Hi Readers! This is news to me: The well-regarded St. Louis Children’s Hospital has a program whereby they take kids who have tested positive for food allergies to see if they really ARE allergic. To that end, they feed the kids a steadily increasing amount of the allergen for hours on end, while closely monitoring them for adverse reactions. Turns out that in about half the cases, there aren’t any.
Well I’ll be a Mr. Goodbar! Another study, published last month in the Journal of Allergy and Clinical Immunology (no, I don’t read it — I heard about it in the same story I just linked to, above), the University of Manchester performed these “food challenges” on 79 kids who’d tested positive, via a skin or blood test, for peanut allergies. Guess how many turned out NOT to be allergic?
A whopping 66 of them! That means only 13 WERE allergic!
The problem — the BIG problem, it sounds like, to me — is that blood tests measure the antibodies present when a particular allergen is introduced, and skin tests measure hives produced by a prick with the food extract. But it turns out that merely producing antibodies doesn’t mean a person will have any other symptoms, and neither do hives produced via prick. Who knew?
Anyway, I alert us to this info not because I want anyone doubting the veracity of another child’s diagnosis, but only so parents can be aware that perhaps their kids are not living under the allergen-covered Sword of Damocles. I only wish it were easier for the kids to take this “challenge,” to see if they can relax and eat what they want. (Apparently the waiting list can be a year.) Fewer allergic kids could also mean fewer schools having to outlaw peanuts or homemade goodies. Anything that brings homemade cupcakes back into the mix is something I can get behind. — Lenore
67 Comments
This runs into the safety issue and the notion of no risk. My daughter is slightly to moderately allergic to some seeds, citrus seeds, kiwi and sesame in particular. While she has only had a skin reaction, when she was under two her doctor prescribed an epi pen because we couldn’t be certain how the allergies would proceed and with their small airways infants and toddlers are especially vulnerable to allergic reactions. When she turned four we all agreed the epi pen was not necessary unless she shows a systemic reaction in the future. It was nearly impossible to get the daycare to remove the epipen and allergy restrictions from her file. My physician had to actually phone the director that I was not being a neglectful parent. If my daughter wants to eat an orange, which she enjoys I let her try it, she can decide for herself if the orange is tasty enough to be worth a small rash, sometimes she decides it is and other times it’s not. To me it’s a small way to teach risk reward decision making. Sometimes people are surprised that I allow my allergic child to risk exposure.. I won’t say that when she has a new type of seed I don’t watch her carefully, I do, but I think it’s important not to put my worries on her. As a parent it’s my job to worry, not hers
“allergen-covered Sword of Damocles…” I love it! I imagine it looks like a sword version of ants on a log… slathered with peanut butter and dotted with gluten-packed balls of dough.
Hey — a little off topic, but I thought of you when I read it. Here’s Mark Twain’s take on risk:
http://www.schneier.com/blog/archives/2010/02/mark_twain_on_r.html
I was just thinking of a related question the other day — how many cases are there of people who have had a reaction because of those down the line type exposures, like food processed in a factory that processes nuts, or food served on a clean dish that previously had nut-containing foods on it (which really is something that nut allergic people avoid), or food cooked in a non-allergic person’s kitchen that’s likely to be “contaminated” and the like?
I have a friend who has a child who is genuinely allergic and has had life-threatening reactions, so I willingly abide by all her strictures (I even avoid eating nuts the night and morning before going to her home, at least if I remember!), and I’m not saying I don’t believe that reactions are possible in these situations. But I wonder what the actual data is, because I’ve never seen it.
Another line of thought that needs to be investigated.
BG – The more you are exposed to a food allergen the more severe the reaction becomes.Your body gets more and more sensitive to the the allergen.
My hypothesis – When children with a genetic predisposition to the allergy are not exposed to the allergen at a young age due to the positive test, this gives their immune systems time to develop and normalize. Meaning later they may test not allergic.
I wonder if the scientists your site also performed a new blood test on these kids before to exposing to the allergen. If they did, did the children still test allergic?
From my family – kids are not allowed to eat peanut products until 3 or 4 – because of the family history. Many have the blood test at that time and test negative. The 2 people currently allergic found out at about 18 months old. One by eating peanuts (Late 1960’s). One because of an early blood test due to other medical conditions linked to the peanut allergy. The little one is going to be retested when he is a preschooler. I don’t need to be retested because I landed in the ER last year.
I have a bit of an ethical problem with medical experimental procedures on children because they can’t really give informed consent. For life ending conditions (cancer, CF) I think the effort to save lives overrides this concern as long as the parents are fully informed.
I don’t think peanut allergy treatments reaches this level. Honestly, I read labels, ask that people don’t eat peanut products in my home or classroom – it isn’t that big of a deal to me. (One other I don’t like people touching me – but I wouldn’t like it without the peanut thing.)
I knew that gently adding an allergen helps the body build up a tolerance to the substance, but this confirms what I ‘ve suspected this all along about how prevalent the problem really is.
I live in the town cited for cutting down some hickory trees because a nut might fall into a pool (being diluted by all of that water) and cause an allergic reaction in a grandkid, There was no checking whether the kid in our town was sensitive to that particular nut.
http://freerangekids.wordpress.com/2009/08/25/the-risk-of-avoiding-all-risk/
Reputable allergists know that skin and blood tests are only part of the story. The results MUST be interpreted in light of a clinical history. The most common allergens are dust mites, dog dander, ragweed–you know, the normal stuff that we’ve been fighting for centuries.
Unfortunately, our current world is loaded with pseudo-scientific junk about “allergies” causing everything from poor school performance to hyperactivity. Desperate moms read this stuff and put their kids on gluten free, fruit free, fun free diets–and guess what? Some of the kids get better. Nothing like maternal attention and fussing to raise kids’ self esteem. (Not to mention that many illnesses are cyclic, anyway, as are things that are going on in the kids’ school).
Ever wonder why the rates of gluten allergies are skyrocketing? People have been eating wheat for 15,000 years.
That is not to say that there aren’t truly atopic people, who have real, dangerous allergies and must carry epipens with them at all times. But many of the allergies being “diagnosed” are not anaphylactic. They’re GI or respiratory. Much easier to find “symptoms” to match.
