Signs you may have a food allergy

Chances are you or someone you know may be affected by a food allergy. The American College of Allergy, Asthma and Immunology states, “A food allergy reaction occurs when your immune system overreacts to a food or a substance in a food, identifying it as a danger and triggering a protective response.” While we may think of them as something you’re born with, food allergies can develop at any age. 

Dr. Gina Coscia, an allergy and immunology attending physician with Northwell Health in Long Island explains, “People react to foods in different ways. Some people can have a true allergy, and develop symptoms 30 minutes to a few hours after eating a food, or patients can also experience intolerances where it’s not a true allergy, but a particular food doesn’t make them feel good.” 

Reactions can be mild to severe (even life-threatening), and because your body may not react that same every time, most healthcare providers counsel patients to avoid those triggering foods in case they have a much worse reaction to something they’d previously had a milder response to. Allergy symptoms can impact the skin, GI tract, or even the cardiovascular and respiratory systems, so take them seriously and call your doctor if you suspect you have an allergy. These are some signs you should pay attention to. 

Whether it sets in immediately or within a few minutes or hours, breathing difficulty is a serious sign of an allergic reaction. Feeling like your throat is tight and like it’s hard to draw a deep breath are also key indicators. Some people may notice they develop a cough or wheeze. Dr. Coscia told me, “Any difficulty breathing should be taken seriously. With wheezing, you might hear a high-pitched sound when you breathe or feel tightness in your chest.” Seek help ASAP. 

The thing that finally convinced me to make an appointment with an allergist was a trip to a raw vegan restaurant where pretty much every dish contained nuts. I struggled to draw a deep breath all night long afterward. In retrospect, I got super-lucky my reaction wasn’t worse.  

You may have heard of anaphylaxis — Dr. Vincent Pedre, a board certified internist and author of HAPPY GUT®: The Cleansing Program To Help You Lose Weight, Gain Energy, and Eliminate Pain, explained, “A true food allergy is characterized by anaphylaxis, which can involve the swelling [and] closing of the wind pipe (trachea) and bronchospasm (spasm of the small airways in the lungs, like in asthma), leading to breathing difficulties and possibly death.” 

If you start turning pale or blue, that means your oxygen may be cut off. Translation: call 911 right away.   

Breaking out in hives? Itchy all over? It’s not random! Even an eczema outbreak could be the result of a food allergy. Note if there is a particular area of the body where you get itchy or break out in hives or eczema. Not totally sure what you’re looking for? 

Hives, as Dr. Pedre told me, involves “a very uncomfortable rash that appears as raised red patches on the skin.” Eczema is similar, but a little different. It will appear as “a sometimes itchy rash that looks like areas of red, dry skin, which occasionally flake. It tends to occur along the inner folds of joints like the elbows, knees, fingers, [and] wrist but can happen anywhere on the body.”  

Dr. Coscia explained, “Itching may show up on the chest the arms, the arms, the abdomen — anywhere. If it’s just minor itching in one part of the body that usually indicates a mild reaction, but if it’s anything on your entire body or anything that involves difficulty breathing or vomiting or any sign of a systemic reaction, you should seek medical attention immediately.”

Sometimes allergic reactions show up as gastrointestinal distress. We tend to write off bathroom stuff as a bug or food poisoning, but if you experience stomach cramps, nausea, diarrhea, or vomiting, it could indicate an allergy, said Dr. Pedre. However, in some cases, Dr. Cosia explained, these symptoms may actually be related to an intolerance. “Lactose intolerance is often confused with a true milk protein allergy” because of some overlap in symptoms. However, “a true allergy to milk protein would involve hives, itching, shortness of breath, vomiting, or weakness and feeling like they’re going to pass out.”

Dietitian Linzy Ziegelbaum of LNZ Nutrition, LLC in Long Island, New York added, “It’s important for people to realize food allergies and food intolerances are not the same thing. While food intolerances can be uncomfortable and can make you feel horrible, food allergies can be life threatening.”

Dr. Pedre notes that while foods you have a true allergy to and that cause anaphylaxis “need to be avoided completely,” when it comes to food sensitivities, he generally recommends a functional medicine approach that involves “rebalancing the gut microbiome” and resolving gastrointestinal health issues that are often associated with allergies. “Western medicine focuses on symptoms,” he said, “whereas functional medicine focuses on resolving the root causes of symptoms.” Once the gut is healed, many foods that were reactive may be reintroduced in limited quantities. To be on the safe side, it’s best to work with a doctor or certified specialist on this one.

Once you’ve realized your symptoms are related to what you’ve been eating, it’s time to schedule an appointment with an allergist. 

Dr. Coscia said to expect a full work-up on your first visit. After a conversation about your symptoms, “if your allergist is suspicious of an allergy they’ll do either skin testing or blood testing. Based on those results, your allergist will help you figure out whether you need to avoid or those foods or not. You don’t want to put yourself at risk because you need to balance the risk of a serious reaction with excessive, unnecessary elimination, risk of nutritional deficiency, and fear.” In some cases, your doctor may have you do a food challenge, where you eat the food you’re potentially allergic to in the doctor’s office so they can monitor your symptoms.  

“Allergy shots are used only for environmental allergies,” Dr. Coscia explained, and not to treat food allergies. In most cases, avoiding the food or foods you’re allergic to is the main line of defense.