Allergy, Asthma, Immunology of Delaware
Nasheds, PA          Maher Nashed MD


Food Allergy

Food and Allergy Prevention

An increased diversity of food within the first year of life might have a protective effect on asthma, food allergy, and food sensitization.
Current Allergy and Asthma Reports, 01/10/2014

​​Peanut Allergy and Tree Nuts

 Allergy to peanut does not mean you are allergic to tree nuts. You can be allergic to peanuts but still can eat other nuts with no problem.

Cereal and Allergy

Early consumption of cereal (1st year) is associated with less allergy to pollen and Dust.
Atopic sensitization in the first year of life, Depner et al, Jaci 2012,11,048
 Wheat flour allergy is one of the top eight food allergens.
Symptoms: A child or adult with wheat allergy is likely to develop symptoms within minutes to hours after eating something containing wheat. Wheat allergy symptoms include:
Swelling, itching or irritation of the mouth or throat, Hives, itchy rash or swelling of the skin,Nasal congestion, Headache, Itchy, watery eyes, Difficulty breathing, Cramps, nausea or vomiting, Diarrhea, Anaphylaxis. (Mayo clinic website)
Lab tests: IgE for wheat
​​Treatment: Wheat avoidance.

Wheat Allergy

It is autoimmune to gluten which is in the wheat. It is also present in Barley and rye.
Symptoms and Signs: The most common signs for adults are diarrhea, fatigue and weight loss, bloating and gas, abdominal pain, nausea, constipation, and vomiting.
Other signs and symptoms that are not related to the digestive system, including:
Anemia, Loss of bone density or softening of bone, Itchy, blistery skin rash, damage to dental enamel, mouth ulcers, headaches, fatigue, Nervous system injury, including numbness and tingling in the feet and hands, possible problems with balance, and cognitive impairment, Joint pain, Reduced functioning of the spleen, Acid reflux and heartburn.
Lab: IgA (IgG) anti-tTG, IgA(IgG) anti-endomysium.
​Treatment: Gluten avoidance.

Celiac Disease 

Non-Celiac Gluten Sensitivity
Non-coeliac gluten/wheat sensitivity (NCG/WS) is a syndrome characterized by intestinal and extra-intestinal symptoms occurring a few hours or days after the ingestion of gluten and wheat proteins in patients testing negative for coeliac disease and wheat allergy.
Symptoms: abdominal pain, bloating, diarrhea, constipation, headaches, bone or joint pain, “foggy mind”, depression, ADHD-like behavior, and chronic fatigue (They are similar to those with celiac disease)
​Lab: IgG antigliadin antibodies (in only a part of the patients)
Treatment: Gluten Avoidance.

Non-Celiac Disease

There is little information in the literature on minimal disease-eliciting doses of gluten, which would be safe for CD patients. Apparently, it should lie between 10 and 50–100 mg daily intake.
GFD, which has low fiber, may lead to possible nutrient deficiencies in fiber resulting in consequent diseases.
GFD also leads to deficiency in Vitamins C, B12, D and folic acid, which is associated not only with malabsorption caused by villi atrophy but also with low quality of GFD.
GFD appears to be unbalanced in terms of calcium, magnesium, zinc in male and iron in women.

Gluten Free Diet Problems

Consuming fruits and vegetables rich in vitamins and antioxidant substances up to five times a day is recommended.
There is a need for additional folate supplementation as well as Calcium, Magnesium, Zinc and Iron.
It is recommended that gluten-free products are substituted with other cereals such as quinoa, sorghum and amaranth, which are safe and rich in folic acid, vitamins (riboflavin, Vitamin C and Vitamin E) and minerals.
Annual screening for nutrient status of a patient is required.

Management of Gluten Free Diet

Non-Celiac Gluten Sensitivity and Nickel Allergy. 
People with Non celiac wheat sensitivity have a higher chance of having Nickel allergy.
People have Non celiac wheat allergy and nickel allergy, will have more skin symptoms after eating wheat than those without nickel allergy. 
People with Non celiac wheat allergy and get frequent skin symptoms after wheat ingestion, should be screened for nickel allergy.

Non Celiac and Nickel Allergy

Oral Allergy Syndrome

If you have allergy to pollen of Trees, Grass or Ragweed, you might get itching and burning sensation in the mouth, lips, ear canal or pharynx when you eat fresh fruits. It is called Oral Allergy Syndrome.

Cow milk and Goat Milk

If you are allergic to Cow's milk, you cannot drink Goat's milk but you can eat the cow itself with no problem.

Peanut and Sesame

If you are allergic to Peanut, you might be able to eat Sesame with no problem

Boiled Milk and Allergy

IBoiled Milk and allergy
 Allergy to  Milk is less common if you drink unboiled milk rather Than boiled Milk.