Food allergies occur when your immune system overreacts to harmless proteins in food – known as allergens – which could otherwise be harmless, leading to severe reactions that could even be life-threatening. Medicines can help alleviate symptoms and prevent further reactions; people with food allergies should carry injectable epinephrine for emergency use as fast-acting emergency medication.
Some children outgrow allergies to eggs, milk, wheat and soy as they get older; however, peanuts, tree nuts, fish and crustacean shellfish allergies are likely lifelong.
Peanuts
Peanuts and tree nuts are staples in many diets. Unfortunately, for some individuals they can cause life-threatening reactions known as anaphylaxis – swelling of lips, tongue, throat or body and difficulty breathing as well as drop in blood pressure requiring immediate medical intervention using an epinephrine autoinjector.
Peanut allergies are caused by proteins found in peanuts which the immune system mistook as dangerous substances. These allergens survived stomach acid and digestive enzymes to reach the small intestine, where they stimulate IgE antibodies as well as mediators such as histamine release.
Peanut allergies are one of the most prevalent food allergies. But they may also react adversely to other nuts, seeds and legumes like peas, beans and lentils – and those allergic to peanuts could potentially react similarly to other legumes (beans).
Tree Nuts
Tree nut allergies are extremely prevalent among both children and adults, affecting walnut, almond, hazelnut, cashews, pistachios and Brazil nuts. People with these allergies are also often allergic to peanuts which are legumes.
These foods cause allergic reactions when their proteins interact with IgE antibodies in the immune system. This interaction may produce symptoms that range from itching and hives to life-threatening anaphylaxis that impairs breathing and sends the body into shock.
Avoiding these allergens requires reading ingredient lists carefully and being aware of the possibility of cross-contamination. People with tree nut allergies should carry an epinephrine auto-injector for emergency use if an allergic reaction arises; consult an allergist about other methods for managing them such as oral immunotherapy or omalizumab treatment.
Milk
People with milk allergies react negatively to proteins found in cow’s milk that are similar to those found in goat, sheep and deer milk products. Most children develop milk allergies within the first year of life but most outgrow it over time.
If you are allergic to milk, your immune system misidentifies it as an invader and overreacts violently – potentially life-threatening if breathing problems develop as a result.
Doctors can diagnose milk allergies through skin and blood tests. Allergists may also perform food challenge tests where you consume slowly increasing quantities of milk under medical supervision. It is advisable for anyone allergic to milk to carry two doses of epinephrine (EpiPens).
Eggs
Hen egg allergy is typically IgE-mediated and symptoms usually involve rashes, angioedema and urticaria on the skin but may also include digestive and respiratory symptoms. Rarely, egg allergies can even result in life-threatening allergic reactions (anaphylaxis).
Egg allergies are relatively common among children, and most will outgrow them with age. If your child has been diagnosed with an egg allergy, be sure to ensure they carry two doses of an epinephrine autoinjector at all times and let their school, friends and family know so they can help protect against accidental exposures.
Egg allergy testing can be done through skin prick testing wherein small amounts of an allergen is applied to an arm and any signs of hive-like bumps indicate positive results. Blood tests that identify antibodies against egg white can confirm an IgE mediated allergy.
Soy
Soybeans, which belong to the legume family, are an allergenic food product commonly encountered by infants and young children, although many outgrow their allergy by age 3. Soy products include natural and artificial flavorings, vegetable broth, vegetable gum, soybean oil and protein; an allergic reaction could cause hives, itching, swelling of lips, mouth or throat, vomiting, belly pain or diarrhea – more severe reactions could even result in difficulty breathing or shock, which may be life-threatening if left untreated.
Doctors can quickly diagnose soy allergies with blood and skin prick tests, or by conducting oral food challenges where patients gradually increase the amount of suspect foods under careful observation. It’s wise to carry an epinephrine auto-injector at all times and notify those preparing or serving food of your allergy.
Wheat
Wheat protein (Triticum aestivum) has the capacity to cause IgE-mediated reactions in people. Symptoms generally occur after eating wheat but can sometimes manifest when breathing in wheat flour (for instance when baking).
Allergic skin testing is used to detect wheat allergies. An allergist will apply drops containing wheat proteins directly onto an arm or back and puncture with a needle (similar to mosquito bites), testing for allergic reactions which typically appear as round, raised spots that resemble bug bites (wheals).
Allergies to wheat range from mild to life threatening, so those who suffer from this allergy must avoid all foods containing wheat and may need to read labels carefully for advisory statements like “processed in a facility that also processes tree nuts” or “made on shared equipment”. Two doses of epinephrine should always be carried as symptoms of anaphylaxis can develop suddenly.
Fish
Fish provides high-quality protein that’s easily digestible, including essential iodine and omega-3 fatty acid sources like salmon. Unfortunately, those allergic to fish may develop severe reactions ranging from oral allergy syndrome (in which mouth and throat tingle or swell) to anaphylactic shock with symptoms including difficulty breathing and circulatory collapse.
Skin and blood tests may help detect an allergy to fish, but may not give an accurate picture. A provocation test may be necessary; in this scenario, someone goes off fish temporarily before being exposed to small doses of allergen under medical supervision.
Due to the variety of allergens present in seafood, those allergic to shellfish may not necessarily react adversely when exposed to finned varieties; vice versa. Therefore, it’s wise to carefully read ingredient lists and “may contain” advisory panels before dining out, as well as inquire about cross-contamination concerns when eating at restaurants.
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