Possible food allergy--what would you eliminate first?

[HSmomof2]

I'm wondering if my ds(10) has a food allergy/intolerance that is causing some long-term issues he's been dealing with. I suspect it is either dairy or gluten, but am not sure which to try eliminating first. I've talked with our pediatrician multiple times about it, but he doesn't think an allergy is involved--he says he would have other more allergy-like symptoms (rashes, hives, etc). He had a tonsillectomy/adenoidectomy last year and they were supposed to do allergy testing while he was under anesthesia. Although we discussed food allergy testing with the ENT multiple times, they only did environmental allergy testing. Ds gets very, very upset about medical procedures, and even a blood draw causes a complete meltdown. I may end up just taking him and enduring the meltdown, but am considering just eliminating the suspected foods as a trial first. He's seeing a psychologist for the anxiety/meltdown issues, but I'm starting to think there may be another medical component contributing to his problems.

 

His symptoms are:

daytime fatigue even after sleeping 9-10 hours

dark circles under eyes

chronic constipation (since age 2)

frequent acid reflux

frequent hunger (his weight is normal)

bedwetting

irritability/anxiety/easily upset

inability to focus/very distractible

 

Has anyone had a child with these type of symptoms? Any suggestions?

 

ETA additional symptoms.

 

 

[Tangerine]

If I were going to do it, I think I would eliminate all potential allergens (an elimination diet) and then add things in very slowly. And keep a food/symptom log. I say this as my baby is covered in eczema...I should take my own advice.

[Spryte]

Have you considered taking him to a board certified allergist?  Not the pedi or the ENT?  I would consider going that route, so you have documentation for the medical records, etc.

 

We deal with multiple food allergies - some are life threatening, some are not (yet, they could be).  Our new allergist (new as of last year) identified that DS has IgE allergies to both wheat and dairy and a few other things, though he wasn't having obvious symptoms.  We tried an elimination diet and found that his asthma radically decreased while off of wheat and dairy, and the eczema disappeared.  But then, asthma and eczema are closely related to allergies.

 

Personally, I'd go to an allergist, but I like concrete answers.

 

If you're not going to go that route, then a true elimination diet might be the way to go.  Keep painstakingly detailed notes, and be vigilant that it's a good elimination diet so you get reliable results. 

 

 

[Ann.without.an.e]

I would eliminate the major allergens:  wheat, all dairy, peanuts, nuts, soy, corn, shellfish, eggs for 2-3 weeks and see if there is improvement.  If there is improvement then you slowly introduce one at a time, waiting a week or two between additions.  This is a difficult road.  I suggest that you keep a detailed food diary.  List sauces, etc.  I just went through this with my 4 year old.  It was tedious.  I couldn't figure it out.  When I took away all packaged, processed foods and all allergens he was fine but then later he wasn't.  It turned out to be sulfites.  I only figured this out because I narrowed down his reaction to every time he had a sauce or apple juice and the hive helped me figure it out.  He is great now and completely allergy medication free unless he gets into something with too much sulfite.

[Runningmom80]

My ds has multiple food allergies, I've lost count, I think it's between 15-17.  Personally, I wouldn't eliminate anything without talking to an allerigst first.  They may not be IgE mediated allergies, and therefor, impossible to test for, but talking to someone who knows about allergies is extrememly helpful.

 

Also talk to a nurtritionist if you can.

[Crimson Wife]

Bedwetting is frequently dairy-related. Constipation is often gluten-related. If you don't want to go full-on elimination diet, I would start by removing those two.

[Ellie]

Dairy, dairy, dairy.

 

And wheat, and soy.

 

But definitely dairy.

 

I do agree that you should see a pediatric allergist. Your pediatrician may be a very nice person, and a good doctor in many ways, but the fact that he is unaware that the list of symptoms your dc has could absolutely be food related--heck, even *I* know that!--tells me that you need to see a specialist.

 

And if you suspect gluten, then your dc should be tested for that. You shouldn't try to "treat" it without knowing for sure.

