Symptoms msg allergy. MSG Allergy vs. Sensitivity: Understanding Symptoms and Health Effects
What are the symptoms of MSG sensitivity. How does MSG allergy differ from sensitivity. Is MSG harmful to health. What foods contain MSG naturally. How can you identify MSG on food labels.
What is MSG and How Does it Affect Food?
Monosodium glutamate (MSG) is a flavor enhancer commonly used in many foods, particularly Asian cuisines. It’s composed of water, sodium, and glutamate – an amino acid that occurs naturally in various foods and is also produced by our bodies. Despite not having a distinct flavor on its own, MSG is prized for its ability to enhance the natural flavors of foods, making it a popular additive in dishes like soups, stews, meat dishes, and snack foods.
Glutamate, the key component of MSG, is found naturally in many common foods, including:
- Corn
- Green peas
- Mushrooms
- Tomatoes
- Grapes and grape juice
- Certain cheeses (e.g. Parmesan, Roquefort)
Its presence in these foods contributes to their natural umami flavor profile. When added as MSG, it amplifies these savory notes, making food taste more flavorful and satisfying.
MSG Allergy vs. Sensitivity: Understanding the Difference
While many people believe they have an MSG allergy, what they’re experiencing is more accurately described as a sensitivity. Dr. Andy Nish, a board-certified pediatrician and allergy-immunologist, explains that true allergies involve a protein called IgE, an antibody that plays a crucial role in the body’s allergic responses. MSG sensitivity, on the other hand, does not involve IgE.
This distinction is important because it affects how the body reacts and how the condition is treated. An allergic reaction can be severe and potentially life-threatening, while a sensitivity, though uncomfortable, is generally less serious.
Symptoms of MSG Sensitivity
People who are sensitive to MSG may experience a range of symptoms, typically occurring about 20 minutes after consuming MSG and lasting for about two hours. These symptoms can include:
- Tingling or burning sensations
- Facial pressure
- Headaches
- Nausea
- Chest pain
- Flushing
- Sweating
- Weakness
- Drowsiness
- Numbness and tingling in the face, back, and arms
It’s important to note that experiencing these symptoms doesn’t automatically mean you have MSG sensitivity. Other conditions or allergies could be responsible, so it’s advisable to consult with a doctor for a proper diagnosis.
Is MSG Safe for Consumption?
Despite the controversy surrounding MSG, numerous health organizations, including Health Canada and the World Health Organization Expert Committee on Food Additives, have declared MSG safe for consumption. Research has not conclusively linked MSG to any serious health hazards when consumed in normal amounts as a food additive.
However, for individuals who experience sensitivity to MSG, avoiding foods containing this additive is the best course of action. It’s worth noting that the glutamate in MSG is responsible for the symptoms in sensitive individuals, so naturally occurring glutamates in food may also trigger similar reactions.
MSG and Its Relationship to Other Health Conditions
There has been speculation about MSG’s potential role in triggering certain health conditions. Let’s examine some of these claims:
MSG and Migraine Headaches
The link between MSG and migraine headaches remains inconclusive due to insufficient research. However, some individuals report experiencing migraines after consuming MSG-containing foods. If you notice this pattern, it’s advisable to avoid MSG in your diet.
MSG and Asthma
While some people with asthma have reported worsening symptoms after consuming MSG, scientific evidence supporting a direct link between MSG and asthma exacerbation is limited. As with any suspected food trigger, individuals with asthma should consult their healthcare provider if they notice any correlation between MSG consumption and their symptoms.
How to Identify MSG in Food Products
For those looking to avoid MSG, whether due to sensitivity or personal preference, understanding food labels is crucial. Here are some tips for identifying MSG in food products:
- Check the ingredients list: MSG must be listed as “Monosodium Glutamate” when added to pre-packaged foods.
- Look towards the end of the list: MSG is typically added in small amounts, so it’s often found near the end of the ingredients list.
- Be aware of other names: Sometimes MSG may be listed under other names like “hydrolyzed vegetable protein” or “autolyzed yeast extract”.
- Remember naturally occurring glutamates: These don’t require labeling, so foods like tomatoes or mushrooms may contain glutamates without any mention on the label.
It’s important to note that while added MSG must be declared on food labels, there are no labeling requirements for naturally occurring glutamates in foods.
Alternatives to MSG for Flavor Enhancement
For those looking to avoid MSG but still enhance the flavor of their dishes, there are several natural alternatives:
- Herbs and spices: Fresh or dried herbs and spices can add depth and complexity to dishes.
- Nutritional yeast: This deactivated yeast has a nutty, cheesy flavor and is rich in glutamates.
- Seaweed: Many varieties of seaweed are naturally high in glutamates and can add an umami flavor to dishes.
- Aged cheeses: Parmesan, aged cheddar, and other aged cheeses are naturally high in glutamates.
- Mushrooms: Especially dried mushrooms, which have a concentrated umami flavor.
- Fermented foods: Soy sauce, miso, and other fermented products can add depth to dishes.
These alternatives can help maintain flavor complexity in dishes without the use of added MSG.
Managing MSG Sensitivity: Tips and Strategies
If you suspect you have a sensitivity to MSG, here are some strategies to help manage your condition:
- Keep a food diary: Track what you eat and any symptoms you experience to identify patterns.
- Read food labels carefully: Always check ingredient lists for MSG and other sources of added glutamates.
- Cook at home: Preparing meals from scratch gives you full control over ingredients.
- Inform restaurants: When dining out, inform the staff about your MSG sensitivity.
- Explore alternatives: Experiment with MSG-free flavor enhancers to maintain taste in your cooking.
- Consult a dietitian: A professional can help you navigate your dietary needs while ensuring balanced nutrition.
Remember, if you’re experiencing symptoms that you think might be related to MSG consumption, it’s important to consult with a healthcare professional for proper diagnosis and guidance.
The Future of MSG Research and Public Perception
As our understanding of food science and nutrition evolves, so does the research surrounding MSG. Current studies are exploring various aspects of MSG consumption, including:
- Long-term effects of MSG consumption on overall health
- Potential benefits of MSG in reducing sodium intake
- The role of glutamates in appetite regulation and satiety
- Genetic factors that may influence MSG sensitivity
These ongoing studies may provide more clarity on the effects of MSG and help shape future dietary recommendations. In the meantime, public perception of MSG continues to evolve. While some consumers still view MSG with skepticism, others are reevaluating its role in cuisine and nutrition.
As we move forward, it’s crucial to approach the topic of MSG with an open mind, relying on scientific evidence rather than anecdotal claims. Whether you choose to include or avoid MSG in your diet, making informed decisions based on reliable information and personal health needs is key.
In conclusion, while MSG sensitivity is a real concern for some individuals, the scientific consensus currently supports the safety of MSG for the general population when consumed in moderation. As with any dietary concern, personalized advice from healthcare professionals remains the best guide for individual health decisions.
The Truth about MSG – Unlock Food
If you’ve been wondering about MSG and its effects on health, read on for some interesting facts
What is MSG?
MSG stands for “Monosodium Glutamate” and is made of water, sodium and glutamate. Glutamate is an amino acid that is used to make proteins in food and our body.
MSG doesn’t have a specific flavour of its own. Instead, MSG is used as an ingredient to enhance the natural flavours of foods such as meat, poultry, soups, stews, casseroles, gravies, seafood, snacks and vegetable dishes.
Glutamate itself is also found naturally in foods such as corn, green peas, mushrooms and tomatoes
Is MSG the same as salt?
No. MSG is made from water, sodium and glutamate. Table salt is made from sodium and chloride
Is MSG safe to eat?
Yes. According to Health Canada and other organizations worldwide like World Health Organization Expert Committee on Food Additives, MSG is not a health hazard. Some people have reported a sensitivity to MSG. It is the glutamate part of MSG that can produce symptoms such as:
- Tingling and/or burning sensation
- Feeling of pressure on the face
- Headache
- Nausea
- Pain in the chest
These symptoms of MSG sensitivity are generally temporary and can appear about 20 minutes after eating MSG and last for about two hours. If you suffer from this sensitivity, it is best to avoid MSG and glutamate.
Note: Do not automatically assume that you have a sensitivity to MSG if you experience any of these symptoms. Check with your doctor to make sure that you do not have another condition or allergy that might be causing these symptoms
Is there a link between MSG and migraine headaches? What about asthma?
There is not enough research to prove whether MSG triggers migraine headaches. If you find that you tend to get a migraine after eating MSG, the best advice is to avoid eating MSG-containing foods. For more information on dietary triggers of migraines and headaches read our article
Which foods contain naturally-occurring glutamate?
corn
green peas
grapes
grape juice
|
mushroom
some cheeses (Parmesan and Roquefort)
tomatoes
tomato juice
|
How can I tell if a food contains MSG?
“Monosodium Glutamate” must always be stated on the list of ingredients whenever it is added to a pre-packaged food. MSG is usually added in small amounts, so you’ll find it towards the end of the ingredients list (because ingredients are listed in descending order of the amount present in the food).
If the MSG is part of a spice or other ingredient used in the food, it must still be declared on the list of ingredients. Note that there are no labelling requirements for naturally-occurring glutamates.
How can a dietitian help?
A dietitian can help teach you the skills to read and understand food labels. If you are having particular symptoms after eating, a dietitian can help you identify potential food triggers and give you advice on how to eat well while avoiding these foods. To connect with a dietitian, use our Find a Dietitian tool.
Bottom line
Glutamate is an amino acid (protein) naturally found in many foods. According to research, MSG is not considered a health hazard when eaten in small amounts to enhance the flavour in food. If you are concerned about MSG, read the ingredient list of the food product.
You may also be interested in:
Migraines and Headaches – Unlock Food
Understanding Food Labels in Canada – Unlock Food
How To Make A Healthy Stir-Fry – Unlock Food
This article was written and reviewed by dietitians from Dietitians of Canada.
Last Update – November 2, 2021
Does MSG Allergy Really Exist? – Allergy Center
Flushing, sweating, chest pain, and weakness are all potential reactions to monosodium glutamate, or MSG, a flavor enhancer and popular ingredient in many Asian cuisines. Other symptoms include headache, facial pressure, drowsiness, and numbness and tingling in the face, back, and arms.
But while some people assume the symptoms they’re feeling are the result of an allergy, an MSG reaction is really more of a sensitivity than a true allergy. According to Andy Nish, MD, a board-certified pediatrician and allergy-immunologist practicing in Gainesville, Ga., the difference between an allergy and a sensitivity is the involvement of a protein called IgE, an antibody that works in the allergy department of your immune system.
True allergies, like pollen or pet allergies, are IgE-mediated. A sensitivity to MSG is not. It can seem like an allergy because symptoms arise after exposure to the offending ingredient. But without IgE involvement the reaction can’t be called a true allergy.
MSG Allergy Versus Sensitivity: Why Does It Matter?
Distinguishing between an allergy and a sensitivity is important because the treatment for each is different. The science behind allergies is fairly well-understood. There a number of treatments for symptoms, including medications and injections.
The science behind food sensitivity to MSG isn’t as established. Glutamate, the main ingredient in MSG, is a neurotransmitter — a chemical that carries messages in the nervous system. Scientists have been searching for a link between glutamate in the nervous system and the symptoms of MSG sensitivity. But a connection has not yet been made. So for now, Nish says, avoiding MSG if it bothers you is the best thing to do.
While MSG is best known for its use in restaurants, it can also be found in frozen meals, packaged snack foods, canned foods and soups, and even seasoning mixes. Check the ingredients lists on food labels. As a general rule of thumb, if you eat something that gives you a reaction you’ve had before you should eliminate that food from your diet.
The Bottom Line on MSG
Research hasn’t shown MSG to trigger allergy symptoms in large studies, but according to Nish, that doesn’t mean a sensitivity to the ingredient doesn’t exist. “No double-blinded, placebo-controlled studies have shown it to cause problems in a large number of people, [but] I’m sure it can cause this in certain people,” he says.
So if you think you’re sensitive to MSG, figure out which foods trigger your symptoms and avoid them.
Sensitive to MSG? Guess What… You’re Not!
