If you’ve ever wondered the best way to test for food allergy sensitivity, this episode is for you!

What do I mean by food allergy sensitivity?

Many people think that you’re either allergic (and thus highly reactive) to specific foods or you’re not. And that’s not actually true as there’s a scale of reactivity or sensitivity that you could be on for IgE food allergies.

Making this even more complex is that your level of reactivity can change with time (this is especially true for children) which is why today’s episode is so important!

Food allergy testing isn’t perfect and can sometimes show false positives. Unfortunately, many practitioners (including many in the functional or integrative space) may recommend unnecessary elimination of foods that came back as a positive IgE reaction yet lacked any real-life reactivity.

Though it might seem harmless, it deserves to be repeated that unnecessary food eliminations can potentially lead to IgE food allergy reactivity if left out of your diet for too long.

Throw in chronic skin rashes like eczema, which increase the risk of food allergy (especially in children), and the question of what food is safe becomes increasingly confusing.

That’s why I wanted to bring in a food allergy immunotherapy specialist to talk about this important topic.

So if you’re wondering if skin tests are the gold standard, whether blood tests are accurate, and what the pros and cons are when trying oral food challenges or subcutaneous allergy shots, tune in to this fascinating episode with my guest, Dr. David Fitzhugh.

Dr. Fitzhugh is an allergist/immunologist in private practice in Chapel Hill, North Carolina.

He specializes in food immunotherapy for children and adults with severe food allergies but treats a wide variety of allergic and immunologic conditions, including allergic rhinitis, asthma, atopic dermatitis, mast cell disorders, and anaphylaxis.

In This Episode:

• Options that test for food allergy
• Can positive serum IgE blood tests be wrong?
• Food sensitivity vs food allergy
• Benefits of doing oral food challenges
• What is more likely to trigger a reaction like food allergy hives: subcutaneous allergy shots or oral food challenges?
• Is it possible to tolerate (to some degree) something you’re allergic to?
• Oral food challenges dos and don’ts
• How to reduce your food allergy reactivity
• Sublingual versus oral immunotherapy
• Thoughts on elimination diets and food allergies

Quotes

“In our field, we consider someone sensitized who's test-positive to an IgE test. That could be a skin test or a blood test. So you are sensitized. But if you're test-positive and you eat the food routinely with no issue, you're not allergic, right? Allergic means a clinical syndrome of having an allergic reaction. And where we see this most commonly is the eczema kids.”

“...every allergist in North America is doing subcutaneous allergy shots. These are the typical allergy shots to desensitize people against hay fever, grass pollen, dust mite, et cetera. And we see a decent rate of really serious reactions that occur with those. And so every allergist needs to be prepared to manage an allergy shot reaction, sometimes requiring multiple rounds of epinephrine, IV fluid. Those don't happen commonly, but they do happen. But yet the dichotomy is, there's in many ways a reluctance to do oral food challenge because parents and/or providers are worried about the possibility of reaction. And the thing is with carefully selected food challenges, we have the luxury of knowing where most kids will tolerate, following the blood test to the skin test.”

Links

Find Dr. Fitzhugh online

Finding a hidradenitis suppurativa treatment that works can be frustrating and difficult, especially with certain symptoms like intense pain.

Hidradenitis suppurativa (HS) pain can severely impact your day to day quality of life — I speak from experience here!

When I first discovered a swollen, painful lump in my armpit, I panicked, and immediately worried about getting checked for breast cancer. Fortunately, the lump wasn’t cancer – it was hidradenitis suppurativa.

For me, laser hair removal was the key to stopping hidradenitis suppurativa symptoms in their tracks, but that’s not the case for everyone. Plus, laser hair removal isn’t always a permanent solution.

Because I personally know how awful this skin condition can be, I want to share more on what causes hidradenitis suppurativa pain, how the immune system and inflammation play a role here, as well as sharing some hidradenitis suppurative home remedies and other conventional treatment options.

Dr. Steven Daveluy is back to share more on HS! He is an associate professor and program director at Wayne State University in Detroit, Michigan, and holds special interests in teledermatology, noninvasive skin imaging, skin of color, integrative dermatology, and complex medical dermatology, including hidradenitis suppurativa (HS).

