In kids, it's actually cow's milk.

"You can cure food allergies."

You cannot cure food allergies right now.

"The best way to find out if you have a food allergy

is to get tested."

Myth.

Hi, my name is Dr. Wei Wei Li.

I am a board-certified adult and pediatric

allergy immunology specialist.

I have been in practice in New Jersey for the past 10 years.

Hi, everyone. My name is Dr. Payel Gupta,

and I am the cofounder and chief medical officer at Cleared,

and I've been practicing in New York City

for over 12 years.

Today, we'll be debunking myths about food allergies.

"Peanuts are the most common food allergy."

So, even though peanuts is a common food allergy,

it is not the most common.

In adults, it's actually a cross

between peanuts and shellfish.

In kids, it's actually cow's milk.

So, the nine most common food allergens

are cow's milk, eggs,

peanuts, tree nuts,

shellfish, fish, wheat, soy, and sesame.

Peanut allergies grab more headline

because they tend to cause more severe reactions,

especially in kids.

Gupta: Other foods like cow's milk and eggs,

when you have those allergies in infancy,

you'll grow out of them.

But for peanuts,

that allergy you're not going to grow out of.

And so I think that for those reasons,

it just kind of caught on a little bit more

than some of the other food allergens.

"You can use Benadryl to treat an allergic reaction."

You should not use Benadryl

as the only means of treating an allergic reaction,

for food allergies in particular.

Li: Benadryl is an oral antihistamine.

It can help with mild symptoms such as itchiness or hive,

but if you have more than just itchiness or hive,

like symptoms of anaphylaxis, such as trouble breathing,

difficulty swallowing, tongue swelling,

or feeling dizzy because of blood pressure dropping,

you really should go to your epinephrine auto-injector.

The saying is, "Epi first, and epi fast."

"Food allergies and food intolerances are the same thing."

I see that a lot of people,

even sometimes medical professional,

will confuse the two,

but they're really different.

Gupta: So, food allergies are actually mediated

by our immune system, and they're caused by

an antibody called IgE in our immune system

that reacts to food when it shouldn't.

When that happens, we release a chemical called histamine,

which then produces all of those symptoms,

like hives, difficulty breathing, low blood pressure,

swelling of the face, of the eyes, of the tongue,

vomiting, and sometimes even death.

Food intolerances,

or sometimes called food sensitivities,

don't have any of that.

They are not mediated by our immune system.

You have more gastrointestinal symptoms,

and they are not life-threatening.

Gupta: For example, lactose intolerance is a big one

that people have an issue with.

It's actually an enzyme deficiency in your body

where you can't digest lactose

because you don't have the enzyme called lactase.

And so you're going to have that bloating,

sometimes diarrhea, and just general feeling

of not feeling good after you ingest things

with cow's milk or with lactose.

Li: Knowing the difference between food allergies

and food intolerance will determine

what kind of treatment you need to receive.

"Food-sensitivity testing is accurate."

We just don't have good tests

to determine if somebody has a food sensitivity.

There are commercially available tests

called IgG, food-specific IgG testing.

They're not FDA approved.

We see IgG as a memory test

to show that you have eaten the food,

not an allergic reaction to the food.

Gupta: Which is different than true food-allergy testing,

which is an IgE test.

So those IgG tests that are often sold online,

we don't go by them.

Instead of testing, we would recommend a food diary,

where you can keep track of your symptoms,

the foods that you've been eating.

And then, over time, we'll start to see some patterns.

That's actually the most accurate and helpful tool

that we have at this time

to help determine food sensitivities.

"The best way to find out if you have a food allergy

is to get tested."

Myth.

The best way to find out if you have food allergies

is to eat it and to see if you have symptoms

after eating it.

So, that's called an oral challenge,

which is considered the gold standard

in diagnosing food allergies.

It's very safe, and it's in a controlled setting

with emergency medication on hand.

You can get an IgE blood test done at home.

We might get people showing up as possible positives

to some of the foods,

but it doesn't mean anything

unless you've actually reacted to the food.

For example, if I have a patient that comes in

who ate peanut and shrimp sauce

and then they had a reaction

and we're trying to determine,

was it the shrimp or was it the peanut

that they were reacting to?

That's when those IgE tests

and the skin tests that we do are super helpful

in helping us determine what the person reacted to.

"You can cure food allergies."

You cannot cure food allergies right now.

The only food that we currently

have an FDA-approved protocol for

is for peanut allergy.

Oral immunotherapy for peanut allergy

is where you get small amounts

of the peanut allergen over time.

In the beginning, you get monitored to make sure

that you're not having reactions right away.

And then the critical thing is

to take that amount of peanut every single day.

If they don't, if they miss a dose,

then it could kind of set things back,

and they could have a reaction

the next time that they're exposed to the peanut protein.

And I will add to that,

oral immunotherapy will lead to a temporary state

of desensitization or tolerance,

but not a permanent cure.

I would avoid the word "cure,"

because it can lead to misunderstanding for patients.

"Allergic reactions won't happen

if you didn't swallow the food."

Myth.

Even touching the food

without ingesting the food

can cause allergic reaction.

Gupta: That's why it's important to not touch a food

and then touch somebody that has an allergy to that food.

With shellfish allergy in particular,

because shellfish is usually steamed or boiled,

sometimes the food allergen protein from the shellfish

can actually end up in some of that steam or that vapor.

And so therefore it is, to a certain degree, airborne.

And if somebody who's highly allergic to that food

enters a room where shellfish is being boiled or cooked,

they may start having symptoms,

even without ingesting the food.

"Each allergic reaction will be worse than the last."

So, that's a myth.

The reaction can be unpredictable.

Reactions to food are unpredictable

because there are multiple factors that go into play.

So, what was the exposure, and how much of it?

Li: Asthma, that can worsen the severity of your reactions.

Gupta: And so adding an additional component

of inflammation and irritation

will make your symptoms worse.