[HN Gopher] Australia starts peanut allergy treatment for babies
       ___________________________________________________________________
        
       Australia starts peanut allergy treatment for babies
        
       Author : peutetre
       Score  : 175 points
       Date   : 2024-07-31 03:43 UTC (2 days ago)
        
 (HTM) web link (www.bbc.com)
 (TXT) w3m dump (www.bbc.com)
        
       | praseodym wrote:
       | In The Netherlands it is recommended to introduce peanut and egg
       | to babies between 4 and 6 months, to reduce the chances of food
       | allergy.
       | 
       | More information (in Dutch):
       | https://www.voedingscentrum.nl/nl/service/vraag-en-antwoord/...
        
         | mikeyouse wrote:
         | That's the current guidance in the US as well.
         | 
         | https://mana.md/peanut-allergies-may-affect-your-child/
        
           | hammock wrote:
           | How have outcomes improved since the guidance?
        
           | 01100011 wrote:
           | and IIRC you need to maintain consistent exposure to the
           | allergens throughout the first, idk, 18 months of life to
           | have the best result. So don't just expose them once early on
           | and stop.
        
             | t0mas88 wrote:
             | Yes that's part of the advice in the Netherlands as well.
             | Keep giving them things that can be common allergies.
             | 
             | My 4 year old's favourite food is shrimp and sushi... Not
             | sure whether it's related to her eating those when she was
             | a toddler, but it's fun to see the reactions in restaurants
             | when you don't order the children's menu.
        
         | soperj wrote:
         | Australia changed their recommendations to match this years
         | ago, and the incidence of allergy didn't change measurably.
        
           | curiousgal wrote:
           | lol did they measure whether people were following the
           | recommendations?
        
             | soperj wrote:
             | lol yes.
        
         | JumpCrisscross wrote:
         | > _introduce peanut and egg to babies between 4 and 6 months_
         | 
         | What goes wrong if they're exposed before that? If the mother
         | eats peanuts and eggs while breast feeding, does that confer
         | desensitisation?
        
           | ecshafer wrote:
           | I am not sure if you had a child or not, but you don't give
           | the baby _food_ before 4 to 6 months. So its not that you
           | aren 't exposing them at all, but not feeding them the food.
        
             | theNJR wrote:
             | There are powders to add to your formula / breast milk to
             | introduce allergens early (we used Ready Set Food but easy
             | to DIY). Kind of annoying since they often clog the nipple
             | of the bottle, but we did it with my daughter who is now 20
             | months and her favorite breakfast is a spoon of peanut
             | butter. Sesame gives her a slight reaction still, we
             | unfortunately don't eat it very often.
        
           | ascorbic wrote:
           | No, it's the opposite. The advice we were given was that it
           | was very important that their first encounter with the
           | allergens was to eat them, and not to allow skin contact or
           | anything before that. This meant that with my youngest we had
           | no peanuts in the house until she was old enough to eat solid
           | food, and peanut butter was the first food she ate. It's
           | still her favourite food!
        
             | pc86 wrote:
             | > we had no peanuts in the house until she was old enough
             | to eat solid food
             | 
             | That seems like overkill. I can't imagine having peanuts or
             | peanut butter in the pantry is going to meaningfully affect
             | a 2 month old infant.
        
               | brnt wrote:
               | Babies change fast. I can certainly imagine it. You won't
               | know when exactly the flip happens, so you err on the
               | safe side. Also, spread of stuff though the air and by
               | hands: I thought we just spend lockdowns realising that
               | crap spreads far and wide.
        
               | robxorb wrote:
               | Makes sense to me.
               | 
               | If you're avoiding skin contact, then you might not have
               | time to wipe the peanut butter mess off your hands as you
               | rush to rescue your kid who's got into trouble.
        
           | britishfetish wrote:
           | I'm assuming you're not a parent, but it's a valid question!
           | No food before 4 months, babies can and should subsist on
           | breastmilk or formula before that.
        
           | t0mas88 wrote:
           | It's the opposite. Usually babies don't eat any food at 4
           | months. They only get breastmilk or formula. The advice is to
           | start early with peanutbutter and egg.
           | 
           | In our case diary products were an issue instead of nuts. My
           | daughter would get very sick from anything that had diary in
           | it, even if my wife ate diary products while breastfeeding.
           | But at about 1.5 years one she got over that and now at 4 she
           | is completely fine drinking normal cow milk.
           | 
           | So allergies in kids are not a permanent set in stone thing.
           | They can get over some, and early exposure makes a
           | difference.
        
