One day in 2020, a friend reached out to Alana Roshay, QPOC (queer People of Color) advocate and co-host of The Consciousness Salon Podcast, to share fresh baguettes that a restaurant had just given her.
Roshay enthusiastically accepted the offer, not expecting the reaction her body would have to the gift.
“I brought it home, cut it up, toasted it, ate it, and I was so congested,” says Roshay. “It was pretty instant. It was within 10, 15 minutes, and I went out to go for a walk. And I thought, ‘Why do I feel awful?’”
Then she woke up the next day with “full-blown symptoms.”
Roshay had stopped keeping bread in the house around 2018, after moving in with her partner at the time, and just wasn’t eating much of it.
“So here I am with all this bread, and it messed me up,” says Roshay. “When I met with a doctor, we talked about it, and she said, ‘Look, you can try having a piece [of bread], but if your body reacts that way, you know you have your answer.’”
Roshay shares that discovering her new allergy to wheat was a bummer. “I would eat bread like it was going out of style growing up,” she says.
But Roshay adjusted. She was no stranger to frustrating allergies. Wheat wasn’t the first major allergy, nor the fifth, she’d been diagnosed with in her lifetime.
“Most food allergies develop in childhood,” says Dr. Kelly O’Shea, clinical assistant professor in the Division of Allergy and Immunology at the University of Michigan and research assistant professor at the Mary H. Weiser Food Allergy Center.
“The most common new onset food allergies in adults occur with shellfish or fish. However, in very rare cases, adults can get a new onset food allergy with other foods as well.”
O’Shea notes that another food allergy that can develop later in life is a type of sensitization to certain meats that occurs after a tick bite, called alpha-gal syndrome.
“This presents as delayed (3–8 hours after eating) anaphylaxis to meats,” explains O’Shea.
Additionally, O’Shea explains that some people with seasonal allergies may develop a condition called pollen food allergy syndrome.
“This typically presents as mouth itching with uncooked fruits and vegetables with cross-reactive pollen-related proteins. Symptoms do not occur if the fruit or vegetable is cooked.”
Roshay’s first allergies began when she was a baby.
“Immediately, my mom could see that my skin would start to break out when she would start to breastfeed me,” says Roshay. Her mom had to do an elimination diet so that she could continue to breastfeed.
Tree nuts (TNs) were a big issue for Roshay as a child and continue to be a problem for her and many others.
Research finds that when it comes to food-related allergies, nuts are a common allergy that can lead to anaphylaxis, a severe and potentially fatal reaction. In a 2015 and 2016 survey, 2.9 percent of adults in the United States reported having a peanut allergy.
“I remember being in third grade, and my mom accidentally gave me something with nuts in it, and I threw up in the administrative office,” says Roshay. “As early as I can remember, the smell of peanut butter made me nauseous.”
Roshay discovered that she had a tier system for nut allergies. “Cashew and pistachios are EpiPen statuses, and then for pine nuts, almonds, and peanuts, I have a less extreme reaction,” she says.
When it comes to her nut allergies, Roshay’s symptoms include an itchy throat and nausea.
She also has a dairy allergy. “With dairy, my sinuses become inflamed, my nose turns into a faucet, and I sneeze constantly,” says Roshay.
O’Shea shares that the most common childhood food allergies that people outgrow are egg and milk.
“Although less likely, other food allergies common in childhood — like peanuts, tree nuts, soy, wheat, sesame, fish, and shellfish — can also be outgrown,” says O’Shea.
While Roshay grew out of her childhood banana and shellfish allergies in her twenties and thirties, she still has sensitivities to dairy and nuts.
Since allergies can change over time, O’Shea recommends that those with food allergies get regular evaluations.
“If there is evidence that someone is outgrowing an allergy, your allergist may recommend what is called an ‘oral food challenge,’ where the patient is closely monitored in the office while they consume the food to ensure that they have truly outgrown their allergy,” says O’Shea.
It’s not just foods that brought on Roshay’s childhood allergies. Dogs, cats, and horses also cause reactions.
“What’s crazy is that until this day, I can be around puppies because something about them going through puberty, that is what I’m allergic to. They then start to produce a different type of dander,” says Roshay.
Other childhood health conditions that Roshay continues to deal with include asthma and eczema, which seem to flare up in a trifecta with some of her allergies.
Though most of Roshay’s allergies originated in childhood, the wheat allergy wasn’t the first new food allergy that she developed as an adult. In her twenties, she became allergic to certain fruits, including cherries, nectarines, peaches, and coconuts.
“Any of those fruits with larger seeds or pits in the center caused a reaction,” she says.
