Food Allergies: Facts, Myths, and Pseudoscience

The price of life is eternal vigilance. If you have severe food allergies, that is your reality. Every day, every meal, every bite. Eating is an intrinsic and essential part of what we do and who we are, so the idea that our bodies can rebel violently to everyday foods can be difficult to believe. But it’s real, and the numbers of the severely food allergic are growing. Frustratingly, we don’t know why. While recognized over 100 years ago, the social acknowledgment had lagged. That’s improved in the past decade. Food allergy prevention approaches are now a routine part of travel, school, sports, and the workplace. Peanuts on planes seem to have completely disappeared. The days of lunchbox peanut butter sandwiches are over, with many schools completely banning all peanut-containing products. It is the education system that seems to have become a ground zero for allergy programs and policies, where educators are challenged to ensure that schools are safe environments for all children, some of whom have long lists of food allergies.

While 30% of the population believes that they have a food allergy, the actual prevalence is about 5%. Allergies are a product of our immune systems, with multiple biochemical pathways triggered in response to a specific antigen. “Allergy” can describe mild skin reactions and respiratory distress, right through to life-threatening reactions. The majority of food-related allergic reactions are not life-threatening. Anaphylaxis is the term that describes the most rapid and severe immune response, which can occur in response to a drug (the most common cause of anaphylaxis), an insect, or food. Food-allergy anaphylaxis is rare, occurring in one to 70 per 100,000 of the population. Eight food cause over 90% of anaphylactic reactions: milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. Reactions may involve multiple body systems (gastrointestinal, skin, respiratory) including breathing difficulties and swelling of the throat. Anaphylaxis is estimate to have fatality rates of 0.7-2%. Death occurs due to upper airway obstruction, vascular fluid shifts, and depressed heart function. The risk of anaphylaxis, and how quickly it can appear in any individual with a history of allergy, is difficult to predict, and can be influenced by age, the type of allergen, the extent of exposure, and underlying illness like asthma.

Evaluation of anaphylactic food allergies involves a number of diagnostic tools including skin testing, in-vitro tests, and food challenges. There is no single diagnostic test. Different tests may be used depending on the patient’s history of reactions. All of these tests have different risks and benefits and must be performed under the supervision of an allergist, where immediate access to resuscitation equipment is available. Food allergies in children can resolve over time, like milk and egg. Tree nut and peanut allergies, however, are more likely be life-long conditions.

Given the life-threatening nature of some food allergies, you’d think there would be no room for myths or pseudoscience. You’d be wrong. Confusion and misinformation abounds. There is the unfortunate tendency to label any sort of negative reaction to any substance as being an “allergy”. I see this frequently when speaking with patients about their medical history, who rhyme off a long list of drug “allergies”, which more frequently describe intolerance, like diarrhea to antibiotics, or nausea and drowsiness from narcotics. Then there are “allergies” pulled out of thin air. The current fad food “allergy” is gluten, a self-diagnosed condition in which gluten is believed to be some sort of dietary toxin – which must be distinguished from (1) the person with the documented anaphylactic wheat allergy and (2) those with celiac disease, an auto-immune response to gluten that requires absolute avoidance (but does not cause anaphylaxis if ingested). Capitalizing on the confusion about allergies and intolerances are alternative medicine providers, who offer their own definitions of allergies, and (conveniently) their own cures. The result is widespread confusion about allergies, and worries that we’re seeing too many nonexistent allergies while raising the risk we’ll miss the truly life-threatening ones. As a parent of young children, I sympathize with the staff at my local school, where each year means a new group of parents who grumble about the school’s policies in place to minimize the risk of allergic reactions. Eggs, peanuts and milk are the most common allergies, but peanuts and tree nuts cause more fatal anaphylactic reactions, so restrictions on those food products are more common. Tragic deaths have driven systems to implement new policies. What’s worse, severe reactions are more common in children and children and young adults are at greater risk of a fatal reaction.

With food allergies, the consequences of a single wrong decision can be fatal. I was reminded of this when I heard about Natalie Giorgi, a 13-year-old girl who died of anaphylaxis this past July after accidentally biting a peanut butter-contaminated Rice Krispie square. Here parents were present and they immediately gave her an antihistamine, diphenhydramine (Benadryl). She initially showed no signs of a reaction. Suddenly she started vomiting, which quickly progressed to a massive anaphylactic reaction. Her father, a physician, administered the two epinephrine injections (Epi-pens) they had on hand, with no effect. A third Epi-pen was found, and given. No effect. Sadly, she could not be resuscitated, even after EMS arrived. Her last words were “I’m sorry, Mom,” and she died in front of her parents. From dancing to dead, in minutes, simply because of a bite of food.

This type of scenario is terrifying to those with allergies, parents, and health professionals. Was this tragedy preventable? Based on the limited information in the story, the only possible error may have been the administration of Benadryl, which may have delayed the first dose of epinephrine. With food-related anaphylaxis fatalities, the median time to death is 30 minutes. Seconds count. Delays in using epinephrine may be based on fears of the inappropriate administration of epinephrine. Given there is essentially no risk to epinephrine when administered via Epi-pen, nothing should delay prompt administration when anaphylaxis is suspected, even if the reaction is initially mild. Immediate referral to emergency services is also essential.

There is currently no cure for food allergies. Research into desensitization looks promising, but it’s not ready for use outside of clinical trials yet.

With Natalie’s tragedy in mind, here are some of the more common myths and facts about food allergies.

1. Myth: Allergies are a fad, and they’re not dangerous

Fact: While 50-90% of self-reported food allergies are not allergies, severe food allergies do exist. They can have a sudden onset, and be fatal in minutes. Prior reactions don’t predict future reactions. The only way to prevent reactions in those with a history of anaphylactic allergies is strict and complete avoidance of the allergen. Other types of reactions, such as celiac disease (an immune disorder triggered by gluten), require allergen avoidance, but are not immediately life-threatening like allergies can be.

2. Myth: Benadryl can be helpful for anaphylaxis

Fact: The only treatment useful for the management of anaphylaxis is intramuscular epinephrine (e.g., Epi-pen). All other treatments, such as antihistamines like Benadryl, inhalers, and steroids are secondary treatments and do not replace the need for the immediate administration of epinephrine. There is no established role for the administration of Benadryl during what is known to be an anaphylactic reactions.

3. Myth: I was exposed to an allergen, but I’m fine. Maybe I’m not going to have a reaction.

Fact: Maybe, but maybe not. Anaphylactic reactions do not always appear immediately, and can be delayed by minutes or even hours. Reactions can manifest in different ways.

4. Myth: Food allergy is the same as food intolerance.

Fact: A food intolerance is non-allergic by definition. Lactose intolerance is an example, where the reaction to lactose does not involve the immune system. Intolerances may be unpleasant but they are not fatal.

5. Myth: My naturopath/chiropractor/acupuncturist/homeopath diagnosed my allergy:

Fact: Naturopaths and other alternative medicine providers do not diagnose allergies in evidence-based ways. Yet many offer purported different diagnostic tests as part of their practice. Treatments have either been shown to be unreliable or have been demonstrated to be useless. Unproven or disproven tests for food allergy that alternative practitioners may offer include:
IgG blood tests
IgG blood tests (e.g., Hemocode and Yorktest) cannot identify food sensitivities or allergies, only recent exposure to different food ingredients. It has no established value as a diagnostic test for food allergies.
Applied kinesiology
AK is a well-known scam that is purported to diagnose allergies by holding a suspected allergen and then pressing down on that limb. Muscle weakness is said to signify an allergy. Careful evaluations show that AK tests can be completely manipulated by the tester, and they have no relationship to actual allergic responses.
Electrodermal test or “Vega Testing”
The Vega test is claimed to measure body electric currents (to acupuncture points) with an allergen in the electrical circuit. There is no correlation between Vega test results and reality, in that it cannot identify allergies at all.
Cytotoxic testing (Bryan’s test)
These fake allergy tests were last generation’s IgG blood tests, sold in storefronts, and involves mixing a patient’s white blood cells with suspected allergens. There is no correlation between the results, and allergic responses. The FDA and other regulators have taken action to clamp down on cytotoxic assay sales, but providers can still be found.
Hair analysis
While useful for testing for exposure to drugs and some chemicals, there’s no basis for examining the hair to determine allergies
Pulse test
Used more for diagnosing food “intolerance”, this involves measuring the pulse before and after eating a suspected allergen. It should be self-evident why this sort of testing isn’t advisable for suspected allergies.

6. Myth: My naturopath/chiropractor/acupuncturist/homeopath can eliminate my allergy
Fact: Despite claims that are made with regularity, there are no “cures” for allergies that exist within alternative medicine. Perhaps because of the limited treatment options, alternative purveyors offer a variety of “allergy elimination” treatments that are claimed to be effective for a variety of allergens. NAET, or Nambudripad’s Allergy Elimination Techniques is claimed to eliminate “energy blockages” through some combination of chiropractic and acupuncture treatments. Testing includes some elements of applied kinesiology (see above) and electronic devices that measure skin resistance, akin to the Vega test (see above). Not surprisingly, there is no credible evidence that “NAET” can eliminate allergies of any kind but this does not prevent its proponents from making wildly dangerous claims:

Perhaps not surprising, NAET techniques can kill.