Dr. Daveluy serves on the board of the Hidradenitis Suppurativa Foundation. He serves on the editorial board for the JAAD and is building a growing body of publications of his own.

Let’s dive into this really important topic!

In This Episode:

• What causes hidradenitis suppurativa (HS) pain?
• Hidradeniis suppurativa tunnels
• Immune response, cytokines + hidradenitis suppurativa symptoms
• New research bacteria found in the fluid + pus from HS lesions
• Stages of HS (hidradenitis suppurativa)
• Can HS surgery help with pain?
• Is laser hair removal a permanent hidradenitis suppurativa treatment?
• Hidradenitis suppurativa home remedies
• How to get help with pain management because of HS
• Medication options for hidradenitis suppurativa treatment

Quotes

“Even where you don't have lesions, your skin microbiome is still different than someone who doesn't have HS, which then sort of talks to this picture of HS isn't just something in your hair follicles, it's something that affects your whole body. And things are different in your gut, in your skin, in the skin that doesn't even have HS lesions. Things are just really out of balance.”

“...It's not to say that stage one can't be severely painful, but as a general trend, the more tissue damage you have, the more risk you have for the pain becoming more severe.”

Links

Find Dr. Daveluy on Instagram | Twitter

HS Foundation website

Healthy Skin Show ep. 103: Hidradenitis Suppurativa: The Tip That Stopped My Flares

Healthy Skin Show ep. 232: How Yeast + Zinc Can Play A Role In Hidradenitis Suppurativa w/ Steve Daveluy, MD

If you’ve found it frustrating that no one can tell you why you have chronic urticaria hives (including chronic spontaneous urticaria, dermatographia, and even angioedema), I feel you.

Especially when IgE allergies are ruled out (testing is negative) or even avoiding what you’re allergic to isn’t helpful. At that point, most doctors will say that there is no answer or clear trigger to what causes urticaria, basically leaving you with an increasing number of medications that may or may not help to control your skin.

To say that this leaves many like you feeling enormously helpless and hopeless is an understatement.

In my clinical practice, I’ve worked with many cases of chronic urticaria hives around the globe, helping to troubleshoot when doctors have all but given up in seeking an answer. Some cases have dated back decades, often having been seen at some of the most prestigious health institutions only to be told that there’s nothing to be done beyond antihistamines (which have their own problematic side effects) and biologics like Xolair.

I love helping people stop having hives and urticaria, especially since I get to explore the complex causes of chronic urticaria, which conventional medicine often ignores or assumes is impossible. So when new research starts pointing out connections to what I have seen in practice, I must share it!

If you missed my previous article on hidden causes of chronic urticaria, check it out here! This will help you see that what this new paper demonstrates is highlighting a big missing link to chronic spontaneous urticaria, hives, and other histamine-driven issues.

Before we dig into gut-chronic urticaria hives connection, I highly recommend that you download my Skin Rash Root Cause Finder. This is the exact method I’ve used with thousands of my private clients to help them discover what’s really causing their rash (and yes, this works for hives, dermatographia and angioedema issues) >> Get the easy-to-use Skin Rash Root Cause Finder.

In This Episode:

• Chronic urticaria (hives) gut causes
• Problems with urticaria treatment options (even Xolair)
• Gut imbalances noted in chronic spontaneous urticaria (hives)
• What are lipopolysaccharides + short-chain fatty acids (and why are they important)?
• Key findings from new research on gut-skin connection (specifically for hives)

Quotes

“The incidence of true histamine intolerance is much lower than you’re led to believe and is based on old assumptions that need a serious update.”

“Nearly 50% of those living with urticaria experience depression and anxiety (especially when the flare-ups are severe).”

Links

Gut microbiota facilitate chronic spontaneous urticaria

Healthy Skin Show ep. 261: Chronic Hives: Why Aren’t They Going Away

Healthy Skin Show ep. 265: Problem with Antihistamines That No One Tells You w/ Dr. Chris Thompson, MD

Healthy Skin Show ep. 317: Itchy, Painful Rash From Thyroid Disease: Your Guide to Stopping It

Healthy Skin Show ep. 188: Histamine Intolerance + Skin Rashes (PART 1)