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Discussion Boards > Adults with Food Allergies
Orange allergy
CMdeux:
Keep in mind that I'm not saying that you are not allergic, because: 1) I'm not a medical professional, just another person with a lot of experience with allergies and atopic conditions in general, and b) if you do really have an allergy, then what you did (knowingly eating something cross-contaminated) was potentially pretty DANGEROUS...
--- Quote --- It was really surprising. When I had the skin test I tested positive for oranges. I never remembered getting hives or anything from oranges before. The nurse told me that if I had't had any reactions I could still eat them even if the test showed positive.
--- End quote ---
This is not the same thing as being diagnosed with a food allergy. If this is the kind of guidance you got from your allergist and/or his/her staffers, this is NOT good care with respect to food allergy. The reason is that it isn't clear whether or not you had history to support being skin tested in the first place-- er, or maybe it is, actually, since you said that the result was astonishing. That indicates that this is probably something that shouldn't have been tested to begin with. The reason? Skin testing is NOTORIOUS for producing false positive results. At least 50% of positive SPTs for foods are false positives, in the absense of reaction history to support a diagnosis.
--- Quote ---I was diagnosed with several allergies by an allergist. My allergist didn't say that I might have an allergy to oranges. She said that I am allergic to them. The skin test that she gave me was positive for an allergy to oranges as well as a few other foods and some environmental allergies.
--- End quote ---
Sn+Sn, I promise I'm not picking on YOU-- though I might be picking on your doc a bit...
This really doesn't sound valid as a means of diagnosing you with food allergies. Had you-- ever-- had more specific food allergy symptoms prior to testing? Is your allergist someone who specializes in environmental allergies, by any chance? Lots of those people will make diagnoses of food allergy on the basis of positive test results alone, most never realizing that they aren't following best practices for food allergy in particular.
Orange is an odd food allergy, also. Not very many people are truly allergic to oranges. I am and have been since I was about five years old. I can count on one hand the other people I've known with orange allergy, and that's after over a decade being a FA advocate for my duaghter with MLTFA.
Might be time to ask some questions of your doc. Living with a food allergy you DO have is hard enough-- living with one you do NOT have is just unecessary and cruel of your medical practitioners. "Avoidance" is a very different ballgame when you do it because of suspected intolerance or aversion than when you do it because a trace of the food might kill you.
I'm glad you are feeling better!
CMdeux:
For reference (and since Sn+Sn asked about experience with orange allergy):
the last time I was exposed to uncooked citrus was in a glass of (plain) water in a restaurant.
I did NOT know that the water contained lemon slices, since the server filled my glass with ice cubes and then water-- at a station, away from our table. Each 'pitcher' of water at the station contained a couple of thin lemon slices.
I took ONE SIP, and I could immediately feel my lips burning. My nose started to run. My eyes watered, itched, and my lips swelled slightly. My entire mouth felt like it was on fire. That single sip of water very definitely burned as it went down, and I had a few hives around my mouth (according to my DH, who was sitting across the table from me). I started feeling nauseous and took a benadryl strip. Within about ten minutes, the symptoms started to subside.
I knew that it was the water, and I didn't know what was in it (until I asked the server), but I knew that it was citrus.
I had a similar reaction about two years ago to a breakfast plate (in a different restaurant) that had been garnished with an orange wedge. Sometimes I get away with that, and sometimes I don't-- it really depends on whether or not the food itself is absorbing enough of the juice from the citrus, and on how freshly cut the slice is, and how much of it is in direct contact with my food.
My citrus allergy is more like really bad OAS than like an anaphylactic food allergy; I can tolerate small amounts of citrus if it is well-cooked. I would NEVER treat shellfish this way, because traces of shellfish can and have caused me life-threatening reactions.
On the other hand, this illustrates several things about allergic responses to food: a) immediacy (this was pretty much instantaneous... the vast majority of food reactions begin within twenty minutes), b) responds to antihistamines (at least in part-- I also carry epinephrine for my LTFA in case antihistamines are NOT enough), and c) mostly tend to be proportional both in time and intensity to the level of exposure...
in other words, the kind of protracted, non-specific symptoms you experienced would be unusual from a single exposure to an allergen that you don't have anaphylaxis history with.
