The Allergic March

Common pattern:

Atopic dermatitis (eczema) as a baby
Food allergies (milk, egg, soy) in infancy to early childhood, majority outgrown,
Asthma in childhood
Rhinitis (environmental allergies) in teens,
Possible new food allergies (tree nut, seafood) emerging in adulthood, usually not outgrown

There is a lot of individual variation.
Not all people with allergic tendencies will develop all of these components, but they do have a higher probability.
Unfortunately some childhood food allergies (nuts) are less likely to outgrow.

What If?

What if my allergies/ FPIES had been diagnosed as a child?

If I had a chance to outgrow, would I have fit the more typical pattern of the allergic march? Outgrow milk, soy, grains, and possibly newly acquire tree nut and shellfish allergy as an adult. Instead I have multiple (too many!)  allergies right now as an adult including typically childhood ones.

Will I outgrow these allergies?

Now that my issues are identified, even as an adult, is there a possibility that I will outgrow these allergies? I don’t have high hopes but time will tell. And if I do outgrow something I will update with celebration!

List of My Allergies by Symptoms

FPIES with shock

Milk, shrimp, hazelnut, aspergillus mold

Itch and abdominal pain (immediate)

Chestnut (raw)

Exercise induced headache and itch

Wheat, chestnut (roasted)
suspected: other tree nuts, some seeds and beans

Headache (immediate)

Pecan, Live yeast, pumpkin seed, sunflower seed
Sorghum? Macadamia nut? Garbanzo (chickpea)?

Gastrointestinal Issues (GI)

Almond, quinoa, chocolate, buckwheat, chia
Amaranth? Adzuki bean?

GI and headache (delayed)

Soy

Mood

Wheat, chocolate, alcohol, mold?

Hives

Milk (immediate)
Shrimp (delayed)

Sore throat

Buckwheat (immediate)
Milk (delayed)

Acne

Milk, chestnut, sunflower seed?

Punished for Trusting False Negatives

Note, my negative skin prick test for shrimp. At the time shrimp was a moderate suspicion but I didn’t have any in recent times in much quantity at all. It was just that after having certain asian dishes flavored with fermented shrimp paste I would not feel well. Another possibility is that it was just emerging. Shellfish allergies are known to start in adulthood.

In any case, after the very negative skin prick test, I thought I must have been reading too much into my data. In hindsight what I did next was extremely dangerous but I put too much faith in that negative result. Getting the constant vibe that patients are much more likely to overdiagnose themselves didn’t help either.

Yes, patients may overdiagnose or pick the wrong culprit if they don’t track thoroughly, but they probably do have some problem. Maybe not a problem that can be detected by current available tests. I think we resort too quickly to the explanation that one must be imagining it or it is all in the head when the truth is that we don’t know yet.

Anyhow, after the results came in, we fried up some shrimp that was sitting untouched in the freezer. The happiness of adding shrimp back in my diet lasted a mere thirty minutes or so.

I had another similar incident with hazelnut, which was also negative according to skin prick test. Granted, both these reactions were likely cases of FPIES and expected to test negative IgE. The lesson was even a non IgE allergy can be very severe and when it is suspected by history we should be very cautious when introducing these foods.

Visit with Allergist

My suspects before the visit were wheat, milk, chestnut, pecan, shrimp, and chocolate. Although I thought most of these likely had mechanisms other than an IgE type allergy. That is, I didn’t expect them to be detected through skin prick tests.

My test results were positive to buckwheat, barley, rye, milk, pecan, also dust mite, mold (aspergillus mix), and ragweed. (Chestnut and soy were not included in the panel.)

The allergist was very cautious about false positives, and was pretty much only concerned about pecan and dust mite. I do understand the concern about too much restriction on one’s diet and needlessly making life difficult. But as it turns out at least in my case it may have helped to be more cautious about false negatives and trust my own tracking history.

In real life the worst culprits for me are wheat, milk, shrimp. These are also the trickiest to avoid. Pecan, hazelnut, chestnut are also severe but much easier to avoid.

Mold is something I didn’t think much of at the time but was helpful later when I had a bad reaction to traditionally prepared fermented soy paste eaten raw. The “safe to consume” mold cultures here, is what else? Aspergillus.