This study doesn’t surprise me at all. It’s indicative of our science/medical illiteracy and all the folks selling snake oil to the public.
Yay! Now I don’t feel so guilty about letting my daughter eat whatever she wants provided she doesn’t swell up or immediately break out into hives. My daughter has tested allergic to cow’s milk (a year later, she did NOT test allergic to cow’s milk but instead to soy, this after a year of giving her soy milk instead of cow’s milk because she had tested allergic to cow’s milk but not to soy!), eggs, peanuts, tree nuts, and coconut. She has some uncomfortable eczema, which may or may not be linked to food allergies, but I’ve never been able to draw a straight line. The only thing I avoid assiduously is tree nuts, because she HAS had a severe allergic reaction — swelling of the face, breathing difficulty (and we have an epi pen). The other things I don’t give her straight up (whole eggs, whole soy beans) but I let it go if it is baked in to something or is one ingredient in something. I don’t give her peanuts, but I don’t worry about “traces of peanuts.”
It’s just so hard to create a diet with no eggs and no soy and no nuts. I’ve always felt a little guilty for thi — am I making her eczema worse? Would it go away if I completely eliminated all these things from her diet? But I’ve never seen a direct effect, and no one really knows what causes exzcema, and so…I’ve let it go.
I guess we do our own “challenging” at home. We never had her tested for strawberries, but once she broke out in hives after eating them, so we cut them out for a year. When she tried them again a year later, no hives, so she happily eats away.
This allergy stuff is a huge mystery and I have thrown up my arms an exclaimed, well, as long as she’s breathing and she’s not vomiting and her face isn’t swollen, go for it.
This kind of made me laugh. Two weeks ago we had a moms’ night out dinner for our elementary school. One of the moms, who is a really nice person, but definitely one of “those” moms, brought a typed list of the allergens of all three of her kids. Every time a new person showed up she would whip out the list to show them and talk about how she was going to go to a dietician the next day to find out how to work around all of her kids allergies.
According to the list, all three of her kids are allergic to many things, such as peanuts, wheat, dairy and on and on and on. Their allergens filled an entire 8×10 sheet of paper. I asked her if they had had allergic reactions (since they had not been avoiding these items before now) and she said no, but they tested positive to these items in blood tests.
I will be interested to see how long she will be willing to modify her children’s foods based on the results of these blood tests.
I know that some people truely have life-threatening allergies and I feel bad for them because they are being lumped with all of the people with potential allergies or mild allergies.
I have had a chronic cough my whole life. I recently saw an allergist to determine if it might be caused by allergies. I agreed to go on allergy shots, since it was one thing I have never tried for my cough. They made me watch an Epi-pen video and demonstrate to them that I knew how to use it. They strongly encouraged my getting one. I refused based on the fact that I am 43 years old and my allergies have never caused me to have anything other than a cough and itchy eyes (if those are indeed due to allergies). It made me wonder how many of the kids whose moms carry around Epi-pen really need them.
Here is some more information on allergies – older but unrefuted and in fact somewhat validated by anecdotal reports of allergies/hay fever clearing up on Low Carb diets.
http://comfort-eaters-diet.blogspot.com/2010/02/hyperinsulinism-and-allergies.html
The food challenge is considered the gold standard in food allergy diagnosis. The reason food challenges are not used more often is because they are a more expensive, time-consuming test to administer. They have to be double-blind, so neither the patient nor the doctor knows which sample has an allergen, or which one; they have to be done in a hospital setting so any anaphylaxis can be treated right away; and they take half a day or more.
I’ve been reading an amazing book called “Good Germs, Bad Germs” that explained current research into the so-called hygiene hypothesis, the idea that the increasing prevalence of allergies is due to modern sanitary living. The most current data seem to show that harmless soil bacteria can not only prevent allergies, they can actually improve existing allergies. We may one day have a “dirt vaccine” against allergies that contains the proteins from the soil bacteria that teach the immune system how to be tame. (Apparently we got really close, but the company with the patent is no longer actively pursuing it, for complicated reasons.)
Before any moms go feeding their kids mud pies, keep in mind that soil also can contain parasites like Ascaris worms and Toxoplasma, as well as pathogenic fungi and bacteria. (In fact, that’s the only thing keeping ME from taking a bite out of the backyard right now, because my allergies are trés troublesome.) But perhaps we don’t need to be too concerned about scrubbing fresh fruits and veggies, especially organic ones (no pesticide worries), or sweat if our kids don’t always manage to wash up before meals. Dog kisses are supposed to be very protective, as are brothers (no kidding: the epidemiological studies show that families with dogs and/or lots of siblings, especially male siblings, have lower rates of allergy!)
A final note—the hypothesis that getting lots of colds from daycare, siblings, etc. “builds” the immune system or helps prevent allergies has been more or less disproven. Deliberately trying to get children sick does more harm than good, even though at one time there was a legitimate theory that it might be protective.
I have a kid with a tree nut allergy (discovered when he ate a cookie at a local restaurant that had nuts thrown in, and his lips and tongue blew up – we were able to knock it down with Benedryl). I also grew up with a brother allergic to bee stings, and have seen an anaphlatic reaction, so I understand the fine line that must be found on this issue. But the issue is exacerbated by doctors who don’t relay food challenge information to parents, and parents who want to put their kids in a plastic bubble rather than help them learn how to deal with their allergy in the real world. We only got the food challenge information when we got a second opinion at Boston’s Children’s Hospital (after a horrible experience with a local allergist). The kid was tested for soy (blood & skin tests were positive) and 10.5 grams later without a reaction, he was found NOT have a soy allergy. We’re doing peanuts next.
Thanks to the “soy allergy”, I began reading labels more closely, and have come to believe that the rise in food allergies is related to the food additives in everything we eat and drink. Our grandmothers didn’t add soy proteins and corn syrups to the foods they made, and if they did, it was not in the quantities we are consuming on a daily basis. Even when I was a kid in the 70s, you didn’t have cereal bars for breakfast (many contain almond meal), and the only time I saw nuts (besides peanut butter) was on a holiday. I am all for Free-Range Parenting, but subsidizing the corporate soy and corn farms seems to be far more profitable for our government that being concerned with why more kids are being labeled as having a food allergies, real or misdiagnosed. And just think of all the copayments and Epipens being sold!
