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Places Peanuts Can Hide

People newly diagnosed with a severe peanut allergy often find that limiting their exposure to products that contain peanuts is more difficult than they expected.  Peanut proteins can be found in a surprising number of places, including several non-food items. Here’s a list of some common foods and ingredients that people with peanut allergies should keep an eye out for:

Flavored or artificial nuts: Sometimes, flavored and artificial nuts and nut mixes contain peanuts that have been processed to look and taste like another nut.  To make these artificial nuts, de-flavored peanuts are ground into a meal, re-flavored and molded to the shape of another nut, such as a walnut or cashew. These artificial nuts still contain peanut proteins that can cause allergic reactions, so it’s best to avoid them. For more information on how artificial nuts are produced, check out this article from Allergyfreeandsugarfreesnacks.com.

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Arachis: Arachis is a genus of plants in the pea family, and Arachis hypogaea, or peanut, is its most well-known species. On some food labels, peanut products are listed as “arachis” rather than “peanut,” so it’s best to check for both words. Arachis oil (peanut oil) is also a common ingredient in foods and non-food products, including some cosmetics. People with peanut allergies should obviously avoid any products that contain these ingredients.

Food additives: Several food additives and preservatives are derived from peanuts and can cause reactions in highly sensitive people. This article by Nicole Evans, M.D. explains the dangers that these additives can pose and includes a helpful list of ingredients to watch out for. Some of the most common peanut-derived food additives are calcium stearate, lecithin, linoleic acid and polysorbates.

This is by no means an exhaustive list of peanut protein hiding places. If ANY exposure puts you at risk, you’ll certainly want to learn much more about this topic and discuss it with your doctor. To get you started, however, we’re inviting others to share their experiences with hidden or unlikely peanut sources in the comments below.

May 02 / 2013
Author Wendy Harman
Category Food Allergies
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Tips to Prepare Your Child for Allergy Testing

If your kids are anything like mine, they get a little pre-appointment anxiety whenever they are going to a medical visit. When it is a new office or provider, their nerves are even worse. If you throw in a procedure, well, that stresses me out sometimes too.

Since I have been on both sides of the table – parent and provider – when it comes to allergy testing, I compiled this list of tips on how you can prepare your child for allergy testing.

  • Know what type of testing you are having done. If it’s in vitro or blood testing, it will be a simple blood test. I know, the words “simple” and “blood test” for a child don’t go together. While it’s true that this is a venipuncture (needle inserted in a vein), this is usually done by a skilled phlebotomist or provider that is used to drawing blood on kids. The procedure also takes less than a minute. There are even some “tricks” that can lessen the prick if you think your child may be overly sensitive, such as ice packs, prescription numbing creams, tiny needles, etc. Blood testing is the preferred method if your child needs to be on medications such as antihistamines or has a skin condition that can interfere with skin testing.
  • For skin testing, explain the process to your child. If you will be having allergy skin testing, you will also want to inquire exactly what type of testing is being done at each visit. Most of the time with kids, liquid allergens are applied to a device or the skin and then scratched or pricked with a plastic instrument. There are a variety of devices and some allow multiple tests to be put on at once. This tends to make the administration of the testing go faster and easier for kids. To ensure that you won’t need to repeat the test or reschedule your appointment, it’s also important to know if any medications need to be stopped several days ahead of time.
  • Prepare for the “itchies.” Once the testing has been administered, you will wait about 15 minutes to have the results “read.” You should let your child know ahead of time that if a test reacts it will feel itchy like a mosquito bite, but they shouldn’t scratch it or it will itch more (and potentially interfere with the results). Bring whatever toys, games, books or anything else you think will make for a good distraction during this waiting time. It will also give the child something to look forward to during the visit. Some offices have TVs in the exam rooms for this purpose, but don’t rely on having one available. To offer a light at the end of the tunnel, let your child know that once the time is up, they may be given topical or oral medication if the reactions are severe or bothersome. This helps take the “itchies” away.
  • Know that one test may not be enough. In some cases, another form of skin testing, called intradermal testing, is recommended. In this test, the liquid form of the allergen is injected right below the surface of the skin. Results are read in 15 minutes and positive tests result in warm, itchy wheels (similar to hives). This can be difficult testing for children since it may mean multiple needle sticks, so I never recommend this procedure without discussing it with the parents in detail first. We also typically consider some numbing skin preparation if warranted.

