My WebMD Sign In

Please enter email address

Enter your password

Keep me signed in on this computer

Show more Information

If you select "Keep me signed in on this computer", you can stay signed in to WebMD.com on this computer for up to 2 weeks or until you sign out. This means that a cookie will stay on your computer even when you exit or close your browser which may reduce your levels of privacy and security. You should never select this option if you're using a publicly accessible computer, or if you're sharing a computer with others. Even if you select this option there are some features of our site that still require you to log in for privacy reasons.

Forget your password? Having trouble signing in?

Why should I
sign up for WebMD?

With a WebMD Account you can:

Track your way to weight loss success
Manage your family's vaccinations
Join the conversation

See more benefits Sign Up

Why WebMD?

My WebMD

Show Menu

Facebook Twitter Pinterest

WebMD Home

Allergies Community

DUKE MEDICINE

Reply: Horrible allergies to deodorant

Dear Mapgirl8, What you've described above sounds like you may have developed a...

Posted by Michael H Land, MD

11 Replies | Reply | Watch This DiscussionReport This| Share this:Horrible allergies to deodorant Dear Mapgirl8, What you've described above sounds like you may have developed a...

DUKE MEDICINE

Reply: Chronic phlegm ? in throat after going to China

Dear Anon_228591 I have several patients who have increased mucus production...

Posted by Michael H Land, MD

1 Reply | Reply | Watch This DiscussionReport This| Share this:Chronic phlegm ? in throat after going to China Dear Anon_228591 I have several patients who have increased mucus production...

DUKE MEDICINE

Reply: Can't drink milk/protein shakes but can eat ice cr...

Dear Anon_179058, Your symptoms are a little bit tricky and I would consider a...

Posted by Michael H Land, MD

Dear Anon_179058,

Your symptoms are a little bit tricky and I would consider a few possibilities for your diagnosis. There are a few individuals with milk allergy who can tolerate the foods if they are prepared a certain way (highly heated, or baked). A subset of milk allergic patients cannot tolerate milk, but they can have another dairy product if it has been baked in a dessert or food (i.e. lasagna with cheese or cakes). It is not clear to me why you can have ice cream but not milk without the same symptoms. Can you have yogurt or pudding? Another possibility is that you might have a lactose intolerance, which is not an "allergy" by definition, but a GI problem where you lack an enzyme to help digest lactose. This could explain your stomach upset that occurs later. Another possibility is that you are developing a milk allergy or it is going away. I have had adult patients who were fine drinking milk as children and young adults and began having symptoms more often intermittently with milk or pizza, and over a period of a few years, discovered that they would have symptoms more frequently until it was every time. This is pretty rare, but it could occur.

Regarding the egg, you might also be in a small subset of patients who can tolerated highly heated (baked) goods containing egg but not able to tolerate low-heated versions. I have several pediatric patients who are egg allergic (if they eat a scrambled egg), but they can eat cakes, brownies and cookies that contain egg that has been baked.

What happens at high heat is the temperature may denature (or change the shape) of proteins, which changes how it appears to your immune system.

Since your case is challenging, I would encourage you to bring up your questions with a well qualified Food Allergy specialist to further define if you actually have the food allergy, if it is to certain forms of the food, or if it is an intolerance. You could talk to them about considering a blood test for ovomucoid IgE, which can also help define the egg allergy.

Good Luck, and let us know what happens.View Thread

Posted byMichael H Land, MD

6 Replies | Reply | Watch This DiscussionReport This| Share this:Can't drink milk/protein shakes but can eat ice cream, cheese, and other dairy? Dear Anon_179058, Your symptoms are a little bit tricky and I would consider a...

DUKE MEDICINE

Reply: New Allergies

Dear Bluegray8 and ryanandleigh, You bring up a very very common question and...

Posted by Michael H Land, MD

Dear Bluegray8 and ryanandleigh,

You bring up a very very common question and an issue that is often misunderstood by patients and even physicians. The blood tests for food specific IgE that some allergists send for evaluation of food allergies are tools that help us determine if there is something called "sensitization" or another way of putting it is "if your body has 'recognized' the food immunologically." Presence of sensitization does not make the diagnosis of food allergies or mean that you would have clinical reactions. This is the part that most people (even doctors) have difficulty understanding.

If you were to measure someone off the street for IgE to foods that they regularly consume, it is quite possible that "several foods" would be detectable. I might tell this person that the results are not applicable to their food ingestion history and to ignore the results.

Having "Detectable" antibody does not necessarily mean "positive or negative." I see this every day in my clinic. A typical scenario: a patient has a blood test done by a practioner who does not understand the interpretation of the result and is told that they have a food allergy when it makes absolutely no sense. In fact, it is sometimes a food that they eat every day. You would be right to question this strongly.

The most important part of their evaluation is "can you eat the food without having an allergic reaction?" If it is a food that is regularly tolerated without the presence of an immediate allergic reaction, I would strongly question the diagnosis. I have had patients who drink milk every day and love ice cream, yogurt, pudding, and cheese pizza who are told they are milk allergic based on a blood test, which is absolutely incorrect in my opinion.

The bottom line is that I would be very careful about trying to interpret these tests outside of the appropriate clinical context or jumping to conclusions without talking to your doctor. These tests are tools that help allergy specialists determine the risk of a reaction but MUST be interpreted in the context of a clear clinical history of a reaction.

I would encourage you to have a detailed dietary discussion with your doctor and focus on actual foods that your son has tolerated that contain sesame (hummus, burger buns, etc.). If he has not really eaten it before (or you cannot be sure), it is certainly possible he may have the allergy, but this diagnosis is more difficult/complicated to make. A skin prick test may also help lean your doctor one way or another.

