All posts by Charleston Allergy and Asthma

What are inhalers & how do they work?

Bronchodilators, or most commonly called inhalers, are medications that are breathed through the mouth and into the lungs to help relax muscles that tighten around your airways. The medicine helps open the airway and lets more air move in and out of your lungs and helps you breathe more easily. 

People with asthma use inhalers during an attack when their airways swell and become narrower. These attacks cause the person to cough, wheeze and have trouble breathing. Almost everyone with asthma will use a bronchodilator to help open their airways. Others may use one at some point in their life if diagnosed with a persistent cough, COPD, bronchitis, etc. Different inhalers have different medications, or a combination of drugs, to address different illnesses. 

Different Kinds of Inhalers

There are three basic types of inhalers that deliver medications. The most common is the metered-dose inhaler (or MDI) which uses pressure to push the medication out of the inhaler. Nebulizers use air or oxygen and deliver a mist of the medication through a tube or mask that fits over your nose and mouth. Dry powder inhalers (or DPIs) deliver medication, but they require a strong and fast inhalation.

Short-acting bronchodilators are used as “quick-relief”, “reliever”, or “rescue” inhalers. These bronchodilators open the airways and help stop or relieve acute asthma attacks very quickly. While they’re best known for working on sudden attacks, they’re also great to use before exercise to help stop asthma during your workout. 

While many people use short-acting bronchodilators, the overuse of an inhaler, tablet, or liquid/nebulizer, is a sign of uncontrolled asthma that needs better treatment. If you are using short-acting bronchodilators more than twice a week, call Charleston Allergy & Asthma about improving your asthma control therapy.

Long-acting bronchodilators provide control, not quick relief, of asthma. Your board-certified allergist will prescribe the medication, which is usually taken twice a day along with inhaled steroids for long-term monitoring of symptoms. 

Unlike short-acting inhalers, long-acting inhalers do not work on muscle inflammation directly. Instead, they help the airways relax, allowing more air to pass through.

If you’re struggling with your asthma or think you may be in need of a prescribed inhaler, request an appointment online today.

 

Sources:

https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/asthma-inhalers

https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/bronchodialator

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Vocal Cord Dysfunction (VCD) – A Very Misunderstood Illness

Have you noticed an increased shortness of breath or tightness in your chest when exercising? Do you feel like you’re choking or do you experience wheezing when you take part in strenuous activities? Does your voice feel hoarse after working out? Many of these symptoms are common in patients who are diagnosed with vocal cord dysfunction.

Commonly misdiagnosed as asthma, vocal cord dysfunction (VCD) is a function disorder of the vocal folds, which are located in the “voice box.” VCD is characterized by abnormal movement of the cords resulting in respiratory symptoms. Patients with VCD typically experience symptoms during inspiration or when they take a breath in. This is because the vocal cords close at a time when they usually would not. VCD can occasionally cause symptoms during exhalation, but this is less common. VCD poses challenges for both patients and providers as it can mimic and co-exist with asthma. However, an asthma attack is treated very differently than a VCD attack, and misdiagnoses can lead to inappropriate and unnecessary treatments.

The most common symptoms seen in VCD include difficulty with shortness of breath, throat tightness, difficulty swallowing, feeling like something is “stuck” in your throat, choking, gagging, voice changes (hoarseness, raspiness, loss of voice) and wheezing. The “wheezing” that occurs with VCD is a high-pitched wheeze-like sound that comes from the throat, not the lungs, as seen in asthma.

There are several possible causes of VCD, some of which result in irritation of the vocal cords, leading to the abnormal movements. Underlying issues or coexisting conditions are also common with VCD and can sometimes even lead to misdiagnosis. These include heartburn (GERD or reflux), post-nasal drainage from poorly controlled allergies, viral upper respiratory illnesses or colds, depression, anxiety, irritable bowel syndrome (IBS) and chronic pain syndromes. Exercise and inhaled irritants (strong scents/smells like colognes, perfumes, cleaning agents and fumes) are also very commonly identified triggers.

