Our son is very allergic to peanuts and less so to cashew, and sesame. We went through oral immunotherapy and it's been absolutely life changing. He used to need an epi pen in case of chance encounter, but now he eats 2 whole peanut m&ms every day to keep his dosage up. It's been difficult finding an allergist in Germany that's willing to accept this and move forward
Obviously everyone's mileage will vary, but I'm happy to see this treatment being more widely adopted
I always think about the low incidence of peanut allergies in developing countries and wonder if the mother's diet during pregnancy has an effect on allergies in children? Has this been researched? Because instead of introducing peanuts and eggs to babies, introducing it to mothers is almost a no brainer.
It most likely has to do with how bored our immune systems are.
We evolved to be constantly dirty, and we live in an extremely clean society. When your immune system has a lot to fight, it doesn't worry to much about dumb shit like pollen and peanuts.
Clean vs. dirty isn't even the right way to think about it. We used to be immersed in an environment full of life, and now we live in mostly sterile environments free of life except for maybe some of the first wave colonizer specialist microorganisms. You are filled and covered with life that isn't from your own genes, and that microbiome is now mostly disconnected from the biosphere.
I get some weird skin issues sometimes which are almost magically fixed if I visit a natural body of water... it's clearly an issue of my immune system interacting unfavorably with a microbiome which is out of whack.
How fascinating. This reminds me that my autoimmune condition went into a brief and mysterious remission two summers ago, when I spent most weekends swimming in creeks. I will have to see if increased creek swimming this summer will help my autoimmune symptoms...
Yeah getting hooked up with some bugs from the creek keeps your immune system occupied.
Hookworms are another option; maybe two generations ago kids regularly walked barefoot in grass and was pretty common.
I hope it works. I can think of far more unpleasant treatments. Let us know the results!
Just curious, is it the ocean, or a fresh water body that helps?
A small Minnesota lake, just walking on the beach and taking a little dip.
How do you see reactivity to house dust, air pollution, stuff like asbestos and adjacent construction materials etc. ? Then I'd assume the living ecosystem also shifted from mostly open air to indoor insects, i.e. "life finds a way"
We sure aren't exposed to the same things as 4 centuries ago, but I can't imagine we're living a what anyone would call a "clean" environment.
Those are not microorganisms, and don’t necessarily trigger your immune system in the same way.
Dust allergies are extremely common these days but you can't have an (IgE mediated) allergy to asbestos or smog. Generally the immune system reacts to biological substances.
We're vastly more sterile from a germ perspective. The term "hygiene hypothesis" is apt.
We're a very different kind of dirty. We've got microplastics in our organs, and pesticides, PFAS, and other pollutants in our blood.
People in the olden days got their hands dirty chopping down trees and building solid wood tables while today we keep our hands clean by buying flat-pack furniture that out-gasses formaldehyde into our homes and our lungs.
We're much dirtier than the people were a long time ago, only it's mostly on the inside. The filth in our bodies doesn't wash off with soap.
About 20 years a doctor told me that this was a theory that wasn't widely accepted YET, but it deserved to be taken seriously. Now it's much more mainstream.
It's mainstream, but has it actually been confirmed in some way beyond "it makes sense"? I've never seen a paper trying to test it in some way. (Would love to know if it's out there)
idk. I was about to say that children from farms have fewer allergies, but I can't actually back that up.
We evolved to be constantly dirty
And infested with worms. Most allergies are caused by the antibody we evolved to fight worms (and venom) [1].
Reminds me of people having intestinal auto-immune diseases treated with helminth therapy.
This checks out. After moving to a state with a lot of greenery I developed a rather severe allergy to grass and pollen. Literally the entire face would get swollen and stuffy for several months in any given year. Not life threatening, thankfully, but very unpleasant. It went away within a year after I started mowing my own lawn and working in the garden without gloves.
The immune system doesn't know how to rest. It must always fight something.
So if it runs out of intruders to fight, it will attack the body itself.
No link because I'm on mobile, but I remember reading about how peanut allergy in Israel is nearly non-existent. This is notable because:
1) Israelis come from all over the world, and the incidence of peanut allergies are lower in, say, Sephardic Jews living in Israel compared to Sephardic Jews living in Spain.
2) a very popular snack there for kids(but also adults) are these peanut butter corn-puffs called "Bambas"(like, literally 25% of the snack market is this one snack)
Strictly speaking, if all babies eat peanuts, you'll get to "nearly non-existent" peanut allergy one way or another. But you need better data than that to conclude that the change comes from allergy prevention, rather than... allergy "removal".
Edit: I guess I was just trying to say "surprising data needs detail." I should have just said that, instead of making light of how dangerous allergies are. Downvotes deserved, lesson learned.
You think Israel could cover something like that up?
I don't think parent is hinting at a conspiracy, and more at "natural" selection based on omnipresence of peanuts.
With no knowledge about how i goes for babies, the question would be how a 2~3 month allergic kid [0] would react to peanuts, including when not directly ingested. If it had adverse effects it would go along the line of what parent is describing.
[0] can kids that age already be allergic to peanuts ?
So, at the end of a long thread full of information that discards genetics, your explanation for it is... genetics.
I took it as a warning about potential misinterpretation of causes and effects, and in particular the difficulty to assign a single cause to the near absence of allergy in a population.
Allergies are a subject I need to know a lot more about, so sadly at this point I don't have an explanation for anything.
Yet you are the one insisting on a single cause.
Having some babies get hit at early age by allergies doesn't exclude any other mechanism running in parallel, including other babies adapting their immune system, or even families moving out of the country for health reason.
I don't see how any of what I said is either insistant or limiting to a single cause.
I was not hinting at any conspiracy, and my comment wasn't directed toward Israel in particular (knowing nothing about the study that the top-level comment alluded to).
I was facetiously pointing out that a population where everyone eats peanuts at a young age is likely to be allergy-free if only due to the fact that those with peanut allergies would die, and therefore would no longer be allergic to peanuts. A naive analysis of the data could lead to a conclusion that eating peanuts at a young age causes a favorable change in allergy outcomes later in life.
For the record, I don't agree with your edit saying that your original comment deserved the downvotes it got. I'm not sure if people just completely missed the point you were making, or if, as I think likely, the current political climate around Israel/Palestine led to a few pro-Israel people wrongly assuming you were being anti-Israeli, but either way I'm glad you contributed and were able to clarify what you meant.
No, I didn't mean to imply anything like that. I guess I was just trying to say "surprising data needs detail." I should have just said that, instead of making light of how dangerous allergies are. Downvotes deserved, lesson learned.
https://en.wikipedia.org/wiki/Bamba_(snack)#Peanut_allergy
You can click on the footnotes for sources.
Thanks! That thread leads to LEAP (Learning Early About Peanut allergy) which is a study that seems to have done a pretty good job of demonstrating that peanut exposure is in fact prophylactic against later allergy (as measured by a skin test). The data is pretty thorough: https://www.nejm.org/doi/full/10.1056/NEJMoa1414850
Notably,
No deaths occurred in the study.
so it's not a "naive analysis" of the kind that I facetiously alluded to. I didn't mean to imply that I believed naivete was a a factor... I was just pointing out that the top-level comment of "I heard {country} doesn't have any peanut allergy, and they eat peanuts from a young age" (without any further detail) was illustrative of a particularly insidious fallacy.
