The Doctor Is In: When to Seek Help for a Food Allergy and How Testing Works

Don’t ignore your body when it responds to food in a certain way.
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Don’t ignore your body when it responds to food in a certain way.

For many, the act of eating is done without much thought or concern. It is something we do on the daily, after all. But when your body has an allergic reaction, big or small, it’s worth paying attention to—regardless of how good the food tastes.

An adverse response means that something isn’t quite right. And while it may be scary to deal with, a food allergy should not be taken lightly. It’s your body’s way of alerting you. It’s also up to you to take care of it.

We turned to Dr. Neeta Ogden, M.D., an adult and pediatric allergist, asthma specialist, and immunologist in New Jersey, to understand food allergies and the lowdown on allergy tests.

Q: What are the typical signs of a food allergy?

“The thing with food—especially in women—is that there are allergies and intolerances. There’s a big difference. An allergy is immune-mediated and typically has a spectrum of immediate symptoms. It activates cells, almost like an invader.

“Typical symptoms are hives or an itchy mouth. This can progress and eventually block airways. In some cases, anaphylaxis can occur. In this, we see severe coughing; someone might feel woozy and nauseous. They might also have vomiting and abdominal pain.

“An intolerance is different. Here, we see headache, diarrhea, and stomach issues that happen hours after the food is consumed.”

Q: What are the most common foods people are allergic to?

“There are eight really common allergens: peanuts, tree nuts, shellfish, fish, milk, eggs, soy, and wheat. Tree nuts and shellfish are more common in adults. Milk and egg allergies are usually seen in childhood—people typically grow out of it with time.”

Q: Why do I need to pay attention to possible allergies?

“That first reaction doesn’t predict the severity of the next reaction. You can just get one hive because you ate a shrimp, but you can’t be casual about it. It does have this nature that can go [from] mild to severe.”

Q: What can I do if I experience a mild allergy?

“If you’re at home and this is your first time experiencing an allergy, take Benadryl. Make sure you look at the packaging and take the right dose. Otherwise, any kind of antihistamine will do. Monitor yourself to make sure your reaction isn’t progressing. There is something called a delayed allergic reaction, which can be severe. In a second, an allergy can escalate very quickly. You can also look online for an emergency action plan. If it gets severe, call 911.”

Q: When might it be time for me to take an allergy test?

“As soon as you experience an allergy. Go straight to an allergist; seeing a general doctor is an unnecessary step.”

Q: How do I prepare for the appointment?

“Pay attention to what you ate and what happened. There’s a lot of detective work, so write down what you ate so you can give this to the doctor. There are so many things in food, so it starts with a really good history. The doctor will test for possible culprits. I have some really smart patients that even take a picture of the food in a restaurant or the label on packaging.”

Q: What can I expect during a consultation with an allergist?

“A few things can happen. You can get a blood test or a scratch test that provides information on your allergies. In a scratch test, the doctor will look for food that causes redness and swelling. You might also get an oral food challenge after a positive blood test. In this case, you’ll eat something and sit in the doctor’s office for a few hours. They’ll watch you closely to monitor any reactions.”

Q: Can food allergies be prevented?

“There is immunotherapy research going on, but prevention really depends on avoidance. With enough avoidance, the allergic quality may come down so low that your doctor may challenge it again for different results.

“But the world is always changing, so it’s really about eliminating. Go online to learn about where allergens are found. For example, milk may be hiding in caramel. But labels are not enough—play it safe, and ask questions when you’re in a restaurant. Paying attention is so important."

Photo Credit: Lean Timms