When we think of food sensitivities, we often think of food allergies, but there are actually many other types of sensitivity. This article contains a list of 21 types of food sensitivity, their most common symptoms and the types of foods that cause them. You’ll see that many of the symptoms and foods show up in more than one category.
Food sensitivities are generally assessed by combining information from health history, family history, diet diary, and elimination diet. Sometimes blood tests may be helpful.
Prevention of Food Sensitivities
Food sensitivities arise because of complex factors that involve the diet, immune system, digestive system, inflammatory balance, genetic susceptibility, microbiome, stress, mental-emotional state, and liver health.
Maintaining good overall health, managing stress, and eating an anti-inflammatory diet are the best ways to prevent food sensitivities from arising in kids and adults.
When considering prevention of food sensitivities in infants, the most current recommendations are to introduce small amounts of a number of different foods, especially allergy-causing foods, when solid foods are introduced around 4-6 months of age.
Even with a thorough preventative plan, food sensitivities still sometimes arise in people who are genetically predisposed.
Treatment of Food Sensitivities
Treatment of food sensitivities requires an individualized approach and depends on the type of sensitivity and the root cause.
During treatment, foods which cause problems are either removed completely (in the case of allergens) or reduced to a level that doesn’t produce symptoms (in the case of most other intolerances).
A solid nutritional foundation is established with an anti-inflammatory diet, multivitamin, probiotic, and fish oil.
Specific treatment includes the promotion of digestive health, liver health, immune balance, mental-emotional health, and inflammatory balance.
Types of Food Sensitivity
This list includes 21 of the most common food sensitivities that I see in my practice. Most of these foods are well tolerated in people who don’t have a sensitivity to them and there’s no need to limit otherwise healthy foods unless they cause a reaction.
- IgE Food Allergies
- IgG Food Intolerance/Allergy
- Bladder Irritants
- Stimulant Food Additives
- Nightshade Sensitivity
- Lactose Intolerance
- Non-Celiac Gluten Sensitivity
- Celiac Disease
- Tyramine Sensitivity
- Aspartame Sensitivity
- Sugar Alcohol Maldigestion
- MSG (Monosodium Glutamate) Sensitivity
- Histamine Intolerance
- Salicylate Sensitivity
- Sulfite Sensitivity
- Yeast Sensitivity
- Egg Maldigestion
- Caffeine Sensitivity
- Food Coloring
- FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols)
- Inflammatory Foods
1. IgE Food Allergies
IgE food allergies are the type of reaction that is regarded as a true food allergy. Symptoms usually occur immediately after eating the food and can be mild and easy to ignore or dramatic and sometimes dangerous. These types of allergy and this type of testing should always be monitored by a health professional. If a rechallenge of a certain food is deemed appropriate by a doctor, it may need to occur in a controlled setting with an epipen available in case a serious reaction occurs.
Symptoms of IgE food allergies include: hives, face swelling, itchy tongue, warm face, coughing, wheezing, difficulty swallowing, tightness of throat, itchy/watery eyes, runny nose, metallic taste in mouth, nausea, abdominal pain, uterine cramping, vomiting, diarrhea, dizziness, palor, anxiety, headache. Symptoms in babies may include change in sound of their cry, change in disposition, spitting up food or drink after feeding (in a way that is different than usual for them), becoming unexpectedly sleepy, or appearing frightened.
Usually offending foods can be identified with a 2 week diet diary. The most common allergy-causing foods include: dairy, eggs, wheat, peanuts, mustard, sesame, shellfish, fish, soybeans, tree nuts. However, there are many rare allergies that can be detected with an IgE blood test [link to elimination diet vs blood test blog].
2. IgG Food Intolerance/Allergy
IgG mediated food reactions are sometimes termed allergies and sometimes termed intolerances. These are delayed type reactions that can occur several hours or days after ingesting a food and can be difficult to pinpoint using a diet diary. IgG food sensitivity testing is available, but I have found that it is rarely helpful in my clinical practice. Serum IgG levels rise in response to frequently ingesting a food and may simply reflect commonly eaten foods. IgG levels can also reflect an immune tolerance to certain foods, which is the opposite of an allergy.
Symptoms of IgG food intolerance may include rashes, hives, asthma, irritable bowel syndrome, diarrhea, abdominal cramping, constipation, migraine, chronic fatigue, hair loss, eczema, hay fever.
The most commonly implicated foods are dairy, wheat, gluten-containing grains, soy, potatoes, corn, eggs, yeast. Other foods may also be investigated as suggested by diet diary, family history, and/or IgG blood panel.
