Monday, January 4, 2010
A Process of Elimination
I don’t know about you, but when I think of food allergies, I think: Anaphylactic shock. Epi-Pen. Hives. My son never experienced any of those symptoms. As such, I never suspected he was allergic to any foods.
I knew he had seasonal and environmental allergies. A skin prick test revealed that he was highly allergic to trees, some grasses, cats, and horses. He spent nine months out of the year sniffling and sneezing. When his allergist suggested following up the skin prick test with a RAST food sensitivity test, I wondered if that was really necessary. The doctor explained that often, environmental allergies and food allergies go hand in hand. High level tree allergies can be related to foods that grow on trees, for example. There are different schools of thought on whether the skin prick test or RAST is more accurate in measuring allergic reaction, but we went with the RAST test, which is a simple blood draw. One needle, one prick. The results showed that my son had sensitivity to TEN foods. Ten foods that were a regular part of his daily diet. Foods such as: Wheat, corn, rice, peanuts, soy, apple, banana, tomato, potato, and citrus. Great. Now what?
Next came the elimination diet, which works like this: For a period of two weeks, ALL foods that have shown positive allergic reaction are eliminated. In a daily journal, you note any symptoms, change in symptoms, lack of symptoms, etc. After the two week period, you add one food at a time back into the diet. Ideally you eat as much of the food as you can stomach, to really challenge yourself. You do this for a period of two weeks with each food. If you notice a definite reaction, you eliminate the food and note if the symptoms are alleviated. If so, you can assume you are allergic to that food and move on to challenging yourself with the next item. It is quite possible to have false positives with allergy testing, so the elimination diet is necessary in order to confirm or deny.
Included in the detailed elimination diet instructions was a list of what to eliminate for each allergen. Sounds easy enough, right? For some foods, it is pretty simple. He’s allergic to bananas, so…no bananas. Not as easy as you would imagine for other items. Luckily my son is not allergic to meat and dairy, but here’s where it gets interesting. Yogurt. Sounds safe, right? I spent a great deal of time reading labels in preparation for the elimination and guess what? Most yogurts contain fruit pectin. Pectin often comes from apples. Apples are on the “do not eat” list, so…no yogurt. Ham is another example. Pre-packaged deli ham contains citric acid. Citric acid comes from…? You guessed it – citrus.
What added an additional challenge to this task was the fact my son was a finicky eater. Sure, he wasn’t allergic to fish, chicken, or beef, but would he eat fish or chicken without breading? No. Would he eat a burger without the bun? No, of course not. He’s also not allergic to veggies, but let’s not go there.
Some common signs of food sensitivity that you may not be aware of are: nasal congestion, irritation of the throat, headache, stomachache, nausea, diarrhea, red ears, eczema, etc. These are also common signs of seasonal allergies. This elimination period was really quite challenging and many of the results were unclear. Here’s what we concluded. There didn’t seem to be any food in particular that caused a strong reaction. It did seem, however, that a combination of foods sparked an onset of symptoms. Not every time, though.
Presently, my son does not have any food restrictions. I have noted when he reacts to certain foods, but it’s so inconsistent. One day, a glass of lemonade sparks a throat clearing marathon. The next day, he can guzzle a gallon of it and…nothing. Frustrating? You bet. Confusing? Is it ever! While I feel a bit of a let down that we weren’t able to close the book on the food allergy issue, I do feel satisfied that we’ve taken steps in the right direction and we’ll keep trying until we find our answers. Do I feel guilty about the years I unknowingly fed my son foods he was sensitive to? Sure, but Maya Angelou says it best – “you did then what you knew how to do, and when you knew better, you did better”.
*NOTE: At a follow up appointment with my son’s allergist recently, we decided to re-test him for food allergies, since two years have passed. This time, the skin prick test will be used. I’ll let you know how it goes.
Here are some links to resources on food allergies: