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How To: Identify Food Allergies and Intolerances

By Sophie Pettit 26 May 2016
Graeme Bradshaw

Graeme Bradshaw

  With research showing that 1 in every 20 children in Hong Kong has a food allergy, and that more Hong Kong kids (15 percent) suffer from severe allergic reactions than the international average (10 percent), we decided to investigate what causes them, how to identify them, and most importantly, how to mange them. Graeme Bradshaw, founding director of Integrated Medicine Institute (IMI), fills us in.

What is the difference between a food allergy and a food intolerance?

Food allergies are distinguished by the immediate effect they have on the body after consuming a certain food, such as peanuts, shellfish, and eggs, or being exposed to certain environmental conditions such as dust, pollen, cat or dog hair, or even man-made chemicals like sulphites which you can find in wine and beer. Allergies are easy to detect as reactions usually occur one minute to 30 minutes after exposure, so you will quickly realise that you've come into contact with something you are sensitive to. The only exception is dust, where some people don't realise that this is causing them to have nasal congestion at night and sneezing in the morning. Interestingly, dust is actually the most common allergy in Hong Kong. Food intolerances, on the other hand, are not as easy to identify, as symptoms tend to take effect around 12 hours after consumption, by which point you've already eaten two more meals, so you may not realise it's the milk you had for breakfast and not the nuts you ate at dinner time that are causing you to feel congested at night. This delay in reaction is a critical distinction between an allergy and an intolerance. The other distinction is that people are born with allergies, whereas intolerances develop later in life.

What are the main reactions to a food allergy and food intolerance?

The main symptoms of an allergic reaction are nasal congestion and skin rashes, but some people do develop a reaction in the throat which can cause it to swell and close up which is extremely serious - what we call an anaphylactic shock. Luckily this doesn't happen very often. Food intolerances, however, create more chronic symptoms which don't tend to go away such as eczema, joint pains, diarrhoea or constipation, bloating, or irritable bowel syndrome (IBS). Intolerances tend to create more thick congestion in the sinuses and not so much sneezing or a runny nose, making it more difficult to breathe at night. The symptoms tend to affect parts of the body where you have a weakness.

What happens to the body during a reaction to an allergy and intolerance?

During an allergic reaction, the body releases a substance called IgE (Immunoglobulin E) which are antibodies produced by the immune system. The body then releases a histamine in response, and this is what causes the sneezing and rashes, which can occur a minute or two after consumption. Food intolerances develop in a slightly different way and are mostly a result of the gut becoming permeable, or what we often call a "leaky gut". This doesn't mean that you suffer from diarrhoea, which is a common misconception, it means that the lining of the gut has become more like an open colander rather than a closed system that is selective about what it lets through. Once the gut becomes "leaky", large proteins are able to get through which triggers the immune system to do extra work again. It does this by releasing IgG (Immunoglobulin G) which binds onto the protein and sticks somewhere in the system, such as the joints which causes pain. 

What causes a "leaky gut"?

A leaky gut is quite common in Hong Kong and there are two main causes - frequent use of antibiotics, and frequent travel. A leaky gut occurs when you have lost your digestive health and that is usually caused by taking a course of antibiotics which wipes out the good bacteria in the gut, leaving it susceptible to an overgrowth of resistant bacteria or yeast such as candida, which can lead to chronic yeast and fungal infections. This is particularly common if the immune system is low and the person is feeling stressed. The unfriendly bacteria or yeasts and fungi begin to flourish in the gut and gnaws away at the lining, creating a leaky gut and allowing food intolerances to develop. This is a very common sequence in Hong Kong where antibiotics are heavily prescribed to treat various illnesses. The other possible cause of leaky gut is if you have been traveling and happened to pick up a nasty parasite (or amoeba) from abroad, so you have a bout of diarrhoea or vomiting, or IBS which goes away, but then keeps returning. This occurs because amoeba have a life-cycle and hatch out every two weeks, which means the symptoms come and go, eventually leading to an infection in the intestines. The solution to this is to get rid of the parasite - usually with an antibiotic as they are hard to kill - and then begin the process of repairing the gut.

How do you repair a "leaky gut"?

There is a specific sequence needed to repair a leaky gut, which involves using nutrients (which can be in powdered form) to repair the gut lining and putting back the probiotics which were striped out by the antibiotics. This process can take up to four to six months to complete, after which point the food intolerances tend to go away. Occasionally a person will require a bit of homeopathy towards the end of the sequence to help restore the immune system.

Why do you think food allergies are on the rise in Hong Kong?

Aside from the frequent use of antibiotics and tendency to travel, there is a strong link to the 'hygiene concept', which suggests that people are not being exposed to natural bacteria which are found in soil and dirty vegetables due to the city's over hygienic situation. These natural bacteria are an important party of the probiotic law needed to establish a healthy immune system and gut, and it's been recently discovered that these bacteria are missing in people with allergies. Their gut has become too sterilised and therefore their immunity is not built up, leading to more allergies - particularly in children. It does raise the question - is Hong Kong too clean?

How can you get tested for allergies and intolerances?

We offering testing for allergies and intolerances at IMI. A simple blood test can give you an IgE allergy profile, which involves a trip to the lab for a blood test. This can identify potential reactions to things such as dust mite, animal hair, airborne moulds, tree, grass and weed pollen, nuts, eggs, fish, clams, lobsters, shrimps, cows milk, soy, yeasts, citrus, and several other fruits. An IgG intolerance profile is done in the same way and includes dairy, wheat, gluten, eggs, sugar, soy, meats, fish, nuts, Candida, and yeasts. The blood sample is sent to Great Plains Labs in the USA, and the results take around three weeks to come back. The cost of this test is $2,400. Once the profile is ready, one of our practitioners will explain the findings, help to identify the underlying causes, and suggest medications to manage the symptoms for both allergy and food intolerance. So if you suffer from allergies and/or symptoms related to food intolerance, it is recommended that you begin with the tests. Want to take the test? Visit IMI's website to find out more.
Read more! Find out How To: Prevent Childhood Obesity, and explore the rest of our How To section.

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Sophie Pettit


Sophie is always on the lookout for a great story and her next big adventure and loves nothing more than discovering the city’s hidden gems—and most delicious cocktails. When she’s not exploring new places, she’s off travelling and ticking countries off her bucket list.