Medicine Mondays: Food Allergies in an Adult

Hi Everyone,

Welcome back to Medicine Mondays.

Each Monday I'll post the questions that I have collected over the week. If you have a question please feel free to send me an email or leave me a comment. I welcome every comment and hope to help answer some questions. Just remember that my advice is not a substitute for a physical exam and medical advice that your family doctor can provide.

Here is a topic that we have been discussing for the past week on an older post Food Allergies in the School.


Food Allergies in an Adult


Dr. Cason -

Just a question - what could cause sudden almond allergy in an adult?- G

G-

I can't say I know for sure. Is it a sudden systemic reaction like hives or swelling, anaphylaxis to almonds or just contact dermatitis? - Dr. Cason

Dr. Cason -

The almond allergy only started a few years ago - now I can't even tolerate trace amounts of almond. The reaction is nausea, sweating, extreme abdominal pain (once so bad I was on the bathroom floor for an hour or so - I couldn't move). I was fine with almond until this started, also I can't tolerate coffee any more either - just makes me feel extremely nauseous!- G

G-

Sounds like you have a true allergy to almonds. Unless it was with something else that you are reacting to.

You can test the blood to see if you have an increase in IgE level to almonds. But the gold standard to see if you have an allergy to food is what happens when you eat it. You know that it makes you sick so you have your answer. I would probably still go and have them evaluate it though because it is unusual that you would acquire this as an adult.- Dr. Cason

Dr. Cason-

It was definitely almonds - I had my first reaction after eating some whole ones - just to be sure I tried it again, but only ate one. It definitely pays to ask - we went to a huge dinner last night, before dessert was served I asked if either contained almonds (I've never done that before) one was sticky date pudding, the other was a chocolate cake/mousse type thing - the waitress checked with the chef - both had almonds - I would never had guessed looking at them. p.s. Is there anything you can have, say like anti-histamine to help with a reaction?

G-

Great that you asked! It's amazing the cross contamination that is present. One can never be too sure. Yes, you can take Benadryl (an Antihistamine) to help counter the effects that histamine has on the body. Medscape.com explains it nicely. (I added the emphasis)

All antihistamines are reversible, competitive antagonists at histaminic (H₁) receptors. They act by inhibiting binding of circulating histamine to its receptor site, but do not prevent histamine release. Administration of an antihistamine results in inhibition of respiratory, vascular, and gastrointestinal smooth muscle constriction, a decrease in histamine-activated secretions from salivary and lacrimal glands, and anti-inflammatory effects. Antihistamines also decrease capillary permeability, which reduces the wheal and flare response to an allergen, as well as diminishes itching.

If you truly have vomiting, facial swelling, tongue swelling, difficulty breathing and a drop in your blood pressure then what you are experiencing is anaphylactic shock. You need to carry 2 Epi Pens around with you. Benadryl is good if the symptoms are pretty mild- hives, itching- but for a life threatening reaction you want Epi! - Dr. Cason