7. Myth: “May contain” warning labels just provide legal protection for companies. Those foods are fine for those with anaphylactic allergies.
Fact: May contain labels should be taken literally. A recent study of products labelled “may contain peanuts” contained detectable levels of peanuts 8.6% of the time.

8. Myth: I diagnosed my child’s allergy so they don’t eat “X” anymore.
Fact: Many more people believe they have food allergies than actually have them. Unnecessary dietary restrictions can have nutritional consequences, so professional evaluation is warranted if food allergy is suspected.

Did I miss any? Add yours in the comments.

Posted in: Science and Medicine

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148 thoughts on “Food Allergies: Facts, Myths, and Pseudoscience

  1. I was surprised about the Benadryl. I have a good friend with peanut allergy, which seems to have worsened as she gets older. She carries Benadryl and has relied on it a number of times to stop a reaction. She no longer even enters a Thai restaurant–where several reactions have occurred.

    I will forward this to her immediately. She does not carry EpiPen so far as I know (we don’t live in the same part of the country anymore), nor does she see an allergist. She has known about the allergy since childhood and simply uses avoidance, so I’m pretty sure she has not discussed Benadryl or EpiPen with a doctor. Yikes!

    Thanks for a thorough discussion; I have been guilty of thinking schools are over-reacting and appreciate this medically sound presentation to set me straight.

    1. Young CC Prof says:

      Not all food allergies are potentially anaphylactic, my food allergies are reversible with Benadryl. My friend used to be anaphylactic and her shrimp allergy has improved to the point that it’s now reversible with Benadryl.

      If I remember correctly, that’s part of the reason Natalie’s accident went as badly as it did: Her family started with Benadryl precisely because she’d never had an anaphylactic reaction before.

      In your friend’s case, however, as her allergy is progressively getting worse, she should see an allergist and ask about EpiPen as soon as possible.

      The problem with food allergies and schools is that schools like blunt-instrument polices and food allergies are a subtle and individual problem.

      Some children have potentially deadly allergies that can be triggered by trace exposure. Others have nutty parents, and possibly no allergies at all. (A school should ALWAYS presume it’s #1 if a parent says so, although they might be advised to alert the authorities if there are enough red flags, like two dozen supposed food allergies, an underfed-looking kid, and no actual allergist signing doctor’s notes.)

      And sometimes schools do ridiculous things, like keeping peanuts banned when there aren’t actually any peanut allergic children enrolled, but there is a child with an anaphylactic allergy to a non-banned food.

    2. Kate McAfee says:

      I understand the severity of allergic reactions, but I still feel like schools take restrictions too far. This year my daughter’s preschool has a child allergic to peanuts, cashews and pistachios and the school (rightfully) banned peanut/tree nut snacks and lunches. However, they also “suggested” that it might be wise for all of the families to stop eating peanut/ tree nut products at home as well “as they could get dust on their clothes and bring it to school” and that’s taking it too far IMO.

      1. Young CC Prof says:

        Yeah, that might be a bit excessive! Just, if your child has one of those foods in the morning, make sure she washes her hands properly before going to school. If it is all over her shirt, change her shirt.

        My allergist’s office simply bans ALL food in the building, to make sure that all their patients are safe, and I always wash my hands and brush my teeth before I go, especially if I’ve been eating something both allergenic and sticky, like peanut butter.

        Sometimes I wonder if that’s partly why peanuts are the most dangerous allergy: peanut butter is sticky and that leads to easy cross-contamination and accidental contact.

        1. calliarcale says:

          That’s an interesting idea, Young CC Prof. I have a good friend who had an anaphylactic incident at school when we were kids. They were serving ants on a log, and the lunch lady didn’t change gloves before handing her the plain celery. (My friend had an EpiPen and is fine, BTW.)

        2. Nashira says:

          As a grown up who’s had two PBJs today, I can attest to peanut butter getting *everywhere* even you are trying to be careful. This problem gets worse the groggier you get, according to my completely and totally scientific observations from this morning. :P

          1. Chris says:

            PBJ = Peanut Butter and Jelly sandwich

  2. Sullivanthepoop says:

    You know that they have new guidelines for feeding infants high allergen foods as early as they can physically digest them and it is showing great promise for reducing new incidence of severe food allergies.
    The thought is that some foods, like peanuts or shellfish, have such a unique protein that if you give it during a time that all food proteins are unique to an infants system than the really unique proteins will seem like any other protein to the child’s immune system. Not to mention that immune reactions before 18 months are much milder than later in life.

    1. calliarcale says:

      Yes. This goes hand-in-hand with the suspicion that maybe the recommendation to *avoid* allergens in the first year of life might be partially to blame for the increase in food allergies. I’m not totally convinced, but it seems very plausible.

      1. Sullivanthepoop says:

        I have a friend who is an epidemiologist and he is working on a paper about this subject. Looking at his work shows an impressive correlation.

    2. duggansc says:

      I wish I could find more scientific explorations of this. I would not be surprised at all if early exposure to allergens resulted in a lower incidence later in life. The question is, how much of the gain will result from individuals with severe reactions getting eliminated early in life?

      My grandmother long believed that she “cured” my Uncle Jim’s peanut allergy when he was a child through progressive desensitization, but that was almost 60 years ago, and it’s entirely possible that it wasn’t an allergy, or that it just went away as allergies sometimes do.

      1. Matt says:

        The book ‘An Epidemic of Absence” explores this theory, as well as the theory that our clean environment, including the absence of parasitic worms, exposes us to more allergies since the symbiotic relationship we’ve developed with parasites was providing benefit against unwanted proteins.

        1. duggansc says:

          I’m hoping that there’s some degree of cross-checking of symptoms too. I was discussing with a nurse friend of mine the situation of areas where kids are protected from allergens being less likely to have allergies and she pointed out that those areas also have lower test scores. She admitted that part of it is that most such areas understudy are also third-world countries, but it got me to thinking, could web be causing some minor damage due to lower levels of oxygen due to having low-level allergic reactions at an early age? Common sense would suggest not, since most of us don’t lose brain cells from a case of the sniffles, but we’re also talking about human newborns, who have been found to be fragile enough that bright fluorescent lights were inducing blindness. Given babies can easily cry themselves into unconsciousness due to lack of oxygen, how unlikely would it be that a child with a congested airway could experience oxygen deprivation at a crucial stage of development?

  3. Ally says:

    I had seasonal allergies diagnosed by my doctor, every medication we tried treated my allergies, but even non-drowsy formulas made me unable to drive a car safely. I went to a naturopath and they told me to stop eating gluten. I scanned the literature and had trouble finding evidence to support the suggestion. In disbelief my mom convinced me to try it. I haven’t had seasonal allergy symptoms since, and that was 6 years ago. I tested negative for celiac, and though I recognize every test has its own drawbacks, my symptoms were not congruent with celiac disease. Additionally food contaminated with gluten seems Ok for my system to process.

    1. Ally says:

      Sorry not saying I have an allergy to gluten! Just wondering if anyone had heard of any research that could explain what happened to me?

      1. TeeDee says:

        Ally, I had tests to try to determine if I had an allergy to anything because of chronic hives. I had no allergies, but a couple of years ago, I decided to see what would happen if I gave up gluten as I’d heard some people say it helped with all sorts of autoimmune disorders. I was skeptical going in since I’d been having the hives for 5 years and tried cutting out certain things to see if it would help, and, nothing.
        But after a week and a half of going gluten free, my rash disappeared, not to mention the arthritis in my right hand that had bothered me daily.
        I wasn’t going to take a chance that it was a coincidence however (it can be quite an adjustment giving up gluten), so I added it back in after several months of being rash and arthritis free. Within a week, all symptoms were back again–I was frankly stunned.
        So, whether I have an allergy, or sensitivity, or something else going on all together, I’m living gluten free now because it’s much easier to tolerate than daily itching, Benadryl, and arthritis strength aspirin on bad days…All the best.

        1. Beth says:

          You might consider looking into intestinal yeast overgrowth. Inflammatory problems, including arthritis and skin disorders can be worsened if there is too much yeast in your intestinal tract. Eliminating gluten seems to solve the issue because your body is drastically reducing its sugar intake (carbs convert to sugar during digestion). Yeast need sugar to live, without enough, they die off, thus reducing the inflammation problems that you have. It really doesn’t have anything to do with gluten, it’s your gut flora. You can also try looking in the candida diet and non-yeast based probiotics to repair your intestinal flora.

          1. Allergy Doc says:


            (face palm) The name of the blog is Science based medicine. The hypothesis that yeast overgrowth in the colon is the cause of disease and myriad symptoms is sorely lacking any scientific verification (such as blinded controlled trials).


        2. Allergy Doc says:


          Glad you are feeling better, but gluten is not recognized as a cause of chronic hives (recurring daily hives, AKA Chronic Idiopathic/autoimmune Urticaria). Wheat ALLERGY (not to be confused with Gluten Enteropathy/Celiac disease) can cause occasional hives, but not daily hives. Your experience is anecdotal, and given that intermittently active disease is a common feature of Chronic hives, your improvement and relapse can be explained by coincidence, with perhaps some confirmation bias thrown in. Also, Aspirin is suspected to aggravate chronic urticaria.

      2. stanmrak says:

        Many people have reactions to wheat and don’t know it. Sometimes it’s the gluten (altho it may or may not be an allergy), but it could be another substance in wheat called wheat germ agglutinin (WGA) or any of the over 20,000 different proteins that can be found in modern wheat, most of which we know little about.

