Diagnosing and Treating Food Allergies - doctor's office

It’s no secret that food allergies have recently gained heightened awareness. From national conversations about peanut-free schools to the rise of upscale restaurants that cater to people who are gluten-free, the ways in which society accommodates people with food allergies is ever-evolving.

But what about the process of being diagnosed and treated with food allergies?

We researched the diagnoses and treatments for food allergies, specifically for Celiac disease and peanut allergies, so that we can best inform the Nima community on current practices. If you have any questions or think you might have Celiac disease or a peanut allergy, contact a medical professional or allergist immediately.

Celiac Disease Diagnosis

Celiac disease symptoms can include abdominal pain, bloating, diarrhea, constipation, headaches, bone or joint pain, chronic fatigue, depression, or ADHD-like behavior. If you notice yourself experiencing these symptoms, schedule an appointment with your primary care provider as soon as possible.

According to The Celiac Disease Foundation there are several blood tests that doctors use to screen for Celiac disease antibodies, but the most commonly one used is called a tTG-IgA test. The only caveat to this test is that it only shows accurate results if you are consuming gluten. If you have already switched to a gluten-free diet, it may be more difficult to diagnose. If the results suggest Celiac disease, your physician will then recommend a biopsy of your small intestine to see if there is any damage consistent with Celiac disease. If there’s intestinal damage in addition to symptoms improving with a gluten-free diet, then a diagnosis is confirmed.

Celiac Disease and Genetic Testing

If someone in your family has Celiac disease, does this mean you can have it too? It depends.

People with Celiac disease carry one or both of the HLA DQ2 and DQ8 genes, but so do up to 40% of all people, which means carrying HLA DQ2 and/or DQ8 is not a diagnosis of Celiac disease nor does it mean you will develop it. However, if you are gluten-free or are a first-degree family member of someone with Celiac disease (such as a parent, sibling, or child), genetic testing can help to rule out if you will ever develop Celiac disease.

Celiac Disease Treatment

As of right now, the only treatment for Celiac disease is adhering to a strict and lifelong gluten-free diet. This means avoiding foods made with wheat, rye, and barley, including beverages and condiments like beer and soy sauce. Even eating trace amounts of gluten (usually as a result of cross-contamination), such as crumbs from a cutting board, can trigger intestinal damage to people with Celiac disease. It can sometimes seem like gluten is in everything, so reading nutritional labels and seeking out gluten alternatives if you’re diagnosed with Celiac disease are extremely important. Getting in the habit of using your Nima Gluten Sensor, especially when eating out, can also give you more information about the gluten content in your food and prevent you from experiencing Celiac disease symptoms.

Non-celiac Gluten Sensitivity Diagnosis

If you’ve been to the doctor and have tested negative for Celiac disease but chronically deal with Celiac disease symptoms, you might be non-celiac gluten sensitive. This is diagnosed by a process of exclusion, first getting tested for wheat allergy and Celiac disease. If both tests are negative, physicians often recommend elimination diets to figure out what your body can and cannot safely process. Elimination diets typically range from two to four weeks and involve cutting gluten out of your diet to see if symptoms improve. For the best diagnosis results, Beyond Celiac suggests working with an experienced physician to oversee this whole process.

Fun fact: Nima’s CEO, Shireen, discovered she has a non-celiac gluten sensitivity through an elimination diet. Her gluten sensitivity (and trouble with avoiding gluten) is actually what led her to founding Nima.

Peanut Allergy Diagnosis

According to the American College of Allergy, Asthma & Immunology, diagnosing a peanut allergy can be more complicated than diagnosing other food allergies. This is because peanut allergy symptoms vary from person to person and a single individual may experience different symptoms during every reaction. In addition, allergen skin tests and blood tests don’t always provide accurate results.

Keeping a food journal (including any reactions) once you suspect you have peanut allergy and making an appointment to see an allergist are the first steps to diagnosis. Once an allergist learns about your health and family medical history, you’ll likely be recommended to begin an elimination diet to see whether your symptoms improve without peanuts in your diet. If a food elimination diet doesn’t provide conclusive results, your allergist may recommend an oral food challenge, where you’ll consume small amounts of peanut or peanut-based products in increasing doses in an allergist’s office or a food challenge center. While this may sound potentially scary, medication and equipment is on hand during this procedure in case you have a severe reaction, such as anaphylactic shock.

Peanut Allergy Treatment

The Mayo Clinic states that peanut allergy treatment “involves taking steps to avoid the foods that cause your reaction and knowing how to spot and respond to a severe reaction.” This means carrying and knowing how to use an epinephrine autoinjector (such as an EpiPen) in case of a severe allergic reaction as well as sticking to a strict peanut-free diet. Whether you’re cooking at home or eating out, being extra vigilant about reading labels and asking restaurant staff about ingredients and preparation are important ways to maintain food safety. Packaged foods that contain peanuts in the U.S. are required by law to clearly include the presence of peanuts, but even foods that don’t contain peanuts in the ingredient list can be contaminated by peanuts in the manufacturing process. Some companies do include warnings on their packaging that state when a product has been made in a facility that also produces peanuts, but this type of labeling is not required by law.

Peanut Allergy Drug

We should also add that the thinking around peanut allergy treatment has been changing in recent years. Some experts believe exposing children or those at risk for developing peanut allergy to increasing doses of peanut-containing food can help to overcome the allergy. Although researchers studying the effects of desensitization as a potential treatment have found recent success in building peanut tolerance in children, this treatment is not yet approved by the FDA.

These are the current diagnosis and treatment processes for Celiac disease and peanut allergy right now; however, we know that everyone’s food allergy journey is unique. Information is every changing, so make sure to engage a physician for any suspected issues.

Do you have any recent experiences with food allergy diagnosis and treatment? How has Nima impacted your treatment? We’d love to hear from you!