AllergyEats.com

I got a great email recently.

As a father of 5 children, 2 of whom with food allergies, I am very aware of the difficulties and anxieties that go along with having to manage food allergies/intolerances on a daily basis. In my experience, dining out has been one of the greatest challenges and sources of frustration.

As a result of this, I decided two years ago to create an easy-to-use online guide to allergy-friendly restaurants for the benefit of our entire community. I am writing you today in an effort to introduce you to this new website, AllergyEats (www.allergyeats.com), with the thought that you might find it a valuable tool to share with your readers.

AllergyEats is a peer-based guide with a database that includes over 600,000 US restaurants. Individuals with food allergies or intolerances can rate any restaurant experience by answering 3 simple questions (adding comments if they like). The process can take under a minute. The answers to these questions are translated into a simple “allergy-friendliness” rating.

Other users can then go to AllergyEats when seeking an allergy-friendly restaurant. By simply typing in the geographic location they’re interested in, users can see a restaurant’s “allergy-friendliness” rating, as well as other useful information where available, such as menus, allergen lists, gluten-free menus, nutrition guides, industry certifications, and more.

AllergyEats is new, having been live for roughly 10 weeks. However, where awareness has blossomed, initial reaction has been fantastic and word-of-mouth has driven many ratings quickly (the Boston metro area achieved over 200 ratings in this short amount of time!). Each additional rating, anywhere in the country, increases the value of AllergyEats as a tool for our entire food allergy community. That is why major food allergy and Celiac organizations have endorsed or become friends of AllergyEats so quickly (please see these tabs on the site)... and there are more to come!

The overall look of the site is great and easy to use. Typing in at least your state and zip code is necessary to narrow down that huge database, but you can search by distance, by restaurant name, and by ten allergens: Peanuts, Dairy, Wheat, Fish, Sesame, Tree Nuts, Eggs, Gluten, Shellfish, and Soy. If you find a restaurant that looks good you can get a Google map and directions.

The problem, of course, is that 99% of local restaurants have not been rated yet. Chains do have very useful links to nutritional information and allergen pages, however.

It's the usual chicken and egg problem. The site would be more helpful if people used it and added ratings, but getting people to use a site with no ratings is a challenge.

That's why Paul emailed me, to get the word out, and I'm glad to help. Go there, rate a few restaurants, and tell your friends.

More Desensitization Therapies for Allergies

The Boston Children's Hospital did a major and apparently successful test of desensitization treatments. I reported on them and a series of videos on the progress of the treatments in "Desensitization: the Hot New Word In Allergies and Desensitization Injections Cured Boy's Milk Allergy.

Today a report emerged from Dallas of another desensitization treatment, a different one of a different type. Take a look at Controversial Treatment Ends Food Allergies by Deborah Ferguson of the Dallas NBC affiliate.

Both treatments do have the same basic idea. Start with tiny quantities of the allergen, so tiny that the immune system can handle them with antibodies, and then so gradually increase the dosage that the body can keep up. It's based on well-tried cures for other allergy types.

"We fool the body's allergy and immune system by kind of sneaking up on it. We give very, very teeny doses of the food that causes the problem and gradually increase over time," is how Dr. Richard Wasserman described his food desensitization program. "This is an approach that has been done for one thing or another for a hundred years. It just hasn't been done for foods very often, and developing the protocol we use has allowed us to make a difference and take care of a lot more children."

Even in the small, 50 person trial, however, it's not all successes and champagne.

"Sometimes people do have problems and can't tolerate the food even with this procedure," Wasserman said. "This is a demanding thing for a patient and family."

The increasing number of successes is certainly promising and the fact that some insurance plans will pay for it is a cause for that champagne, especially for a $5000 program.

What's also great is that these programs are treating children who have had allergies for years. One 10-year-old who had to avoid dairy since infancy can now have milk.

Small clinical trials don't always translate into mass programs that everyone can use. The fact that several different programs are reporting good results is a good sign. Parents should talk to their pediatricians and keep informed.

Anaphylaxis - Life-Threatening Allergy

I found an excellent article on anaphylaxis on the AAIR (Asthma and Allergy Information & Research) site. Information and Research. My heart is beating faster already.

And much good informtion there is.