Ya I get it - I was just pointing you to sources. It made some waves back in the day to the point where its become sort of an allergy meme but it was a real study.
apparently there was a follow up study called LEAP-ON where some of the subjects who had eaten bamba in the LEAP study were then asked to abstain from peanuts from age 5 to 6 and their tolerance to peanuts was then tested, and the results showed that infant peanut exposure reduced allergy levels even if they abstained later (you don't have to keep eating them, at least not within the time envelopes of the study).
Also another study that measured the different peanut allergens in bamba and compared it to peanut flour that concluded allergen levels were lower and more uniform in bamba making it useful for this purpose.
truthfully I don't need an excuse to eat bamba. If you like peanut butter its basically peanut cheatos (without the cheese) and is amazing, even though its super processed and definitely not healthy to eat compared to real food.
From Epidemiology of anaphylaxis in Europe [1]:
Case fatality rates were noted in three studies at 0.000002%, 0.00009%, and 0.0001%.
Fatal allergic reactions are so rare as to be completely irrelevant as a cause of death. Most of them are drug induced and most of those occur in hospitals when someone has an allergic reaction to an intravenous drug, not something they eat [2]. They're unlikely to be a significant driver of any evolutionary adaptation.
[1] https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.12272
[2] https://linkinghub.elsevier.com/retrieve/pii/S00916749140119...
Allergies are weird and our understanding of them is very incomplete. My son has/had a peanut allergy (very successful oral immunotherapy, knock on wood) and I ended up doing a lot of research. One study that is particular interesting is this one: https://pubmed.ncbi.nlm.nih.gov/26728850/
It shows that east asian children, who very rarely have nut allergies in their home countries, develop nut allergies at a higher rate than non-asian children when born in Australia while east asian children who immigrate to Australia after their early infancy continue to maintain very low rates of nut allergies.
This is what our allergist said. Living in Australia wife and I are both asian both eat peanuts. No peanut allergies in either families. Wife ate peanuts while pregnant but son has peanut allergy.
What's the implication here? That exposure to peanuts in utero might not help avoid peanut allergies after birth? (I'm not sure what the literature on that says)
Or that there's something unusual about simply being in Australia as an infant that causes peanut sensitivity?
Or that infants in Australia have less exposure to nuts?
There are a lot of hayfever allergens in Australia. I have to wonder if that has something to do with it, or whether it's got something to do with how kids today don't seem to get covered in dirt.
Perhaps there's something to that. As kids we were dirty little buggers much to mother's chagrin. In the backyard throwing mud pies at each other was a commonplace activity.
And I've no known allergies.
I read at one point that my oral allergy syndrome, my mild reaction to apples and other fruits, tends to be correlated with hay fever. It doesn't seem unreasonable for something similar to be afoot with peanuts.
it could be some other environmental trigger. for example, there was a study a few years back that suggested that some kinds of baby wipes could make it more likely that the child develops a food allergy: https://www.goodhousekeeping.com/health/wellness/a19719094/b...
"Or that there's something unusual about simply being in Australia as an infant that causes peanut sensitivity"
OK, but why now and not when I was a kid growing up in Australia?
We have to get to the root cause of this new problem. (Read my other posts here.)
I am the parent of twins. Their mother ate multitudes of peanut M&M's and similar items when pregnant. One twin has zero peanut allergies, the other one has deadly allergies and we are at the ER at least once a year from food contamination.
On the assumption that such allergies have a genetic component, presumably the twins aren't identical?
It's also possible for things which do have genetic components to _also_ have environmental triggers, so its not impossible that, for example, identical twins who happened to get different levels of exposure to peanuts in their first year of life based on random luck of which family member ate peanuts near them at which times, or something like that, could lead to different outcomes even if genetics were the reason that both twins were at risk of developing such an allergy.
Indian kids are fed peanuts as early as possible
Maybe the children die without anybody diagnosing allergies?
I am kinda of curious about populations where peanuts aren’t common at all. I certainly didn’t have many fancy nuts (i know peanuts aren’t nuts) until well into adulthood. Why were there not wide spread peanut allergies among migratory populations?
I have a suspicious that apparent elevated rates of allergies are caused by overzealous preemptive testing. The tests are very sensitive and trigger for people that have only slight allergies which, in the past or in developing countries, could have been simply unknown and naturally diminished with subsequent exposure.
Only if mom isn’t allergic.
Is it possible that in developing nations having more limited dietary options and/or the risk of allergic reaction makes a child less likely to survive and therefore makes it appear that allergies are less common?
This is just speculation, I don't know of any evidence one way or the other.
low incidence of peanut allergies in developing countries
I know this sounds extremely insensitive, but I genuinely think the answer is simply that the vulnerable die.
I spent 3 years moving through 35 different African countries and 2 years through Latin America.
I honestly believe it is simply the harsh reality of life that many more infants and young children die than in developed countries.
the low incidence of peanut allergies in developing countries
https://en.wikipedia.org/wiki/Hygiene_hypothesis
The human genome didn't evolve in a sterile environment, it evolved in an incredibly hostile environment and developed some nasty defenses as a result. If you don't expose children to pathogenic microbes at an early age to train the immune system on what to attack, it will find other things to attack. Allergies are the result. Stop the constant use of antibacterial hand gels and surface sanitizers and for bonus points get a dog.
In The Netherlands it is recommended to introduce peanut and egg to babies between 4 and 6 months, to reduce the chances of food allergy.
More information (in Dutch): https://www.voedingscentrum.nl/nl/service/vraag-en-antwoord/...
introduce peanut and egg to babies between 4 and 6 months
What goes wrong if they're exposed before that? If the mother eats peanuts and eggs while breast feeding, does that confer desensitisation?
No, it's the opposite. The advice we were given was that it was very important that their first encounter with the allergens was to eat them, and not to allow skin contact or anything before that. This meant that with my youngest we had no peanuts in the house until she was old enough to eat solid food, and peanut butter was the first food she ate. It's still her favourite food!
we had no peanuts in the house until she was old enough to eat solid food
That seems like overkill. I can't imagine having peanuts or peanut butter in the pantry is going to meaningfully affect a 2 month old infant.
Makes sense to me.
If you're avoiding skin contact, then you might not have time to wipe the peanut butter mess off your hands as you rush to rescue your kid who's got into trouble.
Babies change fast. I can certainly imagine it. You won't know when exactly the flip happens, so you err on the safe side. Also, spread of stuff though the air and by hands: I thought we just spend lockdowns realising that crap spreads far and wide.
I am not sure if you had a child or not, but you don't give the baby food before 4 to 6 months. So its not that you aren't exposing them at all, but not feeding them the food.
There are powders to add to your formula / breast milk to introduce allergens early (we used Ready Set Food but easy to DIY). Kind of annoying since they often clog the nipple of the bottle, but we did it with my daughter who is now 20 months and her favorite breakfast is a spoon of peanut butter. Sesame gives her a slight reaction still, we unfortunately don’t eat it very often.
