**Updated February 2019**
False food allergy beliefs are extremely common. The word allergy refers to a specific reaction of the immune system. and medical treatments are directed toward blocking this reaction. False food allergy beliefs or myths drive many people to over treat and aggressively manage symptoms. This over-treatment occurs out of fear that a progressive food allergy reaction may happen.
Food intolerances may mimic food allergies. Many people spend excessive amounts of time eliminating foods and taking supplements and medications to avoid worsening symptoms. False food allergy beliefs place a heavy burden on families and significantly impact social interactions.
A food intolerance occurs when a food, drink or additive is eaten and a reaction happens. Symptoms are usually related to digestive symptoms; however, other reactions are possible. Food intolerances do not progress to urgent life-threatening reactions, but they can have chronic or intermittent symptoms.
A true food allergy may occur when food is eaten, touched or even inhaled. The food then triggers the immune system to mount a reaction which can affect many organs in the body; consequently, severe or life-threatening reactions may occur. These are the food reactions most people fear. Allergy is a true disease.
Food allergies are extremely common with 1 in 13 children showing some degree of food allergy. I plan to discuss different aspects of allergic disease in future posts; however, it is important to fully understand the difference between a true allergy and an intolerance.
The most severe forms of food allergies show obvious immediate symptoms, and no doubt exists about the presence of an allergy. Mild to moderate food allergies, where reactions are are not clearly known to be caused by that food, remain more difficult to diagnose. An allergy specialist should be consulted because recurrent symptoms are occurring but they may only show up when the food is eaten in different forms.
An example I see in my office includes a tomato allergy. Some kids cannot eat raw tomatoes or their tongues will swell and facial rashes and itching occur. These same kids can sometimes eat modified tomatoes, as in ketchup or spaghetti sauce; however, if too much of the food is eaten, the symptoms recur.
Because many true food allergies show mild to moderate symptoms, parents may feed children these foods in moderation. Ask your child’s physician the severity of the allergy reaction to best determine the appropriate treatment plan.
The best approaches to diagnosing food allergies include a combination of obtaining a history, performing an exam, ordering allergy blood and/or skin testing, and eliminating foods from the diet. Many people do not need all of these steps because an accurate history is incredibly reliabl. Check out a post that highlights the different methods to determine if you have allergies but also remember why it is important for you to know the history and symptoms to accurately report to your physician.
For many years, physicians have believed it to be necessary to avoid foods that have a high chance of causing severe allergic reactions. However, new information about introducing infants to peanuts early in life has provided significant hope for severe food allergy reduction in the future.
The most important fact that parents need to know is that all food allergies are not the same. Because of the well-known severe allergic reactions, many parents believe several false statements about allergies. Every day in my practice, I spend time explaining the reasons that these common beliefs are false.
4 false food allergy beliefs
1. Food allergies can always be determined by history
A complete history remains the best method to assess allergies. I am a Pediatric Ear Nose Throat (ENT) and Allergy specialist and find that children often provide incomplete symptom history. We must rely on what parents notice.
My own daughter had obvious nasal allergies and asthma. When her symptoms became difficult to control, she underwent allergy skin testing. Not only did I find her severe pollen allergies, but I found unsuspected severe food allergies!
When questioned directly, she admitted that some foods made her mouth itch and caused her gums to swell; however, she kept eating the foods because she liked them. In addition, eating some foods caused her to develop an itchy facial rash. I am not at all sure why she kept eating these foods!
While some kids report the foods that bother them, others simply are labeled ‘picky eaters’ because they cannot explain how the foods make them feel. Of course, there are many others, like my child, who never complain or stop eating the foods despite clear symptoms.
2. I cannot eat foods that I am allergic to
Many people carry a diagnosis of food allergies but eat offending foods with no obvious symptoms. Allergists routinely report that these foods cannot then be true allergies. Because allergies trigger an immune response every single time the allergen is exposed to the body, I agree that there can be no true allergy is symptoms are not present.
However, over the past 30 years, I have treated countless children with food allergies that were undiagnosed until more detailed questioning was done. Because the symptoms are not the severe, life-threatening ones that require emergency care, I found that many children did not report their lip tingling or coughing or throat clearing when certain foods are eaten. Many of these kids reported to me that they just stop eating the food when they feel their throat getting tight. But they would eat it again later. They learned how much they could eat without feeling bad.
Most people simply need to “reduce and rotate” but not completely eliminate these offending foods. Your physician should discuss this plan with you.
3. Allergy blood tests are all the same
One of the most common tests to screen for allergies is a blood test. However, there are many types of tests which do not measure the same thing.
Often a food intolerance test reveals 50-100 reactions! First of all….just NO. Second of all…just NO.
Ask your doctor exactly what the test is measuring. Tests that measure IgG, show results for food intolerances. IgG measures a different immune reaction in the body. Tests that measure IgE show results for true food allergies. We often look for specific IgE to specific foods and not just the total amount of IgE in the body. Each measurement tells us different information.
After blood test results are obtained, your physician will determine if skin testing is needed. Tests combined with clinical history provide the best treatment plans.
4. My child will outgrow the allergies
Allergy evaluations occur based on reported problems; therefore, if no symptoms are reported, an allergy evaluation does not occur.
Many children outgrow their allergy symptoms. When parents request an allergy test to ensure the allergy no longer exists, I frequently find ongoing allergy reactions based on test results. The allergy reaction may continue to exist, however, it is no longer significant.
A positive allergy test with no significant allergy symptoms leads people to falsely claim the allergy is gone. There may be no need to take medications or avoid the foods; however, I have seen patients return years later with obvious symptoms.
The immune system is not predictable and I believe that many patients with one set of allergy symptoms later show different symptoms.
The children who fail to improve their allergy symptoms make up a large part of my practice! The Allergy March is the term used to describe the progressive changes in allergy symptoms over time.
Mild symptoms may later develop into chronic more severe symptoms. As an ENT with an extensive allergy practice, I witness this progression regularly. Allergies often occur forever; however, the symptoms and management may change. Many of my food allergy patients actually have nasal symptoms and require classic nasal allergy treatments.
I suggest that parents ask questions during their child’s visit with their allergy physician. Do not simply believe the false food allergy beliefs and myths that are frequently repeated.
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