Susan and others,
Just a note of caution… in anaphylaxis deaths, the most common thing is an adult with a history of non-anaphylactic allergic reactions to food. (If I remember right.) This is why *I* carry an Epipen. I’m allergic to most shellfish, and though I’ve never had a systemic reaction, I don’t want the first to be the last, if you know what I mean. It’s a decision each individual has to make for him or herself, though.
Sky, eczema is considered an atopic (allergy-related) disease. Unfortunately it is complicated. A food, an environmental allergen, or any number of things can be a trigger, and since the reaction is not immediate, it can be nearly impossible to figure it out. Other factors affect it too, as I’m sure you know. I have eczema as an adult and I have to do a lot of things to manage it, especially in the winter when the air is dry: buy only certain soaps and shampoos (hypoallergenic, sensitive skin varieties), moisturize like crazy, etc. I feel your daughter’s pain, literally! Don’t beat yourself up, please; you can’t see what’s going on in your daughter’s immune system, and you can’t control everything even if you could.
This is a hard one for me. My daughter would randomly break out in hives and have anaphylactic reactions. We had no idea what was wrong as every single allergy test came back no allergies. Turns out she is allergic to LATEX and that cross reacts with many many foods. she is in the small category of children that even touching something that has one of her cross reactive foods could cause her to have a life threatening reaction. Still, I didn’t freak out this year when the school did their poinsettia fund raiser. We just watched dd very closely…Last year during school she had major respiratory issues during the fund raiser. We weren’t sure if it were the plants or just a bad cold. Poinsettias can cause problems for people with latex allergies. This is a big fund raiser for the school and I didn’t want to over react, but I didn’t want to under react and risk my dd’s life. It’s a fine line. As it is, we insisted that she is NOT allowed to clean up the cafeteria tables at lunch. There has to be a way to create a balance. And to a poster who asked, I do know a girl (13 now) who will have an anaphylactic reaction from just the smell of peanut butter. Yet there are three kids in my kindergartener’s class who are peanut allergic and we are allowed to send peanut snacks and homemade goodies. *shrug*
I was a child that had a lot of food allergies but I grew out of them in time. Sadly , 1 of my 4 bio kids has severe food allergies and some of them we found out due to the horrible reactions once they were eaten. That being said, I think a lot of people claim their children are allergic to certain foods after their doctors suggest that they “may have” an intolerance or allergy because the child has something unexplained. I think we have to remember balance when we feed our children.
Lenore, to be fair, not all allergic reactions are created equal and allergic reactions can vary DRAMATICALLY in the same person and with age. My mother was allergic to strawberries. For years, all it meant was that her face swelled up a bit when she ate some. Then one day, she had a serious anaphylactic reaction, was minutes away from having to get trached.
So yeah, it’s possible people are over-reacting. But that doesn’t mean we can laugh it off. We just need to be a little more sensible. My daughter inherited my mother’s allergy: she gets a little rash. We tell her daycare not to give her strawberries. But if she eats some, it’s not the end of the world and not to panic. Just keep an eye on her in case she blows up.
Addendum: I had a similar response to bee stings. I’d been stung many many times as a kid and never had a reaction. Then one day, I got stung and has a major anaphylactic episode. Fortunately, my dad had an epi around. Since then, I’ve been stung and had no reaction.
So I don’t fly into a panic whenever a bee stings me or bees are nearby. But if I get stung, I go inside, keep an eye out for symptoms and known where my shot is.
I’m not convinced that allergy diagnosis is genuinely scientific. There is much to be learned about immune responses and proper diagnostic methods. Physicians know much less than they think they do, but Authority is part of their schtick.
At one time roughly 100 percent of gastroenterologists knew that ulcers were caused by stress. But that certainty melted into slush as a rebel researcher, much ridiculed a the time, proved that most are caused by a bacterium. Almost all the rest are caused by corrosive medications. After the stress ulcer theory was demolished and ulcers easily treated, Irritable Bowel Syndrome became the most common GI diagnosis. Guess what gastroenterologists then claimed causes IBS? Stress, of course. But now we see convincing evidence that this too is superstitious nonsense.
It just may turn out that many allergies are not detected by today’s crude techniques.
@Sky, as another poster said, don’t beat yourself up too much about your daughter’s eczema. I’ve had outbreaks for 35 years now. For me personally, it can be exacerbated by cold, dry (winter air); insufficient sleep; little.
For the first time in decades, I’m having outbreaks on my toes. I think this has to be related to my pregnancy, and possibly to the fact that I have only one pair of shoes I can wear comfortably–and even though I’m wearing them with the white cotton socks my doctor recommended when I was a kid, I’m still having an outbreak.
FWIW, I read several years ago that those of us who got the smallpox vaccine as children and now have eczema should not get the vaccine again if it is made available again in case of biological warfare. I have no idea if there’s a connection, but it doesn’t make me regret the fact that my mother fought for both me and my younger brother to be vaccinated. I’d rather have eczema than smallpox.
Yet another alarmist movement revealed. This does not surprise me at all.
I think whenever this happens, the costs* of the “big movement” should be computed and its proponents should have to pay. Maybe then, people would do a proper cost-benefit analysis before they make a mountain out of a mole-hill (or invent something out of thin air).
It’s one thing to encourage awareness. It’s another thing to force lifestyle changes without proven justification. All too often, the “do-gooders” in today’s society have absolutely no responsibility for being wrong. That’s often what distorts decision making processes.
*The costs I’m talking about in the present case are the lost opportunities for kids (especially non-allergic ones) to experience a broad variety of foods and food-related experiences, as well as the cost that parents have to incur to find viable alternatives to staples, mainly peanut butter. Sure, this is a small price to pay “if” someone is truly “endangered” by being in the vicinity of peanut butter. But as we see, that’s usually not the case.