Clogging because it’s gelatinous or because it needs to be screened?
It's the opposite. Usually babies don't eat any food at 4 months. They only get breastmilk or formula. The advice is to start early with peanutbutter and egg.
In our case diary products were an issue instead of nuts. My daughter would get very sick from anything that had diary in it, even if my wife ate diary products while breastfeeding. But at about 1.5 years one she got over that and now at 4 she is completely fine drinking normal cow milk.
So allergies in kids are not a permanent set in stone thing. They can get over some, and early exposure makes a difference.
(unrelated) friendly tip: i think you meant dairy. A diary is not edible. :)
I'm assuming you're not a parent, but it's a valid question! No food before 4 months, babies can and should subsist on breastmilk or formula before that.
That's the current guidance in the US as well.
How have outcomes improved since the guidance?
There's very strong evidence of the success of this -- for babies with no indication of a peanut allergy, intentional exposure led to an ~85% reduction in allergies -- for those who had a positive allergy test before the study, they had a ~70% reduction in allergies by 5 years old.
Among the 530 infants in the intention-to-treat population who initially had negative results on the skin-prick test, the prevalence of peanut allergy at 60 months of age was 13.7% in the avoidance group and 1.9% in the consumption group (P<0.001). Among the 98 participants in the intention-to-treat population who initially had positive test results, the prevalence of peanut allergy was 35.3% in the avoidance group and 10.6% in the consumption group (P=0.004). There was no significant between-group difference in the incidence of serious adverse events. Increases in levels of peanut-specific IgG4 antibody occurred predominantly in the consumption group; a greater percentage of participants in the avoidance group had elevated titers of peanut-specific IgE antibody. A larger wheal on the skin-prick test and a lower ratio of peanut-specific IgG4:IgE were associated with peanut allergy.
and IIRC you need to maintain consistent exposure to the allergens throughout the first, idk, 18 months of life to have the best result. So don't just expose them once early on and stop.
Yes that's part of the advice in the Netherlands as well. Keep giving them things that can be common allergies.
My 4 year old's favourite food is shrimp and sushi... Not sure whether it's related to her eating those when she was a toddler, but it's fun to see the reactions in restaurants when you don't order the children's menu.
My daughter took part in a large study that led to similar guidance being introduced in the UK. The was randomised into the early introduction group, which meant that she had to eat peanut, egg, cow's milk, fish, wheat and sesame on a regular schedule when she was a baby. It was interesting - though lots of work, and when she was old enough to understand why she was going up to London for the follow-up tests, she was very proud of her role as "scientist". It was very satisfying when the results were published many years later, proving the hypothesis.
https://www.food.gov.uk/research/food-allergy-and-intoleranc...
Overall, food allergy was lower in the group introduced to allergenic foods early but the difference was not statistically significant.
How is that proving the hypothesis?
Keep reading:
... Early introduction of all the foods was not easy but it was safe. Among the infants who did manage to consume the recommended quantity of the allergenic foods there was a two-thirds reduction in overall food allergy.
For those who fed their infant the recommended amount of peanut there was a significant reduction in peanut allergy, 2.5% in the standard introduction group compared to no cases in the early introduction group (0%).
There was also a significant reduction for egg allergy- 5.5% in the standard introduction group compared to 1.4% in the early introduction group.
In other words, in the group as a whole when considering all food allergies, the difference was not statistically significant, but that can be attributed to a large number of families in the test group failing to actually perform the test. It sounds like when you control for actually following the instructions there is a statistically significant difference in overall food allergy incidence.
I fail to see how your chosen quotes prove your point. How is 66% reduction not statistically significant?
It is.
OP took a sentence out of context that said that overall food allergies across the whole group were not reduced by a statistically significant amount. But the authors go on to explain why that was and explain that if you control for real participation in the test then it is significant.
Australia changed their recommendations to match this years ago, and the incidence of allergy didn't change measurably.
lol did they measure whether people were following the recommendations?
lol yes.
Source?
Where does the peanut and egg allergy come from? My understanding is that peanut oil and egg albumin are ingredients in many common medicines given early to infants.. is there any chance that could be contributing?
In short, we don’t know.
Egg albumin is also interesting because the vast majority of kids outgrow it. My toddler has a peanut allergy but has already outgrown his egg albumin allergy.
It does make you wonder if we shouldn’t vaccinate until exposing the children to solid foods in ordinary healthy cases. The mother’s antibodies from her milk do good work.
There are other commenters warning about skin exposure before dietary exposure. If that’s true then it would make sense.
Didn't know that introducing these foods early in life can help build tolerance
Immunotherapy works. I run a company (YC w21) that wants to eliminate allergies forever. It's ancient medicine to manage symptoms with antihistamines when we can remove the root cause completely.
Right now, we fix cat, dog, pet, pollen, and dust allergies. In a few years, we'll be doing nuts.
Our launch HN: https://news.ycombinator.com/item?id=26227807
company: https://www.wyndly.com/
book a visit with a doc: https://www.wyndly.com/products/allergy-doctor-consult-onlin...
Or just start with an allergy test: https://www.wyndly.com/products/at-home-allergy-test
US Only right now. If you can help us expand into your country, contact me at aakash@wyndly.com
Can you show us any peer reviewed paper ?
I tried searching pubmed but turns out there are a lot of Mana Shahs working in bio research and pharma.
The big question for me is whether this is a permanent fix or if you have to keep taking their tablets (at $99-ish a month, it looks like?)
Unfortunately this doesn't look to be covered by my insurance as the at-home test is not administered by a doctor.
My insurance in Germany only accepts peer reviewed stuff anyway so I keep waiting.
My toddler is on oral immunotherapy for peanuts, and unless he outgrows it or chooses to stop treatment, or new research comes out, he is going to be doing oral immunotherapy for life.
Fortunately, peanuts aren’t expensive. The expensive part is the trained allergist whose job is to keep up with the research, and in my case, who I suspect will be publishing interesting papers in the next few years.
I have some allergies that the allergy doc’s test doesn’t show; he said they are there but not by histamine reaction. Do you support these?
Also, what about things like gluten and dairy sensitivity?
Most people with a gluten allergy have celiacs which is not an allergy at all, but rather an autoimmune disorder.
It’s similar enough to an allergy, though
A wheat allergy, though, is fairly common: order of 1% per [1], similar to celiac. And if you're allergic to wheat, then it's suffices to avoid gluten, since wheat contains gluten.
(Also, there are forms of gluten intolerance that are neither a wheat allergy nor celiac.)
But for those of us who have non-celiac gluten sensitivity, does this help?
I've done two rounds of sublingual drops over the past 8 years and both times I've seen no noticeable improvement. Once was directly through my doctor and the second time was through a service similar to this (Curex).
I don't doubt this works for some people, but I also don't think it works for everyone. I had much better results with shots.
This is a brilliant idea. The product and system also look extremely well put together.
How is this different or better compared to diagnostics and treatments available from allergists? At least one office in my area says they do immunotherapy and desensitization.
