Docs get guide for ID'ing food allergies
December 6th, 2010
08:00 AM ET

Docs get guide for ID'ing food allergies

The first guidelines for  diagnosing and managing food allergies were released Monday by The American Academy of Allergy, Asthma and Immunology (AAAAI).

Designed by and for allergists, immunologists and other health care professionals, the guidelines represent the best practices for management of a disease where there is no current treatment.

It's a framework  intended to help doctors make appropriate decisions about treating patients, but not fixed rules that must be followed. Doctors and patients still need to develop individual treatment plans based on the circumstance of the patient.

The most common food allergens in this country are milk, eggs, peanuts, tree nuts, shellfish, wheat and soy. Milk and eggs are the two most common allergies seen in pediatric patients, but 80 percent of children outgrow them.

Peanuts, treenuts and shellfish allergies more often last a lifetime–less than 10-20 percent of kids outgrow them according to Dr. Hugh Sampson, Professor of Pediatrics at Mount Sinai School of Medicine and a member of the Guidelines Coordinating Committee.

Sampson says food allergy is often overdiagnosed. In fact, he says one of the most common problems is confusion over whether a patient has food sensitivity - a reaction to foods that does not involve the immune system - or true food allergies. Some of the symptoms are the same. 

"A lot of doctors order large numbers of blood tests to various foods and when they find small amounts of antibodies present they indicated allergic reaction," Sampson said, leading to children being put on very highly restricted diets. "The exercise of diagnosing a food allergy is not just doing a skin test or blood test. It takes a combination of patient history, and oral food challenges."

An oral food challenge is when a food is given to a patient in a controlled setting to watch for a reaction. Sampson says many doctors don't perform oral tests because it's time consuming, and there is some risk involved.

A set of 18 guidelines address diagnosis. For example, when food allergies should be considered: If a combination of symptoms like hives, chest tightness, wheezing, tongue swelling occur within minutes to hours of eating, or if symptoms occur more than once after eating a specific food.

Other diagnosis recommendations include doing a physical exam, using a patient's medical history and doing a skin puncture test (SPT) the most common skin test, in which the skin is scratched or pricked with very small amounts of the allergen.

The guidelines do not recommend intradermal testing. In an intradermal test, a small amount of the suspected allergen is injected under the surface of the skin. After about 20 minutes the skin is examined for any reaction such as redness and swelling. An atopy patch test (APT), where a sticky patch is attached to the skin for up to 48 hours, should not be used.

Other guidelines address who is at risk, how to manage non-serious reactions and how to prevent allergies. There are detailed guidelines on diagnosing and treating life-threatening, food-induced allergic reactions like anaphylaxis, a serious reaction that happens quickly and can be deadly. Epinephrine, according to the report, is the first line of treatment in all cases of anaphylaxis. All other drugs have a delayed response.

Dr. Matthew Fenton oversees allergic diseases research for the National Institutes of Allergies and Infectious Diseases at the National Institutes of Health and served on the Coordinating Committee. He says the agency is now working on a summary for consumers.

"It's important for patients and their families to understand that the symptoms of food allergy can mimic several other very legitimate diseases such as food intolerance and gastrointestinal problems. It is important for them to work with their doctors so they can identify the true root cause of the health affect caused by food."

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  1. Curious

    Wait a minute;
    3-4% of food allergy diagnoses may not really be food allergy, and this represents 10-12 million people? That suggests that 250 million people in this country are diagnosed with food allergies; presumably all within the US because of the name of the board recommending the new guidelines ("American Academy of ....". Last I checked, the estimated population of the US was 310 million. So 80% of the country has been diagnosed with food allergies????

    December 6, 2010 at 12:10 | Report abuse | Reply
    • jlgood

      Perhaps what they meant to say is that 10 to 12 million people are diagnosed with allergies, and 3-4 % of those are misdiagnosed. It was not worded well.

      December 6, 2010 at 12:23 | Report abuse |
    • bkl

      If one person is diagnosed with four food allergies, but really has only one, that one person had three misdiagnosed allergies. Do you count that as one person misdiagnosed or three? The 12 million "people" might represent multiple instances of the same person.

      December 6, 2010 at 14:40 | Report abuse |
  2. Jeff

    Maybe humans tend to have allergic reactions to milk and eggs because this is newer to our diet as of the last century or so? Our bodies also don't tend to digest these things the best. So maybe we have not evolved to accept them like we have meat and other plants over thousands of years of evolution.

    December 6, 2010 at 12:31 | Report abuse | Reply
    • KDW

      People have been eating milk and eggs for thousands of years. The genetic mutation that lead to lactose tolerance is a minimum of 2,000 y/o with most estimates being older at 6,000. The mutation in europeans may be as old as 20,000 years.

      December 6, 2010 at 12:49 | Report abuse |
    • Anne

      People ate milk and eggs long before 1910.

      December 6, 2010 at 13:20 | Report abuse |
    • medstudent

      milk isn't so much an allergy as it is an intolerance. lactose intolerance is the larger problem and it's a widespread problem because the enzymes for lactose degradation (lactases to be specific) are only really found towards the outer layer of your intestinal epithelium (or the outer layer of intestinal cells). Your body gradually loses the cells that produce these enzymes as you get older and as the population ages lactose intolerance will be more frequent.

