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Food Allergy Basics

The prevalence of food allergies is rising, which means there is an increasing number of families living with fear and anxiety. The burden of food allergies can involve attempts to strictly control your environment, buying special foods, and limiting social encounters. At LAFAI, we aim to ease those fears by placing food allergy education at our forefront. From diagnostic testing and thorough evaluations to individualized treatment plans, we help patients and their families achieve a comprehensive understanding of their food allergies every step of the way. As new developments in the field of food allergy are emerging rapidly, we will continue to support our patients and keep them informed about potential new treatment options.

What Are Food Allergies?

When you have a food allergy, your immune system mistakenly identifies a protein in that food to be an intruder and takes action to fight against it. This overreaction by the immune system ultimately leads to an allergic reaction. The immune response in food allergies can be IgE-mediated, non-IgE-mediated, or mixed IgE- and non-IgE-mediated. Food allergies are usually first diagnosed in young children, and they may be outgrown, however; they may also develop in older children and adults. The foods responsible for the majority of allergic reactions include:

Non-IgE-Mediated Food Allergies

Non-IgE-mediated reactions involve other components of the immune system, including white blood cells called T cells. Symptoms in this type of food allergy are typically delayed, occurring 4 to 48 hours after ingesting the trigger food. They are associated with rare conditions such as food protein-induced enterocolitis syndrome (FPIES), food protein-induced allergic proctocolitis (FPIAP), and food protein-induced enteropathy (FPE). Non-IgE-mediated reactions primarily affect the gastrointestinal tract, causing the symptoms of vomiting, bloating, and diarrhea.

Cow's milk
Egg
Fish
Peanut

Shellfish
Soy
Tree Nut
Wheat

IgE-Mediated Food Allergies

Food allergies typically occur through an IgE-mediated pathway in which the immune system produces antibodies called Immunoglobulin E (IgE) upon detection of the food allergen. These antibodies travel to cells that release chemicals, causing an allergic reaction. Symptoms in IgE- mediated reactions are immediate, occurring within seconds to 2 hours after consuming the trigger food, and commonly include:

Hives (itchy, red rash)
Angioedema or swelling
Abdominal pain, vomiting, or diarrhea
Throat tightness or wheezing

This type of reaction can be potentially life-threatening, leading to anaphylaxis.

Mixed IgE- and Non-IgE-Mediated Food Allergies

Mixed food allergy reactions involve both IgE-mediated and non-IgE- mediated immune pathways. Symptoms in this type of food allergy are also delayed, occurring 4 to 48 hours after ingesting the trigger food. They are associated with conditions such as food allergy-related atopic dermatitis (eczema), eosinophilic esophagitis (EoE), eosinophilic gastritis (EG), and eosinophilic gastroenteritis (EGE). Food allergy-related atopic dermatitis commonly presents as dry, itchy, red rashes that are worsened by exposure to the food allergen. EoE, EG, and EGE are eosinophilic gastrointestinal disorders (EGIDs) that commonly involve symptoms of decreased appetite, abdominal pain, diarrhea, difficulty swallowing, food getting stuck in the esophagus, and vomiting.

Common Food Allergy Misconceptions

Slide 1

Misconception:

Food allergies are not life-threatening․

Reality:

Reactions due to food allergies can range from mild to severe․ Symptoms can range from nasal congestion, itching, and hives to difficulty breathing, vomiting, and loss of consciousness. When an allergic reaction is severe and affects multiple body systems, it becomes anaphylaxis and is potentially life-threatening. It is important for individuals with food allergies to be attentive to the foods they are consuming, knowledgeable about the signs of a reaction, and prepared to use an epinephrine auto-injector.

Slide 2

Misconception:

Nothing will happen if you eat a small amount of the food you are allergic to.

Reality:

There are different levels of how allergic a person can be to different types of food. At times, small amount or traces of the food or cross-contamination can lead to a severe allergic reaction. It is important to be evaluated by a provider so the proper guidance can be given.

Slide 3

Misconception:

You do not need an epinephrine auto-injector if you have only had mild
reactions to foods.

