As you entered perimenopause and menopause, did you notice any new responses to foods you’ve been eating for years without any problems? Have you become more sensitive or intolerant of certain foods? Food allergies and food intolerances frequently develop or worsen when women reach their perimenopause and menopause years. So what’s going on and what can you do about it?

What are food allergies and food intolerances?

People often use these phrases interchangeably, but they are not the same. Food allergies are an abnormal immune system reaction to otherwise harmless proteins found in food. These harmless substances, referred to as allergens, cause a hyperactive reaction that can result in itchy skin, hives, wheezing, and the shut down of your airways. This reaction typically occurs immediately after eating the offending food, even a tiny amount. Without immediate attention, it can cause a life-threatening reaction called anaphylaxis. 

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A food intolerance or sensitivity usually takes longer to appear, sometimes up to 72 hours after you have consumed the food. This can make it challenging to identify which food has caused the reaction. Symptoms can include gas, bloating, nausea, stomach pain, heartburn, diarrhea, headache, fatigue, joint pain, migraines, vomiting, and skin reactions such as acne and eczema. These reactions do not involve the immune system. 

Other ways food allergies and intolerances manifest

In addition to the symptoms of food allergies and food intolerances that have already been listed, there are other ways your body can tell you there is a problem with what you are eating. For example, stress and anxiety, which are common in the menopause years, impacts the enteric nervous system, which connects your gut to your brain. Anxiety can affect how you make neurotransmitters (e.g., serotonin, epinephrine, dopamine), which in turn have an important role in regulating your gut-brain axis and thus your responses to food. 

Autoimmune conditions and cardiovascular issues also can be indications of food allergies and intolerances. Are you experiencing muscle and joint aches and pains? Inflammation in the body is another way food allergies and intolerances can manifest.

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Reactions to food and your gastrointestinal tract

We all react to the foods we eat in different ways. While eating ice cream may make us smile and liver may make us cringe, there are other reactions going on internally. In your intestinal tract, for example, there is a layer of epithelial cells just one-cell thick. The spaces between these cells are where food is absorbed. Food can interfere with and change the integrity of the intestinal lining, which can result in bacteria and undigested food particles entering your bloodstream and impacting your immune system, or the foods don’t get metabolized and absorbed efficiently. These are situation in which you can react to certain foods.

Food allergies and intolerances in perimenopause and menopause

Both of these food related conditions may occur during this life transition for several reasons. One is that as estrogen levels fluctuate, it can result in spikes in histamine production. That means your body can become more sensitive to allergens when histamine is elevated. You also can become more intolerant of specific foods as you age because digestion tends to slow down. This allows more time for the bacteria lurking in your gastrointestinal tract to ferment and cause stomach pain, bloating, gas, and other symptoms. 

According to Dr. James LaValle, clinical pharmacist and nutritionist, 
“You can’t separate emotion and stress from physiology ever….It is a whole body expression.” He also notes that “Women are more tuned to fight or flight than men are,” which places them at a greater risk of experiencing gut-brain reactions, including food allergies and intolerances.

How to test for and manage food allergies and intolerances

It can be a challenge to determine which foods are involved in allergies and intolerances. A doctor can refer you to the appropriate specialist so you can undergo testing. There are four ways of testing your doctor may use to identify food allergy or food intolerance:

• A blood test can measure the allergy-related antibody called immunoglobulin E (IgE).
• An elimination diet involves eliminating all suspected foods especially common triggers like gluten, dairy, soy, and nuts from your diet for six weeks or longer and then adding them back one at a time. This approach is not recommended for anyone who has severe reactions but can be very helpful for intolerances.
• An oral challenge involves getting an injection or taking a capsule containing the suspected food and watching for an allergic reaction.
• A skin prick test is done by placing a small amount of the suspected food on the back or forearm and pricking the skin. The appearance of a red, itchy bump indicates an allergy. 

Once you know which foods you are allergic to or have an intolerance for, the best you can do is avoid the offending foods. For food intolerances, you may be able to eat certain foods in small amounts without experiencing significant symptoms. And after doing an elimination diet for up to six weeks you may be able to reintroduce the food gradually without any effects. You can also take natural supplements that can aid digestion, such as probiotics and plant enzymes, to help cope with symptoms.

Bottom line

Food allergies and intolerances may develop in perimenopause or menopause or they may worsen if they are preexisting. Hormone changes can play a role, as can some of the symptoms of menopause, such as anxiety, mood swings, and muscle aches. See your doctor for allergy and intolerance testing so you will know which foods you need to avoid and then discover alternatives.