How accurate are food allergy tests?

For about a year or so now, I've been getting a burning in my mouth after eating nuts. It started with just raw nuts, and only certain brands seemed to cause it. Then, more recently, even roasted peanuts started to make my mouth burn. At Christmas, I ate a raw, just cracked, walnut. I immediately got a burning feeling, then I had some difficulty swallowing, and after just a short while, I was having minor difficulty breathing. I went to my doctor last week and he sent me for blood work, including a food allergy test. I just got the results. I am not allergic to nuts. I'm apparently allergic to shrimp. I like shrimp. I eat shrimp and don't notice any problems with it. So, how accurate can the test be? Why do I get a reaction to nuts, and not to shrimp? Should I stop eating shrimp now? I'm baffled. I expected either a nut allergy or no allergy and just something weird going on that coincides with eating nuts. This is so not what I expected.

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magalicious's picture

Postulant

o.O
I would avoid nuts regardless! Anyone can develop a new allergy at any time, and existing allergies can become worse (much worse) without warning. I might also recommend having an emergency Epi Pen on hand, just in case. (Unless you have bad reactions to steroids.)
I might also get a second opinion. Wink

blwinteler's picture

Supplicant

I do like nuts, particularly almonds and peanuts. So far, if they are roasted, they only cause that weird burning. But what about shrimp? I have 1/4 lb of shrimp in my fridge waiting to be in a salad. I haven't noticed any reactions, so can I still have it? I just looked online at the details of the test, and it is apparently a moderate (level 2?) allergy. Oh, it was an IgE test, if that means anything to anyone.

magalicious's picture

Postulant

I don't want to give you any advice that would lead to an allergic reaction - I already have all that Catholic guilt Wink - so think carefully about the shrimp. I'm more concerned about the nuts, as the reactions seem to be getting worse.
Also, all reactions are not classified as 'allergies' - for example, I have violent reactions to all opium-based medications (morphine, vicodine, codine, hydrocodone, etc) where my body purges for days if I have even one dose. I am completely incapacitated, experience respiratory distress, become extremely dehydrated, and am in terrible pain - but it is not classified as an 'allergic reaction'. It should be, in my opinion, but it is not. So, you could be having a worsening reaction without it being, technically, an allergy.
Stoopid semantics.

Voyeur's picture

Hey, I'm guessing you like living and the trouble swallowing and breathing is upsetting to you and you're seeking advice because you're worried. Unfortunately, there are lots of people on the web who give very bad medical advise. Some are malicious, others are misinformed, and others are ignorant but willing to venture an opinion anyhow. For many things, such as what color should I dye my hair, bad advice is pretty harmless. For things like nut allergies, bad advice can kill you. Since you probably wold like to eat your shrimp and nuts, it's probably quite tempting to believe anyone who says "yeah sure don't worry about it"... because that's probably what you'd like to hear. My advice is to make your doctor go over the results with you and if s/he cannot explain your symptoms (or maybe even if s/he can) you should insist on a referral to an allergy specialist. By "insist" I mean ask nicely and if s/he says no you keep the conversation going until they say yes.

magalicious's picture
attercob's picture

Petitioner

Look, I'm registered now and everything. Go me.

I've been posting previously using just "voyeur"... but I decided that if I was going to post stuff more often I might as well have a persistent identity.

MeiLin's picture

Most High

Thanks for registering. It makes knowing people so much easier.

The Vixen's picture

Devotee

Psht, I kept getting my Celiac panels back as negative, yet if I eat anything with gluten in it I get massive debilitating stomach cramps and a rash.

Allergy tests often come back negative, but you can still DIE from anaphylactic shock. Avoid all raw nuts, and get yourself an Epi Pen. Avoid roasted nuts, because it may just be a matter of time.

You may want to start avoiding shrimp, but if it doesn't bother you, you're fine, for the time being.

Andrea's picture

Supplicant

You might want to ask your doctor whether an Epi pen would help with a non-IgE, anaphylactic-shock-type reaction to nuts. I think epinephrine is generally the default instant cure for anaphylaxis, but there's a chance your doctor will have something better. (I'm not sure if Epi pens are specialized to reverse IgE reactions or if it just works to open your airways. Epinephrine = Adrenaline, so I'd imagine it's good at suppressing a lot of things.)

Oh, and please let me know if your doctor has any suggestions besides Epi pens! My SO has really bad reactions to a really common preservative that just so happens to be used to preserve Epi pens, so we don't really have anything to use on him when he has reactions Sad We've asked a few doctors but none of them seem to have any ideas.

