Nov 22, 2012

How to of the Day: How to Pinpoint Food Allergies

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How to Pinpoint Food Allergies
Nov 22nd 2012, 20:00

If you suspect you have a food allergy, there are several key ways to identify the particular food or foods that are causing problems. Follow these steps to pinpoint your potential food allergies.

Edit Steps

Keep a Food Diary

  1. If you're unsure which particular foods seem to cause problems for you, keep a food diary for two or more weeks. Having a record of foods and symptoms can help you associate particular foods or ingredients with particular reactions. Once you have an idea of a few foods that may be causing discomfort, you can try elimination diets or formal allergy testing at a health care provider's office.
  2. Write down everything you eat and drink. It is essential to have a complete record of everything you consume during the weeks of your food diary.
    • Continue to eat your regular diet, but carry a small notepad with you everywhere to record snacks, vending machine purchases, and other drinks or bites to eat you may have throughout the day.
    • Include all ingredients. For example, if you eat an oatmeal cookie, write down all ingredients or save the ingredient list if the cookie is store-bought. This will help you pinpoint potential allergens, as you should be able to distinguish between an oat and an egg allergy by knowing exactly what everything you eat contains and performing an elimination and reintroduction later.
  3. Carefully record the timing, type, and severity of reactions. In some cases, food intolerance can be confused with actual allergic reactions, and temporal reactions may point to the wrong offender foods.
    • Write down the details of symptoms such as itchiness, swelling, hives, stomach discomfort, diarrhea, nausea, cramps, fever, and any other reactions of the skin or gastrointestinal tract. This will help identify the type of sensitivity you have and the management techniques that will be most appropriate for your food intolerance or allergy.
  4. Discuss your findings with a dietitian or health care provider. Once you have a detailed food diary, you can discuss potential offending foods with a nutrition specialist or allergist to identify particular foods to avoid or strategies to reduce reactions.

Perform an Elimination Diet or Challenge Test

  1. Once you have collected thorough information about your diet and symptoms and have discussed it with a medical or nutritional professional, consider performing an elimination diet or challenge test to pinpoint particular food allergies. If you experience anaphylaxis from any foods at all, do not attempt to perform an elimination diet or oral challenge without the supervision of a physician. If your reactions are typically mild or nondescript, however, an elimination diet or oral challenge can help narrow the list of possibilities.
  2. Select a list of foods to eliminate. After carefully reviewing your food journal for foods that appear to be related with symptoms, make a list of foods to eliminate entirely from your diet, albeit temporarily.
    • Unless you suspect an allergy to a very pervasive ingredient, such as gluten or lactose, avoid dramatically restricting your daily diet by selecting no more than five individual foods to eliminate at a time.
  3. Begin the elimination diet by strictly avoiding the selected foods entirely for 1 to 4 weeks. Continue recording your diet and symptoms during this time. If symptoms have subsided or disappeared, add one food each week back into your diet and continue to track reactions.
    • If the re-introduced food causes no reaction for the entire week, cross it off your list of potential allergens and introduce the next food the following week. Continue this way until you have identified the particular food or foods that cause reactions, avoiding them and discontinuing the challenge for the week if your symptoms return.
    • Be thorough when eliminating foods. For instance, if you suspect that honey is the allergen, check labels for cookies, sauces, cereals, flavored nuts, bottled teas. If you eat a lot of pre-packaged or prepared items, always check ingredient labels to see whether foods you might not suspect could possibly contain the potential allergen.
  4. Keep track of all foods that cause reactions upon reintroduction. Make a list of the food that caused symptoms and keep the food out of your daily diet until you can discuss the reactions with a health professional or get tested for the specific allergen.
    • If you experienced a reaction from a food with more than one ingredient, write down all ingredients in the food item, including additives, preservatives, dyes, and nutritional supplements. Although applesauce, mustard, or soda may seem to be the allergen, the offender could really be a spice, food coloring, or sugar substitute.
  5. Repeat the process if necessary until reactions disappear. If you continue to experience symptoms, albeit reduced in severity or frequency, it is possible you identified the majority of allergens in your diet or that you missed hidden allergens that are present in processed foods.
    • If you need help tweaking your elimination diet, consult a dietician or allergist for advice. In some cases, he or she may be able to examine your list of suspect foods and your food diary to identify potential areas for experimentation.
    • For example, a nutritionist may be able to look at your notes and identify offending food groups or types (such as seeded fruits or emulsifiers in sauces), cross-contamination (often with nuts or grains), or incomplete elimination (due to hidden sources of the offending ingredient or multiple published names of ingredients on food labels).
  6. Perform an oral challenge test. If you experience swelling, hives, or any symptom of anaphylaxis upon eating certain foods, do not perform an oral challenge test without the direct supervision of a physician or allergy specialist.
    • An oral challenge test involves consuming small but increasing portions of a single potential allergen, allowing time in between increasing doses to detect reactions. If no reaction is experienced, an increased amount is consumed.
    • Only one specific food is tested at a time in oral challenge tests to avoid confusion with other potential allergens. Do not perform more than one oral challenge test per week unless under the supervision of a health professional.

Get Tested for Food Allergies

  1. Seek a test if you're still unsure and for the sake of certainty. In many cases, it can be difficult to pinpoint food allergies. If you have already performed a food diary exercise and an elimination diet or oral challenge, a health professional should be able to specify potential allergens through skin prick tests or blood tests. In cases of mild or variable reactions to foods, multiple types of food allergy discovery methods are necessary to confirm a particular allergy. Examining the combination of information gained from food diaries, elimination and oral challenge attempts, and skin or blood allergy tests usually helps identify specific food allergies.
  2. Request a skin prick test. In most cases, skin prick tests can be performed quickly and safely in the office of your primary care provider or in that of an allergy specialist.
    • Skin prick tests involve drawing a grid on your skin and inserting tiny amounts of potential offenders under the surface of the skin. Any square on the grid that shows a reaction may indicate a specific food allergy or sensitivity.
  3. Request a blood allergy test. Blood tests for allergies are able to screen for many more food allergies than skin prick tests, and can sometimes provide information that better represents true allergies (skin prick tests may only indicate a skin allergy to contact with the food).
    • A blood allergy test involves a small blood draw that will be sent to a laboratory for testing. It can take several weeks to get results, which often includes a print-out of all tested foods and the particular results for each food.

Edit Tips

  • If you're managing a food diary for your child, request the assistance of his or her school teachers to ensure that your child is not consuming food of which you are not aware.
  • A simple blood test can determine many common food allergies. Ask your doctor for an IgG allergens test.

Edit Warnings

  • Some foods can cause severe allergic reactions that require injections of epinephrine. If you or your child has previously suffered an anaphylactic reaction, do not attempt to pinpoint food allergies independently.
  • Take care not to turn this into a hypochondriac's hunt. In some cases there is a risk of self-diagnosis occurring simply from wishful thinking, from seeking to be set apart from others because of a special food intolerance. If there is any doubt, get the advice of a doctor who specializes in food allergies rather than making assumptions that you're allergic.

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