I mention that only because your INITIAL symptoms weren't severe, nor was what you describe like a biphasic anaphylaxis episode. For an anaphylactic reaction, on the other hand, gradually subsiding symptoms are entirely in keeping with how these things seem to work. I've had anaphylaxis last a few days, and it's not pleasant, by any means... but those kinds of reactions are hard to ignore since they tend to be extremely scary/debilitating and most often include something fairly specifically "allergic" in nature (like breathing problems, hives, swelling, etc.).
Definitely to have low-level symptoms that last and last points more to an on-going exposure to an allergen or to another cause (like illness).
Some people who are not allergic to citrus fruits have trouble with the acidity re: reflux, especially during periods of stress or other illness. I know that I do have that problem with tomato-based foods when I'm under stress or if I'm coming down with something. It's different from my allergic responses to food, though.
Snifflesandsneezes:
--- Quote from: CMdeux on December 11, 2011, 10:45:19 AM ---Keep in mind that I'm not saying that you are not allergic, because: 1) I'm not a medical professional, just another person with a lot of experience with allergies and atopic conditions in general, and b) if you do really have an allergy, then what you did (knowingly eating something cross-contaminated) was potentially pretty DANGEROUS...
--- Quote --- It was really surprising. When I had the skin test I tested positive for oranges. I never remembered getting hives or anything from oranges before. The nurse told me that if I had't had any reactions I could still eat them even if the test showed positive.
--- End quote ---
This is not the same thing as being diagnosed with a food allergy. If this is the kind of guidance you got from your allergist and/or his/her staffers, this is NOT good care with respect to food allergy. The reason is that it isn't clear whether or not you had history to support being skin tested in the first place-- er, or maybe it is, actually, since you said that the result was astonishing. That indicates that this is probably something that shouldn't have been tested to begin with. The reason? Skin testing is NOTORIOUS for producing false positive results. At least 50% of positive SPTs for foods are false positives, in the absense of reaction history to support a diagnosis.
--- Quote ---I was diagnosed with several allergies by an allergist. My allergist didn't say that I might have an allergy to oranges. She said that I am allergic to them. The skin test that she gave me was positive for an allergy to oranges as well as a few other foods and some environmental allergies.
--- End quote ---
Sn+Sn, I promise I'm not picking on YOU-- though I might be picking on your doc a bit...
This really doesn't sound valid as a means of diagnosing you with food allergies. Had you-- ever-- had more specific food allergy symptoms prior to testing? Is your allergist someone who specializes in environmental allergies, by any chance? Lots of those people will make diagnoses of food allergy on the basis of positive test results alone, most never realizing that they aren't following best practices for food allergy in particular.
Orange is an odd food allergy, also. Not very many people are truly allergic to oranges. I am and have been since I was about five years old. I can count on one hand the other people I've known with orange allergy, and that's after over a decade being a FA advocate for my duaghter with MLTFA.
Might be time to ask some questions of your doc. Living with a food allergy you DO have is hard enough-- living with one you do NOT have is just unecessary and cruel of your medical practitioners. "Avoidance" is a very different ballgame when you do it because of suspected intolerance or aversion than when you do it because a trace of the food might kill you.
I'm glad you are feeling better!
--- End quote ---
I appreciate your input. Although you've said you're not picking on me but, I'm beginning to feel a bit picked on by some of your responses.
I'm not really interested in describing or defending my allergic reactions. I have had numerous allergic reactions. My allergic reactions to nuts, medication and environmental triggers is what prompted my primary care doctor to refer me to an allergist who also specializes in asthma which I also have. My allergist tested me for a great deal of foods and orange just happened to be one on the panel. I did not walk into her office and claim a stuffy nose and therefore thought I was allergic to an orange.
I've had allergic reactions in front of family, friends and doctors alike. And none of the doctors diagnosed me with allergies based on my words alone. I was having reactions in their office. I've even had an anaphylactic reaction where I needed to be intubated.
The only reason I continued to drink the smoothie last week was because, after avoiding oranges and anything containing oranges and orange juice for 10 years when I tasted it in the drink I remembered what the nurse said when she told me that if I hadn't had any reactions to oranges then I didn't have to avoid them. I avoided them anyway.
