Food allergy

Anyone who has ever reacted severely carries two auto-injectors with them, not one in the cupboard. In doubt one injects too early rather than too late; afterwards always call the emergency number 144 and lie flat, do not stand up.

Hoarseness, tightness in the throat, cough, wheezing, dizziness, pallor or vomiting together with wheals. As soon as two areas of the body are involved, there is no more waiting.

Food, amount, preparation, minutes to the reaction, which parts of the body, how long, what helped. This note later decides more than any value.

A broad search panel without a concrete suspicion produces hits that help nobody and lead to needless avoidance. What is tested is what appears in the account.

Every food struck off costs variety and, in children, growth. What is reliably tolerated stays on the plate — and what has to be avoided is learned from labels, traces included.

If the complaints only come after hours, affect only the belly and depend on the amount, the road lies elsewhere. That is unpleasant but not dangerous.

It is neither allergy nor intolerance but an illness of the small bowel in its own right. Important: investigate first, then leave out gluten — otherwise the values no longer hold.

An allergic reaction after sushi, sashimi or marinated anchovies can be directed at a worm in the fish. The difference decides whether fish must be avoided in future.

Antihistamines work against skin and mucous membrane signs — they do not work against anaphylaxis and must not delay it. With breathing difficulty or circulatory failure, adrenaline into the thigh muscle is the treatment, and at once; every minute of delay counts for more than worry about the injection. After it is given, observation follows, because a second wave can come four to twelve hours later. Oral immunotherapy raises the tolerated amount, it does not cure the allergy.

A true allergy shows within minutes to two hours of eating — that window separates it from an intolerance, which takes hours. About two to four in a hundred adults and six to eight in a hundred children are affected; far more people suspect it in themselves. Cow’s milk and hen’s egg allergy are outgrown by most children before school age, peanut and tree nut allergy by about one in five. An adrenaline auto-injector lasts one to two years.

The time window is the most important feature. What only causes stomach ache the next day is hardly an allergy; what itches and swells within twenty minutes very probably is.

This is the cross-reaction with pollen allergy: the protein in the raw apple resembles the one in birch pollen and breaks down on cooking. Mostly it stays a tingling in the mouth — with nuts caution is warranted.

Some people tolerate a food at rest and react severely if they exercise afterwards. Painkillers, alcohol and an infection can also strengthen a reaction.

Allergies to milk, egg and wheat fade in many children by school age, while those to peanut, nuts and fish more often persist. So in children it is regularly rechecked instead of avoiding for life.

Bloating, diarrhoea and stomach pain hours after eating, with no skin and no airway signs, speak for an intolerance. It is unpleasant but not dangerous — and it needs a different workup.

Shows antibodies against a single food. A positive value means readiness, not allergy — only together with the history does it become a diagnosis.

An overall measure that rises with hay fever, eczema and worm infestation. On its own it says little about a single food, but it helps to place the other values.

Is taken shortly after a severe reaction and confirms it afterwards. A permanently raised value points to an illness of the mast cells in its own right.

Belongs alongside when complaints follow bread and pasta. Coeliac disease is not an allergy and is established quite differently — and the value only holds while gluten is still being eaten.

Taken up right at the end of the small bowel and needing a helper from the stomach. If either place is affected a deficiency arises — often only after years, because the liver holds a store.

Taken up in the upper small bowel and needing stomach acid. Acid blockers, an inflamed lining and silent blood losses often come together here.

One of the fat-soluble vitamins, lost with the fat when fat digestion is disturbed. Fatty, floating stools over months are the pointer to it.

Needs vitamin D for uptake, and with disturbed fat digestion it additionally binds to fatty acids in the bowel. So bone density and bowel disease hang together more closely than assumed.

Lost in considerable amounts with lasting diarrhoea. Signs are cracked corners of the mouth, loss of taste, poor wound healing and thinning hair.

A low level in the first year of life is linked with more food allergies. Whether topping up prevents them is open — what worked in studies was introducing the foods early, not avoiding them.

The gap that opens: leaving out milk removes the most important calcium source and part of the iodine. 1000 mg a day stays the target — from fortified plant drinks, calcium-rich mineral water or a supplement.

With a nut allergy one of the most important sources falls away. Sunflower seeds and vegetable oils cover it — a supplement is rarely needed for this.

Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.

Clearly effective with proven deficiency, useless without. Take only with a documented deficiency — excess is harmful.

With a severe reaction adrenaline into the thigh muscle is the only remedy that works fast enough. Antihistamine and cortisone take too long — they are accompaniment, not treatment of the emergency.

Leaving out milk removes the most important calcium source. The regulation through vitamin D and parathyroid hormone makes up for a while, after that the calcium comes from bone — which is why replacing it here is not optional.

Exertion, alcohol, painkillers and infections lower the threshold at which a reaction is triggered. This is why the same food can be fine for months and then suddenly not — it is a question of the sum, not of the substance alone.

Check labels; watch for cross-reactions.

With a proven allergy avoidance is the treatment. Without proof it harms more than it helps — especially in children, where early avoidance can even raise the risk.

A low level is linked with more frequent allergies. Whether supplementing changes that is open — the studies contradict each other.

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