[fraidycat]

It is my understanding from my own research that the proteins in milk/dairy are very similar in size and shape to gluten. Therefore an intolerance to one quite often means an intolerance to both. Not always, but more often than not.

 

This is just my layman's understanding of it, but I'd say eliminate both.

 

An elimination diet is a good idea. With food diary. Advice I have been giving to myself for the past couple of years, but haven't actually taken yet! We eliminated gluten and dairy a couple days ago, but haven't started the diary yet. :)

[xixstar]

I believe that parents are often very intuitive about their children. If you think dairy or gluten is an issue then I would remove both for a few weeks and the reintroduce one at a time and just see how things go. Think of it as a challenge or contest. The prize may be great health improvements and some new food behaviors and snacks or you may have wasted a couple weeks time and still have some new snacks or food patterns that can be still be helpful.

 

I would not take a child adverse to any procedures or medical stuff to a dr over this, I would just try it out first and see what you learn.

 

If this does nothing then I would consider other options as well but I find taking a small step first makes it easier to keep going forward.

[sbgrace]

Is his muscle tone normal?

 

Was he with the ENT/having surgery because of sleep apnea? If so, did the surgery correct the apnea? A lot of what you mention sounds possibly sleep related. Did he have environmental allergies?

 

I'd cut dairy and gluten. If you don't yet have good/healthy alternative protein sources he will eat, just cut gluten while you work on protein replacements for dairy. If you think celiac might be involved, you really want a test before you cut gluten out if at all possible. They aren't accurate when he's not eating it anymore.

 

 

[PinkyandtheBrains.]

Have you considered taking him to a board certified allergist?  Not the pedi or the ENT?  I would consider going that route, so you have documentation for the medical records, etc.

 

We deal with multiple food allergies - some are life threatening, some are not (yet, they could be).  Our new allergist (new as of last year) identified that DS has IgE allergies to both wheat and dairy and a few other things, though he wasn't having obvious symptoms.  We tried an elimination diet and found that his asthma radically decreased while off of wheat and dairy, and the eczema disappeared.  But then, asthma and eczema are closely related to allergies.

 

Personally, I'd go to an allergist, but I like concrete answers.

 

If you're not going to go that route, then a true elimination diet might be the way to go.  Keep painstakingly detailed notes, and be vigilant that it's a good elimination diet so you get reliable results. 

 

Agreed. I like concrete answers as well.

[HSmomof2]

Yes, the ENT thought he may have apnea since he was snoring, sleep walking and the bed wetting. His adenoid was also very large. The surgery did nothing for the bed wetting, but he no longer snores or sleep walks at all and seems to be breathing quietly and regularly when asleep, so he doesn't suspect apnea. Environmental allergy testing showed no

environmental allergies.

 

He has sensory processing disorder and had occupational therapy for about a year for that. She noted his core muscle tone was low but was within normal range for his age when he completed OT. This child is very bright, very sensitive and can also tend to be overly dramatic. It's hard to know with him what to be concerned about versus what is no big deal.

 

Generally, I agree it would probably be best to see an allergist. But, he has a lot of medical anxiety which is why I hesitate to take him in without a clear reason. (For example, he saw the commercial on TV about the meningitis vaccine, then spent the next four nights upset and worrying that he had meningitis.) I also understand the issue with gluten as far as it needing to still be in his system if he is tested. My instinct would be to do a trial of removing dairy first. I've read some relationship between some of his symptoms and dairy. Also, my younger dd had confirmed dairy allergy as a toddler. She's outgrown it, but will still have digestive problems if she has too much.

[Alenee]

He has sensory processing disorder and had occupational therapy for about a year for that. She noted his core muscle tone was low but was within normal range for his age when he completed OT. This child is very bright, very sensitive and can also tend to be overly dramatic. It's hard to know with him what to be concerned about versus what is no big deal.