Hopefully this helps. This is a very confusing issue to many folks out there and one reason why food allergies are sometimes overdiagnosed/misdiagnosed. If you can tell by what I've written above, it is an issue I feel VERY strongly about (making the correct diagnosis). Recent food allergy guidelines were released for physicians who take care of people who might have food allergies to help with making the diagnosis and treating patients with it.

Good Luck!View Thread

Posted byMichael H Land, MD

2 Replies | Reply | Watch This DiscussionReport This| Share this:New Allergies Dear Bluegray8 and ryanandleigh, You bring up a very very common question and...

DUKE MEDICINE

Reply: Allergy to Soy.....but problem with cheese...HELP

Dear Jaylee4841, I'm sorry to hear about your symptoms and recent diagnosis of...

Posted by Michael H Land, MD

2 Replies | Reply | Watch This DiscussionReport This| Share this:Allergy to Soy.....but problem with cheese...HELP Dear Jaylee4841, I'm sorry to hear about your symptoms and recent diagnosis of...

DUKE MEDICINE

Reply: Struggling with whether to start 5 year old son on...

Dear Christine, Your question is a very good one and always a difficult...

Posted by Michael H Land, MD

Dear Christine,

Your question is a very good one and always a difficult decision to make. With your son's age group, some kids are very open to getting shots if they have some pain-free "cream" or a numbing device (like a handheld massager) to prevent sensation of the injection, while other children will start to hyperventilate if they know they're going to the doctor's office and the entire experience each week is a nightmare from a panic-like attack. Depending on what kind of child your son is, it may not be worth the added stress in your life if it's going to be a weekly anxiety-filled visit, tantrum, etc. If things are going well, why change? I would say "just because you can do it, should yo do it?"

I always ask parents to weigh the pros and cons. It is a time consuming (3-5 year) therapy, and each visit requires a 30 minute observation period after the shot. It has a great potential to reduce his sensitivity and he could possibly not require the medications (or as much) in the future.

Firstly, if medical therapy controls his symptoms very well, and he tolerates taking the medicines without too much trouble, you could maintain him on treatment for a few more years (seasonally). The decision could be deferred. Is he an indoor kid (crafts, games, reading, etc.) or an outdoor kid (sports, bikes, running around)?

If he's a child who may not have that much exposure to the triggers, he might do just fine on medical therapy.

On the other hand, if he is always outside, always exposed to the triggers, or the medications aren't as effective, then it may make a big difference in his quality of life. I have patients who are soccer players, football players, and their sports performance suffers from their allergies and asthma, even on medication.

I give every family different advice depending on their unique circumstances: How the child feels about shots (will it make your life worse?), if he is a kid with high exposure, if the medications are effective or not, and other factors like if they have Asthma or other conditions they might suffer from. Also, if you plan on moving anytime soon (to another country, or to a different region of the US (assuming you are in the US)), it will make a difference on if the shots are necessary or not.

I would have a good discussion with your allergist and perhaps get a second opinion if you're still not sure. If you decide to go for it, I would encourage you to get the shots done by a Board Certified Allergist who has done a 2-3 year fellowship in Allergy/Immunology. This type of doctor has trained in either pediatrics or internal medicine for 3 years before doing their specialty training. The difference between this type of physician and doctors in general practice (i.e. Family medicine) or Ear, Nose Throat surgeons is the training in allergen vaccine dosing and regimens.

Good Luck!View Thread

Posted byMichael H Land, MD

6 Replies | Reply | Watch This DiscussionReport This| Share this:Struggling with whether to start 5 year old son on allergy shots Dear Christine, Your question is a very good one and always a difficult...

DUKE MEDICINE

Reply: Itching all over body without obvious rash or caus...

Dear mflint, I'm not sure if you're the same person who posted "itch but no...

Posted by Michael H Land, MD

17 Replies | Reply | Watch This DiscussionReport This| Share this:Itching all over body without obvious rash or cause Dear mflint, I'm not sure if you're the same person who posted "itch but no...

DUKE MEDICINE

Reply: Itch but no rash

Dear Anon_173507 I'm sorry to hear that your problem is not going away....

Posted by Michael H Land, MD

3 Replies | Reply | Watch This DiscussionReport This| Share this:Itch but no rash Dear Anon_173507 I'm sorry to hear that your problem is not going away....

DUKE MEDICINE

Reply: Acupuncture for Allergies

Dear Anon_169125 You bring up a very interesting question and one that I...

Posted by Michael H Land, MD

2 Replies | Reply | Watch This DiscussionReport This| Share this:Acupuncture for Allergies Dear Anon_169125 You bring up a very interesting question and one that I...

DUKE MEDICINE

Reply: Allergic Rhinitis plus Flonase...no help

Dear Brett128, It may be too early to see if you are having a response to your...

Posted by Michael H Land, MD

5 Replies | Reply | Watch This DiscussionReport This| Share this:Allergic Rhinitis plus Flonase...no help Dear Brett128, It may be too early to see if you are having a response to your...

1 234

Women's Health Newsletter

Find out what women really need.

For more information, visit the Duke Health Asthma and Allergies Center

Other Allergies Information

The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment.

Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately.

Allergies Community

See All

Preferences

My Communities

My Discussions

My Email Digests

Michael_Land

Latest Activity

Women's Health Newsletter

Other Allergies Information

Health Solutions From Our Sponsors

More From WebMD:

Find us on:

Allergies Community

See All

Preferences

My Communities

My Discussions

My Email Digests

Michael_Land

Latest Activity

Women's Health Newsletter

Other Allergies Information

More Related Communities

Health Solutions From Our Sponsors

More From WebMD:

Find us on: