Mayuri Bhakta, FNP-BC
Food allergies can be life-changing and can be a source of much anxiety and stress for a patient, parent, or caregiver. According to Food Allergy Research and Education (FARE), 32 million people in the United States suffer from food allergies.1 Unfortunately, there is no known cause for food allergies. You can develop a food allergy as a child or as an adult. Many children outgrow allergies to foods such as eggs, soy, wheat, and dairy. Peanut, tree nut, fish and shellfish allergies tend be lifelong allergies. Food allergies can be mild or life-threatening. Being aware of food allergy risks and knowing their symptoms and precautions can help allay fears and make living with allergies manageable.
The American Academy of Allergy, Asthma, and Immunology identifies the top eight food allergens:2
- Tree nuts
You can be allergic to one or more foods. You can also be allergic to things such as spices, fruits, meats, and vegetables.
You can have a reaction when you eat, touch, or breathe in an allergen. An allergic reaction occurs when your body’s immune system has an abnormal reaction to the food protein you have come in contact with. Your body releases cells, such as histamines, which causes symptoms of allergic reaction and can lead to life-threatening reactions. Reactions usually occur within minutes, but can occur up to hours, after an exposure.
Symptoms of an allergic reaction can include:
- Hives or red, itchy skin
- Itchy, watery eyes
- Sneezing or runny nose
- Worsening eczema
- Difficulty swallowing
Anaphylaxis, left untreated, is a life-threatening reaction. Call 911 immediately if you experience symptoms of anaphylaxis, which can include:
- Vomiting or diarrhea
- Difficulty breathing or shortness of breath
- Swelling to the mouth, tongue, or throat
- Dizziness or passing out
- Hives all over the body
- Combination of two or more symptoms of an allergic reaction
You may initially have a mild reaction to an allergen, but reactions can change over time. Reactions can be mild, moderate, or severe. You can experience different symptoms with each exposure to each allergen.
It is important that you establish a relationship with an allergist. An allergist can do tests, including blood or skin tests, in order to help determine what foods you are allergic to. Food allergy testing may not be 100% accurate so it is important that you keep a food journal to document what type of reactions you have to certain foods.
Your allergist should work with you to develop an Action Plan. The Action Plan will help you determine what steps you should take in the event you have an accidental exposure. You will most likely be asked to carry an epinephrine auto-injector (epi-pen) as well as an antihistamine. If you have an accidental exposure to an allergen, but do not have an epi-pen with you, call 911 immediately. If you have an epi-pen, administer the epi-pen immediately and call 911.
Avoidance of the food allergen is the only way to prevent a reaction. It is important that you read all food labels, even if it is a product you always buy. Food manufacturers can change ingredients without notifying consumers. Check labels on cosmetics, personal care products, crafts, and over-the-counter medications. Ask your pharmacist and primary care provider when you are given a vaccination or medication as the inactive ingredients may contain allergens.3
Always ask about ingredients used in meals and notify people of your allergies when you are eating at a restaurant or eating food prepared by someone other than yourself. It is important to remind anyone who is preparing your foods to have a change of gloves, clean hands, clean utensils and dishes, and a clean workspace in order to prevent reaction from cross-contamination.
With the prevalence of food allergies on the rise, much research into the cause and treatment of food allergies is underway. You can speak with your allergist about treatments such as oral immunotherapy (OIT) to see if it is right for you.
1 Food Allergy Research and Education, “About FARE,” accessed March 27, 2019, https://www.foodallergy.org/.
2 American Academy of Allergy, Asthma, and Immunology, “Food Allergy Overview,” accessed March 27, 2019, https://www.aaaai.org/conditions-and-treatments/allergies/food-allergies.
3 Scott H. Sicherer, “Management of food allergy: Avoidance,” UpTo Date, updated September 14, 2018.
Scott H. Sicherer, “Food Allergies,” Medscape, accessed March 27, 2019, https://emedicine.medscape.com/article/135959-overview.
“Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel,” Journal of Allergy and Clinical Immunology 126, no. 6 (2010): S1 – S58, DOI: https://doi.org/10.1016/j.jaci.2010.10.007.