Food Allergies/Food Allergies

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Question
Hello, I am allergic to milk, peanuts, and corn. I've been allergic to milk since birth. As a baby, I had to drink soy milk. I learned I was allergic to peanuts by eating an asian dish that had peanuts in it. I became very nauseated, dizzy, sweaty, and my stomach was upset. A cook accidentally put peanuts in my dish years later and the same thing happened again. My mom boiled some peanuts in the house and my chest felt tight and I started wheezing (It felt like congestion). I can't even touch peanuts. I don't understand why the smell of peanuts cooking bother me. Milk and corn cause me to itch (everywhere - including my mouth and genitals), become nauseated, have diarrhea, dizzy, sweat, weak, and become disoriented\fear of doom. A few years ago, I could eat corn, but now I can't, which I don't understand.

Is there a such thing as cooking foods long enough or at a high enough temperature to break the protein down (temping out)- like milk used in baked goods? For example, I can eat buttermilk biscuits but not a piece of cheese or a glass of milk.

Does vinegar break milk proteins down? I have been eating Olive Garden salad dressing, which contains Romano cheese, vinegar, and other ingredients. I have not had a reaction from it. I didn't know cheese was in it until I bought the dressing.

I can eat a Chick-fil-a sandwich that is fried in refined peanut oil but I am allergic to peanuts. I heard refined oils are cleansed and deodorized.

Is it possible that I will develop more allergies? I know I have all of these allergies because I most recently took a scratch test and blood test. Thank you and I'd appreciate your help.

Answer
You are asking rather a lot of questions at one go! I'll try and separate them out:

1. Your story convinces me that you have true IgE-type allergies to peanuts, milk and corn. No tests other than double-blind feeding tests can confirm or deny such an opinion. That includes all forms of blood and skin tests.

2. Peanut allergy: The main allergen is a protein. It is not present in highly-refined peanut oils. It is however in significant quantities in many commercially available brands at supermarkets. It is often present in much higher quantities in bulk oils sold to the catering profession. It is my clinical experience, many people who know they are peanut allergic get reactions in resteraunts but never at home. Sometimes this can be related to misinformation, but on occassion very careful investigation indicates the cooking oil. Cooking in any way (esp. frying or boiling) can lead to significant airborne allergen levels). I have watched a known fish-allergic person go into first, a total face and body rash, followed by asthma/anaphylaxis, within minutes of walking into a house in which fish had been fried more than 4 hours before!

3. Cooking of foods: Milk is an exception to the following. Most allergens are heat-labile. That is, that their allergenicity is broken down even when the primary structure is not. So much so, that in the case of certain fruit allergens, the allergenicity is broken down very rapidly by just freezing or drying. However in the case of fish allergy, some people will reactive to cooked fish but not uncooked; and sometimes vice versa,

4. Milk. The story about milk, the importance of different proteins in milk, the relative importance of milk breakdown products (produced by stomach acid, cooking and normal digestive processes) is, quite honestly, controversial. Very different things may be more applicable to different syndromes and at different ages. For example, some babies can react to their own mother's milk if she has consumed cow's milk. Therefore, that mother will be both absorbing and excreting some part of the cow's protein, small enough to get where it is; but big enough to be recognised as cow and not human. Plese do not ask for easy answers.

The processing of milk products (both in factories and in normal home cooking) can make a huge difference. The results with "milk-free" products depends very much on how that label is used. There are strict laws concerning such dietary labeling within the EU; and in the UK, lists of foods guaranteed to be "Free-from ..." by their manufacturers are available via qualified medical dieticians. I do not know if similar services are available in the US - I doubt it.


5. I cannot answer questions about "corn" allergy. By this I assume you mean maize. I come from a part of the world where this has not been a significant part of the diet except in imports from the US until recently. I have never ever, seen a case of maize allergy confirmed by double-blind food testing. Plenty of people who have blamed all sorts of things on it, but never confirmed by us. However, I must add in fairness, that there are vast differences in the patterns of food allergy across Europe. And of course peanut allergy is vastly more significant in the USA than in Europe. They feed the nasty-tasting, hyper-allergenic stuff, to young children for heaven's sake!

6. Other. You do not mention your age. This is critical in food allergy. Prognosis. 75& of food allergies in the first year goes within 12 months. 75% at one year has gone by aged 7. And 75% of that has gone by 12. Since that was a paediatric survey, it went no further. But a significant number will still grow out of it by age 20. If you have a true food allergy by then, you are probably stuck with it for life. New true food allergies starting after childhood are exceedingly rare, with the exception of fresh fruit syndrome. However in some people who claim to have a later onset, proper investigation shows that the same allergy was actually there before, just less severe for one of several reasons.


I hope this answers your questions? If not, write again with specific points. No the chances of you developing new food allergies in adulthood are low. The chances of you outgrowing peanut allergy is as good as zero. Some of your attacks/reactions sound dangerously like mild anaphylaxis. I think you should have further advice about these, that you should wear a "Medic Allert" bracelet; and that you should carry adrenaline for self-injection, and that both you and your family, know when and how to use it.

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David Pearson

Expertise

Any in the field I believe. Only experience of questions that get asked will tell.

Experience

I am a retired medical academic from the UK. I have done major research on Food Allergy and have been a government adviser in the area. 30 years experience running an allergy clinic. And undergraduate and post-graduate teaching.

Organizations
Well, apart from the FRCP, I'm no longer active in the area. I'm too busy writing books. And I no longer have the cash to go to international meetings. But was active in many.

Publications
Will 120 scientific papers help? Chapters in books. Patient advisory materials. Magazine articles. TV appearances. Live and recorded. National and international invited lectures, etc. It was my job for 40 years. Do you think I count!

Education/Credentials
MD, PhD, Postgraduate Diplomas etc. Fellow of the Royal College of Physicians. etc. But I don't want that put out on the net! Just to let you know!

Awards and Honors
irrelevant.

Past/Present Clients
Too many to count, patients of course and a large number of all sorts of corporate consultancies and considerable work as an expert witness in the Courts. I'm volunteering because your Greek expert has been so helpful, I thought I'd offer something back.

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