I grew up being allergic to more things than I can remember. All I know was I was allergic to 32 things plus shell fish when I was a child and 21 things now. As a child, because both my brother and I are allergic to over 30 allergens and not all of them are the same, my mom essentially “gave up” on trying to keep us away from allergens. We don’t have carpets, fabric sofa, blinds, stuffed animals, or pets, but other than that the policy is for us to roam free and use our inhalers and/or go to the ER if we’re in trouble. (She did take us to all kinds of doctors and sought out all kinds of treatments.) We also lived in a metropolitan area with one of the worst air qualities in the world. An “asthma attack” would last a week to two weeks and any common cold would ultimately turn into an asthma attack, making any common cold a three week ordeal. While I can’t say I love my allergies or I enjoy having asthma attacks, I really appreciate my mother letting us decide how much is enough. Even after a few ER trips she didn’t purposely keep us away from allergens. She allowed us to live as normal a childhood as possible, never telling us we’re not allowed to go hiking because we’ll wheeze our way to the top then wheeze our way back down. Learning my “limits” over the last 21 years allowed me to not be afraid of events like marathons, allowed me to try new foods even if I know it has crabs in it, allowed me to basically live my life to the fullest and not let asthma hold me back.
When I was a kid, I was continually runny-nosed and was diagnosed with allergies (but not tested), and the advice our (otherwise quite good) pediatrician gave my mother was the standard one for the time– no pets, no knickknacks in the house, no carpets, no stuffed animals, and plastic over pillows and mattress. We lived on a farm, in a 200 year old house with limited forced air heating. My mom asked me if I wanted to do what we could of that. I opted not to– it would have been a cold environment indeed for me! When I was an adult I had the ‘prick test’ for common allergens, and turned up negative for all of them, including those allergens that the above measures are recommended for. Still don’t know what causes my runny noses and sinus infections, but at least I didn’t live a sterile childhood!
It’s possible some of these children were allergic when first tested, but have since outgrown them. Allergies are a bit weird like that – you can outgrow them at any time, or, conversely, you can develop them even in adulthood.
Someone help me understand. I have heard that if you are allergic to something, each subsequent exposure can make your reaction worse, meaning that a kid with a mild peanut allergy (even with no real visible effects), could, each time he encountered peanuts, develop a worse reaction until he’s in danger of going to the hospital from just a tiny bit of peanut butter. Meaning that it’s better to err on the side of caution and not give a kid peanuts (but maybe also not freak out if some are in the room – just saying…)
But I’ve also heard that exposure can help your body build up an immunity. This seems to have been my experience. As a child I had a very severe allergy to cat hair (and dog and others, but cat was by far the worst). My whole face would turn red and my nose would stop breathing. Not life threatening, but extremely uncomfortable. I can remember my eyes being so red and watery I could barely see. By the time I was about 10, it was better, but not great. Then we had to live in a duplex with three cats next door. For a year, I looked slightly sick. Then I began to get better and now cats have no effect on me. I even have a cat.
These two things seem to be diametrically opposed. Which is true? Or are they both true in different circumstances?
Someone help me out here!
The latest studies show even severe peanut allergies can be treated with repeated exposure (under doctors’ supervision of course.)
http://www.nytimes.com/2009/03/16/health/16peanuts.html?ref=health
This probably works for other allergens as well. This is huge for people fatally allergic to trace amounts or peanuts or other things.
Kind of tells us avoidance is not the best policy. It raises your risk of developing severe allergies drastically, in fact.
We are creating kids unable to deal with the real world in every way, from allergies to strangers.
pentamom: I don’t know of any studies about allergic reactions due to cross contamination, but I do know that it does happen and can be life threatening. In 2003, a girl in Canada with a milk allergy died because the tongs used for the fries were also used for the cheese fries.
http://www.allergicliving.com/features.asp?copy_id=17
Sadly, she did not use the epi-pen in time.
I have known also personally several people who have had reactions due to cross contamination issues, ranging from mild to life-threatening. My daughter got a hive where a dog licked her; the dog had eaten a peanut butter dog biscuit. (It wasn’t life threatening but just an example of how allergens show up in the most unsuspecting place.) Additionally, before she was diagnosed she had mild reactions to Chinese food and some baked goods, neither of which had peanuts as an ingredient but which were made in the same place.
As a parent, I don’t need studies. All I need to know is that one kid died and that makes me be as vigilant as possible for my situation. It’s a difficult thing for me to do and be free range but I am trying. I am not surprised by the report, but someone going to a good,reputable allergist would not have this problem.
As for Fengru’s question, both points are correct. The more you are exposed to peanuts, the more severe the reaction can be. Each person reacts differently. For example, my daughter had a mild reaction to eating Chinese food which probably had some peanut in it; someone else with a peanut allergy may not have reacted at all, while someone with a sever allergy could have a full anaphalatic reaction.
We discovered my daughter’s allergy to chickpeas because we ate something with chick pea flour. It was during the summer and I noticed her lips were red several times after dinner. I assumed it was from being in the sun too much until her entire lip blew up and I realized that she had been having mild allergic reactions.
There are currently clinical trials going on where patients are given peanut protein, and at each visit are given a little more. So far, this seems to have worked and it seems that it can help rid some kids of food allergies. But someone with a severe allergy is probably not a good candidate for the clinical trials because they react to such a small amount of protein that it is very dangerous for them. No one knows for sure why there is a rise in food allergies and why some people have such a severe reaction. Probably a mix of things — genetics, environment, diet, etc.
Fengur,
Both are true. In a person with a genetic predisposition, exposure is still necessary to “start” an allergy. And subsequent exposures often have worse reactions, But at the same time, repeat exposures, especially to small amounts, can help teach the immune system to react less strongly to an allergen. This is the principle behind allergy shots. The key is to start with an amount of allergen that is too small to trigger a reaction. It works best with environmental allergens like dust and pollen and with insect stings. Food allergies are considered too unpredictable at this time for this type of therapy, although they are doing research—I’ve heard of severely peanut-allergic people in trials being able to consume up to 4 peanuts’ worth of allergen without a reaction, which is astonishing.