        Some people say that the only way to tell is to eliminate all wheat and gluten for 30 days and see how you feel. You’ve discovered this on your own.

    2. Young CC Prof says:

      Did you have allergy scratch tests and IgE blood tests? Maybe you never had allergies, only acid reflux irritating your sinuses.

    3. tariqata says:

      I had severe seasonal allergies growing up (diagnosed by symptoms and a skin allergy test), but they became less and less severe in my twenties and I haven’t needed to take medication at all for the last three years or so, and really haven’t experienced any symptoms beyond a mildly itchy nose. I haven’t made any dietary or other lifestyle changes, and I haven’t undergone any kind of treatment. Is it possible that your change in symptoms occurred by itself?

    4. Allergy Doc says:

      You have fallen into a post hoc, ergo Propter hoc logical fallacy. Just because your allergies improved after you went gluten free does not establish your gluten free diet as the cause of your improvement. Seasonal allergies often spontaneously improve as children go through adolescence. Perhaps your living environment changed. I’m glad you are better, but there is no convincing data that going gluten free is useful for anything other than Celiac.

  4. Excellent informative article!

    A question on “3. I was exposed to an allergen, but I’m fine. Maybe I’m not going to have a reaction.
    Maybe, but maybe not. Anaphylactic reactions do not always appear immediately, and can be delayed by minutes or even hours. Reactions can manifest in different ways.

    When is the appropriate time to use the epi-pen if you have a food allergy and you know you were exposed? Does immediate use prevent a reaction happening hours later? Or if you don’t have a reaction, should you wait for symtoms and use the epi-pen then?

    I know that may be a uninformed question. I don’t know much about food allergies, beyond to take them seriously. But, my husband coaches a soccer team and one of the boys has a peanut allergy, parents take turns providing peanut free snacks…but to be honest, I’m not sure how concientious all the snack contributors are…It seems like it might be good to know.

    1. Young CC Prof says:

      This much I know: If you used the epi-pen, call an ambulance. That’s written in big bold letters right on the pen.

      It only works for about 10-30 minutes, and the patient will probably need IV steroids and other drugs to completely eliminate the reaction. Even if they recover fully in a few minutes, the hospital will hold them for several hours to rule out bi-phasic reactions.

      1. @Young CC Prof – That clarifies things, Thanks!

    2. Alex T says:

      A friend had severe peanut allergies and she learned to refuse any food that was prepared by others, no matter how well-meaning. People may think it’s peanut free, but how did they clean the food prep surfaces? How closely did they check all ingredients? Could there have been peanuts touching any of the storage containers? People sometimes imagine that ‘peanut free’ means not adding any peanuts, but even incidental contact can be enough to trigger reactions.

      I think the ‘peanut free’ snacks might be nice to avoid unintentional reactions, but it might not be enough to let kids with allergies safely eat. Depends on the kid.

      1. Alex T – That is a good point about homemade snacks. Everyone brings individual snacks packs, like Sunchips or Fruit/Grain bars. The coaches lets parents know in an email “We have a peanut allergy so check the snack package contents to make sure it doesn’t contain peanuts.”

        The local school have a policy against homemade snacks (for parties, etc) so I guess that’s just understood.

      2. Sullivanthepoop says:

        When I was a teenager I babysat a little boy who had a bad peanut allergy and one day while I was watching him I took him to a playground across from his house and he had a reaction. It was the only time I ever had to give anyone an epipen. Anyway, the ER doctor said peanut butter was probably transferred to the equipment from the hands of another child. I am so glad none of my children have any food allergies. My oldest is allergic to penicillin and some molecule that is often in deodorants, but those things are easy to avoid.

  5. Tuck says:

    “Other types of allergies, like celiac disease”

    One of the myths is that celiac disease is an allergy. It’s not.

    Gluten sensitivity can be closely involved in allergic symptoms, and allergy-related conditions like exercise-induced asthma, but while there’s some case reports in the literature, very little research has been done.

    BTW, one of the great tips I got from this blog was to get retested for my penicillin “allergy”. I’d had a reaction to it once, and was thus diagnosed. Sure enough, I did a challenge at my allergist’s office: no reaction. I’m “officially” not allergic to penicillin. So thanks.

    1. Scott Gavura says:

      You’re right, celiac is not an allergy, as I pointed out earlier in the post. I’ve modified the wording. Thanks.

  6. Alex T says:

    Great article, especially considering that “gluten-free” is the new “all-natural”.

    When I first scanned through, I saw that you had things like “Allergies are a fad, and they’re not dangerous” in bold. When I read closer, I saw that was intended to be a “myth”, but it sure didn’t read that way on first pass. At least to me. I heard that even prefacing this with “Myth: ” can still sometimes have people ignore the “myth” part. Have you tried rephrasing it to have the facts in bold while de-emphasizing the myths & errors?

    Probably a small nit, but after finding myself having to do double (and triple) takes, I thought it was worth a small comment. Maybe it just affects people skimming your stuff :)

    1. Scott Gavura says:

      Alex T: I modified the text slightly. More clear?

      1. Alex T says:

        Scott – Yes, labeling things as “Myth” is an improvement, but…

        Here’s Joe Romm on some of the difficulties with discussing myths:

        When the Centers for Disease Control and Prevention put out a flier to debunk myths about the flu vaccine, it repeated several myths, such as, “The side effects are worse than the flu” and labeled them false. A study of people given the flier found that “within 30 minutes, older people misremembered 28 percent of the false statements as true.” Worse, “three days later, they remembered 40 percent of the myths as factual.” And they identified the source of their erroneous beliefs as the CDC itself!

        His point is “If you want to debunk a myth, you should focus on stating the truth, not repeating the myth”.

        I hate to appear as a tone troll or some internet loon demanding you change your writing. The blog post has several more detailed links if you’re still interested.

      2. Tim says:

        I have always used myth to mean something that is believed but which is neither verifiable nor falsifiable. It may be true or false but we just don’t (can’t) know.

        1. iefske says:

          Tim, your definition of ‘myth’ is very much against convention, and, I assume, not the definition used here.

          (conventional def. of myth: a widely held but false belief or idea)

          Using your definition the existence of god would be a myth, even to believers…

  7. TCC says:

    Has anyone ever heard of a broad test for allergies to all kinds of foods that is hearing based?

    My wife had this “test” in which she wore headphone and they played tones of some sort and then based on that they came up with a list of about 50 things and it rated her allergy to those substances. I guess they must have had some sort of sensor somewhere as well to tell how she reacted to the tones.

    This was in Switzerland, where the woo is strong.

    Does that ring a bell with anyone?

    1. Sara says:

      Wow, that’s a new one! Haven’t heard of that one before … how can anyone possibly believe that something like that could detect allergies is beyond me.

  8. Tuck says:

    One other thought:

    “…in which gluten is believed to be some sort of dietary toxin…”

    You then contrast this with celiac and wheat allergies. There’s a third possibility, non-celiac gluten sensitivity, which has only recently been demonstrated to be a real condition.

    “Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity.”

    “Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease: A Double-Blind Randomized Placebo-Controlled Trial”

    “A Controlled Trial of Gluten-Free Diet in Patients With Irritable Bowel Syndrome-Diarrhea: Effects on Bowel Frequency and Intestinal Function”

    “Spectrum of gluten-related disorders: consensus on new nomenclature and classification”

    Gluten clearly meets the definition of a “toxin” in people who have either celiac disease or NCGS.

    1. calliarcale says:

      Could it be that in addition to wheat allergies and celiac disease, there is a third condition where gluten is not digested properly? Lactose intolerance is a condition where the person lacks the enzyme needed to crack lactose into glucose and fructose. Rarer is sucrose intolerance, where the sucrase enzyme is absent.

      I don’t know much about this. I’ve read on celiac disease, since my cousin has it. (It’s kind of scary; due to a defective gene, the immune system cannot distinguish between gliadin and the “kill me now” signal disease cells emit. So it dutifully attacks.) But how do we digest gluten? What happens when that process goes wrong?

      Another thought: what if the intolerance has nothing to do with ourselves but with our gut flora? A change in the typical human’s gut flora could thus explain an increase in symptoms.

      I’m quite sure I’m not the first to have thought of this, but it’s a new thought to me, anyway. ;-)

      1. stanmrak says:

        Modern wheat may not even be fit for humans. Why wait for “proof”? There are plenty of other more healthy things to eat.

        1. Modern wheat was cultivated for humans by humans. Stop reading that nonsense.

          1. stanmrak says:

            Modern wheat is cultivated by humans for PROFIT, not health. Everything they’ve done to the wheat plant was done for that reason, none other. There are some foods that are cultivated to be healthier – they’re called organic.

          2. WilliamLawrenceUtridge says:

            Yep, and thank Dog for the profit motive, improving as it does so many things – cheaper commodities, improved efficiency, more choice, and specifically for wheat – more options. Bread flour. Whole wheat flour. Cake and pastry flour. Pure gluten.

            Profit does not equal poison. And last I checked, organic food cost money. In fact, it rather sells at a premium, doesn’t it? To make up for the fact that it is less efficient, that more of it spoils in the fields before harvest, that more is consumed by pests, to cover the cost of tearing up more forests and filling in more wetlands to create enough farmland to make it economically viable.