Direct visualization of the abnormal vocal cord movements via rhinolaryngoscopy (camera scope through the nose and down the back of the throat) is the gold standard for diagnosing VCD. However, if the patient is not actively having a VCD attack with the symptoms listed above, then this scope will be normal at the time, Therefore, normal rhinolaryngoscopy cannot definitely rule out a diagnosis of VCD. A pulmonary function test can help to diagnose VCD as well, but this can also be normal in VCD patients. More likely, your board-certified allergist can diagnose VCD based on symptoms and history. 

The mainstay of VCD treatment involves recognizing triggers, appropriately managing co-existent diseases, and utilizing breathing exercises. If patients have difficulty with these exercises, their allergist may refer them to a speech therapist to help as well. Education for patients on the signs and symptoms of VCD and how they differ from asthma can help to reduce unnecessary emergency department visits, hospitalizations, procedures, breathing treatments and steroids.

Statistics on VCD are really hard to find because of how often it is missed. It is almost always diagnosed as something else at first. Our practice has seen many patients who have been treated for “asthma” for years with inhalers and steroids, but all they really needed was vocal cord exercises and maybe some help from speech therapy. 

Treatment by a board-certified allergist for VCD is critical because of how much time, money, energy and unnecessary medications, procedures and emergency department visits/hospitalizations are present on misdiagnosed VCD patients. The treatments for these other issues are not only unnecessary and unhelpful for VCD patients, but they can have side effects of their own. Incorrect treatments for VCD often include inhalers, prednisone or the unnecessary use of EpiPens. Additionally, VCD is seen in a significant amount of the asthma population. VCD attacks and asthma attacks have subtle differences that can be picked up on once patients are better educated. The typical treatments for asthma don’t help with VCD and vice versa.

If you believe you might be experiencing VCD symptoms, scheduling an appointment with a board-certified allergist can lead to a diagnosis and proper treatment so that you can find relief. Request an appointment with our team today.

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The Flu Vaccine: More Important Than Ever

Like clockwork, we hear the warnings every year. When flu season rolls around, everyone is encouraged to get the vaccine to prevent the spread of influenza. There are many reasons why getting the flu vaccine is beneficial and highly recommended. What are some of those reasons and, more importantly, why is it more vital than ever that you get your flu shot during the COVID-19 pandemic?

The Usual Benefits of the Flu Vaccine  

The most obvious benefit of flu vaccination is that it can keep you from coming down with the flu. While 100% protection is not guaranteed, getting vaccinated does make a difference

In fact, during 2018-2019, it was estimated to have prevented more than 4 million flu illnesses, more than 2 million flu-related medical visits, tens of thousands of hospital visits and 40,000-60,000 deaths. It may have even been you who was spared from the flu and its potential complications as a result of vaccination (on your part or that of others)! 

What other compelling reasons are there to get your flu shot yearly? Besides reducing your risk of getting sick and reducing hospitalizations, the vaccine has been shown to:

  • Prevent and limit the severity of influenza illnesses in people with chronic health conditions that put them at higher risk for complications
  • Protect women during and after pregnancy, as well as protecting their newborn child(ren)
  • Reduce the severity of illness in people who get vaccinated but still get the flu anyway. Since every flu season and every individual’s response to influenza are different, you’ll want to have the most protection possible against things going south

Don’t forget that, even if you’re not pregnant or dealing with chronic illness, your flu shot can protect others around you who are. This is especially true during the COVID-19 pandemic.

How Flu Shots Can Save Lives During COVID-19 

Experts have predicted that the viruses responsible for the flu and COVID-19 will be co-circulating this fall and winter. This has the potential to cause several problems. 

  1. It could perpetuate the spread of COVID through individuals who mistake symptoms as mild flu and do not adhere to the recommended guidelines for the sick
  2. Contracting the flu and coronavirus at the same time comes with an increased risk of serious and even life-threatening illness
  3. Severe but preventable cases of the flu requiring hospitalization take away the staff and resources needed to treat COVID-19 patients

Protect Yourself, Protect Others 

As you can see, the flu vaccination is more important than ever before. While in 2018-2019, less than half of all Americans got the flu shot, we hope that many more will do their part to protect themselves and others this year, especially since the stakes have been raised by the pandemic. 

With fall already upon us and flu season looming, now is the time to get your flu shot. Since the vaccine takes about two weeks to trigger the creation of antibodies, the sooner, the better! 