I’ve experienced the exact same thing you have with my cats. I have a cat allergy, but it hardly ever causes acute symptoms anymore. If I leave the house for a few days, I often have hay fever and itchy eyes when I get back, but only for a day or two. As a child I had much worse hay fever, and often hives. I had to wash my hands every time I touched them; now I don’t. (And no, my parents didn’t get rid of our cats despite my allergy. I would have been the family member most upset to lose them!)
The words people often use with immune system problems can be confusing. In an allergy, the problem is that you are immune—immune to something harmless. The body treats it like an invading parasite, with inflammation, sometimes out of control. Imagine an army that panicks and let loose its big guns indiscriminately when it sees a piece of paper blow past in the wind. Having that reaction over and over can make the army even more sensitive to paper, but if it instead sees only a tiny bit of paper, not enough to make it panic, it can be the start of desensitizing the reaction. Remember that with the immune system, immune = inflammation. Inflammation is the weapon that makes you immune. What you want with allergies is to develop tolerance, not more immunity.
My two-year-old was diagnosed with dairy, egg and peanut allergies once she started eating table food. We were told she might outgrow the dairy and the egg but probably not the peanut.
Over the past 18 months, she has been accidentally exposed to eggs only a couple of times and now seems to be outgrowing that one (the vomiting now takes 30 minutes to start rather than three minutes). The dairy allergy, however, has gotten worse. She violently vomits at least three or four times immediately after she ingests dairy, which (thank God) has only happened a few times in the last six months. So far, we’ve never had to deal with a peanut reaction.
I know a family who lost their 18-year-old son when he ate chocolate mousse at a resort buffet, suffered a peanut reaction and didn’t have an EpiPen on hand.
Stories like those make it difficult and stressful to deal with my daughter’s reactions, to help her start to understand that some foods will make her violently ill, and to work with the staff at her daycare to try to put together a plan for meals and parties. It’s also hard work to try to find ways to let her have a normal food-related childhood. I’ve started experimenting with vegan cooking to deal with the egg and dairy issue, and my husband and I have changed our own eating patterns, because this really is a family issue.
I guess what I’m saying is that I believe food allergies can only be evaluated on a case-by-case basis — even a report that many allergies are misdiagnosed doesn’t change my mind that my daughter certainly responds to these foods — and that it’s up to each family to deal with them the best way they know how.
It helps when outsiders who don’t have to deal with this issue on a daily basis try to be understanding. Food allergies can be a life-or-death situation, and even though I try not to hit the panic button in challenging eating and dining situations, the possibility of my daughter having a life-threatening reaction is never far from the back of my mind.
Ellen — I wasn’t asking for studies, I was asking whether there were known cases of it, and how many. You’ve answered that there are known cases of it, which is what I didn’t know. How many is admittedly pretty hard to determine, but as I said, I wasn’t basing my views on whether it was important to protect children (or adults) from possible reactions on the answer to the question, I just wanted to know.
So, thanks!
Allergies are a very unpredictable phenomenon, difficult even for allergy experts to understand and diagnose, very confusing even for those with long experience of allergies, and so almost impossible for lay-people — reading one or two articles — to comprehend enough in order to make accurate judgements about the severity of others’ medical conditions and their needs. Allergies can develop early in life or late; they can disappear after a time or stay forever; small exposures can improve the situation or small exposures can cause the allergy to increase in severity (sometimes dangerously rapidly); and allergic reactions can remain stable and predictable over a lifetime, or they can slowly increase in severity over time, or they can jump from being just hives for one reaction to being life-threatening anaphalaxis in the very next reaction. Allergies vary significantly from one allergic person to the next, and what works for one may not work at all for another. Much of the battle that allergic people face in dealing with their conditions is the partial understanding (and partial ignorance) of the people around them — particularly those who have read a few articles and think they understand the situation, and then discount the genuine medical needs of an allergic person.
It is already well-known and has been long understood in the allergic community that testing alone is not a reliable indicator of an allergy. Blood tests and skin tests tell us the *likelihood* of an allergy, but do not actually diagnose the allergy (a high score on a blood test indicates only a high likelihood of the allergy, but nothing more). The only true test is an actual reaction, either accidental or deliberately caused (ie, a food challenge). Until that happens, one does not actually know if an allergy is really present, but *must* still treat the allergen with real care and caution, because any possible reaction could potentially be very severe.
One thing that lay-people often don’t understand (because it does not come through in the articles) is what taking a food challenge is really like. These are time-consuming and often stressful tests, which carry real risks for the patient and which have to be taken under clinical conditions with emergency staff and medication standing by in case things go wrong. And when they do go wrong, the whole experience can be very painful and extremely distressing, especially for children. An anaphalactic reaction is not something anyone wants to experience if they can avoid it — the painful swelling, itching, racing heart, the feeling that one can’t breathe — and the after-effects of the medicine used to treat it (epinepherine) are nearly as unpleasant too. And then, even after the initial reaction is brought under control, the body continues reacting for days as the food makes its way through the digestive tract, and the patient must continue to take medication to keep everything under control.
Our last food challenge took well over four hours (a long time for a bored two year old to handle in a sterile examination room). It went wrong, she had a serious reaction and had to have epinephrine (with all the side-effects that brings) and then we had three days of screaming-crying and three nights of no sleep whatsoever as she thrashed about trying (in vain) to find some position that would relieve the pain as the food went through her system. That is the reality of what a food challenge is — though no one could ever be expected to understand that just from reading an article (or, really, until they’ve experienced it). It’s not something I relish putting my daughter through any more than is *absolutely* necessary, and I certainly give her a mercifully long rest period between food challenges. For parents whose children have had positive blood/skin test results to a long list of potential allergens, going through and food challenging them one-by-one is not going to be a quick or easy process (indeed, it could take months or even a year to get through). And, in the meantime, the only thing they can do is to treat the test results as real and to diligently avoid the potential allergens.
…And to hope that the lay-people around them will extend them the benefit of the doubt and give them their support during this stressful time.
i have exema and my feet break out when i wear colored socks doesnt stop me from wearing them. the only thing that does is when holes get worn in them from being worn to much and i have to get rid of them.
