Yeah, some of my allergens I have to lump and deal with. The others my general plan is to knock down the well-studied ones with established treatment namely the environmentals. Same for my younger one who is wheat, barley, rye, oats, cow milk, beef, dermatographic, systemic temperature change hives, severely sensitized to dust mites, suspected nuts, shellfish, soy, and overall produces a lot of histamine. The likelihood of him being able to tolerate high histamine foods is very low and skin testing is almost pointless because he reacts to control.
He was the single most significant reason my husband went to the allergy & atopy conference in Asia. The profile of allergic population there is different and treatment has gone a little differently, I think. There's a lot more attention paid to dermatology issues, which coincides with the limited amount of focused study on Asian American patient population here in the states, that our kids are very atopic and prone to eczema. If it's true that transcutaneous sensitization is increased by skin barrier breakdown then it changes our approach slightly to increase attention to treating the underlying environmental allergens earlier through SLIT (as proposed at the conference) and/or SCIT.
For myself I've given it one year. If my pollen-food hasn't resolved I'm pursuing pollen and other environmental immunotherapy. I've decided for my longer term self-care to beat down what I can. I also take Zyrtec daily to deal with the minor issues so I don't have to break my stride any time I have a slightly itchy tongue from a spice.