 

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Calm Fall Allergies & Enjoy Every Second of the Season

There’s nothing quite like Charleston in the fall. In contrast to the hot and humid summer, most of us welcome the perfect balance of sun and comfortable temperatures, which make it an ideal time to enjoy the great outdoors.

However, this beautiful season isn’t completely free of downsides. Charleston is notorious for bringing on fierce fall allergies of all sorts. What are some allergens that are especially prevalent here in the fall? More importantly, how can you manage them effectively so that you can still enjoy the season to the max?

Allergens Common in the Fall

Along with year-round allergies that are found here in the Lowcountry, many are also affected by some allergies that are more prominent in the fall. Some of the most common culprits for seasonal allergies this time of year include:

Ragweed. Did you know that each ragweed plant produces 1 billion pollen grains that can travel hundreds of miles? Although not as obvious as its bright yellow counterparts, this form of pollen is everywhere in fall! An allergy to ragweed pollen can result in symptoms such as sneezing, runny nose, irritated eyes, a scratchy throat and more.

Alternaria alternata. Or, in simpler terms, mold, is a year-round issue here in the Lowcountry. In the fall, it grows on leaves thanks to the warmth and humidity. These mold spores, which can be easily disturbed, can cause headaches, coughing, fatigue and even skin rashes. And this is just one type of mold; there are many more (both indoors and out) that can produce similar symptoms.

Dust mites. While not limited to the fall season, dust mites love warmth and humidity. As a result, they thrive in late summer and into early fall, leading to sneezing, itchy and watery eyes, sinus pressure and itchy skin.

Pollen food syndrome. Some who have allergies to ragweed and other pollens, like birch trees, may notice they have reactions when eating certain seasonal foods. These can include cucumbers, zucchini, melons, bananas, apples, pumpkins and squash. In this case, the pollen cross pollenates with certain fruits and vegetables which can cause allergic reactions such as an itchy or tingly mouth when consumed. This is not a true food allergy but an allergic response to inhalant allergies.

Treating Fall Allergies Successfully

You shouldn’t have to miss out on enjoying the fall in the Lowcountry simply because you have allergies. There are things you can do to reduce and manage your symptoms. You can:

-  Try over-the-counter medications to combat sneezing, runny nose, throat irritation and other symptoms.

-  Wear masks when performing certain outdoor activities such as raking leaves or other yard chores to protect yourself from pollen and other allergens in the air.

-  Use a dehumidifier to reduce the humidity in your home, which can minimize the prevalence of dust mites.

-  Keep doors and windows closed to prevent mold and pollen spores from entering, along with showering as soon as you get home to reduce the spread of allergens.

-  Pay us a visit so that we can find the cause of your allergies with an allergy test and put together a personalized treatment plan. Such a plan may include avoidance measures, medications or even allergy immunotherapy, which can help you permanently increase your tolerance to allergens.

If you’re a fall allergy sufferer, take action now so that you can enjoy the season while there’s still time!

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Meet the Girls: Our Charleston Allergy Trio!

Let’s hear it for the girls! Our Charleston Allergy & Asthma team has been blessed with some fantastic board-certified providers who all go above and beyond in giving exceptional care for our patients. For more than 30 years, we’ve been providing relief from allergies and asthma to the people of the Lowcountry.

To celebrate the incredible women in our lives, we’re thrilled to introduce you to our three female providers and share their stories of how they came to lead the way for women in healthcare. Get to know our favorite female allergists below!

Dr. Meredith Moore
Did you want to be a doctor when you were a little girl?
“Yes, I had to have a surgery when I was young and afterward, had to stay in a big ward with no parents. A burn victim was next to me and they would change her dressings. She was so sad and would cry. One night, she was crying and hysterical. All the physicians and nurses had left her, no parents were there and I went over and sat with her and made her feel better. I knew that I wanted people to have a better experience.”

What is your favorite part about being a doctor?
“Hard to answer because there are so many things! It’s the relationships you develop with people. They have allowed you the privilege of sharing their lives with you. It’s an awesome privilege and an amazing experience that someone was able to open themselves up to you and then you help make their lives better.”

What’s it like to balance personal and work life as a doctor?
“Practicing medicine with passion takes a lot out of you, whether you are a man or a woman, mom or not. Universally, it’s difficult if you want to approach medicine as a calling. It’s a very rewarding but demanding profession, no matter who you are.”

