Can a Plant or Pollen Allergy Turn into a Food Allergy?

A while back I woke up with very swollen lips. Well, actually ‘very swollen’ is a bit of an understatement; I looked like Mick Jagger with some very bad collagen implants! After I taught a Pilates class in a very dark room (I told the class we are going to focus on breath and awareness that morning), I grabbed my 3yr old daughter and hightailed it to my dermatologist’s office. I thought the reaction was from a cookie (I am gluten intolerant) I ate at a holiday party after having two (or more) glasses of wine.

My regular Dr. was not available so I saw her associate. He knew right away that my pumped up lips were not from a reaction to gluten, but he was determined to find out the cause rather that just treat it. After asking me tons of questions, he figured out that I had some mango the day before and, since I am severely allergic to poison ivy, the mango was a ‘secondary reaction’ to the ‘primary’ poison ivy allergy. He also told me that he noticed my chart shows an allergy to cashews as well and told me that cashews are also linked to poison ivy.

Although it was definitely a ‘eureka!’ moment at the time, it isn’t really that mysterious. The active ingredient in poison ivy that causes the reaction is urushiol , and both mangoes and cashews contain small amounts of it. Therefore, if someone is severely allergic to poison ivy (primary allergen), that person can have a reaction to the secondary allergen. I thanked him so much for figuring this out, and my daughter asked him if he could now fix ‘the crease right there on Mommy’s forehead’ (yes, thanks so much darling!). I left with a steroid cream and something else to add to the list of things I can’t eat (although it is only fresh mango that is a problem for me, I can still have Trader Joe’s mango sorbet).

This type of condition is not overly uncommon. I recently read an article in More magazine claiming that up to 10 percent of the adult population suffers from something similar, Oral Allergy Syndrome (OAS), which is a pollen associated food allergy. The sufferer’s immune system sees a similarity between the proteins of pollen and those of certain foods and a reaction is triggered. This also happens in the adult years rather than in childhood since it takes repeated exposure to (in the case of OAS) pollen allergens, causing repeated stimulation of the immune system causing it to become so overly sensitive that it picks up on related proteins. My crossover allergy is similar to OAS.

Here are some common pairs of primary allergens and their secondary allergens. The proteins are similar. Also remember, this is only a problem for the few with very severe allergies to the primary allergen. Data from the American College of Allergy, Asthma, and Immunology:

• Birch Pollen: apples, pears, peaches, kiwis, plums, cherries, celery, carrots, hazelnuts, and almonds
• Ragweed: bananas, melons, cucumbers, zucchini, and sunflower seeds
• Grass Pollen: tomatoes and oranges
• Mugwort Weed: apples, carrots, kiwis, coriander (spice)
• Dust Mites: Shrimp and other shellfish
• Poison Ivy: Cashews and mangoes
• Latex: Bananas, kiwi, papayas, avocados, and peaches

These allergies are hard to recognize and even harder to diagnose. The food allergy responses are often inconsistent. For example if you are allergic to ragweed, your immune system is heightened in the fall when ragweed is abundant and you may have a reaction to a cucumber then but not in the spring. Peeled fruits and vegetables can also cause much less of a reaction as well since the crossover proteins tend to be in higher concentration in the skins. Another obstacle is the fact that food allergies are very hard to diagnose in adults. It is important to pay attention to your body and to know what doesn’t feel right for you.

Please remember that these secondary allergic reactions are rare, but they can still be serious. Do not ignore any itchiness, swelling, or rashes. Also, the reactions often get worse with repeated exposure. I recently made the mistake of having a tiny bit of cashew and had to take Benadryl right away. I am lucky that it worked, since after repeated exposure I would eventually require an EpiPen. That was a lesson-learned for me though. I now read every label and make sure to tell people about my allergies at parties and restaurants. I have come to realize it is not embarrassing, or being difficult, but that it can be life threatening.  If you suspect that you may have a crossover allergy, please see your doctor since they can be very serious but they can also be very well managed.

