Food allergy is an abnormal response to a food triggered by the body's immune system. Allergic reactions to food can sometimes cause serious illness and death. Peanuts and tree nuts are the leading causes of deadly allergic reactions called anaphylaxis.
The American Academy of Allergy Asthma & Immunology distinguishes between true food allergy and food intolerance. True food allergy occurs when an individual's immune system overreacts to an ordinarily harmless food by producing an allergic antibody called IgE. Food intolerance refers to an abnormal response to a food that is not an allergic reaction. This is not necessarily the opinion of other physician groups, who diagnose and treat food allergy. The original definition of allergy was "altered reactivity", which is a much less narrowly defined description of allergy not limited by IgE antibody reactions.
Symptoms of Food Allergy
Allergies can affect any organ system in any person at any age:
- Infants - colic, feeding problems, "spits up a lot", diaper rash, ear infections, eczema, runny nose.
- Children - asthma, recurrent ear infections, eczema, frequent "colds", recurrent throat and tonsil infections, bedwetting, ADD/ADHD, "growing pains".
- Adults - symptoms involving the eyes, nose, ear, throat, skin, respiratory tract, cardiovascular system, intestinal tract, muscles and joints, central nervous system.
Generalized Symptoms-fatigue, brain fog, achiness, depression.
Eye allergy - itchy, watery, swelling, pain, redness, itching of the inner angle of lower lid.
Ear, nose and throat allergy - nasal congestion, itching, runny nose, postnasal drip, sneezing, recurrent sinus infections, sinus headaches, sinus pressure, sore, dry or tickly throat, clearing throat, itchy palate, hoarseness, cough, ear ringing/popping, fullness, dizziness.
Cardiovascular symptoms - increased pulse rate, palpitations, chest pain, cold tingling extremities.
Respiratory allergy - asthma, wheezing, reactive airways disease, recurrent bronchitis, unexplained coughing episodes, shortness of breath, excess mucus production.
Gastrointestinal allergy - "irritable bowel syndrome", canker sores, heartburn, indigestion, abdominal cramps, gas, bloating, belching, diarrhea, constipation, difficulty swallowing, reflux.
Genitourinary allergy - frequency and urgency, painful urination, incontinence, bedwetting, recurrent cystitis, vaginal itching and or discharge.
Musculoskeletal allergy - arthralgias and myalgias, muscle and joint pain, neck pain and tightness, backache.
Nervous system allergy - headache, migraine, difficulty concentrating, spacing us, drowsy, groggy, dull, brain fog, unexplained depression, mental confusion, memory impairment, allergic fatigue-very common.
Food Allergy Testing
Food allergy reactions can be immediate or delayed-sometimes up to 72 hours after ingestion. Food allergies often have a cumulative effect, where the person doesn't react after eating the allergic food one time, but after several exposures in the diet. These are some of the reasons it can be difficult to determine what you are allergic to and why allergy testing may be necessary.
Testing procedures are done in an environmentally controlled testing area. Food and chemicals are tested in a blind fashion i.e. the patient will not be told what he or she is being tested for. This is done to decrease any psychological influence on the allergy testing. The environmentally controlled unit helps decrease exposure to external allergens such as dust, pollens, and chemicals.
Provocative Neutralization testing is the method we employ for evaluating food sensitivities. During this procedure, carefully produced skin wheals are made for each food tested. The whealing response normally correlates well with the presence or absence of sensitivity to that food. Rather than just evaluating wheal response, the patient's symptom are observed and recorded throughout the testing. Provoking symptoms is not required, but frequently occurs in this form of testing. One food is tested at a time rather than a whole group of them at once in order to be more precise in the diagnosis of food sensitivities. The symptoms that are produced during testing are usually mild and rarely severe. Since foods are tested one at a time, this type of allergy testing takes longer than scratch, prick or previous forms of intradermal allergy
Treatment of Food Allergy
The most effective treatment for allergies is avoidance of what causes them. In the case of food allergy, it means eliminating allergic foods from your diet for a specified amount of time, anywhere from 2-12 months or more depending on the severity of the allergy. This can be difficult because people are usually allergic to the foods the most commonly such as wheat, dairy products, corn, soy, yeast, eggs etc. If you have only one or two food sensitivities elimination of them shouldn't be that difficult. However, if you have several food allergies eliminating them can be difficult. The other reason for doing food allergy testing the way we do at this clinic is to desensitize you to foods by determining "neutralizing doses" for each food tested.
Once you have completed food allergy testing, the next step will be to eliminate the foods you were found to be allergic to. In order to get the best results, you need to completely eliminate the allergic foods. Be sure to refer to the food source lists for hidden ingredients in foods.
