July 9, 2009

Food Allergies Unsimplified

Filed under: Allergies, Food, Health, Personal Blog — marcstober @ 1:34 am

A few months ago I was diagnosed with some food allergies. These days people tend to associate food allergies with children, but food allergies have always impacted me, since my mom is allergic to peanuts and some other things. Reading labels on food packages and worrying at restaurants has always been part of my life.

Here are the foods I’m avoiding, along with the allergy test results and some comments.

Sesame seed (Skin prick test reaction. In hindsight, this was probably a main source of problems for me, as I can recall several incidents of mostly mild but disturbingly unexplainable irritation in my mouth, face and lips after eating hummus [with tahini – Trader Joe’s now has a tahini-free version!], Asian sesame dressing, sesame seed bagels and Kashi cereal.)
Sunflower (Skin prick; surprisingly, this was my most severe skin prick test reaction for a food.)
Hazelnut (Skin prick, class 3 RAST [blood] test reaction.)
Almond (Skin prick.)
Walnut (Skin prick.)
Peanuts (Negative, but avoiding them anyway based on family and personal history.)
Cherry (Skin prick, class 2 RAST.)
Peach (Class 2 RAST.)
Apricot (Class 2 RAST.)
Plum (Negative test, but had an episode of severe itching at the back of my throat to eating a fresh plum a few years ago, and in the same family as the above 3 foods.)
Nectarine (Not in the doctor’s orders, but similar to plum and peach, so I’m avoiding it.)
Apple (Class 2 RAST and an equivocal skin prick test – I’ve definitely eaten apple, although I’ve never enjoyed whole apples much, maybe that was a sign.)
Black bean (Class 1 RAST – I’ve definitely eaten them so this test is equivocal, but why not eat pinto beans instead?)
Corn (Class 1 RAST – although it’s nearly impossible to avoid corn as an ingredient, I’m going to avoid whole corn; corn-on-the-cob always sounded better than it was anyway. Heavy cornmeal coatings like on the bottom of some bread or used as breading seems to irritate me a bit.)
Green beans (Skin prick – again, never enjoyed them much as compared to other vegetables – these days we tend to do more broccoli, cauliflower, or sometimes squash.)
Lobster (Skin prick, haven’t eaten in years for religious reasons anyway.)
Clam (Ditto.)
Eggs (Negative, but I have a long history sensitivity of some sort that results in gastrointestinal symptoms rather than throat/mouth reactions, as confirmed by increased avoidance over much of the past year. Still eating them as an ingredient but avoiding whole eggs and mayonaise, although I’ll still order a tuna salad sandwich sometimes [at home I make it without mayo now, though].)

I also was tested for environmental allergens by a skin prick test. I was also tested for these as a child, so I pretty much knew about these, and for the most part had much larger reactions to these than to the food allergens:

Grass (Various types.)
Dust mite
Cat pelt (Nothing personal, Molly and Pepper!)
Aspergillus mold
Hormodendrum mold

(I didn’t clearly react to dog, which I did as a child. I’m not sure if this means we can get a dog.)

The earlier diagnosis of environmental allergies and oral symptoms to food seem consistent with something like oral allergy syndrome although I don’t exactly fit the plant/food pairings (no problem with tomatoes!) and don’t want to diagnose myself on Wikipedia.

What made me go to an allergist? In addition to personal and family history, I felt my environmental allergies had been getting worse over the past few years, and that it included stuffy noses and sore throats that didn’t really follow any allergy season. (This site suggests that could be a mold allergy, which probably explains some of it, and why I’m allergic to damp basements.) I sometimes had irritation around my lips and the roof of my mouth that wasn’t consistent with benign effects such as from salty, spicy, or acidic foods, but couldn’t pinpoint the offending food. Also, Hannah has been tested for allergies several times starting with a concern raised at day care when she was 1, with consistently inconclusive results.

Results have been mixed. I’ve been avoiding foods and taking non-drowsy over-the-counter antihistamines (Claritin or Zyrtec, or more likely the store brand) on a regular basis with good effect. Along with a medication for migraines prescribed by my primary care doctor, I’m feeling better than I have in years. I really feel “clear,” like on the Claritin and Zyrtec TV ads. With the exception of corn, which is an ingredient in everything but I’m barely allergic to it, all of the food allergens are pretty easy to avoid. Essentially, I have some environmental allergies and some fortunately mild food allergies, and I can feel better by avoiding the foods but probably won’t have any bad reaction if I somehow consume one from cross contamination.

However, I have a lot of anxiety now. My allergist prescribed an EpiPen, which I was told I’d probably never need. I should think of it like a life insurance policy, that I don’t often think about and can relax knowing I have it, but it serves more as a reminder that there is a small but clinically significant chance I could die from this. I’ve had a panic attacks that were most likely caused by my (psychologically) overreacting to some insignificant, non-allergy itch, like one time when my tounge felt itchy after eating some salty pretzels. I may have even been reacting to general stress–the incident with the pretzels happened during a particularly stressful time at home and work. Unfortunately, taking Benadryl, which can be indicated for a real allergic reaction, can make you jittery, hypertensive, and unable to concentrate all at the same time; in other words, it makes a little panic attack much worse. Rationally, my anxiety is out of proportion to the reality of the allergies, but that’s not how it feels sometimes. So, I take a deep breath, remind myself that I’m not having trouble breathing, and that there are people around who would take me to the hospital or call 911 if I needed it.

I write this in the hope that it will explain to friends and family (who might see me picking at food, etc.) what’s going on; and also in the hopes that it will be useful to someone else with similar issues out there on the Internet. (Note: This is a partial description of my patient experience; feel free to compare notes but more importantly get advice from a good doctor.) Plus, it’s a good way to deal with the issues in my head. There is more I want to write: about what I eat; social/political issues of food allergies; allergies vs. kashrut and other physically and spiritually healthy ways to eat; and maybe even some recipes. But I so rarely get a chance to write as it is, so I’ll save rest for some other time.