Daily precautions for food allergy sufferers

Accurately avoid known allergens, carry emergency medicine with you, and regularly review immune tolerance. All the remaining details are centered around these three points, without so many bells and whistles.

The first patient I treated in the allergy department was a little girl who had just entered junior high school and was severely allergic to peanuts. That day, her mother brought her a piece of whole-wheat bread bought in the supermarket. There was a very small line on the corner of the package that read "Peanut products are processed in the production workshop at the same time." She didn't pay attention and started to gasp after taking two mouthfuls. When the bread was delivered, her throat was already swollen. It took a long time to recover. In fact, many people’s understanding of “avoiding allergens” is “just don’t eat the things I’m allergic to”, which is far from that simple. The current domestic prepackaged food standards require clear labeling of 8 common allergens: peanuts, nuts, fish, crustaceans, eggs, milk, soybeans, and wheat. If the thing you are allergic to is not in these 8 categories, don’t bother, be sure to ask the manufacturer, or simply don’t touch it. When going out to eat, you should save your dignity. Don't think, "I'll just mention it in an understatement." It's better to state the severity directly. For example, "I am severely allergic to cashew nuts. I will go into shock if I touch a little bit. Please confirm that there are no cashew nuts in all the ingredients, including seasonings, and the cutting board has not cut cashew nuts." If something goes wrong, it is you who will be blamed. No one will think that you have too much trouble.

Oh, by the way, many people now ask, “Can I slowly eat small amounts of allergens to develop tolerance? ”In fact, there are always different views on this matter in the industry, and there is no standard answer. The European Academy of Allergy and Clinical Immunology (EAACI) has been promoting oral immunotherapy in recent years. Under the strict supervision of doctors, you start with very small amounts of allergens and slowly increase the amount. It takes 1-3 years to establish immune tolerance. I have a little patient who is allergic to milk. After 14 months of treatment, he can now drink 200ml of pure milk normally. Before, he could not even touch cookies containing milk. However, the guidelines of the American Academy of Allergy, Asthma, and Immunology (AAAAI) are conservative, and patients with a history of anaphylactic shock are especially not recommended to try this type of treatment. After all, everyone’s immune status fluctuates too much. Even if you have tolerated the amount before, it may induce severe reactions if you encounter a cold, stay up late, or are stressed. Which plan to choose depends entirely on the individual's specific situation and needs. The premise must be to seek evaluation from the allergology department of a regular hospital. Don't try it blindly at home. I have actually seen myself try eating peanuts at home and being admitted to the ICU after eating 1/4 of a pill.

Don’t think, “I usually only get a rash when I’m allergic, so I don’t need to bring emergency medicine.” The degree of allergic reaction may be different every time. Last time it was a rash, next time it may be shock. When severe allergies occur, oral anti-allergic drugs such as loratadine take effect too slowly, and epinephrine pens are the only life-saving medicine. Many people feel that it hurts, or they are afraid that others will find it strange when they see it. When you can't breathe, you will know that the pain is nothing at all. By the way, don’t hesitate when pricking. You don’t need to take off your pants, just prick the outside of your thigh through your outer pants. After pricking, hold it for 10 seconds. Regardless of whether the symptoms are relieved or not, you must go to the hospital for observation for at least 4 hours. About 20% of severe allergies will have a biphasic reaction, which means that the symptoms will suddenly relapse a few hours after the symptoms disappear. Don’t take it lightly.

There is another piece of trivia that many people don’t know: cross-allergy. For example, people who are allergic to wormwood every autumn will most likely have itchy and swollen mouths after eating peaches, mangos, and lychees. This is called pollen-food cross-reaction. It’s not that you suddenly have an additional allergen. It’s that the protein structure of these fruits is similar to that of wormwood, and the immune system gets confused. There are also people who are allergic to latex. Eating bananas, kiwis, and avocados can also easily trigger reactions. Knowing these points in advance can save you a lot of pitfalls. Oh, yes, don’t just focus on what you eat. Food ingredients are also hidden in many medicines and daily necessities: honey may be added to cough syrup, nut oil may be included in lip balm, and even flu vaccines may contain egg white residues. People who are allergic to eggs must tell their doctor before taking the vaccine.

Many people think that allergies are a lifelong thing, but this is not necessarily the case. Especially for children who are allergic to milk, eggs, and wheat, about 70% of them will tolerate it on their own by the time they reach school age. The most exaggerated parent I have ever seen is to avoid eggs for their children until they are 9 years old. When they came for a review, the specific IgE was already so low that it was almost undetectable. There was no problem at all after a food challenge test. So many years of egg custard and birthday cakes were missed. What a pity. Even if it is an adult with allergies, it is best to recheck once every 1-2 years. Maybe one day the immune system will "think of it" and you will no longer need to avoid foods. Of course, if the reexamination results still indicate a high risk, then the taboos should still be tabooed.

It's not that complicated to say the least. The worst thing is luck. I've seen too many people say, "I was fine last time I took one bite." That one bite almost cost them their lives. My friend who is allergic to mango now asks if the ingredients contain mango wherever he goes. He carries allergy medicine and epinephrine pens with him. Last year he even went to Southeast Asia and squatted on the roadside eating seafood every day. He lived a better life than anyone else. To put it bluntly, allergies mean that your immune system just accepts it as a dead end and you just follow it without delaying anything.