I can’t keep count of how many people have casually told me “I’m actually really sensitive to monosodium glutamate (MSG).” News breaker… you’re not. I know you think you are… and you really want to tell me all about your symptoms… and that you’re the special one… but I promise, you’re not.
You do not have an MSG allergy. You do not have MSG intolerance. These so-called MSG reactions have been found to vanish like steam from hot and sour soup when studied under controlled conditions.
That being said you probably could cut back on the fried rice and General Tsao’s chicken. I mean you did just complain about being bloated…
Let’s walk through the science.
What is MSG?
MSG is a flavor enhancer which has been used effectively for nearly a century to help bring out the best flavors in foods. MSG can be used in many savory dishes including meat, fish, poultry, many vegetables and in sauces, soups and marinades. It harmonizes well with salty and sour tastes but contributes little or nothing to sweet or bitter foods.
MSG is the sodium salt of the common amino acid glutamic acid (or glutamate), which is naturally found in most foods and in your body (remember – amino acids are the building blocks for proteins). It occurs naturally at high levels in many foods such as tomatoes and Parmesan cheese, and the glutamate in commercially produced MSG is chemically indistinguishable from the glutamate naturally present in food. Our bodies handle both sources of glutamate in the exact same way. Breast milk actually contains high levels of glutamate that’s produced naturally by the human body.
The average adult consumes about 13 grams of glutamate each day from the protein in food, while intake of added MSG is around 0. 5 grams. Want to taste the best scrambled egg on earth? Add a pinch of MSG. Try it… you won’t regret it.
How is MSG created?
In 1908 a Japanese scientist, Kikunae Ikeda, was able to extract glutamate from seaweed broth and show that it provided the savory taste to the soup. Today, instead of extracting MSG from seaweed broth, it is created by the fermentation of starch, sugar beets, sugar cane or molasses. This process is the same used to make other common food products such as soy sauce, vinegar and yogurt.
Is MSG safe?
Absolutely. Scientists have not been able to confirm MSG causes any of the reported “MSG allergy symptoms” (e.g., headache, nausea, etc). There is no limitation for use of MSG in foods because international scientific and regulatory bodies have failed again and again to identify any harm from consumption of MSG.
In 1968, an American doctor wrote a letter to the New England Journal of Medicine claiming to have experienced symptoms of numbness in the back of the neck and a feeling of pressure in the face and upper chest muscles, which he coined as “Chinese Restaurant Syndrome. ” He suggested this was caused by MSG because of its widespread use in Chinese restaurants, without any study, data or proof. While the term Chinese Restaurant Syndrome caught on in the U.S., and people began reporting MSG headaches and other side effects, study after study has failed to show any consistent effects among individuals who claim to be “MSG-sensitive” when blindly exposed to fairly high levels of MSG.
How much sodium is in MSG?
MSG has a low sodium content. It contains about 12% sodium while salt contains 39%. MSG is used at levels much lower than salt. Using low levels of MSG allows food scientists to effectively reduce the sodium content of foods, like ready-to-eat soups, by up to 40%, without sacrificing flavor. Take out salt, add a pinch of MSG, and cheers to your health.
Don’t get me wrong, you are a very special person… just not one that’s sensitive to MSG.
For additional information see the U.S. Food and Drug Administration’s “Questions and Answers on Monosodium Glutamate (MSG)” consumer information website.
The monosodium glutamate symptom complex: assessment in a double-blind, placebo-controlled, randomized study
Background:
Considerable debate swirls about the validity of symptoms described by many people after ingestion of monosodium glutamate (MSG), and the question has remained unresolved largely because of a paucity of well-designed challenge studies.
Methods:
We conducted oral challenge studies in self-identified MSG-sensitive subjects to determine whether they had a statistically significant difference in the incidence of their specific symptoms after ingestion of MSG compared with placebo. First, 5 gm MSG or placebo was administered in random sequence in a double-blind fashion. Subjects who reacted only to a single test agent then underwent rechallenge in random sequence in a double-blind fashion with placebo and 1. 25, 2.5, and 5 gm MSG. A positive response to challenge was defined as the reproduction of > of 2 of the specific symptoms in a subject ascertained on prechallenge interview.
Results:
Sixty-one subjects entered the study. On initial challenge, 18 (29.5%) responded to neither MSG nor placebo, 6 (9.8%) to both, 15 (24.6%) to placebo, and 22 (36.1%) to MSG (p = 0.324). Total and average severity of symptoms after ingestion of MSG (374 and 80) were greater than respective values after placebo ingestion (232 and 56; p = 0.026 and 0.018, respectively). Rechallenge revealed an apparent threshold dose for reactivity of 2.5 gm MSG. Headache (p < 0.023), muscle tightness (p < 0.004), numbness/tingling (p < 0.007), general weakness (p < 0.040), and flushing (p < 0.016) occurred more frequently after MSG than placebo ingestion.
Conclusions:
Oral challenge with MSG reproduced symptoms in alleged sensitive persons. The mechanism of the reaction remains unknown, but symptom characteristics do not support an IgE-mediated mechanism. According to Food and Drug Administration recommendations, the symptoms, originally called the Chinese restaurant syndrome, are better referred to as the MSG symptom complex.
MSG Allergy: Separating Facts from Fiction
You may have heard someone claim they are “allergic” to monosodium glutamate, or perhaps you think you have an MSG allergy, or you’ve been wondering if claims about MSG side effects are true.
Here’s a review of just some of the research that has been undertaken to investigate whether an MSG allergy is something to be worried about or is even real.
The first report of a reaction to MSG, back in 1968, was an anecdotal account by one person after he ate at a Chinese restaurant – it was published as a letter to the editor in the New England Journal of Medicine.1 The writer described his reaction as generalized weakness, palpitations and numbness in the arms, but acknowledged that these symptoms may have been due to any number of ingredients in the meal including sodium, or alcohol from Chinese cooking wine, and not necessarily the MSG. However the letter spawned the idea that vague reactions such as these might be attributed to monosodium glutamate (MSG) and introduced the phrase Chinese Restaurant Syndrome.
In 1995, an independent scientific panel, the Federation of American Societies for Experimental Biology (FASEB) published a comprehensive analysis of the safety of MSG and included a list of MSG symptoms and alleged side effects that reports claimed were associated with consuming foods with MSG.2
According to FDA:
FASEB’s report concluded that MSG is safe. The FASEB report identified some short-term, transient, and generally mild symptoms, such as headache, numbness, flushing, tingling, palpitations, and drowsiness that may occur in some sensitive individuals who consume 3 grams or more of MSG without food. However, a typical serving of a food with added MSG contains less than 0.5 grams of MSG. Consuming more than 3 grams of MSG without food at one time is unlikely.
3
The FDA, in its Q&A about monosodium glutamate, notes: “Over the years, FDA has received reports of symptoms such as headache and nausea after eating foods containing MSG. However, we were never able to confirm that the MSG caused the reported effects.”
Research on MSG, conducted for over decades, has found that most people who believe they respond adversely to MSG do not have these reactions when evaluated in carefully controlled tests. As Food Standards Australia New Zealand concludes in its thorough review affirming MSG’s safety, “Although the prevalence of CRS (Chinese Restaurant Syndrome) has been estimated to be about 1–2% of the general population it is not clear what proportion of the reactions, if any, can be attributed to MSG. The vast majority of reports of CRS are anecdotal, and are not linked to the actual glutamate content of the food consumed. Furthermore, when individuals with a suspected sensitivity to MSG are tested in double-blind challenges the majority do not react to MSG under the conditions of the study (or react equally to placebo). Many individuals may therefore incorrectly be ascribing various symptoms to MSG, when in fact some other food component may be the cause. This highlights the need for individuals with suspected MSG sensitivity to undergo appropriate clinical testing.”4
The Bottom Line: Seek a proper medical diagnosis if you believe you are reacting to something you’ve eaten.
Allergens are well defined and packaged foods list common allergens on their labels. Sensitivities are not uncommon and can be attributed to a wide variety of foods and ingredients. In Chinese food, for example, ingredients such as peanuts, sesame seeds, shell-fish or even egg can cause reactions for some people. This is why it’s important not to self-diagnose. As with any product to which you suspect you are having an allergic-type reaction consult a healthcare professional to get a proper medical diagnosis.
References:
- Kwok RHM. Chinese-restaurant syndrome [letter]. N Engl J Med 1968; 278:796.
- Raiten DJ, Talbot JM, Fisher KD, eds. Analysis of adverse reactions to monosodium glutamate (MSG). J Nutr 1995; 125: 2892S–2906S
- FDA: “Questions and Answers on Monosodium Glutamate (MSG)“
- “Monosodium Glutamate, A Safety Assessment” (Technical Report Series No. 20), Food Standards Australia New Zealand (FSANZ)
Further references can be found on Wikipedia here.
Studies Investigating MSG Allergy and “Sensitivity”:
Review of Alleged Reaction to Monosodium Glutamate and Outcome of a Multicenter Double-Blind Placebo-Controlled Study | The Journal of Nutrition
ABSTRACT
Monosodium glutamate (MSG) has a long history of use in foods as a flavor enhancer. In the United States, the Food and Drug Administration has classified MSG as generally recognized as safe (GRAS). Nevertheless, there is an ongoing debate exists concerning whether MSG causes any of the alleged reactions. A complex of symptoms after ingestion of a Chinese meal was first described in 1968. MSG was suggested to trigger these symptoms, which were referred to collectively as Chinese Restaurant Syndrome. Numerous reports, most of them anecdotal, were published after the original observation. Since then, clinical studies have been performed by many groups, with varying degrees of rigor in experimental design ranging from uncontrolled open challenges to double-blind, placebo controlled (DBPC) studies. Challenges in subjects who reported adverse reactions to MSG have included relatively few subjects and have failed to show significant reactions to MSG. Results of surveys and of clinical challenges with MSG in the general population reveal no evidence of untoward effects. We recently conducted a multicenter DBPC challenge study in 130 subjects (the largest to date) to analyze the response of subjects who report symptoms from ingesting MSG. The results suggest that large doses of MSG given without food may elicit more symptoms than a placebo in individuals who believe that they react adversely to MSG. However, the frequency of the responses was low and the responses reported were inconsistent and were not reproducible. The responses were not observed when MSG was given with food.
Postprandial discomfort is experienced by many people after eating certain types of foods. There are many reports of adverse reactions to particular food ingredients; the quality of these reports range from anecdotes ascribing symptoms of postprandial discomfort to the ingestion of a particular food ingredient, to clinical studies using double-blind, placebo-controlled (DBPC)4 challenges with the food ingredient in question.
Monosodium glutamate (MSG) is used worldwide as a flavor enhancer. L-Glutamic acid is the amino acid component of MSG, and has a long history of use in foods as a flavor enhancer. It is added either as the purified monosodium salt or as a component of a mix of amino acids and small peptides resulting from the acid or enzymatic hydrolysis of proteins. This amino acid is a major constituent of food proteins (in some foods comprising 20% of the total amino acid content), a pivotal metabolic intermediate in amino acid metabolism and a major energy source for cardiac myocytes. Regardless of dietary source (protein, protein hydrolysates or salts of free glutamic acid, including the monosodium salt MSG), all glutamate molecules entering the circulation from the gastrointestinal tract are structurally identical.
The average daily intake of MSG is estimated to be 0.3–1.0 g in industrialized countries, but can be higher occasionally, depending on the MSG content of individual food items and an individual’s taste preferences. In the United States, the Food and Drug Administration (FDA) has classified MSG as generally recognized as safe (GRAS). Nevertheless, MSG has been alleged to cause many ills. The complex of symptoms that follow ingestion of a Chinese meal and consist of numbness at the back of the neck and arms, weakness and palpitations was first described in 1968. MSG was suggested to trigger these symptoms, which were referred to collectively as Chinese Restaurant Syndrome (CRS). More recently, in its 1995 report, the Federation of American Societies for Experimental Biology (FASEB) proposed the term MSG symptom complex to denote the reactions alleged to occur after the consumption of MSG. In addition to the MSG symptom complex, ingestion of MSG has been alleged to cause or exacerbate numerous conditions, including asthma, urticaria, atopic dermatitis, ventricular arrhythmia, neuropathy and abdominal discomfort. An ongoing debate exists concerning whether MSG indeed causes any of the alleged reactions and, if so, the prevalence of reactions to MSG. For example, in the case of asthma, MSG was reported in a single-blind challenge to exacerbate symptoms (Allen 1987). This study suffered from severe methodologic flaws in patient selection, use of bronchodilator during the control period but not during the challenge, drug withdrawal from the patients during the challenge period and, in fact, lack of true single blinding. Using the same protocol, Manning and Stevenson (1991) were not able to confirm asthmatic reactions due to MSG in patients who experienced asthma within 12 h after ingesting MSG in restaurants. Schwartzstein et al. (1987) used a double-blind crossover protocol and did not see any decrease in pulmonary function after MSG challenge in 12 patients. Simon (1986) also reported not finding asthmatic reactors to MSG in double-blind challenges; however, one reactor was found in a single-blind challenge.
