Top 10 Questions to Ask Your Allergist After a Food Allergy Diagnosis
A food allergy diagnosis can be overwhelming—especially if food allergies are new to you. At least, that’s how I felt 10 years ago.
Back in 2014, my daughter was diagnosed with life-threatening peanut and tree nut allergies after an unexpected allergic reaction. That was followed by a second reaction a couple of weeks later that sent her to the hospital. My head was spinning those first few weeks trying to “school” myself on how to manage food allergies and what I needed to ask my allergist in the precious few minutes we had together during those first appointments. Because here’s the thing about food allergies: they don’t give you any ramp-up or prep time!
With that in mind, we’ve compiled our top 10 questions to ask your allergist after a food allergy diagnosis to help you better prepare for those first appointments.
01. What is the difference between a food allergy and a food intolerance?
This may sound obvious, but it’s important to understand which camp you fall in. A food allergy can lead to anaphylaxis, which can be life-threatening, and a food intolerance can lead to severe symptoms but is not life-threatening.
02. What is the difference between allergy blood testing and skin prick testing?
These tests are used to diagnose a food allergy and will likely be one of the first steps taken in the allergist’s office if a food allergy is suspected. Ask your provider if they do one or the other (or both!) and ensure you’re comfortable with their suggested approach. Sometimes, no testing is performed if symptoms are inconsistent with an IgE-mediated food allergy.
03. How do I handle the “may contain” labeling on packaged foods—is it ok to eat?
If you’re new to food allergy, the FDA has mandates for how federally-regulated packaged food products must be labeled. Essentially, if a top nine food allergen is in the food, it must be called out either in an ingredients statement or a “contains” statement. But what about if it’s processed on a shared line or in a shared facility and the package says, “may contain?” What then? Everyone has different risk tolerances, so the answer to this question may differ from person to person. If you want to read more about food allergy labeling, this article is a helpful resource!
04. Should I completely remove the allergen from my house?
This is a great question for your doctor, as different people take different approaches. For example, when my daughter was first diagnosed, we became a nut-free house. However, after my son was born, we knew we needed to expose him to nuts. The LEAP study had recently been published, underscoring the importance of early and consistent allergen exposure to prevent developing a food allergy, and we wanted to do everything we could to ensure he didn’t develop one. Our doctor was a great sounding board for IF we exposed him to nuts in the house and HOW we did it.
05. Is it ok to eat an allergen around a family member with that allergy?
Many factors will likely be considered when posing this question to your allergist: how does that family member feel about it? How severe is their allergy? Have they ever had an issue with airborne allergens or a reaction from touching a surface with their allergen residue on it? In my family, we decided we would only have my daughter’s allergen present when our son was eating it for exposure purposes, and even then, we were extremely careful.
06. Can my food allergies be outgrown?
Statistically, there’s a chance this is possible, but it depends on many factors, such as what you’re allergic to and your age. For example, 68 percent of children will outgrow an egg allergy, but only nine to 14 percent will outgrow a tree nut allergy.
07. How often should my allergies be re-tested?
This is a great question for your allergist, as this can differ depending on their approach. For example, we had one allergist who wanted to test yearly and another allergist who was fine spacing it out more. We decided to test yearly, but that may not be the case for everyone. For example, as your child gets older, they may not re-test every year if they haven’t outgrown their allergies.
08. What is a food challenge and who qualifies for one?
An oral food challenge is just that—you ingest a very small dose of the food you suspect you’re allergic to under the supervision of your doctor. Today, oral food challenges are considered the gold standard for food allergy diagnosis in children and adults. Your doctor may suggest a food challenge because you tested positive for a food allergy but have never eaten the food, you tested positive for a food allergy and have eaten the food before with no symptoms, or to see if you’ve outgrown a known food allergy! 🤞
09. What immunotherapy options exist to help manage food allergies? Ex: OIT (oral immunotherapy)
Because there’s no cure in sight for food allergies, several tools and methods have emerged to help those with food allergies better manage them. For example, my daughter completed OIT for her nut allergies with success. SLIT is becoming an option for some people with food allergies, and Xolair was recently approved to help reduce the severity of allergic reactions in individuals with food allergies!
10. Do all food allergies lead to anaphylaxis or just some?
In theory, all food allergies have the possibility of anaphylaxis—some more than others. This is a great topic to discuss with your doctor as they’ll have your personal history and testing results to bring to this conversation!
While there’s definitely a ramp-up period with food allergies, we hope these questions help you get your ducks in a row a bit faster. 🦆 If there are any questions you think we’ve missed, feel free to share in the comments below!
— Meg and the Amulet Team
This article was written by the Amulet team and reviewed by Amulet advisors Dr. Jordan Scott and Dr. John Lee. Dr. Scott is an allergist/immunologist and operates private allergy clinics throughout the Boston area. He’s the past president of the Massachusetts Allergy and Asthma Society and currently, is an allergy/immunology instructor at the University of Massachusetts. Dr. Lee is the clinical director of the food allergy program at Boston Children’s Hospital. Dr. Lee is widely recognized for his work in food allergy and his commitment to patient health.