In The News: Food Allergy

A Simply Stress-Free, Allergy-Friendly Cookie Recipe

We’ve found a delicious cookie recipe that’s free from 7 out of 8 of the top food allergens! Read along and take this recipe for a spin to enjoy a delicious holiday treat:

From the glow of fall foliage freshly laid upon the ground to the adornment of red and green wreaths on storefront windows, it’s clear to see that the signs are here…the holiday season is upon us! 

This time of the year is prime for family gatherings and home-cooked meals. But while time in the kitchen is perfect for bringing loved ones together, being tasked with cooking for others can sometimes prove stressful. This is especially true if any of your guests are living with food allergies.

Over 15 million Americans are currently living with a food-related allergy, and that number rises daily. While these allergies are most common amongst children, they are prevalent in people of all ages. Minding the diets of those enjoying your creations is especially important for keeping those around you happy and healthy this holiday season. 

We recently tested out this almond cookie recipe from Kitchn, and it was a household success. If you’re looking for a sweet treat that’s simple to make and safe for most individuals with food allergies (except those with nut and almond allergies), these cookies are the ticket!

Easy-To-Make Almond Cookies


  • 2 cups finely ground almond flour (ex. Honeyville, Bob’s Red Mill)
    • Note: Avoid almond meal as its course texture will leave cookies crumbly.
  • ½ teaspoon baking powder
  • ⅓ cup dark maple syrup labeled Grade A with “dark with robust flavors”
    • Light maple syrup can be used but will leave cookies with a less pronounced maple flavor.
  • 2 teaspoons vanilla extract


  1. Arrange a rack in the middle of the oven and heat to 350°F. Line a rimmed baking sheet with parchment paper.
  2. Whisk the almond flour and baking powder together in a medium bowl. Switch to a wooden spoon and stir in the maple syrup and vanilla. Stir until a sticky dough forms and holds together.
  3. Drop rounded tablespoons of the dough onto the prepared baking sheet, about one inch apart. For crisp cookies, press down the dough lightly with the flat bottom of a drinking glass or measuring cup. (If the glass sticks to the dough, dip the bottom of the glass in water.) For softer cookies, don’t press down the dough.
  4. Bake until the edges are golden brown, about 12 minutes. Allow the cookies to cool on the pan for about 3 minutes, then transfer them to a wire rack to cool completely. Cool the baking sheet between batches.

Mix-Ins: Add 1/2 cup chopped chocolate, nuts, or dried fruit to the batter before baking. 

Note: It’s always kind to consider those friends who might have food allergies when selecting your tasty mix-in additions. 

Not only are these almond cookies tasty, but they are also paleo, vegan and gluten-free! These sweet treats are perfect for satisfying the tastebuds and dietary restrictions of holiday party guests across the board. We’ll definitely be adding this recipe to our holiday baking traditions and hope you enjoy them too.

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Allergy-Friendly Restaurants in Charleston

When it comes to food allergies, we know that trying to pick a place to go out to eat can be quite the challenge. Whether you or someone you know is at risk of a slight reaction or could potentially go into anaphylactic shock from exposure to food allergens, it’s important to know which restaurants can provide a safe dining experience. 

We’re fortunate to live in a community that offers a wide variety of delicious culinary experiences, from downtown Charleston and Mount Pleasant and into West Ashley or Summerville, there is no shortage of restaurants that deliver on crowd-pleasing tasty dishes. The key for those who have food allergies is finding out which restaurants cater to your needs and maintain an allergy-safe environment so that your risk of exposure is eliminated.

While the elimination of all food allergens is rarely achieved, there are some restaurants that locals have recommended based on their personal experience with navigating food allergies. We’re sharing some of the top recommendations our team has received recently to help narrow down your search for the perfect restaurant for you!

Please note, while the following restaurants have earned a local reputation for accommodating many food allergies, those suffering food allergies are always recommended to contact any restaurant prior to visiting in order to ensure it is fully safe based on each individual’s allergy triggers. Charleston Allergy & Asthma has not received any compensation for the below selection, all recommendations are based on customer reviews and feedback.