      Eggs are however a relatively new food item (only since domestication of chickens which evolutionarily speaking is a recent phenomenon) so you're on to something there

      in general however, allergies are far more widespread in the US. The most supported hypothesis at the moment based on both clinical and lab empirical data is that because the US is more "sanitary", meaning, we have running water, soap, antibacterials and filtration systems and good hygiene for the most part, children are not exposed to as many pathogens at a young age as other countries are.

      There is a strong correlation between countries with high sanitation and frequency of allergies. This can be explained by the body switching over it's immune T cells from a TH1 response (which is for normal pathogens such as viruses) to a TH2 response (which has a purpose of fighting off parasites but is accidentally activated and causes the allergy response), in teh face of new pathogens.

      So the bottom line is, studies have actually shown exposing your child to more things at a young age tremendously decreases likelihood of allergies all around. Let them roll around in the dirt and grass, and in general just let them be kids and you've already done your part to fight against future allergies : )

      December 6, 2010 at 13:25 | Report abuse |
    • Foodallergymomx2

      This is in response to MEDSTUDENT: Looks like you might want to hit the books a little a more and start listening to patients before you start mentioning what is and is not a food allergy!! Your statement "milk isn't so much an allergy as it is an intolerance" is simply not true. I have a 4 year old who was diagnosed with allergies to milk, eggs, peanuts/treenuts, watermelon, and bananas. I can tell you from first hand experience that you are seriously underestimating the severity of what can be a life threatening problem! After my son took a SINGLE drink of milk when he was 2 he had several and immediate symptoms of anaphylaxis: projectile vomiting, severe hives, swelling lips, wheezing...and then he passed out. Thankfully, once we got to the emergency room they were able to stabilized him and then filled him full of steroids via IV's!!! I can tell you, it wasn't just him being "lactose intolerant". You seriously need to study this topic much more before you send your patients on their way with a misdiagnosis that could cost them their lives!!! Lesson learned....we never go anywhere w/out an Epi-pen now.

      December 6, 2010 at 14:07 | Report abuse |
    • Tim

      My son developed food allergies at about 6 months of age. He developed rashes on his face and the doctor thought it was baby eczema. He had been pretty much breast feed to this point. Then a neighbor gave him some frozen yogart and his face ballooned up. We had tests done and it turned out he was allergic to milk, eggs, and peanuts. My wife stopped consuming these foods and my son's face cleared up. These food proteins were passing through her milk in small amounts, enough to cause the rach, but not enough to cause a full reaction.

      Maybe the lack of exposure to germs is one possible cause, but there has to be others. He had just had a series of shots before the rash started so it may be the immunizations caused his immune system to over react.

      Also, my wife worked at an air bag plant which had some toxic chemicals. She and a lot of coworkers developed thyroid problems. Some of these chemicals were probably in her breast milk. Maybe the reason for the increase in food allergies in the US is because of all the toxic chemicals in our air, water, and food?

      The bottom line is more reasearch needs to be done and people need to stop jumping to conclusions. Food allergies are complicated which is why a cause and a cure has not been found.

      December 6, 2010 at 14:11 | Report abuse |
    • MedStudent


      maybe you should finish that GED of yours and learn some reading comprehension skills before you blindly attack people who are far more educated than you

      I am well aware of milk and egg allergies, however the increase in dairy intolerance is not so much an increase in allergies it is an increase in lactose intolerance which are two entirely separate things.

      yes your child has a milk allergy. want a medal? people were saying there is a recent jump in dairy allergies and it's not really true, there's a recent jump in lactose intolerance, dairy allergies haven't really increased too much at all.

      so learn to read is the message here, learn to read.

      December 6, 2010 at 14:18 | Report abuse |
    • Nurse Lisa

      Medstudent needs to spend a bit more time on English, grammar and manners. All intents and purposes (not all "ntensive" purposes) ending sentences with a preposition, no capital letters – and scathing corrections of well meaning lay people. Seems someone mistook education for wisdom.

      December 6, 2010 at 15:12 | Report abuse |
    • Raed


      What a rude creature you are. The less intelligent ones are always more pompous. You need to get on your high horse to feel good about yourself. Happy?

      December 6, 2010 at 15:14 | Report abuse |
    • TheShadowKnows

      @MedStudent has the personality of a small soap dish. Clearly he/she will be very successful in his/her chosen field of endeavor.

      December 6, 2010 at 15:20 | Report abuse |
    • TheShadowKnows


      Wow, your rude comment to Foodallergymomx2 was so unnecessary! I take it you're not a parent, or someone who has enjoyed the love of a parent. Did you not read what they went through with their child? Do you really think that is deserving of such unkindness? Grow up or go to http://www.disneyworld.com instead.

      December 6, 2010 at 17:04 | Report abuse |
    • Karen

      The report also discusses how disproportionately high the food allergy rate is in the US compared to other countries. Why will no one make a connection between our over-vaccinated, over-medicated society which eats mostly processed foods, and our inability to properly digest food or fight off illness?? Vaccines have fundamentally changed the biological structure of people in our society.