Now, about the shrimp: A coworker of mine developed a shrimp allergy a while back, and her allergist told her that it could be a sign of a thyroid issue. She got on some sort of thyroid medication and the shrimp allergy went away, so you might want to ask your doctor about that.

NorthwoodsMan's picture

Embodiment

Many allergies are cumulative. The more you are exposed to the allergen, the larger your reaction is. This happens with pets, it is particually a problem with nurses and latex.

shy_gryphon's picture

Mine was rather inaccurate but for a lot of people find them to be accurate. I am allergic to all milk and molds, they didnt show up on the alergy tests. you could be allergic to iodine which is in shell fish and not react to the shell fish. I have trouble with nuts too and they didnt show up on my allergy screening either.

NorthwoodsMan's picture

Embodiment

Tropical fruits have the same protens as latex and cause a similar reaction as well.

Davik's picture

Embodiment

Something else to keep in mind, mango, as well as (I believe) cashew are related to plants like poison ivy. A friend of mine learned the hard way that if you're having an outbreak of poison ivy, that eating something with mango in it will result in you developing sores on your lips. This, of course, just makes me even more happy that I'm apparently utterly immune to poison ivy, oak, and sumac Blum 3

MeiLin's picture

Most High

The toxins are in the skin. It doesn't always affect me; usually if I wash my hands after peeling one, all is hunky dory.

blwinteler's picture

Supplicant

is that I have a follow up on the 25th for other issues and want to know what to bring up on this one. My biggest problem right now is that my doctor is overbooked. At my last appointment, he seemed incredibly distracted and I felt like I did all the work. Unfortunately, that is what happens on an HMO, which is what we can afford right now. So, being as prepared as possible is very important.
Anyway, thank you all for your input. I will ask for a referral to an allergist to get more details.

attercob's picture

Petitioner

When I was in grad school we had an HMO. It sucked but there were some things that helped. The main thing was to change doctors a few times (avoid the PAs) until you find one you like. Then make a point of seeing him/her several times and always asking for him/her. The idea is to form a relationship so that you're not just someone that s/he needs to get in-n-out with in 5 minutes or less. Good luck.

Pedes's picture

Postulant

I know there is something called cross allergy; you might be allergic to something inhalable. At the times it is often that food allergy doesn't come out in the test (my doctor said it). And if I remember correctly, nuts are there quite often.
Tests won't tell you everything. Also, there are different types of allergic reactions. I've had at least a few:
To the ferret: rash and acne-like things all over my body.
To the cat: I had to live with a cat (2 actually) for 3 weeks. I KNEW I'm allergic, so I was prepared with medications and I've "only" had swollen face and overdried throat at night (to the point of small bleedings and waking at night from the pain). If I didn't have the medications I'd probably move out halfway the first night.
to preservatives (?) in canned fruit (I was sure it was pineapple at first but I can eat fresh one) and some artificial sweeteners (like in "light" soda) and hazel: I feel weak, sick all over and dizzy. (my mom has the same with dust).
My friend, similarly to you has allergy to nuts. Not to all kinds, though, and she can e.g. eat almonds as long as they're without the brownish skin (so she seems to be allergic to the skin).
I also have a strange reaction to alcohol - not an allergy, more like instant hangoverish-thing but as I was teetotal for long and don't even like the taste of alcohol it's just another reason for me not to start drinking. 8)

On the other hand I'm supposed to be allergic to dust (but not strongly) but I somehow can't see any reaction to it (OK, if you spray it in my face I'll sneeze like everybody else :D). So uhm, don't put too much faith in the test. I'd be careful with shrimps and observe myself closely when eating them, but no panic I guess.

faile486's picture

Petitioner

magalicious - You said that's not an allergic reaction, so what does a doctor classify it as? Just curious.

As someone already said, get an appointment with an allergist. If you know anyone with allergies you might want to ask who they see.

kawaiikune's picture

Embodiment

Allergists are great! Are shrimp allergies related to nut allergies, or have you had problems with shrimp before?

blwinteler's picture

Supplicant

I have never had problems with shrimp. In fact, I realized last night that I had eaten shrimp just the night before the test. It was actually the only thing on the test that I had eaten in the past 24 or so hours. Could that have affected it in any way?