         | ascorbic wrote:
         | My daughter took part in a large study that led to similar
         | guidance being introduced in the UK. The was randomised into
         | the early introduction group, which meant that she had to eat
         | peanut, egg, cow's milk, fish, wheat and sesame on a regular
         | schedule when she was a baby. It was interesting - though lots
         | of work, and when she was old enough to understand why she was
         | going up to London for the follow-up tests, she was very proud
         | of her role as "scientist". It was very satisfying when the
         | results were published many years later, proving the
         | hypothesis.
         | 
         | https://www.food.gov.uk/research/food-allergy-and-intoleranc...
        
           | soperj wrote:
           | > Overall, food allergy was lower in the group introduced to
           | allergenic foods early but the difference was not
           | statistically significant.
           | 
           | How is that proving the hypothesis?
        
         | hammock wrote:
         | Where does the peanut and egg allergy come from? My
         | understanding is that peanut oil and egg albumin are
         | ingredients in many common medicines given early to infants..
         | is there any chance that could be contributing?
        
           | User23 wrote:
           | It does make you wonder if we shouldn't vaccinate until
           | exposing the children to solid foods in ordinary healthy
           | cases. The mother's antibodies from her milk do good work.
           | 
           | There are other commenters warning about skin exposure before
           | dietary exposure. If that's true then it would make sense.
        
       | darth_avocado wrote:
       | I always think about the low incidence of peanut allergies in
       | developing countries and wonder if the mother's diet during
       | pregnancy has an effect on allergies in children? Has this been
       | researched? Because instead of introducing peanuts and eggs to
       | babies, introducing it to mothers is almost a no brainer.
        
         | jagged-chisel wrote:
         | Only if mom isn't allergic.
        
         | Workaccount2 wrote:
         | It most likely has to do with how bored our immune systems are.
         | 
         | We evolved to be constantly dirty, and we live in an extremely
         | clean society. When your immune system has a lot to fight, it
         | doesn't worry to much about dumb shit like pollen and peanuts.
        
           | colechristensen wrote:
           | Clean vs. dirty isn't even the right way to think about it.
           | We used to be immersed in an environment full of life, and
           | now we live in mostly sterile environments free of life
           | except for maybe some of the first wave colonizer specialist
           | microorganisms. You are filled and covered with life that
           | isn't from your own genes, and that microbiome is now mostly
           | disconnected from the biosphere.
           | 
           | I get some weird skin issues sometimes which are almost
           | magically fixed if I visit a natural body of water... it's
           | clearly an issue of my immune system interacting unfavorably
           | with a microbiome which is out of whack.
        
             | supertofu wrote:
             | How fascinating. This reminds me that my autoimmune
             | condition went into a brief and mysterious remission two
             | summers ago, when I spent most weekends swimming in creeks.
             | I will have to see if increased creek swimming this summer
             | will help my autoimmune symptoms...
        
               | nytesky wrote:
               | Yeah getting hooked up with some bugs from the creek
               | keeps your immune system occupied.
               | 
               | Hookworms are another option; maybe two generations ago
               | kids regularly walked barefoot in grass and was pretty
               | common.
               | 
               | https://en.wikipedia.org/wiki/Helminthic_therapy
        
               | jdougan wrote:
               | I hope it works. I can think of far more unpleasant
               | treatments. Let us know the results!
        
             | kristianp wrote:
             | Just curious, is it the ocean, or a fresh water body that
             | helps?
        
               | colechristensen wrote:
               | A small Minnesota lake, just walking on the beach and
               | taking a little dip.
        
           | AlbertCory wrote:
           | About 20 years a doctor told me that this was a theory that
           | wasn't widely accepted YET, but it deserved to be taken
           | seriously. Now it's much more mainstream.
        
             | viraptor wrote:
             | It's mainstream, but has it actually been confirmed in some
             | way beyond "it makes sense"? I've never seen a paper trying
             | to test it in some way. (Would love to know if it's out
             | there)
        
               | AlbertCory wrote:
               | idk. I was about to say that children from farms have
               | fewer allergies, but I can't actually back that up.
        