      December 9, 2010 at 08:49 | Report abuse |
  3. BooBoo

    I went to the AAAAII and it said gastro reaction are considered food intolerance not food allergy. But later down the paragraph, it said that if you vomit or have diarrhea after eating something, that's consider food allergy. Which is it???

    December 6, 2010 at 12:38 | Report abuse | Reply
    • JennyLou

      To be considered an allergy (not an intolerance), the reaction must be multi-systemic i.e. some combination of gastro, skin and pulmonary response.

      December 6, 2010 at 13:11 | Report abuse |
    • Xilo

      The article says that many of the symptoms of food intolerance and food allergy are the same (such as gastrointestinal distress). The difference between the two is that food intolerance doesn't involve an immune response while allergy does. So, if you're vomiting as a part of an immune response, it's an allergy. If you're vomiting and the immune system is not involved, it's an intolerance.

      December 6, 2010 at 13:14 | Report abuse |
    • Patricia

      A food allergy can give you gastrointestinal type reactions, but not everyone who has these types of reactions have a food allergy. An allergy involves an immune system response. Some people just can not digest certain foods. That doesn't mean they are allergic. Food allergies can make you sick to your stomach, but not everyone who is sick to their stomach has a food allergy....just as though brain tumors cause headaches, you can have a headache without having a brain tumor.

      December 6, 2010 at 13:17 | Report abuse |
  4. Andy

    We have allergies because we have fewer natural infections to fight off. Hand sanitizer, antibacterial soap, antibiotics and vaccines have reduced the amount our immune system has to fight. An immune system without these balancing factors becomes dysregulated and acts against other targets causing allergies.
    Before we all get mad about vaccines though, think about the diseases we don't have anymore because of vaccines: small pox, polio, measles, mumps, whooping cough. I'll trade a food allergy for 1-2% of the population for smallpox that would affect nearly everyone who comes in contact with it.

    December 6, 2010 at 12:40 | Report abuse | Reply
    • Xilo

      Not sure why you felt the need to lump vaccines in with the rest – vaccines DO trigger an immune response. That's how they work. So vaccines would not be at all similar to sterilization (wherein we try to destroy pathogens before they come into contact with our immune system.

      December 6, 2010 at 13:17 | Report abuse |
    • Andy

      Because the general population gets vaccinated there are fewer infections spread (heard immunity). You benefit from vaccines even if you haven't been vaccinated. So yes, vaccines do cause an immune system response, but also stop the spread of infections. That is why I "lumped" it with the others.

      December 6, 2010 at 13:57 | Report abuse |
    • MedStudent

      you're about 90% wrong.

      You are right that allergies are due to less immune activation during childhood. But vaccines actually induce an immune response, they are not responsible for allergies in fact vaccines decrease chances of allergies but activating TH1 responses earlier in life.

      the lower immune activation is due to less rolling around in dirt and grass and getting exposed to pathogens

      vaccines still count as pathogen exposure for all intensive purposes, they are an attenuated pathogen or an adjuvant that induces the same response as a pathogen, but all in all they are still activating the immune system in the same way just safer since the vaccine is not a full strength pathogen that can get out of control.

      please research before you spread false information. You do a disservice to everyone who reads your post

      December 6, 2010 at 14:15 | Report abuse |
    • GraduatedMedStudetn

      For all your comments, some of which have been fairly condescending, notably those referring to other readers' GEDs and so forth...
      I find it ridiculous that you either misquoted or are unaware that the "intensive purposes" you mention should actually read "intents and purposes".
      From one doc to another, a little humility goes a long way.

      December 6, 2010 at 15:01 | Report abuse |
    • Nurse Lisa

      Medstudent needs to spend a bit more time on English, grammar and manners. All intents and purposes (not all "intensive" purposes) ending sentences with a preposition, no capital letters – and scathing corrections of well meaning lay people. Seems someone mistook education for wisdom.

      December 6, 2010 at 15:16 | Report abuse |
    • Karen

      Do some more research on "vaccine-controlled diseases." Studies have proven that these are now controllable with proper vitamin use.

      December 9, 2010 at 08:50 | Report abuse |
  5. TheShadowKnows

    Of course doctors get a guide for ID'ing food allergies, how else are they going to be steered away from recognizing the ill effects of the great GE/GMO food experiment being perpetrated on the American public either directly or through the food chain? In this way they can diagnose the symptoms...er, I mean the "allergy" and push more drugs for Big Pharma. The important thing is to keep Americas all doped up so they never open their eyes and see what is truly going on around them. Isn't it more important to ensure obscene profits for the pharmaceutical industry than to educate people in proper nutrition? I think the government put us all straight when it imposed the unprecedented bail-out of big business over our future generation's financial well-being. ...And I'm proud to be an American where at least I know I'm free.

    December 6, 2010 at 13:02 | Report abuse | Reply
    • MedStudent

      i think your tinfoil hat is a bit tight

      December 6, 2010 at 14:06 | Report abuse |
    • TheShadowKnows

      @MedStudent we can all see that you've taken your meds today. You're only posting here to provide misinformation.