My original question wasn't me asking if I was allergic to oranges. It was if any of the symptoms that I was experiencing sounded like any reactions anyone allergic to oranges had ever experienced themselves. And how long did it last if so. I know that a headache and stuffy nose can sound very much like a cold. And I've had many colds in my life and I can tell when I have one and when I don't. The burning in my stomach was near to when I'd had an ulcer years and years ago. Yet my initial thought was that the acid was simply causing the burning.
My thought was that if it was in fact some kind of allergic reaction that was common with oranges then maybe I'd had the reaction in my past ..before getting diagnosed and that I just didn't recognize the symptoms as being an allergic reaction.
You're right that having food allergies and avoidance diets are stressful. That's why I came to this message board. To talk with people who experience things that I do as well. I didn't come to defend my reactions or my tests and results or why any of my doctors ordered the tests that they did.
I have a very close family friend who has anaphylactic reactions to peanuts every single time she comes in even airborne contact with any peanut products ever since she was a little girl. She has been hospitalized in the ICU for some very extreme anaphylactic reactions. So, I am very well aware that even trace amounts can be life threatening.
YouKnowWho:
I know it seems like she is attacking you, she is not though. I want to work through a few of my thoughts and I hope it doesn't come in a attacking sense - we really do want to help.
Add my son to the list of people falsely diagnosed based on testing alone - SPT and RAST. If it was up to two previous allergists we would still be avoiding corn, rice, oats, milk, soy, peanuts and tree nuts. All foods he was eating with no issues. The reality is that his only allergies are to wheat, rye, barley and egg. It took nearly 5 years for us to finally found an allergist who understood food allergies and the importance of in office food challenges.
Keep in mind that all allergists are not created equally. Yes your allergist deals with asthma and that is awesome. But are they specialized in asthma because they see it in patients who have environmental allergies? The understanding of food allergies in the last ten years has changed dramatically, even the testing protocol has changed. Allergists should not be doing blanket testing without strong clues to indicate specific foods. So many environmental allergists are parading as allergists who have a clue about food allergies without proper knowledge. Blanket testing is easy for allergists to do but hard on the person has to avoid all of those foods, especially if they are false positives.
So you are wondering if orange could cause the symptoms you experienced. One of the things you may need to do is to have an in office food challenge to see if oranges are truly an allergen for you. I am making the assumption that smoothie was made commercially? Do you get those on occassion? The reason I ask is because the likelihood of cross contamination is likely. Was it in the mall where perfumes are in higher concentration? Headaches lean more toward environmental and not food reactions. Runny noses can go either way.
Believe me when I say that I know how hard it is to figure out mystery reactions. I am going through that right now with my other son whose lips swelled while eating a dinner we normally have to fight to get him to eat, post steroids (where he was having odd reactions such as all over body itching with no hives and purple patches on his face) and while on Amox. Not sure we will ever have a clear answer because there is also a chance it could have been viral.
rebekahc:
I'm sorry you're feeling attacked. :-[ I know CM is trying to help answer your question while also keeping in mind the many other people (especially those who are new to food allergies) who read and take advice here without ever posting. It's important that we (as a board and the allergic community) emphasize current best practices in food allergy diagnosis/treatment/management, the accuracy (or not) of testing, and which types of reactions are likely to NOT be IgE mediated immune responses.
Now, as to your question - does your reaction sound typical of reactions experienced by those with orange allergy? Probably not. There aren't allergic reaction symptoms specific to a certain food. You can't say people who are allergic to milk tend to get hives and vomit or people allergic to peanuts tend to wheeze and get swollen lips. Any food allergy can cause any number or combination of symptoms. The symptoms are not food specific or even the same each time a person reacts.
Could you be having an adverse reaction to the orange? Maybe. But your symptoms, if caused by the orange, would more likely be due to some type of intolerance rather than a true allergy. For one, your symptoms aren't typical for those of an IgE mediated allergic response. Also, if others experience the same symptoms to the food, that would tend to be more typical of an intolerance (ie lactose intolerance causes gas and bloating).
Regardless of intolerance or true allergy, I'd think your reaction was more likely to be caused by the orange if the stomach burning hadn't lasted so long. I would think that once it was out of your system that symptom would have gone away.
I hope your stomach is feeling better soon!
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