3. Bladder Irritants
Some people have more sensitive bladders than others. Discovering and removing or reducing offending foods can create significant improvement in symptoms. In children, symptoms include bed wetting, difficult or lengthy potty training. In adults bladder irritants can cause or worsen bladder pain, frequent or urgent urination, overactive bladder, interstitial cystitis, and urinary incontinence.
Bladder irritating foods may include apples, strawberries, citrus fruits, grapes, guava, pineapple, plums, prunes, raisins, bananas, cranberries, melon, peaches, juice, alcohol, carbonated drinks, cheese, chocolate, coffee (including decaffeinated), tea (including decaffeinated), nuts, aspartame, onions, sour cream, yogurt, tomatoes, vinegar, soy sauce.
Treatment focuses on healing the bladder. Cornsilk (Zea mays) tea is a good choice for soothing and healing the bladder. St. John’s Wort (Hypericum perforatum) is another frequently used herb for bladder problems as it calms the nervous system, including the nerves in the bladder which may be overstimulated. Bladder irritating foods rarely need to be eliminated, rather they are reduced, and in the case of children dealing with bedwetting, they are avoided after dinner.
4. Stimulant Food Additives
Food additives, colors, and preservatives may cause mood and behavior problems in some people. ADHD, hyperactivity, difficulty focusing, difficulty with emotional regulation, insomnia, anxiety, depression, irritability, increased crying may all be linked to food sensitivities.
The most important foods to look into are those that contain artificial colors, aspartame, MSG, nitrites, and sodium benzoate. Sugar and salicylate containing foods (see below) are also potential causes of these symptoms.
5. Nightshade Sensitivity
It is possible to have an allergy to nightshade plants, but it is more common to have a sensitivity caused by incomplete digestion. Symptoms caused by nightshade sensitivity are gas, bloating, diarrhea, fatigue, and joint pain.
Foods in the nightshade family include tomatoes, potatoes, bell peppers, eggplants, chili peppers, and paprika. (Note: sweet potatoes and yams aren’t in the nightshade family). A sensitivity to one, some, or all of the members of the nightshade family may be present.
6. Lactose Intolerance
Lactose is one of the main components of milk. Lactose intolerance is caused by the body’s inability to break down and absorb lactose. Lactose intolerance causes digestive problems like gas, bloating, abdominal pain, diarrhea, constipation, and nausea. Unlike a dairy allergy, lactose intolerance can be managed by taking digestive enzymes and/or switching to lactose-free products.
*Note: lactose-free products aren’t helpful for dairy allergies because allergies are usually caused by a reaction to the protein casein rather than the sugar lactose.
7. Non-Celiac Gluten Sensitivity
Non-celiac gluten sensitivity is estimated to affect up to 13% of the population. This is a form of gluten sensitivity that isn’t caused by celiac disease or a food allergy. The symptoms of non-celiac gluten sensitivity may include bloating, indigestion, constipation, diarrhea, headaches, fatigue, anemia, depression, anxiety, joint pain, and skin rash.
Treatment involves limiting or eliminating gluten, depending on the severity of the reaction. Enzymes that digest gluten may be helpful. Look for the ingredient DPP-IV, which is the enzyme that breaks down gluten on digestive enzyme labels.
8. Celiac Disease
Celiac disease is a sensitivity to gluten that causes an autoimmune response by the body. It occurs in approximately 1% of the population and rates seem to be rising. If an elimination diet reveals a sensitivity to wheat, it is important to follow up with testing to determine whether it is caused by a gluten allergy, non-celiac gluten sensitivity, or celiac disease. Celiac disease is managed and treated differently than other gluten sensitivities. Strict and complete elimination of gluten is necessary.
9. Tyramine Sensitivity
Tyramine is an amino acid broken down by an enzyme called monoamine oxidase (MAO). Some people have naturally low levels of MAO and others have artificially low levels of MAO because of pharmaceutical inhibitors called MAOIs which are used to treat some types of depression and other psychiatric disorders. Tyramine may build up in the systems of people with low levels of MAO and cause symptoms like migraines, brain fog, digestive problems, heart palpitations, and difficulty regulating blood pressure.
Common foods high in tyramine include aged cheeses, smoked/cured meats, and some types of beer. A more complete list can be found on webMD. Tyramine sensitivity is usually discovered through a diet diary and confirmed via an elimination diet. Treatment involves diet modification.
10. Aspartame Sensitivity
Aspartame is an artificial sweetener found in all kinds of sugar free and diet foods. In people with a sensitivity, aspartame may cause mood effects like anxiety, depression and irritability. It may also cause headaches, learning problems, migraines, and insomnia. I don’t recommend aspartame containing foods for anyone, especially children.
