Mixed Food Hypersensitivity - All About the Food Allergy

What Is Food Hypersensitivity?

Food hypersensitivity is defined as a condition when a living body experiences an adverse reaction to a causative food. The symptoms can be experienced by the person on the skin, digestive system, mucosal surfaces, respiratory system, or in the form of anaphylactic reactions. Doctors in the primary health care setup are commonly challenged with such patients. Therefore, it becomes crucial to accurately diagnose and manage these patients in order to differentiate a true food allergy from other types of adverse food reactions.

What Are the Types of Food Hypersensitivity?

Depending on the mechanism of immunological response, food hypersensitivity can be classified as

• IgE-Mediated Food Hypersensitivity- It is mediated by IgE-type of antibodies.

• Non-IgE Food Hypersensitivity- It is a heterogeneous cluster of food hypersensitivities in which the allergic reaction is against the food components. The primary pathogenesis primarily acts through cell-mediated mechanisms.

• Mixed Food Hypersensitivity- In this type, both IgE-mediated and cell-mediated immune responses are involved in the immunological reactions.

What Is Mixed Food Hypersensitivity?

Mixed food hypersensitivity is a type of food allergy where the affected individual experiences negative reactions to a causative food or a food component, including drinks, color additives, food additives, and food supplements in the diet, and both IgE-mediated and cell-mediated immune responses are involved in the immunological reactions. The symptoms of food allergy are commonly found in infants and children. However, the symptoms can appear in any age group. One can develop a hypersensitivity to even those foods that have been eaten for years without having any problems.

What Are the Types of Food That Cause Mixed Food Hypersensitivity?

While any type of food can cause an allergic reaction, particularly there are eight types of food that account for more than 90% of adverse food allergies.These include the following:

• Eggs.

• Cow’s milk and dairy.

• Peanuts.

• Tree nuts.

• Fish.

• Wheat.

• Soy.

• Sesame.

What Is the Pathogenesis of Mixed Food Hypersensitivity?

• Immunoglobulin E (IgE) mediated Type- In this form of food hypersensitivity, the immune system of the body generates IgE antibodies that interact with the food. Antibodies are immunoglobulin proteins of the blood produced by the immune system to identify and attack infectious agents. An IgE-mediated hypersensitivity reaction usually develops within a few hours of consuming the food allergen and can cause mild to severe symptoms.

• Non-IgE Mediated Type- In this type of food allergy, the immune system does not synthesize IgE antibodies. Instead, other parts of the immune system in the body get activated and induce a cell-mediated immune reaction. A non-IgE-mediated hypersensitivity reaction often causes cutaneous or digestive symptoms, including vomiting and diarrhea, and usually develops within three days of consuming the food allergen.

What Are the Symptoms of Mixed Food Hypersensitivity?

The symptoms of a mixed food hypersensitivity reaction usually involve the skin, the digestive tract, the cardiovascular system, and the respiratory system. They can manifest in the following ways:

• Vomiting and nausea.

• Abdominal cramps.

• Urticaria.

• Breathlessness.

• Wheezing.

• Persistent cough.

• Shock.

• Hoarse throat.

• Difficulty swallowing.

• Edema of the tongue.

• Weak pulse.

• Cyanosis (bluish discoloration of the skin).

• Dizziness.

• Anaphylaxis (a life-threatening condition that can potentially impair breathing and the body can come into a state of shock; the adverse reactions can simultaneously affect several parts of the body such as a stomach ache along with a rash).

Most of the symptoms that are food-related occur within two hours of ingesting the food allergen, usually starting within minutes.

How Is the Diagnosis of Mixed Food Hypersensitivity Made?

Sometimes it is difficult to distinguish between food allergies and food intolerances. If the patient suspects having a food allergy, it is important to consult with a doctor.

To identify whether you have a hypersensitivity reaction or intolerance, the healthcare clinician can suggest a number of diagnostic tests which include:

• Diet Review- This is a detailed review of the diet taken, including the timings and symptoms.

• Skin Prick Test- In this test, a small amount of sample food is pricked into the skin using a very tiny needle to closely monitor an adverse reaction.

• Oral Food Challenges- The problematic food is consumed in a well-controlled and monitored environment under medical supervision and gradually the amount is increased.

• Blood Tests- In some cases, blood is withdrawn, and the level of IgE antibodies is calculated.

How to Treat Mixed Food Hypersensitivity?

Currently, there is no cure for food allergies. Scientists are trying to find new ways to manage food hypersensitivity of people and desensitize them to food allergens possibly in the near future. Whether the individual suffers from an IgE-mediated or non-IgE–mediated or mixed food hypersensitivity, the gold standard treatment to avoid an adverse food reaction is to recognize the foods or food components that are allergic to and avoid them strictly.

Based on the severity of the food allergy reaction, the healthcare professional may suggest certain medicines, including Epinephrine auto-injections, to carry at all times in case patients accidentally consume and develop an allergic reaction to those foods.

The medications suggested by the doctor usually include:

• Epinephrine - Epinephrine helps reverse the clinical symptoms of anaphylaxis (a life-threatening allergic reaction).

• Antihistamines - These drugs can help reduce symptoms in less severe allergic reactions.

• Corticosteroids - These medications are usually suggested by doctors to reduce swelling in serious allergic reactions.

All symptoms of mixed food allergy should be taken very seriously. In case one suspects having a food allergy, consult a doctor, allergist, or dietitian to identify which foods are allergic to and should not consume.

Conclusion

Most mixed food allergies are in particular caused by eight foods including milk, dairy products, eggs, tree nuts, peanuts, shellfish, fish, soy, and wheat (gluten). These food allergies are caused due to an autoimmune reaction. This can lead to potentially life-threatening reactions. The only treatment is to completely avoid the causative food component from the diet. Individuals should immediately consult a doctor about food hypersensitivity who will advise them on how to effectively manage it. They can also refer to a registered dietitian to help manage their diet chart.