Epidemiologic surveys of reactions to MSG.
An epidemiologic survey of ∼5000 MSG users and nonusers in Hawaii found no increased recall of neurologic symptoms among MSG users. The use of MSG was found to have no relationship to blood glucose or cholesterol, and MSG consumption did not contribute to excessive weight gain (Go et al. 1973). A questionnaire study in a medically oriented population indicated that the prevalence of CRS-sensitive people was as high as 25% (Reif-Lehrer 1977). This study was criticized for many methodological problems such as demand bias in questionnaire design and population bias in survey technique. In a 1977 questionnaire survey, Kerr et al. (1977) showed that, in a medical school community, no one reported experiencing the triad of symptoms for CRS and that 3–7% of subjects could be classified as having experienced “possible CRS. ” This figure was increased to 31% when demand-biased questions were introduced. To determine the incidence of CRS symptoms in the general population, Kerr conducted a survey utilizing the National Consumer Panel of the Market Research Corporation of America. Of 3222 respondents, 43% recalled experiencing one or more unpleasant symptoms associated with the consumption of food sometime in their past. The symptoms were relatively nonspecific in nature, and there were no responses that could be categorized as “definite CRS” or “probable CRS.” Only 1.8% of responses could be considered to represent “possible CRS,” and these symptoms associated with Chinese food were linked to only 0.19% of the respondents according to the authors (Kerr et al. 1979). A questionnaire survey in Thailand also showed “no correlation between susceptibility to CRS and MSG intake” (Pothisiri 1983).
Clinical studies with MSG ingested with food.
Studies in which MSG was administered with food have shown an absence of CRS symptoms. Oral administration of up to 147 g/d of MSG to adult humans as the sole source of nonessential nitrogen for 2–6 wk appeared to cause no clinical pathologic changes, and no CRS symptoms were manifest (Bazzano et al. 1970). The only biochemically demonstrable effect was a reduction in serum cholesterol and β-lipoprotein levels. Supplements of glutamate as high as 100 g/d showed no toxic manifestations (Bazzano et al. 1970). When 3 g MSG was administered in 150 mL of beef bouillon at lunch time to 73 healthy subjects either in an open label or double-blind design with each subject acting as his or her own control, no differences in symptomatology were found between the control and MSG-treated groups (Morselli and Garattini 1970, Zanda et al. 1973). In a study to examine the absorption of glutamic acid from solutions of MSG or a casein hydrolysate, 60 mg MSG/kg casein hydrolysate or a mixture of the two were administered to 12 healthy adults; no general ill effects were observed (Marrs et al. 1978). In other studies, 60–150 mg MSG/kg body weight was given to 14 adults and 13 infants with a typical Chinese rice porridge meal. No adverse reactions were observed (Tung and Tung 1980).
Clinical studies with MSG ingested without food.
The first clinical study on CRS was performed by Schaumburg et al. (1969). In that study, it was found that intravenous or oral administration of MSG could cause dose-dependent symptoms in nearly all six individuals tested. The symptoms of burning, facial pressure and chest pain were reported, and headache was reported to occur in a small number of the individuals. The challenges were open, or when blinded, did not take into consideration the taste of MSG.
In single- and double-blind studies, a total of 169 doses of up to 12 g were given in 99 subjects. Only subjective symptoms of lightheadedness and tightness in the face appeared significantly more often in the MSG group than in control. No subjects reported the triad of symptoms of CRS, and objective measurements of blood pressure, pulse and serum chemistries were not significantly different between the two groups. The samples were osmotically matched, but the tastes were not disguised (Rosenblum et al. 1971).
In a placebo-controlled study in 77 subjects, it was found that symptoms were felt after MSG ingestion but that the classic CRS combination was rare. There was no correlation between the appearance of symptoms and blood glutamate concentrations (Kenney and Tidball 1972). In a nonblind study, 15 subjects were given 100 mg MSG/kg and six subjects reported subjective symptoms. The occurrence of the symptoms was not related to plasma glutamate levels (Hsu and Huang 1985).
In a study to test the effect of aspartame on CRS sufferers, six individuals were found who reported one or more CRS symptoms after drinking tomato juice containing 150 mg MSG/kg but not after drinking tomato juice with 10 mg NaCl/kg. The solutions were administered in a double-blind manner, but the tastes of the substances were not disguised (Stegink et al. 1981).
In a double-blind study with 55 subjects, a significant number reacted more frequently to MSG than placebo, but none complained of any of the classic CRS symptoms. It was noted that there were significant differences in taste and aftertaste of the MSG samples compared with placebo (Gore and Salmon 1980). To test whether CRS symptoms were caused specifically by MSG, symptoms experienced after the ingestion of various common food items were examined. Of 60 subjects tested, it was found that all materials provoked symptoms and that symptoms of burning, tightness or pain in the chest, neck, face or arms, or numbness were reported in response to coffee in six subjects and spiced tomato juice in six subjects, and in two subjects after the ingestion of a 2% MSG solution. MSG was found not to be unique in producing discomfort after eating (Kenney 1980).
The Chinese Restaurant Syndrome (CRS) or MSG symptom complex
In 1968, a letter appeared in the New England Journal of Medicine describing a syndrome which began 15 to 30 min after eating in certain Chinese restaurants, and lasted about 2 h with no residual effects. The symptoms described were the triad of “numbness at the back of the neck, gradually radiating to both arms and the back, general weakness and palpitations.” The author noted that these symptoms were similar to those of hypersensitivity to acetylsalicylic acid from which the author also suffered. Numerous possible causes were suggested, among which were alcohol, salt and MSG used in cooking (Kwok 1968).
The syndrome was called “Chinese Restaurant Syndrome (CRS)” and numerous reports, most of them anecdotal, were published after the original observation. Some reported symptoms similar to the original report, whereas others reported symptoms differing from those originally reported. The range of symptoms described in these reports included numbness, headache, migraine, palpitations, tightness, weakness, aching, flushing, sweating, fasciculation, lacrimation, syncope, dizziness, shudder attacks, paresthesias, arrhythmias and tachycardia. Further uncontrolled study indicated that a triad of symptoms, differing from those originally described, of “burning, facial pressure and chest pain” could be induced in individuals given high doses of MSG and that there was a dose response (Schaumburg et al. 1969).
Since then, clinical studies on these acute, temporary and “self-limited” adverse reactions have been performed by numerous groups, with varying degrees of rigor in experimental design ranging from uncontrolled open challenges to DBPC studies. DBPC challenge of individuals believing to be MSG sensitive did not confirm their sensitivity, and studies indicate that the symptoms observed in some experiments are not specific to MSG ingestion and can also be elicited by other foods. Studies in which MSG was administered in food rather than in pure form have generally shown a lack of symptoms altogether. Thus, a causal relationship between MSG and acute, temporary and “self-limiting” adverse reactions is far from established.
Proposed mechanisms to explain MSG symptom complex.
Numerous mechanisms have been proposed for CRS but none has been proven. Restriction of circulation by the application of an axillary cuff confined burning sensation to the arm after MSG injection; thus the stimulation of peripheral receptors was proposed as the mechanism for CRS (Schaumburg et al. 1969).
The symptoms of CRS were noted to be similar to those observed after acetylcholine administration. Glutamate can be converted to acetylcholine via the tricarboxylic acid (TCA) cycle, and experiments indicated that drugs affecting the cholinergic mechanisms could modulate CRS symptoms; thus it was proposed that CRS was a form of acetylcholinosis (Ghadimi et al. 1971). However, it should be noted that this should be true for any TCA cycle intermediate.
The symptoms and regions of the body affected by CRS were noted to be similar to those of pain referred from the upper esophagus. Studies indicate that individuals purportedly reacting to MSG may react to concentration rather than dose; furthermore, the same dose of MSG taken in capsules is associated with fewer reactions. Because MSG was found not to be unique in producing CRS symptoms, it was proposed that CRS may be a manifestation of esophageal irritation (Kenney 1986).
Plasma sodium levels were found to be increased after a Chinese meal, and the high sodium content of Chinese restaurant meals was suggested to be the cause of CRS (Smith et al. 1982).
Folkers and colleagues suggested that subjects experiencing CRS symptoms did not do so after vitamin B-6 supplementation and proposed that CRS was a manifestation of vitamin B-6 deficiency (Folkers et al. 1984).
The symptoms of CRS were suggested to be similar to those of histamine intoxication. When the histamine content of ingredients used in Chinese cooking was measured, it was found that some Chinese meals could contain levels of histamine close to the toxic threshold established by the FDA for histamine in foods, leading the authors to propose that CRS may be caused by histamine (Chin et al. 1989).
MSG challenge studies in subjects claiming to be MSG sensitive.
A drink vehicle with a novel taste that could effectively mask the taste of MSG was used to challenge individuals who believed themselves to be MSG sensitive. Of >30 such individuals with whom contacts were made, only six agreed to be tested. When these individuals were challenged with 6 g of MSG in a double-blind, placebo-controlled manner, it was found that four of the six did not react to either substance, whereas two reacted to both MSG and placebo. Of the subjects who reacted, one reported tingling of hands and warmth behind the ears after both MSG and placebo; the other subject experienced tightness of the face after ingesting either substance. The remaining four individuals who had ascribed their previous symptoms such as headache, nausea, tongue swelling and uncontrollable coughing to MSG ingestion, did not react to either substance (Kenney 1986).
In a study designed to monitor flushing, which study participants felt was caused by MSG ingestion, 24 subjects, including 18 who had a history of subjective flushing symptoms after eating Chinese food were challenged with 3–18.5 g MSG. No one reported flushing sensations. Six subjects, three with a history of flushing, were challenged with 35.7–285.7 mg MSG/kg body weight or 7. 1–71.4 mg pyroglutamate/kg body weight. None reported flushing sensations and no significant changes in cutaneous blood flow occurred (Wilkin 1986).
Yang et al. (1997) recently conducted a DBPC study of 61 self-identified MSG-sensitive subjects. The subjects were challenged with 5 g MSG or placebo, and a positive reaction was defined as the occurrence of two or more symptoms among 10 symptoms described to occur after MSG ingestion. The rates of reaction to placebo and MSG were not significantly different. Upon rechallenge with placebo and increasing doses of MSG (1.25, 2.5 or 5 g), the frequency and severity of the responses increased with increasing doses, reaching significance for headache, muscle tightness, flushing, general weakness and numbness/tingling.
We recently conducted a multicenter DBPC multiple challenge study with a crossover design to evaluate reactions allegedly due to the consumption of MSG in 130 self-identified subjects who believed they had had reactions to MSG (Geha et al. 1998). In three of four protocols (A-D), MSG was administered without food. A “positive response” was defined as the presence of at least two of 10 symptoms reported to occur after ingestion of MSG-containing foods. In Protocols C and D, a “reproducible response” was defined as the same two or more symptoms among those listed in the enrollment inclusion criteria that were reproducible in separate challenges, with no symptoms produced by placebo.
