Question 1

What Are Allergies?

Answer

Allergies are abnormal immune system reactions to things that are typically harmless to most people. Substances that cause allergic reactions, such as certain foods, dust, plant pollen, or medicines, are known as allergens. In an attempt to protect the body, the immune system produces IgE antibodies to that specific allergen. Those antibodies then cause certain cells in the body to release chemicals into the bloodstream, one of which is histamine (pronounced: his-tuh-meen).

The histamine then acts on a person's eyes, nose, throat, lungs, skin, or gastrointestinal tract and causes the symptoms of the allergic reaction. Future exposure to that same allergen will trigger this antibody response again. This means that every time you come into contact with that allergen, you'll have an allergic reaction.

Allergic reactions can be mild, like a runny nose, or they can be severe, like difficulty breathing. An asthma attack, for example, is often an allergic reaction to something that is breathed into the lungs in a person who is susceptible.

Some types of allergies produce multiple symptoms, and in rare cases, an allergic reaction can become very severe — this severe reaction is called anaphylaxis (pronounced: ah-nuh-fuh-lak-sis). Some of the signs of anaphylaxis are difficulty breathing, difficulty swallowing, swelling of the lips, tongue, and throat or other parts of the body, and dizziness or loss of consciousness. Anaphylaxis usually occurs minutes after exposure to a triggering substance, such as a peanut, but some reactions may be delayed by as long as 4 hours. Luckily, anaphylactic reactions don't occur often, and they can be treated successfully if proper medical procedures are followed.

Question 2

Why Do People Get Allergies?

Answer

The tendency to develop allergies is often hereditary, which means it can be passed down through your genes. (Thanks a lot, Mom and Dad!) However, just because a parent or sibling might have allergies, that doesn't mean you will definitely get them, too. A person usually doesn't inherit a particular allergy, just the likelihood of having allergies.

Question 3

What Are Some Things That People Are Allergic To?

Answer

Some of the most common allergens are: Foods - food allergies are most common in infants and often go away as a child gets older. Although some food allergies can be serious, many simply cause annoying symptoms like an itchy rash, a stuffy nose, and diarrhea. Most allergy specialists agree that the foods that people are most commonly allergic to are milk and other dairy products, eggs, wheat, soy, peanuts and tree nuts, and seafood. Insect Bites and Stings - the venom (poison) in insect bites and stings causes allergic reactions in many people. These allergies can be severe and may cause an anaphylactic reaction in some people. Airborne Particles - these are often called environmental allergens, and they're the most common allergens. Some examples of airborne particles that can cause allergies in people are dust mites (tiny bugs that live in house dust); mold spores; animal dander (flakes of scaly, dried skin, and dried saliva from your pets); and pollen from grass, ragweed, and trees. Medicines, Antibiotics - medications used to treat infections are the most common types of medicines that cause allergic reactions. Many other medicines, including over-the-counter medications (those you can buy without a prescription), can also cause allergic reactions. Chemicals - some cosmetics or laundry detergents can cause people to break out in an itchy rash (hives). Usually, this is because the person has a reaction to the chemicals in these products. Dyes, household cleaners, and pesticides used on lawns or plants can also cause allergic reactions in some people.

Question 4

How Do Doctors Diagnose and Treat Allergies?

Answer

If your family doctor suspects you might have an allergy, he or she might refer you to an allergist, a person who specializes in allergy treatment, for further testing. The allergy specialist will ask you questions both about your own allergy symptoms (such as how often they occur and when) and about whether any family members have allergies. The allergist will also perform tests to confirm an allergy — these will depend on the type of allergy a person has and may include a skin test or blood test. The most complete way to avoid allergic reactions is to stay away from the substances that cause them (called avoidance). Doctors can also treat some allergies using medications and shots. Avoidance:

