For the longest time, “allergy” referred to a range of reactions that varied from mild irritation to life-threatening (and even then only if it caused your throat or mouth to swell shut).
However, several people I’ve talked to have been told (by medical professionals) that they’re merely “sensitive” to or “intolerant” of a substance because it’s not a life-threatening reaction.
Many sensitivities and intolerances, including some of the most common, are not allergies. Lactose intolerance, gluten intolerance, and alcohol intolerance all operate through different mechanisms than allergies do.
There was most likely a miscommunication here, but there is an effort to clarify that “allergic reactions” are related to hypersensitivity of the immune system.
People often claim to be allergic to something when they may just have a food intolerance or in lots of cases just don’t like something.
The critical bit of information here is that an allergy causes an immune system reaction, which is not being gassy etc…
It is a very important distinction for medical professionals, and for the ~4% of individuals that have this very real medical condition. When you have more than 20% of people claiming to have “allergies”, which has a very specific definition and medical implications it can cause serious issues for those who do have the medical condition.
To be clear, I am not making any judgments about those who may have biological intolerance or psychosomatic reactions. But the reality is that they do not have “allergies” but by claiming to make policy, public perceptions and medical care more difficult.
Note that this is not new, hypersensitivity reactions, known as Type I to Type IV were defined in 1963 and only Type I are called allergies.
Zyrtec, Claratin, and Allegra are all over-the-counter allergy medications but I don’t think any of them are advertised as “life-saving” or are meant for life-threatening allergies.
I would be highly surprised if the number of people with allergies were as low as 20%. The number with severe allergies is much lower than that, but there are a heck of a lot of people who get puffy eyes and a runny nose from ragweed pollen, cat dander, etc. And those are actual allergies.
20% was claimed food allergies and was a more conservative number, some of the more popular dieting trend organizations claim 30%+ of people have multiple food “allergies” but I was avoiding those sites to keep the thread on topic.
Here is the most recent paper that I could find that provided the less than 4% for more accurate immune response meaning of the word.
ra touched on some points here re what a medical person is asking when they ask you
these questions.
The OP states that “, several people I’ve talked to have been told (by medical professionals) that they’re merely “sensitive” to or “intolerant” of a substance because it’s not a life-threatening reaction”.
If the medical person is trying to ascertain your general history, or help you with something allergy related, then yes, they are interested in everything you feel affects you.
However, the question frequently (usually?) is asked because we may be giving you drugs. We are interested in allergic reactions to drugs. Drugs are concentrated doses of a substance. We frequently inject these drugs directly into your bloodstream. If you are truly allergic to these drugs, it will cause an anaphylactic reaction. That is immediately life threatening. I’ve seen it happen many times. We like to avoid this if at all possible.
In conclusion, I believe the OP comes from a miscommunication when patients are asked about allergies. The medical professional may be mostly interested in drug reactions.
And yes, I know about cross sensitivities like shellfish and iodine.
I am walking a fine line here, but to be 100% clear there are not broad populist movements claiming that non-immune system responses are allergies with ragweed.
There is a very real problem with serious food allergies is being seen, and often treated, as a fad due to the misuse of the term in popular culture.
50-90% of self-reported food allergies are not allergies, but those who do suffer have a median time to death is 30 minutes for food-related anaphylaxis.
In those cases intramuscular epinephrine is the only solution, and due to a flood of naturopath/chiropractor/acupuncturist/homeopath false diagnosis mixed with the misuse of the term “allergy” for conditions that are food intolerance. Which creates a growing problem with parents, schools or other organizations administering antihistamines which do not work with anaphylactic allergies due to the signal to noise ratio.
it doesn’t matter if it is fad, psychosomatic or a non-allergic intolerance the food segment is where the most confusion and problems exist today.
I may be simplifying as this is GQ, and while your point may be valid non-allergic hay fever is not the reason that health professionals are trying to educate the public about the differences between these important terms.
Intolerance is unpleasant but not fatal, and the misinformation is mixed in with a recent increase in scam testing by CAM provider including Hemocode, Yorktest, Applied kinesiology, and Cytotoxic testing.
So while as a fellow ragweed/cat allergy sufferer, it is very prudent to be OK with these more limited descriptions as a clarification because these issues are actually killing people.
A cite showing how misinformation and CAM providers can lead to deaths.
While I may feel like I want to die during a bad allergy attack, the stakes are much higher for others.
So yes I will error on explaining why this is serious focused on food allergies, while also trying to avoid the thread from ending up in great debates.
I had this very conversation last night. I’m allergic to shellfish in that it makes me swell up a bit in the mouth, lips and tongue and then later keeps me confined to the toilet. I’m also allergic to mangos. (Google “mango mouth” to see examples) Neither of these are life-threatening situations.
We were out for dinner and the waiter was in a panic when I took the scallops off my plate and gave them to my wife. He was offering a new meal that scallops hadn’t touched, etc. I said , “I’m not that allergic.”
Actually, I’ll expand a bit on my previous statement: The statement “only 4% of the population has genuine food allergies” also doesn’t include drug allergies and bee-sting allergies, which can also be anaphylactic and life-threatening. And on the other hand, there are also genuine food allergies which are not severe or life-threatening.
The total number of all allergy patients is interesting. The total number of all severe allergy patients is interesting (“severe” might be equivalent to “anaphylactic”; I’m not certain on that). But I’m not sure that the number of food allergy patients is all that interesting.
Just to clarify what “allergy” means to me as a physician: It’s an IgE mediated reaction to an antigen. It generally occurs within minutes of exposure, and it might be mild and cause a rash, might be moderate and make someone a bit short of breath, might be severe and cause anaphylaxis or death.
There are many, many other symptoms that are triggered by exposure to a food or drug or other chemical such as abdominal pains due to gluten sensitivity, nausea due to opioid ingestion, or even a rash due to irritant exposure. But if it’s not IgE mediated, it’s not really medically considered an allergy.
There are a class of reactions called “Non IgE mediated food allergies” which probably involve some other bits of the immune system but the phenomena are not well understood, generally take hours or days to develop after exposure, and are rarely health or life-threatening. And most allergists are trying to get people from applying the term “allergy” to these reactions, as it runs counter to the scientific definition of allergy.
There is another thread around here where someone (non-medical) said something like “I’m so sick of people saying they have food allergies, when it’s not really an allergy or it would be life-threatening like my childs allergy”
So perhaps there may also be that perception about.
On the other hand, in my world I have no ability to record sensitivities or intolerance to meds in your chart, so if you tell me that Vicodin makes you puke for 24 hours it’s going in the allergy box because I don’t want to take a chance on you getting any.