All subjects who satisfied the inclusion/exclusion criteria were enrolled in Protocol A. Subjects were randomized to receive placebo on d 1 and 5 g MSG (in a citrus-flavored beverage) on d 2 (Arm 1) or 5 g MSG on d 1 and placebo on d 2 (Arm 2). Prior testing on normal volunteers established that the citrus flavor effectively masked the taste of MSG. Subjects who responded with two or more symptoms to at least one test article in Protocol A were eligible to be enrolled in Protocol B. Protocol B was initiated immediately after completion of Protocol A and consisted of four challenges, each on a separate day. Each subject was administered randomly four test articles consisting of placebo, 1.25 g, 2.5 g or 5 g of MSG in 200 mL citrus-flavored beverage. Subjects who responded with two or more symptoms to 5 g MSG but not to placebo in both Protocols A and B were eligible to be enrolled in Protocol C. Subjects were randomly assigned to receive 5 g MSG or placebo first in each of two sets of challenges administered on two separate days. Subjects who responded to 5 g MSG but not to placebo in both sets of challenges in Protocol C were eligible to be enrolled in Protocol D. Protocol D consisted of six challenges each performed on a separate day. Each subject randomly received three times capsules containing 5 g MSG and three times capsules containing placebo (5 g sucrose) during a cereal breakfast consisting of Frosted Flakes.
In Protocol A, 50 (38.5%) of 130 subjects reported two or more symptoms (“positive response”) during the MSG challenge and had no symptoms or one symptom after placebo. Nineteen subjects (14.6%) reported two or more symptoms to both MSG and placebo, whereas 17 subjects (13.1%) reported two or more symptoms to placebo and no symptoms or one symptom after MSG. Forty-four subjects (33.8%) reported no symptoms or one symptom to both MSG and placebo. Administration of 5 g MSG was associated with a significantly higher frequency of response, i.e., of occurrence of two or more symptoms and with significantly higher frequency of occurrence of four of the 10 symptoms.
Eighty-six subjects who responded to at least one of the two challenges in Protocol A were eligible for Protocol B. Of these 86 subjects, 17 either chose not to participate or did not complete Protocol B; 69 subjects completed Protocol B. Administration of 1.25, 2.5 and 5 g of MSG was associated with significantly increased frequency of response. There was no significant increase in frequency of response for any of the 10 symptoms with 1.25 g MSG. An increased frequency of response was observed only for numbness/tingling with 2. 5 g MSG and for six of 10 symptoms (general weakness, muscle tightness, flushing, sweating, headache/migraine, numbness/tingling) with 5 g MSG. Nineteen subjects responded to 5 g MSG but not to placebo in both protocols A and B.
Twelve of the 19 eligible subjects participated in Protocol C and underwent two challenges (C1 and C2), each with 5 g MSG vs. placebo. Only two of the 12 subjects responded to MSG and not to placebo in both challenges. However, in none of these subjects did the symptoms in Protocols C1 and C2 reproduce those observed in Protocols A and B.
Subjects who report reactions allegedly caused by MSG ingest MSG in food. It was therefore important to ask whether the two subjects who had responded to 5 g MSG but not to placebo in protocols A through C would react to the same dose of MSG administered with food. Both subjects who responded to MSG in protocol C enrolled in protocol D, which consisted of six challenges, three with 5 g MSG and three with placebo, in which the test articles were administered in the middle of a standard breakfast and the subjects were asked to report their symptoms. Each subject responded to only one of the three MSG challenges with two or more symptoms. In both subjects, the symptoms reported differed from those reported in the previous three protocols.
The data from the study suggest that large doses of MSG given without food may elicit more symptoms than a placebo in individuals who believe that they react adversely to MSG. However, neither persistent nor serious effects from MSG ingestion were observed and the frequency of the responses was low. More importantly, the responses reported were inconsistent and were not reproducible. The responses were not observed when MSG was given with food (Geha et al. 1998).
FDA position on MSG
In 1958 the Food Additive Amendments to the Federal Food, Drug and Cosmetic Act designated L-glutamic acid and hydrolyzed protein products containing L-glutamic acid (including monosodium glutamate and hydrolyzed vegetable proteins) as GRAS. This status was reaffirmed when the FDA’s Hypersensitivity Committee in 1986 and the FDA Health Hazards Evaluation Board in 1990 concluded that dietary intake of glutamates does not present a hazard to human health and requires no additional regulatory action. In addition, a report of the FDA Clinical Nutrition Assessment Section prepared in 1989 “… could find no evidence that MSG is a health hazard to large segments of the general population. Although there is some evidence that dose-dependent, mild reactions occur in a small portion of the population, continued label declaration of MSG and surveillance of adverse reactions should be sufficient to protect public health.” On June 21, 1991, the FDA published a proposal to not require listing monosodium glutamate on a product label when protein hydrolysates are added to a food product. In presenting this proposal, the FDA again affirmed the lack “of any scientific evidence that establishes that monosodium glutamate causes particularly severe adverse reactions, or that reactions to low doses of monosodium glutamate occur and are life-threatening.” The August 1995 FASEB report on MSG reaffirms again the GRAS status of MSG and recommends that in order to confirm the MSG symptom complex, three DBPC challenges on separate occasions must reproduce symptoms with the ingestion of MSG and produce no response with placebo. In addition, the FASEB report recommends the use of capsules as test articles to ensure the greatest control over dose and blinding and to obviate the potential role of the oral cavity in the precipitation of adverse effects.
SUMMARY
The weight of the evidence supports the designation of MSG as a generally safe food flavoring agent. Neither epidemiologic surveys nor challenge studies provide evidence that ingestion of MSG is associated with adverse reactions in the population at large. In subjects who report adverse reactions to MSG, rigorous DBPC challenge studies indicate that large doses of MSG given without food may elicit more symptoms than a placebo in individuals who believe that they react adversely to MSG. However, neither persistent nor serious effects from MSG ingestion were observed, and the frequency of the responses was low. More importantly, the responses reported were inconsistent and were not reproducible. The responses were not observed when MSG was given with food.
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Abbreviations
CRS
Chinese Restaurant syndrome
DBPC
double-blind, placebo-controlled
FASEB
Federation of American Societies for Experimental Biology
FDA
Food and Drug Administration
GRAS
generally recognized as safe
MSG
TCA
© 2000 The American Society for Nutritional Sciences
Food Allergy vs.
Food Intolerance: Symptoms, Causes & Prevention
Overview
What is a food allergy?
A food allergy is an immune system response. It is caused when the body mistakes an ingredient in food — usually a protein — as harmful and creates a defense system (antibodies) to fight it. An allergic reaction occurs when the antibodies are battling an “invading” food protein. The most common food allergies are shellfish, nuts, fish, eggs, peanuts, and milk.
What is food intolerance?
Food intolerance is a digestive system response rather than an immune system response. It occurs when something in food irritates a person’s digestive system or when a person is unable to properly digest, or break down, the food. Intolerance to lactose, which is found in milk and other dairy products, is the most common food intolerance.
How common are food allergies and intolerances?
Food allergies affect about 1 percent of adults and 7 percent of children, although some children outgrow their allergies. Food intolerances are much more common. In fact, nearly everyone at one time has had an unpleasant reaction to something they ate. Some people have specific food intolerances. Lactose intolerance, the most common specific food intolerance, affects about 10 percent of Americans.
How can you tell the difference between an allergy and intolerance to food?
Food allergies can be triggered by even a small amount of the food and occur every time the food is consumed. People with food allergies are generally advised to avoid the offending foods completely. On the other hand, food intolerances often are dose related; people with food intolerance may not have symptoms unless they eat a large portion of the food or eat the food frequently. For example, a person with lactose intolerance may be able to drink milk in coffee or a single glass of milk, but becomes sick if he or she drinks several glasses of milk. Food allergies and intolerances also are different from food poisoning, which generally results from spoiled or tainted food and affects more than one person eating the food. Your health care provider can help determine if you have an allergy or intolerance, and establish a plan to help control symptoms.
Symptoms and Causes
What are the symptoms of a food allergy?
Symptoms of a food allergy can range from mild to severe, and the amount of food necessary to trigger a reaction varies from person to person. Symptoms of a food allergy may include:
Anaphylaxis is a very serious and potentially fatal allergic reaction that involves a sudden drop in blood pressure, loss of consciousness and body system failure.
What are the symptoms of food intolerance?
Symptoms of food intolerance include:
What causes food allergies and intolerances?
Food allergies arise from sensitivity to chemical compounds (proteins) in food, even compounds that are found naturally in food. Food allergies are more common in people whose family members have allergies, suggesting a genetic — or hereditary — factor may be involved with the development of food allergies.
Food allergies develop after you are exposed to a food protein that your body thinks is harmful. The first time you eat the food containing the protein, your immune system responds by creating specific disease-fighting antibodies (called immunoglobulin E or IgE). When you eat the food again, it triggers the release of IgE antibodies and other chemicals, including histamine, in an effort to expel the protein “invader” from your body. Histamine is a powerful chemical that can affect the respiratory system, gastrointestinal tract, skin or cardiovascular system.
The allergy symptoms you have depend on where in the body the histamine is released. If it is released in the ears, nose and throat, you may have an itchy nose and mouth, or trouble breathing or swallowing. If histamine is released in the skin, you may develop hives or a rash. If histamine is released in the gastrointestinal tract, you likely will develop stomach pains, cramps or diarrhea. Many people experience a combination of symptoms as the food is eaten and digested.
There are many factors that may contribute to food intolerance. In some cases — as with lactose intolerance — the person lacks the chemicals, called enzymes, necessary to properly digest certain proteins found in food. Also common are intolerances to some chemical ingredients added to food to provide color, enhance taste and protect against the growth of bacteria. These ingredients include various dyes and monosodium glutamate (MSG), a flavor enhancer.
Substances called sulfites, which may occur naturally — as in red wines — or may be added to prevent the growth of mold, also are a source of intolerance for some people. The Food and Drug Administration has banned the use of spray-on sulfates to preserve fruits and vegetables, but sulfates are still found naturally in some foods. Salicylates are a group of plant chemicals found naturally in many fruits, vegetables, nuts, coffee, juices, beer and wine. Aspirin also is a compound of the salicylate family. Foods containing salicylates may trigger symptoms in people who are sensitive to aspirin. Of course, any food consumed in excessive quantities can cause digestive symptoms.
Diagnosis and Tests
How are food intolerances diagnosed?
Most food intolerances are found through trial and error to determine which food or foods cause symptoms. You may be asked to keep a food diary to record what you eat and when you get symptoms, and then look for common factors. For example, after charting what he eats every day for a month, a man finds that he had symptoms only on the days he ate cheese. This points the finger at cheese as a possible cause of his discomfort.
Another way to identify problem foods is an elimination diet. You begin by completely eliminating any suspect foods from your diet until you are symptom-free. You then begin to reintroduce the foods, one at a time. This can help you pinpoint which foods cause symptoms. Seek the advice of your health care provider or a registered dietitian before beginning an elimination diet to be sure your diet provides adequate nutrition.
Management and Treatment
How are food intolerances treated?
Treatment is based on avoiding or reducing your intake of problem foods and treating symptoms when you do eat a problem food; for example, taking an antacid medication for heartburn or stomachache.
Prevention
Can food intolerances be prevented?
Taking a few simple steps can help you prevent the symptoms associated with a food intolerance.
- Learn which foods in which amounts cause you to have symptoms, and limit your intake to amounts you can handle.
- When you dine out, ask your server about how your meal will be prepared. Some meals may contain foods you cannot tolerate, and that may not be evident from the description on the menu.
- Learn to read food labels and check the ingredients for problem foods. Don’t forget to check condiments and seasonings. They may contain MSG or another additive that can lead to symptoms.
90,000 What is MSG Allergy?
MSG allergy is a serious allergic reaction to MSG, a popular flavor enhancer used in many types of cuisine. Allergies of this type include severe symptoms that include severe nausea, abdominal cramps and pain, and skin rashes. In the worst cases, an allergy to monosodium glutamate can cause breathing difficulties or even cause anaphylactic shock.
While many people experience some type of reaction to MSG ingestion, a compound intolerance reaction is more common.Relatively mild nausea, sour stomach or loose stools would characterize MSG intolerance. The main difference between allergies and intolerances is related to the effect of the substance on the immune system and the severity of the reaction.
There is a debate in the medical community as to whether MSG allergy is a true medical condition. One scientific idea is that while symptoms can be severe, they are often indicative of an intolerance and require simple treatment to correct.Others believe that if symptoms cause a serious life-threatening reaction rather than just uncomfortable and uncomfortable, the classification of the phenomenon as an allergy is more consistent.
