Could I have a food allergy, intolerance or both?
November 17, 2010 5:27 AM   Subscribe

Could I have a food allergy, an intolerance, both or neither? Special snowflake diet/symptoms info inside.

I've been reading a lot about nutrition and health lately, and some of the info I've come across leads me to believe I might have a food allergy or intolerance, or some kind of combination. I've already made an appointment with my doctor to find out for sure, but she's on holiday and can't see me for three weeks. So I turn to you guys for a general idea of what kind of measures I should be taking in the meantime, if any.

Salient points to consider:

- I frequently have episodes of feeling bloated, somewhat nauseous (though I don't vomit) and constipated. It feels as if my body is taking a long time to digest the food I eat.

- I'm often really tired/sleepy and can't figure out why - especially in the mornings and mid-afternoon. I usually get around 7-8hrs of sleep a night.

- I know I'm allergic to cats and dust. I have allergic asthma. However, I'm often wheezy/short of breath even when there's not much dust or no cats around. Yet my lung capacity is (according to my doctor) apparently very good.

- I sneeze all the time. Every day, up to a few times an hour, in all manner of different environments, at all times of year. My eyes and especially inner ears are often also very itchy. This 'sneeziness' has been an issue all my life.

- My diet is not the healthiest, but not the crappiest either. I eat a decent amount of veggies, fruits and legumes each week, nearly always cook at home and pack my work lunch. 1 cup of coffee a day. But I have quite the sweet tooth, and particularly, a big thing for dairy. Everything tastes better with cheese melted on top of it.

- I'm a mid-twenties female, from an Asian family, in case it's relevant. No other health issues.

So do you think it's likely I have a food allergy/intolerance?

Is there a way I can test for it myself?

Is it safe to cut foods out of my diet before I see my doctor? If so, which foods, and what should I eat instead to make sure I don't miss out on any nutrients? Any supplements I could take?

I'm currently suffering from a particularly severe case of 'funny tummy', with more digestive problems than usual - feeling bloated, really full, and often slightly nauseous. So while I'm looking for ideas about my general nutritional health, I would also really appreciate tips on what I should be eating and doing right now to make myself feel better before I can see my doctor.

Of course, YOU are not my doctor :)

With many thanks in advance!
posted by greenfelttip to Health & Fitness (23 answers total) 6 users marked this as a favorite
It could a billion different things. A million billion. Maybe it's a food allergy, maybe it's a seasonal allergy, maybe there is mold in your living space, maybe it's related to stress, maybe maybe maybe. Best thing to do would be to see a doctor and explain your symptoms. Until then, it's just throwing darts.
posted by (Arsenio) Hall and (Warren) Oates at 5:31 AM on November 17, 2010 [1 favorite]

It took me a while to discover my lactose intolerance since it didn't start until my mid-20s. In hindsight, I'm embarrassed by how long it took for me to correlate ice cream consumption with feeling awful 20-30 minutes later. Note that different dairy products contain different amounts of lactose, so most cheeses aren't a problem for me, but milk, cream-based soups, and ice cream are awful.

To rule out lactose intolerance, eat a bowl of ice cream when feeling ok and see if you feel awful within the next hour. If so, it's simply a matter of buying Lactaid or a probiotic with lactase.
posted by JMOZ at 5:37 AM on November 17, 2010

Note also that lactose intolerance is very common among certain groups (in my case, Ashkenazi Jews, but also many Asian groups and much of Africa. The last correlation is so strong, in fact, that most Lactaid advertisements depict African Americans.)
posted by JMOZ at 5:39 AM on November 17, 2010

In general, food allergies are more immediate and severe (anaphylaxis, hives, etc.) while food intolerances would be more likely to cause vague gastrointestinal stuff. So if food is the culprit for you, it's more likely an intolerance.

The best way to check for an intolerance is to eliminate the food from your diet, then reintroduce small amounts. Lactose intolerance is by far the most common, and since you eat lots of dairy anyway, it's a logical start. Cut out ALL dairy (meaning milk and cheese as well as any processed foods containing any amount of milk, whey, or any of their byproducts) for a couple weeks, then try eating a small amount. If you start feeling sick, there's your problem, if you don't, try something else (wheat, fructose, soy).

