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Natural Allergy Solutions: Allergy 101 6-8-08
Quick Facts
Food allergy occurs in 6-8 percent of children 4 years of age or under, and in
3.7 percent of adults.
In young children, the prevalence of allergy to cow’s milk is 1.9-3.2 percent
and allergy to egg is 2.6 percent.
Allergy to peanuts and tree nuts in the general population is, respectively,
0.6% and 0.4%, with the rate in children of age <18 (0.8% and 0.2%) slightly
different from adults (0.6% and 0.5% respectively) These two foods are the
leading causes of fatal and near fatal food-allergic reactions.
Despite attempts to avoid foods, accidents are the major causes of allergic
reactions to foods. Over a period of 2 years, approximately 50% of subjects in
the United States with food allergy have an allergic reaction to accidental
exposure
In the United States, there are approximately 30,000 episodes of food-induced
anaphylaxis, associated with 100-200 deaths; most deaths occur in adolescents
and young adults.
The prevalence of seafood allergy in the general population is 2.3% and
represents the commonest form of food allergy in adults.
The prevalence in the general population is 0.4% to fish, 2.0% to shellfish and
0.2% to both. Seafood allergy is less common in children (0.6%) than adults
(2.8%).
Food allergy is the most frequent single cause of emergency room visits for
anaphylaxis, and accounts for 34 to 52 percent of these visits.
What Is Food Allergy?
Food allergy is an abnormal response to a food triggered by the body’s immune
system. In this pamphlet, food allergy refers to a particular type of response
of the immune system in which the body produces what is called an allergic, or
IgE, antibody to a food. (IgE, or immunoglobulin E, is a type of protein that
works against a specific food.)
Allergic reactions to food can cause serious illness and, in some cases, death.
Therefore, if you have a food allergy, it is extremely important for you to work
with your healthcare provider to find out what food(s) causes your allergic
reaction.
Sometimes, a reaction to food is not an allergy at all but another type of
reaction called “food intolerance.”
Food intolerance is more common than food allergy. The immune system does not
cause the symptoms of food intolerance, though these symptoms may look and feel
like those of a food allergy.
How Do Allergic Reactions Work?
An immediate allergic reaction involves two actions of your immune system
Your immune system produces IgE. This protein is called a food-specific
antibody, and it circulates through your blood.
The food-specific IgE then attaches to mast cells and basophils. Basophils are
found in blood. Mast cells are found in body tissues, especially in areas of
your body that are typical sites of allergic reactions. Those sites include your
nose, throat, lungs, skin, and gastrointestinal (GI) tract.
Generally, your immune system will form IgE against a food if you come from a
family in which allergies are common —not necessarily food allergies but perhaps
other allergic diseases, such as hay fever or asthma. If you have two allergic
parents, you are more likely to develop food allergy than someone with one
allergic parent.
If your immune system is inclined to form IgE to certain foods, you must be
exposed to the food before you can have an allergic reaction.
As this food is digested, it triggers certain cells in your body to produce a
food-specific IgE in large amounts. The food-specific IgE is then released and
attaches to the surfaces of mast cells and basophils.
The next time you eat that food, it interacts with food-specific IgE on the
surface of the mast cells and basophils and triggers those cells to release
chemicals such as
Depending on the tissue in which they are released, these chemicals will cause
you to have various symptoms of food allergy.
Food allergens are proteins in the food that enter your bloodstream after the
food is digested. From there, they go to target organs, such as your skin or
nose, and cause allergic reactions.
An allergic reaction to food can take place within a few minutes to an hour. The
process of eating and digesting food affects the timing and the location of a
reaction.
If you are allergic to a particular food, you may first feel itching in your
mouth as you start to eat the food.
After the food is digested in your stomach, you may have GI symptoms such as
vomiting, diarrhea, or pain.
When the food allergens enter and travel through your bloodstream, they may
cause your blood pressure to drop.
As the allergens reach your skin, they can cause hives or eczema.
When the allergens reach your mouth and lungs, they may cause throat tightness
and trouble breathing.
Cross-Reactive Food Allergies
If you have a life-threatening reaction to a certain food, your healthcare
provider will show you how to avoid similar foods that might trigger this
reaction. For example, if you have a history of allergy to shrimp, allergy
testing will usually show that you are not only allergic to shrimp but also to
crab, lobster, and crayfish. This is called “cross-reactivity.”