Whether the condition is called MSG allergy or intolerance, the fact remains that getting a diagnosis and seeking treatment is essential. As with any type of food allergy, a trained healthcare professional can run tests to determine if MSG consumption is a major cause of health problems.If so, a diagnosis of intolerance or allergy can be obtained and a course of treatment for intolerance or allergy appropriate to the patient’s current situation can be initiated.
After completing an allergy or intolerance diagnostic task, several options are available. The first is to treat symptoms caused by allergies or MSG intolerance. Most treatments involve the administration of oral medications or injections to relieve the patient’s condition. On rare occasions, a patient may stay overnight in the hospital for observation if symptoms are severe enough to warrant this response rate.
Whether the condition is classified as an MSG allergy or an intolerable reaction, there is no question that a person should avoid eating foods prepared with MSG. This could include avoiding certain restaurants known to use this flavor enhancer in food preparation, and buying meats from supermarkets and butchers that don’t have MSG added.
OTHER LANGUAGES
Allergy to food additives: dyes, preservatives, flavorings
This section is only for specialists in the field of medicine, pharmacy and healthcare!
Content
- Prevalence of allergy to food additives
- Symptoms of Allergy to Food Additives
- Urticaria and angioedema after food additives
- Asthmatic events after food additives
- Anaphylactic shock on food additives
- “Chinese Restaurant Syndrome”
- Indications for referral to an allergist
- Pitfalls of the no additive diet
- References
The list of additives used in the food industry is extensive and includes thousands of natural and synthetic substances used as flavorings, colors, preservatives, sweeteners, antioxidants, thickeners, etc. e. Often people believe that their allergic manifestations after eating a particular food are not associated with the ingredients of the products themselves, but with the industrial substances added to them with the index “E”.
Patients and parents of young children suspect allergies and intolerance to food additives much more often than they actually do. The prevalence of real reaction to food additives was only 0.23% in a population-based study. Many of the cases of adverse reactions associated with food additives reported in the medical literature are either casuistic or lacking in causation.In fact, it has been conclusively demonstrated that relatively small amounts of dietary supplements can induce reactions such as urticaria, angioedema, asthmatic reactions or anaphylaxis.
Allergic reactions to food (eg nuts or seafood) are much more common than reactions to food additives, and food allergies should always be considered first in the differential diagnosis.
Food additives should be considered as a possible cause of allergic or asthmatic reactions when signs / symptoms appear clearly in connection with the ingestion of food or specific foods (candy, canned food, etc. )).
Signs that the patient may be responding to the dietary supplement include:
- Allergic or asthmatic reactions that occur with the timely intake of food or certain foods (i.e. usually within a few minutes or several hours after a meal).
- Convincing response to several apparently unrelated products.
- Reactions to industrially prepared foods, but no reaction to identical homemade meals.
The following types of allergic and asthmatic reactions to food additives have been reported:
- Anaphylaxis. Classic IgE-mediated allergic reactions most commonly include one or more of the following signs and symptoms: hot flushes, hives, pruritus, angioedema, bronchospasm, nausea, vomiting, or tightness in the throat. Anaphylaxis is the most severe form of IgE-mediated allergy, accompanied by a drop in blood pressure with possible loss of consciousness, coma, and death.
- Isolated asthmatic reactions in people with asthma.
- Urticaria and angioedema, alone or in combination.
In contrast, there are no known associations between food additives and other chronic atopic conditions such as atopic dermatitis or eosinophilic esophagitis.
Reactions to several additives. When patients do have a genuine adverse or allergic reaction to a food additive, it is usually caused by a single agent.The medical literature does not support the idea that patients are generally “chemically sensitive”.
These two clinical forms of allergy are the most common, although patients generally describe the intensification of existing symptoms, rather than the emergence of new ones – after consuming suspicious trigger foods. They often contain high levels of naturally occurring histamine-like substances. The most accurate way to assess potential adverse reactions is to use double-blind, placebo-controlled challenge test protocols, as is done with food samples.
Individual cases of urticaria and angioedema are described for the following food additives:
- Butylated hydroxyanisole (E320) and butylated hydroxytoluene (E321) are antioxidants commonly used in breakfast cereals and other cereals to maintain crispness and prevent rancidity. There is one well-documented case of allergy confirmed by a double-blind, placebo-controlled challenge test.In susceptible subjects, an improvement in urticaria was observed after eliminating these additives from the diet.
- Aspartame, a dipeptide, is a low calorie artificial sweetener. Two cases of aspartame-induced urticaria, confirmed by a placebo-controlled double-blind challenge test, have been reported, and additional cases by the same author have been reported. However, other researchers found it difficult to recruit subjects with adverse reactions to aspartame and found that such subjects did not have reproducible reactions.
- Lysozyme in eggs, aged cheeses and pharmaceuticals was mentioned in a report of recurrent angioedema.
Sulfites are the only compounds that have been proven to provoke bronchospasm in some patients with bronchial asthma, most often steroid-dependent. Evidence that other supplements, especially sodium benzoate, monosodium glutamate and tartrazine, can trigger asthma is limited to case reports and not supported by rigorous, double-blind, placebo-controlled studies.
Sulphites have been widely used for centuries to refresh and prevent oxidative discoloration (browning) of food. Sulfites are also used as disinfectants and to inhibit the growth of unwanted microorganisms in the fermentation industry. Sulfitating agents include sulfur dioxide, sodium potassium sulfite, bisulfite, and metabisulfite. The highest levels of sulfites are found in industrially prepared dried fruits (such as apricots), potatoes, wine, and some seafood.
Sulfitating agents can cause serious and potentially life-threatening asthmatic reactions in patients with asthma, as shown in double-blind controlled trials. Up to 5% of asthmatics may experience adverse reactions ranging from mild wheezing to severe bronchospasm after ingestion of sulfite-containing foods or drinks. Asthmatic reactions are rare in patients without prior asthma.
While any patient with asthma can develop a sensitivity to sulfite, many such people who are sensitive to sulfite have more severe asthma and are dependent on steroids. Therefore, sulfite sensitivity should be considered in patients with moderate or steroid-dependent asthma who have a history of reactions to foods / drinks that may contain moderate to high sulfite levels.
Tartrazine (E102) is an acidic colorant derived from coal tar that is used as a colorant in food and medicine. It has been reported to induce bronchospasm in patients with asthma, although studies supporting this conclusion in the 1960s and 1970s have not been adequately controlled by modern standards.Some doctors at the time also believed that tartrazine “cross-reacts” with nonsteroidal anti-inflammatory drugs (NSAIDs) and should be avoided in patients with “aspirin asthma.” However, tartrazine is not a cyclooxygenase-1 (COX-1) inhibitor like NSAIDs, and subsequent studies have shown that it is well tolerated by patients with “aspirin asthma.” Well-controlled studies have also shown that sensitivity to tartrazine in other patients with asthma is rare, so that avoiding tartrazine in patients with bronchial asthma is currently considered inappropriate.
Sodium benzoate (E211) is used as an antimicrobial preservative in food. In a double-blind, placebo-controlled study, there was only one subject in the medical literature who showed benzoate-induced asthma. This patient was not sensitive to aspirin and did not experience improvement in asthma symptoms with a benzoate-free diet.
Menthol , a natural mint flavor of the species Mentha spicata, Mentha piperita and Mentha labiatae, used in chewing gum and toothpaste.In two cases, it was confirmed that he provoked bronchial asthma. Anaphylaxis is described in another case report.
Several cases of anaphylaxis have been reported following natural supplementation. As the popularity of “natural” products that do not contain “chemistry” grows in popularity, there are more reports of anaphylactic reactions to them.
Over the past decades, food manufacturers have replaced synthetic food additives with compounds derived from plant, insect and animal products. Since most IgE-mediated allergies are caused by proteins from other living organisms, this switch to natural agents has been associated with an increase in IgE-mediated allergies to these substances. As examples, case reports mention potential anaphylaxis with annatto, carmine, psyllium, and guar gum. IgE-mediated spice allergy also occurs.
Several other additives have also been implicated in anaphylaxis, such as:
- Carrageenan, a gel-like polysaccharide derived from seaweed that is used as a stabilizer and thickener.He has been implicated in anaphylaxis caused by a barium enema solution.
- Lupine flour, an inexpensive flour filler that causes allergic reactions. Lupine may cross-react with peanuts.
- Pectin, a gelling agent and thickener, has been reported to cause anaphylaxis by ingestion and occupational asthma by inhalation. Pectin can cross-react with cashews.
- Gelatin in gummy candies and gummies causes anaphylaxis. Gelatin in vaccines (especially in Japan) is more likely to cause anaphylaxis.
- Mycoprotein, a fermented fungus (Fusarium venenatum) associated with egg albumin. It shares common allergenic determinants with other molds. Mycoprotein is used as a meat substitute. Allergic reactions, including anaphylaxis, have been reported, mainly in patients allergic to inhalation mold.
Monosodium glutamate (MSG) is a salt of a nonessential dicarboxylic amino acid, which is a normal component of dietary protein, a transmitter of umami taste.Extra MSG is added to food as a flavor enhancer, especially in Asian food. Many non-allergic symptoms are associated with monosodium glutamate, while allergic and asthmatic reactions are rarely reported and generally underreported.
Chinese Restaurant Syndrome is perhaps the most famous adverse reaction to a food additive. This is not an allergic reaction to monosodium glutamate.
Symptomatic monosodium glutamate complex usually appears 1-14 hours after ingestion. Reported symptoms include headache, myalgia, back pain, neck pain, nausea, sweating, tingling, redness, palpitations, and chest tightness. Children have been reported to have tremors, chills, irritability, screaming, and delirium.
It has been suggested that the mechanism of these reactions involves hypersensitivity to this compound, which is metabolized after ingestion to glutamate, the main excitatory amino acid neurotransmitter.
MSGS symptom complex was not reproduced in controlled trials, and symptoms were not consistently induced in 130 patients who were identified as MSG-sensitive and underwent a double-blind trial.Those patients who had intermittent symptoms most often only developed when MSG was taken in amounts greater than those found with a normal diet and no accompanying food. Thus, monosodium glutamate is considered a safe food supplement. However, a patient with these symptoms who believes MSG is the cause may be advised to avoid foods containing added MSG, as it is relatively easy to do. These patients should primarily avoid liquid foods (such as wonton soup), from which high levels of MSG can be rapidly absorbed.
A small number of clinical cases describe urticaria and angioedema while taking monosodium glutamate. As an example, in one case, a delayed angioedema was described, which began 16 hours after ingestion of 250 mg of monosodium glutamate, which was reproduced using a single-blind, placebo-controlled infection.
Although MSG has been implicated in causing asthma, this association has not been confirmed in studies that performed double-blind, placebo-controlled MSG tests in patients with high-risk asthma (aspirin-sensitive or with a positive history).
One group of researchers reported a small number of subjects with perennial MSG-associated rhinitis and a positive response to double-blind, placebo-controlled challenge tests.However, this hypothesis warrants further study, as MSG can aggravate rhinitis due to its vasoactive properties, and it has not been suggested that it is the cause of rhinitis.
Certain patient populations with suspected allergic or asthmatic reactions to the food additive require further evaluation and should be referred to an allergy specialist with knowledge of the appropriate testing and contamination procedures:
- Patients with anaphylaxis.
- Patients with recurrent idiopathic urticaria or angioedema with refractory or severe symptoms or glucocorticoid-dependent.
- Patients with chronic persistent asthma or life-threatening exacerbations of asthma.
Diagnosis may require skin tests and infection procedures, which must be performed by an allergy expert because these methods require training and experience to interpret correctly.In addition, during these procedures, allergic reactions are possible (although rare).
General objectives of allergy assessment:
- Evidence that a food supplement produces a specific acute reaction, especially in patients with anaphylaxis.
- Eliminate reactions to food additives and normalize the diet in people who avoid multiple foods because of concerns about possible reactions to food additives.