            Do you know what does equal poison? E. coli. You know, like what was contaminating those organic sprouts that killed what, 31 people in 2011? Oh, yeah, tell me how great organic food is.

        2. WilliamLawrenceUtridge says:

          Modern wheat may not even be fit for humans. Why wait for “proof”? There are plenty of other more healthy things to eat.

          For one thing, wheat is delicious, producing an astonishing variety of amazing foodstuffs. Breads alone are one of the great gustatory experiences of the world. Health is not the sole determinant of what food to eat is, nor should it be. People who adopt such a mindset appear to have adopted the delusion that somehow, through food, we can prevent all morbidity and mortality, which is nonsense.

          For another thing, wheat can be quite healthy, providing a valuable source of macro and micronutrients, including soluble fiber and folate. Even white flour, demonized as it is, is an excellent source of calories and protein, and is only problematic in cases of overconsumption in the absence of a diverse diet and adequate exercise.

          If you have no genuine reason to avoid wheat, if you find it tasty and it doesn’t cause you symptoms – why would you avoid it just because a small number of unscientific fools think modern versions are dangerous? You can’t live forever in perfect health merely by limiting your diet.

        3. windriven says:

          “Why wait for “proof”?”

          Because only morons act on fear and superstition.

        4. calliarcale says:

          Why rush to judgement without proof of harm, stanmrak? That’s as legitimate a question. Because you’ve clearly gone beyond “asking questions” and would gladly convict wheat. Besides, bread’s awesome.

          1. stanmrak says:

            Unless you’ve actually gone gluten-free yourself, you have no argument. There’s sufficient evidence, but you have to look.

          2. “Unless you’ve actually gone gluten-free yourself, you have no argument.”

            Unless you have experienced the love of the Great Prophet Zarquon through our ritual of year-long noodle-eating you can’t argue that that he won’t save your soul. Are you wiling to risk your SOUL stanmrak? ARE YOU?

            I skimmed this book in the Drugstore last night:–Your-Killers/dp/031623480X/ref=sr_1_1?ie=UTF8&qid=1379439880&sr=8-1&keywords=wheat+brain

            Same old nonsense as Wheat Belly – and William Davis gives Grain Brain an pull-quote endorsement on the back too!

      2. WLU “Do you know what does equal poison? E. coli. You know, like what was contaminating those organic sprouts that killed what, 31 people in 2011? Oh, yeah, tell me how great organic food is.”

        Ehh, I’m not buying stanmrak frankenfoods* line. But bean sprout…and all kinds of spouts have been plagued by food poisoning for years.

        a tidbit –

        E. coli., salmonella, listeria, bleech! – Just stay away from those buggers, whether conventionally or organically grown.

        *The monster, he was just misunderstood.

  9. Art Malernee dvm says:

    My Clients are requesting USDA approved oral allergy “sublingual” treatments. The USDA often allows veterinarians to sell stuff that does not work including some pet vaccines and allergy injectable hyposensitation vials. What do we know about fda approved oral vs injectable allergy shots in people?

    1. Young CC Prof says:

      Short answer: In progress.

      Currently, allergy shots for things like pollen are a very standard treatment. They are looking at ways to replace the shots with sublingual drops, I saw an ad for a clinical study a few months ago.

      For food allergies, they are looking into desensitization, starting with very small quantities of the food and working up. By “very small” I mean barely-visible grains of powdered peanut, and by “working up” I mean a measured dose every day in a hospital. It’s nowhere near mainstream, but they have taken some severely food-allergic children and gotten them to the point where they are no longer at risk of anaphylaxis from accidental trace exposure.

      However, caveat emptor, there are some woo folks out there selling sublingual allergy drops that probably don’t do any thing at all.

      1. Lovleanjel says:

        A friend of mine has severe food-allergic children, and they spent a summer at a clinic going through desensitization. It didn’t get all of their allergies, but there were a number of them that are now moderate to minimal.

  10. Moderation says:

    Maybe this will clarify some of the above questions. Benadryl, for the purposes of an allergic reaction, can only treat hives and the itching symptoms of an allergic reaction. For the true anaphylactic component of an allergic reaction, that is swelling of the airway the tongue and other respiratory symptoms, the only medication which can treat this is epinephrine. For this reason patients with potential anaphylactic reaction should use an EpiPen at the first sign of respiratory or oral symptoms including difficulty swallowing,breathing, etc. Additionally, the previous commoner was correct, after use of epinephrine the patient should be observed in a monitored situation such as an emergency room for approximately three hours.

  11. Alia says:

    I think I should count myself lucky in that I’m only very allergic to wasp and bee stings. Which I managed to avoid for the last 20 years, it’s certainly much easier than avoiding any given food group (especially as there are no insects around here for roughly half a year).

  12. “Given there is essentially no risk to epinephrine when administered via Epi-pen…”

    There’s some pretty serious risks from administering an Epi-pen. Are you trying to say that in the context of fatal Anaphylaxis, the risk is comparatively low…?
    “The potential for epinephrine to produce these types of adverse reactions does not contraindicate its use in an acute life-threatening allergic reaction. “

    1. Scott Gavura says:

      Epinephrine can have adverse events when the drug is given intravenously or at excessive dose. When given intramuscularly, for the treatment of anaphylaxis, using a device like Epi-pen, there are no absolute contraindications to epinephrine. Delays to the use of intramuscular epinephrine are reported to be associated with mortality.

      1. I see, thanks for the clarification.

  13. mho says:

    A common symptom of ovarian cancer is a feeling of indigestion or feeling full. My doctor recommended an anti-acid or an histamine H2 blocker as a first effort to manage symptoms.
    My symptoms continued. I believed I had a food allergy or insensitivity and scheduled an appointment with an allergist, but I couldn’t get seen for 2 months. When I did get seen, I had so much fluid in my belly from the cancer I could barely get up on an exam table.
    My belief in the pervasiveness of food allergies delayed the proper diagnosis by several months.
    Cancer was diagnosed only after I began having severe pain with only a few bites of food, and then constant pain.

  14. Jo says:

    This was a wonderful, if not heartbreaking, article. It might be a good idea prefixing those myth headers with “Myth:”, because readers otherwise might need to fight a first visual impression that they’re statements you’re arguing *for*. I certainly did.

  15. Olivia says:

    I’d love to hear something about some of the non-IgE mediated food allergies that are legitimate: FPIES, eosinophilic esophagitis, etc. My daughter has FPIES, which is a very real, life threatening condition diagnosed by her allergist. If she eats the wrong food, she vomits to shock and end up in the hospital. I’m loathe to bring it up for fear of being seen as one of “those” people, but it is real and serious. However, I’m grateful to live in a city were a good proportion of the population has “allergies”. It makes finding food that she can eat much easier.

  16. Denise says:

    I usually give no credence to people’s anecdotes about how changes in diet, OTC supplements and CAM have cured them of this or that, but the number of people who say they’ve had miraculous improvements by going off gluten is so huge that I wonder if it could really all be delusional. Half the people at my autoimmunity forums are on gluten-free diets and some of them claim to be symptom-free as a result.

    Does anyone here think there’s anything to this?

    1. Sullivanthepoop says:

      I was having a lot of symptoms of IBS and my doctor told me to try a gluten free diet. Well, I wanted to lose some weight and did the low carb diet plus no gluten and it was like a miracle. I had no more symptoms of IBS, though it did nothing for my autoimmune disorder. After I came off the low carb diet and added gluten back I still felt great. Then when I started adding other carbs back I started feeling really bad again. Anyway, it turned out I have fructose malabsorption disorder and a lot of the reason that I felt better was because without gluten my intestinal flora decreased and when I eat too much fructose I have too much intestinal bacteria because they have a steady diet of my unabsorbed fructose. So, I think it might be confounders.

    2. Young CC Prof says:

      Here’s the thing. Let’s say you are moderately overweight, or even obese. And then let’s say that you eliminate an entire food group, one that contains a lot of your favorite junk food, like cookies and cake.

      Guess what, you’ll lose weight and feel great, at least for a few months, until your eating habits adjust to the limitation and your calorie count goes back up. Same thing would happen if a big meat-eater went vegetarian or a cheese lover decided to ban lactose.

      Folks who truly have celiac often GAIN weight when they eliminate gluten, because the inflammation in the intestines starts to heal, and they can once again eat and absorb what they’re eating.

    3. WilliamLawrenceUtridge says:

      There might be something to this, but only careful testing will reveal it. The thing is, the human mind is a self-justification machine. Read Mistakes were made (but not by me) by Carol Tavris and the guy whose name I should really, really memorize but always forget. Aaronson? Aaron-something?

      While people may claim to be symptom free, it is easy to minimize what was before a “pain” into a “twinge” that hurts less or is less significant. If you are monitoring, and expecting, relatively constant pain – every minor ache and pop can be evidence of your impending doom. If you’ve made a big life change and you want to justify that effort, the fading of every ache and pop becomes evidence of your improved health. If people trying gluten-free lose weight (because wheat is pretty calorie dense, even if it’s good for you) then joints suddenly ache and pop less, possibly making it a self-justifying prophecy.

      There may be something to it, but the self-selecting nature of the internet pollutes the discussion and the self-justifying and anecdote-loving nature of the mind muddies evidence. Hence, what you have here is a slightly interesting hypothesis with some prior plausibility. It needs study, but mostly what it needs is far, far less certainty.

