Food Allergy Prescription Sheet

Precisely avoid allergens, always have emergency medicines on hand, and people who meet the indications can try individualized tolerance training - there is no folk prescription, no miracle drug, this is currently the only effective program verified by evidence-based medicine.

When I was out of the general outpatient department of the allergy department last week, I met a 3-year-old patient whose mouth was so swollen that he could hang an oil can. When his mother dragged him into the clinic, he was still mumbling, "I just ate two mouthfuls of mango, and I thought I was getting angry. Why did it get worse after applying toothpaste for two days?" After checking the serum specific IgE, it was found that the mango allergy was level 4. The first thing my mother said when she took the report was, "Doctor, please prescribe some radical cure medicine. The child will want to eat mangoes in the future." I could only shake my head and read the three sentences above to her again.

Don’t think that allergy avoidance means just putting the food you are allergic to on the diet blacklist and everything will be fine. There are too many people who fall into this trap. Oh, by the way, many people don’t know the existence of “hidden allergens” at all. For example, people who are allergic to milk should not think that they will be fine if they don’t drink pure milk. Milk powder is added to cakes, milk tea, and even some processed ham sausages to adjust the flavor. The small words in the corner of the ingredient list “This production line also processes dairy products” and “may contain trace amounts of dairy products” are really not excuses for businesses. The cross-residues in the production process are really enough for people with allergies to drink a pot. I just admitted a 16-year-old high school student two months ago with a level 3 milk allergy. He was greedy and ate the imported energy bar given by his classmates without looking at the whey protein in the ingredient list. He was out of breath after half a meal. When he was sent to the emergency room, his throat was already swollen by one-third. If he arrived ten minutes later, he would have had a tracheotomy.

There is another misunderstanding that is widely spread: "Allergy means low immunity, just take more supplements". This is simply the opposite of cause and effect - allergies are not caused by insufficient immunity at all, but by the immune system being too "diligent" and mistaking food proteins that are originally harmless to the human body for invading viruses and bacteria, causing chaos such as rashes, edema, and shock. Consuming Ganoderma spore powder, multivitamins, and protein powder to "supplement immunity" may actually make the immune system more active and allergies occur more frequently.

At present, there is no completely unified view on the treatment of food allergies in the academic circles. There are two schools of thought, each with its own reasons. One group is the traditional "absolute allergy avoidance group", which advocates that as long as you are found to be allergic to a certain food, you should not touch any of it. The risk is the lowest. It is especially suitable for people who have a history of severe anaphylactic shock, or whose allergens are peanuts, nuts, seafood and other people who have a high probability of lifelong allergies. As long as they avoid it strictly enough, there will be basically no problems. The other school is the "tolerance induction school" that has become popular in the past ten years. It is believed that long-term no contact with allergens will make the immune system less and less tolerant to it. Even a trace amount of allergens may cause serious problems. As long as there is no history of severe allergies, under the full monitoring of a doctor, start with microgram-level doses. Once you begin to slowly come into contact with allergens, there is a nearly 70% chance of achieving a state of "no allergy to daily food". Now many allergy departments of tertiary hospitals in China are carrying out oral immunotherapy. I have a colleague's child who is allergic to eggs. After a year and a half of treatment, he can now eat boiled eggs normally. But I have to say this up front: You absolutely cannot try it on yourself at home! Last month, a patient was transferred from another hospital. After reading a "desensitization tutorial" on the Internet, I fed my 7-year-old son who was allergic to peanuts ground peanuts at home. As soon as I fed him a little bit the size of a millet grain, the child's face turned purple and he couldn't breathe. He was sent to the ICU for three days before he was rescued.

No matter which plan you prefer, there is one thing you must always have: an epinephrine pen. Don’t think that allergies are just an itchy rash that will go away. A severe allergic reaction can take as little as 5 minutes from onset to laryngeal edema and suffocation. It may be too late by the time the ambulance arrives. I have a 27-year-old patient who is allergic to cashew nuts. He ate a cookie at the company's annual meeting last year, with some cashew nuts mixed in it that he didn't notice. As soon as he walked to the parking lot, his throat felt tight and he couldn't speak. Fortunately, he kept the epinephrine pen in his bag and injected himself into the thigh. He was able to hold on until the ambulance came and saved his life. Oh, by the way, don’t use antihistamines such as loratadine as life-saving drugs. They can only relieve the itching of rashes and are completely useless against severe allergic reactions such as laryngeal edema and hypotensive shock. Adrenaline is the only first-line emergency medicine. This must be remembered.

Every time I write a prescription for an allergy patient, I am used to handwriting three reminders in the blank space of the printed prescription. It is not a doctor's advice, but a practical experience I have learned on my own: First, don't be embarrassed to ask about the ingredients when eating out. Just state clearly what you are allergic to. The waiter will not think you are too busy. If you are really allergic, you will be the only one who feels uncomfortable.； Second, it is best to buy two epinephrine pens. Keep one in your bag all year round and throw the other at home or in the office. Don’t be too expensive. Spending thousands of dollars to buy life-saving insurance is really not a loss. ； Third, if you accidentally come into contact with an allergen, even if it’s just a little chest tightness or itchy skin, don’t insist on not going to the hospital. Some delayed allergic reactions are more severe than the initial attack. You should observe it for two hours and then go away, be safe.

In fact, this prescription does not have a unified dosage or a universal course of treatment. Everyone has different allergens, different allergic levels, and suitable plans vary greatly. To put it bluntly, dealing with food allergies is like dealing with an eccentric neighbor. If you figure out his bottom line, don't take the initiative to provoke him, and prepare ways to deal with emergencies in advance, you can live in peace and harmony. As for the gimmicks on the Internet that say "drinking traditional Chinese medicine to cure the disease" or "acupuncture to remove the root", to put it bluntly, they are all scammers who are eyeing your wallet, so don't believe it.