In some cases, like food allergies, avoiding the allergen is a life-saving necessity. That's because, unlike allergies to airborne particles that can be treated with shots or medications, the only way to treat food allergies is to avoid the allergen entirely. For example, people who are allergic to peanuts should avoid not only peanuts, but also any food that might contain even tiny traces of them. Avoidance can help protect people against non-food or chemical allergens, too. In fact, for some people, eliminating exposure to an allergen is enough to prevent allergy symptoms and they don't need to take medicines or go through other allergy treatments. Here are some things that can help you avoid airborne allergens: • Keep family pets out of certain rooms, like your bedroom, and
bathe them if necessary.
• Remove carpets or rugs from your room (hard floor surfaces don't
collect dust as much as carpets do).
• Don't hang heavy drapes, and get rid of other items that allow dust
to accumulate.
• Clean frequently (if your allergy is severe, you may be able to get
someone else to do your dirty work!)
• Use special covers to seal pillows and mattresses if you're allergic
to dust mites.
• If you're allergic to pollen, keep windows closed when pollen season
is at its peak, change your clothing after being outdoors — and don't
mow lawns.
• Avoid damp areas, such as basements, if you're allergic to mold,
and keep bathrooms and other mold-prone areas clean and dry. Medications: Medications such as pills or nasal sprays are often used to treat allergies. Although medications can control the allergy symptoms (such as sneezing, headaches, or a stuffy nose), they are not a cure and can't make the tendency to have allergic reactions go away. Many effective medications are available to treat common allergies, and your doctor can help you to identify those that work for you. Another type of medication that some severely allergic people will need to have on hand is a shot of epinephrine (pronounced: eh-puh-neh-frin), a fast-acting medicine that can help offset an anaphylactic reaction. This medicine comes in an easy-to-carry container that looks like a pen. Epinephrine is available by prescription only. If you have a severe allergy and your doctor thinks you should carry it, he or she will give you instructions on how to use it.

Shots: Allergy shots are also referred to as allergen immunotherapy. By receiving injections of small amounts of an allergen, your body can gradually develop antibodies and undergo other immune system changes. These changes help block the reaction caused by the substance to which you're allergic. Immunotherapy is only recommended for specific allergies, such as allergies to things you might breathe in (like pollen or pet dander) or insect allergies. Although a lot of people find the thought of allergy shots unsettling, shots can be highly effective — and it doesn't take long to get used to them. In many cases, the longer a person receives allergy shots, the more they help the body build up antibodies that fight the allergies. Although the shots don't cure allergies, they do tend to raise a person's tolerance when exposed to the allergen, which means fewer or less severe symptoms. If you're severely allergic to bites and stings, talk to a doctor about getting venom immunotherapy (shots) from an allergist.

Question 5

Is It a Cold or Allergies?

Answer

If the spring and summer seasons leave you sneezing and wheezing, you may suffer from allergies. Colds, on the other hand, are more likely to occur at any time (though they're more common in the colder months). Although colds and allergies produce similar symptoms, colds usually last only a week or so. And although both may cause your nose and eyes to itch, colds and other viral infections may also give you a fever, aches and pains, and colored mucus. Cold symptoms often worsen as the days go on and then gradually improve, but allergies begin immediately after exposure to the offending allergen and last as long as that exposure continues. If you're not sure whether your symptoms are being caused by allergies or a cold, talk with your doctor.

Question 6

Dealing With Allergies?

Answer

So once you know you have allergies, how do you deal with them? First and foremost, try to avoid things you're allergic to! If you have a food allergy, that means avoiding foods that trigger symptoms and learning how to read food labels to make sure you're not consuming even tiny amounts of allergens. For people with environmental allergies, keeping your house clean of dust and pet dander and watching the weather for those days when pollen is high can help. Switch to perfume-free and dye-free detergents, cosmetics, and beauty products (you may see non-allergenic ingredients listed as hypoallergenic on product labels). If you're taking medication, be sure to follow the directions carefully and make sure your regular doctor is aware of anything an allergist gives you (like shots or prescriptions). If you have a severe allergy, you may want to consider wearing a medical emergency ID (such as a MedicAlert bracelet), which will explain your allergy and who to contact in case of an emergency. If you've been diagnosed with allergies, you have a lot of company. The National Institutes of Health (NIH) report that more than 50 million Americans are affected by allergic diseases. The good news is that doctors and scientists are working to better understand allergies, to improve treatment methods, and to possibly prevent allergies altogether

Question 7

What is Food Allergies?