magalicious's picture

Postulant

Basically, it's toxic to me. I am chemically incompatible with opiates. From what I understand, it doesn't set off my immune system - which is the basic definition of an allergy - it's just potentially lethal. So, something can be toxic to you, but you may not be allergic to it.
Unfortunately for me, and others in my family who have this particular 'incompatibility', doctors Do Not Take This Seriously. I can't even tell you how many times a doctor has looked at my chart and tried to give me an opiate, and then stared at me like I was blue when I refused. One time a doctor injected morphine into my IV while I was asleep in the hospital, after I told everyone within a hundred yards that I couldn't have it. Of course, when I woke up violently ill several minutes later and continued to be so through the night and the next morning, it was one of the nurses that got to clean up after me. Not him. He didn't care enough to even check on me, never mind look at my chart.
My ten year old niece recently went to the hospital to have her tonsils out. My brother, her father, has the same incompatibility, and told the nurses, the surgeon, everyone he could get ahold of, not to give her opiates - and he is Big and Scary and Bald. Yet, what does the doctor give her as soon as Big Brother is out of the room?
Morphine.
She was so sick she lost ten pounds in three days, one fifth of her body weight.
When her mother called the doctor to give him a Piece, he offered to prescribe her morphine for the pain.
He then accused my sister in law of being 'irrational' when she got even more upset.
He is so lucky neither of us was anywhere near him, because I think I might have broken his nose if we had been face to face.

MeiLin's picture

Most High

Remember my death experience? Brought on by a sensitivity to beta blockers that I begged my doctors to take seriously. It took dying, but they believe me now. (I was given beta blockers in the emergency room and during an ICU stay after a cardiac spasm--two years after I'd documented the problem with beta blockers. But because "no one" has troubles with beta blockers, they didn't believe me. Fucktards. I could so own that hospital.)

magalicious's picture

Postulant

when Doctors refuse to listen to patients - either because of ego, indifference, or idiocy. It makes me so very angry. And unbearably righteous. Wink
If there are any MDs (practicing or future) reading this, take one thing away:
Listen to your patient before all things.

Katie's picture

Embodiment

I'd kill 'im. Doctors are supposed to FIX people, and to just ignore something like that? When you've been told repeatedly not to and WHY not to? That's damn near evil. I'd at least sue him for malpractice. Grrrr.

"I'm the doctor, I know best!"

GRRRRR!

Willow's picture

Devotee

Allopathic medicine is based on averages. Doctors don't believe you if you vary from the average naturally. 100 degrees is a serious fever for me since my temp is around 97 usually, but they don't buy it. I am very insensitive to opiates myself, and my oral surgeon had difficulty believing I could feel anything with the dose he gave me. This leads to doctors believing I am a drug addict, since they don't believe in varying tolerances to opiates as your family has noticed in the opposite direction.

The Vixen's picture

Devotee

All of this is just shocking to me! The worst situation I had to deal with is now having to argue with a clinic that I shouldn't have to pay a $300 charge for a celiac panel (test) that I was told to take after I had already been on a gluten free diet for 3 mo (my aunt, who also suffers from Celiac's, told me that you CANNOT test positive for a gluten intolerance if you have NO gluten in your system).

But if my health was seriously at risk because of that, I would get some compensation, hell if I had to sue, I would try, cause that's RIDICULOUS, irresponsible, dangerous and just ridiculous. Hell I know physicians that would get red in the face to hear that stuff. My best friend tells me how her mom who's an RN gets murderous from MD's pulling that shit.

magalicious's picture

Postulant

was an angel, and God bless her, I know it was a bad night for her too.

Andrea's picture

Supplicant

"One time a doctor injected morphine into my IV while I was asleep in the hospital, after I told everyone within a hundred yards that I couldn't have it."

...My god. And doctors wonder why their patients don't trust them. *sigh* It's like you literally need to have someone awake and in the room with you at all times just to be your guard.

MeiLin's picture

Most High

After my death experience, Sir made sure someone was with me 24 hours a day. He has it all planned out in case, Venna forbid, it ever happens again. You can't leave anyone alone any more. It's like the third world. Next you'll have to bring your own blankets and sheets.

Davik's picture

Embodiment

Thankfully I've never had a doctor do anything that bad/life threatening, but in the course of a couple of months I had a doctor unscrew a traction pin from my leg before the morphine kicked in (ouch), had another doctor not realize that the saws they use to remove casts get FUCKING HOT during the course of cutting a half body cast off (only pleasure I got out of this was when I told him to touch it and it sizzled when his finger hit it), and had a doctor apply silver nitrate to a couple square inches of open wound (OMG OUCH). Note for the latter, if a doctor every approaches you with silver nitrate, grab him/her by the most delicate piece of anatomy you can find and start SQUEEZING.

TheFerret's picture

Devotee

aren't you glad this ISN'T the 3rd world?

on allergies first - as far as I know nuts and shellfish allergies aren't necessarily related, although there are a lot of people that seem surprised daughter #1 cannot have peanuts, but eats shrimp like it's chicken..
Your reaction certainly sounds like anaphalactic shock (or however that's spelled) and at the level of your last reaction - GET AN EPI PEN!! (prescription only, and very short shelf life, & expensive. have fun.) However, actually using the EpiPen does mean you then get to immediately call the ambulance. They don't stop the reaction - they just delay it enough you might not die right then n there.
I would consider allergy tests accurate, but I do recommend actually talking to a specialist.