When I was 12 I was diagnosed as being allergic to dairy, peanuts, peas (yay!), wheat, and citrus. I’m 40 now. The only problems are that dairy gives me unpleasant digestion and causes my skin to get more red and blotchy (I have rosacea). Peanuts, peas, eggs, and citrus also cause very unpleasant problems with digestion. (It’s hard to find a filling protein that does not give me digestion problems.)
The only thing I’m allergic to I wasn’t diagnosed as being allergic to — mussels. I found that out after I finally made the connection of being increasingly ill after eating them once every 2-3 years in my 20s. Throwing up while driving through the tunnel under the Boston Harbor after eating mussels at a potluck is something I was always remember. The last time I had mussels was the night I became engaged in Brussels, Belgium, when I still wasn’t sure if I was allergic to them. I had one — that’s 1 — single delicious garlic white wine and butter soaked mussel and threw up the entire night. Thank God the reaction wasn’t worse.
I used to get hives and a throat swelling, coughing, itching reaction when eating take-out pizza. Never did figure out what it was. I think it was actually an anxiety attack.
All this study proves is that the standard diagnostic testing for allergies is not reliable, rather unreliable in fact.
In my experience, the test error by reporting both false positives and false negatives, in other words just as often (if not more often) does the standard IgE blood or skin prick testing miss an allergy as it accurately diagnoses one.
I don’t think that allergies (especially for children are over-diagnosed.) As much as I wish that was the case. In my sample set of friends and family I see many undiagnosed allergies and food sensitives, especially to things like wheat and dairy. To further complicate the issue, some sensitives don’t develop in the first few hours, my daughters violent reactions to dairy develop about 12 hours later and last for approximately 48 hours.
If your (or your child’s) body is giving you a clear sign that it can’t tolerate a food, such as a skin issue, digestion problems, sinus issues, mucus, etc., you should consider yourself fortunate your body is communicating so clearly to you. And stay off the food. This outward sign is just one symptom of how the food is reeking havoc on your body and causing a myriad of other, less pronounced, problems such as sleep issues (waking up and not being able to go back to sleep), malnourishment (your body isn’t able to absorb the nutrients properly b/c of leaky gut or other chronic digestive issues, low immune system (from being taxed by dealing with an allergen) and many many more.
The only true way to feel the impact it to stay off the food or foods for a significant time period (a month? at least 2 weeks) and then add them in very slowly, noticing any changes.
Elimination diets are really the only diagnostic tool available for food allergies, and they can also be a cure.
Good Luck!
This is a little off-topic, but is it possible that we’re seeing a rise in allergies because of all the GMOs being used in processed foods today? Genetically modified soy beans, corn, peanuts, etc. are abundant in today’s processed foods and the manufacturer does not have to disclose that it is using GMOs.
And markets don’t have to advertise that veggie or fruit produce is a GMO product, either. I did hear something about the bar code on the produce: for instance, those codes that start with an 8 are GMO and those that start with a 9 are organic, according to one web site I read on the subject.
You should take a gander at mothering.com. Some of those poor kids are allergic to 2394890328092 at just under a year old, and most likely growing in to malnourishment. Some of those parents are absolutely insane.
What the heck is “2394890328092,” and why are kids under a year eating such large numbers?
I would definitely rather be guilty of incorrectly assuming that my kid had allergies than to have some doctor diagnose her with ADHD and turn her brain into a science experiment. At least allergies are an authentic disease.
Are we seeing a rise in allergies? Perhaps. We are seeing a rise in asthma.
More likely candidate is vitamin D deficiency from kids staying indoors and
being slathered with sunblock when they go out. Vitamin D deficiency is one of the profound harms arising from the unfree childhood.
Children can also outgrow their allergies, which many parents seem to forget. My nephew had a serious (lengthy hospital stays required) allergy to rice. French fries coated in rice flour sent him to the ER; once admitted and feeling better he ate hospital pancakes only to have another severe reaction. Yep, rice flour. As he got older he carried his own epi-pen. Finally, one day, he tried one rice krispie on his own (adults were nearby). Nothing happened, so he had a little more, then a little more. Ta-da! Allergy outgrown, and the grown-ups would have never thought to check!
I am a 32-year old, and I have had food allergies my entire life. I have a 2-year old son who has been tested for allergies and has shown positive skin prick tests to those allergies.
For him, his allergy tests came about because of a bad reaction to yogurt when he was almost 1 year old. The subsequent skin prick tests were done to help us avoid any further reactions at a young age.
There are many systemic (ie, swelling, difficulty breathing, etc) reactions to food allergies which can become severe and even life-threatening, the advice of any pediatric allergist should be to avoid those foods which show up in a positive skin test AT LEAST until the child is able to clearly communicate any symptoms they may have after eating said allergic food.
There are a lot of different ways that our bodies react to allergens, different times that we may or may not outgrow them. Let’s not all jump on the bandwagon that everyone who has an allergy is “crazy.”
I think that this study must be a sigh of relief for the parents of the 66 children who were able to tolerate the previously-thought allergic foods.
The best book on allergy I’ve found is Joneja’s and Bielory’s “Understanding Allergy Sensitivity and Immunity.” It is serious and technical, but not out of reach for the intelligent reader, and is very comprehensive. Amazon has it for 1 cent. Literally.
http://www.amazon.com/Understanding-Allergy-Sensitivity-Immunity-Comprehensive/dp/0813515203/ref=sr_1_4?ie=UTF8&s=books&qid=1267023169&sr=1-4
This thread brings to mind a great quote from Dennis Potter’s play, “The Singing Detective.”
“Why is it that doctors take it as axiomatic that when you’ve lost your health you’ve also lost your mind.
Thank you, thank you, thank you for posting this.
I have a life-long severe (full anaphylaxis) allergy to fish. I have TWICE tested negative to any fish sensitivity with skin tests, while at the same time testing positive for various allergens to which I have experienced no true reactions (e.g., dogs). Skin tests are not determinative and should be only one step in a diagnosis.
There is also a vast difference between a sensitivity/intolerance and an actual allergy.
“But it turns out that merely producing antibodies doesn’t mean a person will have any other symptoms, and neither do hives produced via prick. Who knew?”