      December 6, 2010 at 14:15 | Report abuse |
    • MedStudent

      misinformation? interesting....

      explain to me the exact evidence that shows GMO food is dangerous

      then when you realize there is 0 evidence, you can go finish your GED and then come back once you've learned a thing or two.

      don't like physicians? don't use them. Then we can all watch as evolution takes its course and the idiot conspiracy theorists fade out of the population far earlier than everyone else.

      December 6, 2010 at 14:22 | Report abuse |
    • TheShadowKnows

      @MedStudent you can eat all the GE/GMO food that you can stuff into your magnificent and awe-inspiring pie hole, and you can have my share too. In fact, the more the better. Plus you can have some tasty farmed salmon to go with it. Then we'll see which one of us lives longer and enjoys a more disease-free life. (Spoiler alert: It will be me!)

      December 6, 2010 at 14:56 | Report abuse |

    Lies all lies. We can and DO develop food allergies as adults. It is not just kids. I was hospitalized for food allergies as an adult. Of course the idiot doctors thought it was a host of other things and therefore I had to pay through the butt for endless tests. Had a naturopath test me for food allergies and GUESS WHAT? I HAVE FOOD ALLERGIES!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    Once I cut the foods out, I feel ten times better. People, these doctors are liars. I would say that 75% of Americans CANNOT tolerate any dairy in this country. Please get allergy tested.

    December 6, 2010 at 13:17 | Report abuse | Reply
    • MedStudent

      lactose intolerance is not an allergy....

      also if doctors are idiots why did you go to one. Just dont see doctors anymore, problem solved.

      December 6, 2010 at 14:12 | Report abuse |
    • orionsway

      yeah, I had an intestin problem going on a few years – that is to say, I had constant bloating and gas. Ofc, I was told I wasn't drinking enough water, getting enough fiber, blah blah blah. Then, I started getting sick all the time – colds would hit me constantly. Flu, colds, whatever the flavor of the day/week/month was. Ofc, I was told it was this or that – given a prescription and sent home. Finally, from making a list of my foods (yes, I drink plenty of water, take in plenty of natural food fiber, and have a generally good diet (low on meats, high on fresh uncooked veg's) I went to dr. google.

      And what popped up? gluten! I went to my doc and asked her about it. She told me she didnt' practice eastern medicine – whatever the heck that means. I called an allergist, made an appointment. At the initial visit, the allergist laid out a full lineup of testing. 3 months, bloodwork and skin testing. I asked her what the goal was – she was insulted by the question. I then asked her what happens if we find out I'm allergic to any of the items we're testing for. She explained the 3-5 yr shot program. Uh-uh! whatever!

      I got off gluten and all my gastro problems disappeared within 1 week. I got off dairy and my asmtha attacks diminished to almost none daily. I got off processed sugar and that nailed the coffin on all the problems I had. Its been 1 yrs now. I don't get sick, my asmtha is gone, my colon works again, and I've dropped 10% of my body weight – all by eliminating gluten, dairy, and refined sugar.

      Take it for what its worth – but you don't need a doctor to try it.

      Best of luck to anyone and everyone......my children have had severe allergic reactions to peanuts – I know how you feel when your kid is in the hospital with IV's stuck in their arms.

      December 6, 2010 at 17:36 | Report abuse |
  7. Pam in Oregon

    Food allergies can be extremely serious. I am allergic to MSG. I thought I only had to be careful in specific restaurants. It was a real surprise when the soup I was eating at a chain restaurant was loaded with the nasty stuff. Luckily, the ER was close by. I think ALL food vendors/restaurants should post or provide a list of allergy prone foods and additives.

    Pam in Oregon

    December 6, 2010 at 13:43 | Report abuse | Reply
    • Joe B.

      That sucks. If you're that allergic, have a doctor (internist or allergist) prescribe you an Epi-pen. If you're that allergic to MSG, I suggest you never eat in a restaurant again. MSG is everywhere, and the restaurant will never be able to guarantee the food is completely MSG-free.

      December 6, 2010 at 14:36 | Report abuse |
  8. Misdiagnosed

    I am one of the misdiagnosed. The second of three dermatologists I consulted did the patch test in October, ( not now recommended according to this article) which enlarged and intensified the ongoing problem. The Dr. said " You overreacted to the patch test...let me know if it isn't better in 4,6 or 8 weeks" When will the summary for consumers be available? Who should I turn to for help if the dermatologists and allergists are just now getting guidelines for diagnosing food allergies. Do they have any guidelines for telling the difference between food and non-food allergies? I doubt mine is a food allergy. Its hard to imagine any other profession charging customers or insurance companies to fix a problem, when they have no guidelines for their practice.. How does a consumer know which medical specialist to consult, when each only knows about one aspect of the body and not much about the interrelationship of parts?