Diets without additives are usually useless.These diets are sometimes offered as an initial means of determining a patient’s susceptibility to a supplement, without involving any specific one. For example, patients may be advised to eat limited amounts of certain meats, grains, fruits, and vegetables for three weeks, and if symptoms improve, the patient may be inferred that the patient is allergic to a supplement. However, this approach has several disadvantages. Patients’ symptoms often improve at first, but then the gradual resumption of industrially prepared foods does not lead to the identification of a specific culprit.Sometimes patients remain healthy for some time despite resuming a normal diet, and then their symptoms eventually return and begin to worsen and subside again. In addition, patients who have experienced anaphylaxis and who typically eat industrially prepared or processed foods find it difficult to maintain a non-supplemented diet over time, and the patient is likely to return to their previous eating habits over time. This approach puts the patient at risk of recurrence of anaphylaxis in the future.Whenever possible, patients with anaphylaxis should be referred to a specialist allergist to maximize the chances of identifying the culprit allergen.
References / References
- Asero R. Multiple intolerance to food additives // J Allergy Clin Immunol 2002; 110: 531.
- Aspinall RL, Saunders RN, Pautsch WF, Nutting EF. The biological properties of aspartame. V. Effects on a variety of physiological parameters related to inflammation and metabolism // J Environ Pathol Toxicol 1980; 3: 387.
- Baker GJ, Collett P, Allen DH. Bronchospasm induced by metabisulphite-containing foods and drugs // Med J Aust 1981; 2: 614.
- Bock SA, Sampson HA, Atkins FM, et al. Double-blind, placebo-controlled food challenge (DBPCFC) as an office procedure: a manual // J Allergy Clin Immunol 1988; 82: 986.
- Buckley R, Saltzman HA, Sieker HO. The prevalence and degree of sensitivity to ingested sulfites // J Allergy Clin Immunol 1985; 77: 144.
- Bush RK, Taylor SL, Holden K, et al. Prevalence of sensitivity to sulfiting agents in asthmatic patients // Am J Med 1986; 81: 816.
- Garriga MM, Berkebile C, Metcalfe DD. A combined single-blind, double-blind, placebo-controlled study to determine the reproducibility of hypersensitivity reactions to aspartame // J Allergy Clin Immunol 1991; 87: 821.
- Geha R, Buckley CE, Greenberger P, et al. Aspartame is no more likely than placebo to cause urticaria / angioedema: results of a multicenter, randomized, double-blind, placebo-controlled, crossover study // J Allergy Clin Immunol 1993; 92: 513.
- Genton C, Frei PC, Pécoud A. Value of oral provocation tests to aspirin and food additives in the routine investigation of asthma and chronic urticaria // J Allergy Clin Immunol 1985; 76:40.
- Goodman DL, McDonnell JT, Nelson HS, et al. Chronic urticaria exacerbated by the antioxidant food preservatives, butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT) // J Allergy Clin Immunol 1990; 86: 570.
- Kulczycki A Jr.Aspartame-induced hives // J Allergy Clin Immunol 1995; 95: 639.
- Kulczycki A Jr. Aspartame-induced urticaria // Ann Intern Med 1986; 104: 207.
- Ortolani C, Pastorello E, Fontana A, et al. Chemicals and drugs as triggers of food-associated disorder // Ann Allergy 1988; 60: 358.
- Pérez-Calderón R, Gonzalo-Garijo MA, Lamilla-Yerga A, et al. Recurrent angioedema due to lysozyme allergy // J Investig Allergol Clin Immunol 2007; 17: 264.
- Rajan JP, Simon RA, Bosso JV. Prevalence of sensitivity to food and drug additives in patients with chronic idiopathic urticaria // J Allergy Clin Immunol Pract 2014; 2: 168.
- Sampson HA, Aceves S, Bock SA, et al. Food allergy: a practice parameter update-2014 // J Allergy Clin Immunol 2014; 134: 1016.
- Sampson HA. Food allergy. Part 2: diagnosis and management // J Allergy Clin Immunol 1999; 103: 981.
- Samter M, Beers RF Jr.Intolerance to aspirin. Clinical studies and consideration of its pathogenesis // Ann Intern Med 1968; 68: 975.
- Settipane GA, Pudupakkam RK. Aspirin intolerance. III. Subtypes, familial occurence, and cross-reactivity with tartarazine // J Allergy Clin Immunol 1975; 56: 215.
- Simon RA, Green L, Stevenson DD. The incidence of metabisulfite sensitivity in an asthmatic population // J Allergy Clin Immunol 1982; 69: 118.
- Simon RA.Adverse reactions to food and drug additives // Immunol Allergy Clin North Am 1996; 16: 137.
- Simon RA. Update on sulfite sensitivity // Allergy 1998; 53:78.
- Spector SL, Wangaard CH, Farr RS. Aspirin and concomitant idiosyncrasies in adult asthmatic patients // J Allergy Clin Immunol 1979; 64: 500.
- Stenius BS, Lemola M. Hypersensitivity to acetylsalicylic acid (ASA) and tartrazine in patients with asthma // Clin Allergy 1976; 6: 119.
- Stevenson DD, Simon RA. Sensitivity to ingested metabisulfites in asthmatic subjects // J Allergy Clin Immunol 1981; 68:26.
- Turner PJ, Kemp AS. Intolerance to food additives – does it exist? // J Paediatr Child Health 2012; 48: E10.
- Vedanthan PK, Menon MM, Bell TD, Bergin D. Aspirin and tartrazine oral challenge: incidence of adverse response in chronic childhood asthma // J Allergy Clin Immunol 1977; 60: 8.
- Weber RW, Hoffman M, Raine DA Jr, Nelson HS. Incidence of bronchoconstriction due to aspirin, azo dyes, non-azo dyes, and preservatives in a population of perennial asthmatics // J Allergy Clin Immunol 1979; 64:32.
- Wilson BG, Bahna SL. Adverse reactions to food additives // Ann Allergy Asthma Immunol 2005; 95: 499.
- Worm M, Ehlers I, Sterry W, Zuberbier T. Clinical relevance of food additives in adult patients with atopic dermatitis // Clin Exp Allergy 2000; 30: 407.
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Allergic research | Medicum
Medicum / Allergic research
In case of allergy (hypersensitivity), the body reacts sharply to one or another external or existing factor in the body itself, which usually does not cause such a reaction. Allergy manifests itself in the form of a variety of symptoms: runny nose, rash, difficulty breathing, itching, diarrhea, anaphylaxis, etc.Allergy can manifest itself at any age, it creates restrictions in everyday life, significantly impairs the quality of life, and can also be life-threatening. Hypersensitivity can occur to many things, for example, food, drugs, insecticides, inhaled particles, etc.
Food intolerances are not the same as allergies, although symptoms may be similar: for example, hives, digestive problems, headache, nervousness, worsening eczema, etc. Food intolerance is when certain foods or their components cause pathological symptoms, but they are not the result of an immunological reaction.Very rarely, food intolerance can be extremely difficult, resembling anaphylaxis.
In order to find out the cause of an allergic reaction, a skin prick test or determination of the level of IgE-type antibodies in the blood is used.
When carrying out a skin prick test, drops of solutions of various allergens are applied to the inner surface of the forearm and, using a lancet, a light incision of the surface layer of the skin is made through the drop. The result of the prick test is assessed after 15-20 minutes.In the case of a positive result of an allergy test, redness and a blister appear on the skin at the injection site of the allergen, which disappears in about an hour.
An increase in the level of allergen-specific IgE antibodies in the blood indicates sensitization towards these allergens. This allows you to identify single allergens that should be avoided. To assess sensitization, the so-called screening test with inhalation allergens, mixtures of various food and inhalation allergens, and tests with single allergens are used.Screening tests provide an answer to the question of whether a patient is sensitized to a particular group of allergens, but do not allow to more accurately determine what the patient is allergic to.
Determination of antibodies to single IgE-type allergens allows you to identify specific allergens that are likely causative agents of an allergic reaction.
If you suspect an allergy or food intolerance, you should first contact your family doctor. The family doctor will prescribe the necessary tests and evaluate their results, if necessary, prescribe treatment or refer them to another specialist for consultation.
Allergy to ragweed – symptoms and treatment
July, August is the month when AMBROSIA blooms peak. It is known that this particular plant is one of the largest allergens. What do people who are allergic to ragweed need to know?
The concentration of ragweed pollen, which is considered one of the most powerful allergens, is now growing in the air. In the southern regions of the country, ragweed is the number one allergen, but every year there is a tendency to increase the distribution area of this plant.I must say that 20% of allergy sufferers react to ragweed pollen. In addition, in August, there is a third wave of hay fever (after trees and grasses). And besides ragweed, the problems this month are adding wormwood, quinoa and sunflower.
But it is ragweed among all other plants that is capable of provoking bronchial asthma in humans.
First aid and treatment for ragweed allergy: rinse mouth and nose with warm saline solution (1 tablespoon of salt per 5 liters of water).If necessary, take antihistamines to relieve symptoms of a runny nose, itchy throat, and itchy eyes.
Few people know that if you are allergic to the same ragweed, it is strictly forbidden to drink chamomile, thyme, elecampane, herbs that are part of the expectorant fees. This can lead to serious consequences – up to anaphylactic shock.
It is necessary to completely abandon honey (it is prohibited for any allergy), and if you are allergic to ragweed, bananas, melon, beets, spinach are prohibited.If you are allergic to wormwood, add citrus fruits to this list, and halva and seeds to sunflower. And, of course, you need to contact an allergist to identify the allergen. Then the specialist will prescribe medications Antiallergic actions and preventive treatment (vaccination). You should also resort to certain safety measures: limit your stay in nature (summer cottage, forest, personal plot), do not participate in agricultural work (for example, mowing grass). On the street, you should wear sunglasses, close the windows in the house with wet gauze (to trap pollen), and do not open the windows while driving in the car.Clothes should be washed frequently, but not dried outside or on an unglazed balcony.
Food allergy symptoms and diagnosis
Diagnostics of food allergy and food intolerance
Food allergy (PA) and food intolerance (food reactions not related to the reagin type – PN) is one of the causes of many acute and chronic diseases, therefore, the number of diagnostic tests for food has been increasing recently. intolerance associated with the detection of an immune response to food allergens.PN is difficult to recognize. Many people have PN symptoms to frequently consumed foods, but they are unaware of this and do not know how to determine which foods are allergic.
In food allergy , symptoms of delayed food reaction develop at least 2 hours later, but more often several days after taking certain foods, and the patient cannot associate it with any particular food. In addition, the manifestations of PN can be very diverse, provoking the development of hundreds of different symptoms or diseases.
Food allergies and food intolerances
At some point almost everyone has to deal with food allergies and food intolerances. Often people experience a painful reaction to certain foods, and they start to wonder if this is an allergy. One in three states that he is allergic to food or that they are reconsidering their diet in the family, as there is a suspicion that one of the family members is allergic to food. However, only about three percent of children have clinically proven food allergies. Among adults, the number of allergy sufferers is only about one percent of the population.
This difference between the clinically proven existence of food allergies and public perceptions of the problem is in part not due to this allergy at all, but to reactions called “food intolerances”. Food allergy, or hypersensitivity, which manifests itself in a matter of minutes, is a pathological reaction of the body’s immune system to any food product.The immune system is not responsible for all symptoms caused by food intolerances, even if they resemble food allergy symptoms .
It is very important for people with food allergies to be able to distinguish between these symptoms and to prevent similar allergic reactions, as these reactions can cause devastating illness and, in some cases, death.
Mechanism of allergic reactions
A true allergic reaction has two characteristics that are characteristic of the reaction of the immune system. One of these involves the production of immunoglobulin E (IgE), a type of protein called an antibody and carried in the blood. The other is mast cell, a special cell that can be found in all tissues of the body, but its presence is especially pronounced in those parts of the body that are most susceptible to allergic reactions, including the nose, throat, lungs, skin and digestive tract.
The ability of an individual to produce immunoglobulin E in response to such a safe factor as food is a congenital predisposition.Typically, these people are born into families whose members are allergic, not necessarily to food, but possibly hay fever, asthma or hives. If both parents suffer from allergies, then the likelihood of inheriting it is higher than if only one of the parents suffers from it.