I did. And a lot of other families dealing with food allergies do as well. That’s why, as an adult, when I tested allergic to literally dozens of foods my doctor put me on an elimination diet for several weeks to see which ones were causing an increase in my symptoms. HOWEVER, elimination diet is not really do-able for people who already have had reactions to foods prior to testing – such as my son experienced with egg, peanut and garlic. So, no, not all of us are having our children tested willy-nilly. In my case, it was because we had cause for testing not because we thought it would be a hoot to have blood drawn from a toddler.
As for the peanut “cure”: In the Duke-Arkansas testing, at least, some kids who are so highly allergic – such as those who already experienced anaphylaxis – are not candidates for the program to begin with. Yes, there is remarkable progress being made in this area. But even the story link provided does not promise a definitive, widely available treatment for all peanut allergic children.
“Let’s not all jump on the bandwagon that everyone who has an allergy is “crazy.” ” – WELL SAID Melissa!
As a very free-range parent of a severely allergic to all nuts 7 YO, I applaud you. I am NOT crazy. My son has been skin and blood tested for his allergy since he was 2 YO due to a family history of allergies (to everythign under the sun, it seems….). He is moderately allergic to soy (causes hives and tongue swelling) but analphylaxtic (sp?) to all nuts.
Unfortunately, my free-range spirit has ended up with him having a reaction to ice cream, where there were nuts in the restaurant, but we placed an order without nuts and didn’t advise the restaurant of his allergies. The oh-so-kind server just decided on her own to throw in a scoopful of peanuts, and after one small bite, my son started to react. Luckily, it was just severe stomach upset and vomiting for 6 hours, but we caught it early enough and he’d only eaten a 1/2 teaspoon.
I am happy to let my son do many things other parents won’t let their kids do on his own, but when it comes to what he eats, he’s learned to ASK before he eats, and I’ve learned NOT to under-react.
So, like Melissa says, not everyone who has an allergy and carries an epipen “just in case” is crazy. Some of us really do need it.
I know people whose kids are really and legitimately allergic to things. One little girl needed an epipen after someone touched her after touching a chocolate chip cookie that had nuts in it. I saw her start to react and it was scary.
On the other hand, I also know moms who claim their kids are allergic to all sorts of things with no real reason other than that they did an “elimination diet” and had some subjective feeling that their child’s behavior improved afterward. I feel bad for kids whose diets are limited or who are put on these stict elimination diets where there has never been any kind of dietary reaction. But I hear moms talking to each other about a kid with bad behavior, and another mom will say, “Have you tried an elimination diet?” I mean really, maybe it’s just plain old bad behavior. Maybe the kids were so afraid of being put on this restrictive elimination diet again that they shaped up. And were never given dairy or gluten again when they’d be fine eating it.
Reading back through the original post, I get the feeling that food challenges appear to be some sort of new or unusual procedure (“…St. Louis Children’s Hospital has a program…” “…the University of Manchester performed these ‘food challenges’…” “…I only wish it were easier for the kids to take this ‘challenge,’…”). They are not — they are regular and established part of almost every allergist’s battery of tests, and they are very easily arranged for any patient who wishes to undergo them (although, as I said in my previous comment, often not an easy experience). Food challenges are done in their hundreds (if not thousands) in every city in the country.
There are many, many issues that are ripe for re-examination with a FreeRange mindset. But food allergies are such a real and significant danger to the children that suffer them — though they produce parental behaviour that looks appears to the inexperienced as classic over-protectionism — are not one of them.
Just found out that my kid is allergic to the new soap at the daycare. Her teacher says her own kid (in the same daycare) is allergic too. But they are not going to change the soap back, because there aren’t enough kids having reactions to it. And my kid is required to use soap, can’t just wash with water. My only option is to provide alternative soap for my kid to use at school. (You know where that’s gonna go in a room full of 3-year-olds.) Until that happens, my kid is required to rub the known irritant onto her skin.
Meanwhile, my kids are not allowed to bring a single molecule of peanut into the school. This is a new, schoolwide rule, so I assume it is to accommodate one single child in one of the 10 classrooms at the school. (Obviously they also have nothing remotely resembling a nut product on the breakfast, lunch, and snack menus offered to all of the kids.)
It would be nice if there were some balance, some sanity, when it comes to rules concerning children.
When my niece was about 6 mos she noticed that she was allergic to dairy foods. Cheese, milk, etc. She cut out all dairy for about 5 mos, then started trying little bits of cheese and other foods that contained milk. She is 12 mos now and has no signs that she is allergic anymore. Kids do grow out of allergies. It’s a shame that so many kids go years and years without the foods that they are/were allergic to when they could have grown out of it in a few months. I think that this type of allergy testing is great!
And I’m glad that my niece (and my sister) don’t have to suffer through all of the dietary restrictions.
My son has food ‘sensitivities’, which neither give him hives or show up positive on a blood test (well the latter is difficult to tell because a week on a normal diet turned him so barmey that we put him back on his special diet), but he clearly has problems. I have to ask if they observed ‘behaviour’ as well as physical signs of allergy in these studies.
He goes completely hyperactive and can’t sleep for quite a while. After injesting play dough (he is very sensitive to wheat) he bounced off the walls past his day nap time, was frantic and finally fell into an unsettled sleep at 10pm. Has anyone else had this sort of experience?
Hi Andrea,
I have no doubt that genetic modification has an impact. There are also some other interesting factors. Research in Australia has been showing that peanuts grown in circumstances with more carbon dioxide (apparently something associated with the disappearing ozone layer) produces peanuts which are far more condensed with allergens. Maybe this is why Victoria Australia is the asthma capital of the world, ie. we have a much bigger ozone layer hole here. Perhaps there truely are more allergens around. I am sure there are many many factors though.
N writes: “I also know moms who claim their kids are allergic to all sorts of things with no real reason other than that they did an “elimination diet” and had some subjective feeling that their child’s behavior improved afterward.”
This is probably rare. It’s hard for me to imagine that many parents would want to go to the trouble of eliminating wheat or dairy or eggs (the three things we’ve cut out of our son’s diet) without pretty good reason, and it’s hard for me to imagine that many parents wouldn’t try letting their kids eat the stuff every once in a while to see what happens.
