MR: Joining us. Now is Dr. Melissa Graham from Advanced Allergy Clinic here in Little Rock. Dr. Graham, thank you so much for joining us today.

Dr. Melissa Graham: Thanks for having me, Michelle.

MR: So, May, I didn’t know this, is food, let me make sure I get this right; Food allergy and asthma awareness month. Did I get that?

MG: Yes. May is always that month every year. So just to bring awareness to everybody’s, you know, food allergy and asthma.   so that’s what that month is set aside each year to recognize those conditions.

MR: Okay, so when we talk about food allergies and as I was preparing for our visit today, I was thinking, you know, kind of as I was growing up, I don’t really remember hearing a whole lot about food allergies. There were the occasional kids in elementary school that would have a terrible reaction to shellfish, but I don’t ever really remember growing up hearing about peanut allergies and dairy allergies and gluten free or gluten intolerances and allergies and kind of all the different things that we hear about now. And so my question I’m curious to is have those allergies always been there? Or is this really kind of as we’ve grown up and aged, these new allergies have come along as well.

MG: Well   allergies have always been there. There’s the classic food allergy like you remember with shellfish and peanut allergy, but allergies have been on the rise. There’s some kind of Shocking statistics about peanut allergy for instance, it has tripled over the last two decades.   so, it definitely has increased, but allergies in general like hay fever sneezing, those allergies have also increased   over the last several years. And those you know that’s increasing for reasons we don’t quite understand. And even in the United States versus Asia the incidence of peanut allergy is increasing. And   so again we know more about it and we’re studying it more but definitely the increase of 200,000 emergency room visits 100 and 50 deaths each year from wonderful axes to food allergens. And those classic foods like you remember the shellfish allergy now the peanut allergy the most common foods that cause that serious anaphylactic immune response. Our peanut fish, shellfish tree nuts, milk, egg, soy wheat and the ninth most common food origin   that got added back in 2020 was sesame seed. And so those are the classic food origins that cause an immune response. And it’s called an I. G. E. Which is the allergy antibody that is made in in in certain individuals who have the chance of being allergic like that.   That’s the I. G. E. Mediated response and it causes the drastic can be life threatening reaction where you have wheezing hives usually their skin response and most of those reactions but it can lead to hives vomiting, diarrhea. And then what can be life threatening. And those individuals can be swelling of the throat and the airway which cuts off the oxygen and then   low blood pressure which leads to anaphylactic shock so that they don’t get good blood flow to their organs like brain and heart and kidney, kidneys and that’s what ultimately leads to death in the extreme cases.

MR: Well, I was in hearing you describe what type of a reaction someone might have. That is utterly terrifying. I can’t imagine having that experience. And and that’s the way that you find out, oh, you’re allergic to fill in the blank.

MG: I think, you know, 75% of people can react the first time they’re exposed to peanuts for instance. They can have reaction it fortunately if it if it does present usually in childhood. And so the first time might not, it usually is not that severe. It can, there can be warning signs before it gets to that point.   so thankfully, uh the way the immune system works, you are exposed more and more times. And so with future exposures, the reactions become more severe. So you can have warning signs so that you can get evaluated by a physician and hopefully a board certified allergist. So they can give you the tools and the education so that you know how to recognize And avoid those foods and teach everyone around you to help you be safe. But you can imagine how terrifying that is for families and patients to have to deal with that. And most of these foods, you don’t outgrow only 20% of people outgrow their peanut allergy, 10% outgrow tree nut allergy. Most people don’t outgrow fish, shellfish or seed allergy. But the good news is most everyone outgrows milk soy wheat and soy milk, egg and wheat allergy. And so those usually are childhood allergies and over 80% of people outgrow those by their teenage years. So that is the good news. And we have lots of you know studies that are ongoing about for peanut and tree nut allergy to help kids outgrow those.

MR: You know you mentioned some of the allergies that we know we may not be as familiar with.   Let’s go ahead and touch on some of those.

MG: Right. So there are other you know that is an immune reaction that is a IGE mediated and there are other   immune mediated reactions that are non IGE mediated that I heard you mention. And like celiac disease, it is an allergy, still an allergy to gluten and it’s an immune reaction where your body is develops an allergy to   that protein that is found in wheat. And it can cause serious symptoms too. But the skin test that an allergist has where we just prick your back and look for an IGE antibody that causes a wheel and a flare response looks like a mosquito bite. That’s not a way to pick that allergen up.   It can cause GI symptoms. Bloating, cramping. It can also cause skin findings. It can cause you to have joint aches more like an autoimmune. It is an autoimmune process. So it still can cause lots of serious problems.   and make you feel ill. But there are blood tests that can pick that up if it’s affecting it does usually affect your colon.   And so G. I. Doctors can help with that too. So definitely   It needs to be evaluated starting usually with your primary care doctor to run some of those tests and then to decide who to send you to from there.   Sometimes involving a gastroenterologist which is a stomach doctor that can help with that.

MR: That’s great. My one final question that I wanted to ask is can you can a person develop allergies at any point in their life just because they were born without allergies doesn’t mean that they can’t develop them later on or no. If you’re born without him, you’re pretty good.

MG: Yes you can develop allergies at any point.   You’re more likely you’re predisposed with an allergic immune system and it’s a very linked to your family history. And so a lot of babies. The first sign that you might be an allergic person   would be having eczema or a topic dermatitis and then   you could have a food allergy or not. And the most common food allergies again that you might develop early on would be milk, eggs, soy, wheat, possibly peanut. The foods that you’re more likely to develop though as an adult would be fish, shellfish, peanuts, tree nuts or seeds like sesame seeds and the peak age that most adults would develop. An allergy would be in their thirties. There is a newly discovered   and described food origin though that has been been described I think since probably 2006. And it’s an allergy to a protein and carbohydrate combination in mammalian meat. And that has been something that we’ve seen related to tick bites. We think to the lone star tick bite and it’s called an allergy I. G. E. Allergy to alpha gal. And it’s after eating meat 4 to 6 hours later developing anaphylactic symptoms of hives and usually gi symptoms. So that’s something that’s new that people should be aware of. Usually, you wake up in the middle of the night having hives, usually stomach cramps can pass out and I think more people are aware of it over the last several years. Usually, those people are allergic that so many people only about 30% of people are allergic and have hay fever sneezing but most people think everybody is allergic to something But 70% of the population don’t have any allergy. They never blocked by any Kleenex. They never have to use the Claritin. And so it’s you know 30% of people are allergic and are at risk of having a food allergy.

MR: Okay Dr. Melissa Graham, thank you so much. I’m excited to have you back because we still have   asthma to talk about as well. So we’ll get you back on and cover some other topics too.

MG: Thanks, Michelle. I’m happy to come back anytime.

MR: Thank you so much and thank you so much for joining us. We’ll see you back here next week for more AFMC TV.