If dairy does turn out to be your problem, don't worry - after the elimination phase is over, you can eat it again with Lactaid tablets. And many foods with very small amounts may not bother you at all. It is important to avoid these during the initial test though, to get it all out of your system for a clean slate.
posted by ella wren at 5:42 AM on November 17, 2010

The bloatedness definitely sounds like what I experienced when my lactose intolerance set in. You can test it with LactAid, but beware - there's dairy in EVERYTHING that can trigger your symptoms. Most processed foods seem to have some amount, so reading labels is important if you don't want to screw up your testing. Even pills often have lactose - I was wondering why I felt bloated every morning during allergy season, until I read the label of my Claritin more closely.

Might not be your problem, but start reading labels...
posted by jetsetlag at 5:46 AM on November 17, 2010 [1 favorite]

Wheat and dairy are two of the most common foods to cause problems. If you have celiac or are gluten intolerant stopping wheat will not instantly make your symptoms go away - it takes a few weeks to feel better. I can't speak to dairy - it sounds as if you'll get faster relief and confirmation if that's the cause of your symptoms. There are blood tests for the antibodies that show up with celiiac but you do need to be eating gluten at the time for them to be accurate so you may want to hold off on eliminating wheat from your diet and request the blood work.
posted by leslies at 6:00 AM on November 17, 2010

You could also look into using EnteroLab. They do all kinds of testing for food intolerance
posted by MorningPerson at 6:19 AM on November 17, 2010

You don't have a food allergy. As a basic rule, if you don't have to go to the hospital after you eat it, you're not allergic to it.
posted by reddot at 6:27 AM on November 17, 2010

reddot, your link (did you read it?) says: Allergic responses include dermatitis, gastrointestinal and respiratory distress, including such life-threatening anaphylaxic responses as biphasic anaphylaxis and vasodilation; these require immediate emergency intervention.

Including. Not limited to. Including.

She has gastrointestinal and respiratory distress.
posted by (Arsenio) Hall and (Warren) Oates at 6:31 AM on November 17, 2010

I find it a bit peculiar that nobody else has mentioned this already, but cheese can cause constipation even for people who do not have a food allergy or intolerance. Cheese is known as a binding agent, which tends to make the stool more solid. Since you mention that you eat lots of cheese (which you like to put on everything) and you suffer from constipation, I would suggest that you greatly reduce, or eliminate cheese from your diet and see what happens. Other than that, cheese is also a dairy food and it could be causing you problems if you are lactose intolerant, as others have noted. Given that you are of Asian descent, lactose intolerance is quite likely. Try cutting all dairy food out of your diet and see what happens. It will probably help.
posted by grizzled at 6:52 AM on November 17, 2010

I am the QUEEN of telling people "GO SEE YOUR DOC!"... however, when I was concerned that I might have allergies, my GP told me, in effect, "We COULD test you, but the tests aren't terribly accurate... if I were you, I'd probably just pick up a few packs of Zyrtec and Claritin and see if they do any good."

Similarly, if you've had a recent GYN exam and physical, it can't really HURT to put yourself on a standard elimination diet and see if you feel any better within a few weeks.
posted by julthumbscrew at 6:52 AM on November 17, 2010 [1 favorite]

You might want to try a couple of weeks with absolutly no dairy and wheat and see what happens. Most Asians don't tolerate dairy very well and there are plenty of people who suffer all kinds of digestion problems when they eat wheat. Try acidophilous (found in the vitamin aisle) to help with digestion and when you do see your doctor, you might want to have your thyroid and blood iron level checked.
posted by MsKim at 7:21 AM on November 17, 2010

You sound very much like me before I was diagnosed with Celiac Disease in my mid twenties. Add in random muscle aches and anemia and you'd be describing me almost perfectly. I also thought I was lactose intolerant, but it turns out that when I've already been damaged from gluten I'm also sensitive to other things (like lactose and fructose.) When I'm on the gluten free diet I don't have the lactose problems.

The thing with Celiac Disease is that the only sure-fire way to be diagnosed is by having an endoscopy. There are blood tests but they are far from accurate, you can have a negative blood test and still have Celiac Disease. The endoscopy will look for intestinal damage from the gluten. If you start a gluten free diet before you get the 'scope and you do have CD you'll start to heal and that may cause a false negative on the biopsy.

If it is gluten intolerance it usually takes months to start feeling better. Trying the diet without a diagnosis is difficult because there really isn't any motivation to stick to it. Without knowing that it will make you feel better eventually it's easy to 'cheat' which will obviously set the healing back. It's my opinion that getting the diagnosis first is more important than just starting the diet on your own a few weeks early.
posted by TooFewShoes at 7:24 AM on November 17, 2010 [1 favorite]

If you *really* want to do the elimination thing, you should rule out autosuggestion. By that I mean eliminate the foods you think are causing you problem. If you are feeling better, then a friend, *without your knowledge* slips in some of the bad food. If you don't react, or if you react when friend *didn't*anything, then it is likely that your feeling better is the power of suggestion.