In the end, preparation is key to a successful allergy test, and that can look different depending on the personality of your child. Do they want to know everything that will happen? Do they do better with just a little information? Would they like to hear from any of their friends that had testing done? You know your child the best, so be aware of all the facts before proceeding and ask lots of questions to ensure both you and your child will be ready.

April 30 / 2013
Author Becky Rosenberger
Category Allergy Testing, Asthma, Seasonal Allergies
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Only One in Four Adults is Prepared for This Allergy Season

According to a recent survey conducted by Harris Interactive on behalf of Target, only 25 percent of adults who suffer from spring allergies are prepared for this season. That’s not good. As we’ve written many times, failure to understand how to address allergy triggers is an invitation to misery or, even worse, a costly trip to the emergency room for asthmatics.

That Target stands to gain from customers building deeper relationships with its pharmacists doesn’t diminish the wisdom of doing so. If a pharmacist – any pharmacist – can help increase awareness, education and vigilance, it’s a good thing. Target’s survey is a good reminder that pharmacists should be part of a consumer’s trusted healthcare network, which also includes primary care physicians and specialists.

Another notable finding of the survey was that one of the questions Target pharmacists answer most is “Which of these drugs would you recommend I take to alleviate my allergy symptoms?” Considering that OTC allergy medications simply alleviate symptoms of allergen sensitivity, this brings up an important follow-on question: Do these thousands upon thousands of allergy sufferers know their triggers as well as their symptoms? That’s certainly important information too.

Target logo

It seems that Target agrees. Its associate medical director, Kevin Ronneberg, is quoted as saying that “Target pharmacists serve as a partner on both sides of the counter and can help guests find relief by identifying the best over-the-counter products to alleviate and treat specific allergy symptoms and triggers.” In Dr. Ronnenberg’s quote, we take “over-the-counter products” to mean more than just medication. This is confirmed by the fact that Target also spotlights its “spring cleaning products,” such as disinfectant wipes, air filters and vacuums. Medication is only part of the equation.

While we’re not endorsing Target’s pharmacies per se, we are supporting the company’s effort to encourage richer engagement between consumers and pharmacists. And to that end, we’re hoping that Target’s pharmacists are probing “guests” about their triggers as well. Presumably this is already happening, since the store’s inventory includes well-known “trigger reducers” such as cleaning products, wipes and filters.

So pharmacists, fellow supporters of the allergy sufferers community (more than 270,000 of you in the U.S.), this is your reminder to dig deeper into triggers as well. Do customers know their triggers? Have they been tested? Has a primary care physician or allergist given them a list of triggers already? We’re sure that many of you pose these questions already. If not, add it to your checklist this season – it is a critical part of the larger allergy equation.

April 24 / 2013
Author Wendy Harman
Category Allergy Testing, Seasonal Allergies
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Is Allergy Season Getting Longer?

Many news outlets have proclaimed 2013 will be one of the worst allergy seasons in history because spring allergies are showing up earlier and fall allergies are expected to last longer. But we’re seeing that same warning every year now. Typical, media hyperbole aside, is it possible that allergy season is actually getting progressively worse each year?

The easy – and correct – answer is no. Each year is not progressively worse. There is, however, evidence that 2013 could be exceptionally rough for allergy sufferers, and the long-term trend generally indicates extended seasons and more plentiful allergens in future years. 800px-Sunflower_PollenGlobal climate change is the most obvious culprit. As warmer weather lengthens growing seasons, plants begin distributing pollen earlier in the year, dramatically increasing the amount of airborne allergens. A 2011 study by the U.S. Department of Agriculture confirmed the link between warmer weather and a ragweed season that’s almost a month longer than it was in the mid-1990s.