Burton’s Grill

Word on the street (or on the internet, that is) is Burton’s Grill is fully committed to accommodating individuals’ food allergies. They even have an Allergy Commitment on their website! Their Mount Pleasant location features a wide variety of options from seafood and Italian cuisine to Asian-inspired dishes and American classics, there’s sure to be something for every member of the family at this local allergy-friendly go-to. 

SNOB (Slightly North of Broad)

SNOB is a downtown favorite features a variety of allergy-friendly options for those looking for a delicious night out in downtown Charleston! It’s also a good option if individuals in your party are looking for gluten-free options. 

Gnome Café

Gnome Café’ is always happy to meet the needs of its guests with dietary restrictions. Gnome Café has garnered a great reputation for delicious vegan and vegetarian cuisine while also taking food allergies into consideration. Another plus: one of our own team members shared she’d eaten at Gnome Café numerous times and didn’t even realize she was eating vegan chicken salad and dairy-free, egg-free chocolate chip cookies! They’re just that good!

Cru Cafe

When it comes to avoiding dairy, some folks have shared that Cru Cafe is an excellent option to consider. This spot features a range of American cuisine and local seafood. It also prides itself on local vendor partners who supply its ingredients, so it’s a good option for supporting local as well!

Halls Chophouse

With locations in downtown Charleston and in Summerville (as well as across the Palmetto state), Halls is not only a Lowcountry staple, but has earned an incredible reputation for catering to its guests needs. If you’re looking for a fine dining experience with delicious food, Halls Chophouse is always an excellent choice. While it is known for its signature steaks, the staff takes dietary restrictions and food allergies seriously. They’ve been known to go out of their way to provide a superb experience for all guests and will even provide custom creations and combinations to meet allergy needs. Another fun fact: vegetarians can enjoy an excellent meal here too!

Kid Cashew

For those with soy allergies, Kid Cashew has been shared as a strong recommendation. They’re also known for their extensive vegan options if you have any in your party that are avoiding meat, dairy, etc. – they have several gluten-free options and feature a wide variety of small plates, sandwiches and salads. 


If you’re craving delicious Asian food but need to avoid shellfish, Basil is known for accommodating those with shellfish allergies. With locations in Mount Pleasant and North Charleston, these tasty Thai dishes are only a short drive away. 

Brown Dog Deli

When it comes to tracking down a tasty lunch in the heart of downtown Charleston, Brown Dog Deli offers a variety of sandwiches, wraps, salads, soups, hot dogs and more. You can dine inside or enjoy the backyard patio while getting your fill of this lunchtime favorite. The staff offers accommodations and substitutions for “groovy” patrons with food allergies and we promise once you try it, you’ll want to go back for more.

Page’s Okra Grill

Several patrons have shared on social media that Page’s Okra Grill is accommodating for different allergies such as nuts and soy. This Mount Pleasant staple is widely known for incredible Southern food (just like grandma’s) and an insanely delicious variety of desserts. 

Do you have additional recommendations? We’d love to hear them! Send us a message on social media to share your favorite go-to allergy-friendly spots in and around the Charleston area. 

Also, be sure to let your server know if you have a food allergy prior to ordering at a restaurant, and always keep your EpiPen handy!

If you or someone you know suffers from food allergies, our team of board-certified allergists is here to help! Whether you’re in need of allergy testing or you’re looking to lessen your risk of allergic reaction through oral immunotherapy, we’re here for you every step of the way to help you find relief. Request an appointment today.

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The FASTER Act: What it Means for the Rise of Sesame Allergies and Food Allergy Research

On Friday, April 23, 2021, President Biden signed the Food Allergy Safety, Treatment, Education and Research (FASTER) Act (S. 578), requiring that sesame be labeled on packaged foods and prioritizing food allergy research. This milestone has been years in the making, largely due to the rise in sesame allergies and the growth of food allergies and intolerance worldwide.