           | makeitdouble wrote:
           | How do you see reactivity to house dust, air pollution, stuff
           | like asbestos and adjacent construction materials etc. ? Then
           | I'd assume the living ecosystem also shifted from mostly open
           | air to indoor insects, i.e. "life finds a way"
           | 
           | We sure aren't exposed to the same things as 4 centuries ago,
           | but I can't imagine we're living a what anyone would call a
           | "clean" environment.
        
             | ricardobeat wrote:
             | Those are not microorganisms, and don't necessarily trigger
             | your immune system in the same way.
        
             | jnwatson wrote:
             | Dust allergies are extremely common these days but you
             | can't have an (IgE mediated) allergy to asbestos or smog.
             | Generally the immune system reacts to biological
             | substances.
             | 
             | We're vastly more sterile from a germ perspective. The term
             | "hygiene hypothesis" is apt.
        
             | autoexec wrote:
             | We're a very different kind of dirty. We've got
             | microplastics in our organs, and pesticides, PFAS, and
             | other pollutants in our blood.
             | 
             | People in the olden days got their hands dirty chopping
             | down trees and building solid wood tables while today we
             | keep our hands clean by buying flat-pack furniture that
             | out-gasses formaldehyde into our homes and our lungs.
             | 
             | We're much dirtier than the people were a long time ago,
             | only it's mostly on the inside. The filth in our bodies
             | doesn't wash off with soap.
        
           | JumpCrisscross wrote:
           | > _We evolved to be constantly dirty_
           | 
           | And infested with worms. Most allergies are caused by the
           | antibody we evolved to fight worms (and venom) [1].
           | 
           | [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010491/
        
           | ein0p wrote:
           | This checks out. After moving to a state with a lot of
           | greenery I developed a rather severe allergy to grass and
           | pollen. Literally the entire face would get swollen and
           | stuffy for several months in any given year. Not life
           | threatening, thankfully, but very unpleasant. It went away
           | within a year after I started mowing my own lawn and working
           | in the garden without gloves.
        
           | BurningFrog wrote:
           | The immune system doesn't know how to rest. It must always
           | fight _something_.
           | 
           | So if it runs out of intruders to fight, it will attack the
           | body itself.
        
         | IncreasePosts wrote:
         | No link because I'm on mobile, but I remember reading about how
         | peanut allergy in Israel is nearly non-existent. This is
         | notable because:
         | 
         | 1) Israelis come from all over the world, and the incidence of
         | peanut allergies are lower in, say, Sephardic Jews living in
         | Israel compared to Sephardic Jews living in Spain.
         | 
         | 2) a very popular snack there for kids(but also adults) are
         | these peanut butter corn-puffs called "Bambas"(like, literally
         | 25% of the snack market is this one snack)
        
           | type_enthusiast wrote:
           | Strictly speaking, if all babies eat peanuts, you'll get to
           | "nearly non-existent" peanut allergy one way or another. But
           | you need better data than that to conclude that the change
           | comes from allergy prevention, rather than... allergy
           | "removal".
           | 
           | Edit: I guess I was just trying to say "surprising data needs
           | detail." I should have just said that, instead of making
           | light of how dangerous allergies are. Downvotes deserved,
           | lesson learned.
        
             | Vecr wrote:
             | You think Israel could cover something like that up?
        
               | makeitdouble wrote:
               | I don't think parent is hinting at a conspiracy, and more
               | at "natural" selection based on omnipresence of peanuts.
               | 
               | With no knowledge about how i goes for babies, the
               | question would be how a 2~3 month allergic kid [0] would
               | react to peanuts, including when not directly ingested.
               | If it had adverse effects it would go along the line of
               | what parent is describing.
               | 
               | [0] can kids that age already be allergic to peanuts ?
        
               | marcosdumay wrote:
               | So, at the end of a long thread full of information that
               | discards genetics, your explanation for it is...
               | genetics.
        
               | makeitdouble wrote:
               | I took it as a warning about potential misinterpretation
               | of causes and effects, and in particular the difficulty
               | to assign a single cause to the near absence of allergy
               | in a population.
               | 
               | Allergies are a subject I need to know a lot more about,
               | so sadly at this point I don't have an explanation for
               | anything.
        
               | marcosdumay wrote:
               | Yet you are the one insisting on a single cause.
        
