Allergies Food Allergies Treatment & Diagnosis Food Allergies Guide Food Allergies Guide Symptoms Causes Diagnosis Treatment Coping How Food Allergy Is Treated The avoidance of allergens remains the first-line response By James Myhre & Dennis Sifris, MD James Myhre & Dennis Sifris, MD Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. James Myhre is an American journalist and HIV educator. Learn about our editorial process Updated on October 26, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel More, MD Medically reviewed by Daniel More, MD Daniel More, MD, is a board-certified allergist and clinical immunologist with a background in internal medicine. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Home Remedies and Lifestyle Over-the-Counter (OTC) Therapies Prescriptions Specialist-Driven Procedures Complementary and Alternative Medicine (CAM) Frequently Asked Questions Next in Food Allergies Guide Tips for Those Just Diagnosed With Food Allergies If you have been diagnosed with a food allergy, the simplest and most effective way to prevent a reaction is to avoid the foods that cause problems. Food allergens can often be hidden in the foods you buy, making it all the more important to remain vigilant. zoranm / Getty Images In some cases, medications may be needed to treat acute allergy symptoms. Mild to moderate food allergies often respond to over-the-counter antihistamines. Severe reactions may require an injection of epinephrine to treat a potentially life-threatening, whole-body allergic reaction known as anaphylaxis, along with supportive care. People at risk of anaphylaxis may benefit from immunotherapy, a procedure used to desensitize the immune system to a an inhalant or venom. Palforzia is a peanut food immunotherapy (OIT) approved for peanut allergy by the Food and Drug Administration (FDA). A number of experimental drugs are also being studied to prevent or treat allergies in new and novel ways. How Food Allergy and Food Intolerance Differ Home Remedies and Lifestyle There is no cure for food allergies, nor are there any medications that can prevent reactions. The only sure-fire way to avoid an allergic response is to omit known food allergens from your diet. This is not always a straightforward process. Skin-prick tests are used to diagnosed allergies and can used on any food allergen, including eggs, fish, milk, peanuts, shellfish, soy, tree nuts, and wheat. Similarly, elimination diets (in which suspected foods are removed from the diet and gradually reintroduced to see if a reaction occurs) don't always provide a clear picture of which foods are you are truly allergic to and which you are not. Moreover, people with "true" food allergies are often cross-reactive to a wide range of other foods. These challenges can make avoidance diets both difficult to design and hard to adhere to. At the early stages of treatment, it often helps to work with a certified dietitian to formulate a sustainable self-management strategy. This not only includes adhering to dietary restrictions but also learning how to read ingredient food labels and avoid cross-contamination. 7 Rare but Severe Food Allergies Food Restrictions The biggest challenge of any avoidance diet is the sudden and often extreme restriction of foods you cannot eat. If your reactions are severe or your allergy profile is anything less than certain, your healthcare provider may throw a wide net over the foods you should no longer consume This may include foods, including spices, that are likely to cause a cross-reaction. Allergic cross-reaction occurs between closely related foods that the immune system sees at the same. Peanuts, soybeans and other legumes have high rates of cross-sensitization but low rates of cross-reactivity (5%). Fish and shellfish allergies don’t cross-react. These are completely different allergens. While this may suggest that you can no longer eat entire food groups—a daunting prospect for even the most severe allergy sufferer—most avoidance diets are not nearly so restrictive. Even though you may be reactive to a wide range of foods, not all triggers elicit the same response. For example, while 50% of people with a peanut allergy will have a positive skin test for soybeans, only 5% will develop symptoms. As such, the food you need to eliminate at the onset of an avoidance diet may be extensive but can be gradually whittled down once you gain better control over your symptoms. This is why allergists will recommend keeping a food diary when first starting an avoidance diet. This not only allows you to track foods that cause problems but offers you the means to test cross-reactive foods in small amounts to see if a reaction occurs. (As a general rule, never test a cross-reactive food without first speaking with your healthcare provider.) By keeping an accurate record of your dietary history, you may be able to gradually expand the range of foods you eat (or find hypoallergenic alternatives you