Have a wonderful and healthy week

XOX

This blog is for informational purposes only.  It’s not intended to diagnose, treat, cure, or prevent any health problem, nor is it intended to replace the advice of a physician.  No action should be taken solely on the contents of this website.  Always consult your physician or qualified health professional on any matters regarding your health. It is advised see your physician before changing your diet, starting an exercise program, or taking any supplements of any kind.

Ain't Nothing But a G-Thang Baby

Gluten is a protein found in wheat, barley, and rye. The ‘usual suspects’ are bread, cake, most cereals, pizza, and pasta. However, many processed foods may contain hidden gluten. For example, (depending on the brand) gluten can be found in: soy sauce, barbecue sauce, ketchup, mayonnaise, salad dressing, thickened soups and sauces (ie gravy), processed meats (Boar’s Head is gluten-free), non-stick spray, and even hidden in sweeteners such as barley malt and brown rice syrup. It is also found in some non-food items such as lipsticks, shampoos and the adhesive on envelopes.

Celiac disease is the most serious form of gluten intolerance. It is a genetic disorder that affects about 1 in 133 Americans. Symptoms of celiac disease can range from obvious ones, such as diarrhea, excessive gas and bloat, and weight loss to a bunch of non-gastrointestinal symptoms, or even no symptoms at all. Those affected suffer damage to the lining of their small intestines when they consume gluten (this can also lead to many other disorders as well. I included some resources at the end of this post to learn more). Unfortunately, this disease often is undiagnosed. Often people think they just have ‘bad tummies’ and do not bother seeing the doctor. The most dangerous, though, are the ones with no symptoms at all. The person feels fine, but the damage to the internal organs is still happening.

Experts now believe that celiac disease represents just one extreme of a very broad spectrum of gluten intolerance that includes millions of people with less severe, but still annoying reactions to gluten. Celiac disease can be ‘definitively’ diagnosed using a two-step approach: First step is a blood test for the presence of antibodies (IgA and IgG) activated by gluten, and, if it comes back positive, the next step is a biopsy to look for intestinal damage to confirm the diagnosis. Gluten sensitivity, on the other hand, does not have any test and winds up being a ‘default diagnosis’ when a person just feels better on a gluten-free diet. I, however, am not 100% confident in the test to determine celiac disease. Since a person must consistently eat a high gluten diet for some time before the blood test in order for the antibodies to even show up, there is a pretty big chance of a false negative.

I am not a doctor but I will gladly share my own personal experience with gluten sensitivity. However, if you have any concern that you may be gluten intolerant, I strongly suggest seeing your doctor. Then, I recommend making an appointment with a Registered Dietician (RD)(www.eatright.org) and looking through some of the resources at the end of this post.

I have been gluten-free for two years now. I feel great and I do not miss gluten in the slightest. I am not your average gluten-sensitive person since my problem with gluten is not GI related. I started to get eczema in my mid-twenties and, although annoying, it didn’t bother me very much. However, after my daughter was born, the eczema became much worse and much more frequent. I did not agree with the many doctors who said it was an allergic reaction to something external and to ‘just use the steroid cream, it won’t hurt you’. Well, I just knew my problem was systemic (meaning the trigger was within my blood, as opposed to contact dermatitis) and I also just knew that it wasn’t good for my skin to rely on those creams. I did tons of research and then decided to try an elimination diet. I planned to start with gluten and then try dairy. I did it in this order because I read that dairy is often linked to eczema in children, but gluten is more likely the trigger for adults. After eliminating gluten for 10 days my skin became so much better (today it is 100% better, but that took awhile). After the 10 days I had a bowl of cereal in the morning, slice of pizza for lunch, and my daughter’s animal crackers throughout the day. That night I woke up with my skin itching horribly (plus I did feel bloated and uncomfortable!). The next morning I had the ubiquitous red rash and blisters that take so long to heal. My diagnosis was confirmed (by Dr. ME). I went to my new doctor (I recently moved so all of my doctors were new), who agreed that I should see an allergist to be tested. I made the attempt to eat gluten before the blood test but was so miserable I had to stop. I tested negative for celiac disease and that may or may not be correct. However, I will not eat anything with gluten anyway, so it did not matter to me. My physician, allergist, and dermatologist all agree that I do have a form of gluten intolerance, and if I do not eat gluten, there is no need for me to have a biopsy done. The only ‘cure’ for celiac is to adopt a life-long gluten-free diet.

