October 2014

The diagnosis of Food Allergies, and Peanut Allergy in particular, is not always straightforward. Food allergies are often missed in children with severe eczema. This is unfortunate, since simple diet controls often lead to significant improvement to this terrible condition. For patients who are at risk for anaphylaxis, the most severe form of food allergy, this could be life-threatening. Even trace quantities of allergenic foods can provoke severe, sometimes fatal, reactions.

A more common problem, however, is the inappropriate diagnosis of food allergy. Food allergies are often attributed to a number of disorders, including headaches, chronic fatigue syndrome, and various gastrointestinal disorders. These “allergies” are often “confirmed” by a variety of unproven tests, the most common of which is IgG to foods.

Unfortunately, these tests have never been demonstrated to relate to any particular disease, and more often than not they lead to unnecessary restrictions in diet. They are not usually covered by insurance, leading to significant cost to the patient.

For our patients who have already been subjected to these tests, our practice is to try to confirm food allergies through more appropriate testing. If our tests are negative, we are usually able to reintroduce the foods into the patient’s diet.

A careful food history is key
When considering a food allergy, we first take a careful history to determine whether the symptoms in question are typically related to a type of known food allergy. We then look at previous tests, so that we do not duplicate work already done. If we think that the patient has a food allergy, we then choose the safest test to evaluate the food allergy.

For most foods, the Skin Prick Test is fast, safe, and highly accurate. For some foods, in particular peanuts and tree nuts, the Skin Prick Test may cause a severe reaction in the patient. For those foods we often start with a blood test to the IgE antibody to peanut.

If we think that a patient is not allergic based on history and testing, we give the food to the patient in a controlled manner in our Allergy & Asthma Specialists office to confirm that they can tolerate the food. This test, called an Oral Challenge, should only be performed by a trained Allergist who is experienced in treating severe reactions to foods.

Food Allergy and Peanut Allergy causes
A small number of foods are responsible for most food allergies. In children, cow’s milk, egg, wheat, soy, and peanut are the biggest offenders. Children usually outgrow cow’s milk, wheat, and egg allergy. While it is less common to outgrow peanut allergy, it does occur in 20% of cases.

It is important to continue to follow-up with your Allergist to determine if the food allergies have resolved. There is also a lot of exciting research on desensitizing peanut allergy in children. While more research is required, this may become available in the next few years.

If you live in Virginia Beach, Norfolk, Chesapeake, Portsmouth, and Hampton Roads, and may be suffering from food allergies or a peanut allergy, please call us at any of our 3 locations listed below. Our Allergists are here to help you.

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About Allergy & Asthma Specialists
Our Allergists specialize in diagnosing and treating food allergy and peanut allergy health problems for patients in Virginia Beach, Norfolk, Chesapeake, Portsmouth, and Hampton Roads.