In order for an allergic reaction to occur, firstly, it is necessary that a person who is predisposed to the production of immunoglobulin E comes into contact with the corresponding food product. After this food has been digested, certain cells begin to produce in large quantities certain immunoglobulin E.Immunoglobulin E is then released and attached to the surface of the mast cells. The next time this person comes into contact with this food, the food will interact with immunoglobulin E, which will cause the cells to produce chemical compounds like histamine. Depending on the tissue in which these chemical compounds are made, a person may experience various symptoms of food allergy. If mast cells release chemicals in the ears, nose, or throat, the person may have an itchy throat or trouble breathing or swallowing.If the exposed mast cells are located in the gastrointestinal tract, the person may experience abdominal pain or diarrhea. Conversely, chemical compounds produced by the mast cells of the skin can cause hives.
Food allergens (food particles that cause an allergic reaction) are proteins contained in food that are not destroyed by cooking temperatures, gastric juices or enzymes involved in digestion. As a result, they are resilient enough to traverse the intestinal wall, enter the bloodstream, and reach target organs, causing allergic reactions throughout the body.
The complex process of food digestion affects the time and location of the allergic reaction. For example, if people have an allergic reaction to certain foods, their first reaction to it is likely to be itchy mouth once they start eating it. After food is digested in the stomach, intestinal symptoms such as vomiting, diarrhea, or pain may appear. After food allergens enter and circulate in the blood, blood pressure may drop. If allergens get to the skin, it can cause rashes or eczema, and if they get into the lungs, it can cause asthma.The whole process can take from a few minutes to an hour.
Common Food Reactions
Foods that cause the most common allergic reactions in adults include a variety of shellfish and crustaceans such as shrimp, crayfish, lobster and crabs; peanuts, a legume that most commonly causes severe anaphylaxis, which is a sharp drop in blood pressure that can be fatal if not treated immediately as well as nuts, such as walnuts; fish and eggs.
Allergic reactions are slightly different in children. The most common food allergens in children are eggs, milk and peanuts. Adults usually have to live with their allergies all their lives, and children sometimes manage to get rid of them with age. Children are more likely to get away with allergies to milk and soy than to peanuts, fish or shrimp.
Adults and children react to the foods they eat frequently. For example, in Japan, rice allergy is more common.And in Scandinavia, cod allergies are more common.
Cross-reactivity
If a person suffers from a life-threatening allergy, the doctor will advise the patient to avoid foods that may cause an allergic reaction. So, for example, if someone has an allergic reaction to shrimp, then the tests are likely to reveal a similar reaction not only to shrimp, but also to crabs, lobsters and crayfish. This phenomenon is called cross-reactivity.
Another interesting example of cross-reactivity is the allergic reaction of some people to ragweed. When ragweed has a pollination period, people who are sensitive to it sometimes find that when they eat melon, especially cantaloupe, their mouth becomes itchy and they cannot continue to eat it. This phenomenon is called oral allergy syndrome.
Differential diagnosis
Differential diagnosis means the division into allergies, intolerances and any other diseases.If a patient comes to the doctor and says, “I think I’m allergic to a food,” the doctor must consider a variety of other factors that could lead to symptoms similar to those of a food allergy.
One of these possibilities is contamination of food with microorganisms, such as bacteria and their waste products, as well as toxins. Contaminated meat sometimes causes a reaction similar to a food allergy, which is actually food poisoning.
There are also natural substances, such as histamine, which can be found in food and cause an allergic-like reaction. For example, high levels of histamine are found in cheese, some wines, and certain types of fish such as tuna and mackerel. It is believed that histamine appears in fish due to bacteriological contamination, especially if the storage conditions in the refrigerator have been violated. If you eat one of these foods with a high level of histamine, you can get a reaction that in many of its features resembles an allergic reaction.This reaction is called histamine toxicity.
Another cause of food intolerances, which is often confused with food allergies, is lactase deficiency. This very common food intolerance affects one in ten people. Lactase is an enzyme found in the contents of the intestines. This enzyme breaks down lactose in milk. If the body’s lactase content is insufficient, then a person cannot digest lactose, which is contained in most dairy products.Instead, lactose is used up by bacteria, gas is produced, and the person suffers from bloating, abdominal pain and sometimes diarrhea. There are some diagnostic tests in which the patient takes a certain amount of lactose and then the doctor measures the body’s response by analyzing blood samples.
Another type of food intolerance is an adverse reaction to certain foods that are added to food to improve flavor, color, or protect against microbial growth.Compounds that often cause allergic-like adverse reactions include dye yellow # 5, monosodium glutamate, and sulfites. Yellow dye # 5 can sometimes, though rarely, cause hives. Monosodium glutamate (MSG) is a flavor enhancer and, in large quantities, can cause redness, warmth, headaches, facial muscle tension, chest pain and, in some people, apathy. These transient reactions occur shortly after the ingestion of large quantities of foods to which glutamate monosodium has been added.
There are some other diseases that resemble allergies in their symptoms, these include peptic ulcer and gastrointestinal cancer. These disorders can lead to vomiting, diarrhea, and abdominal cramping pain that gets worse with food intake.
Some people may suffer from food intolerances due to psychological reasons. In some cases, close psychiatric examination can reveal an adverse event in a person’s life, usually related to childhood experiences associated with the ingestion of a particular food. If a person eats the same product many years later, even as an adult, it will cause discomfort, reminiscent of an allergic reaction to food.
Diagnosis
To diagnose food allergies, the physician must first understand whether the patient has adverse reactions to certain foods. This assessment is based on the patient’s detailed medical history, dietary log or diet for food allergy .
The first of these methods is the most reliable. The doctor sits down and discusses the patient’s history with the patient to determine if the symptoms are the same as those of a food allergy.
Sometimes it is impossible to make a diagnosis based on medical history alone. In this case, the doctor uses food intolerance tests , which can more objectively assess a person’s allergic reaction to food. One is an allergic skin test, in which small amounts of food extracts are placed on the forearm or back.Scarification is performed and the skin reaction is assessed (the presence of swelling or redness, which indicates a local allergic reaction). If the skin test gives a positive reaction, it means that the mast cells of the patient’s skin contain immunoglobulin E, which is characteristic of the tested food.
If a patient has very strong anaphylactic reactions, then a skin test is contraindicated for him, as it can lead to dangerous consequences. A skin test is also contraindicated in patients with extensive eczema.In this case, the doctor uses a blood test, such as a radioallergosorbent test (RAST) and an enzyme-linked immunosorbent assay (ELISA). These tests reveal the presence of a food-specific immunoglobulin E in the patient’s blood. As with the skin test, a positive reaction to these tests prevents a definitive diagnosis.
Exercise-induced food allergy
At least one type of allergy is caused not just by ingestion of a food allergen, but by exercise.People get this reaction if they eat certain foods just before exercise. As they exercise, their body temperature rises, they develop itching, dizziness, and soon an allergic reaction similar to hives or anaphylaxis. Treatment for exercise-induced food allergy is to abstain from food for several hours before exercising.
Treatment
For the treatment of food allergies, there are special diets for food allergies .As soon as the doctor and his patient identify a food product to which the patient is sensitive, this food should be excluded from the patient’s diet. To comply with this condition, the patient is forced to read long, detailed lists of ingredients on the food that he is going to eat. Many of the food allergens, such as peanuts, eggs or milk, can be found in other foods that are not usually associated with them. Peanuts, for example, are often used as a protein source, and eggs are found in some salad dressings.The law requires all ingredients to be listed on food packaging. People can avoid consuming most allergenic foods if they read the packaging carefully and do not eat food prepared in a restaurant that may contain allergenic ingredients.
In severely allergic people, even microscopic amounts of a food allergen (eg 1 / 44,000 of a peanut kernel) can cause an allergic reaction. Other people who are less susceptible to allergies will probably be able to tolerate small amounts of the allergen product.
Patients with severe allergies should be prepared for unexpected contact with an allergen. Even those who are well aware of all the products that are dangerous to themselves make mistakes from time to time. For self-protection, severe allergy sufferers with anaphylactic reactions to food should wear health information bracelets or chains that indicate they are experiencing severe allergies. They must receive immediate medical attention by calling a rescue team or being transported in an ambulance.Anaphylactic allergic reactions can be fatal even if symptoms are mild at first, such as a sore mouth or throat or indigestion.
Special precautions must be taken with children. Parents and caregivers should be aware of how to protect children from food allergens, or what to do if children have taken food allergens, including epinephrine administration. Schools should have instructions for dealing with a sudden onset of allergies in a child.
There are several medicines a patient can take to relieve allergy symptoms other than an anaphylactic reaction. These include antihistamines that relieve gastrointestinal symptoms, hives, sneezing, and runny nose. Bronchodilators relieve asthmatic symptoms. These remedies are taken after the accidental ingestion of an allergen product, but do not help if they are taken before meals. There are no medicines that are taken in any form before a certain food intake and provide reliable protection against allergic reactions to it.
There are several unproven treatments for food allergy. One is to inject small doses of food extracts that cause an allergic reaction in the patient. The injections are given regularly over a long period of time in order to “desensitize” the patient to the food allergen. Researchers have not yet proven the effectiveness of injections in treating food allergies.
Immune system disorders associated with monotonous eating
The digestive tract has the most powerful defense and immune system in the body.The digestive and immune system reacts to almost any complex high-molecular substance with the formation of protective substances, the so-called immunoglobulins. There are many types of immunoglobulins. Immunoglobulins of group A (IgA) are secreted on the surface of the mucous membrane, combine with the corresponding substance (antigen) and thus prevent them from entering the mucous membrane and the immune system. Although the immune system can produce quite a large amount of IgA, its capabilities are also not limitless.Too many substances, antigens and / or constant load of these substances exceeds the capacity of IgA synthesis and weakens it. Antigens pass through the mucous membrane to the immune system, which in turn produces Group G immunoglobulin (IgG). Usually, the breakdown of substances in this group occurs rapidly in the liver. With large amounts of a substance, the volume of the liver may be insufficient for their splitting, which leads to a deterioration in the blood picture. It is not yet entirely clear that an increased IgG content in food is itself capable of causing painful disorders in the body, as is the case with wheat protein (heat allergy), celiac disease, or they are only a sign that the immune system is not responding well. and a high IgG content only indicates which food product may be causing harmful effects.Food intolerances, accompanied by an increase in IgG levels, cause diseases that (as in the case of celiac disease) can affect all body systems. They can have a long chronic course, and painful symptoms do not appear immediately after eating, but in the period from 10 minutes to 72 hours. In this case, they talk about an allergic reaction of a delayed type.
Rarely, the immune system reacts to an antigen transition to form immunoglobulin E (IgE).In these cases, strong reactions are observed, including life-threatening ones (similar to an allergy to a bee sting). There are diseases in which both types of allergies are present, such as asthma, eczema, hay fever, the so-called atopy.
Causes of food intolerance.
As such, the following factors are mainly discussed:
Heredity. As in many other areas, there are also differences in the ability to produce group A immunoglobulins (IgA).The body of people with a reduced ability to produce IgA is more prone to the manifestation of food intolerance. Other innate properties of the immune system are more likely to trigger reactions such as celiac disease.
Nutrition and lifestyle (smoking, consumption of alcoholic beverages) of the mother and father, especially during pregnancy.
Nutrition in the first months of a child’s life (breast milk, milk replacement, additional nutrition, the process of switching to regular food).
Further nutrition.In addition to the aforementioned unsatisfactory dietary change, the acid content of the diet is of great importance. In addition to the development of other diseases, oxidation contributes to the occurrence of hypersensitivity.
Digestion. The more food remains undigested, the more it will pass through the intestinal mucosa and be processed by the immune system. This means that all influences that impede digestion can lead to food intolerances, such as:
5.1 Insufficient chewing. Enzymes from saliva already in the mouth begin to facilitate the absorption of food. If the food is thoroughly chopped and ground, then this facilitates its further processing in the lower zones of the gastrointestinal tract. The longer we taste the taste of a dish, the better the part of the gastrointestinal tract knows what juices it must prepare for digestion.
5.2 Diseases affecting the production and secretion of these juices. These are acute and chronic inflammations of the stomach and intestines, liver and pancreas.A person’s condition after operations that reduce or even remove these organs. Medicines affecting the production and secretion of juices for digestion.
5.3 Large amounts of food are poorly absorbed. This is why we should eat more often but less. Food should be simple yet varied and balanced.
The state of the intestinal mucosa.