Dr. Carolyn Word
Why did you become a doctor?
“Growing up, my grandfather was a general practitioner and when we visited him in his office, I loved seeing how he interacted with patients and how he was able to help them. It seemed like a great way to help people. I always loved math and science, so I did biomedical engineering for undergrad. In the process of that, I realized that though I loved science, I loved working with people more. It’s a great way for me to take my love of science and apply it to patient care, which led me to medicine. I loved my rotation in allergy/immunology and all the ways we can make a difference in our patients’ lives.”

Have you overcome any obstacles as a female in the medical field?
“I think there certainly are stereotypes about women in medicine. There have been times when patients have thought I was a nurse because I was a woman or question my knowledge but more often, they have been grateful. When I was a medical student, I felt more pressure as a woman to work harder, push harder and prove myself to be accepted. I have never felt like that in my practice now and I’m grateful to work in such a wonderful practice.”

What’s your favorite part about your job?
“When I get to see a patient for a follow-up and hear that they are feeling so much better. When a patient has recently started allergy shots and has been coming in for frequent injections for a couple of months, then they share that after years of medicine, they had no idea how they could feel so much better; that’s the best part! Patients who have been struggling with a food allergy and who have passed their food challenge, then seeing their excitement. It’s a great thing to be a part of. And just getting to know my patients in general. We catch up about their lives beyond helping them find relief. We’re building relationships. It’s personal.”

Dr. Lindsey Stoltz Steadman
Why did you want to become a doctor?
“I was always interested in the sciences: biology, anatomy, physiology. On top of that, I enjoy interacting with people and going into a profession that was going to allow me to give back was important to me. I really enjoy teaching. I believe as a physician, my job is to educate our patients, our patients’ families and the community about our field.”

What’s it like to balance personal and work-life in the medical industry?
“My husband is a physician as well, so a major part of our relationship is that we’re very understanding of what the other person is going through. We bounce ideas off of each other and educate each other. There are a lot of sacrifices made when you decide you want to be a doctor and it doesn’t end after graduation of medical school, fellowship, etc. We understand that about each other. I understand when he needs to do a surgery in the middle of the night and he understands when I have to take a call over the weekend. Our training kept us a part in different cities and different states, but we understood what the other person was going through. We may have been a part, but we were together.”

What do you love most about your job?
“Critical thinking. I really enjoy the process of meeting a patient and getting to put the pieces of the puzzle together to help them. I’m grateful that I get to improve people’s quality of life. Nothing is more rewarding than hearing their success stories.”

Is there anything you want to add about being a doctor?
“You can know all the science but if you can’t explain it to your patient then it all goes out of the window. Rapport with your patients is equally as important as understanding the science. Patients need to feel comfortable with their doctor. At the end of the day, you just need to be good at what you do.”

We’re thankful for the incredible team of compassionate and talented providers that we have here at Charleston Allergy & Asthma! If you think you may be suffering from allergy symptoms or if you’re in need of a local board-certified allergist, schedule an appointment with our team today.

 

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FDA Recalls Perrigo Albuterol Sulfate Inhalers

Albuterol sulfate inhalational aerosol manufactured for Perrigo Pharmaceutical Company has been voluntarily recalled. The U.S. Food and Drug Administration announced the recall was due to possible clogging of the inhaler that results in patients not receiving a full dose of medication.

If you have an unexpired albuterol inhaler with the Perrigo logo, please contact the pharmacy you received it from. The pharmacy can advise you on how to get a replacement for the recalled inhaler.

For additional information on the recall, please see the FDA notification here: https://www.fda.gov/drugs/drug-safety-and-availability/fda-alerts-perrigos-voluntary-albuterol-inhaler-recall

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How COVID-19 Has Impacted Pediatric Wellness Visits

Our whole world has been turned upside down. One year ago, you were enjoying social activities, going to the beach, watching and participating in competitive sports, and visiting your physician if you had a medical problem. Since the beginning of this year, however, we have experienced a global pandemic with a coronavirus that has rapidly spread throughout the world. This phenomenon was fairly unknown to current generations, as the most recent pandemic of this nature occurred with the Spanish flu over 100 years ago. To date, the world has experienced tens of thousands of deaths and crippling, long lasting disease, overflowing hospitals, overwhelming fear and the addition of new terms to our vocabulary such as “social distancing” and “flatten the curve.”

