Controlling a Wheat Allergy

Yes, you’ll need to read every food label. But having a wheat allergy does not mean you or your child can’t enjoy good foods.
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Most cases of wheat allergy affect children under the age of 3, but adults can have a wheat allergy, too. Someone who has a wheat allergy has an allergy to a protein in wheat, which is a type of grain. The proteins in wheat known to cause an allergic reaction are albumin, globulin, gliadin, and gluten.
What Is a Wheat Allergy?

In a true wheat allergy, IgE, or immunoglobulin E, in your body causes the immune system to overreact when you consume a wheat protein. Symptoms of a wheat allergy vary, and can range from hives or eczema to gastrointestinal symptoms (such as vomiting, diarrhea, abdominal cramping, and pain).

If you think you or your child has a wheat allergy, it is important to see an allergist to confirm the diagnosis. “When someone comes in with what sounds like an IgE-mediated allergy, they should have some skin testing done,” says Julie McNairn, MD, an allergist and immunologist in Cincinnati.

Allergen skin testing can help an allergist determine whether you have an allergy to wheat protein. The tests involve introducing a small amount of the suspected allergen into your skin through a prick or an abrasion. If a small, raised bump develops within a few minutes where the allergen was introduced, you are allergic to the substance.
Living With a Wheat Allergy

People who have a wheat allergy need to “avoid anything containing wheat,” says Dr. McNairn. This includes wheat flours, beer, baking mixes, batter-fried foods, and many processed foods. This can be difficult, as a number of foods, such as ice cream and ketchup, may contain wheat proteins or use wheat flour in their recipe.

Additionally, eating out can be a challenge. Some concerns include:

Cross-contamination of wheat products in shared cooking pans.
Oil used in fried foods that was also used to cook breaded products.
Sauces in which wheat flour may be used.
Meat substitutes, common in Chinese food, that often contain wheat.

You will need to read labels of packaged foods carefully to determine if a product contains wheat. The Food Allergen Labeling & Consumer Protection Act of 2004 requires foods produced after January 2006 to be labeled as containing wheat in the ingredients, just below the ingredient list, or in parentheses after the specific protein.

You may also need to read the label each time, since manufacturers will occasionally change recipes. According to the Food Allergy Initiative, products that list the following as part of their ingredients list contain wheat protein:

Any type of wheat flour (e.g., all-purpose, cake, enriched)
Bread crumbs
Cereal extract
Sprouted wheat
Wheat gluten
Wheat bran
Wheat germ
Wheat grass
Wheat malt
Wheat starch
Whole-wheat berries

Talk to your allergist to determine whether you can consume the following wheat substitutes: amaranth, arrowroot, buckwheat, corn, millet, oats, potatoes, rice, soy, tapioca, and quinoa flour.
Wheat Allergy vs. Gluten Intolerance

People sometimes refer to gluten intolerance, which is also called celiac disease or celiac sprue, as a wheat allergy. But these are separate conditions.

In gluten intolerance, there is an abnormal immune response when gluten is introduced into the small intestine. And while most children will outgrow a wheat allergy by the age of 3, gluten intolerance is a lifelong condition that requires strict avoidance of gluten, which is present in wheat, rye, barley, and their by-products. It is important to distinguish between these conditions, since untreated gluten intolerance can lead to malnutrition, intestinal damage, and other serious health complications.

Are You Allergic to Sunscreen?

Learn how to identify and deal with a sunscreen allergy.
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Summer means sun — and plenty of it. As we spend more time at the pool, park, and beach, lathering up with sunscreen can become a daily activity. And it should. A recent study from Australia — which has some of the highest rates of skin cancer in the world — found that applying sunscreen daily reduced the risk of melanoma, the most deadly kind of skin cancer, by 50 percent.

For some people, however, applying certain types of sunscreen can actually cause a skin allergy. Sunscreen allergies are fairly uncommon, but if you’re worried your skin irritation is caused by sunscreen, here’s what to do.