I enjoy eating this way and I find it gives me more energy. I eat a ‘naturally gluten-free’ diet, meaning that I do not buy the processed mass marketed gluten-free products. That is not to say this didn’t have a learning curve. Having a few glasses of wine and thinking a that some holiday cookies won’t hurt, not realizing that restaurants flour their fish before baking, giving in when someone is hurt that I won’t try their baking, and a few other mishaps have led me back to the dreaded steroid creams plus fatigue and bloat. And in my opinion, just not worth it!

I mentioned in a previous post that I tried eating a vegan diet and it didn’t work well for me. Well, in the past, most of my iron and B-complex vitamins came from my big bowl of Kashi cereal each morning. Now that I don’t eat fortified grains, (gluten-free products are not as fortified as the ones with gluten) I needed to add back some animal proteins as my energy levels were becoming low. Now my diet is balanced again and I feel great. Those with celiac disease have to be very vigilant in making sure they get all of their nutrients. That is why it is so important to see an RD nutritionist if you receive this diagnosis.

Somehow eating gluten-free has become ‘trendy’ with the Hollywood scene.  I even had more than a few people say to me, ‘you are so lucky you can’t eat gluten, that is why you are thin’. Well, no… The reason I am thin is because I eat healthy, I do not exceed the calories my body needs, and I exercise a lot. In fact, a person may very likely gain weight eating gluten-free. The marketed products do not contain as much fiber as the wheat/rye/barley grains. These gluten-free carbohydrates tend to be nothing more than non-nutritional starch, which will pack on the pounds. I did not replace my morning cereal with a gluten-free version; I replaced it with either whey protein or Greek yogurt. Instead of having a sandwich, I pile my protein over a large salad. My carbohydrates are mostly vegetables and fruit. When I want a grain, I choose brown rice or quinoa rather than gluten-free pasta. I don’t worry about looking up ingredients for hidden gluten since I mostly stick to whole foods. It is really quite easy for me. And when I want a treat, there is ice cream, sorbet, and dark chocolate (read labels). I have also found the best gluten free ginger cookie in a health food store by the brand Nana’s (although I have this maybe twice a year). I also use Luna Protein bars (they are now gluten free) when I need a quick meal on the run.

Even though I do not rely on convenience foods, I have tried some for fun when I first discovered that I am gluten intolerant. Some pretty good choices are; Chex cereals, Vans waffles and French toast, Environ-kids cereals and bars, Amy’s Organic gluten-free/vegan burrito, Pirates Booty, and of course the Nana’s brand cookies. There are so many more out there since food companies are recognizing the real demand in the gluten free lifestyle.

There are tons of information available on celiac disease and gluten sensitivity. If you have, or suspect you have either, I strongly suggest educating yourself as much as you can. There are lots of books available. I like the one by Elisabeth Hasselbeck, http://www.gfreediet.com/. It is co-authored by Dr. Peter Green, MD, who is the Director of The Celiac Disease Center at Columbia University. Some good websites are: www.celiac.org, www.celiac.com, There are also so many gluten-free cooking websites and cookbooks. Most recipe websites have a gluten-free option as well. A simple Internet search will come up with so many resources.

Thanks for listening to my personal story. Please know that everyone is different. There are so many causes for eczema, so if you have any skin problems, please see your dermatologist first.

Have a strong and happy week.

XOX

This blog is for informational purposes only.  It’s not intended to diagnose, treat, cure, or prevent any health problem, nor is it intended to replace the advice of a physician.  No action should be taken solely on the contents of this website.  Always consult your physician or qualified health professional on any matters regarding your health. It is advised see your physician before changing your diet, starting an exercise program, or taking any supplements of any kind.