      But hey, if you’ve removed wheat from your diet, all the power to you provided you’re replacing those missing macro and micronutrients! There’s no reason to eat wheat if you’re getting what you need elsewhere (except of course, for its culinary flexibility, and the deliciousness with which its products are generally infused – but there’s lots of delicious things out there, so how much of a loss it is, is up to you).

  17. Chris Hickie says:

    Thank you for an excellent article. I am somewhat spoiled in that there is an allergist next door to my pediatric practice. As an aside, here is an interesting case report of a 3 year-old girl who didn’t have any real food allergies, but was malnourished to the point of abuse by her parents (who also, of course, didn’t immunize her either):

  18. Mike says:

    “There is the unfortunate tendency to label any sort of negative reaction to any substance as being an “allergy”. I see this frequently when speaking with patients about their medical history, who rhyme off a long list of drug “allergies”, which more frequently describe intolerance, like diarrhea to antibiotics, or nausea and drowsiness from narcotics.”

    That’s not our fault.

    I don’t tolerate a particular antibiotic very well. Every single time I visit the clinic they go over my current prescriptions and drug allergies, and every single time I remind them that I’m not allergic to the antibiotic, but prefer not to take it if there’s an effective alternative available.

    Their clinic software does not have any way to keep track of “does not tolerate” or “prefers something else” so they just leave it listed as an allergy. (This is an Allina clinic. They operate 11 hospitals and >50 clinics.)

    1. @ Mike – That’s a good point. My son got a few bad cold sores after he had dental work done. The dentist switched to non latex gloves and he hasn’t had cold sores after seeing the dentist since. It doesn’t seem like an allergy, some sort of irritant that brings on the virus and is worse with the latex gloves.

      I tell nurses that he’s not allergic to latex (apparently the latex allergies are scary), but don’t use latex gloves in his mouth, because of the sores, but they just have to check the allergy box on the computer.

      Luckily his hospital only has latex free gloves now, so I don’t have to worry about it.

      Also, I don’t take pseudophedrine because it make me crazy. They don’t have any place to list “medications that make you crazy and you will only take in a life or death situation.” But I just tell my doctor if it comes up…then she looks at me like I’m crazy, but better to have people think I’m crazy then feel crazy, I say.

      1. Young CC Prof says:

        Exactly. I have a couple of genuine drug allergies, like full-body hives, went back to the doctor and he said, “Yup, allergy, never take THAT again!” I also separately have some drugs that cause completely non-allergic effects so nasty that I should never take them, like NSAIDS and my erosive gastritis. Unfortunately, there isn’t a space for that on the forms, so it all goes under “allergy.”

        1. corky says:

          I have the same issue. I have had several severe responses to narcotic pain relievers (stopping breathing and plunging BP while fully conscious). When I tell Drs about this they generally say “oh, you have an allergy” to which I respond NO, I do not swell up or get a rash or sneeze, I just do not tolerate the drugs. And then they make the allergy box….Many of the doctors have tried to argue with me about it being an allergy, I am allergic to many things (cats, chickens, tree pollens, ragweed, dust, etc) but not to those drugs!

          On another note, my sister (and several other people I know) seem to have developed allergies to many kids of fresh fruit, such as apples or peaches. When she eats them (even if they are well washed or organically grown) her lips swell up, get numb and she develops both nasal and asthmatic symptoms. Does anyone know the cause of this?

          1. Sara says:

            Sounds a little like OAS (Oral Allergy Syndrome).


          2. Sara says:

            Sounds like OAS (Oral Allergy Syndrome). I earlier posted a link to a great review article from CMAJ but I think it’s hung up in moderation.

          3. Young CC Prof says:

            Mmm, plunging BP actually is a sign of anaphylaxis.

            And yes, that’s oral allergy syndrome. Washing and organic growing has nothing to do with it, it’s the proteins in the fruits themselves that are the problem.

            Sometimes peeling can solve it, but many people, including myself, can only eat the fruits if they are completely cooked, until soft all the way through. That reliably destroys the proteins. Note that dried fruit can still trigger reactions, as it’s dried at a fairly low temperature. Also note that veggies can sometimes cause this, too.

            Mine got worse recently, I’m currently waiting on IgE blood tests to find out if there are any fresh fruits or veggies I can actually eat. I know all the ones I actually like are out…

          4. Chris says:


            I have the same issue. I have had several severe responses to narcotic pain relievers (stopping breathing and plunging BP while fully conscious).

            And I thought my reactions to narcotic pain relievers are bad! I just get nauseous and throw up. Not something you want to do when you have a broken ankle and are on crutches (hobbling to the toilet every few minutes is quite annoying).

            It is also not good to have the dry heaves during a colonoscopy. So they gave me something to combat the nausea from the anesthetic and all went well. Whew!

            I don’t think that would work for you. When you get old enough for that extremely annoying procedure, do make sure to tell them that you tend to stop breathing and have low blood pressure. That would be extremely important.

    2. Alia says:

      Which reminds me – a few years ago I learnt I am mildly allergic to clindamycinum. Nothing serious, a bit of rash on the back and arms, so I just took some antihistamines to get rid of it. But when I next went to my dental surgeon to have another dental surgery, I told her about it, so this time she prescribed amoxicillinum (Augmentin). I did not get a rash but other side effect were so nasty that now, given a choice, I would totally go for clindamycinum.

  19. stanmrak says:

    “The numbers of the severely food allergic are growing. Frustratingly, we don’t know why.”

    Why not do some research into GM crops? FDA scientists repeatedly warned that GM foods can create unpredictable, hard-to-detect side effects, including allergies. They urged long-term safety studies, but of course, Monsanto doesn’t want anyone to know about the negative health effects of GM agriculture and have had laws passed that make it illegal for independent labs to do research on Monsanto seeds.

    1. lol no. GMO’s are tested frequently to control for allergens. They don’t cause allergies.

        1. stanmrak says:

          Spoiler Alert! There is virtually nothing truthful in Ms. Federoff’s assertions. Studies, not Monsanto PR, have clearly borne this out.

          1. duggansc says:

            Excellent. Can you provide these studies so that we might be enlightened? Or can you provide the studies where the FDA scientists made those warnings?

        2. stanmrak says:

          …if only some of it was factual; unfortunately, not so much.

    2. windriven says:

      “Monsanto doesn’t want anyone to know about the negative health effects of GM agriculture and have had laws passed that make it illegal for independent labs to do research on Monsanto seeds.”

      Some much wrong with so few words.

      First, one needn’t have seeds to do research on negative health effects of GM agriculture unless the hypothesis that planting or handling them is the problem. If the issue is consumption of GM foodstuffs one only need buy the food. Monsanto would be thrilled.

      Would you kindly point us to the specific law(s) that Monsanto ‘had’ passed that make it illegal for independent laboratories to do research on the health aspects of Monsanto – or any other – GM foods. Laws preventing reverse engineering of the seed don’t count – those don’t go to your allegation.

  20. Guy Chapman says:

    As a relatively recently diagnose coeliac, the bullshit touted by “wheat belly” readers is profoundly irritating to me.

    Diagnosis of gluten intolerance is entirely objective. TTGA and (usually) duodenal biopsy finding villous atrophy. Absolutely solid diagnosis, tiresome dietary restriction for life but no more feeling like death warmed up, which is a result, basically.

    Fake food “intolerance” is a conceit of the worried well.

    1. How do you tell the conceited worried well from the dismissed undiagnosed unwell?

      1. windriven says:

        The conceited worried well have an unmistakable smugness about them.

        1. I don’t know windriven – Do we have data that says smug people are struck by less illness or have a higher early accurate diagnoses rate*? Or that genuinely sick people are more likely to be pleasant?

          Maybe we need some new categories. Smug Worried Well, Unassuming Worried Well, Smug Diagnosed Unwell, Unassuming Diagnosed Unwell, Smug Undiagnosed Unwell, Unassuming Undiagnosed Unwell – Oh wait I almost forgot – Smug Well, Unassuming Well

          I think we are all just are annoyed by smug people, but being annoyed by smug worried well is more socially acceptable, so we just fudge our assumptions about their physical well being a bit.

          I also think that attribution bias is at play.

          Personally, I’d put the Smug Well in my top annoyance category…because they never seem to acknowledge that part of the reason that they are well is luck. Also they are so smug about their wellness that they won’t see a doctor when they are sick.

          hmm – maybe I should add two categories.

          Smug In Denial Unwell – Unassuming In Denial Unwell


    2. Matt says:

      Understanding.that your condition is very serious, why not be open to the possibility that your condition is the far end of a spectrum which also contains less severe issues? Especially since the “movement” is providing a multitude of safe foods for your consumption? To me, the lack of ability to prove with a test, that an individual has a sensitivity to a food, but that experimenting and finding that certain conditions (in my case eczema and seasonal allergies) disappear when I am 95% compliant with avoiding bread), speaks to the need for better means to “prove” such situations, than blind dismissal of them.

  21. John J says:

    The biggest myth and the one that has put my peanut allergic son at greatest risk is almost an inverse of one of your listed ones: if an allergen is NOT listed that does NOT mean it is safe. In the United States, the FDA does not require labeling for cross contamination risks, only for direct, intentional ingredients. Thus if a piece of equipment is used to package peanut butter ice cream and then immediately switches to chocolate, only the peanut ice cream needs to be labeled even though the likelihood of cross contamination ishigh.