While sesame allergies have been increasing in the United States over the past 20 years, recent research released by the American Academy of Allergy, Asthma & Immunology (AAAAI) in 2019 officially denoted sesame as the ninth most common food allergy in the United States. This new act mandates that beginning on January 1, 2023, all foods containing sesame should indicate the ingredient on the label.

Why is the FASTER Act important?

The passing of the FASTER Act is critical and timely as this will not only provide safety measures through food labels for individuals who are allergic to sesame, but also prioritizes food allergy advocacy and research. In fact, the act requires the Secretary of Health and Human Services (HHS) to issue a report on scientific opportunities in food allergy research that examines prevention, treatment and potential cures – an exciting step in management and care for the 85 million Americans who are affected by food allergies or intolerances.

How prevalent are sesame allergies in the U.S.?

Currently, more than 1.1 million Americans are allergic to sesame and some experts consider sesame allergy to have “increased more than any other food allergy over the past 10 – 20 years” in the United States. Until now, it has been much trickier to avoid sesame for those who are sesame allergic given the lack of official labeling, compared to other prevalent food allergies such as peanuts, eggs, etc.

What are the most common foods for sesame to be found in?

Oftentimes, sesame seeds are added to breads or sprinkled on hamburger buns. They are also frequently included in baked crackers. In addition, sesame is very popular in a variety of cuisines including Middle Eastern, Chinese, Japanese, Vietnamese and Korean. Sesame oil is also used for cooking such as marinating meats and vegetables for deep frying.

Here in the Lowcountry, sesame seeds are plentiful in our infamous “benne wafers,” believed to have been brought to Charleston during the 17th century by West African slaves. The benne wafers, or cookies, are both sweet and savory, and have always been deemed a “Charleston staple.”

Other foods that commonly contain sesame include:

  • Bread crumbs
  • Cereals (such as granola or muesli)
  • Chips (bagel chips, pita chips and tortilla chips)
  • Dipping sauces (baba ghanoush, hummus, tahini)
  • Falafel
  • Flavored rice, noodles, risotto, shish kebabs, stews and stir fry
  • Herbs and herbal drinks
  • Margarine
  • Processed meats and sausages
  • Protein and energy bars
  • Sushi
  • Vegetarian burgers

As you can see, avoiding sesame can become quite cumbersome, as it is found in so many foods that our society enjoys on a daily basis. It can even be found in some non-food items such as cosmetics, medications, nutritional supplements and pet foods.

What are the most common symptoms for a sesame allergy?

The level of sensitivity to sesame can vary from person to person, so not all reactions are the same. As with any allergy, reactions can also be unpredictable. Symptoms of a sesame allergy reaction can range from mild, such as hives, to severe, such as anaphylaxis.

How do I know if I’m allergic to sesame?

As recommended for suspicion of any food allergy, it is suggested that you request an appointment with a board-certified allergist. Your allergist will administer a physical exam, take a detailed medical history and possibly suggest a skin test. With a skin test, your results are available within minutes.

If you are diagnosed with a food allergy, your board-certified allergist will determine the best course of action to manage your allergy and avoid ingredients that could trigger an allergic reaction.

Our hope is that with the latest improvements in legislation surrounding sesame allergies, it will become easier for those who are allergic to sesame to avoid foods that can cause dangerous allergic reactions. We are also excited for the future of food allergy medicine with the emphasis on research and treatment that the FASTER Act brings!

If you are concerned you might have an allergy to sesame or another food, contact our team today to meet with one of our board-certified allergists.

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Allergy and Immunology: A Misunderstood Medical Field

Ever wonder why there is a specialized medical field just for allergy? How about those old tales you’ve heard of classic allergy symptoms only to realize they were caused by something else? Believe it or not, there are plenty of misconceptions about allergy and asthma, which is why our team is dedicated to educating our patients on their condition and treatment every step of the way. Dr. Lindsey S. Steadman took the time to share about her experience becoming a board-certified allergist and how our team’s training equips us to give our clients the very best allergy and asthma care.