How can you tell if someone is having anaphylaxis?
Anaphylaxis usually happens quickly.
Anaphylaxis can produce:

• An itchy nettlerash (urticaria, hives)
• Faintness and unconsciousness due to very low blood pressure. Unlike an ordinary fainting attack, this does not improve so dramatically on lying down.
• Swelling (angioedema)
• Swelling in the throat, causing difficulty in swallowing or breathing
• Asthma symptoms
• Vomiting
• Cramping tummy pains
• Diarrhoea
• A tingling feeling in the lips or mouth if the cause was a food such as nuts
• Death due to obstruction to breathing or extreme low blood pressure (anaphylactic shock)

And a table of epinephrine injectors.

What is the best treatment for anaphylaxis?

Although there are several important treatments, by far the most important
is:

Adrenaline (epinephrine)

There is one drug which will work against all the effects of all the dangerous substances released in anaphylaxis. It is adrenaline (epinephrine). For serious attacks, it is a vital treatment. You need to inject it; inhalers may no longer be an option.

There are special syringe kits to make injection easy:

Name of injection kit	Country (incomplete list)	Dose	Source	Comment
Epipen	USA, Europe	Adult 0.3 mg Child 0.15 mg	Dey Laboratories (USA) ALK (Eur)	Long-established
Anapen	UK	Adult 0.3 mg Child 0.15 mg	Lincoln Medical Limited, UK	Identical drug & dose to Epipen. Easy to use.
AnaKit	USA	2 doses of 0.3 mg: other doses possible	Bayer	Long-established. Red box also contains antihistamine tablets and flimsy tourniquet (for bee or wasp sting).
Anaguard	USA,also available elsewhere.	As AnaKit	Bayer	Syringe as AnaKit, pen-like container is compact and strong, no tablets or tourniquet.
Min-I-Jet	UK	1 mg, other doses possible	IMS, UK	Seems designed more for hospital use.

LI Links - World

I've updated my LI Links page in my Lactose Intolerance Clearinghouse. I've culled the dead links, so all the links are currently live. Many are new to the page.

The links go to pages that deal with every topic that I cover on this blog, so they include not just pages on lactose intolerance, but also ones on allergies, dairy-free foods, other diseases, getting calcium into your diet, and much more.

For your convenience I'm also listing them here. This post is for Multi-country and travel to multiple country links. If you have others to suggest that I've missed please put them in a comment. I'll try to update the LI Links page more regularly in the future.

World Links

Gluten Free Product Sources - Multi-Country

http://www.enabling.org/ia/celiac/vendors.html

Travel Links

Food Allergy Translation Cards

http://www.selectwisely.com/selectwisely/content_pages/traveling_with_food_allergies.htm

Vegetarian Travel and Restaurants FAQ

http://www.vrg.org/nutshell/faqtravel.htm

"Food Detective" Home Allergy Test Flunks

Intolerances are not the same as allergies. Lactose intolerance is defined as having symptoms because of the body's inability to digest the lactose sugar in milk. A milk allergy is caused by antibodies that react to the proteins in dairy products. They are totally different. I know that. If you've been reading this blog from more than about five minutes you know that.

And the makers of the "Food Detective™, the world’s first food intolerance self test" kit know that. They have a whole page devoted to the difference.

And yet they keep calling the Food Detective a food intolerance kit. It isn't. It tests for protein antibody reactions. Not the same.

Why make a big deal of this? Many people, especially in the UK where the Food Detective is based, confuse the terms or even use them interchangeably. But I'm cynical. And as their own food intolerance page says, as many as 45% of the population of the UK may have food intolerances, but only 2.5% have food allergies. Now which set would you rather your marketing department pitch your product to?

And that's assuming that the product can possibly work as claimed. You take a mere pinprick of blood and put it into the tiny test tube in the kit. Pour on some developer and in 40 minutes you'll know if you have allergies to any of the following:

Cereals
Corn, Durum Wheat, Gluten, Oats, Rice, Rye, Wheat.

Nuts & Beans
Almond, Brazil Nut, Cashew, Cocoa Bean, Peanut, Legume Mix (pea, lentil, haricot),
Soya Bean, Walnut.

Meats
Beef, Chicken, Lamb, Pork.