Another interesting example of cross-reactivity occurs in people who are highly
sensitive to ragweed. During ragweed pollen season, they sometimes find that
when they try to eat melons, particularly cantaloupe, they experience itching in
their mouths and simply cannot eat the melon. Similarly, people who have severe
birch pollen allergy also may react to apple peels. This is called the “oral
allergy syndrome.”
Common Food Allergies
In adults, the foods that most often cause allergic reactions include
Shellfish such as shrimp, crayfish, lobster, and crab
Peanuts
Tree nuts such as walnuts
Fish
Eggs
The most common foods that cause problems in children are
Eggs
Milk
Peanuts
Tree nuts
Peanuts and tree nuts are the leading causes of the potentially deadly food
allergy reaction called anaphylaxis.
Adults usually keep their allergies for life, but children sometimes outgrow
them. Children are more likely to outgrow allergies to milk, egg, or soy,
however, than allergies to peanuts. The foods to which adults or children
usually react are those foods they eat often. In Japan, for example, rice
allergy is frequent. In Scandinavia, codfish allergy is common.
Food Allergy or Food Intolerance?
If you go to your healthcare provider and say, “I think I have a food allergy,”
your provider has to consider other possibilities that may cause symptoms and
could be confused with food allergy, such as food intolerance. To find out the
difference between food allergy and food intolerance, your provider will go
through a list of possible causes for your symptoms. This is called a
“differential diagnosis.” This type of diagnosis helps confirm that you do
indeed have a food allergy rather than a food intolerance or other illness.
Types of Food Intolerance
Food poisoning
One possible cause of symptoms like those of food allergy is food contaminated
with microbes, such as bacteria, and bacterial products, such as toxins.
Contaminated meat and dairy products sometimes cause symptoms, including GI
discomfort, that resemble a food allergy when it is really a type of food
poisoning.
Histamine toxicity
There are substances, such as the powerful chemical histamine, present in
certain foods that cause a reaction similar to an allergic reaction. For
example, histamine can reach high levels in cheese, some wines, and certain
kinds of fish such as tuna and mackerel.
In fish, histamine is believed to come from contamination by bacteria,
particularly in fish that are not refrigerated properly. If you eat one of these
foods with a high level of histamine, you could have a reaction that strongly
resembles an allergic reaction to food. This reaction is called “histamine
toxicity.”
Lactose intolerance
Another cause of food intolerance confused with a food allergy is lactose
intolerance or lactase deficiency. This common food intolerance affects at least
1 out of 10 people.
Lactase is an enzyme that is in the lining of your gut. Lactase breaks down or
digests lactose, a sugar found in milk and most milk products. Lactose
intolerance, or lactase deficiency, happens when there is not enough lactase in
your gut to digest lactose. In that case, bacteria in your gut use lactose to
form gas which causes bloating, abdominal pain, and sometimes diarrhea.
Your healthcare provider can use laboratory tests to find out whether your body
can digest lactose.
Food additives
Another type of food intolerance is a reaction to certain products that are
added to food to enhance taste, provide color, or protect against the growth of
microbes. Several chemical compounds, such as MSG (monosodium glutamate) and
sulfites, are tied to reactions that can be confused with food allergy.
MSG
MSG is a flavor enhancer and, when taken in large amounts, can cause some of the
following signs:
Flushing
Sensations of warmth
Headache
Chest discomfort
Feelings of detachment
These passing reactions occur rapidly after eating large amounts of food to
which MSG has been added.
Sulfites
Sulfites occur naturally in foods or may be added to increase crispness or
prevent mold growth.
Sulfites in high concentrations sometimes pose problems for people with severe
asthma. Sulfites can give off a gas called sulfur dioxide that a person with
asthma inhales while eating food containing sulfites. This gas irritates the
lungs and can send an asthmatic into severe bronchospasm, a tightening of the
lungs.
The Food and Drug Administration (FDA) has banned sulfites as spray-on
preservatives in fresh fruits and vegetables. Sulfites are still used in some
foods, however, and occur naturally during the fermentation of wine.