On bad doctors - my grandma will tell you about the doc that wanted to give Grandpa a morphine shot when he was in-hospital w/ his 3rd heart attack. She wouldn't let him, and left the room to go get somebody else, I guess. (I was a little kid) While she was out, he put the shot in the IV anyway, says 'it won't be long now" and left. She got back right after he took his last breath. She still feels a lot of hate for that doc.

On weird reactions - my Grandma can NOT have a blood transfusion that is not her own blood. It's not a +/- or wrong blood type thing. There's a missing - i just blanked on what. protein? no - in her immune system. It's one of the ANTIBODIES! That's it! that stays up around your nose and keeps colds and things from getting in your respiratory system. She does not have that antibody at all. So, getting blood from someone who does will send her into shock.
Scared the SHIT out of me when I walked in about 2 min into a transfusion, and the reaction started. Her doc honestly forgot what happens when she gets blood (because it'd been 30+ years since her last transfusion).

blwinteler's picture

Supplicant

I work for a pharmaceutical company Smile
While I may have poor healthcare, I have awesome prescription coverage. An epipen prescription for whatever the doctor determines is a 3 month supply will only cost $30 by mail. Or, I can get a 30 day supply at retail for $25. So, it is definitely an option for me. Too bad there is no generic. I get those for free.
I certainly have a lot to talk to my doctor about. Hopefully I will get the time. At the least, I will get a referral to an allergist. Only problem is how much time I'm taking off work for appointments. I only have so much time I can take each year. Don't want to use it all this early in the year. But I'll get it figured out.
Thank you all again. I knew asking here was a good way to get information for my follow up.

TheFerret's picture

Devotee

sorry - i was getting long-winded, and this was the important part.

And on personal reactions to meds - this is something I read about a year ago or more, and can NOT wait to see on the market! A lot of medicine dosages are based on the "average", we understand this. Your personal reaction to a dosage or side effects to a medicine depend highly on the way you metabolize it. Recently, researchers actually figured how to look at your DNA and tell you how you will metabolize certain meds. HOW COOL IS THAT?!??!?!??!

They're looking at basically getting this down to something the size of a credit card. You give it a teensy sample of blood, and a chip in the card runs the blood, and tells you and your doc how you will metabolize meds. Then, you can always carry this with you, like a MedicAlert bracelet.

And why is this so important? Gee, I think part of the thread just told us why.
Metabolize too slowly, get large build-ups in your system, have nasty side effects. Therefore, you need a smaller than average dose. Metabolize fast, no icky side effects, and you can have larger doses to knock out nasty illnesses, or take care of continuing problems. I can't wait, cause Mr Ferret does metabolize things very very very slowly - and if we have a future need for strong or rare or whatever meds for him for serious health issues, I really want to know what is safe for him.

Requiem's picture

Petitioner

Allergy symptoms are all over the place, and you may not be aware of the symptoms, you really need to find out what problem shrimp causes before you can know if its safe to eat it, and how often its safe. Class one is once a week according to my doctor, dependent on symptoms (my shrimp allergy is class one, but shrimp also makes my throat swell, so the risk is too high).

Nye's picture

Supplicant

Allergies to shellfish, nuts, bee stings, etc. are not related, though they are all common causes of an anaphylactic reaction. Not for the same reasons, though.

Definitely stop eating nuts, since you know those are the source of your symptoms, even if you don't know why. Your symptoms are progressing noticeably, and seem like they're progressing toward that anaphylactic reaction. Stop testing it now because it can get much worse very quickly, and since nuts are so common you're bound to have accidental exposures down the road. It'd be nice to have some more "mild" reactions left before you get to the "gods, I'm dying" stage of reaction.

Ask for a referral to an allergist. They can test different kinds of nuts and possibly even common things in nuts. You may not find out what it is that you are specifically reacting to or get a sold result. But given your experience, you should be able to get an Epi-pen anyway. They don't react to specifically block allergens, they just force your body to work, ie. breathe, have a pulse. So they are effective on a broader range of problems than just allergies.

Start noting if you get tingly or tickling lips or mouth after eating other things... or the burning you describe. The more things you link together, the better you chances of common the common cause.

It took me forever to figure out I'm intolerant to iron, but it's not an allergy. I went through a ton of allergy testing when I was younger, and I'm allergic to a lot of things in a lot of different ways with different reactions.

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