Our son, a normally very sweet kid, used to get wildly out of control quite often and act mean. After trying a million other things, we did an ELISA array test that showed a bunch of potential allergens. We tried an elimination diet (a huge pain in the neck, went on for weeks), and his violent episodes diminished dramatically. He has gotten better and better ever since–unless he consumes wheat, eggs or milk, in which case he usually (always in the case of eggs, which seem to make him very violent and aggressive) starts picking fights, yelling, hitting, etc. (he’s nine). I do hope he’s going to outgrow it at some point, and we’ll keep trying–but there is definitely some kind of sensitivity there. His teachers, grandparents, etc., were astonished at the difference in his behavior. It has made our life much, much better.
So yes, Jennie, gluten (or eggs!) can certainly make kids go crazy.
“This is probably rare. It’s hard for me to imagine that many parents would want to go to the trouble of eliminating wheat or dairy or eggs (the three things we’ve cut out of our son’s diet) without pretty good reason”
This is common amongst my group of mom-friends. I’ve been encouraged to cut out dairy no less than 40 times in the first 4 months of my child’s life because she cried occasionally and had cradle cap. And no, I’m not exaggerating. Infant acne: must be a dairy allergy. Fussiness? dairy allergy. Gas? Dairy allergy. Green poop? Dairy allergy. And so on and so forth. My daughter has no allergies whatsoever, but if I listened to most of the moms I know my diet would be severely limited.
I’ve also been told my kid might have a milk allergy because she had a few quirks – I can’t even remember now what the quirks were, but there was no way I was cutting milk without pretty clear evidence that it was causing harm.
I know someone, her child has eczema. Tests negative on ALL allergy panels. The doctor has told mom, point blank, your child does not have food allergies. Poor kid’s mom is psycho- at last count she has removed wheat, dairy, corn, and soy from the kids diet. There is no evidence that eczema is even caused by food allergies- just a casual association between food allergies and eczema. The same association is found between asthma and food allergies. And now mom is talking about removing all food coloring and preservatives from the child’s diet… because her 3 year old child is “hyper”. Um, yeah.
People can be psycho about food. And it mostly hurts the children with genuine food allergies and intolerances.
FYI, since we are beating this to death:
‘Milk Drops’ Under the Tongue Appear to Treat Milk Allergies
http://www.sciencedaily.com/releases/2010/02/100228203213.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29
Hot off the press.
Hello,
I found your blog on Allergys Interesting. So maybe the skin prick test will need to be revisited. However I do feel this Blog is Minimizing the Actual importance about being vigilant around Some nut allergys. When my daughter was 3 I gave her an asprin size amount of peanut butter. She instantly stopped breathing and dropped to the floor. She spent the next day in the hospital. Being worked on trying to get her to breath again. The Eppy shots did not work, I have to constantly worry about her next contact with nuts Is it going to be Fatal? Every single day I have to worry when I send her off to school. Ironically her teacher fed her a nut bar for a snack this year and again she threw up & sneezed for 12 hrs non stop and had to go back to the hospital. Her allergy is not taken sersiously by her school. Nut allergys need to be taken sersiously they can be life threatening. Or is the enjoyment of a “nut cupcake” worth more than a 5 years olds life?
fair warning, folks: for the truly food allergic, the tolerizing regimens are still a shaky prospect. 9to5to9 makes a good point – the highly allergic kids aren’t eligible to try the new tolerizing protocols. And,even the moderately allergic can find them to be unsuccessful. But still enlightening
We discovered that my multiply-allergic son can have dairy, in certain heated forms (mostly crispy), and as such was eligible for a clinical trial. The trial studied whether you could tolerize an allergic child by having them eat dairy in the tolerated forms for six months. So, browned pizza, 2-4 times per week. Muffin (40 minutes in the oven), 1-3 times per day. Rice pudding (2.5 hrs in the oven), 4-7 times per week.
Six months later, he had half a teaspoon of milk. Vomited, face began flushing and swelling – and nope, he wasn’t tolerized.
Allergy is such a new field, and the individual cases are so idiosyncratic…in many ways, it’s still a combination of blind guessing game and weighing risk. But (taking a step back here) we’re not good at weighing risk, as a country – witness our rates of tests and procedures the stress levels of our fellow parents, and the number of fix-it-now prescriptions. Or heck, go check out a playground, and consider who on earth weighed the risks on those climbing structures? Someone who missed the point of “fun?”
And yet. On the one hand, I’m irked by people who give diagnoses without clinical evidence (like an actual reaction), and furious with general practitioners who try to diagnose allergies (specialists, people, are specialists for a reason). But I’d also rather be liberal with the EpiPen prescriptions. Because I’ve seen my kid turn blue, then grey during an anaphylactic reaction, and it’s a horrible sight.
Somewhere, there is balance. But not, I suspect, in oversimplification of a complex problem, and certainly not in the mockery of the parents who are trying to walk that vanishingly fine line.
Cough is most common among people these days and that’s mainly because of the environment which is causing it. Cough is nothing but expulsion mucus and it is a common tendency of our human body system to clear away all the unwanted materials from the lungs. If the cough is persisting for few days i.e. 7-10 days then it can be easily cured provided proper treatment is taken. If it continues for more than 10 days then a doctor must be consulted and proper treatment must be taken as this type of cough is called as Chronic Cough.
Addendum: I had a similar response to bee stings. I’d been stung many many times as a kid and never had a reaction. Then one day, I got stung and has a major anaphylactic episode. Fortunately, my dad had an epi around. Since then, I’ve been stung and had no reaction.
Thanks for posting this, I found it very informative.
A very interesting post! Although my son has multiple, severe food allergies, I’ve tried to adopt a calm, sustainable attitude towards handling them. To that end, I’ve been encouraged to start a blog on the subject: shmallergy.wordpress.com.
I’d love to use it as a place to start a dialogue on simplifying the lives of individuals (particularly families) managing food allergies.
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I don’t quite understand it all, but I like this article 🙂
not all the itching caused by food allergies, it could be because of skin sensitive to dust and the like, which is often itchy