How does an allergist become an allergist?

In order to become an allergist, we go through many years of medical school and clinical training:

  • 4-year undergraduate degree – Most healthcare providers choose a major that they feel best prepares them for medical school, such as biology, chemistry, biochemistry, etc.
  • 4-year medical school degree – Medical school provides the basis of education in becoming a doctor, covering a wide variety of medical care and topics to ensure a well-rounded education.
  • 3-year residency program – All physicians must enter a residency program of some kind to complete their specialty training. As allergists and immunologists, we all have to receive training in either pediatrics or internal medicine. These are both 3-year residency programs, and they are each followed by a board exam that must be passed in order to become a certified pediatrician or internist.
  • 2 to 3-year fellowship – Residents interested in specializing further can then apply to various fellowship programs. The majority of allergy and immunology fellowship programs are two years long (occasionally three years long). Once we graduate from fellowship, we must pass a board exam in order to be certified in allergy and immunology.

After passing our boards, we are able to treat patients of all ages with any sort of allergic or immunologic disease. This includes, but is not limited to, environmental/seasonal allergies, food allergies, stinging insect allergies, anaphylaxis, hives and swelling, eczema, asthma, chronic/recurrent infections and immunodeficiencies.


Why is allergy and immunology such a misunderstood field?

Allergy and immunology is a poorly understood field not only in the general population, but also within the medical community. There are many different myths and “old wives’ tales” out there about allergy signs, symptoms and treatments amongst the general population. When patients are not properly educated by allergy experts, these myths and misinformation continue to circulate and become accepted as fact. Even in the medical field, allergy is a misunderstood because there is very little, if any, dedicated teaching or training on allergy and immunology in medical school or residency programs. Fellowship is where the true allergy and immunology training occurs, so a board-certified allergist is always recommended for patients suffering from any sort of allergic disease or immune deficiency.

We are trained on how to obtain a detailed history to determine whether or not testing and further work-up is needed. We are taught how to interpret the results of both skin and blood tests for various types of allergies, lung function testing for asthma, and blood work for immune disorders, all of which are oftentimes not very straightforward. We are also taught how to appropriately manage these issues with medications, allergy shots, biologics, immunoglobulin replacement, oral food/drug challenges and oral immunotherapy for select food allergies. Therefore, it is always recommended to seek the help of a board-certified allergist because we are the experts in the disease process, pathophysiology, diagnosis, management and treatment of all allergic and immunologic diseases.


What are some common myths about allergy and immunology?

  • Every sniffle or sneeze is an allergy and every cough or episode of shortness of breath is asthma… FALSE. Fortunately, we are trained to determine whether or not patients have allergies and/or asthma. Not only can we diagnose and treat these issues, but if patients’ allergy- or asthma-like symptoms are caused by something else, we can often help with those problems as well.
  • Every hive or episode of swelling is due to an allergic reaction… FALSE. This can be true at times, but there are also instances when hives are caused by other things as well. We are trained on how to determine whether or not there is an allergy-causing patients’ hives and swelling and how to treat them no matter the cause.
  • All allergic reactions get worse with subsequent exposures… FALSE. There is no way to predict the severity of an allergic reaction based on previous reactions or testing methods. However, we can help diagnose the cause of the allergic reaction (foods, insect stings, medications, etc.) and educate patients on what exposures would be unsafe and how to handle reactions in the future.


If you believe you’ve been experiencing allergy or asthma symptoms but you’re unsure of what to do next, leave it to the experts! All of our allergists are board-certified and our team is dedicated to helping you breathe better, feel better and live better. Schedule your appointment with the experts today.