There are a whole lot more people running around believing that they are sensitive to wheat, dairy, or you name it than actually are.

Celiac disease is a real thing, so is lactose intolerance. Apologies to people who do suffer from this and were probably ridiculed until diagnosed. When it comes to food rules and health, here is just so much charlatanism, urban legends, and FOAF advice that it is hard to get true perspective. (Talking not of the obvious, like don't have a whole cake at lunch or eat 8,000 calories/day.)

I do know that
1) when your allergies flare up you can have a cross reaction. Meaning hayfever might make you have a reaction to red wine, even if you can drink gallons of the stuff outside of allergy season
2) I believe that hard cheese (meaning not cottage cheese or cream cheese) has much of the lactose converted in the process of making cheese.
3) "Asian" can mean a lot of things. South Asian I think have the lactose genes similar to Europeans, East Asians don't. So if your ancestors came from Bangalore, you are likely to do better with dairy than if they came from Beijing.

if you can stand one FOAF anecdote from ME, then here it is. Fried foods. Having a meal with deep-fried foods won't cause an immediate reaction, although constantly eating like that isn't good in long term.
But I believe some restaurants that deep fry (Think French fries at the local burger place, or dumplings and spring rolls at Chinese restaurants) often do not clean, or remove the grease from the deep fryer as often as they should. The grease gets rancid. You can't taste it because it is deep fried, but oh you can feel it! Oh boy can you feel it!

Take it as just another anecdote.

Not a doctor, nor a geneticist, nor a nutritionist.
posted by xetere at 7:57 AM on November 17, 2010 [1 favorite]

I was going to say celiac too--I feel like a good third of my friends had your symptoms for ages, decided to cut out wheat/gluten on a whim, and haven't looked back since. It's gaining a lot of notoriety right now.

Go a week or two without any sort of wheat/typical grains and see if your stomach thanks you. A lot cheaper than getting tested, and it won't hurt you to try.
posted by ifjuly at 9:14 AM on November 17, 2010

IANAD, but I have several major food intolerances - and yes, many of your symptoms sound familiar. A few observations:

- I frequently have episodes of feeling bloated, somewhat nauseous (though I don't vomit) and constipated. It feels as if my body is taking a long time to digest the food I eat.

Pretty classic food intolerance symptoms. In my case, lactose, grains, and fructose are the culprits.

- I'm often really tired/sleepy and can't figure out why - especially in the mornings and mid-afternoon. I usually get around 7-8hrs of sleep a night.

This used to happen to me before I was diagnosed with the aforementioned allergies - so badly that I would pass out at work and I was prescribed an antinarcoleptic drug! In my case, my body can't digest fructose, so it remained in my system for an extended time while all the while my body was pumping out excess insulin in an attempt to process it, thus lowering my blood sugar to dangerous levels.

- I know I'm allergic to cats and dust. I have allergic asthma. However, I'm often wheezy/short of breath even when there's not much dust or no cats around. Yet my lung capacity is (according to my doctor) apparently very good.

Grains were the problem for me here. I've got tons of allergies and had mild asthma for years, but after cutting all grains from my diet, my symptoms are minimal.

- My diet is not the healthiest, but not the crappiest either... But I have quite the sweet tooth, and particularly, a big thing for dairy. Everything tastes better with cheese melted on top of it.

I'm going to guess that you eat a lot of baked goods, perhaps of the kind that marketing people call "healthy" - whole grain bread, low fat stuff, etc.? None of these are good for you, even though our culture is convinced that whole grain and low fat = healthy. Apologies if my assumption is wrong.

That being said - it's tough to find a doctor who can diagnose this stuff. I'd suggest you experiment with an elimination diet instead - cut out all sugars except for fruit, cut out all grains, and cut out all dairy (***except aged cheeses, which only contain a trace if any lactose!***) and see how you feel.

If you still have problems - cut out the fruit. If you improve after that, you can be pretty sure that fructose is the problem. I really hope it isn't, since living with fructose intolerance is not fun. But it beats the heck out of being sick all the time! Good luck to you.
posted by chez shoes at 9:41 AM on November 17, 2010 [1 favorite]

Is it safe to cut foods out of my diet before I see my doctor...what should I eat instead to make sure I don't miss out on any nutrients?

