Very new and VERY confused

[Max]

Hello all. I'm a 26 male, have been suffering from some stomach / digestive / nausea issues over the last 4 months. After many negative tests (blood, endoscopy, ultrasounds, breath tests) my doctor finally gave me a RAST blood allergy test. I have no idea how to read the results and he's so short with me and won't give me answers.

Below is a list of things I tested positive for. All within the range of 1.8-2.2.

Corn
Garlic
Wheat
Soy
Potatoes
Peanuts (2.2)
Tomatoes (1.9)

My burning question is-- is is normal that when eating those above listed foods to ONLY get digestive symptoms? I don't have any other symptoms aside from nausea, bloating, some occasionally dizziness when standing up. Loose stools only sometimes, has been known to happen when I over do one of the above.

I'm  a GOOGLE pro and I've scoured the internet with little, LITTLE results. Any help is appreciated. I just need some reassurance that a 2.2 RAST reading could be a food "sensitivity" since there are no anaphalactic symptoms.

Note, I've been keeping a food journal for the last 4 weeks, prior to the test, and it DOES seem like many of the above foods have affected me either right away or after.

[yelloww]

  welcome!! I don't know how much of this I can answer, but I wanted to at least say hello and welcome.

You will get some good replies here!

[Max]

Thanks! Good to feel welcomed.

[CMdeux]

Hey, Max!

I'm glad that you found us and were able to ask for more, um... detail... about what you've learned from your doctor.  Or more to the point, what you haven't.

Honestly, your test results aren't THAT compelling without really convincing reaction history.  It's not clear that you have that, either.  That's not really good news, actually.  I mean, sure-- it's great that you haven't had anaphylaxis ever.  That's really a good thing.

But to assume that you aren't at risk for it... meh...

unclear, I'd say. 

With that in mind, I'd also say that you're in the market for a different allergist.  Preferably one that specializes in FOOD allergy.  Not just ragweed and pet allergies.

Ideally, this allergist would be happy to challenge -- in his/her office, I mean-- any foods that you seem to test positive to via blood and skin prick testing, just to see whether or not you seem to have IgE-mediated responses to those foods.

If you don't, that doesn't necessarily mean that you want to eat them if they make you feel bad, of course.  But slipping a little probably won't run the risk of actually, you know, killing you.

That's the bottom line.  It is the reason why you NEED to know.   The fact that your allergist doesn't want to take the time to figure out what the heck is going on here is really alarming.  Time for a new doc.  Definitely educate yourself on what current best-practices look like in allergy practice w/r/t food allergy diagnosis.

It's not clear why your allergist chose those particular foods to test-- do you have a food diary that you've kept for some period of time?  If not, you should probably start one.

Have you eliminated all of the potential allergens?

   If you haven't, just record any symptoms and everything that goes on/in your mouth.

If you HAVE, then for heaven's sakes do NOT NOT NOT reintroduce peanuts at home on your own.    The least likely allergens on your list (that is, those which are rarest in terms of IgE allergens) are corn, potatoes, and tomatoes.  While common as intolerances (at least in tomatoes), actual IgE-mediated allergies to them are quite rare, and they are in so much processed food that it is really, really, REALLY unlikely.

Similarly, garlic.  Those are all pretty common acid reflux triggers, though.

The only common food allergens on your list are soy, wheat, and peanuts.

Have you been evaluated for something like celiac? 

[CMdeux]

Oh, the reason for NOT trying peanuts at home is that you don't have epinephrine, I am assuming.

It's possible that you don't need it-- but at this point, with those results and the sort-of diagnosis you have?  You have to assume that you might be actually allergic and you've just had a pretty high tolerance in the past.

About 40% of people with peanut allergy are at risk of anaphylaxis from consumption. 

Avoidance can make your threshold dose much lower than in the past. 


All of those things put together could mean a terrifying reaction that you don't expect and have no way to treat at home.

[CMdeux]

Your questions and my answers--

Can this level of IgE be a food sensitivity and not allergy like anaphylaxis.  No.  No more than your well-trained dog can teach calculus.  It's just not related, those two things. 

It's possible to have a positive RAST (which measures blood IgE levels to an antigen) and not be allergic in a clinical sense.  It is also possible to have a variety pack of adverse symptoms unrelated to IgE.  It's possible to have both.  It's also possible to have neither.  Those would be... foods that don't make you feel awful, foods that don't make you fear death or wish for it either one. 