Nuts are a very good and healthy natural snack; it's a shame they are banned by most daycares and schools now. It would be great if this became so common they could be allowed again. Without nuts...what do we have instead? Chips. granola-bars. These are highly processed foods that have other issues. Raisins or apples maybe? but they are mostly sugar. None of these options have healthy fat & protein like nuts do. What healthy snacks do you feed your children?
Yep, the banning of normal foods from these spaces is a detriment to everyone else. I feel it is a bit unfair, in that everyone else has to “subsidize” the few rare people with allergies. Shouldn’t the burden be on them to avoid public spaces if they’re that sensitive?
Shouldn’t the burden be on them to avoid public spaces if they’re that sensitive?
Depends how emphatic you are to your fellow human being. Peanuts aren't as important in most people's lives as actual people.
On the other hand, avoiding peanut exposure can cause an increase in allergies, so there's a feedback loop at play.
The children who now have allergies, but wouldn't with past exposure levels, are more inconvenienced than the kid who can't eat a peanut butter sandwich at school.
Attempting to make life better for all has unexpected twists and turns
The question is whether children who are already in school are likely to develop an allergy due to lack of exposure at that point in their lives. If the answer is no, the only downside is parents having to make a different sandwich for lunch.
I'm allergic to peanuts and none of my schools banned peanuts. When I was in elementary school, another kid chased me around with a peanut butter sandwich for a couple of minutes before the teachers were able to stop them. I'm not saying this will happen to all kids, but the options for bullying get kinda scary when an everyday food can kill you. Kids at that age may not understand how serious allergies can be, so there's also the more mundane risk of a child with an allergy trying somebody else's food without knowing it contains allergens.
Later on in middle school there was a single peanut-free table, where kids were eating peanut butter sandwiches for lunch every day before I arrived. Fortunately they were willing to bring something else once I told them I actually needed the peanut-free table to be peanut-free.
However since we're currently seeing that allergies are treated by exposure, by removing these from canteens we are strengthening everyone's allergies for the sake of the few. In essence these few unlucky ones, including those who don't want to take the risk, are making us all more ill in the long run.
The Tyranny of the Minority.
One set being small is all it takes for the intersection to be small.
…although I do have some sympathy for those with such severe allergies. ‘The burden be[ing] on them’ does seem a bit harsh.
Oh wow, are nuts banned from US schools? Never heard of that in NL or UK. The only food requests we get from daycare and primary school are to provide healthy snacks for birthday celebrations instead of sugary. And that's a friendly request not a rule.
Nuts are completely banned at schools and childcare centres here in Australia.
When I was a kid in Australia decades ago we'd never heard of peanut allergies and swapping peanut butter sandwiches at school was the norm.
No doubt there were allergies back then but what on earth has made them so much more common these days?
Same with asthma. Something has gone terribly wrong.
I’d be curious to see statistics on this as well. If I were to hypothesize it would be a combination of 3 factors:
- Nut Allergies in particular seem to be reduced with early exposure [0]. Maybe dietary trends have changed in a way that causes less early exposure? - Child mortality rate used to be much higher. Children with allergies used to be part of this mortality rate. This combined with parents with mild allergies that might have previously not survived to have children cause the incidence to increase. - People today are exposed to many more types of food. Many people who might have a particular allergy may not have ever been exposed to that allergen.
Another one I’d throw out there would be nearsightedness. Of course a lot of people wear contacts, but I’d imagine incidence of glasses is higher than it used to be.
Reported rates of nut allergies rates have definitely increased though. [1]
[0] https://www.nih.gov/news-events/news-releases/introducing-pe... [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477625/
Multiple newer parents I've met (in Australia) have practiced complete avoidance of such serious potential allergens. The idea seems to be that a very young child may have a reaction, but not be able to tell you and just cry or go red - as per usual at that age, so you probably don't realise it's serious until it's too late.
They gradually introduce these foods later. Maybe too late, if the idea of early exposure is accurate, but it's very much a case of "can't be too safe" when I asked them.
"Children with allergies used to be part of this mortality rate."
Perhaps so, but I had a mother who was particularly fussy that we kids had good fresh food—I reckon she was a bit obsessed with it, yummy things like potato chips, sweets, etc. were discouraged and not a part of our normal diet—and at no time was anything ever mentioned about nuts, peanut butter, etc. being bad or 'suspect'.
In fact, I was encouraged to eat nuts instead of sweets as they were considered wholesome whereas sweets were not. We always had peanut butter at home (mother encouraged it over jam).
When we did have sweets it was often peanut brittle (and peanut toffee) which I and most kids loved.
Moreover, my mother always thought of herself as up to date, every week she read women's magazines such as the Women's Weekly, if nut allergies were a big deal back then she would have heard of it. But there was nothing said.
Likewise, I'd love to know the statistics. What I do know is that these days something has changed for the worse. If peanut allergies had been so prevalent when I was a kid then there'd have been no way that it could have been covered up so completely that no one would have been aware of it.
Incidentally, it's not as if allergies were unknown back then, we occasionally heard of some unfortunate people who were allergic to shellfish, or occasionally egg, or being near cats or horses—but never peanuts or other nuts.
I saw a show several years ago that said Australia (I think specifically Melbourne?) and a city in Finland are the epicentre of research for food allergies, because of how prevalent they are. The Finnish two was basically split in two decades ago so that half of it is in Russia and half in Finland. The Finnish side has made significantly better economic progress since then, but also has a much higher rate of allergies. In Australia it seemed to affect first generation descendants of immigrants (I vaguely recall SE Asia and South America being over represented in those impacted?). They had a doctor from Malaysia on the show that had 7 kids, the latter 2 both born in Australia and both had peanut allergies. I remember him saying how hard it is to travel home with them “you tell someone in Malaysia your kids are allergic to satay and they just don’t understand”.
I’m like you re lunches as a kid. I never liked peanut butter as a kid, but it was a staple option among kids alongside Nutella and Vegemite. Now peanut butter and Nutella is banned in a lot of classrooms.
"The Finnish side has made significantly better economic progress since then, but also has a much higher rate of allergies."
To me, that's very significant. It's almost a quintessential model. Splitting a population down the middle and changing the circumstances of one and not the other has to be pretty much the ideal situation for researchers. So what's the research say?
"In Australia it seemed to affect first generation descendants!… … “you tell someone in Malaysia your kids are allergic to satay and they just don’t understand”."
Reckon that'd be pretty disturbing for parents who'd consider satay a staple food. Again, I can only say that Australian kids of my generation who came of age in the late '60s—mid '70s and who were exposed to Asian foods including satay for the first time and loved it, never seemed to have problematic allergies with peanut sauces.
BTW, re swapping sandwiches, the trade at school often occurred with peanut butter and honey (or jam) with Vegemite and lettuce (sometimes cheese). I always preferred the latter, the former being a bit too sweet (perhaps I was a bit unusual). :-)
When I was a kid in Australia decades ago we'd never heard of peanut allergies and swapping peanut butter sandwiches at school was the norm.
