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Living with food allergies: How to manage and thrive

Food allergies are a prevalent concern among individuals of all ages in the United States, affecting approximately 4 percent of adults and 5 percent of children. As an allergist, I've seen firsthand the challenges that individuals with food allergies face on a daily basis. Food allergies can be serious and, at times, dangerous and life-threatening. It can be difficult to navigate the world of food when you're allergic to certain ingredients or specific types of foods. However, with the right information and strategies in place, it is possible to manage your allergies and live a healthy and fulfilling life. In this article, I'll share practical tips I give my patients living with food allergies. Whether you're newly diagnosed or have been living with allergies for years, these tips will help you stay safe and healthy while enjoying the foods you love.

7 Safety Tips for Living with Food Allergies

1. The Top Nine Food Allergens:

Despite the prevalent focus on peanuts in food allergy discussions, the U.S. Food & Drug Administration (FDA) mandates that food manufacturers list the following "top nine" allergens in clear language on food packages:

  • Cow’s Milk

  • Eggs

  • Fish

  • Shellfish

  • Tree nuts

  • Wheat (gluten)

  • Peanuts

  • Soybean

  • Sesame

Distinguishing between food allergies and food intolerance is crucial, as while food intolerance may result in symptoms such as nausea, heartburn, or stomach discomfort, it does not involve anaphylactic reactions.

2. Recognize your symptoms

For individuals with food allergies, it is imperative to recognize the symptoms of an allergic reaction, specifically anaphylaxis, as early detection can save lives. The effects of a food-induced allergic reaction on the body may manifest in various ways, including:

  • Skin: itching, redness, hives, swelling, rash, or red bumps

  • Eyes: itching, tears, redness, or swelling around the eyes

  • Upper respiratory system: sneezing, runny nose, nasal congestion, hoarseness, dry cough, or itching

  • Lower respiratory system: chest tightness, wheezing, coughing, or shortness of breath

  • Mouth: swelling of the tongue, palate, or lips, or itching

  • Gastrointestinal: nausea, vomiting, abdominal pain, diarrhea, bloody stools, or reflux

  • Cardiovascular: rapid or slow heartbeat, fainting, dizziness, low blood pressure, or loss of consciousness

  • Other: uterine contractions or a sense of impending doom

3. When eating at a restaurant, always inform your server or chef of your allergy

It is crucial to inform your server, manager, or chef at any restaurant where you dine of any food allergies that you have. Hidden ingredients can be present in unsuspecting menu items, including those that contain your allergen. Be clear in communicating your allergies and any necessary modifications to a dish, and do not hesitate to be assertive. It is also advisable to exercise caution when dining at certain cuisines, as some may frequently use ingredients that you are allergic to. If you find yourself in a situation where your server does not acknowledge your allergies or if you feel uneasy about eating at a particular restaurant, it is advisable to leave. Your safety is of paramount importance, and you should not take risks when it comes to food allergies.

4. Learn how to use an auto-injector

Anaphylaxis can be treated with epinephrine, so it's important to know how to use an auto-injector. Epinephrine is most effective when injected within minutes of an allergic reaction and can quickly treat throat swelling, impaired breathing, and low blood pressure.

To ensure there are no delays in receiving epinephrine, it's essential that you and those around you learn how to use an epinephrine auto-injector. Carry the auto-injector with you at all times, make sure it's easily accessible, and review the instructions with a family member each time you receive a refill.

Administer the epinephrine immediately if you experience symptoms such as difficulty breathing, tight throat, or vomiting. After using the auto-injector, call 911 and inform the dispatcher that epinephrine has been used. Wear a medical band or carry an anaphylaxis wallet card containing your allergy information and emergency contact.

5. Make sure you read the labels on cosmetics, sunscreens, hair products, etc.

It is important to always carefully review the labels on cosmetic, hair, and skincare products, as well as sunscreens, to ensure that they do not contain any allergens. Surprisingly, some of these products can contain peanut and tree nut oils that are listed under various names, such as "arachis hypogaea" for peanut oil. Some of the most common ingredients in these products include peanut, almond, shea, coconut, and argan oils. In addition, some lotions and shampoos may contain hydrolyzed wheat protein and dairy products. To avoid allergic reactions, it is essential to research and be aware of hidden allergens in products that may not seem obvious.

Peanuts and tree nuts can also be found in unexpected places, such as stuffed animals, cat litter, mulch, pet food/treats, bleach, detergents, metal polish, birdseed, certain medicines, and more. Additionally, some types of eczema creams, ear drops, and multivitamins may even contain peanut oil. Since cosmetic products do not have the same labeling standards as food products, it may be a good idea to test new cosmetic products on your arm after receiving approval from your allergist. This will help to reduce the risk of a severe reaction and allow you to monitor any potential allergic responses before applying the product on your face or other sensitive areas.

6. Spread the word

It is crucial to inform the individuals who you interact with regularly, such as co-workers, teachers, babysitters, friends' parents, and classmates, about your food allergies. Ensure they know the specific foods to avoid and what actions to take in case of an allergic reaction. By taking this precautionary measure, you safeguard yourself and educate those in your social circle about the appropriate measures to take around anyone in the food allergy community.

7. Always carry your medication

Be sure to always carry your prescribed emergency medication, such as EpiPen or TwinJet, ideally in two doses to ensure you are prepared in the event of an allergic reaction. In addition, some individuals with food allergies also carry antihistamines. It's important always to have your medication with you and not to leave home without it.

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