Gluten intolerance
Gluten intolerance is associated with the disease called “gluten-sensitive
enteropathy” or “celiac disease.” It happens if your immune system responds
abnormally to gluten, which is a part of wheat and some other grains. Some
researchers include celiac disease as a food allergy. This abnormal immune
system response, however, does not involve IgE antibody.
Psychological causes
Some people may have a food intolerance that has a psychological trigger. If
your food intolerance is caused by this type of trigger, a careful psychiatric
evaluation may identify an unpleasant event in your life, often during
childhood, tied to eating a particular food. Eating that food years later, even
as an adult, is associated with a rush of unpleasant sensations.
Other causes
There are several other conditions, including ulcers and cancers of the GI
tract, that cause some of the same symptoms as food allergy. These symptoms
include vomiting, diarrhea, and cramping abdominal pain made worse by eating.
Food Allergy Diagnosis
After ruling out food intolerances and other health problems, your healthcare
provider will use several steps to find out if you have an allergy to specific
foods.
Detailed History
A detailed history is the most valuable tool for diagnosing food allergy. Your
provider will ask you several questions and listen to your history of food
reactions to decide if the facts fit a food allergy.
What was the timing of your reaction? Did your reaction come on quickly, usually
within an hour after eating the food?
Did allergy medicines help? Antihistamines should relieve hives, for example.
Is your reaction always associated with a certain food?
Did anyone else who ate the same food get sick? For example, if you ate fish
contaminated with histamine, everyone who ate the fish should be sick.
How much did you eat before you had a reaction? The severity of a reaction is
sometimes related to the amount of food eaten.
How was the food prepared? Some people will have a violent allergic reaction
only to raw or undercooked fish. Complete cooking of the fish may destroy the
allergen, and they can then eat it with no allergic reaction.
Did you eat other foods at the same time you had the reaction? Some foods may
delay digestion and thus delay the start of the allergic reaction.
Diet Diary
Sometimes your healthcare provider can’t make a diagnosis solely on the basis of
your history. In that case, you may be asked to record what you eat and whether
you have a reaction. This diet diary gives more detail from which you and your
provider can see if there is a consistent pattern in your reactions.
Elimination Diet
The next step some healthcare providers use is an elimination diet. In this
step, which is done under your provider’s direction, certain foods are removed
from your diet. You don’t eat a food suspected of causing the allergy, such as
eggs. You then substitute another food—in the case of eggs, another source of
protein.
Your provider can almost always make a diagnosis if the symptoms go away after
you remove the food from your diet. The diagnosis is confirmed if you then eat
the food and the symptoms come back. You should do this only when the reactions
are not significant and only under healthcare provider direction.
Your provider can’t use this technique, however, if your reactions are severe or
don’t happen often. If you have a severe reaction, you should not eat the food
again.
Skin Test
If your history, diet diary, or elimination diet suggests a specific food
allergy is likely, your healthcare provider will then use either the scratch or
the prick skin test to confirm the diagnosis.
During a scratch skin test, your healthcare provider will place an extract of
the food on the skin of your lower arm. Your provider will then scratch this
portion of your skin with a needle and look for swelling or redness, which would
be a sign of a local allergic reaction.
A prick skin test is done by putting a needle just below the surface of your
skin of the lower arm. Then, a tiny amount of food extract is placed under the
skin.
If the scratch or prick test is positive, it means that there is IgE on the
skin’s mast cells that is specific to the food being tested. Skin tests are
rapid, simple, and relatively safe. You can have a positive skin test to a food
allergen, however, without having an allergic reaction to that food. A
healthcare provider diagnoses a food allergy only when someone has a positive
skin test to a specific allergen and when the history of reactions suggests an
allergy to the same food.
Blood Test
Your healthcare provider can make a diagnosis by doing a blood test as well.
Indeed, if you are extremely allergic and have severe anaphylactic reactions,
your provider can’t use skin testing because causing an allergic reaction to the
skin test could be dangerous. Skin testing also can’t be done if you have eczema
over a large portion of your body.
Your healthcare provider may use blood tests such as the RAST (radioallergosorbent
test) and newer ones such as the CAP-RAST. Another blood test is called ELISA (enzymelinked
immunosorbent assay). These blood tests measure the presence of food-specific
IgE in your blood. The CAP-RAST can measure how much IgE your blood has to a
specific food. As with skin testing, positive tests do not necessarily mean you
have a food allergy.