Recognition of severe peanut allergies plus a common false hypothesis that early exposure increased the risk of such allergies developing led lots of parents in lots of places for a few decades to avoid their children having early exposure, leading to a huge increase in severe allergies (because it turns out, early exposure actually reduces the risk, which was recognized in large part because Israel, where the avoidance thing not only didn't catch on but where peanut-based puffed snacks remained a popular snack for kids from pretty much when they could eat solid food, was conspicuously left out of the major upswing in peanut allergies). Since the recognition that avoidance is counterproductive has worked its way into general advice in the last few years, we should see a noticeable drop in the incidence.
Same with asthma. Something has gone terribly wrong.
Lots of stuff going on with asthma, I think: It's got a genetic component and treatment getting better probably increases the incidence, all other things being equal, there's a lot of known environmental factors, some of which are probably increasing in probability of exposure, and it’s also made more noticeable and more likely to be diagnosed by allergies and other co-occurring inflammatory conditions, which gets back to the allergy discussion...
"…Israel, where the avoidance thing not only didn't catch on but where peanut-based puffed snacks remained a popular snack for kids from pretty much when they could eat solid food, was conspicuously left out of the major upswing in peanut allergies)."
Seems that common sense prevailed there.
"Lots of stuff going on with asthma,…"
I grew up in a cold, damp mountain environment where mists and rain were commonplace (by the time Ventolin/salbutamol came onto the market in the late '60s I'd have left school), and I recall no kids that I knew who had asthma. I'm not saying that asthma was unknown, I'm just saying it wasn't as common as it seems to be these days.
Again, I'd like to know the stats, population versus reported incidents by year etc., so we had a handle on what's actually happened over this timeframe.
When I worked at a wilderness summer camp I had a kid in my group that was deathly allergic to peanuts, so weeks before we had to rid the camp of them.
He was about 13, and said when he was little they did that scratch allergy test on his arm and he was in a coma for six months. He carried and Epipen around but told me not to stress. If someone ate a snickers then touched a door knob, and he touched it days later he would be dead on the ground before I had the cap off the pen anyway.
Cool kid, he just took it in stride.
Sounds like obvious bullshit. His story I mean, not yours. If his allergy were as bad as he claimed he would be a bubble boy or dead. It's not as if all of society around him could be cleansed of peanut residue as the camp supposedly was. If he went anywhere public without a bubble then by his account he'd be dead.
He was extremely careful not to touch much, and after meeting his parents they lived in constant terror
Yeah, the anxiety with serious food allergies is real. I haven't had a reaction in nearly 22 years and I don't even remember what it feels like, but religiously avoiding a dangerous food from a young age you can have some long-term mental effects. I was super responsible about it even as a young kid, but now I'm a picky eater and occasionally have a mini anxiety episode after eating new foods.
That was my thought too. I am sure his allergy was serious, but this story is entering homeopathic levels of dilution and delusion.
Slight tangent: How do people with an allergy that severe find out they have an allergy? For example people who know even someone's breath after eating peanuts would threaten their lives. Accidental exposures are likely much worse than that, so how do you end up learning about this severity without dying in the first place? Just running a full allergy test after an unexplained exposure to traces of "something", or... ?
For my son, it was another child kissing him on the head when my child was about 6 months old, the child had eaten peanut butter for breakfast. His face started to swell, and my wife ran him to a local GP - and with wiping down and plenty of breast milk he was OK. A month or two later he was at a toddler party and rolled in a little hummus - and the same thing happened. We were already on the list for an allergy appointment, but they wouldn't see him until he was 18 months old - so we found a private hospital who would see him.
---
In terms of 'cause' - we don't know, one or two other children of my sons generation in our family have food allergies, and an older brother thought he was allergic to fish though never tested.
We noticed the reaction after he had a round of antibiotics after he had infected eczema, quickly followed by my wife needing antibiotics which we are sure got to him through her milk, as he'd groan after breast feeding - before that we had plenty of nuts, sesame, milk and eggs in the house, without noticing an issue for him. But that is just a pet theory.
It is not well known but this also works for adults too. I’m 28 and recently completed oral immunotherapy therapy for my extremely severe peanut allergy. I used to go anaphylactic from single milligram exposure and now I’m eating multiple peanuts a day. As an adult you have to go slower and be more careful but absolutely can be done and is life changing.
How long did your therapy take to get to this point?
About a year overall but I started to have meaningful protection after about 6 months. There is no one in the UK currently offering it for adults so I had to travel to a specialist clinic Atlanta a few times.
You travelled the Atlantic multiple times over the year? That must be costly!
It was extremely costly :( But given how dangerous my peanut allergy was I considered it money well spent - it will probably save my life.
What a relief! Thank you for sharing.
Wonderful to hear - my son took part in a milk desensitisation, which has been really successful - but he also has a good few other food allergies. We haven't yet been able to get him onto other trials, so I was worried that if we didn't do it while he was young, we'd miss the 'window'.
Brilliant to hear it still works well in adulthood - if we can get peanuts, sesame and egg under control - so that he can eat 'May Contain' food, that would be a huge change for him.
There is a theory that if your body is not exposed to enough good bacteria and other pathogens then it will build up an army to fight out non important things like pollen and peanuts. I would recommend giving kids probiotics and also not keeping environment so clean with wipes and excessive hand washing that they never get exposed to good and some bad germs.
Can someone confirm that theory and provide evidence?
There are plenty of studies linked here: https://en.wikipedia.org/wiki/Hygiene_hypothesis
This correlation is often referred to as the 'hygiene hypothesis' by researchers. The underlying cause is still being understood; you can find an article comparing two theories here [0].
The grow up eating dirt hypothesis.
Treatment for adults would be nice, but I take solace from the future. At least more kids won't need to grow up with an extreme concern. Meantime grown-ups keep carrying the epipen.
It is not well known but this also works for adults too. I’m 28 and recently completed oral immunotherapy therapy for my extremely severe peanut allergy. I used to go anaphylactic from single milligram exposure and now I’m eating multiple peanuts a day. As an adult you have to go slower and be more careful but absolutely can be done and is life changing.
Weblinks would be very interesting. Congratulations for getting to a safer place.
This is the Australian position: https://www.allergy.org.au/hp/papers/ascia-oral-immunotherap...
I am allergic to coffee (caused by covid).
It is not worth wasting the time of professional help, but coffee is important to me personally. I used to drink 3-5 cups per day, most socially.
Could someone please explain how I can use Zyrtec and doses to coffee to cure this akin to how other people in this thread are curing peanut allergies?
My original symptoms were severe nausea and throwing up.
I have been taking Zyrtec and drinking (fractions of a cup of) coffee for some years now and this has gradually reduced the reaction. I recently came off the Zyrtec and I can drink 1 coffee per day with only minor itching and some swelling in the throat, but I think with a better method I could increase the number of coffees per day and alleviate the remaining itching/swelling.
I am careful about using Zyrtec for long periods because I noticed other side effects from cetirizine such as lethargy when on it and chronic (seemingly incurable) insomnia when I came off it. Ideally if I go back on, I would want to come off after not more than 1 year. 6 months off cetirizine and the insomnia is starting to go away.