Detecting a Sunscreen Allergy

Sunscreens work because they contain chemicals that absorb harmful ultraviolet radiation and keep them from penetrating your skin. Some of these chemicals, including oxybenzone, 4-isopropyl-dibenzoylmethane, PABA (para-aminobenzoic acid), esters, avobenzone, and cinnamates, have been known to cause an allergic reaction in certain people.

There are two ways a sunscreen allergy generally appears: as a contact allergy or contact photoallergy, according to Anna Feldweg, MD, a clinical instructor of medicine at Harvard Medical School and an attending physician in allergy and immunology at Brigham and Women’s Hospital in Boston.

With contact allergies, Dr. Feldweg explains, “you get a rash where the product is applied.” But, in contact photoallergy, the reaction is due to an interaction between sunscreen chemicals and sunlight, “so you get the rash where the sunscreen was applied but only once the skin has been exposed to the sun,” she says. The two conditions may be hard to tell apart, but the difference is important in determining how to test for a sunscreen allergy.

A sunscreen allergy may appear when you first start using sunscreen, or it can develop after years of sunscreen use. You might experience an allergic reaction immediately or several days after applying the sunscreen. Signs of a sunscreen allergy include:

  • Red skin
  • Swelling
  • Itching
  • Blisters that are filled with fluid

These symptoms will appear in the areas where you applied the sunscreen to your body — or in the case of a photoallergy, where your skin was also exposed to sunlight.

Dealing With a Sunscreen Allergy

If you suspect you have a sunscreen allergy, see a dermatologist or an allergist. Your doctor can perform a patch test to figure out exactly what’s causing the reaction. For a contact allergy, the patch test probably will be done without ultraviolet light first; a photoallergy patch test will be performed in combination with exposure to ultraviolet light.

People with sunscreen allergies can use alternative sun protection to keep their skin from burning. Sun protection is an important part of protecting the health of your skin, so if you are allergic to a chemical in sunscreen, your doctor can help you find one which doesn’t contain that chemical. Sunscreens known as physical sunscreens contain powdered versions of zinc oxide or titanium dioxide, which reflect light, keeping it from penetrating your skin. Physical sunscreens are not known to cause allergic reactions.

An allergy to sunscreen doesn’t have to keep you from having fun in the sun. Talk with your doctor to figure out which sunscreen will work for you.

Mold and Other Fall Allergies

If you’re allergic to ragweed pollen, you probably don’t love fall. “Depending on where you live, fall is ragweed time,” says Julie McNairn, MD, an allergist/immunologist in Cincinnati. During the fall, dry leaves, grass, and hay harbor allergens such as mold spores and pollen.

Seasonal allergies vary, Dr. McNairn adds. You may experience symptoms one year and not the next. “It’s very unpredictable,” she says. “It is also really hard to say from year to year how the allergy season will be.”

Diagnosing Fall Allergies

Like most seasonal allergies, the symptoms of fall allergies include sneezing, a runny nose, and itchy and watery eyes. These symptoms can interfere with your daily activities, impairing your ability to perform at work or school.

Ragweed pollen is one of the most common reasons for fall seasonal allergy symptoms. A hardy plant, ragweed grows everywhere, but is particularly common in the Northeast, South, and Midwest regions of the United States. Peak ragweed season starts in mid-August and lasts through October.

Ragweed pollen also is known to cause a condition known as oral allergy syndrome (OAS). In OAS, you may experience itching in your mouth and throat, along with mild swelling, after you consume fresh fruits and vegetables such as banana, cucumber, melon, and zucchini.

In addition to ragweed pollen, pollen from other plants, trees, and grass can trigger allergies in the fall. If you’re allergic, mold can also lead to a reaction during the autumn months.

“Molds can be both indoor and outdoor,” says McNairn. “The only time you really get rid of the mold [outside] is if you have a lot of snow on the ground,” she says.

Tips for Managing Fall Allergies

To reduce your exposure to fall allergens such as mold and pollen, McNairn suggests the following:

  • Use a dehumidifier, an electric appliance that can decrease humidity in your house, to keep the relative humidity in your home at less than 50 percent.
  • Ask someone who is not allergic to clean visible mold with a diluted bleach solution.
  • Regularly clean room humidifiers, because they are prone to developing mold.
  • Have someone who is not allergic do yard work (raking leaves, mowing the lawn), or wear a face mask and goggles if you must do it yourself.
  • Keep the windows shut and the air conditioner running when ragweed pollen levels are high.
  • Shower after being outdoors and avoid taking your dirty clothes and shoes into the bedroom, to keep the room as pollen-free as possible.