Reality:

Food allergy reactions are unpredictable. You may have had only mild
reactions in the past, but you may have severe reactions in the future. This is why patients with food allergies must carry an epinephrine auto-injector and be prepared to use it at all times.

Slide 4

Misconception:

Food additives and artificial flavors are the main culprits in food allergies.

Reality:

Natural foods cause the majority of allergic reactions. The foods
responsible for 90% of all food allergies are cow’s milk, eggs, peanuts, fish, shellfish, tree nuts (e.g., almonds, cashews, and pecans), wheat, and soy.

Slide 5

Misconception:

You develop food allergies during childhood, and they are lifelong.

Reality:

You can develop a food allergy at any age, even to a food that you have
tolerated eating in the past. Children can outgrow food allergies to milk, egg, soy, and wheat over time. Without treatment, allergies to peanut, tree nuts, fish, and shellfish are usually lifelong allergies.

Slide 6

Misconception:

There is no treatment for food allergies.

Reality:

At LAFAI, we offer oral immunotherapy (OIT) as a long-term solution for
food allergies where avoidance is no longer the only answer. OIT is a form of food allergy treatment that involves feeding an allergic individual with gradually increasing amounts of the target food allergen(s) over several months. This therapy aims to raise the individual’s threshold that may trigger a reaction and provide them with protection against accidental ingestion of the allergen. This level of protection will improve the quality of life for both patients and their families by reducing the fear related to the threat of accidental ingestion and life-threatening reactions.

Slide 7

Misconception:

Each time you have an allergic reaction to a food, the reaction becomes
more severe.

Reality:

You cannot predict the severity of your allergic reactions to foods. Your
reactions do not follow a pattern: they may be mild at times, and they may be severe at times. This is why patients with food allergies must carry an epinephrine auto-injector and be prepared to use it at all times.

Slide 8

Misconception:

Food allergies are the same as food intolerances.

Reality:

A food intolerance, or food sensitivity, is often confused with or mislabeled
as a food allergy. Food intolerance responses take place in the digestive
system when a person has difficulty breaking down a particular food. This leads to symptoms such as abdominal pain, bloating, or diarrhea. Food allergic reactions involve the immune system in which it mistakenly identifies a protein in that food to be an intruder and overreacts by producing antibodies and other components to fight against it. This ultimately causes an allergic reaction, which commonly includes symptoms of hives, itching, or swelling. While eating a food you are intolerant to may cause extreme discomfort, eating a food you are allergic to can lead to a life-threatening reaction called anaphylaxis.

Slide 9

Misconception:

You had positive results on your skin and/or blood test, so you have a food allergy.

Reality:

Skin prick and blood tests can produce “false positive” results at times. "False positive" means that the test shows positive results even though you are not allergic to the tested food. This can occur due to cross-reactivity, where the immune system mistakes closely related proteins. For example, if you are allergic to birch tree pollen, your skin prick test may show a positive result for apples because of their similar proteins, though, you may not be truly allergic to apples. As your experts in food allergy, we can effectively interpret the results and provide comprehensive insight into your allergies.

What to expect at your visit

As a clinic rooted in the newest innovations for food allergies and immunotherapy, we go beyond the exhaustive list of therapies that don’t work and only consider groundbreaking solutions that fit our patients unique needs. We accept all major insurance plans, but due to the unique nature of our services, some may not be fully covered under insurance. Please contact our office directly to learn more!

3 / Creating a Plan

We understand how limiting a food allergy can be to the life of your child and family. As a team, we will actively work together to determine the best course of care including treatment options, scheduling follow-up appointments, and working with your schedule to accommodate smooth continuity of care. We want to make sure we are as readily available as possible to answer questions, ease your concerns, and give you back the confidence you need in your daily health.

Educational
Resources

American Academy of Allergy, Asthma, and Immunology (AAAAI)
Food Allergy Research & Education (FARE)

Phone Number:

Fax Number:

Email Address

Address

Phone Number:

Fax Number:

Email Address

Address

What Are Food Allergies?

Non-IgE-Mediated Food Allergies

IgE-Mediated Food Allergies

Mixed IgE- and Non-IgE-Mediated Food Allergies

1 / Initial Consultation

2 / Testing

3 / Creating a Plan