So yes, to the question you DIDN'T ask-- it's possible that those values don't mean an anaphylactic allergy at all.  Completely possible that they don't mean an allergy at all.

Note, I've been keeping a food journal for the last 4 weeks, prior to the test, and it DOES seem like many of the above foods have affected me either right away or after.

Well, but how LONG after?

It's possible to have delayed reactions to foods.  It is.  But it's very, very very very very RARE in IgE-mediated food reactions.  The only way that really CAN work is if your digestive enzymes act upon a food protein to reveal the allergen as the food is digested. 


What KIND of reactions, too?    Feeling bloated isn't necessarily a food allergy symptom.  Dizziness when standing can be-- but a lot depends on how significant it is.  If that is related, then what you've experienced when you put all of these things together is anaphylaxis, albeit fairly mild.

Diarrhea and nausea definitely can be related to IgE reactions, but they're maddeningly non-specific and can also be related to pretty much anything else, too-- UNLESS... these are way, way predictable and happening within minutes to an hour or so after consumption, and in a more-or-less dose-dependent fashion.


And what does "overdoing it" mean?  Does this mean something like a regular serving size as listed on the back of a package?  Three servings?  Or a trace?

[Max]

Well, but how LONG after?

It varies but usually I feel extra bloated and nauseas after eating these foods. It really comes and goes. Random bloating and nausea a few hours later, too.

And to be clear, this was a test panel my GI had me do. I haven't seen an allergist yet, but plan to.

I've just been bloated and nauseas for the last three months and was hoping that these numbers could provide answers to why I'm feeling that way.

Celiac was a negative and since this all started, I developed reflux.


Thanks, CMDuex!

[Macabre]

Welcome!

Well, I would add a few things.  First of all, my son and I both have food allergies.  My son has RAST (well, ImmunoCAP) positive to potatoes and wheat before and never reacted.  So I didn't avoid them.  He tested positive to kiwi in January and negative to kiwi today  (I had assumed false positive, but I've been avoiding kiwi since January with him).  He is allergic to peanut.

I test positive to sesame and crustaceans.  My sesame reactions are very different from my shellfish rxns.  With sesame, I get classic symptoms and within 20 minutes (and I had anaphylaxis in December and epid), but with shellfish it's typically delayed 2 hours.  And they always start off GI. And vast majority of the time they remain GI only, but once after eating beef cross contaminated with shrimp,  I had anaphylaxis with other body systems coming into play and I've epid.  I have had a number of "lesser" reactions (I assumed they were) that were a lot of gas and bloating at the two hour mark of eating something that I suspected was cross contaminated.  I just didn't know how far it'd go.  But I took Benedryl--which even without an allergic reaction can calm a nauseated tummy and diarrhea. 

I would recommend seeing an allergist as soon as possible.  You likely don't need to avoid all those foods, as others have mentioned, but you do need to know that you don't before eating any of them. 

[twinturbo]

Max, save yourself some time and money. Put down the internets.

Tighten your scope to this:

The Science of Anaphylaxis – An Allergic Storm
This is what happens in your body when you have an IgE-mediated reaction that leads to anaphylaxis.

American Academy of Allergy Asthma & Immunology Find an Allergist
Try to find one board certified in allergy who hopefully is competent with food allergies and anaphylaxis.

The problem with some of what you listed is that you could have eaten many of those items in a food product and never known because they do not need to appear in an ingredient list by law.

P.S. Dump that GI practicing outside of his or her area.

[lakeswimr]

What you describe sounds more like Celiac than food allergies to me.  Testing alone can't diagnose a food allergy and should not be used by itself to diagnose since it has a very high false positive rate.  I would not eliminate a food just based on test results. 

If they are allergens and you stop eating them you would see your symptoms resolve.  However, if one were a trouble food for you and you pull all of them you won't know which was the trouble food.

If you have Celiac then pulling those foods isn't going to help.  And pulling these foods can mean you are also eating a lot less gluten depending on what foods you were eating that had the list of foods in them.  Bloating = a very common symptom of Celiac.  People can test falsely neg to Celiac.  Did the GI test you for it?