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Child blowing nose

Childhood Allergies: What You Need to Know

With childhood allergies afflicting around 30% of children, many parents are left wondering what to do. If your child is wheezing, sniffling and coughing often, you may be curious about the cause and what you can do to help. We’ll run through many of the common questions that parents have about childhood allergies, so you can put your mind at ease.

What are the most common symptoms of allergies?

There are many common symptoms that children deal with when suffering from allergies. These symptoms can vary greatly depending on whether the allergy is environmental, a food allergy, a drug allergy or an insect sting allergy.

Environmental allergies, also known as allergic rhinitis, are the most common form of allergic reaction. Most commonly, children will be sneezing or coughing and will experience a runny nose and itchiness in the nose and roof of the mouth. It is also common to experience red, watery eyes. Symptoms are similar to but not the same as the common cold.

Symptoms for allergic rhinitis will usually be seasonal, although this isn’t always the case. If your child is experiencing allergy symptoms only during the spring and summer, allergic rhinitis is likely. However, you should see a board-certified allergist to confirm the root cause.

The most common culprits for environmental allergies in the Lowcountry are dust mites, cockroaches and mold. These often have a year-round impact on an allergic individual’s health.

Food allergies can cause a variety of symptoms, such as tingling or swelling in the mouth, hives, or even anaphylaxis in more severe cases. When food allergies are less severe, they can often be hard to diagnose, especially when the allergen is less common.

If your child ever experiences these symptoms, you should investigate as early as possible. Knowing the cause of a food allergy provides invaluable information so that you know how to best care for your child and eliminate risks of allergic reactions.

How are allergies in children treated?

There are three main ways that allergies can be treated: avoidance, medication and immunotherapy.


Avoidance simply means not coming in contact with the relevant irritant. This will help greatly, but can sometimes be hard to keep up. If your child wants to play outdoors during summer, but comes home with a runny nose or worse, it can be hard to find a balanced solution.

When symptoms are more severe, this can require children to miss school or be unable to see their friends. Finding a way to deal with allergy symptoms can greatly impact a child’s life well into the future, so make sure to deal with the issues head-on.

There is usually a comfortable middle ground to find if the allergies aren’t too severe. For example, dust-proofing your child’s bedroom or making sure to shower after coming indoors to remove any pollen spores can aid in the quick cessation of allergy symptoms.

One question we often get asked is, “Do I need to get rid of my pet if my child is allergic?” While pet allergies can be a nuisance to say the least, your board-certified allergist can provide recommendations on how to best avoid allergens within the home. We certainly won’t ask you to get rid of your pet! Our top recommendation for individuals with pet allergies is to receive immunotherapy, which has shown to be extremely beneficial in treating the cause of pet allergies.


Allergy symptoms can be further aided by using certain medications. Do not give your child any medications without first consulting your doctor or board-certified allergist. If you are told that a given medication doesn’t come with any risk, it may be worth a try.

Medications don’t make allergies go away permanently, but they help deal with symptoms and inflammation. Especially when symptoms get severe, medications can be the difference between a normal day at school and a day spent wheezing and unable to focus. Once you know a given medication is safe and effective, it can be good to have on hand in case your child’s symptoms flare up unexpectedly.

One thing to consider when finding the best medication treatment for allergies are common symptoms, such as drowsiness. It’s important to find the right medicine if that’s the treatment route you wish to take, and your allergist will always be able to recommend the best medication treatment plan for you or your child. If medication isn’t doing the trick, immunotherapy is the closest thing to a cure.


Lastly, most patients benefit greatly from immunotherapy. This is a long-term treatment option that involves injecting small doses of an allergen into the patient so that they build up immunity. Each patient receives an individualized treatment plan that is custom-tailored for your child’s specific allergens.

This option can have some difficulties when it comes to kids — it can be hard to drag them to the allergist each week! But, it is the best long-term solution and the only way to get truly permanent relief from allergies without using medications. Immunotherapy is available for a variety of allergies. It is also helpful to see a board-certified allergist who specializes in care and treatment for pediatric patients. Our allergists are double-boarded to treat both adults and pediatric patients. Oftentimes, they know how to make children feel right at home during their doctor’s visits and can make shot appointments far less scary or intimidating.