Living with so many allergies, Roshay shares that the limitations of testing and treatments have been a major frustration.
“Unfortunately, allergy testing, especially with regards to foods, is limited,” explains O’Shea. “There are no tests available to predict food sensitivities. There can be many ways that foods disagree with people, but our testing is only able to evaluate for food allergy and not food sensitivities.”
According to the American Academy of Allergy, Asthma & Immunology, it’s important for people to understand that allergies are different from intolerances and sensitivities. While intolerances and sensitivities may be uncomfortable, allergies are an immune response that can be dangerous and even lead to a fatal reaction.
Some companies offer food IgG tests that claim to be able to diagnose food sensitivities. However, due to a lack of data and scientific studies to support their use, both the American Academy of Allergy, Asthma & Immunology and the
Growing up, Roshay found that she didn’t have much luck with the treatments available. Throughout high school, she would get weekly immunotherapy shots, but they didn’t work for her.
“They would take those allergens and put it into a solution somehow and inject it into our skin. And they would measure the size of its reaction,” says Roshay. “Sometimes it would react the size of a quarter, like a big welt.”
According to the American Academy of Allergy, Asthma, and Immunology, allergen immunotherapy may decrease symptoms for certain allergies by gradually increasing doses to build up a person’s tolerance for the allergen.
“I did it for years, and my body just never took to it,” says Roshay.
O’Shea urges those who think they might have food allergies to be evaluated by an allergist as soon as possible.
She points out that signs and symptoms of a food allergy may include:
- vomiting or nausea
- shortness of breath
- recurrent coughing
- swelling of the lips, tongue, mouth, or eyes
- trouble swallowing
- hoarse voice
“If someone experiences these symptoms within the first 2 hours after eating, they should seek immediate medical care,” says O’Shea.
“Clinical history is very important for food allergy,” O’Shea continues. “A trained allergist can discern concerning clinical history and perform testing if necessary. Both skin testing and blood testing for food allergens may be warranted, and these tests are used in conjunction, to predict the likelihood of a true food allergy.”
While there are promising solutions on the horizon, O’Shea explains that the only sure way to manage food allergies is to avoid the foods that are causing the issues altogether.
“People should make sure to read food labels closely … In addition, it is so important for everyone with food allergies to always have their epinephrine autoinjectors (a potentially lifesaving medication) on themselves in the event of an accidental exposure.”
O’Shea anticipates that the landscape of food allergies will change drastically in the next 10–20 years, with food allergy management and treatment evolving fast.
One of the biggest breakthroughs in recent years for managing food allergies has been oral immunotherapy. In January 2020, the
“This product is an oral treatment that must be taken every day and helps to lower the risk of an allergic reaction to peanuts from accidental ingestion,” says O’Shea.
“Currently, research in the field of food allergy is growing rapidly. There is global interest in understanding the increased incidence of food allergy as well as improving clinical testing and treatment options for people with food allergies.
“Creative and innovative treatments for food allergy are being studied, including biologics, vaccines, and different forms of immunotherapy,” O’Shea adds.
In May 2021, Roshay decided to meet with a new doctor, a board certified MD, FACEP with a background in both Western and Eastern medicine, to try to better understand her allergies.
“I made an agreement with myself,” she says. “I told myself that by the time I turned 40, I’m going to know what is wrong with me. I’m going to get to the bottom of my health and be in control.”
After some tests, including a stool test, and discussing her experiences with the doctor, Roshay went on a strict diet. She cut out triggers like sugar, gluten, dairy, and foods high in histamines.
Roshay learned about which foods contain histamines, and it turned out that meant eliminating a lot of things she loves, like avocados and fermented foods.
“Let me tell you, I’ve never been healthier,” says Roshay. “My skin cleared up, my eczema went away. I was so hydrated. I had no allergies, and I wasn’t taking allergy medicine.”
It was the first time in her life that Roshay can remember not needing allergy medication for 2 months. “It all came down to what I was eating,” says Roshay.
When it comes to dairy, oat milk alternative has been a game-changer. “Now with oat milk, dairy has been so much easier to navigate. I can have oat milk ice cream, I can have it with my cereal, they have pizza,” says Roshay. This gives her a new world of possibilities because she can’t have almond or cashew milk due to her nut allergies.
“It really saved my life in terms of alternatives to dairy,” she says.
For Roshay, like many others, living with allergies has been an evolving journey. She explains that there’s a certain empowerment around taking steps towards greater awareness of her body.
“I may not be able to solve it or completely heal,” says Roshay, “But now I have the tools, understanding, and awareness to better navigate my allergies.”