F.A.Q.'s on allergies, eczema and asthma
A lot of people ask me questions about allergies, eczema and asthma- some things as simple as 'what are his allergies?' & other things as complex as 'how did you figure out his allergies?' (it may not sound complex, but it's been an adventure!) So I created this page in hopes of offering some guidance.
What is an allergy? (definition taking from the Merriam Webster dictionary)
1: altered bodily reactivity (as hypersensitivity) to an antigen in response to a first exposure <a bee venom allergy so severe that a second sting may be fatal>
2: exaggerated or pathological immunological reaction (as by sneezing, difficult breathing, itching, or skin rashes) to substances, situations, or physical states that are without comparable effect on the average individual
3: medical practice concerned with allergies
4: a feeling of antipathy or aversion
What is an intolerance? (definition taken from Wikipedia)
"Food intolerance is negative reaction, often delayed, to a food, beverage, food additive, or compound found in foods that produces symptoms in one or more body organs and systems, but it is not a true food allergy. A true food allergy requires the presence of IgE antibodies against the food, and a food intolerance does not. Food intolerances can be classified according to their mechanism. Intolerance can result from the absence of specific chemicals or enzymes needed to digest a food substance, as in hereditary fructose intolerance. It may be a result of an abnormality in the body's ability to absorb nutrients, as occurs in fructose malabsorption. Food intolerance reactions can occur to naturally occurring chemicals in foods, as in salicylate sensitivity. Drugs sourced from plants, such as aspirin, can also cause these kinds of reactions. Finally, it may be the result of non-IgE-mediated immune responses."
What is the difference between a food allergy & a food intolerance?
Most reactions to food are actually intolerances, not allergies. However, the symptoms manifest so differently, & less obviously, than allergies that many people don't realize they even have them. Symptoms may include: migraines, eczema & other skin ailments, asthma, bloating, diarrhea, fatigue, nervousness & behavorial changes. Here are some links with more detailed descriptions: WebMD & Mayo Clinic.
How to test for your allergies & intolerances?
Skin tests: the skin prick test is for IgE type allergies, which are food & environmental allergies. This test gives results within 20 minutes. The possible allergen is placed on the skin by pricking the skin quickly with a very small needle. It may feel like a little pinch. If a hive shows up, depending on its size, it may be a positive result. The patch test is for IgG type allergies, or food intolerances. A patch with different substances is placed on the back & taped to the skin for 3-days. Initial results are read when the patch comes off & final results are read the day after. It's important to read the skin on the 4th day because intolerances will show up that day, that may not be visible when the patch was removed on day 3.
Blood tests: not often seen as reliable as skin tests, blood tests looks for antibodies in the blood. Some of the most common blood tests are the ELISA, RAST or ImmunoCAP.
What do I do if I tried all these allergy tests, but the offending food still doesn't show up?
It is fairly common not to discover all your allergens & intolerances from allergy-testing for multiple reasons. These include: the tests do not test for every single food or environmental product you are exposed to, so there is no way they can legitimately tell you exactly what you are allergic or intolerant to; not all allergists use the skin patch test, but you are not necessarily going to see the same results on the prick & patch test. For example, the first time my oldest was tested, only peanuts, dairy & eggs showed up (IgE allergies). These had already been eliminated, so they made no difference for his eczema. Two months later, the patch test showed dairy, eggs, oats, wheat, peas, beef, corn & potatoes (IgG intolerances). These were the ones triggering his eczema.
The most effective way to pinpoint all of your allergens is an elimination diet. While we've tried some very basic ones, there are others, like this one from the Whole Life Nutrition Kitchen, that are highly beneficial. When we did LDA, we noticed on day-1 of the diet that his cough completely disappeared, so what we thought was an environmental reaction appears to actually be a food intolerance or possibly related to reflux.
What do I do now that I've discovered I can't eat anything? (okay, I can, but not dairy, gluten, eggs, nuts & more)
Alright, that may be a stretch. I know not many people have as extensive an allergy & intolerance list as our house, but even just discovering you can't eat one food can be daunting. However, once the reality sets in & the improvements in your health are noticeable, you'll be reminded why you avoiding that specific food(s). To be honest, cooking allergy-friendly has become so natural for us that we usually aren't reminded of the dietary restrictions until someone else points it out, or we're attending a social gathering.
When first discovering allergies & intolerances, there were a few things that were very helpful for us. First, discovering all the different names for one product. Corn surely takes first in that category. For example, dextrin or maltodextrin, dextrose, fructose, mono-& di-glycerides, food starch & sucrose are just some of the many other corn-derived products. Here is a nice resource from Kids with Food Allergies, to help get you started on recognizing other names for specific allergens. Second, reading labels. After awhile, it becomes such a habit, you don't realize you're doing it. If something on the ingredient list isn't clear, look for the phone number & call the company. I've had some really great experiences with customer service & some very poor experiences. Honestly, sometimes I don't bother calling & just put it back on the shelf. Probably more so for items that aren't necessary. It is also important to note, companies are only required to identify the top 8 allergens on their food labels, which are: milk, eggs, fish, shellfish, tree nuts, peanuts, wheat & soybeans. Here is more info on the FDA requirements. Third, google is your friend. Seriously, I don't know how many recipes, support & info I've found from googling information, as well as Pinterest. Of course you have to be cautious because there is certainly misinformation out there, but I think it's fairly easy to tell the bad sites from the good sites (I haven't found many bad sites, besides those that say they'll cure eczema if you give them money). Finally, don't be afraid to experiment. If a recipe calls for something you can't have, again, visit google & see what you could replace it with or just try something that you think would work. Sometimes it won't & other times, you'll make the recipe better.