With the onslaught of this international pandemic and no available adequate medical therapy, we have been forced to isolate ourselves and our families until a protective vaccine is developed. There is currently an international race to acquire this vaccine, however, vaccines require intensive safety and efficacy testing on thousands of people. It is likely that a vaccine for COVID-19 will not be available until the end of this calendar year.

One of the unintended consequences of this isolation due to the COVID-19 virus has been the disruption of routine childhood vaccinations. The decrease of administered vaccines is on a scale that hasn’t been  seen since widespread immunization programs began in the 1970s. Vaccine disruption has been caused by several circumstances. Parents are no longer taking children to clinics because of movement restrictions imposed by spread of the coronavirus or fear of risk of exposure to this virus. Health workers who provide vaccinations have also been diverted to help with response to the pandemic. This disruption has caused some 80 million children around the world to be at higher risk for preventable infectious diseases such as diphtheria, whooping cough, measles and polio.

According to the World Health Organization, UNICEF and the Sabin Vaccine Institute, childhood vaccine programs have been disrupted in at least 68 countries due to the COVID pandemic. With the expected continuation of the pandemic, this immense vaccination program is now under threat, risking the resurgence of previously controlled infectious diseases.

A CDC morbidity and mortality weekly report issued in May 2020 examined the pandemic’s effect on childhood vaccines. This report documented substantial decreases in the number of vaccines ordered and administered to children since the United States declared an international emergency in response to the COVID-19 pandemic in March 2020.

Routine childhood immunizations remain a vital component of pediatric healthcare, even during the COVID-19 pandemic. Children’s immune systems are still developing from passive immunity acquired through the mother’s placenta in utero. Vaccinations help produce antibodies (active immunity) in those who receive them, allowing the immune system to recognize viruses or bacteria and fight off these diseases or limit the severity of complications if exposed to the actual disease. Immunizations also protect public health through herd immunity, preventing widespread outbreak of highly infectious diseases, particularly measles and whooping cough. Individuals who have not been vaccinated and contract these infectious diseases could spread it to susceptible individuals for up to a week before developing any personal symptoms. Some childhood vaccines that were once believed to lead to lifelong immunity have actually been found to decrease in effectiveness during patients’ late teenage years, particularly for pertussis (whooping cough). Recently, recommendations for adult immunizations have changed to include boosters for diphtheria, tetanus, whooping cough and measles. The likelihood of catastrophic spread of common infectious diseases, such as whooping cough, drastically increases if a large portion of the adult population is able to contract the virus without realizing it.

The CDC continues to encourage childhood immunizations during the COVID-19 crisis, with recent recommendations for healthcare providers to continue with patient visits during this pandemic. For parents who choose not to immunize their children during the pandemic, there are “catch-up” schedules provided by the CDC so the children won’t need to start over or repeat doses that have already been received. Many childcare centers are also allowing a grace period for childhood immunizations at this time. In order to help reduce the spread of these viruses, the CDC recommends social distancing and separating sick children from well children.

As of yet, there have been no reports of localized outbreaks of common pediatric infectious diseases such as measles, whooping cough or polio. However, these diseases are still present in the community and if immunization levels drop and herd immunity slips below 70%, the potential for outbreaks both internationally and in the U.S. increase. Our team currently urges patients to please make every attempt to maintain routine childhood immunizations for your children during this pandemic. We are also hopeful for a rapid and effective COVID-19 vaccine!

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Little girl in class wearing a mask. How COVID is making back to school look.

Back to School: COVID-19 and Asthma

Many families are faced with the unusual question of “Should I send my child back to school this fall?” COVID-19 has changed a lot about our lives, and it will affect how our children learn, too. For parents of a child with asthma, this can be a particularly difficult decision and many families are divided on how to proceed. The information presented here is based on our current understanding of COVID-19 to help families make informed decisions. Ultimately, the family will need to decide whether it is in their child’s best interest to return to in-person learning.

