Nut questions

[poppie]

I was wondering if someone could help me with some nut questions.....   

1.  If you have a problem with a couple of different nuts from the tree nut family, are you more susceptible to have problems with other tree nuts?  For example, I know I have a problem with Almonds, and I think walnuts, and so is it MORE likely that I might have problems with other nuts from the tree nut family? and should I be testing these other nuts to make sure I am okay with them? For example  is it quite normal to find that you can eat hazelnuts, and cashews, but not Almonds and Walnuts?

2.   If you have a "sensitivity" to Peanuts (legumes) is it a good idea to maybe have a little bit of peanut butter once a week in the hope of desensitising your body...I had a rash on my forehead recently after eating a little peanut butter, and my allergist suggested that it was a good idea to do this..what are your views? because I am not convinced this is good advice.

3.  Recently after eating walnuts I realised that I could not have them again, I felt unwell but more alarming, my throat felt odd, and only after looking online did I realise this is often symptomatic of allergy problems.  I am thinking of buying an Epi-Pen, mainly for peace of mind.

4.  I live in Costa Rica and Epi Pens arent allowed here, and so I would have to order them online, which company would you recommend if I can even get a company to send them here, as I tried an Australian company and they arent allowed to ship them here.

Thanks a lot

3.   

[rebekahc]

1.  Yes, it is possible to be allergic to some tree nuts but not others.  However, Almond and Walnut are in two completely different 'families' so I would think since you're allergic to both, it's a good possibility you're allergic to others.  Also, even if you're not allergic to a particular tree nut, it could be difficult to find that nut that's not contaminated with nuts you are allergic to since they're often all processed together.

2.  As far as I know, with peanuts either you're allergic or you're not.  I wouldn't eat any amount that gives you a reaction.  (And un-monitored at-home desensitization is a very dangerous game.)  That being said, it's possible your peanut reaction was manufacturer contamination with one of the tree nuts you're allergic to - I think it would be worth checking with the manufacturer to see if tree nut contamination was a possibility with the peanut butter you reacted to.

3.  You will need a prescription for an epi pen or equivalent in order to buy one.  You'll also need to know when to use it and be aware that it's not a 'get out of jail free' type of thing.  You'll still need to be monitored in the hospital for a few hours after using it.

4.  If EpiPens are not allowed in Costa Rica, I'm not sure any company would be willing or able to ship some to you.  You'll need to find out what administration device they prescribe for epinephrine there and get that.  Or, I guess you could travel somewhere you can get a supply of EpiPens to return with.

I found this, so it seems there is something available in Costa Rica, just not EpiPen.

Severe Allergies: If you have severe allergies to anything, such as nuts, bee stings or shellfish for example, it's very important that you carry your own Epinephrine auto-injector (EpiPen). Please be aware that EpiPens are not available in Costa Rica. If you forget it, don't panic, we can put you in touch with a doctor that will recommend alternatives; it's just that the alternatives are not as convenient as the EpiPen. Remember that your EpiPen won't do much good from the bottom of your suitcase while you are out exploring. Be sure to put it in your pocket before excursions, and also to let your guide know where you're carrying it.

[CMdeux]

It sounds as though an AnaKit (or equivalent-- basically a syringe and vial) is the only real alternative in your location-- that is a real bummer, as it requires a more steps and a good deal of practice-- but going without epinephrine is probably not a good idea, either!

[spacecanada]

First, welcome to the forum.  Food allergies aren't fun but you have some good questions and this community is known to be very supportive and helpful.

1. You can be allergic to some tree nuts but not to others.  However, many types of nuts are often processed in the same facility, which could spread traces of a variety of nuts onto ones that may otherwise be safe. Those traces of nuts you are allergic to could make you ill.  As for testing, if you suspect you are allergic to one type of nut, I highly recommend avoiding other types of nuts until you can have allergy testing done by a certified allergist.  Testing done at home (by ingestion) can be extremely dangerous.

