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Thursday, May 12, 2016

Five Things I Want People To Understand About Food Allergies

1) No one knows why food allergies are on the rise.
There are many theories about what has spurred the rise in life-threatening food allergies - but there is no single answer. It can be frustrating to read about or to be told about all the things I should do or should have done to prevent my son's food allergies - especially from strangers who don't know the first thing about the lifestyle we led before my son's anaphylaxis.  If only I had introduced allergens earlier, introduced allergens later, breastfed longer, weaned earlier, took Vitamin D, took probiotics, avoided GMOs, c-sections, vaccines, antibiotics, pesticides, antibacterial hand wash, cleaned my house less, hand-washed my dishes, micromanaged my gut flora, fixed my leaky gut, did a coffee enema, ditched the Western diet, adjusted my Qi... the list goes on and on.

Personally, I'm sure all of these things have potential to have some kind of impact on the epidemic rise of life-threatening food allergies, but the simple fact is that there is no single answer and you, stranger, have no idea what my breastfeeding schedule or hand washing choices were before my son was diagnosed. Even among the food allergy community you'll find exceptions to every new theory that pops up - several families with identical twins that have one child with food allergies and one without raised on the same foods, schedules, environments and with no other notable differences. While it might seem like a good idea to tell a food allergy parent that you've figured out what their massive team of doctors, research, and network of food allergy families have yet to understand because you read a post the other day on Food Babe that says food allergies are caused by invisible shreds of toilet paper lingering in your water supply, here's a tip: keep it to yourself.  Odds are, that someone living with life threatening food allergies has been researching this beast from the day they were diagnosed and has already decided on the best course of action for their own family.  If you're really desperate to get in on the conversation, join a food allergy support group, listen to the stories of people in the thick of it and ask how you can help make the world a little safer for them.

2) There is no cure for food allergies...yet.
Epinephrine is not a cure for allergies or anaphylaxis but it's a crucial tool for a food allergic person to have in their arsenal. Epinephrine can often reverse the progression of anaphylaxis, but it must be administered quickly. Even in multiple doses it may not work 100% of the time if it is administered too late.  It is however the only lifeline someone experiencing anaphylaxis has, so it is vital that a person with serious food allergies carry epinephrine with them at all times.

Other things that are not a cure for food allergies: Benadryl/antihistamines, immunotherapy, diet changes, meditation, etc.  All of these things are or could be integral aspects of food allergy management that can allow a person with food allergies to better tolerate their allergens and survive in an allergy unfriendly world.  As it is right now, immunotherapy is a long term treatment that decreases sensitivity to food proteins and promises to give people with food allergies a fighting chance should ingestion accidentally occur, freedom to board a plane without fear of a reaction from airborne or trace particles, freedom to touch surfaces without worry. Still, being able to tolerate up to 15 peanuts without experiencing anaphylaxis is completely different from being cured of food allergies. There is no cure for food allergies, but the research happening now is robust. Hope is on the horizon.

3) Peanuts are not the only allergen that can kill.
Actually, any allergen has the potential to trigger life-threatening anaphylaxis. It is theorized that even people who are severely allergic to grass, could experience anaphylaxis if they absorbed too much of the allergen through a scrape in the skin or consumed it.  It's not exactly the peanuts that are deadly, it's the anaphylactic reaction that's deadly and a person who is allergic can experience an anaphylactic reaction to any allergen.  My son's anaphylaxis was triggered by wheat and egg. Anaphylaxis can be triggered by foods, biting or stinging insects, medications and latex and is occasionally reported after direct exposure to radiocontrast media and after exercise.  This is why its important to take every allergy seriously and if you've ever had a serious reaction to talk to your doctor about carrying epinephrine.

4) Food Allergies and Food Intolerance are not the same.
But they should both be taken seriously for different reasons. People should treat individuals requesting accommodation with food intolerances as seriously as individuals requesting accommodation with allergy.  Even if an intolerance is not life threatening the way an IgE mediated food allergy can be, an intolerance can harm someone's health and change their behavior.  

What may seem like semantics is an important distinction because they are fundamentally different conditions causing a different chain of reactions in the body, requiring different levels of scrutiny in food labeling and preparation, different treatment approaches, and different research for cures. I understand the word "allergy" gets the point across to the average person who won't take time to learn the difference, but without that immune system reaction, it's technically not an "allergy" and it's a disservice to use the terms interchangeably.  If you believe you have a food allergy or perhaps Oral Allergy Syndrome, contact a board certified allergist for testing to confirm which foods trigger a histamine release and could progress to more serious reactions requiring epinephrine. If there is no IgE mediated response, you may have a food intolerance that might also be helped with strict avoidance of the offending food, or in some cases be alleviated by certain kinds of enzyme supplementation.

Using food allergy and food intolerance interchangeably downplays the very real effect a food intolerance actually can have on a person, and it creates confusion when trying to educate the general public on the fact that food allergy can pose a severe and immediate threat to life.  If you have a food intolerance but call it an allergy and occasionally sneak a bite of food containing your allergens because "you'll just deal with the consequences later" or "a tiny bit won't hurt much" you contribute to the misconception that food allergies do not need to be taken seriously 100% of the time and you put the lives of food allergic people at risk.

5) Labeling laws are SO important.
People with food allergies rely on honest and complete disclosure on the ingredient panel of a food label to stay safe. While there is a legal requirement to disclose the Top 8 allergens in plain English, if you've got an allergy that's not covered by the Top 8, you've got to do a lot more legwork to make sure your food is safe to eat because your allergen might not have to be disclosed in plain English.  A mislabeled food item or a label that doesn't disclose the risk of cross contamination put lives at risk. It may seem like a hassle for a company to have to keep track of every potential allergen that could come into their factory, but when someone's life hangs in the balance, it's a small price to pay.  The number of voluntary recalls that happen because of allergen contaminated food can be terrifying and as a result, families with food allergies treasure the companies that make extra efforts to label clearly for allergens, reduce the risk of cross contamination, and provide clear information when an allergic individual or parent calls for manufacturing practice information. New laws are coming into place which will make allergen labels even more detailed and make companies more liable for good manufacturing practices which is definitely a step in the right direction.

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