Is it possible that conditions such as asthma, eczema, autoimmune disease, migraines, arthritis, obesity, diabetes could be linked to the health of your gut? 
There is a consensus that our overall health is indeed related to our gut health. The proper function of our digestive system is critical to our overall health. What we eat, and how what we eat interacts in our intestinal system plays a critical role in our overall health.
The gut also happens to contain a large part of our immune system. Based on that fact alone, with the impact the current pandemic is having on our health, now more than ever we need to pay close attention to our gut health.
This three-part series will so help you understand why healing the gut is usually the first step when working with a functional medicine physician.
With that in mind, it’s important to start by becoming familiar with some common terminologies when it comes to how what we eat affects us.

Food Reactions- Allergies, Intolerance, and Sensitivities

Reactions to food are common.  The terms food allergies, intolerance, or sensitivities are oftentimes used interchangeably by the lay public. I often hear patients or acquaintances inform me they have an allergy to certain foods. And when I probe deeper it’s not an allergy but rather an intolerance or a sensitivity.
Food reactions can be divided into two broad categories
Food allergies- These develop when the body’s immune system has an abnormal reaction to one or more proteins in a food. 
Food allergies can lead to serious or even life-threatening allergic reactions. According to a 2017 study, about 4% of the US population have food allergies. (1)
In people with “classic” food allergies, the body reacts to proteins in certain foods. This is because the body perceives these as foreign or harmful. In response to this, the body produces antibodies in response. These antibodies are called immunoglobulin E (IgE) antibodies. 
When next the person eats that food, the food protein binds to the IgE antibodies and leads to a release of chemicals which causes the allergic reaction. Allergic reactions usually set in within minutes to two hours after eating. It is also possible to cause a skin reaction if the food touches the skin (hives or a rash at the site of contact), even if they don’t actually eat it. (2)
More than 170 foods have been reported to cause reactions in the US. There are eight major food allergens. (3)
These include 
  • Milk
  • Eggs
  • Peanuts
  • Tree nuts
  • Wheat
  • Soy
  • Fish
  • Crustacean shellfish 
Some common symptoms of food allergies include itching, flushing, sneezing, runny nose, itchy or red eyes, difficulty breathing, dizziness, rapid or irregular heart rate, weakness, nausea, abdominal cramps, diarrhea, anxiety, irritability, confusion. 
The most serious form of food allergy is anaphylaxis. This can cause serious and life-threatening reactions such as swelling of the tongue and/or upper part of the throat, very rapid heart rate, or even respiratory failure where air no longer gets into the circulation or cardiac arrest.
Food intolerance and food sensitivity are not caused by immunologic reactions like food allergies.
Food intolerances and sensitivities are much more common than allergies, with one study estimating a prevalence of 15-20%. (4).  Many food intolerances are caused by difficulty in digesting food.  These food reactions can include enzyme deficiencies (like lactose intolerance), an inability to absorb a particular nutrient or reactions to additives like sulfites or food colorings.

How to identify food reactions

Food reactions can be very challenging to identify because of the wide variety of symptoms. Identifying food reactions can also be time-consuming. It should be performed by a qualified healthcare professional preferably a physician. If your healthcare provider suspects a true food allergy, you may be referred to a specialist in allergy and immunology. 
The first step to managing food reactions is to differentiate a true food allergy from intolerance or sensitivity. 
The gold standard for identifying food allergies is the elimination diet. (5) 
The Institute of Functional Medicine’s elimination diet is designed to clear the body of foods and chemicals that a patient may be sensitive or allergic to. (6)  The goal of the IFM Elimination Diet is to remove triggers and then return the patient to a wide and varied diet that provides adequate nutrition. With the careful reintroduction of foods, patients are able to identify foods that may trigger a recurrence of their symptoms. 
The elimination diet is a three-week program and should be done under the supervision of a qualified practitioner.
Perhaps you’ve been experiencing some symptoms after you eat and you’ve resigned yourself to this just being normal.  This does not have to be your normal. By working with a functional medicine practitioner like me, you can not only start to heal your gut but identify the root causes of what is causing your health issues and move along in your wellness journey.
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Sources:
(1) Acker WW, Plasek JM, Blumenthal KG, et al. Prevalence of food allergies and intolerances documented in electronic health records. J Allergy Clin Immunol. 2017;140(6):1587-1591.e1. doi:1016/j.jaci.2017.04.006
(2)  Uptodate -Patient education- Food allergy symptoms and diagnosis (Beyond the Basics)
(3) NIAID-Sponsored Expert Panel. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126(6 Suppl):S1-S58. doi:1016/j.jaci.2010.10.007
(4) Lomer MC. Review article: the aetiology, diagnosis, mechanisms and clinical evidence for food intolerance. Aliment Pharmacol Ther. 2015;41(3):262-275. doi:1111/apt.13041
(5) Wood RA. Diagnostic elimination diets and oral food provocation. Chem Immunol Allergy. 2015;101:87-95. doi:1159/000371680
(6) Heal the Microbiome with the IFM Elimination Diet (www.ifm.org)