The risk of being exposed to COVID-19 is statistically higher when attending school in person; however, the individual clinical implications of COVID-19 are still largely unknown due to our limited and rapidly changing knowledge after limited experience with this new virus.  Early in the pandemic, the CDC identified asthma as a risk factor for severe COVID-19 illness.  Subsequent studies have not supported this, and the CDC guidance has changed to state that asthma may be a risk factor for severe COVID-19 illness. The American Academy of Allergy, Asthma and Immunology COVID-19 Response Task Force has stated, “…there are no data suggesting that asthma is a risk factor for becoming infected with SARS-CoV-2; and there are no data to suggest that, if infected, asthma patients have a more severe course of COVID-19 disease. Further, there are no data that suggest SARS-CoV-2 exacerbates asthma. As such, the task force members do not see a reason that asthma would be a reason to avoid school. ” 

In-person learning plays a critical role in childhood development with opportunities for hands-on education, consistent supervision, structure which is crucial for learning task & time management, and social and psychological support. Your family will have the best understanding of the social and educational risks to your child with continued social isolation.

Here are some things to consider:

  • Your child’s overall health.
  • Your family’s health – is someone in your household at high risk of severe COVID illness?
  • The community transmission rate – higher rates mean higher risks of infection.
  • Family work demands – is there someone who can supervise children at home in a healthy and engaging environment? Can the household support possible loss of income?
  • Your child’s academic needs. Does your child need the structure of the classroom and teachers for success? Does your child receive special services that require in-person learning?
  • Schedule uncertainty – if your child’s class or school is quarantined will your family be able to adjust to the changing schedule? How will your child adjust to a changing schedule?

For families who decide their children will return to in-person learning, then it is imperative to ensure all  CDC and AAP recommended social distancing measures are followed. Additionally, the CDC recommends remote learning when community transmission is substantial, as is currently the situation this August in Charleston. In-person learning during times of substantial community transmission would be expected to increase the likelihood of exposure to COVID-19.

Based on what we currently understand, well-controlled asthma does not appear to significantly increase the risk of severe COVID-19 illness. Your family will need to balance the physical risks, educational risks, and family impacts of returning to school versus virtual learning to determine the best course of action for your situation.  With either decision, it is always important to follow CDC COVID-19 social distancing guidelines.

 

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Uploaded ToAllergy Friendly Chocolate Chunk Cookies

Allergy-Friendly Chocolate Chunk Cookies

The kids have been out of school for a while now. Many of you may be working from home as well. Are you running out of stay-at-home activities?

When done the right way, cooking with kids can give them something to do and teach them important life skills while having a good time!

We tried this amazing recipe for “Big Chocolate Chunk Cookies” we found in “Allergic Living Magazine”, and honestly… they’re so delicious… we had to roll through the house because we ate so many of them! This recipe is a great opportunity to get into the kitchen with your kids and have a bit of fun!

Ingredients:

2 cups all-purpose flour (or gluten-free variation)

2 tsp baking powder

½ tsp baking soda

½ tsp cream of tartar

½ tsp salt

1 cup allergy-friendly chocolate chunks

½ cup canola, grapeseed or rice bran oil

½ cup maple syrup

4 tsp vanilla extract

  1. Preheat the oven to 350 F. Line baking sheets with parchment paper.
    • Note: When we tried this recipe, we didn’t use parchment paper and the cookies crisped quickly.
  2. In a medium bowl, whisk together flour, baking powder, baking soda, cream of tartar and salt. Stir in chocolate chunks.
  3. Put brown sugar, oil, maple syrup and vanilla in a medium mixing bowl. Beat with a hand mixer until emulsified, about 1 minute.
  4. Stir flour mixture into a wet mixture until fully combined. The dough may be a little greasy.
  5. Shape dough into 1 ½ balls and place 2 inches apart on baking sheets. Lightly flatten the dough and press in any loose chocolate chunks. This recipe should make 24 cookies.
    • Note: The warmer the dough got, the harder it was to mold. Mold what you can and put the rest in the refrigerator for about 5 minutes while you bake the cookies you were able to roll out. Do this process as many times as needed until all the dough is used.
  6. Bake for 8-12 minutes. It will be light in color.
  7. Let cool on baking sheets for 2 minutes, then transfer to wire racks to cool completely.

Free of dairy, eggs, nuts, peanuts and soy.