can tolerate). In the end, the more foods you can consume without incidence, the more likely you will be to adhere to the restrictions. Reading Food Labels We live in a processed food culture. According to a 2016 study in the Journal of Nutrition, no less than 61% of calories consumed by Americans come from highly processed foods and beverages. Beyond the nutritional concerns, eating packaged or processed foods increases the risk of exposure to hidden food allergens. This requires people to be especially vigilant when reading food labels. Most ingredient labels will be situated beneath the Nutritional Facts panel. On multi-pack items marked "Not Labeled for Individual Sale," the ingredients will be printed on the container in which the individual packets were packed. Some food allergens are easier to spot than others. The Food Allergy Labeling and Consumer Protection Act of 2004 (FALCPA) mandates that manufacturers prominently indicate if any of the eight most common food allergens are included in their product, even if they are only additives. In addition, the manufacturer must state the specific type of nut, fish, or crustacean used so that the consumer can make an informed choice. In addition, people with food allergies need to educate themselves about the alternative names of food allergens as well as certain everyday ingredients that contain allergens. Examples include: Dairy: Casein, caseinate, cheese, curds, ghee, kefir, lactalbumin, rennet, wheyEgg: Albumin, globulin, mayonnaise, meringueFish and shellfish: Crabsticks (processed pollack), crevette, puttanesca sauce (anchovies), scampi, Worcestershire sauce (anchovies)Peanuts and tree nuts: Marzipan, nougat, pignoli, satay sauce (peanuts)Soy: Edamame, miso, tempeh, tamari, textured vegetable protein (TVP), tofuWheat: Bulgar, couscous, durum, einkorn, emmet, farina, Kamut, seitan, semolina, spelt Although dairy, eggs, fish, peanuts, shellfish, soy, tree nuts, and wheat account for 90% of food allergies in the United States, less common ones can be just as serious. To be safe, you need to know the scientific and alternative names of any food to which may be reactive. Grocery Shopping for People With Food Allergies Avoiding Cross-Contamination If you are prone to food allergies, you might need to take steps to avoid cross-contamination at home and in restaurants. For 95% of people with peanut allergies, 1 mg of peanut protein or higher can trigger a reaction; Only 5% of people with peanut allergies react to 1 mg or less. In households where a family member is at high risk of anaphylaxis, every effort should be made to control the types of food that can be brought into the house, including snacks or gifts from friends. Other measures may be needed, including: Limiting problematic foods to certain parts of the kitchenHaving dedicated storage, preparation, and dining spaces for allergen and allergen-free foodsHaving allergen-free utensils, preparation spaces, containers, cabinets, and drawersTeaching everyone how to properly clean surfaces and store problematic foods If planning to dine out at a restaurant, do not hesitate to call in advance to advise them if your dietary concerns. You can also carry "chef cards" to pass to the kitchen describing the nature of your allergy and the foods you can and cannot eat. As a general rule, avoid salad bars, buffet-style restaurants, and ice cream parlors where the risk of cross-contamination is high. 6 Food Allergy Apps for Dining Out and Shopping Over-the-Counter (OTC) Therapies Mild to moderate food allergies may cause a runny nose, sneezing, and an itchy mouth or skin. In cases like these, an over-the-counter oral antihistamine can often help. Also known as H1 blockers, antihistamines work by inhibiting the action of a chemical known as histamine that the immune system produces in response to an allergen. These include first-generation (non-selective) antihistamines that tend to cause drowsiness and second-generation (peripherally-selective) antihistamines are non-drowsy. Among the choices: First-generation H1 blockers include Benadryl (diphenhydramine), Chlor-Trimeton (chlorpheniramine), and Tavist (clemastine). Second-generation H1 blockers include Allegra (fexofenadine), Claritin (loratadine), and Zyrtec (cetirizine). Although both have been found to have similar efficacy in treating food allergies, first-generation drugs like Benadryl may be useful if the allergy symptoms interfere with sleep. By contrast, antihistamines like Zyrtec are more appropriate if you have to work or drive. Other side effects of antihistamines include dry mouth, dizziness, nausea, restlessness, blurred vision, vomiting, and difficulty urinating. Should I Take Claritin, Zyrtec, or Allegra? Prescriptions Food allergies can sometimes be severe and require prescription medications, including injectable drugs used in anaphylactic emergencies. Food allergies are the leading cause of anaphylaxis outside of a hospital setting in