than a few weeks or keep coming back.
- They get worse quickly, or stop you doing everyday things.
- You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
- You already take medication and want to change anything about it.
This article explains general health information. It does not replace advice from your own doctor.
Frequently asked questions
- What is Food Allergies: Distinguishing Fact from Fiction?
- True IgE-mediated food allergies affect 3 to 6% of children and 2% of adults. Knowing how to identify them can save lives.
- What are the main symptoms or signs of Food Allergies: Distinguishing Fact from Fiction?
- Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
- When should you see a doctor for Food Allergies: Distinguishing Fact from Fiction?
- See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.
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