Sometimes allergies can be fairly obvious and occur in response to common exposures, for instance, when pollen covers your car in the springtime, and you can’t stop sneezing!  Other times it can be hard to recognize what is causing an allergic reaction. The cause may be something that you would never relate your symptoms to. We will discuss a few of these less recognized allergies below. 

     1. Oral Allergy Syndrome

Patients who suffer from worsening pollen allergies can sometimes develop a condition known as Oral Allergy Syndrome or Pollen Food Syndrome.  This can lead to oral itching and tingling after eating a variety of fresh fruits and vegetables.  Interestingly, these patients can often tolerate cooked versions of these foods because the cooking process can break down the allergenic protein. Think, I can eat apple pie with no problems, but when I eat a raw apple, my mouth is itchy and tingly. If this is you, it’s likely that you are not allergic to the apple, but you are allergic to the pollen the apple cross-pollenates with. 

   2. Alpha-Gal Allergy

There has been an increase in allergies to Alpha-Gal a carbohydrate that is found in mammalian meats.  Unlike most food allergies that occur shortly after ingestion of the responsible food, reactions to eating mammalian meats due to Alpha-Gal allergy can be delayed for several hours after it is eaten.  This is because most food allergies are to proteins, but Alpha-Gal is a carbohydrate which takes longer to digest and trigger the allergic response.  This delayed reponses makes it difficult to diagnoses. One generally becomes allergic to Alpha-Gal after being exposed to Alpha-Gal in the saliva of a tick bite.  After they have developed the allergy, they are then at risk for potentially life-threatening delayed anaphylaxis when they eat mammalian meats such as beef, pork, lamb, or venison.  

   3. Chronic Urticaria

Chronic urticaria is a condition where a patient has recurrent episodes of urticaria or hives and sometimes swelling or angioedema for more than 6 weeks.  Although urticaria can often be a sign of an allergic reaction to a medication, food, or insect sting; chronic urticaria rarely is the result of an allergy.   It can be a very debilitating condition and affect a person’s quality of life due to recurrent unpredictable episodes of extremely itchy hives. Seeing an experienced board-certified allergist who will take a detailed history, physical, and labs, if needed, can help rule out other underlying causes.  Often chronic urticaria is an autoimmune condition which can be controlled with a combination of medications and the help of a physician experienced in treating chronic urticaria. 

   4. Fire Ant Allergy

Although it is very rare to have an anaphylactic reaction to an insect bite, insect stings are at risk of causing allergic reactions.  No one is born allergic to insect stings but can develop an allergy after being stung. Once you become allergic, you will be at risk for a potentially life-threatening anaphylactic reaction with each subsequent sting.  Contrary to common belief, fire ants sting people and inject venom much like bees, wasps, yellow jackets, and hornets. In the Lowcountry, fire ants cause more insect sting allergies than all the other stinging insects combined.  If a patient thinks they have an insect sting allergy they should see a board-certified allergist for testing.  If an allergy is confirmed then the patient should have an anaphylaxis action plan, be prescribed self-injectable epinephrine, taught avoidance measures, and go on a course of venom immunotherapy.  Venom immunotherapy can desensitize a patient which over time can cure them of their fire ant allergy.  

   5. Penicillin Allergy

Over 90% of people who think they are allergic to penicillin, once tested, are not actually allergic.  Incorrectly having a penicillin allergy diagnosis can make it harder for medical providers to treat an infection and make it more costly to have to use alternative antibiotics.  Skin testing to penicillin reagents is approximately 95% effective at ruling out a current penicillin allergy. The board-certified allergist may then elect to do an oral challenge to a penicillin in the office to confirm that the patient is not currently allergic to penicillin and that they do not need to continue to avoid penicillins.  

If you think you may have one of these allergies, make an appointment to see any of our board-certified allergist so we can help you get an accurate diagnosis and treatment plan.