"Food allergy should be considered in patients who have experienced anaphylaxis or other acute symptoms after eating. The acute symptoms include hives, swelling of any portion of the body, nasal congestion, coughing, chest tightness, dizziness, fainting, wheezing or any other symptoms of rapid onset.
A careful, detailed history and physical examination is the essential first step in diagnosing a food allergy. Skin testing to foods can be a good confirmation, but such testing is not necessarily diagnostic because a positive reaction does not always mean a person is allergic to that substance.
Blood testing for food allergy is not necessarily diagnostic either, because a person may have positive tests to foods that don't cause his or her allergic reactions. As well, a person may have negative tests to offending foods. Blood testing requires the correct interpretation of a careful history.
In some situations, the use of a food challenge (giving the patient a suspected food to ingest and observing for symptoms) is helpful. This is usually performed in a hospital setting and under close supervision.
Treatment involves avoidance of the food that causes the allergic reaction. Elimination of the offending food is essential.
Patients and their caregivers must be ever-vigilant, and they must read labels carefully. Eating out can become a challenge, since many restaurants use common serving or preparation dishes and utensils for multiple foods. Wait staff cannot always be relied upon to be knowledgeable (or truthful) about the contents of the various dishes being served. That is why patients with severe food allergies must carry epinephrine at all times. There are no allergy injections available to desensitize patients to foods.
Avoidance is the best treatment and the only way to prevent a serious reaction.
Several years ago, a patient of mine who knew he was highly allergic to peanuts was on a business trip to California. He ate lunch in a local restaurant after he told the waiter he could not have any dish made with peanuts. He was served a dish that was supposedly peanut-free. As soon as he ingested the first spoonful, he developed an itchy mouth. He immediately administered adrenalin to himself and went to an emergency room, where he was also given an antihistamine and sent on his way. At the airport, he developed another anaphylactic reaction and died. Some people have a delayed second reaction hours after their first one. This biphasic reaction occurs 30 percent of the time. Therefore, we always prescribe two doses of adrenalin and advise four hours of observation by medical personnel." DR. JAMES RUBIN
Proactive tools to reduce allergy suffering...
"With allergy season right around the corner, we've sought out the foods that will help ward off those itchy eyes and runny noses. Plus, a list of foods you should skip if you want to stay congestion-free.
Allergies are the immune system's reaction to generally safe substances in the environment (like ragweed and pollen). When allergens interact with immune cells in the blood, histamine and other allergic intermediaries are released into the bloodstream, causing familiar allergic reactions -- namely sneezing, wheezing, itchy eyes, skin rashes and stuffy congestion. Although no diet can prevent allergies all together, certain foods can help alleviate symptoms.
Red Wine, Apples and Onions
Quercetin, a flavonoid that helps the body fight against allergic inflammation by inhibiting the release of histamine, is found red wine, apples and onions. You can also get a dose of this ant-allergy antioxidant in berries, red grapes, black tea, broccoli and citrus fruits.
Grapefruits and Red Peppers
Vitamin C strengthens the immune system and decreases the production of histamine. Oranges, cantaloupe, papaya, strawberries, dark leafy green vegetables, and sweet potatoes are also good sources.
Mustard Greens
Mustard greens are a great source of beta-carotene and vitamins E and C, which fight inflammation, scavenge for free radicals and help break down histamine. Sauté mustard greens with olive oil and garlic or use them as you would any other dark leafy green.
Flaxseed, Walnuts and Salmon
Eating a diet rich in omega 3 fatty acids may help alleviate allergies by reducing inflammatory chemicals in the body. One German study showed that a high level of omega 3s in subjects' diet or red blood cells was associated with a decreased risk of hay fever. Other sources of this essential fatty acid include canola oil, pumpkin seeds, and cold-water fatty fish.
Brazil Nuts
Selenium is an essential mineral that is required in very small amounts. In the body it is incorporated into proteins to make important antioxidant enzymes that both strengthen the immune system and increase the effectiveness of vitamin C. Brazil nuts and tuna are among the best sources.
Green Tea
Green tea is rich in catechin, a polyphenol (antioxidant) that inhibits the enzyme that converts histidine to histamine. For maximum benefits, use loose tea leaves instead of tea bags and pair with fruit or vegetables high in vitamin C.
Cayenne Pepper
Hot, spicy foods thin mucous secretions which can help clear nasal passages. Try adding cayenne pepper, ginger, onion and garlic to your favorite dishes.
Garlic
Garlic inhibits certain enzymes that generate inflammatory compounds, has a kick just like cayenne, and is a good source of vitamin C.
Rosemary
Rosemary contains a substance called rosmarinic acid, a polyphenol that is believed to suppress allergic reactions and inflammation. Try adding rosemary to roast potatoes, marinades, and tomato sauces.
Tumeric
Tumeric, a member of the ginger family, boasts anti-inflammatory properties. A central ingredient in curries and other Indian dishes, tumeric can also be used as a flavor enhancer for fish, meat, vegetable and pasta recipes.
Sunflower Seeds
Sunflower seeds help suppress allergic reactions thanks to high levels of vitamin E and selenium. Vitamin E fights inflammation and selenium stimulates immune function (see above).
In addition to choosing a diet rich in the allergy-fighting foods above, try to avoid pro-inflammatory, cross-reacting, and sensitive foods.
Pro-inflammatory foods increase inflammation, which may aggravate existing allergy symptoms. High-fat meats, fast food and packaged, baked goods are high in unhealthy fats (trans fats and saturated fats) and processed meats (hot dogs, sausage, bacon) contain chemicals called nitrates -- both of which are associated with increased inflammation. Even naturally occurring saturated fats, such as those found in meats, dairy and eggs, contain fatty acids called arachidonic acid, which may exacerbate inflammation in large quantities. Lean meats and low fat dairy products will not promote inflammation.
In the case of oral allergy syndrome, our bodies mistake a plant protein for pollen triggering a cross-reaction. People who suffer from ragweed allergies may experience similar symptoms when they eat certain seeds (sunflower), fruits (bananas, melon) and vegetables (cucumbers, zucchini), take the herb Echinacea, or drink chamomile tea. Individuals with grass pollen allergies may have difficulty eating melons, oranges, peaches, tomatoes and celery. And pollen from alder trees can cross-react with apples, cherries, peaches, pears, parsley, celery, almonds and hazelnuts.
To prevent or reduce allergy symptoms, stick with fresh, unprocessed foods and steer clear of any personal triggers." Victoria Stein
Pro-inflammatory foods increase inflammation, which may aggravate existing allergy symptoms. High-fat meats, fast food and packaged, baked goods are high in unhealthy fats (trans fats and saturated fats) and processed meats (hot dogs, sausage, bacon) contain chemicals called nitrates -- both of which are associated with increased inflammation. Even naturally occurring saturated fats, such as those found in meats, dairy and eggs, contain fatty acids called arachidonic acid, which may exacerbate inflammation in large quantities. Lean meats and low fat dairy products will not promote inflammation.
In the case of oral allergy syndrome, our bodies mistake a plant protein for pollen triggering a cross-reaction. People who suffer from ragweed allergies may experience similar symptoms when they eat certain seeds (sunflower), fruits (bananas, melon) and vegetables (cucumbers, zucchini), take the herb Echinacea, or drink chamomile tea. Individuals with grass pollen allergies may have difficulty eating melons, oranges, peaches, tomatoes and celery. And pollen from alder trees can cross-react with apples, cherries, peaches, pears, parsley, celery, almonds and hazelnuts.
To prevent or reduce allergy symptoms, stick with fresh, unprocessed foods and steer clear of any personal triggers." Victoria Stein
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