6.1 If we eat a lot of food in one sitting, then increased demands are made on the mucous membrane, and it becomes more permeable.
6.2 Acute and chronic (M. Crohn, Colitis ulcerosa) intestinal inflammation weaken the obstruction in the mucous membrane. Then undigested food more easily passes through the mucous membrane into the intestinal immune system and into the blood. In order to allow the mucous membrane to rest, after acute inflammatory processes, it is necessary for some time to refrain from taking large amounts or poorly digested food.
Contents and intestinal bacteria.
An obstruction in the intestine is also weakened by a too acidic or alkaline medium.If we consume too many simple carbohydrates, such as sugar (sugary foods, fruits), bacteria that produce acids and yeast multiply in the intestines. This is manifested by bloating, loose, acid-smelling stools, and an itchy rash on the skin around the anus. Hypertrophy with candida alters the taste – craving for sweets because bacteria and fungi require more nutrition. There are references to the fact that the multiplication of bacteria and fungi, in addition to food intolerance, can contribute to the development of other diseases.
If, on the contrary, we eat too much protein (meat, cheese), then putrefactive bacteria multiply, producing alkaline and partially toxic amines. Again, the reason for the food to be mixed, varied and balanced.
When the balance between the various bacteria and fungi is restored again with the help of an appropriate change in the diet, various ailments will disappear.
Variable food
Variable food was developed already in the twenties of the last century for the diagnosis and treatment of intolerances.It is used for preventive purposes and for healthy people. You can eat vegetarian or meat. The more complex the composition of the food, the more difficult it is to adhere to the principles of variable eating. A variety of foods can be healthier when consumed consistently rather than at the same time. Finished products not only have the disadvantage that they include a varied mixture of ingredients and food additives, but also contain preservatives and flavors.
Cross-reaction between pollen and other substances
It often happens that a person suffering from hay fever and responding to wormwood pollen runs out of the nose, watery eyes, even when he eats something.A similar reaction occurs in 70 percent, and maybe even in a larger number of allergy sufferers. In this case, we are talking about the so-called cross-allergy, one of the types of cross-reaction.
Cross-reaction is understood as the fact that a person is painfully reacting not only to one substance, an allergen, from one source. The reason is that in other sources there are similar or very similar allergens in their composition. They can infect the same organ system that the allergen has come into contact with, or a different one, as in the example above.Then it is called cross-allergy in the narrower sense of the word.
Allergy in a child – the first symptoms, which foods cause allergies in children most often
Allergy is the body’s hypersensitivity to any foreign substance (antigen) followed by an immune response. According to scientific data, this feature itself is not inherited, but the predisposition to it – yes. Children whose parents have allergies (especially if this applies to both of them, or only the mother), are more likely to develop it.
When we come into contact with an allergen, the body reacts in such a way as to block the access of “dangerous” substances, according to its data, into the blood. This is expressed in inflammation that occurs due to the release of immunoglobulin E and histamine, a hormone that regulates various functions of the body.
Histamine causes tissue edema, stagnation of blood in the capillaries, a decrease in pressure, makes the heart beat faster – all these changes should help the body to quickly deliver as many leukocytes – protective blood cells – to those areas where their presence is needed.
Excessive sensitivity of the body to one or another allergen leads to the release of an excessive amount of histamine, which is why doctors prescribe antihistamines for allergies.
It is believed that from 15 to 35% of people in Russia suffer from allergies.
What are the symptoms of allergies in children? Common manifestations of this condition include the following:
- runny nose;
- sneezing;
- cough; 90 024 90 023 itching;
- Watery eyes or dry eyes; 90 024
- Difficulty breathing
- chills;
- rash or redness of the skin, eczema;
- inflammation of the mucous membranes;
- Digestive problems – for food allergies.
In the case of acute allergies, life-threatening anaphylactic shock can develop when pulmonary edema occurs, breathing becomes impaired and blood pressure drops.
The list of the main allergens includes:
- dust – it contains several allergens at once, from pollen of plants and dust mites to scales of the epithelium of domestic animals;
- pollen – allergies can develop to pollen from domestic plants;
- pet hair and particles of their skin, as well as down and feathers;
- spores of fungi or mold;
- food products.Food allergies are common in children. It is very important to take care of its prevention even at the stage of the mother’s pregnancy;
- Insect bites – As a rule, these are wasps, hornets, bees, bumblebees and ants. This allergy occurs in 0.4 – 0.8% of the population. The organisms of these and other insects secrete various poisons that can cause reactions from hives or swelling to seizures, diarrhea, suffocation and shock. If an allergic reaction occurs, it is important to get to the hospital very quickly or give the child the necessary medications within the first hour, about which you need to consult a pediatrician in advance;
- some drugs.It is usually difficult to check in advance which medications are causing an allergic reaction. In addition, an allergy to a specific drug can appear at any period of life, even if a person did not have it before;
- latex – This allergy can manifest itself in very different ways and, as a rule, develops in people who often have to wear latex gloves, for example, by doctors.
Other risk factors include smoking, gas stove use, dry animal feed, household chemicals and industrial pollution.It is believed that a child living in an area where the air is polluted due to proximity to the road can cause allergies.
- Allergies in children can develop instantly – for example, in the case of an ant bite – or within a few months, as happens when it is caused by cat hair or pollen. It all depends on how often the child is in contact with the allergen.
- Seasonal allergies occur every year in spring, summer and fall, and mold allergies can develop if it rains outside and the humidity level rises in the house, leading to the growth of microorganisms.
- It is important to understand that allergies in children can pass and appear, and there is no exact explanation for this.
The cold disappears – at the latest – within 10 days, and the allergy appears constantly.
Here are the obvious signs of an allergy:
- the child is constantly sniffling, especially if the discharge from the nose is clear and runny, not yellow or green and thick;
- The baby constantly sneezes, his eyes are red, moist and itchy;
- the child has dark circles under the eyes, the nose is constantly stuffy, and he breathes through the mouth;
- dry cough;
- The skin is inflamed, reddened and itchy.
It has been proven that the occurrence of hypersensitivity to one or another allergen can occur in a baby while it is still in the mother’s abdomen, in the second trimester of pregnancy. This means that even before he is born, the expectant mother needs to take precautions.
Precautions:
- if she is allergic to a substance, avoid contact with it during pregnancy;
- you need to quit smoking, take medications that are not approved by a doctor, carefully monitor so that there is no contact with allergens at work – they may be platinum salts, formaldehyde, nickel or chromium compounds, pigments, pesticides, epoxy and other phenol-formaldehyde resins, organic compounds, which include chlorine, fluorine and phosphorus;
- unbalanced nutrition, the presence of allergenic food, products with chemical additives in the diet.It is best to formulate a preventive diet that is free of potential allergens;
- to minimize the number of stressful situations.
After the birth of a child, it is necessary:
1. Try to establish breastfeeding (we write about how important it is for immunity in a separate material;
2. Follow a diet (what foods can be included in it, and which ones – no, we tell here;
3. To temper the baby, monitor his health, give him a strengthening massage and do gymnastics with him;
4.If the child’s parents had bronchial asthma or atopic dermatitis, as well as other allergic reactions, the baby should be examined by an allergist: the earlier the problem is revealed, the more effective the treatment will be.
However, it is important to understand that the best way to treat and prevent allergies is to eliminate the factors that provoke it.
If a child is allergic to dust and feathers, in addition to treatment, hygiene rules must be observed:
- mattresses and pillows must be in special plastic covers;
- special bedding should be used;
- If the linen is normal, it should be washed and boiled 1 – 2 times a week;
- it is important to choose pillows and duvets with synthetic filling;
- there should be a minimum of upholstered furniture in the apartment;
- Carpets or carpets with a strong odor must not be used;
- clean with special vacuum cleaners, carry out wet cleaning.
If the baby has a sensitivity to mold and mildew, you need to:
- wipe the surfaces in the bathroom dry after bathing;
- wash the bathroom with special solutions once a month;
- remove steam in the kitchen with a hood;
- Dry laundry in a special room, not in a room.
If a child is allergic to wool, you should:
- exclude clothes from wool, fur;
- do not go to the zoo, circus and houses where there are animals;
- If a cat or dog has lived in your apartment before, the room must be carefully cleaned.
If you need to protect your baby from pollen:
- when plants bloom, you should close the windows;
- Do not walk in windy weather;
- You need to be careful with soaps and shampoos containing herbal preparations.
It is also important to avoid:
- stress;
- hypothermia or overheating of the baby;
- too high humidity;
- intensive physical activity;
- infectious diseases – they provoke an exacerbation of allergies.
It is very important to prevent the development of food allergies in children. The fact is that it is with food that the child encounters first of all, while still in the mother’s belly. And the occurrence of food allergies provokes the development of other types of it.
What products most often cause it?
Foods that often cause allergies:
- eggs;
- wheat, soybeans, rye;
- honey;
- Seafood, fish and crustaceans;
- nuts;
- canned food;
- some fruits.
Of course, this list can be seriously extended, but other products cause allergies less often.
How to protect your unborn baby from food allergies?
1. Read the composition. Get in the habit of studying labels on all products. If they contain flavor enhancers, preservatives, trans fats, it is better to refuse them.
2. Less finished products. Industrial baked goods, various semi-finished products and even dishes served in cafes and restaurants – all this can be harmful to you, because the composition of such food in most cases is unknown.
3. Give preference to seasonal vegetables and fruits in your strip. We do not always have the opportunity to find out the origin of the products on our table. But buying vegetables and fruits of long-term storage, arrived from exotic countries, you also create conditions for the development of allergies in the child. It is worth remembering that the use of red fruits and berries now needs to be limited: they can also cause allergies in the baby. In the cold season, frozen berries and canned vegetables grown in the country will be much more useful than “fresh” fruits brought from other countries.
4. Wash vegetables, fruits and herbs. Various pesticides and fertilizers are also the most powerful allergens, so try to get rid of them, even if you subject vegetables to prolonged heat treatment.
5. Buy baby food. On the shelves of our stores there are not so many products marked “For pregnant women”, but there is a large selection of baby purees, cottage cheese, yoghurts. Buying products in this category from trusted manufacturers, you can be sure of their quality. Try Agusha’s assortment – you will surely find something to your liking.
If you are allergic and expecting a baby, you should consult with your doctor to discuss diet and antihistamines during pregnancy. And how to correctly introduce complementary foods in order to avoid manifestations of allergies, we tell here.
Causes of food allergy in dogs, what are the symptoms?
When a dog appears in the house, we all become a little veterinarian. To help your pet on time, you need to arm yourself with minimal knowledge about his diseases.Let’s talk today about food allergies.
Food allergy in dogs is when the immune system detects certain constituents of the food as hostile to the body and tries its best to fight them by releasing antibodies. Such an unauthorized reaction is outwardly manifested by symptoms that are not very pleasant for the dog:
How can you help your pet? Popular online retailer Dog Kom Yua shares simple tips and professional knowledge.
Is your dog allergic? We treat correctly
It is worth noting that a dog may be allergic not only to food.Just like in humans, an animal’s allergic reactions can occur to any substances in the external environment. But first of all, it is worth excluding food allergies.
Allergy to food in dogs does not appear immediately. It takes time to develop the antibodies that cause all external symptoms. Therefore, after giving the dog a new food, you should not immediately expect manifestations of allergies. And if it manifested itself, then, certainly, not for this food. It is worth suspecting the culprit who has been present in the animal’s diet for a fairly long period of time.
Allergies can occur, in principle, to any component of dog food or treats with which some owners indulge their pets. But most often the reason is:
Of course, the ideal option is to immediately contact a specialist if you find any health problems. But there are different situations, and sometimes it is not possible to show the dog to the veterinarian in a short time.
How can an owner help his pet? Step by step:
exclude all food, additives and treats that the animal received before the problem was detected; | |
introduce hypoallergenic dry food, which is guaranteed not to cause allergies; | |
alternately introduce the tested ingredients and observe the reaction of the dog’s body for 2 weeks. |
In essence, treatment is reduced to lifelong elimination of the allergen from the pet’s diet. In parallel, it is necessary to help the dog using drugs that can alleviate the symptoms of allergies.
High-quality dry dog food is the key to animal health
In case of allergies, the first assistant is the right dry dog food.