Obviously this won’t apply every year.  In 2012, for instance, snowstorms hit parts of the northeastern U.S. in late April.  This year, however, most of the U.S. is seeing the spring warm-up come earlier than normal after a seemingly relentless winter (just ask our colleagues in Portage, Michigan). The combination of plentiful water from snowmelt and an early spring creates something of a “perfect storm” of pollen that has experts such as Dr. Clifford Basset predicting that the 2013 allergy season could be extended by as much as six weeks:  two this spring and four in the fall.

It’s unlikely (hopefully) that future allergy seasons will always be as bad for allergy sufferers as this spring and fall, but even lower levels of allergens are no picnic. The best you can hope for is to control your exposure to allergens wherever possible! And remember, especially if you can’t resist the great outdoors, that allergen exposure has a cumulative effect. As you prepare for the allergen onslaught during soccer games, barbecues and evening walks, be sure to monitor your exposure to allergens in your home, diet, etc. And when in doubt, keep an eye on that pollen meter. Good luck this year!

 

April 17 / 2013
Author Wendy Harman
Category Seasonal Allergies
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Children’s Hospital of Boston Helps Kids Control Asthma

Recently, we heard a story on NPR’s Morning Edition, entitled “To Control Asthma, Start with the Home Instead of the Child,” that detailed the efforts of Boston Children’s Hospital to prevent asthma attacks among children from low-income neighborhoods. The story describes how the hospital’s Community Asthma Initiative identifies children who are frequently hospitalized with asthma attacks and provides their families with tools to reduce their exposure to common environmental allergy triggers, such as mold, pests and pollution. So far, the program has helped more than 1,000 Boston area families reduce the frequency of their children’s asthma attacks.

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The program implemented through Boston Children’s Hospital is very effective. Reducing exposure to allergy triggers is one of the best ways to prevent asthma attacks. A report on the program published last year by the journal Pediatrics gives a sense of the initiative’s impact: participating patients have seen a 56 percent reduction in emergency room visits since the program began. It’s estimated that every dollar spent by the program prevents $1.46 in emergency room costs – and more important, parents and children are saved from the stress and danger associated with asthma attacks. The program is catching on around the country, and its director, Dr. Elizabeth Woods, hopes to persuade Medicaid and private insurers to cover it.

We are pleased to see allergy trigger awareness getting the attention it deserves. As the saying goes, “an ounce of prevention is worth a pound of cure,” and these programs do a great job of showing a direct connection between controlling environmental allergies and reducing attacks that lead to costly hospitalization.

Educating patients with asthma about triggers is step one. Taking it a step further is to create a personalized allergy profile that enables patients to focus specifically on the allergens that trigger their asthma.  A specific and targeted approach to reduce exposure to a patient’s unique triggers can improve outcomes, save time and may lower the cost of a program like the one at Boston Children’s.

Knowing specific allergic asthma triggers is an important next step that helps families improve asthma control and save money, and groups such as the Community Asthma Initiative should be applauded for taking the first step!

 

April 12 / 2013
Author Wendy Harman
Category Allergy Testing, Asthma, Seasonal Allergies, Uncategorized
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Watch: National Jewish Health’s Dr. David Tinkelman On Allergic Rhinitis

Want to hear a doctor’s perspective on the importance of allergy testing in treating rhinitis? How do physicians use test results to help patients develop an allergen-avoidance plan? Check out the video below to watch Dr. David Tinkelman of National Jewish Health in Denver (the top-ranked respiratory hospital in the nation) discuss the process of effective diagnosis and management for patients with allergic rhinitis.

April 10 / 2013
Author Wendy Harman
Category Allergy Testing, Food Allergies, Seasonal Allergies
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