Food Allergy Update: Can You Outgrow Food Allergies?

For as long as I can remember I’ve been the girl with allergies. As much as I didn’t let it define me, it was definitely a part of my identity.

So much so that I became a dietitian and now help others with allergies in my private practice and through the allergy-friendly recipes I share.

So what happens when you OUTGROW some of your allergies?! Utter disbelief, that’s what!

I cannot believe at 30 years old I outgrew SEVERAL of the allergies I’ve had since I was two years old.

Living With Food Allergies

Being allergic to tree nuts, peanuts, and sesame seeds left me resigned to feel like I would always be cautious around food. (Even more so in this age of grain free wellness trends with nut flour everywhere!)

I could never walk into a bakery to get the cookie. I would BYO meals to holiday dinners and never eat at big events. In fact, between ages 29 and 30 I had more allergy-related scares that sent me to the emergency room than in the rest of my life (and we discovered my allergies when I was 2 years old!). 

So how did I make this discovery? What prompted me to get re-tested? Let’s rewind…

A little over a year ago I took a bite of an omelet and definitely bit into something hard. I spit it out immediately and saw a walnut. (yes, a walnut in an omelet is not normal!) I obviously freaked out, had my EpiPen in hand, and downed several benadryl. Although I felt OK, I took a cab to the ER just in case. A few months prior to that I started feeling funny at dinner on our honeymoon in Hawaii and went to the ER because I was certain I was having a reaction.

All of a sudden, after living with food allergies for 28 years WITH NO SCARES, I was having these instances and reactions – what was going on?

Then I got pregnant. My immune system was compromised from pregnancy and I felt like I was having a lot more allergy-like symptoms (especially an itchy throat). I also started to wonder about the child I was carrying – Will he/she have allergies? How will I introduce peanuts and tree nuts when I myself am allergic? What will happen if he’s exposed to a common allergen with my husband or parents (early introduction is recommended at 4-6 months) and then spits up on me later?

When I interviewed our now pediatrician, she suggested meeting with an allergist at Mount Sinai to discuss my concerns ASAP because feeding my child would be here before I know it (and it is!!!).

Had I not been pregnant, I probably wouldn’t have met with an allergist. I had NO reason to think I was outgrowing my allergies – I actually thought I was developing new ones!

After waiting 6 weeks for an appointment, I was actually excited to visit with an allergist. Because of the few scares I had, I was EXTREMELY anxious about dining out at this point. I wanted clarity for my child and felt like I needed to be re-evaluated.

It had been YEARS since I got tested because I never expected to outgrow my allergies. I didn’t do allergy shots or any exposure therapy either. (Side note: when they started doing a lot of the exposure therapy studies here in NYC I was already too old and they wanted younger children!) Most people don’t outgrow allergies to nuts and peanuts… especially after well into adulthood. It’s much more common for kids to outgrow their allergies to milk, eggs, and soy.

Testing For Food Allergies

So at 9 months pregnant (literally, the week before my son was born), I waddled up to Mount Sinai and met with an allergist. I explained my history, hesitations, and current anxiety. She suggested we start with blood work to see my current allergic status. Although blood work isn’t a 100% diagnostic factor for allergies, she thought because I was pregnant it was a good starting point (versus a skin prick test or oral challenge). 

Allergy Blood Tests

Blood tests test for the presence of IgE antibodies against the proteins found in foods. My allergist explained that a value of 0.35 kU/L indicates an allergy. NONE of the foods we tested reached that 0.35 kU/L value. Not cashews, almonds, peanuts, sesame seeds, NONE OF IT. Just WOW. I was SHOCKED. 

Skin Prick Tests

The next step was to do an in-office skin-prick test. Skin prick tests also detect IgE antibodies in the presence of food proteins. I was SO nervous and anxious about getting the test done – what if it leads to anaphylaxis? What about my son? (He was safe with our nanny at home.) What if I can’t take care of him? My thoughts were swirling inside, I almost chickened out and just didn’t get the test done.

Luckily, my husband came with me to the doctor and supported any decision I made. After many rounds of reassurance from the doctor that she wouldn’t do this if she thought it would lead to anaphylaxis (and that she had never had a patient have an anaphylactic reaction as a result of a skin prick test — although it is possible), we did the test.

The doctor pricked my arm with the food proteins and we waited to see if I had a reaction. She also pricked my arm with saline and histamine as controls. The saline is to see any reaction from the act of getting pricked (I think). Histamine will lead to a localized reaction and create what’s called a “wheal” on your arm (the red blotch below is the histamine). It sort of looks like a bug bite. If you develop a reaction or wheal the same size or larger than the histamine, it means an allergy likely exists. Boy is that histamine itchy!

Now, a word of caution — both the allergy blood tests and skin prick tests are not 100% accurate. In fact, 50-60% of tests can lead to a false POSITIVE! A false negative is less likely. You can read more about why false positives are so common here.