If your seasonal allergy symptoms are interfering with your daily life or causing you bothersome symptoms, visit an allergist who can diagnose your allergy and recommend ways to manage it. Treatment for seasonal allergies may involve medications such as:

  • Antihistamines such as diphenhydramine (Benadryl)
  • Leukotriene receptor antagonists (such as Singulair)
  • Steroid nasal sprays
  • Decongestants (as pills or nasal sprays)
  • Immunotherapy (also known as allergy shots).

If you suffer from fall allergies, don’t dread autumn’s arrival. Knowing how to reduce your exposure to mold and pollen can make all the difference.

A Guide to Shellfish Allergies

Know the signs of a shellfish allergy and what to do if you have one.
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Shrimp scampi, baked lobster, and oysters on the half-shell can cause serious illness if you have a shellfish allergy. Here’s what you need to know.

“Shellfish allergy is the most common food allergy in adults,” says Anna Feldweg, MD, a clinical instructor of medicine at Harvard Medical School and attending physician in allergy and immunology at Brigham and Women’s Hospital in Boston. Triggered by eating shrimp, lobster, crab, or crayfish, this type of allergy can lead to a serious illness or even death, so it’s important to get a proper diagnosis and learn some precautions.
What Causes Shellfish Allergies?

“Shrimp is the leading culprit [of shellfish allergy] in this country,” says Dr. Feldweg. But, she adds, in other countries where people tend to eat different types of shellfish, the leading cause can be different.

Shellfish allergies are most commonly caused by crustaceans such as shrimp, lobster, crab, and crayfish. But people have also been known to have a shellfish allergy related to bivalves such as oysters, clams, and mussels, as well as snails, squid, and octopus.
Shellfish Allergy Risk Factors

It is not known for certain why some individuals get shellfish allergies and others do not. However, your risk of having a food allergy increases if your family has allergic illnesses such as asthma or allergic rhinitis. Your chances of having a food allergy is higher if you have two allergic parents than if you only have one.
Shellfish Allergy Symptoms

In people with a shellfish allergy, “the reactions can be very severe, and they are also unpredictable,” says Feldweg. “Someone may get hives one time they eat shrimp. If they are exposed to it again, they can have a much more severe reaction,” she adds.

Symptoms of a shellfish allergy usually occur within a few minutes to an hour of ingestion and may include:

Stomach or bowel symptoms (vomiting, diarrhea)
Hives (raised patches on the skin that are extremely itchy)
Swelling of the lips, face, and/or throat
Low blood pressure symptoms (dizziness, lightheadedness)

In susceptible people, these symptoms occur because the body’s immune system has produced a type of IgE (immunoglobulin E), which is an allergic antibody that recognizes shellfish and reacts to it as if it were a dangerous threat. This antibody attaches to your body’s allergy cells, called mast cells and basophils. When you eat the shellfish again, the IgE on the cells recognizes the shellfish proteins, and causes the mast cells and basophils to release chemicals that result in itching, hives, swelling, and other symptoms of an allergic reaction.
Shellfish Allergy Prevention

For people who have a shellfish allergy, “we usually suggest that they avoid all shellfish,” says Feldweg. However, you can be allergic to one type of shellfish and not another, and you should work closely with an allergist you are comfortable with to determine what types of foods you should avoid, and what types you may be able to eat.

Most people who have a shellfish allergy are able to eat fish with fins, says Feldweg, who commonly advises her patients to cook their seafood meals at home, so that they can control what is going into their meals.

Feldweg said that since seafood restaurants almost always use shellfish-based broths and other ingredients that contain shellfish in all of their dishes, people with a shellfish allergy should avoid eating at seafood restaurants.

And people with a shellfish allergy should carry an injectable form of epinephrine, such as an EpiPen, with them at all time.