Double-Blind Oral Food Challenge
The final method healthcare providers use to diagnose food allergy is
double-blind oral food challenge.
Your healthcare provider will give you capsules containing individual doses of
various foods, some of which are suspected of starting an allergic reaction. Or
your provider will mask the suspected food within other foods known not to cause
an allergic reaction. You swallow the capsules one at a time or swallow the
masked food and are watched to see if a reaction occurs.
In a true double-blind test, your healthcare provider is also “blinded” (the
capsules having been made up by another medical person). In that case your
provider does not know which capsule contains the allergen.
The advantage of such a challenge is that if you react only to suspected foods
and not to other foods tested, it confirms the diagnosis. You cannot be tested
this way if you have a history of severe allergic reactions.
In addition, this testing is difficult because it takes a lot of time to perform
and many food allergies are difficult to evaluate with this procedure.
Consequently, many healthcare providers do not perform double-blind food
challenges.
This type of testing is most commonly used if a healthcare provider thinks the
reaction described is not due to a specific food and wishes to obtain evidence
to support this. If your provider finds that your reaction is not due to a
specific food, then additional efforts may be used to find the real cause of the
reaction.
Controversial and Unproven Diagnostic Methods
Cytotoxicity testing
One controversial diagnostic technique is cytotoxicity testing, in which a food
allergen is added to a blood sample. A technician then examines the sample under
the microscope to see if white cells in the blood “die.” Scientists have
evaluated this technique in several studies and have found it does not
effectively diagnose food allergy.
Provocative challenge
Another controversial approach is called sublingual (placed under the tongue) or
subcutaneous (injected under the skin) provocative challenge. In this procedure,
diluted food allergen is put under your tongue if you feel that your arthritis,
for instance, is due to foods. The technician then asks you if the food allergen
has made your arthritis symptoms worse. In clinical studies, researchers have
not shown that this procedure can effectively diagnose food allergy.
Sublingual provocative challenge is not the same as a potentiallynew treatment
for food allergy called sublingual immunotherapyor SLIT. Researchers are
currently evaluating this treatment.
Immune complex assay
An immune complex assay is sometimes done on people suspected of having food
allergies to see if groups, or complexes, of certain antibodies connect to the
food allergen in the bloodstream. Some think that these immune groups link with
food allergies. The formation of such immune complexes is a normal offshoot of
food digestion, however, and everyone, if tested with a sensitive-enough
measurement, has them. To date, no one has conclusively shown that this test
links with allergies to foods.
IgG subclass assay
Another test is the IgG subclass assay, which looks specifically for certain
kinds of IgG antibody. Again, there is no evidence that this diagnoses food
allergy.
Food Allergy Treatment
Food allergy is treated by avoiding the foods that trigger the reaction. Once
you and your healthcare provider have identified the food(s) to which you are
sensitive, you must remove them from your diet. To do this, you must read the
detailed ingredient lists on each food you are considering eating.
Many allergy-producing foods such as peanuts, eggs, and milk, appear in foods
one normally would not associate them with. Peanuts, for example, may be used as
a protein source, and eggs are used in some salad dressings.
Because of a new law in the United States, FDA now requires ingredients in a
packaged food to appear on its label. You can avoid most of the things to which
you are sensitive if you read food labels carefully and avoid
restaurant-prepared foods that might have ingredients to which you are allergic.
If you are highly allergic, even the tiniest amounts of a food allergen (for
example, a small portion of a peanut kernel) can prompt an allergic reaction.
If you have food allergies, you must be prepared to treat unintentional
exposure. Even people who know a lot about what they are sensitive to
occasionally make a mistake. To protect yourself if you have had allergic
reactions to a food, you should
Wear a medical alert bracelet or necklace stating that you have a food allergy
and are subject to severe reactions
Carry an auto-injector device containing epinephrine (adrenaline), such as an
epipen or twinject, that you can get by prescription and give to yourself if you
think you are getting a food allergic reaction
Seek medical help immediately, even if you have already given yourself
epinephrine, by either calling the rescue squad or by getting transported to an
emergency room
Anaphylactic allergic reactions can be fatal even when they start off with mild
symptoms such as a tingling in the mouth and throat or GI discomfort.
