Food allergies

Food allergies range from threat level apocalyptic (immediate ER visit) to mild (pop a Benadryl). With a severe (life threatening!) food allergy, you might feel your airway closing or experience a swollen throat—it’s similar to the proverbial “lump in your throat” that makes it hard to breathe. Your blood pressure may drop and your heart might race; you could even lose consciousness. It’s a medical emergency that requires immediate treatment. With a less serious allergy, you might just feel a tingly tongue or lips—it can be subtle! Other common symptoms include hives; itching; eczema; swelling of the lips, face, tongue, and more; stomach pain; nausea; vomiting; lightheadedness; or even fainting. So what is this all about? A food allergy is an overreaction by your immune system to a particular food, causing symptoms within minutes to hours. Once you have been sensitized, even the tiniest amount of that food can trigger you. It’s different from a food sensitivity, which isn’t life threatening and can be delayed by hours or even days. If you can eat a small amount of the food without ill effects, or if you can prevent a reaction (say, by popping lactase enzyme pills before ice cream), you likely have a food sensitivity. Even though it doesn’t set off the classic immune response, a food sensitivity can cause fatigue, nausea, bloating, diarrhea, and other icky symptoms. In theory, any food can cause an allergic reaction, but cow’s milk, eggs, wheat, soy, tree nuts and peanuts, fish and shellfish, and certain fruits are the biggest offenders. Your practitioner may do skin or blood tests, or ask you to do an elimination diet to help identify your triggers (but if you’ve already had a severe reaction, you’ll need to ID and avoid that food immediately). Some allergies subside over time, but others can get worse, so keeping track of the foods that set off your reactions—however mild they might be!—is key. The only way to deal with a food allergy is to completely avoid your trigger food(s). Know what you are eating and drinking—read labels carefully, and when you eat out, talk to your server or the chef. Most places take the pressure off and ask about allergies when you order. Rush immunotherapy, a method of allergen desensitization, is an option, but it has to be conducted under the guidance of an experienced practitioner because of potential side effects. Oral immunotherapy, in which small doses of the trigger food is swallowed or placed under the tongue in gradually increasing amounts, is being studied. While desensitization is possible, there are significant risks for reactions and it’s not known whether it can lead to long term tolerance. If you have food allergies, it can be a source of anxiety when you’re in restaurants (or at potlucks, or backyard barbecues…the list goes on), so make sure to talk to your practitioner about creating an anaphylaxis action plan and always have an allergy kit with you. That might mean a Benadryl in your purse, or it could mean having auto-injectable epinephrine (like an Epi-Pen) at close range (very close range)—your practitioner can help you decide what you need. Being prepared helps you manage the situation if you do encounter a trigger, and it can put your mind at ease.