Food allergy: diagnosis, label reading and an emergency plan

A food allergy is an immune system reaction to a specific protein. It is not the same as an intolerance. Assessment is needed before cutting out foods, and this is general information, not a replacement for a doctor.

First steps

1. Note what you ate, what symptoms you had and how long after the meal.
2. See a doctor or allergist for testing. Self assessment is often wrong.
3. If your doctor plans coeliac disease testing, do not cut out gluten before the test without agreeing it with them, because that can distort the result. This does not apply after a possible allergic reaction: do not reintroduce wheat or a gluten containing food that may have caused a reaction on your own to test it.
4. Do not cut out a long list of foods on your own, but do not eat or test again a food you suspect caused a reaction until a doctor or allergist has assessed it.

Avoiding the allergen daily

Read labels every time because recipes change, and note warnings about traces. Ask restaurants about ingredients. At home use separate boards and utensils to prevent cross contact.

Replacing nutrients

Cutting out milk removes a source of calcium: choose fortified plant drinks and other sources with a dietitian’s advice. When avoiding gluten choose gluten free whole grains.

Emergency reaction

Swelling of the lips or throat, difficulty breathing, fainting or severe vomiting may be anaphylaxis. If you have a prescribed adrenaline auto injector, use it straight away according to your personal plan. Also call your local emergency number at once (112 in the European Union) and say you think it is anaphylaxis. Call emergency services even if no auto injector is available. Lie down, or sit up slowly if breathing is hard. Do not stand or walk, even if you feel better. If there is no improvement after 5 minutes and you have a second auto injector, use it too. Carry your auto injector at all times and know how to use it.

Prepare a written plan: a list of diagnosed allergens, your doctor’s contact and instructions on what to do in a reaction. Share it with family, school or workplace. That way others can recognise a reaction and help.

When travelling, take safe snacks and a card listing your allergens in the language of the country you are visiting. At school, nursery or work, agree who knows where the prescribed auto injector is kept.

Sources: NIAID NIAID NHS.