    December 6, 2010 at 13:43 | Report abuse | Reply
    • MedStudent

      2 things...

      one, you should be going to a primary care doctor first, then they can tell you who to go to. That's their job, to know a little of everything and be able to manage the less serious medical conditions, and send you to a specialist when something is out of their expertise. If you are dealing with allergies you shouldn't be seeing a dermatologist you should go to an allergist though, they'll be able to help you a lot more.

      two, the guidelines are not supplementing education. every medical student is educated in allergies, every doctor is aware of allergies, they just don't all have complete expertise in allergies because they are a complex growing field. the guidelines are simply SUGGESTIONS on what the most empirically sound methods of treatment, screening, and diagnosis are. That is all. It's not like physicians around the country sat around twiddling their thumbs waiting for a guideline before they could treat allergies. Guidelines just help clear up some uncertainties and provide a common ground for treatment progression.

      December 6, 2010 at 14:11 | Report abuse |
    • Nurse Lisa

      curious why the student didn't just respond once, and simply recommend that sufferers seek out a real MD with a good bedside manner. Sometimes state magazines have an annual "Best docs" issue, where respected MDs share the names of professionals they'd trust to care for their own family members. Giving respect is how you earn it. MDs with a God complex have the respect of neither other MDs nor their patients and their malpractice suits far out number and out cost, those that more compassionate MDs incur.

      December 6, 2010 at 15:35 | Report abuse |
  9. Sneezyweezy

    I had a milk allergy when i was little and it had nothing to do with lactose intollerance or gastro. Drinking milk based formula and other dairy items as I grew older caused mutliple ear and sinus infections. Once I was 7, that was finally diagnosed and I stopped having those items, I became much better. Now I am allergic to ANY artifical sweeteners. Same allergic response, runny nose and ear and sinus infections. Someone explain that.

    December 6, 2010 at 13:56 | Report abuse | Reply
  10. i'm just sayin'

    Medstudent, I'm just sayin'...you are a STUDENT, not a doctor! Stop talking down to people you know nothing about.

    December 6, 2010 at 14:32 | Report abuse | Reply
    • anne

      What we were ALL thinking... (Another med student)

      December 6, 2010 at 14:56 | Report abuse |
  11. TroubledMom

    This is interesting because w just took my three year old son in to see an allergist. He has had chronic diarrhea for over a year now. The pediatrician isn't concerned about it because my son is doing fine on the growth chart, but he isn't the one who has to change the diapers and deal with the welts on my son's bottom. As someone who has dealt with stomach problems my whole life, I just wanted to rule out allergy at a young age. The Allergist actually told us he doesn't think it is allergy because of the lack of other symptoms. We just completed a bunch of blood test and stool tests. It should be interesting to see what they reveal. I am thankful to have found an allergist who doesn't just assume it is a food allergy though! I'll be glad if it's not a food allergy that is for sure.

    December 6, 2010 at 14:41 | Report abuse | Reply
    • FYI

      Make sure they test your son for gluten intolerance and celiac diesease as well. Unfortunately, the number of times this is overlooked by the medical community is quite remarkable. Good luck!

      December 6, 2010 at 14:56 | Report abuse |
  12. TroubledMom

    Also, I'd love more information about the difference between an allergy and an intolerance, and how intolerance is treated. Does anyone know where I can find that? Wouldn't the treatment be the same either way... avoid the food?

    December 6, 2010 at 14:44 | Report abuse | Reply
    • BeenThere&DoneThat

      @TroubledMom – I went through the exact same thing with my son. He had a dairy INTOLERANCE not an allergy. An allergy includes an immune response. An intolerance means that the body just doesn't handle the food/chemical well and reacts in a NON-life-threatening way. My son spit up constantly as an infant with yucky poops (breastfed for 1 year) and had 'unexplainable' diarreah as a toddler. We had him tested for allergies and everything came back NEGATIVE. But, guess what, when we eliminated all dairy (milk, cheese, yogurt, ice cream, etc.) he was 'magically' cured! We were able to reintroduce dairy products after he was 4 and he can now tolerate them fine. Good luck!

      December 6, 2010 at 16:19 | Report abuse |
    • 3pirateboys

      My 2nd son has allergies, yes, diagnosed correctly to milk, dairy, eggs. He had severe diarrhea and was loosing weight. The peds dr. told me to start him on reg. whole milk. I had assumed milk allergy (no idea about egg). My son's bottom was very raw, and he had eczema on his face, legs and arms. I was furious with the dr. So, I fired him, and went to a different peds dr. She also assumed an allergy and warned me about eggs. She immediately sent me to the allergist and it was confirmed. Severe, life-threatening allergies to milk and eggs. Even though I took those out of the diet, he still had an extremely limited diet. No soy protein and for the first 8 months, no citric acids. We did the elimination diet (pretty much only on rice based products, and did slow introductions). He was on neocate formula, only found in the UK for 2 months. It was his only source of nutrition.

      1. You CAN and SHOULD FIRE your doctor. NO REASON to stay with them if you disagree. If your child is constantly getting sick, he is constantly getting paid. And yes, my husband works in the medical field and supports patients "firing" their doctors. My current peds dr. will send me to any specialist I ask for. The way it should be.

      2. Along with allergies, you can have intolerance or sensitivities. The allergies will send you to the hospital and require an epipen for it's immediate responses. Intolerance or sensitivities have a long term effect...eczema, diarrhea etc. However, you still have to avoid foods. Lactose intolerant deals with sugar and milk-fat. Milk intolerant deals with milk proteins same with milk allergies. Something may not have "milk" in it, but the protein casein and whey may still be in the food. MSG's are derived from milk proteins and must be avoided in those with milk allergies. Thus, hot dogs, processed meats, sausages. I only buy all natural and those foods that say no msg's.