the United States. Even if you have had only minor allergy symptoms in the past, you can still develop anaphylaxis, often without warning. Generally speaking, all severe food allergies are treated as medical emergencies even if they do not appear to be life-threatening. This is because the symptoms of anaphylaxis are highly unpredictable and can suddenly turn deadly if not treated immediately. Epinephrine Epinephrine (adrenaline) is the first-line treatment for anaphylaxis and the only drug that can reverse acute symptoms. It is delivered by intramuscular injection into the thigh, ideally within minutes of the appearance of symptoms. Epinephrine works by inducing vasoconstriction (the narrowing of blood vessels). This rapidly reverses the swelling of tissues and the often-severe drop in blood pressure. It also relaxes the muscles of airways, easing respiration. The effects of epinephrine are fast, but they don't last long. Once injected, emergency medical attention is needed without exception. When to Call 911 Seek emergency care if some or all of the following occur after eating a suspected food allergen:Shortness of breathWheezingSevere skin rash or hivesDizziness or faintingVomitingDiarrheaSwelling of the face, tongue, or throatA weak, rapid pulseDifficulty swallowingA feeling of impending doom A food allergy reaction typically occurs within 20 to 30 minutes after consumption of the food. If left untreated, anaphylaxis can lead to shock, coma, heart or respiratory failure, and death. Side effects of epinephrine include rapid heartbeats, sweating, shakiness, nausea, vomiting, dizziness, and anxiety. Epinephrine should be used with caution in people with severe heart conditions, but its benefits in treating anaphylaxis almost universally outweigh the risks. Other Medications Once epinephrine has been delivered, other drugs may be needed to control the severe allergic reaction. Among the options: Corticosteroid drugs like prednisone may be given orally or intravenously (into a vein) to reduce inflammation and prevent a recurrence of symptoms. Intravenous antihistamines, such as diphenhydramine Short-acting bronchodilators, popularly known as rescue inhalers, can be used to relieve asthma symptoms once epinephrine has been delivered. Inhalants like albuterol are especially useful. Anyone who is at high risk of anaphylaxis should be prescribed a prefilled epinephrine auto-injector (like EpiPen or Symjepi) and taught how to use it. It is important to keep two auto-injectors close at hand at all times. Around 20% of cases will experience a rebound of symptoms after the first injection, and there is really no way to tell if and when a second dose might be needed. Always check the expiration date of your auto-injector, note the date on your calendar, and ask your pharmacist about automated reminders when refills are needed. How to Get an EpiPen Without Insurance Specialist-Driven Procedures Although the avoidance of food allergens remains the first-line approach to managing food allergies, newer therapeutic options are being explored. Food immunotherapy is among the most popular of these emerging interventions. Known more precisely as oral allergen immunotherapy (OIT), the procedure involves the daily administration of a food allergen to gradually reduce your sensitivity. The allergen can either be given as a fixed-dose or in gradually increasing doses. Fixed-dose allergy shots (AIT) is delivered epicutaneously (using an adhesive patch applied to the skin). The choice of AIT is based on the type of food allergy you have. According to a 2016 review of studies in the journal Children, OIT was by far the most effective of the three methods used and has been shown to successfully treat milk, egg, peanut, tree nut, fruit, and vegetable allergies. Daily allergen doses start at around 2 mcg per day; the initial dose of peanut protein for a Palforzia product is half a milligram. By contrast, sublingual AIT was only moderately effective in treating milk, peanuts, hazelnut, and kiwi allergies, while epicutaneous AIT achieved variable results with milk and peanut allergies. According to the investigators, between 70% and 90% of treated individuals were fully desensitized to the food allergens after AIT treatment. Infants and children achieved better desensitization rates than adults, who have a roughly 50/50 chance of overcoming a food allergy. Food oral immunotherapy takes a few years to complete. Side effects, especially gastrointestinal symptoms, can be severe and limit treatment in some patients. Unlike other forms of allergy, food allergies cannot be treated with allergy shots or drops. Experimental Therapies A number of experimental therapies are being studied that scientists hope will one day prevent or reduce the severity of food allergies. One agent edging closer to approval is Palforzia, a standardized peanut powder product used to reduce peanut allergy symptoms in children ages four to 17 as part