2. Right now, the only way to avoid allergic reactions to food is to avoid that food and anything that may contain traces of that food.  There are some studies in the trial phase going on right now to desensitize people to peanut allergies.  Those studies include very precise and supervised dosing of the allergen, often in a hospital setting.  This would not be something to try at home or outside of one of these very limited trials.  If you suspect a peanut allergy, avoid eating anything that may contain peanuts to avoid further reactions.  There are blood tests that can give you a better idea of the severity of a peanut allergy, but I'm not sure if they are available where you live.

3. Throat symptoms are considered life-threatening and require epinephrine and further medical attention at a hospital.  Having an epinephrine auto injector would be essential if you have experienced symptoms like this.

4. If EpiPens aren't available in Costa Rica, your allergist should be able to tell you what other epinephrine auto injectors are.  If none are available, you may have to get a syringe and phial of epinephrine to carry around.  Not exactly my first choice since using an auto injector is difficult enough during a reaction, yet alone drawing up a syringe.  Unfortunately, I do not know of any mail-order pharmacies, yet alone any that would ship to Costa Rica.  Hopefully someone else here will have some options for you.

There are many great resources and links on this forum to read about allergies and how to handle them.  Here are some very helpful links from FARE, to get you started:
Newly Diagnosed: http://www.foodallergy.org/resources/newly-diagnosed
Action Plan: http://www.foodallergy.org/faap

And please continue to ask questions.  We all want you to be safe and healthy. 

[APV]

 "If you have a "sensitivity" to Peanuts (legumes) is it a good idea to maybe have a little bit of peanut butter once a week in the hope of desensitising your body...I had a rash on my forehead recently after eating a little peanut butter, and my allergist suggested that it was a good idea to do this..what are your views? because I am not convinced this is good advice."

That is a good idea. Stopping consumption if you can tolerate a little, may be dangerous.

Fatal allergy as a possible consequence of long-term elimination diet
http://www.researchgate.net/publication/8559620_Fatal_allergy_as_a_possible_consequence_of_long-term_elimination_diet

You have to walk the fine line.

[rebekahc]

Remember, though, if you develop a rash from something you ARE NOT tolerating it. Allergic reactions can and do change with no warning and self desensitization is extremely dangerous.

[CMdeux]

^ please ignore the VERY dangerous advice from APV, above.

If you don't have epinephrine on hand, consumption of ANY amount of a known or suspected anaphylaxis trigger could well be fatal.

Peanut is among those allergens which are very very likely to provoke anaphylaxis (in as many as 30-40% of those allergic, in fact).

[hedgehog]

^ please ignore the VERY dangerous advice from APV, above.

Worth repeating.

it is possible that it was cross contamination that caused the rash, or if it was just one time, that the rash was caused by something else and it was coincidence that it occurred after you ate peanut.  But unless you see an allergist who can confirm that you are not allergic to peanuts, don't ingest peanut. do it yourself desensitization can be fatal.  DON'T DO IT.

[hezzier]

APV is NOT a DOCTOR!  Please do not take their advice.

[GoingNuts]

^^^ What they all said.  DO NOT TRY SELF-DESENSITIZATION AT HOME!!!  (Sorry, didn't mean to yell.)  But really, don't do it.

[poppie]

Thank you all for your advice, and, of course, I will not take any peanut butter, especially as I live in a remote area in Costa Rica.
I am wondering if I should share with you guys what's been happening to me recently, its complicated and frightening, but it might make me feel better to share it with people that understand allergies...

[rebekahc]

We're always happy to help brainstorm or just offer a sympathetic ear. 

[CMdeux]

Absolutely-- we may not have answers, but odds are good that someone here has information or knows where you can find it.

[lakeswimr]

If a person has *just*eczema as a symptoms of a food allergy, then many doctors recommend treating the eczema and keeping the food in one's diet to prevent the allergy from becoming worse, but anyone with symptoms beyond that from a food, even minor hives, is at risk of future anaphylaxis.  I hope you are able to get epi pens.  They are temperature sensitive so if you have to mail order them I'd be careful of the time of year you do this  They can't get too cold or too hot. 