I hope you have an epi-pen because swelling in the throat is exactly how anaphylaxis kills (by asphyxiation, and Zyrtec alone will not save you from it).
Also, EoE is real and can cause permanent narrowing of your esophagus if you are reckless. Please find an allergist who can give you advice.
My understanding is that exposure therapy is nowadays the recommended way to deal with milder allergies. My daughter was allergic to eggs and the doctors advice was to start to slowly introduce them to her diet. About half a year after starting this, she could eat eggs in food no problem.
I've also personally cured my cat allergy. We adopted a cat that was supposedly of hypoallergic breed ("supposedly" because there's really no science behind it, it's just people reporting less reactions from this breed). I still got a mild allergic reaction to her initially, but after a few months, it stopped. Now, a few years later, we are still happily living with her and it seems that I've ceased being allergic to other cats also.
Of course, given that peanuts are legumes, banning nuts eg cashews, sesame, etc makes no sense. There would be some sense in naming peas, beans and chickpeas though, as these are legumes.
I wonder how frequently this could be a vaccine reaction, as peanut oil is used in many vaccines.
Thus has been the norm in Indian culture for centuries now.
I heard the best thing you can do as a woman to prevent allergies is to eat everything you can think of (especially food known to cause allergic reactions) during pregnancy.
Is this true?
Hey, maybe at some point we can get back our free peanuts on flights!
I thought Aussies hate peanuts anyways. Marmite4Lyfe
I read "peanut gallery treatment".
I love peanuts. If I couldn't eat peanuts anymore, I would kill myself.
"Australia starts peanut allergy treatment in little peanuts."
Humans didn't evolve to eat seeds, if anything, we the ones that can tolerate them are the mutations.
Give your babies bamba and peanut snacks early on. bamba snacks are believed to be the primary reason Israeli children have way less occurrence of peanut allergies.
In the book Immune by Philipp Detter, creator or YouTube channel Kurzgesagt, it was mentioned that parasite might been a link in developing allergy (or was it autoimmune disease, can’t remember exactly)
Here's the participating hospitals:
* The Royal Children's Hospital in Victoria
* Perth Children's Hospital
* Fiona Stanley Hospital in Western Australia
* Queensland Children's Hospital
* Women's and Children's Health Network in South Australia
* Sydney Children's Hospital, Randwick
* The Children's Hospital at Westmead
* John Hunter Children's Hospital
* Campbelltown Hospital
* Royal Prince Alfred Hospital in NSW
Sorry for being nosy, but did you do oral immunotherapy with or without professional support?
I AM NOT A DOCTOR OR OTHER HEALTHCARE PROFESSIONAL
I looked into oral immunotherapy for tree nut allergies. There's a paper from 2022: https://onlinelibrary.wiley.com/doi/10.1111/all.15212
They did it in a few stages:
1. First three days: test the child with increasing amounts of cashew protein, until the child has a reaction. Use the amount ingested for that reaction, to determine the single highest tolerated dose (SHTD = the maximal amount of cashew protein each patient could tolerate).
2. Next 24 days: the child ingests the SHTD daily.
3. After that: every month, the dose was increased (I think at an in-person visit), and taken at home for the next 30 days.
For #1, I looked at the amounts of protein they gave the child. Table S2 (in one of the supporting documents) shows how much they gave on days 1, 2 and 3. Of course they stopped increasing once the child had a reaction. If you convert the amounts of protein into equivalent numbers of whole cashews, then you get:
- day 1: start with 1/1800th of a small cashew, increasing up to a fifth of a small cashew.
- day 2: 1/5th small cashew, up to 2 small cashews
- day 3: 2 small cashews, up to 22 small cashews
22 small cashews is about equivalent to what they want to achieve by the end of the therapy, i.e. if you don't have a reaction after eating that many, you won't have a reaction to a greater quantity.
It seems a bit hard to DIY it, because:
- The first three days requires very small amounts of cashew protein. At home we don't have either (i) isolated cashew protein, or (ii) tools to measure such small amounts (starting with 0.1mg cashew protein, or 0.5mg cashew).
- For the first three days, we'd need to be very vigilant to watch out for a reaction. I don't know whether, in a supervised setting, they'd observe or measure other factors than just an apparent reaction, to make sure the procedure is safe.
I AM NOT A DOCTOR OR OTHER HEALTHCARE PROFESSIONAL
For curiosity sake, curious if the tree nut allergy here was typical reactions (hives, nose, etc.)?
I have a tree nut "allergy" but doctors always call it more of a "hypersensitivity" because my reactions are usually involving terrible stomach cramps and pain accompanied occasionally by swollen throat (more so for almonds than cashews).
I've wondered if it's worth trying to do this myself.
Why wouldn’t you see the doctor? Cost? Not covered by insurance?
I have in the past but they weren't much of a help. Allergy scratch test results didn't correlate at all.
They referred me to a throat doctor to make sure it wasn't anything in my digestive system. So ended up doing an endoscopy. No notable findings there either.
So never been given any kind of ideas of things to try other than keeping a food journal, which has been useless to me.
for allergies most doctors are utterly useless. they either dont know the topic or the tests are unreliable and in the end you come out with no more info than you came in.
Sounds like Oral Allergy Syndrome. I also have it with almonds and stone fruits.
Sudden loss of appetite, followed soon by nausea, and then vomiting.
Since you seem to be either a doctor or some other kind of healthcare professional can I ask what would you prescribe for aching butt?
Cortisone
do you mean, if there is no reaction to 1/1800th within minutes(?) then try 1/900th, lather rinse repeat?
Correct. The specifics are in the second page of this doc: https://onlinelibrary.wiley.com/action/downloadSupplement?do...
The intervals start at 10 minutes (start of day 1) and go to 90 minutes (start of day 3).
The dosage increments (in mg of cashew protein) start at 5x, but are mostly 1.5x or 2x.
Ok I’ll bite - Wouldn’t have guessed it necessary to bookend a comment with all caps disclaimers, yet it’s happening, so I’m going to guess you have an interesting or cautionary anecdote around it we can possibly learn from?
Nope. Just being cautious!
With. First they did a blood test (instead of a scratch test) to identify possible allergy levels. Then the allergist had us come into the office to take e.g. a few micrograms of peanut powder and watch him for reactions. Then we maintained the dose at home every day for the next couple weeks, taking zyrtec with it to avoid hives, etc. Then we'd go back in, try doubling the dose as a challenge. If he had a bad reaction, we stayed on the same dose another few weeks, and if not, it became the new standard level. Rinse and repeat for about a year until we got to 2 peanuts, 1 cashew, and 1/4 tsp of tahini, which we maintained now for the past ~1.5y. We're due for another blood test and challenge here soon, as the allergist suggested there's a small chance that the immunotherapy could result in the allergies essentially receding
Our son is allergic to nearly everything (peanuts, nuts, dairy, eggs, sesame, wheat) and we haven't found an allergist willing to work with us. Do you know if there's an age factor for immunotherapy effectiveness? He's 2 1/2 yo.
2 1/2 is right in the window, with the general consensus being that the earlier you start, the better the results. Studies found the best results with 1-year-olds, then it exponentially decreases with each year, until there's little benefit with 4+ year olds.