               | makeitdouble wrote:
               | Having some babies get hit at early age by allergies
               | doesn't exclude any other mechanism running in parallel,
               | including other babies adapting their immune system, or
               | even families moving out of the country for health
               | reason.
               | 
               | I don't see how any of what I said is either insistant or
               | limiting to a single cause.
        
               | type_enthusiast wrote:
               | I was not hinting at any conspiracy, and my comment
               | wasn't directed toward Israel in particular (knowing
               | nothing about the study that the top-level comment
               | alluded to).
               | 
               | I was facetiously pointing out that a population where
               | everyone eats peanuts at a young age is likely to be
               | allergy-free if only due to the fact that those with
               | peanut allergies would die, and therefore would no longer
               | be allergic to peanuts. A naive analysis of the data
               | could lead to a conclusion that eating peanuts at a young
               | age causes a favorable change in allergy outcomes later
               | in life.
        
               | swores wrote:
               | For the record, I don't agree with your edit saying that
               | your original comment deserved the downvotes it got. I'm
               | not sure if people just completely missed the point you
               | were making, or if, as I think likely, the current
               | political climate around Israel/Palestine led to a few
               | pro-Israel people wrongly assuming you were being anti-
               | Israeli, but either way I'm glad you contributed and were
               | able to clarify what you meant.
        
               | type_enthusiast wrote:
               | No, I didn't mean to imply anything like that. I guess I
               | was just trying to say "surprising data needs detail." I
               | should have just said that, instead of making light of
               | how dangerous allergies are. Downvotes deserved, lesson
               | learned.
        
             | LegitShady wrote:
             | https://en.wikipedia.org/wiki/Bamba_(snack)#Peanut_allergy
             | 
             | You can click on the footnotes for sources.
        
               | type_enthusiast wrote:
               | Thanks! That thread leads to LEAP (Learning Early About
               | Peanut allergy) which is a study that seems to have done
               | a pretty good job of demonstrating that peanut exposure
               | is in fact prophylactic against later allergy (as
               | measured by a skin test). The data is pretty thorough:
               | https://www.nejm.org/doi/full/10.1056/NEJMoa1414850
               | 
               | Notably,
               | 
               | > No deaths occurred in the study.
               | 
               | so it's not a "naive analysis" of the kind that I
               | facetiously alluded to. I didn't mean to imply that I
               | believed naivete was a a factor... I was just pointing
               | out that the top-level comment of "I heard {country}
               | doesn't have any peanut allergy, and they eat peanuts
               | from a young age" (without any further detail) was
               | illustrative of a particularly insidious fallacy.
        
               | LegitShady wrote:
               | Ya I get it - I was just pointing you to sources. It made
               | some waves back in the day to the point where its become
               | sort of an allergy meme but it was a real study.
               | 
               | apparently there was a follow up study called LEAP-ON
               | where some of the subjects who had eaten bamba in the
               | LEAP study were then asked to abstain from peanuts from
               | age 5 to 6 and their tolerance to peanuts was then
               | tested, and the results showed that infant peanut
               | exposure reduced allergy levels even if they abstained
               | later (you don't have to keep eating them, at least not
               | within the time envelopes of the study).
               | 
               | Also another study that measured the different peanut
               | allergens in bamba and compared it to peanut flour that
               | concluded allergen levels were lower and more uniform in
               | bamba making it useful for this purpose.
               | 
               | truthfully I don't need an excuse to eat bamba. If you
               | like peanut butter its basically peanut cheatos (without
               | the cheese) and is amazing, even though its super
               | processed and definitely not healthy to eat compared to
               | real food.
        
             | throwup238 wrote:
             | From _Epidemiology of anaphylaxis in Europe_ [1]:
             | 
             | > Case fatality rates were noted in three studies at
             | 0.000002%, 0.00009%, and 0.0001%.
             | 
             | Fatal allergic reactions are so rare as to be completely
             | irrelevant as a cause of death. Most of them are drug
             | induced and most of those occur in hospitals when someone
             | has an allergic reaction to an intravenous drug, not
             | something they eat [2]. They're unlikely to be a
             | significant driver of any evolutionary adaptation.
             | 
             | [1]
             | https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.12272
             | 
             | [2] https://linkinghub.elsevier.com/retrieve/pii/S009167491
             | 40119...
        
         | nytesky wrote:
         | I am kinda of curious about populations where peanuts aren't
         | common at all. I certainly didn't have many fancy nuts (i know
         | peanuts aren't nuts) until well into adulthood. Why were there
         | not wide spread peanut allergies among migratory populations?
        