Key Things to Remember

As always, the best option to pursue if you suspect your child is suffering from allergies is to see a board-certified allergist. Through allergy testing and detailed health evaluations, this can provide you with an understanding of the best treatment path that is specific to your child’s situation, rather than just a guess.


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10 Things People With Food Allergies Want You to Know

More than 30 million people in the U.S. alone have one or more food allergies. In other words, their immune systems deem certain foods harmful and overreact by triggering symptoms such as hives.

Food allergies may not seem like a big deal, especially if you don’t have them or have only ever heard of or witnessed mild reactions. However, they are very serious. With that in mind, there are 10 things that people with food allergies want you to know.

1. Food Allergy & Food Intolerance Are Different

Intolerance to certain foods is a digestive reaction. Think lactose intolerance resulting in gas, diarrhea, nausea and similar symptoms.

Food allergies, on the other hand, are immune reactions and have the potential to be lethal. Therefore, it’s much appreciated when you take the food allergies of those around you seriously.

2. The Most Common Allergens

Eight foods are responsible for nearly 90% of all food-related allergic reactions. They are:

  1. Milk
  2. Egg
  3. Peanuts
  4. Tree nuts such as walnuts and pecans
  5. Wheat
  6. Soy
  7. Fish
  8. Shellfish such as shrimp and crab

Due to the prevalence of these allergies, all of these foods are required by federal law to be named when used in packaged food or when present in a facility where such food was prepared. So when shopping for someone with food allergies, read the labels carefully so you know what items to steer clear of!

3. Any Food Can Cause a Reaction

While the eight foods mentioned are responsible for the vast majority of allergic reactions, no food is off-limits. A person can develop an allergy to any food, which is a good reminder to take any and every mention of food allergies seriously. Just because one may not be common doesn’t mean it’s not real and potentially dangerous.

4. Reactions Are Unpredictable

Allergens can trigger either mild reactions such as hives and an itchy nose or severe ones such as repeated vomiting, difficulty breathing and worse. The trouble is that there’s no way to predict how severe a reaction will be. Even if previous reactions have been mild, there’s no guarantee that future ones won’t be life-threatening. Hence the importance of doing everything you can to help those with food allergies avoid foods that trigger their symptoms.

5. It Doesn’t Take Much to Trigger a Reaction

It doesn’t take a full serving of an allergen to cause a reaction. Depending on the severity of their allergy, a single bite, cross-contact or even being in a room with an allergen can be a trigger. Therefore, it’s critical to avoid the attitude that “just a little bit can’t hurt” and to be understanding when a person has to refuse an offer of food due to an allergy.

6. “Free-From” Labels Are Misleading

Claims like gluten-free and nut-free don’t always mean “100% free of.” Rather, they indicate that the amount of allergens contained in a food is under a certain threshold. So, technically, such foods may still have the potential to trigger allergic reactions.

The solution? Rather than relying on the labels on the front of packages, take a close look at the ingredients list when shopping for people with food allergies.

7. The Symptoms of Allergic Reactions

Allergic reactions can take their toll quickly and unexpectedly so you need to know the signs. Symptoms include:

  • Hives
  • Flushed skin or rash
  • A tingling or itchy sensation in the mouth
  • Face, tongue, or lip swelling
  • Vomiting and/or diarrhea
  • Abdominal cramps
  • Coughing or wheezing
  • Dizziness and/or lightheadedness

By far, the most serious reaction is anaphylaxis, which can cause breathing difficulties, sudden drops in blood pressure, swelling of the throat and loss of consciousness. Anaphylaxis is life-threatening and can set in minutes or even seconds after exposure to an allergen. Swift action is essential to reverse its effects, which brings us to our next point.