Answer

What is a food allergy? Food allergy/ sensitivities are an immune system response to a food that the body mistakenly believes is harmful. Once the immune system decides that a particular food is harmful, it creates specific antibodies to it. The next time the individual eats that food; the immune system releases massive amounts of chemicals, including histamine, in order to protect the body. These chemicals trigger a cascade of allergic symptoms that can affect the respiratory system, gastrointestinal tract, skin, or cardiovascular system. Scientists estimate that approximately 12 million Americans suffer from true food allergies. Although an individual could be allergic to any food, such as fruits, vegetables, and meats, there are eight foods that account for 90% of all food-allergic reactions. These are: milk, egg, peanut, tree nut (walnut, cashew, etc.), fish, shellfish, soy, and wheat.
What are the common symptoms of a reaction? Symptoms range from a tingling sensation in the mouth, swelling of the tongue and the throat, difficulty breathing, hives, vomiting, abdominal cramps, diarrhea, drop in blood pressure, and loss of consciousness to death. Symptoms typically appear within minutes to two hours after the person has eaten the food to which he or she is allergic.
What is the best treatment for a food allergy reaction? Epinephrine, also called "adrenaline," is the medication of choice for controlling a severe reaction. It is available by prescription as a self-injectable device (EpiPen® or Twinject®). Strict avoidance of the allergy-causing food is the only way to avoid a reaction. Reading ingredient labels for all foods is the key to maintaining control over the allergy. If a product doesn't have a label, allergic individuals should not eat that food. If a label contains unfamiliar terms, shoppers must call the manufacturer and ask for a definition or avoid eating that food.
Is there a cure for food allergies? Currently, there are no medications that cure food allergies. Strict avoidance is the only way to prevent a reaction. Most people outgrow their food allergies, although peanuts, nuts, fish, and shellfish are often considered lifelong allergies.

Question 8

Tips for Managing a Milk Allergy

Answer

Baking

Fortunately, milk is one of the easiest ingredients to substitute in baking and cooking. It can be substituted, in equal amounts, with water or fruit juice.
(For example, substitute 1-cup milk with 1 cup water.)

Some Hidden Sources of Milk • Deli meat slices are frequently used for both meat and cheese
products.
• Some brands of canned tuna fish contain casein, a milk protein.
• Many non-dairy products contain casein (a milk derivative), listed
on the ingredient labels.
• Some meats may contain casein as a binder. Check all labels
carefully.
• Many restaurants put butter on steaks after they have been grilled
to add extra flavor. The butter is not visible after it melts. Commonly Asked Questions Is goat milk a safe alternative to cow milk?
Goat's milk protein is similar to cow's milk protein and may, therefore, cause a reaction in milk-allergic individuals. It is not a safe alternative. Can I rely on kosher symbols to determine if a product is milk-free?
The Jewish community uses a system of product markings to indicate whether a food is kosher, or in accordance with Jewish dietary rules.

There are two kosher symbols that can be of help for those with a milk allergy: a "D," or the word "dairy," on a label next to "K" or "U" (usually found near the product name) indicates presence of milk protein, and a "DE" on a label indicates the product was produced on equipment shared with dairy.

If the product contains neither meat nor dairy products it is "pareve" (parev, parve). Pareve-labeled products indicate that the products are considered milk-free according to religious specifications. Be aware that under Jewish law, a food product may be considered pareve even if it contains a very small amount of milk. Therefore, a product labeled as pareve could potentially have enough milk protein in it to cause a reaction in a milk-allergic individual.