11. Sugar Alcohols Maldigestion
Sugar alcohols like erythritol, sorbitol, xylitol, and lactitol, are low calorie sweeteners that are often used in sugar free and diet foods. Their main side effects are diarrhea and bloating if over consumed. In my practice, I prefer natural, minimally processed sugars like honey and maple syrup; however, in people who are sensitive to sugar, sugar alcohols can be consumed in small amounts.
12. MSG Sensitivity
Monosodium glutamate (MSG) is a salty flavor enhancer used in many processed and fast foods. It can cause hyperactivity and mood issues as mentioned above. It can also cause hives, headache, tingling tips, and chest pain. In general I recommend that people avoid MSG for their families even if a sensitivity isn’t present.
13. Histamine Intolerance
Histamine intolerance is caused by the body’s inability to process histamine effectively and a subsequent build-up of it in the body. Symptoms include hives, swelling, headaches, nasal congestion, fatigue, digestive problems, irregular menstrual cycle, heart palpitations, anxiety, dizziness, and more.
In my practice, the first thing that makes me suspect histamine intolerance is a negative reaction to foods that are usually healing like fermented foods and bone broth. Foods that can contribute to histamine intolerance may include foods high in histamine, foods that cause the body to release histamine, and foods that block the activity of histamine degrading enzymes. For more information about foods that contribute to histamine sensitivity, see this article. Our understanding of histamine intolerance is still evolving and so are our treatment strategies.
14. Salicylate Sensitivity
Salicylates have anti-inflammatory properties and are found in herbs like white willow bark and medications like aspirin. They are also found in many foods. Most people have no problem with the amount of salicylates found in food, but in sensitive people, excess salicylates from medication may cause sinus problems, asthma, diarrhea, hives, and gut problems.
15. Sulfite Sensitivity
Sulfite sensitivity is something that I often check for in kids with asthma (but kids without asthma can be sensitive to sulfites too). Symptoms look like an allergic reaction and include hives, wheezing, swelling, flushing, low blood pressure, coughing, nasal congestion, and diarrhea. Sulfites are a common food preservative and occur naturally in some foods like grapes and aged cheese. Common processed foods that sulfites are added to include dried fruit, wine, canned foods, pickled foods, and baked goods.
16. Yeast Sensitivity
Yeast sensitivity used to be very trendy in natural health communities and my personal opinion is that it was overdiagnosed. However, many people do truly have a sensitivity to yeast. Symptoms include yeast infections, gastrointestinal problems, skin rashes, brain fog, and fatigue. Problems with blood sugar control, immune health, and dysbiosis are usually at the root of this type of sensitivity.
17. Egg Maldigestion
Eggs are a common food allergen, but sometimes people may have a sensitivity to egg whites which is caused by a difficulty digesting them rather than an immune response. Symptoms are limited to the digestive tract and include abdominal pain and diarrhea. Protease containing digestive enzymes may be helpful.
18. Caffeine Sensitivity
Caffeine is found in coffee, tea, chocolate, energy drinks, and some medications. Most people can process a moderate amount of caffeine but get symptoms with high doses. However, some people get adverse reactions to even small amounts of caffeine. Symptoms may include anxiety, insomnia, nervousness, jitteriness, restlessness, and racing heart.
19. Food Coloring
Given the number of adverse reactions that food coloring can cause, it is frustrating to me that it is in the food supply at all. It is a good idea to avoid food coloring even if a sensitivity isn’t present.
20. FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols)
A low FODMAP diet can help to treat irritable bowel syndrome (IBS). Removing FODMAP containing foods while healing digestion, gut inflammation, and the microbiome can provide good results for IBS. Fructose is a type of FODMAP found in fruits, vegetables, honey, agave syrup, corn syrup, and sugar. Some people may have a sensitivity to fructose, but not other FODMAPs.
21. Inflammatory Foods
I recently wrote an article about pro-inflammatory and anti-inflammatory foods. Pro-inflammatory foods include food allergens, fried foods, cured meats, processed foods, and foods high in sugar, salt, and other additives. Some people with inflammatory conditions find that they are very sensitive to high levels of inflammation in their diet.
Summary
Though there are many different types of food sensitivity, they have some factors in common. Most sensitivities are caused by either a difficulty with digestion, a problem processing molecules in the liver, an immune imbalance, inflammation, or an unhealthy gut. They are often assessed using an elimination diet.
Knowledge is power, and once offending foods are known, diet modifications and other deeper acting treatments can improve health and quality of life.
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