8. How to Help in Emergencies

Many people with food allergies have a treatment plan in place for emergencies. Such a plan often includes an epinephrine auto-injector, which should always be nearby in the event of a severe reaction. If a family member or friend of yours has food allergies, get informed beforehand about what to do if they ever have a reaction in your presence.

9. The Time Window For Reactions

As mentioned, many reactions happen within minutes of exposure. However, remain alert beyond that time as some reactions can be delayed by as much as four to six hours.

10. Stay Alert

Food allergies should be taken seriously by both the person who is allergic and individuals who spend time with them. If someone makes you aware of their food allergy, consider how you might help keep them safe and avoid any foods that may contain that allergen. If it is questionable as to whether a food contains a certain allergen, it’s best to keep things safe and avoid that food altogether. Your food-allergic friends will appreciate your support.


If you believe you may be experiencing symptoms to food allergies, our team of board-certified allergists offers allergy testing and can advise on the best form of treatment or symptom management. You may even be a candidate for oral immunotherapy! Learn more by requesting an appointment today.

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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!


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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Girl smiling in front of a bowl of food.

Tackling food allergies

Food oral immunotherapy? You’re probably wondering what that means exactly. Let’s break it down into two parts. “Immuno” is derived from the word immune which means to protect from and “therapy” means the treatment of a disease or disorder that entails some type of rehabilitating process. So, when we provide oral immunotherapy to our patients we are providing a therapy by mouth to reduce a person’s sensitivity to foods that cause allergic reactions.

Food oral immunotherapy helps patients tolerate food proteins (allergens) they would otherwise be allergic to by introducing small amounts of the proteins on a daily basis. It is important to note that food oral immunotherapy only works on food allergies caused by allergy antibodies. These are antibodies released from your immune system that cause your allergic reaction.

How does it work?

If you and your board-certified allergist decide food oral immunotherapy is right for you, you will start eating gradually increasing amounts of the specific food over an extended period of time. The amount of food is precisely measured in milligrams based on protocols developed from oral immunotherapy research. This dose will increase over time to reduce your body’s sensitivity to the food allergen. This is known as building tolerance. Tolerance for a food allergen only continues if the food is eaten regularly. 

What is involved?

Oral immunotherapy requires a significant commitment of time and attention. Before you can begin this type of therapy your allergist will want to make sure all other allergic conditions are under control and routine immunizations are up-to-date. Depending on your allergy history, additional steps may need to be taken before starting oral immunotherapy.

The first step in oral immunotherapy is called escalation. This takes place in your allergist’s office and may last up to eight hours. It is important that the first step is monitored closely. After your first dose, the same amount will be eaten at home once a day until the next escalation dose.

Subsequent escalation visits can be as often as every one to two weeks. During these visits the patient will eat the new higher dose and then be observed for one hour to ensure there is no reaction. The goal is to reach what is called a “maintenance” dose. Once maintenance is reached, that dose is continued at home with no more planned escalation visits. At this point, the patient now has a significantly reduced risk of severe allergic reaction if they accidentally eat their food allergen and they do not have to avoid processed foods at risk of cross-contamination with their food allergen.

Whether it’s peanuts, tree nuts, milk, or some other food, oral immunotherapy may be an option to help you lessen the fear of allergic reactions from hidden food allergens and allow you to be more involved in life.  

What are the risks?

As with any type of therapy, there are risks. Adverse reactions to oral immunotherapy are common but the goal is to minimize the reactions through careful monitoring and escalation visits.

In carefully developed research studies, reactions occur in a significant number of patients. Most reactions are mild such as itchy mouth or abdominal pain and resolve without treatment or with antihistamines alone. Abdominal pain, nausea, heartburn and vomiting can be bothersome for patients after doses and can sometimes lead to changes in the treatment protocol. Our experienced physicians can tailor each treatment plan to the individual patient.

Anaphylaxis can occur with oral immunotherapy and families must be prepared to administer injectable epinephrine if needed. Studies show that less than 15 percent of patients are treated with epinephrine for a reaction during home dosing.

