Allergies? Or Just Intolerance?

This article may be somewhat late in coming. Some of us have probably been sneezing, scratching, coughing, and wheezing for about a month now. Nonetheless, it’s always good to put reliable medical information out there, especially on a topic like allergies.

What are allergies?

First, some background. An allergy refers to an abnormal response or over-reaction of the body to certain substances, which are called “allergens.” Allergens may be inhaled, swallowed, or brushed up against, but they all trigger a reaction from the body’s immune system. Normally, the immune system protects the body from harmful foreign substances by producing antibodies and other chemicals to fight them off. An allergic reaction occurs when the immune system mistakes a harmless substance for a harmful one and releases chemicals – such as histamine – to attack the perceived threat. Histamine is what causes the allergy symptoms you experience.

Allergies are often hereditary, but you’re not guaranteed to develop allergies just because a family member has them. Additionally, allergic reactions are consistent every time you encounter the same allergen.

What are NOT allergies

One of my biggest concerns as a pediatrician is the tendency of first-time parents to withhold foods from their children because they’re afraid their child is allergic. When children start eating solid food, some foods will cause the child to have a reaction. For example, a toddler who eats peanuts for the first time may develop a rash. His parents may then completely remove peanuts from the child’s diet in fear that the child has peanut allergies. I do not recommend this response. Without testing, it’s impossible to know whether the child is truly allergic or if s/he simply has an adverse reaction or a food intolerance, both of which are NOT allergies.

An adverse reaction is simply that. A person eats a strange food for the first time and has a reaction. It’s not life-threatening, nor does it affect his/her daily activities. Food intolerance causes adverse reactions and can be overcome with increased exposure to the food. Just remember: if the immune system isn’t involved, it’s not an allergy.

And even if it is an allergy, parent can always try to reintroduce foods when kids reach 5 years of age, which is when most kids outgrow their allergies. Realistically, if your child has an adverse reaction to food, it’s statistically not likely to be an allergy. Only 4% of kids have food allergies. And the only food allergens that have a lifelong impact are seafood and nuts.

The importance of testing

True allergies trigger an immune response and cannot be cured. Some allergy symptoms are benign and don’t affect daily activities or sleep. Other allergy symptoms are potentially fatal and should be treated with steroid sprays, an epinephrine pen, immunotherapy.

Testing is so important; I can’t stress this enough. If you think you or your child has allergies, get tested. There are three types of allergy tests: skin prick test, blood test, and oral challenge. The first two are the most sensitive for detecting general allergies. The last one is the gold standard for food allergies and is usually conducted in a medical setting.

Allergies and Beijing

Upon moving to Beijing, some parents are perplexed why their child – who was perfectly healthy in their home country – is suddenly experiencing allergy symptoms. Beijing has tons of allergens, but I can assure you that your child did not suddenly develop allergies. Allergies are genetic. Your child may have always been symptom-free, but that might have been due to living in an environment with minimal allergic triggers. Another possibility is that your child may not have allergies at all and is simply experiencing an adverse physical reaction to the environmental irritants in Beijing.

Whether or not this is reassuring, just know that the allergies you encounter in Beijing are pretty much the same and the allergies you would encounter anywhere else in the world. Spring and autumn – and the prevalence of pollen – are notorious for being peak seasons for those with respiratory allergies. Skin allergies are most common in winter. Summer is actually a low season for child ailments because pollen has died down and kids are outdoors as opposed to cooped up in rooms that may turn into petri dishes for pathogens. Just be glad you don’t live in a tropical climate where allergies can be exacerbated year-round.

The only allergy-related tidbit that is unique to Beijing is the lack of continuous care. When I worked in Singapore, allergies were more likely to be accurately diagnosed and detected early because the culture encouraged continuous care from one doctor. In Beijing, children get seen by various doctors, all of whom has limited knowledge of the child’s medical history. My suggestion is – if at all possible – to try to receive consistent care from one doctor for your family or children. Familiarity with your family or your children will contribute a lot to developing an accurate diagnosis.

So get some sun. Have fun. And if you find yourself or your children sneezing, scratching, coughing, and wheezing, come by and see us or your family doctor for an accurate diagnosis of what’s going on.