Think you have a food allergy? You might want to reconsider. No one can dispute that food allergies are serious business, and their incidence is on the rise. But while 20-25% of Americans think they have a food allergy, in truth only 2-3% of adults and 6-8% of children test positive for food allergies. For this reason, it’s crucial to get a diagnosis by a board certified allergist if you suspect sensitivity to a certain food.
“Food allergies can be very unpredictable – it’s impossible to know if your next reaction will be more or less severe than previous exposures,” says Dr. Lee Perry, allergist with Chattanooga Allergy Clinic. “You certainly never want to ‘test’ it on your own, but you also don’t want to avoid a food unnecessarily.”
Not only is Dr. Perry a double-board certified pediatric and adult allergy and asthma specialist, he also has personal experience with food allergies. His oldest son was diagnosed with a peanut allergy several years ago.
“When he was first diagnosed we were blown away – we thought ‘How do we deal with this?’” he admits. “But after a while it just becomes a part of your life.”
So, what do you do if you suspect food allergies? Here’s a quick breakdown on everything you need to know, from getting diagnosed to how to cope.
SYMPTOMS
“True food allergies almost always involve a cutaneous (skin) component such as hives, eczema, rash or itching,” says Dr. Perry. “Symptoms occur almost immediately after eating the food – usually within 15 minutes to 2 hours.”
Other common symptoms include:
- Swelling of the lips, tongue or throat
- Vomiting or diarrhea, usually within one hour of digestion
- Shortness of breath, cough or wheezing
- Anaphylaxis
- See full list
ALLERGY VS. INTOLERANCE
Food intolerances are easy to confuse with allergies. Symptoms usually occur within 30 minutes to two hours of ingestion and can mimic allergic reactions like diarrhea and itchy skin rash. However, problems from intolerances remain in the gut and do not involve the immune system, so anaphylaxis can’t happen. The two most common intolerances are lactose and gluten, also called Celiac Disease. A board certified allergist at Chattanooga Allergy Clinic can accurately diagnose whether you have an intolerance or allergy.
OTHER FOOD DISORDERS
Other food disorders confused as allergies include:
- Eosinophilic esophagitis (EoE) -A disorder that causes a large number of eosinophils (a type of white blood cell) to gather in the esophagus, making it inflamed and difficult to swallow certain foods.
- Food protein-induced enterocolitis syndrome(FPIES) -A type of food allergy that affects the GI tract and does not show up in standard allergy testing. Symptoms include profuse vomiting, diarrhea and dehydration.
- Oral Allergy Syndrome -Also known as pollen-food syndrome, OAS causes itchy or scratchy mouth symptoms caused by raw fruits or vegetables in people who also have hay fever. Generally, treatment is not necessary and symptoms subside quickly after exposure. Common food pollen associations include apples, carrots, peaches, plums, cherries, pears, almonds or hazelnuts for people allergic to birch; tomatoes for those allergic to grasses; and melons, zucchini, cucumbers, kiwis or bananas for those with ragweed allergies.
TESTING
As we mentioned above, diagnosing food allergies should be done by a board certified allergist. Testing can be done at any age, even infants. The first step is a detailed medical history. From there, doctors usually order a skin prick test, where your back is lightly “scratched” with the suspected food protein. Usually a large, red welt will appear if allergic. Sometimes blood tests are done, but they’re not a first resort because they’re more expensive and take longer to get results. If results from both tests are still inconclusive, your doctor may order an oral food challenge in which he/she feeds you the suspect food in measured doses, starting with a very small amount.
HOW TO COPE
It’s easy to feel overwhelmed after receiving a food allergy diagnosis, but do not despair. There are plenty of resources available, including websites likewww.foodallergy.org. You may also want to seek out local support groups.
The two main strategies are strict avoidance (your doctor can provide guidance) and always carrying two doses of epinephrine (EpiPen®) and/or Benadryl for milder reactions.
OTHER FASCINATING FACTS
- You can develop food allergies as your get older, and science has not been able to determine why.
- Many children outgrow allergies so doctors recommend retesting every year or two. Retesting in adults is rare – they’re likely to keep them for good.
- Scientist recently discovered a new, unusual food allergy to meat called Gal Alpha Gal, which is caused by a bite from the Lone Star tick. Unlike other food allergies, the reaction occurs within 3 to 6 hours of ingesting any mammalian meat like beef, pork, lamb, goat, venison and buffalo. Symptoms include itching, hives, swelling and even anaphylaxis.
- No one knows exactly why food allergies are on the rise, but most experts suspect diet restriction early in life. The American Academy of Pediatrics used to recommend not exposing kids to certain foods until age 2, such as peanuts. But in Israel, where 69% of babies are exposed to peanuts by 9 months old, the rate of peanut allergies is less than 1%.
- There are promising studies at Duke University for a food allergy cure, called oral immunotherapy. However, Dr. Perry predicts we’re still probably 10 to 20 years away from implementing the therapy on a wide-scale.