Withdrawal Symptoms- Within 1-3 days after starting the elimination diet, you might experience "withdrawal" symptoms, which may include fatigue, headaches, irritability, brain fog and food cravings. These symptoms generally last 2-5 days and are usually followed by improvement in your original symptoms. You can decrease these symptoms by taking buffered vitamin C or alkali salts (2 parts potassium bicarbonate, 1 part sodium bicarbonate) ½-1 tsp in water as needed 3-4 times daily. Withdrawal symptoms are rarely severe and don't require treatment.
Retesting Foods- Plan on testing your allergic foods 3 weeks after you have been avoiding them. By this time you should be feeling better. The main reason for retesting foods is to learn what kind of symptoms your food allergies have been causing. It might take up to 3 weeks for your symptoms to improve enough for you to retest foods. However, if you are sure you are feeling better after 2 weeks, go ahead and start testing. Be sure to review the list of allergy symptoms to watch for and to keep a record of your reaction to each food tested. You can test your allergic foods in any order you wish.
Test Only One Food Each Day- Begin testing on a day you are feeling relatively well (no colds, flu, unusual headaches, etc.). Allergic reactions to the foods you are testing may occur within 5 minutes or take up to 12-48 hours to appear. Allergic induced joint pain may take up to 48 hours or longer to develop. So if joint pain is one of your symptoms, test new foods every 4 days to be safe. Don't test foods you already know cause symptoms or anaphylactic foods.
Eat a fairly large portion of each food tested. If you get symptoms after eating the food, consider this to be a food allergy and put it on your avoidance list. Don't do any further testing until your symptoms have cleared from that reaction. If you do not react to the food tested, you should test it again the same day just to be sure.
Food Sources for Allergy Testing- It is essential that you only test pure sources for each food tested. So you shouldn't test bread when testing wheat since bread has other ingredients including yeast another common allergen.
- Wheat test - Test pure 100% whole wheat cereal with no other added ingredients or grains
- Corn test - Use fresh ears of corn or frozen corn. Sorry, no butter. Pure sea salt OK.
- Dairy Products - Test whole milk and cheese on separate days. You will need to test several cheeses on different days if cheese is commonly in your diet.
- Soy - Use cooked soybeans. Most all soy milks have other ingredients
- Eggs - Test whole eggs-boiled or scrambled-no oil
- Baker's yeast - You can use a small packet of Red Star baker's yeast (Saccharomyces cerevisiae ). Mix 1-2 tsp in water.
- Coffee or tea - Test without milk, sweeteners, non-dairy creamer. Test each on separate days.
- Chocolate - Mix 1-2 tablespoons baker's chocolate in water.
Rotation Diet- You have identified your food allergies and are now following an allergen-free diet. The next step is to prevent further food allergies by rotating your diet. If you eat same food every day you will likely develop an allergy to that food.
A monotonous diet without variation is almost certain to lead to more food allergies. Diversifying your diet is very important and essential to prevent further food sensitization. Use common sense; don't just limit yourself to your favorite foods. Expand your diet to a wide variety of foods. This not only reduces your chances of developing more food allergies, but also increases your spectrum of nutrients. Rotating foods every 4 days is ideal, especially when first starting this program.
Most people will eventually be able to tolerate their allergic foods after an extended period of elimination, usually 6-12 months (This excludes anaphylactic foods). However, if you start eating them again every day, the allergy will likely return.
Recommended reading. Allergy and Candida Cooking by Sondra Lewis. Simplified approach to dealing with food allergies, example rotation diets, food families and allergy free recipes.
Food Allergy Desensitization
Both the SDET and Provocative Neutralization testing procedures allow us to determine the optimum dose to begin desensitizing one to the substances to which they are allergic. You can elect to desensitization using weekly injections administered at our clinic. Or you can choose sublingual desensitization. The appropriate antigens are placed into a vial so they can be administered sublingually.
Sublingual extracts are administered daily. Most people get relief of their symptoms within three to four weeks of starting them and sometimes sooner. Some patients take longer to get relief because of the severity other symptoms. Occasionally a person takes up to three or four months to notice a lessening of their symptoms.
Most patients need to take one drop daily of each of their extracts. However, it is not uncommon for patients to have to increase the dose up to two drops three times daily, if they don't start to get relief within a month. Do not increase the dose of the antigens without talking to Dr. Buscher or a member of the allergy testing staff first.
After you have been on the desensitization vaccines for six to eight weeks, you should make an appointment to se Dr. Buscher for follow-up. If your symptoms have not lessened by that time, then by all means, be sure to make an appointment to see Dr. Buscher, as there may be other problems complicating your situation.
Normally the desensitization process allows patients to eat all the foods to which they are allergic. We recommend, however, that patients go on a rotation diet so that they are not ingesting the same foods on a daily basis. If you continue to eat the allergic foods on a daily basis, you may need to increase the frequency of your allergy extract. Again, if there are any questions, talk to the allergy testing technician or make an appointment to see Dr. Buscher.