of oral AIT treatment. Palforzia is not intended to cure peanut allergies but is rather used on an ongoing basis to reduce the frequency and severity of symptoms as well as the risk of anaphylaxis. The FDA is expected to approve Palforzia. The wholesale price is anticipated to be as high as $4,200 per year. Complementary and Alternative Medicine (CAM) Complementary and alternative medicines (CAM) are widely used in the United States to treat all types of allergies. At present, there is little evidence that they offer any significant benefit to people with food allergies. One of the more touted alternative therapies is a Chinese herbal remedy known as FAHF-2. The oral drug is based on the classical Chinese formula Wu Mei Wan and contains nine herbal ingredients, including gan giang (ginger) and dang gui (angelica root). As with We Mei Wan, FAHF-2 is believed to treat a host of unrelated health conditions, including asthma, chronic diarrhea, endometriosis, glaucoma, insomnia, irritable bowel syndrome, and type 2 diabetes. A 2016 study in the Journal of Allergy and Clinical Immunology reported that FAHF-2, taken three times daily for six months, appeared to alter the skin-prick response in 29 adults with a diagnosed food allergy. However, when compared to adults given a placebo, there was no improvement in either the frequency or severity of allergy symptoms. Other studies have suggested that acupuncture can reduce the severity of hives or prevent the activation of basophils (specialized white blood cells that release histamine). Most of the supporting evidence is either small or of poor quality. Given the limited research and potential harms, it is too soon to recommend any complementary or alternative therapy for people with food allergies. Frequently Asked Questions How can I quickly stop a severe allergic reaction to food? If you or someone you are with is having a severe reaction to a food allergy, epinephrine injected into the front thigh muscle is needed to stop the reaction. People with severe allergies should carry an epinephrine auto-injector, such as the EpiPen. An epinephrine injection should be followed by a trip to the emergency room. Can food allergies be cured? No, food allergies cannot be cured. The best way to avoid an allergic reaction to a food is to avoid it. Depending on the allergy, your healthcare provider may also recommend avoiding foods that may cause a cross reaction. Do allergy shots work for food allergies? No, but other types of allergen immunotherapy (AIT) may help desensitize you to milk, egg, peanut, tree nut, fruit, and vegetable allergies. AIT can be delivered through the skin using an adhesive patch, placed under the tongue, or taken orally, and it requires daily doses for several months to a few years. Coping and Living Well With Food Allergies Was this page helpful? Thanks for your feedback! Get one simple hack every day to make your life healthier. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 9 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Bublin M, Breiteneder H. Cross-Reactivity of Peanut Allergens. Curr Allergy Asthma Rep. 2014;14(4):426. doi:10.1007/s11882-014-0426-8 Dahl R. Food Safety: Allergen Labeling Takes Effect. Environ Health Perspect. 2006 Jan;114(1):A24. doi:10.1289/ehp.114-a24 Plasek JM, Goss FR, Lai KH, et al. Food entries in a large allergy data repository. J Am Med Inform Assoc. 2016 Apr;23(e1):e79-e87. doi:10.1093/jamia/ocv128 Al-Muhsen S, Clarke AE, Kagan RS. Peanut allergy: an overview. CMAJ. 2003 May 13;168(10):1279-85. Park JH, Godbold JH, Chung D, et al. Comparison of Cetirizine to Diphenhydramine in the Treatment of Acute Food Allergic Reactions. J Allergy Clin Immunol. 2011 Nov;128(5):1127-8. doi:10.1016/j.jaci.2011.08.026 Cianferoni A, Muraro A. Food-Induced Anaphylaxis. Immunol Allergy Clin North Am. 2012 Feb;32(1):165-95. doi:10.1016/j.iac.2011.10.002 U.S. Food and Drug Administration. Allergenic Products Advisory Committee Meeting: Peanut, Arachis hypogaea, Allergen Powder for Oral Administration. Silver Spring Maryland; issued September 13, 2019. National Public Radio. Allergists Debate Anticipated FDA Approval Of A Peanut Allergy Drug. Washington, D.C.: September 23, 2019. Li XM. Complementary and Alternative Medicine for Treatment of Food Allergy. Immunol Allergy Clin North Am. 2018 Feb;38(1):103-24. doi:10.1016/j.iac.2017.09.012 Additional Reading Anvari A, Anagnostou K. The Nuts and Bolts of Food Immunotherapy: The Future of Food Allergy. Children. 2018 Apr;5(4):47. doi:10.3390/children5040047 Poti J, Mendez M, Ng SW, et al. Highly Processed and Ready-to-Eat Packaged Food and Beverage Purchases Differ by Race/Ethnicity among US Households. J Nutrition. 2016 Jul;146(6). doi:10.3945/jn.116.230441 Wang J, Jones SM, Pongracic JA, et al. Safety, clinical and immunologic efficacy of a Chinese herbal medicine (FAHF-2) for food allergy. J Allergy Clin Immunol. 2015 Oct;136(4):962-70. doi:10.1016/j.jaci.2015.04.029