[poppie]

Hi! It is nice to share with people that have allergies,  get things off my chest, I don't think I am expecting any answers, but it makes me feel better, to at least write all this down (it's a bit long)

Ten years ago I had a severe problem with Perfumes/chemicals and with immunotherapy treatment the problem was resolved. But, this last year, the problem has reoccurred and is severe, stopping me from going out, with so many people wearing strong perfumes/deodorants, etc.  One whiff of perfume renders me incapacitated, feeling confused, with trembling hands and a headache, with the next day being entirely wiped out. 

I decided to see an allergist and found the only one in Costa Rica, and that I would have to wait four months before I could see him.   At this point, it is probably worth mentioning that the level of care where I live is NOT the same as in other countries,  mistakes are made, daily, serious mistakes, but I have learned to go with the flow and make the best of things.  On top of this, despite being Gluten and Dairy free I knew that I was experiencing some other food allergy symptoms, but I was unable to pinpoint the exact problem, and so I thought seeing an allergist would be helpful.

In August, I had my appointment, I saw the allergists daughter first.  She took down my notes, asked me some questions about food before I was shown in to see him  (the only allergist in Costa Rica)  My interview with him was short, I explained that I had experienced heart palpitations and hand shaking after eating crackers with peanut butter while drinking a glass of wine.  They both immediately said they thought I was histamine intolerant, he did ask if I had experienced any problems with breathing, or if I felt my throat closing, and at that time I had no symptoms of that. 

However, my main priority was to have the immunotherapy treatment; that was my primary reason for being there.   The plan was for skin prick tests on my arms, and I was to return a week later, for more skin prick tests on my back.  Unfortunately it was apparent that he was ready for retirement, not terribly interested anymore, in fact, as a clear indication of this he started eating something during my consultation with him, and at one point left me sat waiting for him while he scuttled off to attend to something else for a while. I was disappointed, and before I knew it I was outside his office on my way home.

I have Ulcerative colitis (diagnosed Feb 2014), and I had been in remission from Ulcerative colitis since that time, but a couple of days after the initial tests, I began to show two different alarming symptoms.  The first, was early signs of an Ulcerative Colitis flare up, and the second was very severe palpitations and shaking hands, after eating some foods, the worse I had had, but again, more noticeably after drinking a glass of wine.  It did not take me long through careful monitoring of my food diary to determine that I had a problem with sulfites, which is the preservatives in food, and I do believe that the skin prick tests had exacerbated the problem, everything felt more intense, heightened!! 

I returned a week later for my other skin prick tests on my back, and I did mention that I had discovered the main problem, sulfite intolerance!!   and I was given the result of my tests, and it appeared that I have a problem with..Yeast, Mold, Oats, Chickpeas, Peanut, and Almonds.  I was given a date to return, a week later to start my immunotherapy treatment.  Unfortunately I had to cancel as the  following week I started bleeding (Ulcerative Colitis) I thought I could maybe get the flare up under control but things just became worse, and it was then that I started to notice that I was having problems with new foods,  discovering new food allergies...

So, after the visit to the allergist I was worse, my UC was flaring, I was now Sulfite intolerant, with new food allergies popping up.  It was during this time that I was eating Walnuts, which I had been tested for by my allergist, but as we all know these tests aren't always conclusive.  One night after eating Walnuts I felt unwell, and then not long afterwards I complained to my husband that my throat felt sore, when I touched the glands in my throat they hurt,  and we both wondered what that meant, it was only the next day that I discovered it can be a sign of allergy, and so of course I have been too frightened to eat any more, especially as I do not have an Epi-Pen.   

The problem I have is finding foods that I can eat.  I feel like I have stepped into a nightmare.  Because I am limited my range of foods are narrow, and then if I overeat something I then have problems with it, a good example is fresh coconut, yesterday I realised that my stomach does not like coconut water anymore, and last week I discovered I could not have goat yogurt anymore.  I have an appointment to see a holistic doctor next week and so I am hoping he may be able to help.  If you have managed to read all this, thanks for listening.