    Other countries have stricter regulations (Canada comes to mind) but not the US. We have to do extensive manufacturer research any time we try a new food/restaurant and on an ongoing basis with foods we eat regularly. For example, Sara Lee, a baking compan6 that used to sell bread Sade for my son, was bought out this past year by a company which has said explicitly that it will not label for cross contamination.

    1. Ellain says:

      This is disturbingly true. In the case of my husband, a diagnosed Celiac, there are certain foods that he can’t eat even though they are labelled gluten free. Post cereals come to mind. There is no gluten in the recipe for Fruity Pebbles, but the cereal is made on the same equipment as Raisin Bran. There is enough cross contamination to cause a reaction. I wish they weren’t able to label things as gluten free unless they are truly safe!

      1. Rachel Engler says:

        Warning labels present a problem for me. I have a severe peanut and tree nut allergy, and in some countries I find it difficult to eat! Canada may have better regulation, but it’s not very helpful. Nearly everything has a ‘may contain’ or ‘may be contaminated’ warning. Even bags of carrots. Many prepared foods, such as tomato soup cans have a ‘may contain traces’ warning.. So, what, no carrots or tomato soup? Seems to lack common sense. It gets ridiculous, and causes me more anxiety trying to figure out whether the chance of contamination is likely. I don’t know what the answer is, but I’d like to know how likely contamination would be. The journal article mentioned studied nutrition bars. Well, I assume they’ll have nut contamination. But what about that frozen pepperoni pizza?

        1. John J says:

          Unfortunately, because of those products manufacturers, those things probably do have a risk of contamination. As talked about in the article, more than 8% of “may contain” labeled products were contaminated.

          When it comes to the soup, it’s likely the company also makes a Thai sauce, soup, or something similar that uses a peanut sauce. This is an issue I’ve run into with some pasta sauces and pizza companies.

          One would think carrots would be safe, but knowing how cheap and lazy manufacturers can be, I wouldn’t be surprised to find they use the same equipment to process nuts.

  22. Vicki says:

    How much, if any, of that difference between the number of people who actually have allergies and the number who think they are is sensitivities that aren’t technically allergies? My partner isn’t technically allergic to mushrooms–but they nauseate him, and eating more than a small amount of mushroom will reliably cause him to vomit. When we’re at a restaurant and he’s asking to be warned about mushrooms in food, the server doesn’t need or want to know the details: the relevant point is that eating mushrooms will make him sick.

    1. Sullivanthepoop says:

      That does sound like it could be an actual allergy. Both my father and I have a real salicylate hypersensitivity, not just sensitivity. He has an IgA antibody for it and I have an IgG antibody for it. Salicylic acid (topical) causes me to break out in hives, Aspirin causes me pseudoanaphylaxis. and oranges or orange juice causes me to have hives in my mouth and throat. My dad’s reaction is almost always vomiting, sometimes topical things can cause him allergic rhinitis and he only has a reaction for actual salicylic acid while I have reactions to many other compound salicylates. If I were him I would get a stick test.

  23. Winter says:

    Piggybacking off of the “fad” idea…those of us who are NOT really allergic to foods need to stop diminishing the real danger of food allergies by sitting in restaurants telling waiters we’re “deathly allergic to onions” just because we don’t like them…So many people are using the “I’m allergic” excuse that the words “I have a serious food allergy” are losing their meaning and their importance in many scenarios.

    1. Possibly wait and kitchen staff should be trained to take food allergies serious in spite of the fact that a small* percentage of people may lie due to being a picky eater.

      Seems like it may be easier to get employees to behave differently, than ALL the restaurant patrons in the country…or world.

      I know when I waited tables I received zero information on food allergies. That was a long time ago, maybe things are different now.

      *I’ve never seen someone who isn’t a child do this…maybe it’s fashionable somewhere, though.

      1. Young CC Prof says:

        I’ve never heard an adult say, “I’m allergic” when they really mean dislike. I’ve heard people use “allergy” for non-allergic sensitivities, but they are real food sensitivities that can ruin the person’s day, though they won’t result in an ER visit.

      2. erikttr says:

        I waited tables in the Midwest US for a smallish corporate entity from 2000-2003. We were definitely trained on food allergies and had to memorize which dishes contained nuts (anything with pesto, btw, has pinenuts). Can’t imagine someone with celiac disease or gluten intolerance would go to an Italian restaurant.

        1. Young CC Prof says:

          Sometimes you have to go where the people you’re eating with are going.

          However, if I’m going to a restaurant where there probably won’t be anything for me to eat, I just eat first. If I wanted to avoid awkwardness with my dining companions, especially for a business meal, I might eat first and then order something, even if the only thing I can eat is a beverage or a side dish.

        2. calliarcale says:

          My cousin with severe celiac disease frequents a particular Italian restaurant at the Mall of America. I know, because her parents cleared us to use that restaurant for a family gathering to which she was invited. ;-) But this is a restaurant that was fairly early in understanding celiac disease (before GFCF diets became fashionable).

    2. Chris says:

      “just because we don’t like them”

      I just tell them to leave the cilantro off because I don’t like the taste of soap. If they give me “oh, come on, it is not that bad”, I explain I am descended from people who cured fish with lye (lutefisk), and it is caused by evolving from those who figured out when it was not properly rinsed out. ;-)

      One Mexican place and a Vietnamese sandwich shop are okay with that. They just have a quiet giggle about the crazy white lady.

      1. calliarcale says:

        Ah, but I am likewise descended from the lutefisk eaters (and I’ve eaten it myself as well), and I enjoy the refreshing, lemony taste of cilantro. My husband, who has not a whit of lutefisk in his background swears it tastes of soap.

        1. Chris says:

          Oh, well. It was as good a reason as any. Though being able to detect alkaloids is good for survival,

        2. ebohlman says:

          Seriously, olfactory saponin receptors are polymorphic, with some people (like me) having an allele that results in cilantro tasting absolutely wonderful (“sublime” is the best single word in can come up with) while others (like the people who named them “saponins”) have one that makes it taste like soap.

          1. Chris says:

            I am also what is known as a “supertaster.” I learned this by going to a food event where I got to try one of those slips of papers, I spent the rest of the evening trying to get the taste out of my mouth.

            What is odd is that Wiki article lists foods I am supposed to dislike, but I do like them! I love grapefruit, coffee, broccoli, olives, etc. The things that I dislike are cilantro and curry. And I also cannot stand the smell. I was most upset when youngest child left some curry in the fridge.

  24. Allergies and Vaccine adjuvants

    Is there any evidence available to refute the following?

    Peanut oil is a common trade secret ingredient in vaccine adjuvants

    I’ve read that the allergic reaction to penicillin that some people have is in fact a reaction to the peanut oil used as an adjuvant in it. Without the peanut oil, penicillin loses it’s effectiveness too quickly to be beneficial.

    1. Chris says:

      1. Wrong thread. The vaccine article where you need to answer questions is over there —> !

      2. This is an article about food allergies, not drug allergies.

      3. You have now invoked Scopie’s Law:

      In any discussion involving science or medicine, citing as a credible source loses you the argument immediately …and gets you laughed out of the room.

      Though this blundering comment does go a long way to explain your inexplicably incredible wrongness in the comments of this thread. It seems that English is not your first language, so you have issues with reading comprehension, plus you actually believe that John Scudamore ( guy) is a valid source of evidence.

    2. WilliamLawrenceUtridge says:

      By citing you have immediately lost all credibility and essentially nothing you say will be taken seriously. You will be justifiably mocked.

      No wonder your beliefs are so wrong, if you consider that to be a serious reference.

    3. Sullivanthepoop says:

      People are confused. They are saying that glycerin which can be made from peanut oil and actually was often made from peanut oil in the 1930-1950s is in vaccines. Now it is synthetic and not made from peanut oil so there is no worry. The same goes for penicillin.

  25. lilady says:

    Scopie’s Law (a logical fallacy): “In any discussion involving science or medicine, citing as a credible source loses you the argument immediately …and gets you laughed out of the room.”

    Adjuvants are not used in penicillin injections. Adjuvants are used in vaccines to potentiate the body’s immunological reaction to an antigen/antigens contained in the vaccine. There is no penicillin in any vaccine used in the United States and there is no peanut oil, sesame oil or motor oil used in vaccines.

  26. @John #20.
    My grandmother was an undiagnosed coeliac until she was in her mid-70s. She thought it (the bloating, fatigue and pain) was just completely normal, and as so many of her relatives had similar lives she accepted it. After diagnosis she regained energy and “life force” (apologies for the woo-istic language). I’m not coeliac, but intolerant to lactose, salicylic acid and pig products, therefore a traditional Christmas of ham and cream based desserts is, sadly, no longer an option for me. A small price to pay for a happy day with loved ones.

    The danger with coeliac disease is that the risk of small bowel cancer is higher than for non-coeliacs. Please ensure you have regular checks, and monitor close family as well for any signs of this. After losing my beloved grandmother to this, I would not want any other people to go through the same.

  27. In the case of coeliac, it’s pretty easy to tell the conceited worried well from the undiagnosed. A TTG antibody test usually does the job.

    With things such as nut allergy it’s also easy. The genuinely allergic tend to be very clear and explicit in their dealings with serving staff, and won’t describe themselves as “a bit allergic” as some of the malingerers do.