         | ilickpoolalgae wrote:
         | Allergies are weird and our understanding of them is very
         | incomplete. My son has/had a peanut allergy (very successful
         | oral immunotherapy, knock on wood) and I ended up doing a lot
         | of research. One study that is particular interesting is this
         | one: https://pubmed.ncbi.nlm.nih.gov/26728850/
         | 
         | It shows that east asian children, who very rarely have nut
         | allergies in their home countries, develop nut allergies at a
         | higher rate than non-asian children when born in Australia
         | while east asian children who immigrate to Australia after
         | their early infancy continue to maintain very low rates of nut
         | allergies.
        
           | goldieboi wrote:
           | This is what our allergist said. Living in Australia wife and
           | I are both asian both eat peanuts. No peanut allergies in
           | either families. Wife ate peanuts while pregnant but son has
           | peanut allergy.
        
             | rconti wrote:
             | What's the implication here? That exposure to peanuts in
             | utero might not help avoid peanut allergies after birth?
             | (I'm not sure what the literature on that says)
             | 
             | Or that there's something unusual about simply being in
             | Australia as an infant that causes peanut sensitivity?
             | 
             | Or that infants in Australia have less exposure to nuts?
        
               | jimcsharp wrote:
               | I read at one point that my oral allergy syndrome, my
               | mild reaction to apples and other fruits, tends to be
               | correlated with hay fever. It doesn't seem unreasonable
               | for something similar to be afoot with peanuts.
        
         | timtyrrell wrote:
         | I am the parent of twins. Their mother ate multitudes of peanut
         | M&M's and similar items when pregnant. One twin has zero peanut
         | allergies, the other one has deadly allergies and we are at the
         | ER at least once a year from food contamination.
        
           | femto wrote:
           | On the assumption that such allergies have a genetic
           | component, presumably the twins aren't identical?
        
             | swores wrote:
             | It's also possible for things which do have genetic
             | components to _also_ have environmental triggers, so its
             | not impossible that, for example, identical twins who
             | happened to get different levels of exposure to peanuts in
             | their first year of life based on random luck of which
             | family member ate peanuts near them at which times, or
             | something like that, could lead to different outcomes even
             | if genetics were the reason that both twins were at risk of
             | developing such an allergy.
        
         | grecy wrote:
         | > _low incidence of peanut allergies in developing countries_
         | 
         | I know this sounds extremely insensitive, but I genuinely think
         | the answer is simply that the vulnerable die.
         | 
         | I spent 3 years moving through 35 different African countries
         | and 2 years through Latin America.
         | 
         | I honestly believe it is simply the harsh reality of life that
         | many more infants and young children die than in developed
         | countries.
        
         | rqtwteye wrote:
         | Maybe the children die without anybody diagnosing allergies?
        
         | harimau777 wrote:
         | Is it possible that in developing nations having more limited
         | dietary options and/or the risk of allergic reaction makes a
         | child less likely to survive and therefore makes it appear that
         | allergies are less common?
         | 
         | This is just speculation, I don't know of any evidence one way
         | or the other.
        
         | lupusreal wrote:
         | I have a suspicious that _apparent_ elevated rates of allergies
         | are caused by overzealous preemptive testing. The tests are
         | very sensitive and trigger for people that have only slight
         | allergies which, in the past or in developing countries, could
         | have been simply unknown and naturally diminished with
         | subsequent exposure.
        
         | trueismywork wrote:
         | Indian kids are fed peanuts as early as possible
        
       | eskibars wrote:
       | Our son is very allergic to peanuts and less so to cashew, and
       | sesame. We went through oral immunotherapy and it's been
       | absolutely life changing. He used to need an epi pen in case of
       | chance encounter, but now he eats 2 whole peanut m&ms every day
       | to keep his dosage up. It's been difficult finding an allergist
       | in Germany that's willing to accept this and move forward
       | 
       | Obviously everyone's mileage will vary, but I'm happy to see this
       | treatment being more widely adopted
        
         | marcod wrote:
         | Sorry for being nosy, but did you do oral immunotherapy with or
         | without professional support?
        