      My third son was showing symptoms after he was born, I took milk and eggs out of my diet since I was nursing. I also started both of them on pro-biotics and myself. The reason? It's a protein issue with food allergies. The body in several people in developed countries do not have enough bacteria in their intestines. This bacteria helps break down foods and proteins. When the proteins enter the body, they are now much larger than normal and the body will attack them as a foreign object. Thus, the symptoms people receive. Since I have started the probiotics, my children do not get sick as often, my son (the allergic one) if he ingests milk does not have an immediate reaction, it's turning into a sensitivity. My third son showed no signs of allergies after testing. I figured, it doesn't hurt them to try the pro-biotics. I'm sold on it.

      December 6, 2010 at 16:43 | Report abuse |
    • TroubledMom

      thanks for the information. I did find a new pediatrician. We will go see her in January. We also went to the allergist. He confirmed that my son is allergic to Soy, Peanuts, and eggs. I'm glad to have an answer but really bummed about having to eliminate so many things from his diet. Soy is in everything. They feed him at school, so I don't even know where to begin with helping them eliminate these things from his diet.

      December 15, 2010 at 18:18 | Report abuse |
  13. with-i'm just sayin'

    Medstudent, you're quite annoying. takes away from all the info....

    December 6, 2010 at 14:50 | Report abuse | Reply
  14. Mamma2Three

    I had a baby born in 2000, and in our childbirth class our group of 7 two of the babies were strongly sensitive to dairy - not the lactose, but the milk proteins; projectile vomiting, rashes, the whole nine yards or the dairy proteins passing through our breastmilk. My friend's doctor figured it out, and my doctor knew nothing about it, but wanted to push the "lactose intolerant" party line. I am glad they are educating doctors a little more. After two weeks cutting out all dairy in my diet I went from a baby who refused to nurse unless asleep and threw up after most feedings to a baby who never spit up at all.
    Her stomach matured enough at 6-9 months to tolerate some dairy in my diet and she's not allergic now, but I think 2/7 having serious dairy issues is a high percentage. I also think many babies are allergic to milk protein to some degree and it is diagnosed as gastroesophageal reflux by doctors who are unaware of the widespread problem.

    December 6, 2010 at 14:59 | Report abuse | Reply
  15. Andy

    Medstudent-Go hit the books, study the hygiene hypothesis, learn about the role that endotoxin has in the development of the allergic response. Re read my response for my first post. Vaccines benefit both the person vaccinated and the population in general. The lack of natural infections may be causing this rise in allergic rhinitis. Are you aware of the studies linking parasite infections and allergies? Those who have the genetics to keep parasite infections at bay and become chronically yet asymptomatically infected develop allergies when they are cured of their parasite infections. It turns out this goes way beyond your TH1 vs TH2 paradigm. Although that is important, is not the entire story.

    And if I could give you career advice, learn to explain things to your patients without being condescending to them. Doctor is Latin for teacher, NOT condescending know it all.

    December 6, 2010 at 15:07 | Report abuse | Reply
  16. pnutallergymom

    My daughter was dianosed @ age 2 with peanut allergy. Her allergist does blood testing (RAST0, SPT test (skin), and oral food challenge. There is no doubt she is allergic. You can't just rely on the blood or skin tests.
    As far as milk allergies go, there is a HUGE difference in lactose intolerance and a milk allergy. Lactose intolerance isn't going to kill you. A milk allergy can. Some kids are even touch sensitive to their allergens.
    Food allergies shouldn't been taken lightly, especially by those who don't fully understand. Unless you have had to deal with it, you are clueless on what we have to do to keep our children alive!

    December 6, 2010 at 15:09 | Report abuse | Reply
  17. Kaye

    "milk isn't so much an allergy"? Who is the med student kidding? My son has an allergy to milk, not an intolerance! He has had oral challenges and failed them miserably. His face, mouth, throat, and airway swell up and he has a true "anaphylactic" reaction. Just to disgard that and tell people that it's usually an intolerance is wrong. It is not educating people the correct way. Maybe he needs a little more bookwork in that area!

    December 6, 2010 at 15:13 | Report abuse | Reply
  18. Foodallergymomismyhero

    Hey med student... That bed side manner will get you far... a$$hat

    December 6, 2010 at 15:22 | Report abuse | Reply
  19. kcfq58

    Where did my comment go to?

    December 6, 2010 at 15:34 | Report abuse | Reply
  20. Klcroft

    I can remember as a child being diagnosed with a dairy allergy and the Immunologist telling my parents that he wished they would remove Cows milk from the store shelfs because its not fit for human consumption. As for now I know that I agree with the multi-level tests being required. My son was diagnosed with allergies to wheat, corn, peanuts, oranges, and a host of seasonal and environmental allergies. We had the scratch test done and then his doc told us to take him off everything that reacted for 2 weeks and then slowly over the corse of the following 6 weeks reintroduce one food at a time. some of the things he reacted to on the scratch test didn't cause him any problems but the wheat and corn cause severe reactions. And unfortunately the corn was so severe that he cannot have any by-product of corn.

