Well Recognized Allergens
Allergy v.s. Intolerance
Intolerance is an unpleasant reaction to a substance that can produce similar symptoms of an allergy but does not involve an immune mechanism. For example, milk lactose intolerance can cause extreme bloating and diarrhea can be very uncomfortable but does not progress to anaphylaxis like an allergy to milk protein can. Smoke, perfumes, and irritants which can trigger severe asthma attacks are also intolerances as opposed to being mediated by an allergic mechanism.
Food allergies, inhalant allergies, and insect venom allergies can be diagnosed by skin testing. Additionally, a blood test that detects the specific IgE allergy antibody may be useful. The skin tests are felt to be more sensitive and the results are available in the office within 15-30 minutes. The only drug which has a standardized skin test available is penicillin. Contact allergens are determined by patch testing which requires allergens to be taped on the back and then read at 48 hours and again at 72 hours. Patch testing is available for multiple substances and can be customized according to the exposure history.
The first line of therapy for allergies is an avoidance of your allergen triggers. We can make recommendations regarding environmental controls. However, often medications are also required. Allergy and asthma medications can be taken prior to allergen exposure, seasonally, or on a daily basis. In addition to environmental control measures, medications, allergy immunotherapy (allergy shots) can be very effective to reduce symptoms and to reduce medication use. Food allergies are treated with avoidance, patient education, a Food Allergy Action Plan, which the physician will write up for you and availability of epinephrine.