Do these ingredients contain milk?
They do not contain milk protein and need not be restricted by someone avoiding milk: Calcium LactateLactic Acid
(however, lactic acid starter culture may contain milk) Calcium Stearoyl LactylateOleoresin Cocoa ButterSodium Lactate Cream of TartarSodium Stearoyl Lactylate

Question 9

Tips for Managing an Egg Allergy

Answer

Baking

For each egg, substitute one of the following in recipes. These substitutes work well when baking from scratch and substituting 1 to 3 eggs. • 1 tsp. baking powder, 1 T. liquid, 1 T. vinegar
• 1 tsp. yeast dissolved in 1/4 cup warm water
• 1 1/2 T. water, 1 1/2 T. oil, 1 tsp. baking powder
• 1 packet gelatin, 2 T. warm water. Do not mix until ready to use. Some Hidden Sources of Egg • Eggs have been used to create the foam or milk topping on specialty
coffee drinks and are used in some bar drinks.
• Some commercial brands of egg substitutes contain egg whites.
• Most commercially processed cooked pastas (including those used in prepared
foods such as soup) contain egg or are processed on equipment shared with
egg-containing pastas. Boxed, dry pastas are usually egg-free, but may be
processed on equipment that is also used for egg-containing products. Fresh
pasta is sometimes egg-free, too. Read the label or ask about ingredients before
eating pasta. Commonly Asked Questions Can an MMR Vaccine be given to an individual with an egg allergy?
The recommendations of the American Academy of Pediatrics (AAP) acknowledge that the MMR vaccine can be safely administered to all patients with egg allergy. The AAP recommendations have been based, in part, on overwhelming scientific evidence supporting the routine use of one-dose administration of the MMR vaccine to egg-allergic patients. This includes those patients with a history of severe, generalized anaphylactic reactions to egg. I've heard the flu vaccine contains egg, is this true?
Yes, influenza vaccines usually contain a small amount of egg protein.

Is a flu shot safe for an individual with an egg allergy?
Influenza vaccines are grown on egg embryos and may contain a small amount
of egg protein. If you or your child is allergic to eggs, speak to your doctor before receiving a flu shot.

Can someone who is allergic to eggs have a flu shot?
Scientists suggest individuals with egg allergy be given an allergy test with the vaccine. If the test results are negative, the vaccine may be given in a single dose.
If the test results are positive, individual assessment of benefits versus risk should be discussed with a doctor.

Because of a family history of allergy, I have been advised to delay the introduction of egg until my child is 2 years of age. Does this mean my child should not be given the flu shot?
Children under 23 months of age may be at higher risk for complications from influenza and are a group that typically require more hospitalizations from this sometimes fatal disease. You and your child's doctor should discuss the options. The general guideline is to follow the current CDC recommendations regarding the administration of the influenza vaccine to infants 6 to 23 months of age, unless the infant has a known clinical history of egg allergy.

Is an intranasal influenza vaccine an option for someone with an egg allergy?
The intranasal vaccine contains egg protein, and it not recommended for use in individuals with egg allergy. It is approved for use in persons ages 5 to 49 years,
but it is not approved for use in patients with asthma.