           | eskibars wrote:
           | With. First they did a blood test (instead of a scratch test)
           | to identify possible allergy levels. Then the allergist had
           | us come into the office to take e.g. a few micrograms of
           | peanut powder and watch him for reactions. Then we maintained
           | the dose at home every day for the next couple weeks, taking
           | zyrtec with it to avoid hives, etc. Then we'd go back in, try
           | doubling the dose as a challenge. If he had a bad reaction,
           | we stayed on the same dose another few weeks, and if not, it
           | became the new standard level. Rinse and repeat for about a
           | year until we got to 2 peanuts, 1 cashew, and 1/4 tsp of
           | tahini, which we maintained now for the past ~1.5y. We're due
           | for another blood test and challenge here soon, as the
           | allergist suggested there's a small chance that the
           | immunotherapy could result in the allergies essentially
           | receding
        
           | rahimnathwani wrote:
           | I AM NOT A DOCTOR OR OTHER HEALTHCARE PROFESSIONAL
           | 
           | I looked into oral immunotherapy for tree nut allergies.
           | There's a paper from 2022:
           | https://onlinelibrary.wiley.com/doi/10.1111/all.15212
           | 
           | They did it in a few stages:
           | 
           | 1. First three days: test the child with increasing amounts
           | of cashew protein, until the child has a reaction. Use the
           | amount ingested for that reaction, to determine the single
           | highest tolerated dose (SHTD = the maximal amount of cashew
           | protein each patient could tolerate).
           | 
           | 2. Next 24 days: the child ingests the SHTD daily.
           | 
           | 3. After that: every month, the dose was increased (I think
           | at an in-person visit), and taken at home for the next 30
           | days.
           | 
           | For #1, I looked at the amounts of protein they gave the
           | child. Table S2 (in one of the supporting documents) shows
           | how much they gave on days 1, 2 and 3. Of course they stopped
           | increasing once the child had a reaction. If you convert the
           | amounts of protein into equivalent numbers of whole cashews,
           | then you get:
           | 
           | - day 1: start with 1/1800th of a small cashew, increasing up
           | to a fifth of a small cashew.
           | 
           | - day 2: 1/5th small cashew, up to 2 small cashews
           | 
           | - day 3: 2 small cashews, up to 22 small cashews
           | 
           | 22 small cashews is about equivalent to what they want to
           | achieve by the end of the therapy, i.e. if you don't have a
           | reaction after eating that many, you won't have a reaction to
           | a greater quantity.
           | 
           | It seems a bit hard to DIY it, because:
           | 
           | - The first three days requires very small amounts of cashew
           | protein. At home we don't have either (i) isolated cashew
           | protein, or (ii) tools to measure such small amounts
           | (starting with 0.1mg cashew protein, or 0.5mg cashew).
           | 
           | - For the first three days, we'd need to be very vigilant to
           | watch out for a reaction. I don't know whether, in a
           | supervised setting, they'd observe or measure other factors
           | than just an apparent reaction, to make sure the procedure is
           | safe.
           | 
           | I AM NOT A DOCTOR OR OTHER HEALTHCARE PROFESSIONAL
        
             | spike021 wrote:
             | For curiosity sake, curious if the tree nut allergy here
             | was typical reactions (hives, nose, etc.)?
             | 
             | I have a tree nut "allergy" but doctors always call it more
             | of a "hypersensitivity" because my reactions are usually
             | involving terrible stomach cramps and pain accompanied
             | occasionally by swollen throat (more so for almonds than
             | cashews).
             | 
             | I've wondered if it's worth trying to do this myself.
        
               | sbelskie wrote:
               | Sounds like Oral Allergy Syndrome. I also have it with
               | almonds and stone fruits.
        
               | 2muchcoffeeman wrote:
               | Why wouldn't you see the doctor? Cost? Not covered by
               | insurance?
        
               | spike021 wrote:
               | I have in the past but they weren't much of a help.
               | Allergy scratch test results didn't correlate at all.
               | 
               | They referred me to a throat doctor to make sure it
               | wasn't anything in my digestive system. So ended up doing
               | an endoscopy. No notable findings there either.
               | 
               | So never been given any kind of ideas of things to try
               | other than keeping a food journal, which has been useless
               | to me.
        
               | rahimnathwani wrote:
               | Sudden loss of appetite, followed soon by nausea, and
               | then vomiting.
        
             | fsckboy wrote:
             | > _day 1: start with 1 /1800th of a small cashew,
             | increasing up to a fifth of a small cashew_
             | 
             | do you mean, if there is no reaction to 1/1800th within
             | minutes(?) then try 1/900th, lather rinse repeat?
        
