THERE'S ONLY ONE WAY DOWN!
There’s Only One Way to Be Sure If You Have a Severe Allergy To a Food – And It’s Scary
When it comes to severe food allergies, skin and blood tests are useful. But the definitive test is a food challenge – eating the food in a doctor’s office.
By Dr. Sanjay Gupta
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Sanjay Gupta, MD, Everyday Health:How hard is this to diagnose? A patient comes to your clinic and they say I think that I might have a severe allergic reaction. How do you sort of figure it out with the patient?
Jennifer Shih, MD, Allergy and Immunology, Emory Children’s Center:It’s actually a lot harder than we think that it is as physicians because there are a lot of symptoms that can be confusing. History is the most important thing – what were you doing close to the time that these symptoms started? And then, the other thing is we can do some testing to decide on that. We can do skin testing if we’re talking about food allergies. We can do skin testing to pollens and animal danders, molds, those types of things. And then we do blood testing as well. But neither of those tests are 100 percent, so sometimes we have do to more than one and also take into account the history. The good thing is in children, for milk, egg, soy, and wheat, we know that by age 3, 85 percent of them will grow out of that food allergy. For peanuts, it’s shown about 20 percent will grow out of it by age 5. So if they look like they may be growing out of it, we can do something called a food challenge to see if they have.
Dr. Gupta:Test them again, or challenge them?
Dr. Shih:We challenge them, yes. We do the regular testing, either skin or blood. And then, if they’re very low, we’ll actually give them the particular product in an office setting.
Dr. Gupta:That’s got to be very anxiety provoking.
Dr. Shih:It is. I had a mother yesterday who went through peanut, and she was very nervous about doing it. But she felt like if she could get through this challenge and not be allergic to peanuts any more, it would be much better for the long term.
Dr. Gupta:They talk about these disease-modifying drugs with regard to autoimmune diseases, for example, looking at the whole cascade and saying we’re going to target there. Can that be done with someone who’s known to have severe allergic reactions?
Dr. Shih:It may in the future. Currently, we can treat regular hay fever allergies, to pollens, dander, molds, things like that, with , which are allergy shots. We know that we can sort of change our immune system from an allergic type to a non-allergic type. Now for food allergies, we don’t have anything as good as that. But there are a lot of studies going on right now doing oral immunotherapy. So we give a little of whatever that protein is, let’s say peanut, and then build that up to certain levels so they can tolerate peanuts. There has been success in that realm, not to the point where you let the patient go out and eat a whole bag of peanuts, but enough so that if there’s an accidental exposure, it decreases some of that anxiety and life-threatening reaction for that accidental exposure.
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