We did it with Latitude [1], with the support of our allergist, who had sent his son through them with successful results. It's not covered by insurance, and is expensive in all of time, money, and attention. The field is very new and data is still sparse - our allergist actually was very curious to hear results because he's adapting his practice as new data comes out from actual treatment.
[1] https://latitudefoodallergycare.com/
Age is a known factor for oral immunotherapy’s risk and effectiveness, and the commonly cited fuzzy threshold is starting before 2 years of age. The data isn’t that strong, but “start very young” basically has practitioners’ consensus.
You have to shop around for allergists willing to do it. Our first allergist told us they weren’t comfortable doing it but it was becoming an increasingly popular option and referred us to several allergists who did it. We’ve also spoken to allergists who were bearish on it. It’s because there’s very little published data.
In Israel this is done naturally by feeding children Bamba, a puffed peanut snack, at a very early age. Research shows significantly decreased levels of peanut allergy.
https://www.npr.org/sections/thesalt/2015/02/23/388450621/fe...
Bambas are recommended in the U.S. as well, but our kid entered anaphylaxis after eating just 5 bambas his first time, at about 6 months of age. It's certainly possible to have a peanut allergy despite early exposure. Recommendation in the U.S. is now for pregnant women to eat peanuts to expose the fetus in utero, but even this doesn't always work.
Kid is desensitized now after a year of oral immunotherapy, so add us to the chorus of voices saying "It works", but it can strike early and severely despite the parents' best efforts.
It's not just about early exposure to allergens, it's also early exposure to pathogens. There's a growing body of research that constant disinfection of hands and surfaces is what really caused the allergy outbreak. Humans need to prime their immune systems with exposure to pathogenic bacteria at an early age so that it can learn to fight them and not other substances which leads to allergies.
Careful, that's not really been proven. There's an enormously important difference between these two hypotheses:
1. The individual human immune system needs to be calibrated by wider exposure to actual pathogens.
2. The individual human immune system needs to be calibrated by wider exposure to benign bacteria that we've co-evolved with. ("Old friends.")
The treatment plan each suggests is very different, with different risks, and there is no guarantee the riskier option will give you better results.
Yeah, we hadn't heard of this when our son was born, but the allergist mentioned it. When our daughter was born, we gave her something like this at his recommendation. The ones we got were some puffs that have a whole pile of allergens in tiny doses. Causation vs correlation and all that, and a small sample size, but our daughter doesn't have any issues with any allergies.
The economist Emily Oster wrote an excellent series of books about pregnancy anf early kid years, where she dives into details about various studies, whether they are causal, etc. It's one of the best practiacl explainations of reading research I've encountered targeted at non-academics, really well done. She has a chapter on peanut exposure allergies and i think inrecall that these early-exposure results are in fact from causal research vs just correlational research (basically there are at least two types of papers out thwre -- correlational and causal. As you might guess causal is harder to get for many reasons). Great books; she may also have published some chapters on her substack (substack came after the book I think).
I realize as I write this that you are probably saying that for your own experience you can't disentangle correlational from causation, to which I would say -- correct!
Emily Oster is a national treasure that is still flying under the radar for most people.
As above, she presents excellent science in an approachable manner for non-science minded folks. She also has enough of the technical details for this with the knowledge to be confident she has done a strong analysis.
If you are a parent and haven’t checked her stuff out, please do. (Zero affiliation or connection)
If you live in the USA and have eastern-european or balkans shop in your area you can buy "smoki" which is essentially the same thing.
Or you can order it from amazon:
https://www.amazon.com/Smoki-Peanuts-Flavored-Snack-Pack/dp/...
To continue the message of availability…
Trader Joe’s in the US has both regular Bamba and chocolate-dipped Bamba. These are sometimes in different parts of the store.
People mention this quite often to me because my toddler is on oral immunotherapy for peanuts, and there’s a small but important distinction here. It’s extra important when relatives start to think it’s okay to be casually leaving peanut products lying around within the toddler’s reach. (It’s not)
The general consensus among allergists is that early exposure reduces the chances of developing the allergy in the first place, but people on oral immunotherapy are still allergic, they just have a high tolerance and can still have anaphylactic reactions. Some will outgrow the allergy, but for peanuts most don’t and the data doesn’t yet exist for whether peanut oral immunotherapy increases the likelihood of outgrowing the allergy.
There are some early studies out [1] that indicate remission is possible with OIT. (For laypeople, "desensitization" ~= can tolerate some peanut exposure without a reaction, but still needs to carry an epipen and remain on the maintenance dose for life, while "remission" ~= no longer has a peanut allergy). The numbers were 71% desensitization and 21% remission for OIT vs. 2% both for a placebo. It was heavily dependent on age, with 71% of 1-year-olds, 35% of 2-year-olds, and 19% of 3-year-olds achieving remission.
Data will be scant at this time, because the full treatment takes a long time and needs to be adhered to closely. It's 30 weeks of OIT, followed by 2 years of a maintenance dose, followed by a 6-month hiatus to verify whether the maintenance dose can be stopped while still achieving remission, so data necessarily lags the start of any clinical trials by 3+ years.
[1] https://www.nih.gov/news-events/news-releases/oral-immunothe...
It’s sad as well.
The original studies on peanut allergy and bamba in Israel came out many years ago.
It’s taken people so long in the US to learn about the value of introducing small amount to babies at a young age to protect them.
I can only think of the many families and children who have been negatively impacted due to the lack of awareness and understanding in America.
I thought there was a study that suggested the weapon of first resort should be breastfeeding mothers eating the allergen-triggering foods so the kids get exposed to them indirectly.
Makes me wonder if there is something we should be doing with baby formula.
What are they saying? They don't believe in oral immunotherapy?
They tend to be critical against immunotherapy in general, if it's not for those allergies where the therapy has a good chance of working and is without risk. Otherwise avoidance of the allergen is preached. We encountered that with a cat hair allergy, treatment was refused.
whats the point of the allergist then?
My question exactly.
To be fair, for hay fever the therapy was offered. And reading it up back then, the treatments against animal hair are often not successful, and they have a certain risk. Plus no standardized medication, so there are problems with keeping the exact dosage needed. All that combined made me conclude that not wanting to lead such a treatment is not a completely unreasonable position for a doctor. One would have to find a doctor specialized enough to do it anyway.
For cats, just feed them egg from chickens that live with cats, as the egg has antibodies against the allergen in cat saliva, and the egg will cause those to get neutralized before the cat spreads them to its fur.
There are commercial products for this that have such egg powder.
It seems that is basically the same mechanism as the Purina Live Clear cat food? That one we tried, and did not notice a definitive effect. What did help was keeping the cats out of the bedroom, and later being pregnant removed the allergy so far almost completely for her ;)
The purpose of a system is what it does. If they make money by identifying allergies and then treating those people for those allergies, as opposed to parents giving their children 2 peanuts a week, then their livelihood is under threat.