What is the correlation between eczema, allergies & intolerances?
I am not sure how many times I've heard there's no correlation between eczema & allergies. Your kids will just grow out of it, right? WRONG! It is my own personal opinion, but I believe that if there is eczema, there is something else going on that is just not right. I always felt like when my oldest's skin was really bad, it was his inside's screaming for help. There are so many different causes, it can be hard to pinpoint exactly what is triggering the eczema. If I could take all the information I've learned, I would start with an elimination diet, as well as allergy testing. The testing gives you a baseline; however, their inaccuracy certainly warrants the elimination diet, as well. If food doesn't seem to be at the root of the problem, I would research yeast overgrowth. For us, treating yeast overgrowth had a huge, positive impact. The power of yeast is often overlooked. Eczema can also often become infected with staph, so it's important to treat that, if needed. All of it comes back to gut health & healing the gut is a huge step towards better health. Here is an extensive list from Mothering.
Will any supplements help allergies or eczema?
I've had mixed results with supplements, & have read a broad spectrum of reviews. I think it depends on the person & the circumstance. Here are some we've tried & some I've heard of being successful: Chinese herbs, high dose of probiotics (25-50 billion cfu's/day), digestive enzymes, Vitamin D (1,000 iu's/day), Quercitin, Bromelain, Nettles, Biotin, Vitamin B12, Magnesium, Zinc, Vitamin C, Fermented Cod Liver Oil, Cedar Bear Naturales Herbs, Omega 3's, Cell Salts & a multivitamin.
Just as a reminder, I am not a doctor so this advice is simply based on my research & personal experiences.
What type of medical care is available for allergies & eczema?
There are so many different types of doctors to see, as well as treatments & prescriptions given. We've tried a lot, but of course not everything. Probably the most common would be Western-medicine doctors. Often, prescriptions of antibiotics, oral steroids & creams (such as hydrocortisone, triamcinolone, elidel & protopic) will be given for immediate relief. Typically, these treatments may provide some relief, but they are not longterm. Many times, the eczema will flare-up worse once off the medication. This is because they are not addressing the root of the problem, but rather the symptom- ezcema. There are M.D. based doctors who have taking a more holistic approach, often practicing Environmental Medicine, or establishing Integrative Medical clinics. Through a combination of prescriptions (to try and knock down the eczema for immediate relief) & addressing the root of the problem, this treatment can be much more successful. Some treatments may include treating yeast overgrowth, gut healing, elimination diets & LDA.
There are also many types of alternative doctors available, including Naturopaths, Homeopaths, Kinesiologists, Chiropractors, Oriental Medicine doctors & Chinese Medicine Doctors. I don't know the foundations of each of these types of doctors, but I do know they can help their patients find success with their allergies & eczema. We've made great headway with our Traditional Chinese Medicine (TCM) doctor. She focused on unblocking the channels of my oldest, through massage & acupuncture, as well as recommended he take Chinese herbs twice a day, until he was 5. These are only a handful of options available, but still wanted to share. If you have any success stories to add, I'd love to hear them.
What are some ideas for foods if I am dairy-free or gluten-free?
It took me a long time (probably a good 1-2 years) to really discover all the variety's of flours & milks out there. There are probably even more that I am not aware of, but here's some to get you started. Dairy-free milks: coconut, hemp, almond, oat, soy, rice & hazelnut. Gluten-free flours: sorghum, brown & white rice, teff, tapioca, arrowroot, potato, sweet potato & almond. Updated 6/2016: we recently discovered Bob's Red Mill 1:1 Gluten-Free flour blend, and this stuff is amazing. I've made pie crusts, cookies, pancakes, waffles, biscuits & more, & you honestly can't tell.
Allergies and school, what to do?
Prior to the start of the school year, we set-up a meeting with the principal to have a504 plan put in place. We started this in kindergarten, and it is good for one year, so we renew it at the beginning of each school year. In this plan, we have things like keeping epi-pens, anthistamine and albuterol in his classroom, nurses office and with the teacher if they're not in the classroom (ie: field trip); he also has a peanut-free classroom, as well as a peanut-free area at his lunch table. I also keep an extra set of clothes at school, as well as his peppermint cream for eczema flare-ups, so if he was to get wet at recess, he can change into the dry clothes. Whenever his skin gets wet, it sometimes gets very itchy and causes quick flare-ups. This helps prevent that. The 504 provides security for me, while our school has been very supportive & would do this regardless of the 504, it's reassuring to know these precautions are being taken. It's crucial that you advocate for your child and this is a big step in doing that in the school environment.
This list continuously grows, as I hear questions from others, & remember certain things we've encountered along the way. If there's anything you're interested in knowing more about, or feel should be added here, please let me know.