Food intolerances

Food intolerances can cause a wide variety of complaints and call for precise diagnostics in order to identify the exact triggers and treat them specifically.

Food intolerances: causes, symptoms and diagnostics

Food intolerances are widespread complaints that can occur after eating certain foods. These intolerances are divided into two main categories: immunological and non-immunological reactions. While genetic factors or absorption disorders in the gut often lead to enzyme-related intolerances such as lactose intolerance, immunological reactions can trigger inflammation and a wide variety of symptoms that often appear with a delay.

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What are food intolerances?

Food intolerances cover all complaints or conditions that occur in connection with eating certain foods. These complaints can appear immediately after eating, or only hours to days later, which makes it more difficult to link them to particular foods. A precise diagnostic differentiation is therefore necessary in order to distinguish between immunological and non-immunological reactions.

Enzyme defects: a common cause

The most common food intolerances result from enzyme defects, as in lactose or histamine intolerance. These defects can be genetic or acquired through absorption disorders in the gut. The immune system plays no part in these intolerances, as all food components are tolerated by the immune system. Examples are a deficiency of the histamine-degrading enzyme diamine oxidase (DAO) or an insufficient production of lactase, which leads to lactose intolerance.

Immune-mediated food intolerances

In immune-mediated intolerances the immune system reacts to certain food components that are normally harmless. These include type I and type IV allergies, in which IgE- or T-lymphocyte-mediated reactions can trigger inflammation. IgG4-mediated intolerance, in which the immune system reacts to food components, is also widespread and often connected with leaky gut syndrome.

Type I allergy (immediate type)

Type I allergies are mediated by IgE antibodies and lead to immediate reactions such as itching, swelling or asthma after eating certain foods. These allergies can also show cross-reactions with pollen allergies.

Type IV allergy (delayed type)

Type IV allergies, also known as delayed-type allergies, only appear 24 to 48 hours after eating and cause a wide variety of symptoms such as skin eczema or digestive complaints. These delayed reactions make the diagnosis more difficult.

IgG4-mediated food intolerance

This intolerance is often connected with a disturbed gut, such as leaky gut syndrome. Here food components enter the blood in greater quantities, which prompts the immune system to form IgG4 antibodies and leads to a variety of symptoms.

Intolerances to food additives

Some people react to food additives such as colourings, preservatives or flavour enhancers. These reactions often resemble allergic reactions, but they are not immunological in origin and are referred to as pseudo-allergies.

Conclusion

Food intolerances are complex and varied. A precise diagnosis is crucial in order to identify the exact cause and to start an effective treatment. With targeted diagnostics and therapy the complaints can be eased and the quality of life of those affected improved in the long term.

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