This is what I wondered about when reading the list of symptoms. Dd has SPD and has almost all of those symptoms. We took her to an allergist and came up with nothing. We then took her to a pediatric naturopath who is also a biochemist. She had dd's urine tested and took blood to be tested. She had no food sensitivities but was found to be low or high in things like iron, B vitamins, dopamine, and seratonin. After putting her on supplements, she sleeps well, her anxiety is nearly gone, she's gained weight (healthy), she can pay attention, socializes with friends, etc. We went from a kid who couldn't sleep and was either angry or afraid most days, to a functioning pre-teen in a matter of a few weeks.

[sbgrace]

Allergy tests aren't concrete answers anyway. Food allergy tests have a high rate of false positives. That means they are far better at confirming a suspected allergy than identifying one. You're too likely to test positive to something that isn't actually an allergen. And they will not ID intolerances at all. My son does allergy test positive to his food allergens (hives to anaphylaxis range of severity). So I'm not anti-allergy tests. But I actually wouldn't recommend them in this situation even if he was not medical test averse. Environmental allergy testing is much more accurate. If he did have environmentals, I'd be more likely to think food allergies might be a possibility than without. Of course he could have one without the other, particularly in intolerances. It's just less likely. Celiac is a possibility though, so I think gluten might be good to try off no matter what.

 

He probably needs a sleep study, but I'm guessing he wouldn't stand for the wires.There may still be apnea or other sleep issues (restless leg, for example). 

 

When you talk about chronic constipation, poor muscle tone, and fatigue it's possible you're dealing with a mild underlying metabolic condition. When you make diet changes, watch for declines. Keep food intake balanced (protein, carb, fat). Consider trying some epic4health (only their brands) co-q10 and some carnitine perhaps. They can't hurt and might help. I'd actually suggest a carnitine test if he weren't fearful of needles. You might look into supplementing D3, if you don't already do that.

 

For my son, the constipation, and slow GI generally, was aggravating the reflux. But there are underlying metabolic issues for him. If you really have poor tone, do think metabolic. If there are metabolics involved, the fatigue might just be a feature. My 9 year old metabolic kid really needs 12 hours a night to be rested. It's a pain and I wish it wasn't the case. We just did a sleep study to see if apnea is contributing. But part of it, I know, is his metabolic state.

 

 

[HSmomof2]

Thank you for all the replies and ideas. We do supplement D3, omega 3's and a multivitamin. I hadn't considered other vitamin deficiencies or metabolic issues. My dh just saw a new dr for his own sleep apnea that is both and MD and a Naturopath. He really liked him and found him very helpful. Maybe a visit to this dr would be a good place to start.

[Mom0012]

As the mom of a son with severe allergies to peanuts, tree nuts, fish and shellfish and formerly to egg, as well as gluten intolerance/celiac, I would at least start with allergy testing. No, intolerances to gluten and dairy won't show up, but you might be surprised at what you find. My son has had the food allergies since he was an infant. We eliminated gluten and dairy when he was three out of sheer desperation, and I still didn't believe he had environmental allergies even though he was experiencing fatigue and dizziness, and foggy thinking (all of which our allergist says are not allergy symptoms but which went away immediately with an allergy nasal spray, but that's another story).

 

Anyway, he tested allergic to pretty much every environmental allergy under the sun even though the only classic symptom was mild congestion in the mornings. Once you have to determined if there are any true allergies, then I would eliminate gluten and dairy for a trial period if he is still having problems.

[walkermamaof4]

The Great Plains IgG is so easy and will tell you. The only thing it missed for my friend's child who has severe allergies to many foods was something she hadn't eaten in years. 

[Crimson Wife]

It is my understanding from my own research that the proteins in milk/dairy are very similar in size and shape to gluten. Therefore an intolerance to one quite often means an intolerance to both. Not always, but more often than not.

Youngest DD has non-celiac gluten intolerance and her doctor told us to avoid casein (dairy protein) and also soy protein because the chemical structures are similar enough to gluten to cause cross-reactions. He said that once DD's body has healed she MAY be able to tolerate small quantities of dairy or soy with the help of digestive enzymes, but so far we have not yet tried re-introducing them.

[Runningmom80]

Any updates?