Yeah, it's safe. Even if you did end up lacking some nutrient, it wouldn't be a problem on a reasonable time scale-- say, two weeks, and probably safe for much longer. Once you identify a problem food, you can figure out what to substitute it with. If you don't like that advice, then it really depends on the specific food you're trying to cut out. I'd be happy to help with specific foods if you wanted to mention them in-thread or me-mail.
posted by nathan v at 11:19 AM on November 17, 2010

Is it safe to cut foods out of my diet before I see my doctor...what should I eat instead to make sure I don't miss out on any nutrients?

You can definitely cut out all sugars, and all grains, without worrying about it negatively impacting you. If you take the "no sugars" to the extreme of not eating any fruit at all (like I have to), vitamin C supplements are recommended. As far as grain products go, they don't contain anything special that your body can't get from other foods.

However - if you are going to be tested for celiac disease, you *have* to be eating grains before the test or the results will not be accurate. I've never had an official celiac diagnosis because years ago when it was first mentioned to me, I cut out grains immediately and felt so much better so quickly that I refused to eat them again!
posted by chez shoes at 12:31 PM on November 17, 2010

Best answer: Could I have a food allergy, an intolerance, both or neither?

Yes, any of those things could be true. Your symptoms so far could fit any of those four scenarios, despite what people are saying in the other comments.

Elimination diets are difficult to do properly and should be done with a dietician. Just randomly cutting stuff out isn't going to get you anywhere, particularly since you currently have nothing to go on. Please don't do this.

The best thing to do over the next three weeks is keep a really detailed food and symptom diary. That's the first thing your doctor will want to see anyway and it will be a good tool in starting to figure out what is going on. Write down everything you eat, including small additives like herbs and stuff, and keep track of any symptoms. If you're female track your menstrual cycle in there too because it can be relevant for things like IBD. Making big changes to your diet now is only going to muddy the waters when you do see a doctor (e.g. any effects you see could just be because of the change and nothing to do with *what* you changed). Much better to track your normal state and have baseline data to start with, then you can work out what is wrong for you specifically rather than random ideas thrown out by the internet in general.
posted by shelleycat at 1:34 PM on November 17, 2010 [2 favorites]

Response by poster: Thanks all for the many informative answers so far, it's much appreciated!

It seems like it really could be a variety of food intolerances or allergies I'm suffering from, or yeah, something completely different altogether. It's nice to know I'm not way off base with that idea, though.

I will definitely talk to my doctor about getting tested for Coeliac's based on what some of you have suggested. It also seems like I have plenty of choice when it comes to food types to eliminate! But since I can't know for sure what's up it seems sensible to do what shelleycat suggested and record my diet and symptoms in a normal state for a while.

If, after a visit or two to the doc, I'm left none the wiser then I will certainly be trying an elimination diet to see what happens.
posted by greenfelttip at 5:32 AM on November 18, 2010

If the doctors don't help and your diet questionnaire shows any hint of a pattern then definitely go to a registered dietician, or possibly an allergist depending on what you find. Of you do have allergies and/or intolerances then you'll probably want to work with a dietician anyway, at least at first, to get a handle on all of it. They can help you with a proper elimination diet too. The Dr is the first step for sure, but don't be afraid to keep working through this if that step isn't enough because clearly *something* is going on.

I know how it sucks when you're feeling bad and there's nothing you can do except monitor the situation (I have IBS). Hopefully getting started with doing something, even if it's not directly addressing the symptoms, will make you feel better about the situation as a whole. And if something jumps out straight away like a direct ice cream-bloating correlation then you can look at cutting things out before seeing the doctor. But then you'll be doing it based on evidence, plus realistically you'll probably want to track for at least a couple of weeks first to be sure anyway.
posted by shelleycat at 10:56 AM on November 18, 2010

Gah, and I just noticed that in my first comment I put IBD (inflammatory bowel disease) when I meant IBS (irritable bowel syndrome) when referring to tracking your menstrual cycle. You'd think that getting a PhD studying one and having the other would make me get that right!
posted by shelleycat at 10:58 AM on November 18, 2010

Response by poster: Thanks, great advice! Despite not having a clear handle on what the problem could be yet, it feels good to have the process of discovery underway, after grinning and bearing symptoms for so long which I never imagined could be connected as part of a wider problem. So now I'm willing to be patient and persistent in getting to the bottom of it :)
posted by greenfelttip at 4:12 AM on November 19, 2010

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