"Peanuts are the most common food allergy."
In kids, it's actually cow's milk.
"You can cure food allergies."
You cannot cure food allergies right now.
"The best way to find out if you have a food allergy
is to get tested."
Myth.
Hi, my name is Dr. Wei Wei Li.
I am a board-certified adult and pediatric
allergy immunology specialist.
I have been in practice in New Jersey for the past 10 years.
Hi, everyone. My name is Dr. Payel Gupta,
and I am the cofounder and chief medical officer at Cleared,
and I've been practicing in New York City
for over 12 years.
Today, we'll be debunking myths about food allergies.
"Peanuts are the most common food allergy."
So, even though peanuts is a common food allergy,
it is not the most common.
In adults, it's actually a cross
between peanuts and shellfish.
In kids, it's actually cow's milk.
So, the nine most common food allergens
are cow's milk, eggs,
peanuts, tree nuts,
shellfish, fish, wheat, soy, and sesame.
Peanut allergies grab more headline
because they tend to cause more severe reactions,
especially in kids.
Gupta: Other foods like cow's milk and eggs,
when you have those allergies in infancy,
you'll grow out of them.
But for peanuts,
that allergy you're not going to grow out of.
And so I think that for those reasons,
it just kind of caught on a little bit more
than some of the other food allergens.
"You can use Benadryl to treat an allergic reaction."
You should not use Benadryl
as the only means of treating an allergic reaction,
for food allergies in particular.
Li: Benadryl is an oral antihistamine.
It can help with mild symptoms such as itchiness or hive,
but if you have more than just itchiness or hive,
like symptoms of anaphylaxis, such as trouble breathing,
difficulty swallowing, tongue swelling,
or feeling dizzy because of blood pressure dropping,
you really should go to your epinephrine auto-injector.
The saying is, "Epi first, and epi fast."
"Food allergies and food intolerances are the same thing."
I see that a lot of people,
even sometimes medical professional,
will confuse the two,
but they're really different.
Gupta: So, food allergies are actually mediated
by our immune system, and they're caused by
an antibody called IgE in our immune system
that reacts to food when it shouldn't.
When that happens, we release a chemical called histamine,
which then produces all of those symptoms,
like hives, difficulty breathing, low blood pressure,
swelling of the face, of the eyes, of the tongue,
vomiting, and sometimes even death.
Food intolerances,
or sometimes called food sensitivities,
don't have any of that.
They are not mediated by our immune system.
You have more gastrointestinal symptoms,
and they are not life-threatening.
Gupta: For example, lactose intolerance is a big one
that people have an issue with.
It's actually an enzyme deficiency in your body
where you can't digest lactose
because you don't have the enzyme called lactase.
And so you're going to have that bloating,
sometimes diarrhea, and just general feeling
of not feeling good after you ingest things
with cow's milk or with lactose.
Li: Knowing the difference between food allergies
and food intolerance will determine
what kind of treatment you need to receive.
"Food-sensitivity testing is accurate."
We just don't have good tests
to determine if somebody has a food sensitivity.
There are commercially available tests
called IgG, food-specific IgG testing.
They're not FDA approved.
We see IgG as a memory test
to show that you have eaten the food,
not an allergic reaction to the food.
Gupta: Which is different than true food-allergy testing,
which is an IgE test.
So those IgG tests that are often sold online,
we don't go by them.
Instead of testing, we would recommend a food diary,
where you can keep track of your symptoms,
the foods that you've been eating.
And then, over time, we'll start to see some patterns.
That's actually the most accurate and helpful tool
that we have at this time
to help determine food sensitivities.
"The best way to find out if you have a food allergy
is to get tested."
Myth.
The best way to find out if you have food allergies
is to eat it and to see if you have symptoms
after eating it.
So, that's called an oral challenge,
which is considered the gold standard
in diagnosing food allergies.
It's very safe, and it's in a controlled setting
with emergency medication on hand.
You can get an IgE blood test done at home.
We might get people showing up as possible positives
to some of the foods,
but it doesn't mean anything
unless you've actually reacted to the food.
For example, if I have a patient that comes in
who ate peanut and shrimp sauce
and then they had a reaction
and we're trying to determine,
was it the shrimp or was it the peanut
that they were reacting to?
That's when those IgE tests
and the skin tests that we do are super helpful
in helping us determine what the person reacted to.
"You can cure food allergies."
You cannot cure food allergies right now.
The only food that we currently
have an FDA-approved protocol for
is for peanut allergy.
Oral immunotherapy for peanut allergy
is where you get small amounts
of the peanut allergen over time.
In the beginning, you get monitored to make sure
that you're not having reactions right away.
And then the critical thing is
to take that amount of peanut every single day.
If they don't, if they miss a dose,
then it could kind of set things back,
and they could have a reaction
the next time that they're exposed to the peanut protein.
And I will add to that,
oral immunotherapy will lead to a temporary state
of desensitization or tolerance,
but not a permanent cure.
I would avoid the word "cure,"
because it can lead to misunderstanding for patients.
"Allergic reactions won't happen
if you didn't swallow the food."
Myth.
Even touching the food
without ingesting the food
can cause allergic reaction.
Gupta: That's why it's important to not touch a food
and then touch somebody that has an allergy to that food.
With shellfish allergy in particular,
because shellfish is usually steamed or boiled,
sometimes the food allergen protein from the shellfish
can actually end up in some of that steam or that vapor.
And so therefore it is, to a certain degree, airborne.
And if somebody who's highly allergic to that food
enters a room where shellfish is being boiled or cooked,
they may start having symptoms,
even without ingesting the food.
"Each allergic reaction will be worse than the last."
So, that's a myth.
The reaction can be unpredictable.
Reactions to food are unpredictable
because there are multiple factors that go into play.
So, what was the exposure, and how much of it?
Li: Asthma, that can worsen the severity of your reactions.
Gupta: And so adding an additional component
of inflammation and irritation
will make your symptoms worse.
"If your child has eczema,
they will also develop food allergy."
Not every child with eczema
is going to have a food allergy,
but if the child does have eczema,
there might be a higher likelihood
that they could have a food allergy.
Having eczema and having allergies,
they all belong to the atopic-disease spectrum.
Which refers to asthma, eczema,
and seasonal or environmental allergies.
So if your infant develops eczema at a very young age,
it's important to determine
if the child has other atopic diseases
as a trigger for their eczema symptoms.
"If your first child has a food allergy,
your next child will have one also."
Food allergy within a family member is a risk factor,
but it doesn't mean that you'll definitely
have a food allergy.
Having risk factor really just increase the risk
of developing the food allergies.
Gupta: And it also doesn't mean
that you'll have the same food allergy.
So if your dad has a shellfish allergy,
that doesn't mean that you're destined
to have a shellfish allergy yourself.
And we don't know a lot about factors
contributing to the development of food allergies.
All we know are the risk factors.
"Throwing up will make your allergic reaction less severe."
That is not true.
Your allergic reactions to food
is dependent on exposure to the allergens.
Throwing up will not make the exposure less.
Essentially, throwing up is just exposing your body
to that food all over again in a different way.
It's coming up, instead of going down.
Having to throw up after have eaten the food
could be a sign of anaphylaxis,
which is a life-threatening reaction.
But self-induced vomiting will not lessen the symptoms
of food allergic reactions.
Food is supposed to be something enjoyable.
We're supposed to eat something
at least three times a day.
And so we don't want to put unnecessary stress around it.
If you're worried at all,
it's super important to go and see a specialist.
That feels passionate about food allergies.
So that we can help figure out what your history is
and figure out what the right testing
and what the right treatment plan will be for you.