Question 10

Tips for Managing a Peanut Allergy

Answer

Some Hidden Sources of Peanuts • Artificial nuts can be peanuts that have been deflavored and reflavored with
a nut, such as pecan or walnut. Mandelonas are peanuts soaked in almond
flavoring.
• Arachis oil is peanut oil.
• African, Chinese, Indonesian, Mexican, Thai, and Vietnamese dishes often
contain peanuts or are contaminated with peanuts during the preparation process.
Additionally, foods sold in bakeries and ice cream shops are often in contact with
peanuts.
• Many brands of sunflower seeds are produced on equipment shared with peanuts. Commonly Asked Questions Can peanut allergy be outgrown?
Although once considered to be a lifelong allergy, recent studies indicate that up to 20 percent of children diagnosed with peanut allergy outgrow it. Can alternative nut butters (i.e., cashew nut butter) be substituted for peanut butter?
Many nut butters are produced on equipment used to process peanut butter, therefore making it somewhat of a risky alternative. Additionally, most experts recommend peanut-allergic patients avoid tree nuts as well. Keep in Mind • Studies show that most allergic individuals can safely eat peanut oil
(not cold pressed, expelled, or extruded peanut oil - sometimes represented
as gourmet oils). If you are allergic to peanuts, ask your doctor whether or
not you should avoid peanut oil.
• Most experts recommend peanut-allergic patients avoid tree nuts as an
extra precaution.
• Peanuts can be found in many foods and candies, especially chocolate candy.
Check all labels carefully. Contact the manufacturer if you have questions.
• Peanuts can cause severe allergic reactions. If prescribed, carry epinephrine
at all times.

Question 11

Tips for Managing a Tree Nut Allergy

Answer

Some Hidden Sources of Tree Nuts • Artificial nuts can be peanuts that have been deflavored and reflavored with
a nut, such as pecan or walnut. Mandelonas are peanuts soaked in almond
flavoring.
• Mortadella may contain pistachios.
• Tree nuts have been used in many foods, including barbecue sauce,
cereals, crackers, and ice cream.
• Kick sacks, or hacky sacks, bean bags, and draftdodgers are sometimes
filled with crushed nut shells. Commonly Asked Questions Should coconut be avoided by someone with a tree nut allergy?
Discuss this with your doctor. Coconut, the seed of a drupaceous fruit, has typically not been restricted in the diets of people with tree nut allergy. However, in October of 2006, the FDA began identifying coconut as a tree nut. The available medical literature contains documentation of perhaps six cases of allergic reaction to coconut; none occur in people with allergy to other tree nuts. Ask your doctor if you need to avoid coconut.

Is nutmeg safe?
Nutmeg is obtained from the seeds of the tropical tree species Myristica fragrans. It is safe for an individual with a tree nut allergy.

Should water chestnuts be avoided?
The water chestnut is not a nut; it is an edible portion of a plant root known as a "corm." It is safe for someone who is allergic to tree nuts. Keep in Mind • Tree nuts can cause severe allergic reactions. If your doctor has prescribed
epinephrine, be sure to always carry it with you.
• Most experts advise tree nut-allergic patients to avoid peanuts as well.
• Most experts advise patients who have been diagnosed with an allergy to
specific tree nuts to avoid all tree nuts.

Question 12

Tips for Managing a Fish and/or Shellfish Allergy

Answer

Allergic reactions to fish and shellfish are commonly reported in both adults and children. It is generally recommended that individuals who have had an allergic reaction to one species of fish, or positive skin tests to fish, avoid all fish. The same rule applies to shellfish. If you have a fish allergy but would like to have fish in your diet, speak with your allergist about the possibility of being tested with various types of fish.

Some Hidden Sources of Fish • Caponata, a traditional sweet-and-sour Sicilian relish, can
contain anchovies.
• Caesar salad dressings and steak or Worcestershire sauce
often contain anchovies.
• Surimi (imitation crabmeat) contains fish. Commonly Asked Questions Should carrageenan be avoided by a fish- or shellfish-allergic individual?
Carrageenan is not fish. Carrageenan, or "Irish moss," is a red marine algae. This food product is used in a wide variety of foods, particularly dairy foods, as an emulsifier, stabilizer, and thickener. It appears safe for most individuals with food allergies. Carrageenan is not related to fish or shellfish and does not need to be avoided by those with food allergies. Should iodine be avoided by a fish- or shellfish-allergic individual?
Allergy to iodine, allergy to radiocontrast material (used in some lab procedures), and allergy to fish or shellfish are not related. If you have an allergy to fish or shellfish, you do not need to worry about cross reactions with radiocontrast material or iodine. Keep in Mind • Fish-allergic individuals should avoid fish and seafood restaurants because
of the risk of contamination in the food-preparation area of their "non-fish"
meal from a counter, spatula, cooking oil, fryer, or grill exposed to fish.
• Fish protein can become airborne during cooking and cause an allergic reaction.
• Some individuals have had reactions from walking through a fish market.
• Allergic reactions to fish and shellfish can be severe and are often a cause
of anaphylaxis.