If kids were left to get dirty and put the occasional thing in their mouth, which kids have been doing since the dawn of time, then there wouldn’t be such an allergy problem
I find that view to be overly pessimistic, and not reflective of what health care providers actually do. Practitioners of all sorts work hard to cure and prevent diseases every day. Every time a cancerous tumour is removed, it significantly reduces the chances of that person needing follow-up care. Every vaccine that is given reduces future hospital visits. Every piece of good advice to exercise and eat right keeps somebody away from the doctor, rather than turning them into a repeat customer.
Doctors aren't evil. They aren't scheming to lock patients in by offering suboptimal treatments. They provide the best care that they're able, within the limits of the knowledge and resources available to them.
I’m not saying the individuals are evil or making any moral claim at the individual level at all, I’m talking about the system and the behaviours that are incentivised.
Even if they believe it, there's a list of treatments and procedures for each diagnosis that insurances are required to cover and oral immunatherapy might not be on said list.
Is health insurance a common thing in Germany? Don't they have universal health care?
Universal Health care is via public health insurance.
You can pick from several public providers, but the price is basically fixed and deducted directly from your salary/payed by the state if you’re unemployed.
There is a 2nd system of private insurance providers. Those tend to get you preferential treatment at doctors because they pay them more than the public insurance which has fixed rates, but they will hike prices as you get older and you can’t go back to the public System.
Is this effective and available for milder chronic hayfever and runny,partially blocked nose, generally speaking?
I've heard that consuming honey from your local variety of bees can help - but the evidence base isn't great [1]
[1] https://www.honeyshoney.co.uk/blogs/news/local-honey-and-hay...
This is nonsense. It doesn’t work.
I think this myth might stem from people not getting hayfever, moving away from where they grew up, and then suddenly getting hayfever and attributing it to where they moved to. But the truth is it just can be (frequently is I believe) adult onset (20s very typical I believe).
At least, that was my experience, I blamed Cambridge, then moved back or even when I visited before that had it just as bad in the town I grew up in. (Cripplingly painful eyes, sometimes migraines. Nose generally fine, but steroidal nasal spray is the best I've found off prescription for my eyes. Eye drops only really seem to help by way of lubrication for me (even though they are active), and pills (best I've tried is fexofenadine) don't give that instant relief.)
I visited my local allergist for this (in the USA). Basically the treatments available to me were either shots or eyedrops. The shots required visiting the office almost daily, then weekly, then less frequently. The eyedrops can be self administered. I was told both treatment options are not permanent and need to be basically done in perpetuity. The cost was a couple thousand dollars per year (basically no insurance coverage).
Seems like the treatment options are evolving pretty rapidly and these options aren't available everywhere. Or this is what I was told.
You were told wrong. Shots have a ramp-up period and then a five year maintenance period where you get one shot a month. Afterwards, you've effectively been cured.
A friend just started the shots and there was no ramp up, he's getting the shots every four to six weeks from the start. When I looked into it ten years ago, you had to come in weekly for a long time, which discouraged me from doing it.
My hayfever is mild. Since some years ago, I chew some grass ends, mostly at the beginning of the season. I do seem to get much reduced symptoms compared to what I used to get. But of course I can't be sure it's causal. I have completely stopped taking antihistamines.
Yes, my girlfriend gets allergy exposure shots for cat dander. It's stupid expensive and time consuming. You will meet your insurance deductible for several years. The outcome is only somewhat good as well.
Yes it is: https://www.aok.de/pk/magazin/koerper-psyche/haut-und-allerg...
I heard that you can choose between pills every day for a prolonged period OR three injections over a year. Not sure how accurate this is, but every "allergologe" provides this in Germany.
I asked our allergist about oral immunotherapy for my daughter and he cited a study that found that avoidance was more effective in preventing severe reactions.
I mean, avoidance is more effective than vaccination in preventing you from getting the flu, but that’s not the point of getting vaccinated.
So there’s one factor that doesn’t get discussed much: adherence to a fairly draconian treatment regimen for “forever”. Our allergist screened us for whether they thought that as parents we had the resolve and diligence to figure out a way to get a baby/toddler to eat a full teaspoon of peanut and cashew every single day. And as any parent can tell you getting them to eat a specific thing every single day is non-trivial.
Oral immunotherapy seems to be very effective but sticking with it is nontrivially hard.
We asked about swim lessons and were told avoidance is the best way to prevent drowning.
This type of advice makes sense in an absolutely litigious risk free training context.
Seems like a problem when avoidance goes even a bit wrong though. :(
Wow that is really good to hear. I am on immunotherapy for a different type of allergy and can't stop talking about its effectiveness. It has been life changing.
I did a whole immunization against dust mites and I feel like it didn't work at all. q.q
I've been wondering if there's something else causing me to be allergic to them, like something I eat or so, idk. But I'll have to get tested again
As a child I was diagnosed with a dust mite allergy too, but much later found out I’m actually allergic to certain pollen and cats.
I do a skin prick test every year and make sure I update allergens. It takes about 6 months to see the results and whole treatment could take upto 3-5 years. I took a break from the treatment during covid and the allergies came back. So it is important to get monthly shots.
If you are willing to say, what was your son’s peanut allergy level?
One of our sons is 6/6 on peanuts and they were very hesitant to try oral immunotherapy, more or less saying they weren’t willing to given the risk of anaphylaxis.
I don't remember for sure, but I'm pretty sure it was 1 below the max level. I seem to recall it was on a scale of 5 with our test, but it might have been on a scale of 6
We did this for our son (peanuts and cashews) and it was also life changing. He’s on a daily maintenance dose for life, but we no longer fear the possibility of either allergen being near him in public places or cross contamination in food. He still has to carry his epipen, but now the prognosis for “oops he ate something with peanut in it” is no reaction at all until he’s several peanuts in. He’s not cured and can still eat his way to anaphylaxis with a bag of peanuts, but he can take a few bites out of a PB&J sandwich and nothing will happen.
One detail in particular makes a huge difference: oral immunotherapy seems to be significantly more effective in babies (starting before age 2) with significantly better outcomes. Adults and young children have a much higher incidence of side effects (most common one is a constantly upset stomach) that makes avoidance potentially still better for overall quality of life, but our allergist told us that among their <2 year old cohorts they’ve seen zero out of [upper two digits] experience any of those side effects at all. We started our son when he was 1 year old.
In our case the kid started eating peanuts basically as soon as they started eating solid foods, so the allergy happened despite early exposure. Actually we caught the allergy early enough to start OIT early because of early exposure.
Our daughter too, she’s been on a maintenance dose equivalent to two peanuts, once a week. It’s been life changing. She’s had several trips to A&E before the treatment but after a few years she was able to tolerate a dose equivalent to ten peanuts (although that still made her quite nauseous).
Me too. My younger sibling, as a child, had (and still has) allergies (at the time, peanuts, tree nuts, eggs, sesame & sunflower). About a year, maybe 2, after starting to eat small amounts, they could do sesame, stovetop (!!) eggs, and nut butter. The problems went from 'allergic reaction' to 'won't eat the eggs and nuts'. (I think at one point the solution was pancakes with nut butters and sprinkles. Kid still had a hard time eating it.)
I don't know why it's taken so long for this to gain broader acceptance.