Photo Credit: ShutterstockDr. Tina Abraham is a board-certified adult and pediatric allergist and immunologist who completed her fellowship at University Hospitals Cleveland Medical Center in July 2018. She was chief of her allergy immunology fellowship in Cleveland with numerous publications and research experience. Dr. Abraham completed her internal medicine residency and was an internal medicine chief resident as well at McLaren Oakland Hospital in Pontiac, Michigan. She completed her medical school training at Michigan State University and undergraduate training at Wayne State University where she received her bachelor of science degree. Through close collaboration and communication, Dr. Abraham’s patients are empowered to make better healthcare decisions as we together formulate an individualized evidence-based treatment plan which takes into account the specific needs of each patient.

Haute Beauty catches up with Michigan-based Dr. Tina Abraham, to learn about food allergies, their reactions, and how to tell when it’s time to consult the professionals.

HB: What are the most common food allergies?

It is true that any food can cause a reaction, but the most common eight foods which account for the majority of food allergies are: eggs, milk, wheat, soy, peanuts, tree nuts, fish and shellfish.

The top foods causing allergic reactions in kids are:

Eggs, milk, and peanuts. While there are no definitives in medicine, children may actually outgrow their egg and milk allergies while those to peanuts and tree nuts tend to be lifelong.

In adults, the most common foods causing allergic reactions are:

Peanuts/tree nuts, and fish/shellfish. Fruit and vegetable pollen can cause a reaction called oral allergy syndrome where the reactions are a result of a cross-reaction of environmental allergens with the offending fruit or vegetable, this type of reaction rarely progresses to anaphylaxis.

HB: What kind of symptoms should people be on the lookout for?

So what do food allergies even look like? Millions of Americans have food allergies. When you are allergic to something, your body is overreacting to a presumptive foreign invader, and your body is trying to do everything it can to get rid of it. Allergic reactions may manifest in different body systems. It can involve the skin, respiratory system, gastrointestinal system and cardiovascular system. Specifically, it is anticipated that the reaction will occur immediately upon exposure to the offending food in the form of itching, hives, itchy runny watery eyes, runny stuffy nose, lip swelling, tongue swelling, throat tightness, hoarseness, coughing, chest tightness, wheezing, shortness of breath, immediate projective vomiting, diarrhea, dizziness, and cardiovascular collapse/shock. Anaphylaxis is a life-threatening reaction that is manifested when two or more of the above-mentioned body systems are involved, for example, hives and immediate vomiting.

HB: How to differentiate between food allergies and sensitivities?

Food allergies follow a true allergic mechanism through “allergic antibodies” in your body called IgE. With true allergies, the protein of the allergen binds to IgE which then binds to other cells in your body causing the release of histamine. Histamine then causes a constellation of symptoms such as hives, itching of the skin, itchy runny watery eyes, nasal congestion or runny nose, lip swelling, tongue swelling, airway compromise, immediate vomiting, diarrhea, and/ or cardiovascular collapse. When 2 or more of these symptoms are involved, this is consistent with anaphylaxis. Sensitivities to foods would not follow this pathway leading to the above-mentioned symptoms.

Photo Credit: Shutterstock

HB: When you should seek help from a professional if you suspect you have a food allergy? What solutions or treatments are available and how do they work?

If you have a suspected food allergy, you should have a consultation with a board-certified allergist/immunologist to make a proper diagnosis. The process at this consultation includes a detailed history in regards to your symptoms and overall health. Based on this, your allergist may recommend skin testing and/or blood testing which is specific to the food in question and whether or not the food-specific antibody, IgE is present in your body. The skin testing is rather quick, and while it is not painful, it can be uncomfortable as the skin is pricked with a small probe that has a minute amount of liquid on it which is composed of the food allergen in question. Within 15 minutes, the testing can be complete and your allergist will measure the positive findings which would show up as a raised bump, or hive in the area of pricking.

It is important to remember that negative results from skin prick testing help to rule out an allergy. But a positive test does not necessarily mean an allergy is present, this can simply mean an irrelevant sensitization to the food being tested. This fact alone makes it imperative to be appropriately tested by a board-certified allergist. After testing, your allergist may recommend an oral food challenge. This challenge is considered the gold standard for truly ruling in, or ruling out a food allergy. This procedure should be done under strict direct medical supervision with emergency treatments on hand as the process involves feeding tiny amounts of the suspected food in incremental doses over a period of time and a long observation period to see if any reaction actually happens.

The only definitive way to manage a true food allergy is strict avoidance of the specific food. There have been many medical advancements that have introduced therapies to possibly reduce the risk of food allergic reactions. An example of this a new medication called Palforzia for peanut allergy. This was approved by the FDA in early 2020 for children between the ages of 4-17. It works on the immune system by exposing the patient to very small amounts of peanut protein in increasing amounts over time. While this does not cure the peanut allergy, it can try to help reduce the severity of the reaction. Many new medical advancements are on the horizon, therefore visit your friendly board-certified allergist for a consultation and discussion about treatment plans that could be right for you.