Gluten-free oatmeal cookie variation: Using a spice grinder, process 1 cup certified gluten-free quick oats into flour. Substitute the oat flour, ½ c starch (corn, tapioca or arrowroot) and 1 ½ cups certified gluten-free quick oats for the all-purpose flour in the above recipe.

Wondering if you or someone you know has food allergies? Schedule an appointment with one of our board-certified allergists today.

 

 

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A table full of ethnic foods

Ethnic Food Allergies

What allergens are found in ethnic foods?

In Charleston, we’re very proud of our unique local cuisine. Whether you’re dining in or enjoying takeout at home, there are so many options to explore! The Lowcountry is a melting pot of people from various countries around the world, and they brought with them diverse and exotic cuisines. Elements of these cuisines are finding their way into the Charleston culinary scene. While delicious, unfortunately, these new foods with their variety of ingredients can have an impact on individuals with food allergies.

Food allergy experts say people with food allergies should apply the same degree of caution to ethnic foods as they do to any other foods they might eat. Language barriers, unknown ingredients and different preparation techniques can magnify the challenges for individuals with food allergies. This is especially important when consuming food outside of the restaurant through takeout. As many are practicing social distancing, it’s important to be aware of allergens before placing a pick-up order.

Researching common ingredients in a cuisine can point out food allergens to avoid. Thai food, for example, incorporates a wide variety of peanut products while Mexican and Italian foods use cheese to flavor and garnish dishes.

Asian cuisines like Japanese, Chinese, Thai and Korean can vary greatly in flavor but they share several of the big eight food allergens as major ingredients including peanut, fish and shellfish, soy, and eggs. Interestingly, soy sauce, always found in Asian restaurants, is usually well tolerated by those with a soy allergy because the soy proteins are destroyed by the fermentation process.

With French food, the emphasis is on fresh local cuisine but salad dressings and vinaigrettes can be hidden sources of nuts, eggs and seed oils. Expensive, hand-pressed oils such as walnut, almond and sesame are frequently used for their intense flavors and can be more allergenic than refined oils because they contain more nut protein. Mustard and mustard seed are common ingredients in French cooking and are a growing concern in France. In 2003 a French study reported mustard allergy accounts for 1.1% of food allergies in children.

A major theme of Indian cuisine is the use of a lot of spices. Some of the most common spices include bay leaves, coriander, cardamom, fenugreek, ginger, garlic and turmeric. These are usually ground-up and mixed into masalas as a flavorful base for vegetable and meat curry. The biggest risk with Indian food, however, is not going to be spices, as traditional spices are not particularly allergenic. Curry sauces can be thickened with cashew or almond paste. Lentils and legumes are a major source of protein in India with a large vegetarian population and can also trigger allergies. Allergies to the legume chickpea (garbanzo bean) is prevalent in India.

Italian food has become popular in the United States, but many common ingredients in it are highly allergenic. These include cheeses and dairy products, bread, pasta and pesto sauce which contain nuts (usually including pine nuts but occasionally walnuts).

Mexican food is typically edgy and saucy and while sauces can add flavor and spices, they can also be problematic for individuals with allergies. The sauces can contain nuts, chilies, cinnamon and garlic.

One of the most prominent allergens in African cuisine is peanuts often referred to as “ground nuts.” They are used in soups, stews and sauces for meat and rice dishes. Cornmeal and millet, starch staples of foods across Africa, can be a safe alternative for those with a wheat allergy.

Foods from areas around the Mediterranean Sea can produce earthy flavors based on a balance of citrus and herbs with liberal amounts of olives and olive oil. Seeds and nuts are prevalent in Middle Eastern cooking and are probably the biggest allergy-inducing culprits in the cuisine. Sesame seeds are particularly pervasive in Middle Eastern food, either as an oil or ground-up in a thin sauce called tahini. Baklava, a pastry made of layers of filo dough, may contain pistachios or walnuts.

So, as you or a family member ventures into an ethnic dining experience to explore the exciting and delicious flavors of another culture, do your due diligence and be aware of hidden food allergens in these foods. And most importantly, always be prepared with your EpiPen or Auvi-Q.

If you think you might be experiencing symptoms of food allergies, contact our team to schedule an appointment with a board-certified allergist today.

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