    Medstudent- I hope that I get the opportunity for you to be my doctor at some point. I will teach you how to treat a person with respect and compassion.

    December 6, 2010 at 15:34 | Report abuse | Reply
  21. TheShadowKnows

    Just for the record, I want everyone to know that CNN or the blog administrator is blocking some of my comments and preventing valuable and beneficial information on the topic from being posted. The flow of information is being controlled and therefore what makes it onto the blog will be only marginally beneficial at best. I wish you and your loved ones well and encourage you all to research the topic through a less restricted medium.

    December 6, 2010 at 15:42 | Report abuse | Reply
    • JennyLou

      I'm fairly certain that MedStudent is not a medical student...lol. Feel free to put him/her on ignore. 🙂

      December 6, 2010 at 15:58 | Report abuse |
  22. I actuallyGraduated

    I find it both interesting & disturbing that nobody has mentioned GMO's in this thread. There is a very strong correlation between the introduction of GE Foods and the rise of allergies in the US that definitely deserves further review. But, since the FDA, USDA & EPA are all captured by Biotech & Big Ag, that's not likely to happen without some sort of public uproar. If you are unfamiliar with the topic, I suggest that you watch Jeffrey Smith on Dr. Oz tomorrow, Tues. Dec. 7th for an introduction to the subject.
    As for MEDSTUDENT, perhaps you should actually earn your degree before you act like such a pompous, self-righteous know-it-all. You DEFINITELY need to work on your bedside manner before someone other than your school puts you in the hospital.

    December 6, 2010 at 15:59 | Report abuse | Reply
    • TheShadowKnows


      Please look above for the post by TheShadowKnows. The GMO factor has been raised for consideration. But thanks for bringing it up again. The more people talk about it the more the word travels.

      Did you know that in Europe has banned GMO food? See: http://www.businessweek.com/globalbiz/content/feb2007/gb20070222_358348.htm Why is America so far behind?

      December 6, 2010 at 16:11 | Report abuse |
    • I actuallyGraduated

      Sorry Shadow, I just went back & noticed your comment. I didn't mean to shortchange you, but medSTUDENT's assinine remarks distracted me. You are right though, the more people talk about GMO's, the better. I do believe however, that Europe is no longer GMO-free. There are trial plots in Britain & mainland Europe (so the genie's out of the bottle already), and if I am not mistaken, the EU voted this summer not to extend the ban. If you know otherwise, I'd be interested to see a source for that.

      December 6, 2010 at 16:16 | Report abuse |
    • TheShadowKnows


      No, I wasn't aware of that. That is truly bad news. I guess that is indicative of the power of the WTO. I think we all need to recruit the French citizens to come over here and show us how to engage in a proper revolution or something along those lines. But seriously, mark my words, the GE/GMO crops will end up being an experiment gone horribly wrong and it will have a devastating impact on humankind. I believe that birth defects and cancer rates will soar, and that wide-spread malnutrition will lead to crippled immune systems which, in turn, allow diseases to run rampant. But that's just my humble opinion.

      December 6, 2010 at 16:38 | Report abuse |
  23. Person

    "milk, eggs, peanuts, tree nuts, shellfish, wheat and soy."
    I'm allergic to everything here but shellfish and soy, along with some others not mentioned. I pretty much can't eat any prepackaged/precooked foods.

    December 6, 2010 at 16:03 | Report abuse | Reply
    • kcfq58

      my wife the same and it is sometimes hell to find something simple as bread

      December 6, 2010 at 19:32 | Report abuse |
  24. Mother

    Medstudent – you need to hit the books before you talk. Lactose intolerance and milk protein allergies are two completely different things. Lactose intolerance means that you can not easily digest the sugars in milk. A milk protein allergies is an allergy to the proteins and means that you can't eat the obvious dairy foods, but also processed meats (like deli and sausage), bread, and foods with MSG. My three month old son has a milk protein allergy and it was discovered because I was eating those things and it passed along in my breast milk. Now, I can't eat anything with milk proteins while still nursing.

    December 6, 2010 at 16:07 | Report abuse | Reply
    • Cow's Milk Protein Intolerance

      I had Cow's Milk Protein Intolerance with my 3 babies (and probably the one due next month). Luckily it waned by 6-12 months depending on the child and I was able to have dairy by the time they were about 12mos old. Stinks, doesn't it? And yes, it is completely different than a lactose intolerance, which is *extremely* rare in human infants (after all, human milk contains lactose). It's amazing how many people confuse the two. Mine did not have a true cow's milk protein "allergy" however, which is less common in infants than an intolerance.

      I hope yours grows out of his sooner than later!

      December 7, 2010 at 00:21 | Report abuse |
  25. Bud

    What about gluten allergies. I've heard that the gluten component of food has a larger allergy base than eggs or dairy?

