FOOD ALLERGY

A large part of our practice is food allergy management, particularly in children.

A food allergy occurs when the body’s immune system mistakenly sees a particular food as a threat and reacts by triggering a reaction.

There food allergies we are most concerned about are Immunoglobulin E (IgE) mediated – this is where symptoms result from the body’s immune system making antibodies called IgE. This type of food allergy can trigger life-threatening allergic reactions, including anaphylaxis

What is anaphylaxis? Anaphylaxis is a whole body immune reaction gone wrong. Symptoms of anaphylaxis are serious and possibly life-threatening. It includes trouble breathing, hives, throat tightness, nausea, vomiting, dizziness, fainting, feeling of doom.

How do we treat food allergies?

There are three approaches: Avoid, expose and more recently provide medication.


First option - AVOID
The first approach is avoidance. Depending on the symptoms you or your child has this may be the best approach. However at Allergy Physicians Calgary, we absolutely do not accept this as the only approach.


Second option - EXPOSE
The second approach is 'exposure therapy', 'microdosing' or ' oral immunotherapy', also know as OIT. They have different terms, but in effect are all the same.

Our clinic has been offering food OIT, also know as food oral immunotherapy, to children for almost a decade. This is acknowledging the presence of a food allergy in your child, but minimizing and managing symptoms by providing a small amount of the food to your allergic child. When done correctly, over time this can improve tolerance of the food allergy in your child enabling you and your family to have a more open lifestyle.

The food that we have been doing this the longest for in our clinic is peanut. We have hundreds of children in our practice who are undergoing peanut OIT. Children start by being given a tiny fraction of peanut (5mg) and after our program ends, eat 500 mg of peanut daily with no reaction. This is the equivalent of 2 peanut kernels! This enables your child now to no longer be worried about foods that 'may contain' and you watching his or her shoulder constantly. As a matter of fact, you can eat peanut butter on toast right next to him or her (although your child still cannot eat more than two peanut kernels daily).

In our clinic we have had great success with this. We have also seen positive finding with the IgE levels in children who are doing Peanut OIT. The IgE antibody in most of these children starts declining. The implications of this is not yet clear, but we do know that low IgE levels means the allergy antibody is diminishing.

We have been offering OIT - Oral Immunotherapy - to foods in children for almost the past decade

We offer OIT to the following foods and continue to expand our program:

Peanut
Cashew
Walnut
Hazelnut
Pistachio
Sesame Seed

It is important to note that currently we only offer OIT in children less than 5 years of age. The reasons are many, but the primary reason is that the safety and benefit of OIT in children older than 5 years of age is not entirely clear.

This may change in the near future as we are actively reviewing research underway in older children with regards to the safety of food SLIT (Sublingual Immunotherapy). This is different type of treatment whereby older children take a fixed dose.

It is important to note that not all children are candidates for OIT. Some children simply cannot tolerate this small starting dose of have reactions with increasing doses. Children with multiple food allergies and asthma are at higher risk of reactions with OIT. Our allergists evaluate each patient for the suitability for OIT.

Premember that our primary and most important objective as allergists is to keep your child safe and sometimes your child is just not a good candidate for this treatment.


Third approach - PROVIDE MEDICATION
The third approach is to provide medication. For the past number of years there is emerging evidence that individuals on medication called omalizumab (Xolair) and more recently dupilumab (Dupixent) are less prone to having bad reactions if they are accidentally exposed to the food to which they are allergic to. This is not entirely surprising as these medication when taken can minimize the antibodies (IgE for instance) that produce allergic reactions. While this does certainly have a role, the difference between this and exposure therapy is that this does not fundamentally change your immune system.

The best comparison of this treatment is in individuals who have seasonal allergies, ie 'hay fever'. Antihistamines, such as Reactine and Claritin can minimize symptoms by reducing your body's histamine levels. Omalizumab (Xolair) and dupilumab (Dupixent) do the same, but once the medication is stopped, it is expected that you would have symptoms again.

Xolair has been approved in the US for food allergy management. It is not yet approved in Canada. Of course as soon as it is, we would inform our patients.


Why Allergy Physicians Calgary?

Our allergists have decades of experience in food allergy diagnosis and management. We focus on all age groups, but we emphasize children due to their immune system still being malleable, which gives us hope that we may be able to mitigate, ie improve food allergies.

We also are active in reviewing literature and each of us attends multiple conferences a year in Canada and beyond as our goal is not just to manage a food allergy, but also to help improve it if possible.








Hours of Operation:
Monday 0800-1500
Tuesday 0800-1500
Wednesday 0800-1500
Thursday 0800-1500
Friday 0800-1200
Weekends and Holidays: closed

Address:
Allergy Physicians Calgary
5918 - 3rd St SW
Calgary T2H 0H8

Telephone:
403-ALLERGY (403-255-3749)
Facsimile:
1-833-816-5734
(Second fax line: 403-457-8237)


Our allergists are medical sub-specialists and per Alberta Health regulations see patients via referral only. If you have an emergency, please call 9-1-1 or go to the nearest hospital. If you have an urgent or semi-urgent medical need, please see your primary care physician for evaluation or advice.

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