There have been reports of eosinophilic esophagitis (EoE) occurring more frequently in patients on oral immunotherapy. Eosinophilic esophagitis (EoE) is an inflammatory condition of the lining of the esophagus that can cause difficulty swallowing, severe reflux, nausea and/or abdominal pain.

Approximately 25 percent of patients discontinue oral immunotherapy before reaching the “maintenance” point. The most common reasons are reactions, especially gastrointestinal side effects, difficulty adhering to the protocol and rest requirements after dosing.

If all steps are closely followed under physician supervision and careful monitoring, oral immunotherapy can be a viable option for some patients and provide lifetime freedom from food fears and stress. If oral immunotherapy sounds like an option for you or a loved one, we encourage you to speak with your board-certified allergist

For more information and differing viewpoints of food allergy management, we recommend the following websites:





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FDA approves first peanut allergy treatment graphic.

Peanut Allergy Treatment Approved

On January 31, 2020, Palforzia became the first FDA-approved “medication” for peanut allergy. Dr. Meredith Moore states, “As a board-certified allergist who has been providing oral immunotherapy (OIT) to patients for peanut, tree nuts, multi-nut and wheat for the past three years, I have been excitedly awaiting FDA approval of Palforzia.” The FDA’s decision helps move OIT to a more accepted option for food allergic patients. Additionally, the safety and efficacy data for Palforzia is comparable to the methods being employed by OIT allergists for 10+ years using other sources of peanut protein.

Palforzia treatment doses start at 0.5 mg peanut protein and gradually build to a 300 mg daily dose over a period of about six months. The 300 mg daily dose is equivalent to about one whole peanut or ¼ teaspoon of peanut butter. The studies show that 67% of patients in the Palforzia study were able to eat at least two peanuts without having allergic symptoms. Palforzia showed success in reducing reactions to amounts that would be expected to occur in accidental ingestions or cross-contamination.

The protocol used for patients undergoing OIT at Charleston Allergy & Asthma for the past three years uses a peanut flour that has been analyzed for OIT use and then transitions to whole roasted peanuts that can be purchased at the grocery store. The ingested amount starts at 0.005 mg and builds to 2000 mg as a daily maintenance. This maintenance has been shown to allow patients to safely eat up to 6000 mg of peanut protein or two tablespoons of peanut butter. Some patients may not want that high of a safety goal in which case our OIT protocol can be customized for each patient’s needs and preferences.

Multiple news sources have reported that Palforzia’s annual price has been set at $10,680 (or $890 per month). At this point, it is not known how much, if any, health care insurers will cover of this drug cost. Charleston Allergy & Asthma’s current OIT patients generally spend less than $300 for peanut protein capsules/flour and supplies before converting to roasted peanuts, Peanut M&Ms or peanut butter.

Aimmune Therapeutics is researching development of other OIT products such as tree nut and egg. Charleston Allergy & Asthma physicians have experience treating patients with OIT for tree nuts and wheat using sources currently available.

OIT, using Palforzia or another food source, helps food allergic patients reduce their risk of allergic reactions from unexpected or accidental ingestions. There are risks with any OIT protocol, including anaphylaxis, eosinophilic esophagitis, stomach aches and frustration with the daily dosing process. Dr. Moore includes, “There are very important precautions for patients on OIT regarding activity, exposure and illness that Charleston Allergy & Asthma physicians have experience educating patients about. Personalized OIT treatment also requires adjustments of dosing protocols for school trips, vacations, and day-to-day life that we understand and have the expertise to implement.”

Dr. Moore says, “For some patients, the benefit of having a ‘safety net’ brings freedom from fear of allergic reactions that is worth the risks and inconvenience. Some patients and families are more comfortable and skilled at avoiding their allergenic food and OIT is not the right path for them. Charleston Allergy & Asthma looks forward to partnering with patients and families to help determine which treatment options are best for you. Reach out today if you would like to learn more about our food allergy treatment plans.

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