Food Allergies and Food Intolerances – What are the Differences and the TCM Perspective

Food allergies and food intolerances have been increasing for years. The reasons are still not fully understood, but changes in lifestyle and eating habits are believed to play a role. More and more people consume highly processed foods rich in fat, sugar, salt, and artificial additives, while lacking important nutrients and dietary fiber. This can negatively affect the microbiome – the collection of beneficial bacteria in the gut – and digestive problems and intolerances can be the result.

Many people suspect that they may have a food allergy or intolerance themselves. The distinction between the two is important, as allergies can potentially be life-threatening and require different diagnostic and treatment approaches.

The main difference lies in how the body reacts:
Food allergies are caused by a reaction of the immune system.
Food intolerances are cause by digestive or metabolic processes, without the immune system playing the primary role.

Food allergies are less common than intolerances. With allergies, the immune system mistakenly identifies a normally harmless substance – such as peanuts or milk protein – as dangerous and reacts with an immune response.

Typical characteristics of allergies include:

Possible symptoms include:

Common triggers include:

With food intolerances, the body is unable to properly digest or break down certain substances. Causes may include enzyme deficiencies, changes in the microbiome, or disturbances in digestive function. The immune system is not directly involved.

Typical characteristics of intolerances include:

Common symptoms include:

Common examples include:

Not every reaction can be clearly fits into those categoroies. There are also mixed forms and gray areas in which both the immune system and digestive function may be involved.

Lactose intolerance means the body cannot properly digest milk sugar (lactose) because the enzyme lactase is absent or produced in insufficient amounts. As a result, lactose is not properly absorbed in the small intestine and passes into the large intestine, where it is metabolised by bacteria. This can lead to bloating, abdominal cramps, and diarrhoea.

In rare cases, lactose intolerance is congenital, but it usually develops over time. It is estimated that around 75 percent of the world’s population develops a reduced ability to digest lactose with increasing age. Symptoms can vary greatly in severity.

Lactose intolerance may also occur temporarily if other gastrointestinal conditions impair digestion – for example, due to inflammation of the intestinal lining, surgery, or pancreatitis.

In a milk protein allergy, the immune system reacts to proteins found in milk. Depending on the type, the allergy may affect only cow’s milk or also other animal dairy products.

Possible symptoms include itchy skin reactions, gastrointestinal complaints, and other allergic symptoms.

Fruit sugar, also known as fructose, is found in varying amounts in many fruits and vegetables. Fructose intolerance (also called fructose malabsorption), is caused when fructose is only partially absorbed in the small intestine. It then passes into the large intestine, where it does not belong and is metabolised by bacteria.

Typical symptoms include:

Not all affected individuals react with the same sensitivity.

Fructose intolerance is often diagnosed through an H₂ breath test. Treatment mainly consists of dietary adjustments – especially reducing fructose intake and combining foods appropriately.

Histamine is a biologically active substance that plays many important roles in the body. Among other functions, it is involved in allergic reactions, blood pressure regulation, the sleep-wake cycle, stomach acid production, and intestinal muscle contraction. The body produces Histamine naturally and also breaks it down.

In addition, histamine is present in various foods, especially fermented or aged products such as wine, aged cheese, processed meats, and other highly processed foods.

If histamine is not adequately broken down, an excess can develop. It is estimated that approximately 1–3 percent of the population develop histamine intolerance during their lifetime, with women being affected much more.

Symptoms often occur after consuming histamine-rich foods and can vary widely. Commonly reported symptoms include:

Gluten is a protein found in many grains that gives dough its elasticity. Complaints related to wheat or gluten can have different causes:

Celiac disease is an autoimmune disorder. Even small amounts of gluten can trigger an immune reaction in which the lining of the small intestine is attacked. The condition is often diagnosed during childhood. Affected individuals must permanently avoid gluten-containing foods.

The immune system reacts allergically to components of wheat. Children are frequently affected, and in many cases the allergy resolves during puberty.

With gluten sensitivity, the body reacts sensitively to gluten-containing products. Affected individuals report bloating, abdominal pain, fullness, or diarrhoea but also symptoms such as fatigue, headaches, or difficulty concentrating. Small amounts of gluten are often still tolerated.

Gluten sensitivity is diagnosed by means of exclusion. This means that other causes, such as celiac disease or wheat allergy, have been ruled out, and the exact cause of the symptoms remains unclear.

TCM looks at connections within body functions and lifestyle choices holistically. From the perspective of TCM, different forms of imbalance within the body can lead to digestive problems. An impaired energy flow, the influence of pathological factors, deficiencies of Qi, Yang, or Blood, as well as congenital predispositions, can interfere with normal digestive processes.

From a holistic point of view, healthy digestion is also important for many other bodily functions: it provides energy, nourishment, and fluids, and helps the body eliminate excess substances. A disturbed digestion can therefore also affect energy levels, mood, skin, sleep, and much more.

At the beginning of treatment, detailed assessment is needed for a Chinese diagnosis. The progression of symptoms over time, accompanying complaints, general physical condition, emotional well-being, pulse-, and tongue diagnosis all provide insight into the imbalance patterns underlying the symptoms.

Treatment with Chinese Medicine aims to guide the body back toward a physiological healthy state and promote healthy digestive function. Most of the time, Conventional medical treatment and TCM can complement each other well. Chinese Medicine may be especially helpful with acquired intolerances and fluctuating symptoms. In congenital or very chronic conditions, it can be used as a complementary therapy.

Acupuncture works particularly on regulating the body’s energy flow and helps counteract the effects of stress, reduce pain, and harmonise the meridian system.

Chinese herbal formulas are tailored to the individual Chinese diagnosis and administered as concentrated herbal decoctions. Therefore, in digestive disorders, they can act directly where symptoms occur. Many of the herbs used in Chinese Medicien have anti-inflammatory, antispasmodic, digestion-promoting, or circulation-enhancing properties. Compared to acupuncture, Chinese herbal formulas work on deeper levels of the body.

In Chinese dietetics, foods and preparation methods are categorised according to their effects on the body. Depending on the individual imbalance pattern, treatment can be supported through personalised dietary recommendations and adjustments in eating habits.

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At a time when more and more people are struggling with digestive complaints and intolerances, Chinese Medicine can offer valuable support. Hectic lifestyles, the constant availability of highly processed foods, and unhealthy quick meal options make it difficult for many people to care for their bodies mindfully and maintain healthy eating habits.

Persistent digestive problems can be a major source of discomfort and significantly reduce quality of life. With its holistic perspective and individual treatment methods, Chinese Medicine can help resolve disease patterns within the body, restore physical balance, and support healthy digestion long-term and sustainably.

You can find general information about nutrition from the perspective of Chinese Medicine here. For contact and appointment requests, please click here.

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With Allergic reactions or persistent symptoms please seek medical evaluation by a doctor. Self-diagnosis is strongly discouraged.