Is it okay to eat more shrimps if you are allergic to them? Don't be silly, many people have been admitted to the ICU because of this

"If you are allergic to a certain food, just eat it a few more times and it will be fine!"

There are rumors online that if you are allergic to a certain food, you can get rid of the allergy by eating it more often. For example, if you are allergic to shrimp, you can get rid of it by eating it more often. There are even netizens who really do this, saying that they are doing a "tolerance test."

Rumor Analysis

Totally wrong!

Food allergies are not as simple as “eating more” to get rid of the allergy. If people with allergies eat allergic foods at will, it may induce severe allergic reactions and may be fatal!

When enjoying delicious food, some people feel helpless and miserable. Because when faced with a certain kind of food they like, they can see and smell it, but they can't eat it... and the reason they can't eat it is that they are allergic to this food. Food allergies are very common in our daily lives. If you are also one of this group, then you must not miss the following knowledge about food allergies.

What is a food allergy?

In 2004, WAO defined food allergy (FA) as an adverse reaction to food mediated by immunological mechanisms, that is, an abnormal or excessive immune response caused by food proteins, which can be mediated by IgE or non-IgE; it manifests as a series of disease groups, with symptoms involving the skin, respiratory system, digestive system, cardiovascular system and other systems, and even severe allergic reactions, which are life-threatening.

Adverse food reactions are abnormal reactions caused by foods or food additives, including food allergies, food intolerances, and food poisoning.

References[1]

Why do food allergies occur?

The causes of food allergies are relatively complex, and their occurrence is the result of the interaction between genes and environmental factors.

Genetic factors play a major role. Studies have shown that children whose parents both have allergic diseases have a 70% chance of developing allergies (50% to 80%), children whose one parent has allergic diseases have a 30% chance of developing allergies (20% to 40%), and children whose parents do not have allergic diseases have a 15% chance of developing allergies.

Other important factors include: intrauterine sensitization during pregnancy, abnormal T cell dominance shift in the body, imperfect development of intestinal barrier function, environmental factors and epigenetic influences, which are not discussed in detail here.

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What are the symptoms of food allergies?

Rash is the most common (80%) allergic reaction, but in addition, it can be any one or more combinations of dozens of symptoms/signs in the following (six major systems):

1. Skin or mucous membrane (mild to moderate allergy)

Skin: Feeling of fever, flushing, erythema, wheals (urticaria), itching, local edema, goose bumps, and sweating.

Eyes: periorbital pruritus, erythema, edema, tearing, conjunctival redness.

Nasal cavity: itchy nose, sneezing, runny nose, and nasal congestion.

2. Lower respiratory tract (severe allergies)

Throat: Itching or tightness (tightness) in the throat, drooling, dysphonia, hoarseness, laryngeal stridor.

Trachea-Lung: cough, chest tightness, wheezing, shortness of breath, difficulty breathing, cyanosis of lips and face.

3. Digestive system (mild to severe allergy)

Oral cavity: itching or tingling of the lips, tongue, or palate; swelling of the lips, tongue, or uvula; metallic taste in the mouth.

Esophageal-gastrointestinal tract: dysphagia (difficulty eating); nausea, vomiting, abdominal pain, diarrhea, constipation or blood in the stool, etc.

4. Cardiovascular system (severe allergy)

Lightheadedness, dizziness, fainting, altered mental status, chest pain, palpitations, tachycardia, bradycardia or other heart rhythm disturbances, low blood pressure, collapse, abnormal vision, difficulty hearing, incontinence, or cardiac arrest.

5. Neuro-psychiatric (mild to severe allergies)

Anxiety, worry, panic, headache, confusion, weakness or convulsions; children may have sudden changes in behavior (clinging, crying, irritability, stopping playing).

6. Others (mild to moderate allergies)

Uterine cramping (lower abdominal pain) in women.

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Allergies to certain foods

Can I become desensitized by eating it more often?

Desensitization is not just about eating a few more times!

The mainstay of management for food allergies in adults is strict avoidance of the allergic food and medication to treat acute allergies in the event of accidental exposure.

Desensitization therapy, also known as oral immunotherapy (OIT), is one of the current treatments for food allergies. However, a large number of studies have found that it is difficult to achieve permanent tolerance through OIT, so the goal of desensitization therapy has shifted to raising the allergy threshold to prevent allergic reactions caused by accidental exposure to small amounts of allergenic foods.

The goal of oral desensitization seems to be consistent with the purpose of the rumor at the beginning, but OIT has a strict implementation process. Eating more at will not only fails to successfully desensitize, but is also likely to induce severe allergic reactions and even be life-threatening.

Standard OIT usually needs to start with a very small dose (such as 3 to 6 mg of the food protein) and, under the supervision of a doctor, increase the dose every 2 weeks based on the specific food, degree of allergy, and physical condition until a certain amount of food protein can be tolerated. During this period, the family needs to prepare epinephrine and an emergency medical plan to deal with severe allergies.

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If you have an allergic reaction once, you can never eat it again for the rest of your life?

There are also rumors that if you are allergic to a certain food, you can't eat it for the rest of your life. In fact, this statement is not scientific either.