Question 13

Tips for Managing a Soy Allergy

Answer

Soybeans have become a major part of processed food products in the United States. Avoiding products made with soybeans can be difficult. Soybeans alone are not a major food in the diet but, because they're in so many products, eliminating all those foods can result in an unbalanced diet. Consult with a dietitian to help you plan for proper nutrition. Keep in Mind • Soybeans and soy products are found in baked goods, canned tuna, cereals, crackers, infant formulas, sauces, and soups.
• At least one brand of peanut butter lists soy on the label.
• Studies show that most soy-allergic individuals may safely eat soybean oil (not cold pressed, expeller pressed, or extruded oil). If you are allergic to soy, ask your doctor whether or not you should avoid soy oil. Soy-Free Recipe Stir-Fried Orange Beef
1 tsp. cornstarch
1 cup orange juice
1 to 1 1/2 lbs. trimmed beef, thinly sliced
1 to 2 T. of oil
1/4 to 1/2 tsp. crushed red pepper flakes
1 clove minced garlic
1 T. grated fresh gingerroot
1/4 cup green onion, thinly sliced
1/4 cup bell pepper, thinly sliced

In small bowl, combine cornstarch and orange juice. Set aside. In wok, add beef, oil, and red pepper flakes. Stir-fry over high heat until beef is browned. Remove beef with slotted spoon. Set aside. Add garlic, gingerroot, onion, and bell pepper to oil remaining in the wok. Stir-fry 2 minutes. Add cornstarch/orange juice mixture. Simmer until thickened. Add beef and toss with sauce. Can be served over noodles or rice.

Question 14

Tips for Managing a Wheat Allergy?

Answer

Baking
When baking with wheat-free flours, a combination of flours usually works best. Experiment with different blends to find one that will give you the texture you are trying to achieve.

Try substituting 1 cup wheat flour with one of the following: • 7/8 cup rice flour
• 5/8 cup potato starch flour
• 1 cup soy flour plus 1/4 cup potato starch flour
• 1 cup corn flour Commonly Asked Questions
What is the difference between celiac disease and wheat allergy?
Celiac disease and wheat allergy are two distinct conditions. Celiac disease, or "celiac sprue," is a permanent adverse reaction to gluten. Those with celiac disease will not lose their sensitivity to this substance. This disease requires a lifelong restriction of gluten. The major grains that contain gluten are wheat, rye, oats, and barley. These grains and their by-products must be strictly avoided by people with celiac disease.
Wheat-allergic people have an IgE-mediated response to wheat protein. These individuals must only avoid wheat. Most wheat-allergic children outgrow the allergy. Are kamut and spelt safe alternatives to wheat?
No. Kamut is a cereal grain, which is related to wheat. Spelt is ancient wheat that has recently been marketed as safe for wheat-allergic individuals. This claim is untrue, however. Wheat-allergic patients can react as readily to spelt as they do to common wheat. Keep in Mind

• Read labels carefully. At least one brand of hot dogs and one brand of
ice cream contain wheat. It is listed on the label.
• Many country-style wreaths are decorated with wheat products.
• Some types of imitation crabmeat contain wheat.
• Wheat flour is sometimes flavored and shaped to look like beef, pork,
and shrimp, especially in Asian dishes.

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Frequently Asked Questions About Food Allergies