Exercise-Induced Food Allergy
At least one situation may require more than simply eating food with allergens
to start a reaction: exercise-induced food allergy. People who have this
reaction only experience it after eating a specific food before exercising. Some
people get this reaction from many foods, and others get it only after eating a
specific food. As exercise increases and body temperature rises, itching and
light-headedness start and allergic reactions such as hives may appear and even
anaphylaxis may develop.
The management of exercised-induced food allergy is simple—avoid eating for a
couple of hours before exercising.
Schools and daycare centers must have plans in place to address any food allergy
emergency. Parents and caregivers should take special care with children and
learn how to
Protect children from foods to which they are allergic
Manage children if they eat a food to which they are allergic
Give children epinephrine
Simply washing your hands with soap and water will remove peanut allergens.
Also, most household cleaners will remove them from surfaces such as food
preparation areas at home as well as daycare facilities and schools. These
easy-to-do measures will help prevent peanut allergy reactions in children and
adults.
There are several medicines you can take to relieve food allergy symptoms that
are not part of an anaphylactic reaction. These include
Antihistamines to relieve GI symptoms, hives, or sneezing and a runny nose
Bronchodilators to relieve asthma symptoms
It is not easy to determine if a reaction to food is anaphylactic, however. It
is important to develop a plan with a healthcare provider as to what reactions
you should treat with epinephrine first, rather than antihistamines or
bronchodilators.
Controversial and Unproven Treatments
One controversial treatment, which sometimes may be used with provocative
challenge, includes putting a diluted solution of a particular food under your
tongue about a half hour before you eat the food suspected of causing an
allergic reaction. This is an attempt to “neutralize” the subsequent exposure to
the food you believe is harmful. The results of carefully conducted clinical
research show this procedure does not prevent an allergic reaction.
Allergy shots
Another unproven treatment involves getting allergy shots (immunotherapy)
containing small quantities of the food extracts to which you are allergic.
These shots are given regularly for a long period of time with the aim of
“desensitizing” you to the food allergen. Researchers have not yet proven that
allergy shots reliably relieve food allergies.
The Natural Way:
1. Supplements:
Fish Oil- I recommend Nature's Way Fisol 3-6 pills a day. Fish oil reduces airway inflammation, chronic inflammation (the real cause of allergies) and works in the same way as a steroid.
Vitamin C With Bioflavonoids and Quercetin: 2000+ milligrams a day has been proven in double blind studies to work as well as Claritin. Take 1-3 times a day. Quercetin has some success on it's own also. You will need 400-1000 mg a day!
Nettle Leaf: Proven in Studies to be as effective as Benedryl without the drowsiness! Make sure you use standardized capsules or tincture. Use up to every 4 hours as needed.
Homeopathic Nosodes: Find one that contains the allergens you are allergic to. These work like allergy shots by reducing the immune response, but unlike allergy shots these immediately reduce symptoms.
Butterbur: Among those generating the loudest buzz right now is the European herb butterbur (Petasites hybridus), which, says Hardy, "has had some very impressive clinical trial results."
In one study, published recently in the British Medical Journal, a group of Swiss researchers showed how just one tablet of butterbur four times daily was as effective as a popular antihistamine drug in controlling symptoms of hay fever -- without the traditional symptom of drowsiness that sometimes occurs. In a second study, presented in March 2003 at the 60th annual meeting of the American Academy of Allergy, Asthma, and Immunology (AAAAI), a group of British researchers put their stamp of approval on butterbur's effectiveness in quelling symptoms of grass allergy.
Daily Saline Nasal Wash: ( NeilMed Sinus Wash) If your symptoms in any way involve your sinuses or nose this should be the first thing you try. Give it at least 2 weeks!
Avoid Food Intolerances and allergies: These will aggregate your allergy symptoms for instance: you should avoid eating melon, banana, cucumber, sunflower seeds, chamomile, and any herbal supplements containing echinacea, all of which can make symptoms much worse.
Magnesium: There is some evidence that this mineral acts as a natural antihistamine, in reality magnesium stops inflammation.