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Food Allergies and Where to Find Them

Egg-free baking, nut-free schools and gluten-free everything! Just like kale and quinoa are “in” these days, things like wheat and peanuts are “out”, and for good reason. They make up two common allergens and intolerances in adults, but do your really know the difference between a food allergy, intolerance, or sensitivity? Consider this your official guide to food. We’ll answer some of the questions we’re most asked by our patients and shed some light on what happens when you body doesn’t react well to the fuel you’re putting into it.

Allergy vs. Intolerance vs. Sensitivity

While it may seem that these all mean the same thing (that food does NOT make me feel well!) the distinctions are important. A food allergy is an adverse reaction caused by an immune response to a food protein. A food intolerance or sensitivity, however, is a negative reaction to a food that is not related to the immune system. Unlike food poisoning, which you get from consuming contaminated food and can happen to anyone who comes in contact with that food, a food allergen, intolerance, or sensitivity is specific to the individual and so are the treatments.

Twenty percent of Americans think they have a food allergy, and change their diet accordingly, but only 1-2% of adults and 6-8% of children actually have a true allergy.

Knowing you have a true allergy and not a sensitivity or intolerance is important, because more than 150 people die each year due to their allergy. There is also evidence that the rate of food allergies is on the rise, but since 85% of food allergies are caused by just a few groups of foods, once you know you have an allergy, it’s relatively easy to avoid.

Top Allergen Food Groups

In children, tree nuts, soy, milk, wheat and peanuts are the most common allergens. If your child is showing a sensitivity to one of these foods, there is a very good chance they will grow out of it within the first 3-5 years of their lives. However, sensitivities to peanuts, tree nuts, fish or shellfish are rarely lost. These food groups also make up the most common allergies in adults.

How Do I know I have a food allergy?

If you experience swelling and itching of your lips, mouth, or throat, throat tightness and difficulty swallowing, or gastrointestinal effects like stomach cramps, nausea, vomiting, diarrhea, hives and skin swelling, those can be signs of a food allergy. The most severe reaction to any food is anaphylaxis.

Symptoms of anaphylaxis are: itching, skin flushing, wheezing, difficulty breathing, throat tightness, nausea, rapid pulse, faintness, and blacking out. If not treated immediately, this can lead to death. If someone is aware of their allergy, they will most likely have a form of injectable epinephrine, like an EpiPen or Twinject. If you see someone experiencing any of these symptoms, inject them with their EpiPen, and call 911 immediately.

Testing for allergies

However, if you experience any of the symptoms above, a doctor can perform a series of tests to officially diagnose a food allergy. The doctor will take a look at your medical history, and perform skin prick tests, which test the amount of antibodies that are produced in reaction to food proteins. A doctor will inject a small amount of an allergen and measure your skin’s reaction. An alternative to this test is the Allergy RAST Test (short for Allergy Radioallergosorbent Test), which detects specific antibodies in the bloodstream.

Other non-invasive procedures, more commonly used for testing intolerances and sensitivities, involve patients keeping a food diary to track when they experience any symptoms. Patients can also try elimination diets, which involve cutting out suspected food groups. After a ‘detox’ period (and under the supervision of a medical professional), patients will slowly add back in the suspicious foods, one at a time.

If a reaction occurs, you will have found the source of your problems. Finally, oral food challenges are also used to diagnose allergies. If the skin prick or RAST testing is inconclusive, the oral food challenge is a highly accurate test that should only be performed under the supervision of an experienced allergist at a controlled facility. In a food challenge, a patient is fed the suspected food in very small increasing doses and then supervised to see if there is a reaction. As soon as a reaction occurs the challenge will stop. Because of the small doses given and immediate ending of the test, most reactions during the food challenges are very mild, and are treated immediately by the allergist.

If you suspect you have a food allergy, intolerance, or sensitivity, we encourage you to stop by one of our clinics. We are happy to discuss your options for determining if you have an allergy, intolerance, or sensitivity, and help with your management of your allergy.

Thank you to David Kaufman, M.D. and the Cleveland Clinic Florida for some great information on food allergens.