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Caitlin Whyte (Host): Welcome to Hally HealthCast, the wellness podcast from Hally Health, your partner in helping you live your healthiest life. Every episode on our podcast addresses a new topic, important to your health and wellbeing, bringing in expert doctors, therapists, advanced practice providers and specialists who offer advice and answer your most pressing questions.

Today's episode is all about food allergies. May is National Asthma and Allergies Awareness Month. So, it's the perfect time to learn more about this important topic. Here with us is Amy Earley-Jessup. She is an APRN or Advanced Practice Registered Nurse at Carle Champagne on Curtis, part of the Carle Health System of central Illinois.

Most important to today's episode, she's also the Coordinator of the Carle Food Allergy Education Program. Welcome Ms. Earley-Jessup and thank you so much for being with us today and sharing your knowledge. Now let's begin, perhaps this is a simple question, but an important one. What exactly is a food allergy? And then what's the difference between a food allergy and food intolerance?

Amy Earley-Jessup, APRN (Guest): Food allergy is a serious and potentially life-threatening medical condition. It affects around 32 million Americans. One in 13 school-aged children has a food allergy, statistically. So, that's about two in every US classroom. Every three minutes, a food allergy reaction sends someone to the emergency room.

So, food allergy is an abnormal response from our immune system where our immune system basically gets confused and decides that a certain food protein, in this case, like, we'll say like peanut is an enemy to our body. So, if you're allergic to peanut, when your immune system sees that peanut is there, it releases an attack against its perceived enemy, the peanut, but instead of protecting us and hurting the peanut, it actually kind of self-destructs and we start having allergic symptoms that can be harmful to us.

And those symptoms can be mild to life-threatening. So, food allergies are not the same as food intolerances and food allergy symptoms can overlap with intolerance symptoms, which can be confusing. Unlike food intolerances, food allergies are IgE mediated, which means that your immune system makes an antibody called immunoglobulin E. We call it IgE. And when it detects the food that it doesn't like, it fights the enemy and releases the histamine and other chemicals. What happens with food intolerance, is more of a digestion problem. So, when I think of food allergy versus food intolerance, think immune system problem versus a digestion problems. Food intolerances don't involve the immune system and more the digestive system.

And they can cause great discomfort. They're not life-threatening. So, food allergy on the other hand can be fatal. So, I think the best way to separate the two in your mind is an immune system problem versus a digestion problem.

Host: Great explanation. Thank you. Another question people might be wondering, what are the most common food allergies?

Amy: Sure. So, there are over 300 foods that have been found to cause true food allergy, but over 90% of the time, a real food allergy is from one of the top nine allergens. Those are cows milk, hen's eggs, wheat, soy, peanut, treenut and there are several treenuts, fish with fins, fish with shells, and then a recently added ninth common allergen is sesame.

All food allergies have one thing in common and they're all potentially life-threatening. So, of course we want to take all of those seriously.

Host: Thank you. And how can someone tell if they have a food allergy? What are some common symptoms and when should someone maybe get tested to see if they have one?

Amy: Common symptoms of food allergy would be allergic symptoms that happen after you eat a certain food. And with real food allergy, it's typically going to happen within two hours. So, we certainly would encourage everyone with any concerns related to food allergy to discuss it with their healthcare provider.

Symptoms that you would look for would be itching or swelling in the mouth or coughing, nausea, vomiting, diarrhea, abdominal pain, passing out. So, there's a wide range of symptoms that can happen. But the most suspicious thing would be if someone had a repeatable issue with a food within two hours.

Host: Such helpful information. Now I know you mentioned that allergies can be fatal. So, tell us more about how harmful food allergies can be and how we should be taking them seriously.

Amy: Food allergy reactions can vary and they are very unpredictable from mild to severe. So, for example, one person may start with a mild reaction symptoms and progress to severe symptoms, or in another case, you may have where someone has mild symptoms for one reaction, and then the next reaction is severe or vice versa.

Mild food allergy reactions may only involve like a few hives or mild upset stomach. But some and many, up to 20% of food allergy reactions, progress to more severe anaphylaxis, which is a severe allergic reaction where you can develop low blood pressure and loss of consciousness and things like that.

Host: So, so important to know. Thank you. And since I understand there's not yet a cure for food allergies, what are the best ways to avoid allergic reactions? For example, should people completely avoid foods with even a small trace of what their allergic to? And other than not eating the foods, how else can people stay safe?

Amy: Good question, also. It's a really common misconception that there's mild food allergies and severe food allergies. And that's a dangerous misconception because even people with real food allergies often don't realize that their next reaction could be severe. When someone has a food allergy at all, it's really important that the food protein is avoided completely. Our immune systems are super smart. They also have a very good memory and they're very easily offendable. So, with a true food allergy, if the food protein is introduced, even in trace amounts, our body will see it and it will cause a reaction that's repeatable every time. So, it's important to read the labels on any food to make sure that the allergen isn't present, including labels that say like may contain or processed in a plant with, because with those, there's about a 10% chance that the food is present.