After confirming a food allergy, doctors usually recommend abstaining from certain foods. For example, if you are allergic to milk, in addition to not drinking milk, you should also avoid eating cakes and biscuits containing milk ingredients. You should learn to read food labels and carefully check the ingredient list to see if there are any milk ingredients. In addition, you should also be careful when eating other types of milk, as there may be cross-allergies.

How long should you avoid certain foods? The natural course of food allergies is affected by the patient's age, food type, and degree of allergy:

Milk, eggs, soy, and wheat usually subside during childhood.

Fruits and vegetables are the most common food allergies in adults, usually with mild oral symptoms. Allergens are quickly inactivated through heating, cooking and digestion. Most people gain tolerance within 6 to 12 months, but a few can persist, or other new allergic foods may appear after tolerance.

Tree nuts, peanuts, fish, and shellfish usually persist into adulthood, with only a few developing tolerance.

References[1]

Below are the recommended times to re-evaluate after abstaining from various food allergies. Your doctor will decide whether you can try the food again based on the results of the evaluation.

Nuts, peanuts, and wheat: It is recommended to abstain from these foods for 1 to 2 years without symptoms before evaluation.

Fruits and vegetables: It is recommended to evaluate every 6 months.

General food types: It is recommended to evaluate once a year or so, and you can follow the doctor's advice for specific details.

What are the common food allergens?

When you think of food allergies, what foods come to mind?

Infants and people with a history of severe allergic reactions need to be careful about 8 common allergenic foods when first exposed to them:

1. Milk and dairy products, including cow's milk, goat's milk, milk powder, and milk-containing cakes and biscuits;

2. Eggs, including chicken eggs, duck eggs, goose eggs, quail eggs, etc.;

3. Seafood, including fish, crustaceans, mollusks, etc.;

4. Meat, such as beef, lamb, chicken, etc.;

5.Soybean;

6. Peanuts;

7. Nuts, such as almonds, cashews, etc.;

8. Wheat.

Most allergic reactions occur within minutes to 2 hours after eating, and a few occur within hours (4 to 6 hours) or days to weeks.

It should be noted that we currently have no targeted measures to prevent food allergies. We recommend that everyone develop a healthy lifestyle, ensure food diversity, and maintain a good immune status, which can reduce the occurrence of food allergies.

Looking in the mirror of rumors

There are many rumors about food allergies, and the ones mentioned in this article are not new rumors. They are just new "vests" that have been circulated on the Internet again and again. The reason why these rumors can appear repeatedly is that they take advantage of the psychology of most patients who are trapped in the disease and are eager to get rid of the disease.

In fact, if you look closely, this rumor is obviously not in line with common sense. Most people with food allergies should know that if they are allergic to a certain food, forcing themselves to eat more may induce a strong allergic reaction, which can be life-threatening. However, this rumor claims that "eating more can relieve allergies", which is obviously not in line with common sense.

Therefore, when facing certain diseases, you must not rush to seek medical treatment, and don’t blindly believe in so-called folk remedies. The correct approach is to consult a doctor as soon as possible and follow the doctor’s advice for treatment.

References

[1] Li Haiqi, Shi Yingshan. Primary Course of Pediatric Clinical Skills Training[M]. Beijing: People's Medical Publishing House, 2023.

[2]DynaMed. Immunoglobulin E (IgE)-mediated Food Allergy. EBSCO Information Services. Accessed March 8, 2024. https://www.dynamed.com/condition/immunoglobulin-e-ige-mediated-food-allergy

[3] Scott P Commins. Food intolerance and food allergy in adults: An overview. UpToDate Clinical Advisor. https://www.uptodate.com/contents/en/food-intolerance-and-food-allergy-in-adults-an-overview. Accessed on Feb 02, 2024.

[4] Wesley Burks. Clinical manifestations of food allergy: an overview. UpToDate Clinical Advisor. https://www.uptodate.com/contents/en/clinical-manifestations-of-food-allergy-an-overview. Accessed on Jun 23, 2023.

[5] Scott H. Food-induced anaphylaxis. UpToDate Clinical Advisor. https://www.uptodate.com/contents/en/food-induced-anaphylaxis. (Accessed on Jun 09, 2023).

[6] Anna Nowak-Węgrzyn. Oral immunotherapy for food allergy. UpToDate Clinical Advisor. https://www.uptodate.com/contents/en/oral-immunotherapy-for-food-allergy. Accessed on Jun 28, 2023.

[7] Corinne Keet, PhDRobert A Wood. Prevalence, natural history, and monitoring for resolution of food allergy in children. UpToDate Clinical Advisor. https://www.uptodate.com/contents/en/food-allergy-in-children-prevalence-natural-history-and-monitoring-for-resolution. Accessed on Aug 11, 2023.

[8] DynaMed. Pollen-food Allergy Syndrome. EBSCO Information Services. Accessed March 8, 2024. https://www.dynamed.com/condition/pollen-food-allergy-syndrome

[9] DynaMed. Fish and Shellfish Allergy. EBSCO Information Services. Accessed March 8, 2024. https://www.dynamed.com/condition/fish-and-shellfish-allergy

Author: Fan Yunzhu, Chief Physician of Jiahui Medical

Review | Feng Jun, Deputy Chief Physician, Dermatology Department, General Hospital of Datong Coal Mine Group Co., Ltd.