Health x Wellness

Can someone develop allergies without a family history and over time?

By  |  0 Comments

Allergies can develop later in life if you’ve had very minimal exposure to the allergen in childhood. It is also possible to become allergic to something that you had no allergy to before.

Most who have allergies from young tend to outgrow their symptoms and become tolerant to the allergen after their teen years.

But the fact is that allergies can develop anytime in one’s life. A possible situation with an allergy returning in your 20s, 30s or 40s could be one where your immune system is impaired from lifestyle, stress or even illness.

Other possible situations include having very minimal exposure to the allergen in childhood, thus not getting an allergy until one is exposed to a higher concentration of the allergen.

Lastly even moving to a new country (from a cold climate to a warm and humid one), or even keeping a new pet. All these situations can trigger off potentially “new” allergies even though one already has allergies to them in childhood.

It is also possible to become allergic to something that you had no allergy to before.

How would they know and what are the tests they can do?

Some people keep an allergy diary and detail the food, environments, and possible triggers they may come into contact with. However, this is still an educated guess approach.

The alternative to find out is to either do an IgE blood test or a skin prick test to test for allergies.

Is there a gold standard to allergy testing?

The gold standard for food intolerance testing is an Oral Food challenge. However, this has to be done under close supervision where emergency treatment and medical staff are on standby to address any life threatening reactions.

An acceptable and possibly safer alternative is an IgE blood test.

The gold standard for environmental triggered allergies is a skin prick test. This can only be done if one has not taken any medications that interfere with the immune system (anti histamines, steroids, immunomodulators) for at least 5-7 days.

Again, the acceptable alternative without these restrictions is an IgE blood test.

Both the skin prick tests and the allergy blood tests can be done at a GP+ practice such as DTAP clinic.

How many people in Singapore suffer from allergies?

About 1 in 10 people suffer from allergies.

Is there an increase over the years?

Allergies are on the increase worldwide but a recent anecdotal phenomenon is that people are increasingly working from home. This means that they are exposed on a prolonged basis to their environment – whether its dusty, or with animals (pets/pests) or with the immediate pollen from their garden, leading to them experiencing more symptoms.

Furthermore, the COVID-19 pandemic has seen more people order take outs which also translates into not knowing what goes into one’s food nor being able to control what goes in. New food exposures could also lead to previous unknown food intolerances flaring up.

What is anaphylaxis and can someone check for this in advance, both adult and child?

Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. It typically causes more than one of the following: an itchy rash, throat or tongue swelling, shortness of breath, vomiting, lightheadedness, and low blood pressure. These symptoms typically come on over minutes to hours

Anaphylaxis is a medical emergency. If you have an epipen, you can use it immediately. If not, one should head to the Accident and Emergency department immediately.

Anaphylaxis is not something you can readily test for but having an idea of what you are allergic to through skin prick testing or IgE blood tests can give you a very good indicator of what to avoid. These items one is allergic to can potentially trigger an anaphylactic reaction.

What are the possible allergic reactions to the COVID-19 vaccine and self-test kits?

Self test kits are safe because there is no external allergen interaction with the body.

Previously COVID-19 vaccines were off limits to people with histories of anaphylaxis. But recently after numerous robust studies, it is considered safe for everyone EXCEPT those who may have an allergic reaction to the first dose.

This allergic reaction would usually occur in the first 30 minutes of the observation time post-vaccination and picked up by the vaccination site medical team on duty.

How does one manage allergies? Are these allergies treatable? What are the treatments available?

Allergy management can be done with a few approaches – allergen avoidance, symptomatic treatment, long term sublingual immunotherapy that “cures” allergy.

But in summary, allergy avoidance involves avoiding food one may be allergic to, modifying one’s environment to prevent a build up of environmental allergens such as dust mites and or reducing exposure to pets which may trigger an allergic reaction.

Symptomatic treatments range from anti-histamines to nasal decongestants to nasal steroids or even steroidal creams for rashes.

What is more exciting is SLIT – shortform for sublingual immunotherapy.

SLIT involves “priming” the body to stop reacting to the exact cause of the allergy. This treatment is also known as Sublingual Immunotherapy or SLIT. A mix of low dose allergens are created in a spray, this spray is taken once a day under the tongue for 3-5 years. Most patients see an improvement after 6 months and the best effects are usually seen after 4 years.

SLIT is currently produced for and useful for inhalant allergens only.

Studies have shown an improvement in symptoms, reduced reliance on medications and the lasting effects many years later even after treatment has stopped.

Overall, this is a safe and effective treatment with no life threatening reactions reported in over 4500 patients treated.

What are some common allergies suffered by men compared to women and are there differences?

Studies have shown that post pubertal females are at higher risk of allergies such as sensitive nose, sensitive skin, sensitive eyes and airways and even food sensitivities and asthma compared to men.

Whereas prepubescent males are found to have more allergies in comparison with females.

Gender differences in immune responses are complex and differ with age with multiple interplays between the immune system.

What is important despite these differences is that the earlier you act on these allergies, the sooner you can return to a better quality of life with the improvement of these symptoms

Article contributed by Dr Julian Hong. Dr Hong is the resident doctor at DTAP Clinic. He graduated from Imperial College London and started his career in the local hospitals, gaining extensive experience across disciplines (Medicine, Surgery, Paediatrics, Obstetrics and Gynaecology) with a subsequent focus on the care of children and gaining procedural skills. He believes in keeping abreast of the latest medical advances and has contributed to medical research, winning research grants, prizes and awards along the way. He is also an alternate director of Resilience Collective, and a moderator at the Singapore Mental Health Conference, on “Empowerment and Recovery”.

Photo by Towfiqu barbhuiya on Unsplash