    In conversation, it is trivial. You ask: “When were you diagnosed?” – if the answer comes back that they self-diagnosed after reading some book, then the bullshit-o-meter swings up to ten.

  28. So in the U.S. the stats say that it takes an average of 4 years from symptom onset to diagnoses with celiac.

    Maybe in the U.K.(?) it’s shorter, don’t know. If during those 4 years, a person has gut symptoms and the doctor says “Oh you’re fine, just eat more fiber.” then the person reads a book on celiac or gluten intolerance and it sounds familiar so they stop eating gluten and claim to experience a benefit, then that means they don’t have celiac?

    Or is it only if they’re smug about it?

    Even in the case of a negative ATTG test, how can you tell that the person doesn’t have another physiological condition that hasn’t been identified? In which case the more accurate term would be worried incorrectly diagnosed unwell.

    Doesn’t this whole idea that you I can tell if a person is well or unwell just by looking at them and asking one question undermine the idea of the importance of an accurate diagnoses and follow-up?

    1. NLA says:

      “Don’t you think this whole idea that you or I can tell if someone is well or unwell just by looking at them…” Etc.

      Don’t agree with everything you’ve said but this is spot on (speaking as a person with an invisible disability, by the way).

      I find these “worried well” frequently annoying, but I’m judging based on the kinds of remedies they tend to be into, not by what symptoms they may or may not have. When I hear people are reading Deepak Chopra and are “open to the possibility” that healing crystals work, I’m aggravated for the simple reason that, every day, I see grievous harm done by pseudoscientific and anti scientific beliefs.

      1. I have no problem being annoyed with a lack of critical thinking or angry with someone who smugly advocates alternative remedies. It’s only the assumption that someone is well because they haven’t (yet) been diagnosed. I think it’s inaccurate.

        I also think that being willing to listen to a self-diagnosed person may provide the opportunity to say. “You know maybe you should follow up with a doctor or see a different doctor about those gut (sinus etc) symptoms. That could be caused by other things besides wheat and you might get better relieve with a more accurate diagnoses. Even throwing in some examples of people who mistook other symptoms for Y when they were actually X. Of course, if they completely refuse to listen, you can be annoyed at their stubbornness. ;)

        But when you are stating that you are concerned about them or their symptoms many people won’t outright discount your advice like they would if you are arguing with them about the invalidness of their self-diagnoses.

  29. WilliamLawrenceUtridge,

    Hi. Yes I am fully aware of the reputation of and I do not use it as a reference source.

    The problem is, many people do read and believe what is on, despite 99% of it being not credible. For example, some of the content is factual, and cause for concern. Have a look at the following links:

    What we need to do is discern fact from fiction using evidence based science. That is why I asked the question.

    (By the way, I’m not an expert. I’m still learning. Yes, I have my opinions and biases, just as you do, and I’m sure mine will change over time.)

    1. Yeah – The problem with websites like is that they include just enough factual information to seem legit to the unsuspecting reader.

      When I was a relatively new parent I came across someone making a thirmasol anti-vax claim (this was in regard to international adoption, where the question is whether to revaxinate kids once home), then I checked out a government website and quickly found out that the thirmasol had been removed from vaccines. But it wasn’t clear (as I remember) if thirmasol had ever been a problem.

      I wondered about the vaccines used overseas in orphanages (sometimes out of date or black market) and came to a dead-end finding information except one of the skeptic sites which was more of a blog format, I didn’t find the info easily. Understand I hadn’t really read much about vaccination. Didn’t know about MedPub…mostly I just used the internet to shop.

      So I post some comment like “What’s up with this Thirmesol in vaccines, why was it pulled off the market?” kinda thing. It was probably the first time I posted something to a blog. My sole past experience with discussion groups was a usenet forum alt.goth which was mostly about clothing, depressing poetry and hair dye and yahoo kazakh adoption, which are highly moderated.

      Oh my god! You’d have thought I suggested mass puppicide.

      I still can’t visit Orac’s blog without having an anxiety attack.

      Luckily, I have a bit of OCD when it comes to tracking down info, so I found another site, I think White Coat Underground and found out that thirmesol had never been linked to autism.

      I know this may be shocking (considering the number of anti-vax folks these sites draw) but sometimes a clueless person is just a clueless person.

      1. I don’t think this ended up under the comment I thought it would…oh well.

    2. Chris says:


      Having interacted with Mr. Scudamore on UseNet, I can tell you he is a total loon. I first clicked on one of his links about the smallpox vaccine, and was surprised to see the author referred to the native American people as “savages”, and other racist epithets. Then I looked again, and saw it was written it the late 1800s.

      So, yes, you will be laughed at each and every time you link to a site.

      By the way, a quick google search reveals that glycerin is a by products of biodiesel manufacturing. Which uses vegetable oils, which are most often not peanuts, but things like canola, flax, sunflower, etc. Synthetic glycerin is made with propylene, from petroleum. Since it is a key ingredient in soap and cosmetics, I doubt you would find much made with peanuts. Most of that was from the glycerol wiki page (only two links are allowed).

      You probably try reading the archives of this webpage before trying to educate us. Learn how conversations in this blog work, like if you make a claim you need to support it with real evidence. Get to learn what is or is not considered real evidence. And try to stay on the topic of the article.

    3. WilliamLawrenceUtridge says:

      That you know’s reputation and still cite it is a further indictment of anything you say. Anything says that is factually accurate could be cited to a real source, which will raise far less alarm. There is no excuse, ever, for linking to it.


      1. One cannot help but be reluctantly impressed by the depth and breadth of craziness that Scudamore has curated at whale.

        What’s even more remarkable is that almost no facts have crept in along the way. It is really very hard to maintain a site that size without ever being right even by accident.

  30. Sullivanthepoop:

    “Now it is synthetic and not made from peanut oil so there is no worry. The same goes for penicillin”

    do you have a reference?

  31. pffft – or maybe I just read to many fairy tales growing up.

  32. Connie says:

    Very interesting. To add to the discussion, it is important to say that food intolerances are also important. I have several intolerances and although I don’t have an anaphylactic reaction I do get very very sick and am out of commission for a couple of days. I have been told repeatedly that I should not be vigilant because it is just an intolerance. It is impossible to explain to those people that although it is not a life and death problem, it is extremely painful and debilitating. And it is VERY tempting to call my intolerances allergies, just so people don’t ignore it. But I don’t, and ooccasionally get very sick because people equate intolerance with not important.

    1. Young CC Prof says:

      I would say that if you need to be that careful, if you need to avoid even trace amounts of the food, using the word “allergy” would not be terrible misuse, assuming you’re talking to a cook and not a medical doctor. Most people with lactose intolerance can deal with small amounts of milk, for example, and if I’m cooking for someone with lactose intolerance, I do it quite differently than if I’m cooking for someone with milk allergy.

  33. TwistBarbie says:

    I have a question about allergic reactions/anaphylaxis. Is vomiting really a symptom? A pharmacist friend/co-worker claims that it is not,but my textbooks and some of the comments above state otherwise. Can anybody fill me in, and, if possible, some of the basic pathophysiology? Thanks :)

    1. iefske says:

      vomiting sounds like a symptom to me (lay person). vomiting would indicate GI tract involvement. I think anaphylaxis is defined as three or more organ systems involved (e.g. GI tract, respiratory system, skin, brain).

      sorry, too lazy to find a reference…

  34. Holmes says:

    “There is the unfortunate tendency to label any sort of negative reaction to any substance as being an “allergy”.”

    This is now so widespread, that I wonder if it could be worth accepting that the meaning of the word has changed. Definitions do often float and alter in the English language, sometimes reversing their meaning all together. We just need a new technical word for ‘allergy’.

    1. duggansc says:

      :) I suggest “anaphylactic reaction” since that seems to be the core symptom.

  35. ActualGFPerson says:

    I’m a first-time poster, but I’ve been reading here since I saw the light and stopped going to my sCam chiropractor…
    Anecdotally I can relate that as a person with Celiac Disease (blood test and biopsy diagnosed by a gastroenterologist) and as a parent to a child with Celiac Disease (blood test and biopsy diagnosed by a pediatric gastroenterologist) that I find self-diagnosing “gluten-free” people a blessing and a curse. They are a blessing because they have expanded the gluten-free market and food products that would not normally have been made are being made (e.g., Glutino “toaster pastries” come to my mind as an example). So in some respects all of these people running around shunning gluten for one reason or another are okay by me. However, the self-diagnosing “gluten-free” people are a curse because of the “uh huh sure, right lady, your kid needs gluten-free food, because that last lady that was here with her son and said he was gluten-free but totally had the regular soy sauce on his dinner, so I’m not really taking you seriously” look at most places where my family tries to go out to eat.

    1. WilliamLawrenceUtridge says:

      You could always open with “yeah, I’m not one of the pretend ones, my doctor actually diagnosed it, and confirmed it with two tests”. Acknowledge the crazies exist, and that you’re not one of ‘em.

  36. Connie says:

    Okay, a bunch of things come to mind about this celiac discussion.

    I don’t think all people with celiac’s are careful. So the soy sauce guy could have had it and chose to eat recklessly. My brother in law had it (diagnosed with biopsy) and used to eat toast with breakfast.