The results

OK, so what happened… First my allergist tested for peanut, sesame, almond, brazil nut, and pecans (the dashes on the left side of my arm). Although I had less than 0.35 kU/L in my blood to all foods I was tested for, I had less than 0.10 kU/L for those foods. 

After 10-15 minutes, NOTHING showed up! Literally I felt nothing (except for a racing heart and a weeeee bit of nausea from anxiety).

Since I did so well with those tests, we then moved on to the nuts that I had slightly higher IgE levels in my bloodwork – cashews and pistachios (which are related, by the way). I DID have a reaction to those. My arm started feeling itchy within a minute or two and then a wheal started to form. The wheal grew to about the size of the histamine control (maybe a littttle bit bigger).

I was SO nervous that a bigger reaction was upon us (I was always told I was “most” allergic to cashews, whatever that means), but my doctor said that’s unlikely and that it was OK for me to take benadryl (so I did).

Yes, there are some nuts we didn’t test for, but I was done and felt pretty good about these results. No reaction to peanuts, sesame seeds, almonds, brazil nuts, pecans, and walnuts. Positive reaction to cashews and pistachios.

So what’s next?

Did I Outgrow Food Allergies?

All that we can say with certainty right now is what I wrote above. I reacted to two tree nuts (cashews and pistachios) and didn’t react to peanuts, sesame seeds, almonds, brazil nuts, walnuts, and pecans.

Does this mean I can go out and eat peanuts and almond butter? NO. 
Does this mean I can have a bite of pecan pie at Thanksgiving? NO.
Does this mean my husband will start eating the foods I’m allergic to? NO.
Will I still tell restaurants I’m allergic to the foods I tested negative for? LIKELY.

These results won’t change ANYTHING in my current life, except give me the slightest bit (and I mean slightest) of peace of mind.

The Next Steps…

The next step would be to do an oral challenge to the foods I tested negative for. I would eat a small portion of these foods in a controlled setting with my doctor present. **If I don’t have a reaction in the doctor’s office, only then could we say if my allergies to these foods truly went away.**

To be honest, I’m not ready for this. Allergies aren’t just physical. There’s a HUGE mental and emotional component as well. For 28 years of my life I was told I could die from eating tree nuts and peanuts. The thought of deliberately eating one is scary. Just visualizing the act of eating a peanut – one single peanut – now makes me feel like I would have a panic attack (the skin prick testing was hard enough).

I’m still keeping an allergy-friendly house, blog, private practice, and life.

However, as a responsible parent, we will be introducing our son to common allergens. My husband and/or parents will likely help with this. They’ll expose our son to tree nuts and peanuts OUTSIDE of our home. However, if I’m with him hours after he eats peanut butter (or any allergen) and he spits up on me, I feel like I can handle it.

I was SO nervous that I wouldn’t be able to introduce my son to my allergens because as his primary caregiver, it was unsafe for me. Now I feel more confident that I won’t go into anaphylaxis. I’m still nervous about cashews and pistachios, and I honestly don’t know how we’ll handle those foods, but this is a definite start.

In conclusion…

Outgrowing my allergies was never something I expected. The thought never crossed my mind. I still don’t believe it or fully trust it (and shouldn’t until an oral challenge, which I’m not yet ready to try). I still consider myself someone living with food allergies, and will take the necessary precautions to protect myself. BUT, I feel a bit more confident in feeding my son and exposing him to some common allergens.

FAQ

I got some really great questions on Instagram, so I wanted to answer them concisely here…

What allergies did you outgrow?

According to my blood test and skin prick test it’s unlikely that I’m allergic to peanuts, sesame seeds, almonds, pecans, walnuts, and brazil nuts. HOWEVER, this is not final because an oral challenge is the only definitive way of knowing, especially with my history of allergies.

Are you scared to reintroduce the foods you’re no longer allergic to?

HELLS YES. So I probably won’t do an oral challenge – at least I can’t see myself doing it any time soon.

How/why do you think you outgrew your allergies? Something you did?

NOPE. I think this change was pure luck. I was told it has nothing to do with avoidance for the past 28+ years. Sometimes it just happens, and I may be part of the small percentage of people who outgrow some allergies.

Are you ever going to introduce your baby to nuts? How so with you being allergic?

This was a driving factor for me to get tested! YES, it’s important for my son to be introduced, if nothing else to know if he’s allergic. I’ll likely have my husband take our son to our sibling’s apartment or my parents/his parents to test. I’ll probably stay away from them for the rest of the day and have my husband give him a thorough bath. It still scares me to be completely honest.

Have you done allergy shots?

Nope. I did NOTHING to prompt this. Total happenstance.

I’d love to hear from you – have you experienced anything similar? 
XO