    December 6, 2010 at 16:23 | Report abuse | Reply
    • Gluten

      Gluten problems are usually going to be a gastrointestinal intolerance rather than a true immune system response. The result is going to be plenty unpleasant for people with severe intolerances, but you won't see an anaphylactic reponse and the "reaction" is usually going to be contained to the GI system and things directly affected by it. Celiac disease is not a trivial thing, but I understand that there is a fairly simple test for it, which is nice. Wheat or other grain allergies do exist, though and can cause typical allergic reactions.

      December 7, 2010 at 00:13 | Report abuse |
  26. Timothy

    Like many others in this thread, we had a child who suffered from extensive protein allergies. When the symptoms manifested themselves, we went through 7 pediatricians before we found one who diagnosed our son correctly and directed him to a pediatric allergist. With a change in formula to one that broke down the proteins into amino acids and other diet restrictions, his vomiting/rashes/swelling went away within a short period. And with ongoing testing and management, he eventually outgrew the allergies and was able to eat normally. I found it very alarming that so many pediatricians could not properly diagnose something that seems to be very common and increasing among children. At least one, outright dismissed the notion that children could have food allergies. I am happy to see some guidelines on diagnosis and treatment finally hit the streets. Lactose intolerance might make your child a little gassy and bloody the stool, but these allergies are certainly life-threatening in many cases. I too would love to see a study relating the use of GMO foods against rising diagnoses of pediatric food allergies.

    December 6, 2010 at 16:46 | Report abuse | Reply
  27. kcfq58

    Why does our government allow bad labeling for food alergies?
    Some labels read "vegetable oil" for someone who is alergic which noil are they using? as none is listed. Soy, peanut.sunflower,etc...
    Why do some salad oils in bio section like olive salad oil, contain less olive than soy. the label should read olive flavored not olive oil. this sort of label makes life for people who have known allergies more difficult than it should be.

    December 6, 2010 at 19:30 | Report abuse | Reply
    • Regarding oils

      Oils are typically safer than the actual foods because they do not contain the plant proteins that set of allergic reactions. Most peanut allergic individuals, for example, can usually eat high quality peanut oil, for example. Not all, but most. There are, of course cases of cross-contamination and there may be a few people who are sensitive to even the oils, but for the most part, it is not as big a concern as one might think. Now, cosmetic quality oils are going to be more dangerous – the oil there is not as highly processed and may not be completely free from proteins, so it is more likely to cause a reaction than food-quality oils.


      December 7, 2010 at 00:07 | Report abuse |
  28. Interesting

    I have a kindergartener who is very allergic to both peanuts and tree nuts – we carry an epi-pen for these and have had to use it recently. His grandfather is also highly allergic to many things, several at the anaphylactic level. Both of them have asthma. That said, there are several other items that have come back positive (but at lower levels) via the blood testing (RAST) that we have not experienced any direct reactions to, among these, eggs, wheat, milk, and soy, so either the reactions are so mild that I haven't noticed them and he has not complained or the test has given us a false positive for these items. I don't know.

    I will say that my kids play in dirt all the time and we have pets and I do not use antibacterial soap etc., so for us, the "cleanliness theory" seems unlikely to be the culprit. Rather, in our case, we probably just have a case of bad genes – what caused those genes to cause whacky immune systems, of course is up for debate.

    December 7, 2010 at 00:03 | Report abuse | Reply
  29. Greg

    If you have private insurance, it is CRUCIAL that you switch to one of the new plans made available after September 23, 2010 because they include free preventative care (like flu shots), they have no annual or lifetime maximums, and kids don't have to go through underwriting and must be accepted up to age 26 regardless of pre-existing conditions. If you bought your health insurance before September 23, you can get a free quote at usabg.net/ghovey/quote

    Surprisingly, rates have even gone down.

    December 7, 2010 at 08:05 | Report abuse | Reply
  30. FDH

    Medstudent’s statements are an indicator of what is failing today in the medical field and in particular with regard to food health. Medstudent’s is an extreme example, full of confidence in his knowledge of medicine and yet unable to forward anything of value to the patient.

    Food sensitivity falls into a niche between allergists and gastroenterologists. A gastroenterologist may dismiss food sensitivity as not being one of the classic diseases or in default call it IBS. An allergist can only dismiss symptoms, as did Medstudent as not an allergy. For this reason, alternative and complementary providers (NDMD, DO and some MD) are often better equipped to diagnose food sensitivities. Likewise, a second opinion may greatly differ.

    The specialist is trained to diagnose a specific set of common ailments that are treated with standard regimen. Without seeing the correct specialist, the patient may be dismissed or misdiagnosed with whatever the specialist generally diagnoses. The adage is “To a man with a hammer, everything is a nail”.

    Congratulations. Your education has taught you to distinguish IgE mediated immune hypersensitivity (allergy) from other immune responses and sensitivities. What good is that to a patient?

    December 7, 2010 at 15:38 | Report abuse | Reply
  31. FDH

    If it is not already clear Medstudent, your remark about reading is misplaced. You did, in fact state that “milk isn't so much an allergy as it is an [sic] intolerance”. That is incorrect. You may have wanted to say that milk allergy is less common than lactose intolerance, but you did not. You owe Foodallergymomx2 an apology. You owe your student peers and those you hope to call colleague an apology.

    December 7, 2010 at 15:39 | Report abuse | Reply
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