    Secondly, I am a person who may or may not have it but I don’t care if I get the label. I get very sick when I get even a cross contaminated piece of gluten. I will never get the label because that would involve going back on gluten for a period of time. The test does not work if you’re already following the celiac diet. I am not concerned enough about “the label” to put myself through pain and risk my health.

    Why is it so important to get a doctor’s label? If you follow the food guide and you feel better without gluten, then go without. If you don’t notice a difference, don’t bother.

    1. Because it’s not simply a label…it’s a diagnosis and it has a reasonably understood mechanism. Whatever is troubling you, even if it has an identical trigger may not have anything to do with celiac disease.

      So every cost/benefit decision concerning celiac disease is completely different for you than it is for someone with a positive diagnosis. For celiac disease sufferers they can weigh the probability of success against the risks of the procedure. You have to weigh the probability of having celiac with the probability of success against the risk of the procedure. Which might make any procedure not worth it.

      1. Connie says:

        I am a little unclear about what you meant by the cost/benefit is different for me vs. a person with celiac’s. The cost/benefit of having wheat at a given meal or the cost/benefit of another medical procedure given that they know they have celiac.

        From what I know there isn’t that much knowledge about celiac disease. For example, they just recently realized that every celiac sufferer is not underweight with a big belly. 39% are overweight but some doctors still walk around looking for celiacs only in people with stick arms and huge bellies.

        They may be able to say that you have an increased risk of colon cancer but they have not gotten to the point of recommending routine screening colonoscopies for those with celiac’s. Actually the state of the medical understanding of celiac’s is almost exactly the same as it was in the 1950s. “If you have celiac’s don’t eat wheat.” End of story.

        When they find a cure I will go back on wheat to see if I have it. But if they find a cure I imagine that they will have a better diagnostic method.

        1. calliarcale says:

          I doubt a cure would be possible. Celiac disease isn’t like lactose intolerance, where all you need to do is supply the missing enzyme, nor like an allergy, where it’s just that the body has decided that a particular protein is an evil invader. It’s far more insidious than either of those and involves a defect in the immune system where it cannot distinguish between gliadin and a cytokine. Thus, gluten is literally poisonous to you.

          BTW, only the blood test requires a challenge of gluten. The biopsy looks for damaged intestinal tissue, and that damage is generally permanent. But, it does involve a colonoscopy, and, well, I can understand not being terribly excited about doing that. If I were you, I’d just avoid gluten and leave it at that. Celiac disease is genetic, a recessive trait, so with relatives that are diagnosed you’ve got good reason to suspect it anyway.

  37. Connie – Maybe you have already done this, but if you have a doctor you feel you trust or if the doctor who diagnosed your brother seems good and is local, maybe you could make an appointment and talk about your symptoms and the pros and cons of being tested and whether they recommend it.

    One concern would be that your symptoms might actually be something else (like maybe an allergy) that may have different health consequences that you are mistaking for celiac because you are familiar with it. Maybe nice to get a doctor’s input on that score?

    As long as you have insurance, you’re not out to much by just talking with the doctor.

    1. Connie says:

      I live in Canada so there would be no charge. I have a gi doc apps next week and I will ask him. Last time he did the test about 4 months after I had gone off gluten and it was negative. I made the choice about not going back on gluten to get an accurate diagnosis. I was so very sick before being gluten free. It was *really* bad, without going into details I would rather die than go back there. Literally.

  38. WilliamLawrenceUtridge says:


    Despite my arguments against Stan’s idiocy, there’s no absolute reason to eat bread. It’s tasty and convenient, it’s a good source of calories, protein and folate, but I myself only eat considerable amounts lately because I’ve been trying to perfect a home-made baguette. Up until starting my quest, I ate bread maybe once a month (usually with sausage and cheese on a baguette round, yummy!). Realistically, aside from the inconvenience, there’s not much reason to keep eating wheat if you feel better without it.

  39. duggansc says:

    Are you kidding me? My posts go into moderation for hours even without links and you put this guy’s ads up? *grumble*

  40. Luara says:

    Negative skin and blood allergy tests do NOT show that someone doesn’t have an allergy.
    There is a new clinical entity called “local allergic rhinitis” which is an allergy to inhalants with negative skin and blood allergy tests. See (pretty common cause of rhinitis, actually).
    As well as in the nose, there’s evidence that other mucous membranes in the body can have local allergies, see
    This reference doesn’t say much about possible local allergies in the mucous membrane in the gut, but I did see a reference about IgE antibodies in the gut, without systemic allergy.
    Local allergy in the gut is a reasonable explanation for some people’s food allergies with negative allergy tests:
    Alternatively, there may be a non-IgE mechanism in food allergies with negative skin & blood tests. Immunoglobulin free light chains are capable of degranulating mast cells, which is the first phase of an allergic reaction. See the interesting thesis “Immunoglobulin free light chains in inflammatory diseases …”
    Ig free light chains are elevated in a lot of autoimmune diseases, and this may be part of the reason that a lot of people with celiac disease say they have allergies to other foods besides gluten (since celiac disease is an autoimmune disease).
    The symptoms of people’s self-diagnosed food allergies are often different from classical food allergy symptoms. But this doesn’t mean that they don’t start the same way, with mast cell degranulation in the GI tract. Allergic reactions involve an “allergic cascade” of immune system activity, triggered by the initial mast cell degranulation. The late phase of an allergic reaction starts several hours after exposure, just like many reported food allergy reactions. So it seems likely that people who have food allergies with negative skin and blood tests, have an intense late phase allergic reaction. The immediate allergic reaction, the degranulation of mast cells, would still be happening, but not noticeable.
    I’ve guessed that in these self-diagnosed food allergies, the negative skin and blood tests may actually be a consequence of the intense late-phase reaction – that something about the late-phase reaction is working to prevent the food allergy from becoming a systemic food allergy. Systemic food allergies are dangerous, so the body has evolved to usually prevent them. Something similar might be true for the nose, see
    I have a lot of non-classical food allergies – negative skin and blood food allergy tests, delayed reaction starting half an hour to several hours after eating the food, goes on about 4 days. I found that the mast cell stabilizer cromolyn, makes those food allergy reactions less intense. So I think they start with mast cells, just as classical allergic reactions do.
    There’s been a lot of recent research on non-celiac gluten sensitivity, which apparently involves the innate immune system: see

    1. Windy says:

      Lots of words. Lots of speculation. A few sorta kinda citations supporting … exactly what? Maybes? Could bes? What exactly would you like the medical community do with this dog’s breakfast of speculation?

  41. fruit dystopian says:

    Most of the literature on anaphylaxis mentions that 90% of anaphylactic reactions are caused by just 8 allergens, then discusses those allergens in detail and ignores the other 10% of cases. Take a moment, please, and consider how difficult it is for those of us who are in that ten percent. Not only do we have an allergy that can kill us, and not only can cross-contamination cause fatal reactions, but we have absolutely no regulatory protection.

    FDA regulations now require labeling for potential cross-contamination on only 8 most common allergens. Those of us who get equally dangerous reactions to another food get no labeling at all and nearly no attention from awareness campaigns. This leaves us in the minority worse off than where we were a decade ago. It used to be simpler to explain; now we have to overcome disbelief from people who assume that adequate protections are already in place.

    “The peanut butter is fine, but that jelly could send me to the emergency room.” Please include fruit anaphylaxis in your conversation so people such as myself do not have to have that conversation de novo at every encounter. Please remind your readers that the cross-contamination precautions for rare forms of anaphylaxis are exactly the same as for peanut butter. The consequences are every bit as serious. My life is at stake.

  42. DaveHPT says:

    Great article, very informative and well balanced.

    Can I also suggest personal trainers diagnosing food intolerances is another issue for your list. I’m a trainer myself but I’m aware of the limitations of my qualifications and experience, unfortunately many of my colleagues’ first move with a new client is to tell them “overweight? it’s because you’re intolerant to all of these things” in an arbitrary manner.

  43. Luara says:

    My daughter has FPIES, which is a very real, life threatening condition diagnosed by her allergist.
    I wonder if the mast cell stabilizer cromolyn makes FPIES reactions less severe. It helps with my delayed food allergy reactions, which are similar in some ways to FPIES.
    I have been looking into the recent research on delayed food hypersensitivities –
    l’ll try and post a summary when I’m done. Researchers study delayed food hypersensitivities that either pass double-blind placebo-controlled food challenges, or have obvious physical symptoms like diarrhea.
    I’ve been wondering if the delayed food allergies that many people with celiac disease describe, are a mild form of FPIES that can occur in adults. I haven’t thrown up from these delayed food reactions but I’ve felt somewhat nauseated. I’ve sometimes had diarrhea from them. Not usually – but usually when I have one of these delayed food reactions, it’s to a very small amount of food protein that I ingested either by accident or as a deliberate food challenge, and perhaps if I ate a normal amount I would have diarrhea, vomiting etc. The parts of FPIES that seem similar to my food reactions are the delayed reaction and the lethargy. For me, the initial food reactions I had in 2003 involved a groggy stupor – it was like a combination of being drunk and hungover – that started about half an hour after eating the food, came on full force about 1-2 hours later and sent me to bed for about 4 days. A couple years later, my food reactions were more mild, came on fully about 4-5 hours after eating the food – but still debilitating enough that I would stay home for several days. FPIES is usually in babies, but it has been described in adults, and one might guess that people with heightened intestinal permeability from celiac disease would be more likely to have FPIES or something similar.

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