May 17, 2015

Q & A: How can you test for an allergy without seeing the doctor for injection/prick testing? (And more about allergies)

**Just as a disclaimer, this is not intended as medical advice. If you are exhibiting symptoms of a severe allergic reaction, go to a hospital.**

This question is about honey, and my answer is based on food-related substances. Obviously you wouldn't ingest a non-edible skin care ingredient to check for allergies, so use your noodles kids. ;)

A commenter on YouTube asked:

Q: Honey makes me red and itchy :( my skin is so sensitive and weird..

I suggested that she might be allergic, and she responded:

Q: I'm afraid so.. don't think I've ever noticed any issues with eating honey though. Are there any ways to test for allergies/intolerances without doing tests and stuff at the doctors?

A:  Patch tests and elimination/reintroduction. Patch test would be applying a substance to the inside of your elbow for a few days to see what happens*. Elimination/reintroduction would be eliminating the substance for 2 months, then reintroducing and assessing how you feel. That sounds like a histamine response to me, so it seems probable. I realized I was allergic to honey because I got eczema on my face every fall after it started to get cold and I was drinking tea (with honey), which I didn't drink during the warmer months. Injection test confirmed it (rather spectacularly--I got a huge welt). 


*Redness and itchiness are two classic symptoms of an allergic response, so if a suspicious substance causes this reaction in a more controlled, but still vulnerable environment (the inside of your elbow), it's pretty safe to conclude that your skin won't tolerate it. 

As for elimination testing, that is a bit more nuanced. There are a wider range of symptoms for food allergies than the stereotypical anaphylactic response (throat closing, face swelling, epi-pen needing). Symptoms can range from headaches, to itchy skin, dizziness, sinus congestion, digestive discomfort/pain/changes (diarrhea or constipation), vomiting, labored breathing, insomnia, muscle/joint pain, fatigue, etc. So the idea is just to eliminate the suspect for a long enough period that can "start over" with it, then eat it again and see how you feel. Sometimes a response can take a few days of consistent ingestion, or one large serving, to manifest. Take note of any changes in how you feel, keeping in mind how varied the symptoms can be, then repeat the experiment if you're not sure. 

There is a substantial connection between digestive health and the skin, so for everyone experiencing skin symptoms of chronic inflammation (chronic acne and eczema primarily, but anything that is chronic and inflammatory, including sensitivity and dermatitis) I always recommend doing elimination testing for the big two allergens, wheat and dairy. Digestive allergies can manifest in such diverse ways that your skin inflammation may be your primary symptom (it may not, but you don't have much to lose by testing it), and you may not have overt digestive symptoms at all. So if you have any suspicion whatsoever that a food is making you feel less than great, I very highly encourage you to try elimination testing.  

For someone like me who has a lot of autoimmune allergies, I can get away with eating most of my allergic foods occasionally in small quantities without having dramatic symptoms (some I have to avoid completely, like wheat, dairy, and alliums). Honey, for example, only manifests as eczema with regular ingestion, but if I have more than a small amount at a time, I will start feeling vaguely ill (kind of dizzy and queasy). So as a minor sweetener in my sister's twice-yearly gluten free cupcakes, sure. But more than that is out of the question. I also avoid honey in skin care products because it does cause external symptoms, again the itching and redness. 

This is my own personal experience, and it is not intended as medical advice. 

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