Fish
Freshwater Fish Mix (salmon, trout), Shellfish Mix (shrimp, prawn, crab, lobster, mussel), Tuna, White Fish Mix (haddock, cod, plaice)

Vegetables
Broccoli, Cabbage, Carrot, Celery, Cucumber, Leek, Peppers (red, green, yellow), Potato.

Fruits
Apple, Blackcurrant, Grapefruit, Melon Mix (cantaloupe, water melon), Olive, Orange & Lemon, Strawberry, Tomato

Other
Egg (whole), Cow's Milk, Garlic, Ginger, Mushroom, Tea, Yeast

That's amazing. Too good to be true? Well, I'm always a skeptic.

You see, the makers of Food Detective are Cambridge Nutritional Sciences CNS), which has done this testing for several years if you mail them a sample of your blood. And the British newspapers have not been kind to CNS.

In You and Yours on Which? Investigation into Food Intolerance Tests, Dr. Mike Walker of CNS reveals that the tests don't test for IgE, the antibody that causes true allergies. It tests for IgG, an antibody which causes hypersensitivities. Some researchers do lump the various antibody reactions together as allergies, some don't. All, to my knowledge, agree that only IgE reactions cause the anaphylactic reactions that are the ones to take most seriously.

Tests on similar testing kits have a large fail sign pasted on them. As Jenny Hope reported in The Daily Mail:

The tests found a total of 183 intolerances, even though the researchers had just one medically confirmed allergy and one already recognized food intolerance between them.

Different test results were produced from identical blood and hair samples sent to the same company under different names. There was little or no overlap of test results from different companies for the same researcher.

A panel of medical specialists and a dietician concluded that none of the tests, which cost between £45 and £275, had ' diagnostic value' for genuine allergies or intolerances.

It's nice to think that one tiny pinprick of blood can tell you what foods not to eat. It's also too good to be true.

The Four Types of Allergies

True allergies are reactions of the IgE antibody system. But there are other antibody systems in the body too and they can produce their own sets of usually different symptoms, creating much confusion. The two types of reactions are sometimes both lumped together as allergies, but they're better thought of separately as allergies and hypersensitivities respectively.

I have a page on my web site, Lactose Intolerance versus Milk Allergy, talking about this. I've posted about it before as well, in The Different Types of Dairy Allergy.

I thought about those when I ran across a column by Dr. Jeff Hersh on the Norwood, MA Daily News Transcript website. He answers a pertinent question from a reader.

Q: My daughter had a blood test which showed she has a delayed IgG egg allergy rather than an immediate IgE (immunoglobulin E) allergy. Can you tell me what this really means?

The whole column is too long to quote here but has a good number of technical details in it that may help people, especially parents, understand allergies better. A few excerpts:

1. IgE helps defend against parasites. It also binds to allergens (things that trigger allergies) to trigger histamine release from mast cells, although how this helps defend the body is not understood.

2. IgG and IgM help "tag" many types of infections, with IgM forming during an acute infection and IgG serving as a "memory" to fight a future similar infection. ...

The types of hypersensitivity are classified according to the part of the immune system causing the problem (although other classification systems exist):

Type 1 is an immediate reaction (usually within minutes to hours) due to IgE and is very common, affecting 50 million Americans. It may be due to foods, environmental allergens (pollen, grasses, etc.), insect stings, medications or many other causes. Typical symptoms include rashes (such as hives), gastro-intestinal symptoms (such as nausea, vomiting and/or diarrhea), swelling (angioedema) and/or respiratory symptoms (such as runny nose, nasal congestion, cough, or even asthma). An estimated 500 people die each year from anaphylaxis, a life-threatening hypersensitivity reaction where symptoms are so severe breathing may be compromised and blood pressure can drop.

Type 2 is due to IgM, IgG and/or complement, and includes conditions where the body's immune system attacks normal body cells such as in autoimmune hemolytic anemia (the red blood cells are attacked), Goodpasture's disease or others.

Type 3 is due to immune complex, IgG and/or complement and can lead to serum sickness or other conditions. It may also lead to allergy symptoms similar to type 1, however with delayed (usually within hours to days) onset.

Type 4 is also delayed onset, but is due to T-cells. It is responsible for contact dermatitis (such as poison ivy), as well as other conditions.