And if that food protein is present, let's say with peanut, the person that's allergic to peanut, their immune system will find it, even if you can't visibly see peanut. So, it's very important to avoid it completely.

Host: Now in terms of treatment, how are food allergies treated and cared for, for example, what if you have a reaction because you accidentally ate something or you didn't know you had an allergy, what happens then?

Amy: Right. So, there is unfortunately, no cure for food allergies. There are some great immunotherapies that are happening, but across the board, not everyone that has a food allergy can just go get, you know, one medical treatment and be not allergic anymore. So, it's very important to be prepared for allergic reactions. That includes people that don't even realize they have the allergy. One thing that people with food allergies need to do is carry their epinephrine with them all the time in their two-pak, because research has shown over and over and over again, that epinephrine is the only thing that can stop anaphylaxis in its tracks or more likely slow it down to give you some time to get to the hospital. Treatment for an allergic reaction, any severe reaction, epinephrine is the first-line treatment. And there's nothing else, including Benadryl or inhalers that are going to help and getting the person to the hospital where they may need steroids. They may need other supportive care. So, right now the only treatment is avoidance and treating reactions when they happen.

Anti-histamines like Benadryl or Zyrtec can be used for mild reactions. But again, you have to be very careful because anti-histamines will not ever decrease the severity of a reaction or keep it from progressing to getting worse. So, epinephrine is a food allergic person's best friend, and we always need to keep it close.

Host: I'd like to circle back to staying prepared for allergic reactions. You know, especially when we're out in the world, restaurants, work, school, what do you recommend?

Amy: Everyone with a food allergy it's recommended that they have a plan of action that they can follow when a reaction starts to happen. In the state of Illinois, we have a great form, which is a food allergy emergency action plan. It is a medical legal document that's signed by your provider, that orders the epinephrine. And we recommend that everyone with a food allergy carry this form with them, because it tells you what to do for what symptom. It's very helpful in an emergency where you can look at this form and go, okay, this form says that if you have shortness of breath, you should get the epi and then call 911, and it gives you instructions step-by-step on what to do. This form is also mandated in the state of Illinois by the State Board of Education, that this form is in place for every student in schools with food allergies. And there is training that's required in schools for food allergy management, which is wonderful. So, it's great to have that form with you at all times if you have a food allergy to help walk you through what to do. The training at the schools is great and there's training for all sorts of areas of life, whether it's how to be a pal with a friend with food allergy, how to help save a life. Food allergy.org has a huge amount of resources and videos and training modules for people in every walk of life on how to be food allergy aware and prepared.

Host: Just some great advice. Thank you. Okay, a couple of final questions to wrap up our podcast. First, if a listener or their child or their loved one has a food allergy or thinks they have one, what else should they know? Or what else should they be doing?

Amy: Food allergy is a scary thing to have. If you think about it, it is scary to know that something that you eat even accidentally could end your life within the next few hours. It affects every second of every day for people who deal with food allergies. I think that it's important to empower yourself with knowledge and with good research and with tips and tricks to navigate this life. And the more knowledge we have, I think the less fear we have.

So, I would recommend that people go to good sources like foodallergy.org, and other good research entities to get their information from and empower themselves with that knowledge.

Host: And our last question, what resources can you point our listeners to? Where can they find out more about food allergies?

Amy: One resource that I've mentioned before is foodallergy.org. Another good one is the Academy of Allergy Asthma and Immunology website, which it's quad a i, so it's aaaai.org. That is the researching body over allergy, anaphylaxis, immunology. So, it's where our allergy providers go to look for resources. So, that's another good one. Just make sure that you're sticking with some of the bigger names, bigger research when you're looking into resources for food allergy. Another one is snacksafely.com is a great resource that keeps up to date on foods that are in the stores right now that are free of certain foods. So, if you need ideas on what to bring to a party or a school party or something, and you want to avoid certain allergens snacksafely.com is a great resource.

Host: Well, these are some wonderful resources and information. Ms. Earley-Jessup, you've simply been a pleasure to have on our podcast. Thank you so much for joining us, and for all that you do everyday at Carle for so many people and their families. That concludes today's Hally HealthCast. Tune in next time as we tackle yet another topic important for your health and wellbeing.

And remember Hally Health is your partner in helping you live your healthiest life. Visit hally.com. That's H-A-L-L-Y.com for resources, information, tips and much more. Let us help keep you and your family healthy and well. Thanks for listening. We hope you tune in again.