               | rahimnathwani wrote:
               | Correct. The specifics are in the second page of this
               | doc: https://onlinelibrary.wiley.com/action/downloadSuppl
               | ement?do...
               | 
               | The intervals start at 10 minutes (start of day 1) and go
               | to 90 minutes (start of day 3).
               | 
               | The dosage increments (in mg of cashew protein) start at
               | 5x, but are mostly 1.5x or 2x.
        
             | WhitneyLand wrote:
             | Ok I'll bite - Wouldn't have guessed it necessary to
             | bookend a comment with all caps disclaimers, yet it's
             | happening, so I'm going to guess you have an interesting or
             | cautionary anecdote around it we can possibly learn from?
        
               | rahimnathwani wrote:
               | Nope. Just being cautious!
        
         | gobins wrote:
         | Wow that is really good to hear. I am on immunotherapy for a
         | different type of allergy and can't stop talking about its
         | effectiveness. It has been life changing.
        
           | sva_ wrote:
           | I did a whole immunization against dust mites and I feel like
           | it didn't work at all. q.q
           | 
           | I've been wondering if there's something else causing me to
           | be allergic to them, like something I eat or so, idk. But
           | I'll have to get tested again
        
         | Obscurity4340 wrote:
         | Is this effective and available for milder chronic hayfever and
         | runny,partially blocked nose, generally speaking?
        
           | spacebanana7 wrote:
           | I've heard that consuming honey from your local variety of
           | bees can help - but the evidence base isn't great [1]
           | 
           | [1] https://www.honeyshoney.co.uk/blogs/news/local-honey-and-
           | hay...
        
             | simonswords82 wrote:
             | This is nonsense. It doesn't work.
        
           | RamblingCTO wrote:
           | Yes it is: https://www.aok.de/pk/magazin/koerper-psyche/haut-
           | und-allerg...
           | 
           | I heard that you can choose between pills every day for a
           | prolonged period OR three injections over a year. Not sure
           | how accurate this is, but every "allergologe" provides this
           | in Germany.
        
           | ad700x wrote:
           | I visited my local allergist for this (in the USA). Basically
           | the treatments available to me were either shots or eyedrops.
           | The shots required visiting the office almost daily, then
           | weekly, then less frequently. The eyedrops can be self
           | administered. I was told both treatment options are not
           | permanent and need to be basically done in perpetuity. The
           | cost was a couple thousand dollars per year (basically no
           | insurance coverage).
           | 
           | Seems like the treatment options are evolving pretty rapidly
           | and these options aren't available everywhere. Or this is
           | what I was told.
        
           | mrguyorama wrote:
           | Yes, my girlfriend gets allergy exposure shots for cat
           | dander. It's stupid expensive and time consuming. You will
           | meet your insurance deductible for several years. The outcome
           | is only somewhat good as well.
        
         | ugh123 wrote:
         | > It's been difficult finding an allergist in Germany that's
         | willing to accept this and move forward
         | 
         | What are they saying? They don't believe in oral immunotherapy?
        
         | mmikeff wrote:
         | Our daughter too, she's been on a maintenance dose equivalent
         | to two peanuts, once a week. It's been life changing. She's had
         | several trips to A&E before the treatment but after a few years
         | she was able to tolerate a dose equivalent to ten peanuts
         | (although that still made her quite nauseous).
        
         | dminor wrote:
         | I asked our allergist about oral immunotherapy for my daughter
         | and he cited a study that found that avoidance was more
         | effective in preventing severe reactions.
        
       | ggm wrote:
       | Treatment for adults would be nice, but I take solace from the
       | future. At least more kids won't need to grow up with an extreme
       | concern. Meantime grown-ups keep carrying the epipen.
        
         | bb123 wrote:
         | It is not well known but this also works for adults too. I'm 28
         | and recently completed oral immunotherapy therapy for my
         | extremely severe peanut allergy. I used to go anaphylactic from
         | single milligram exposure and now I'm eating multiple peanuts a
         | day. As an adult you have to go slower and be more careful but
         | absolutely can be done and is life changing.
        
           | ggm wrote:
           | Weblinks would be very interesting. Congratulations for
           | getting to a safer place.
           | 
           | This is the Australian position:
           | https://www.allergy.org.au/hp/papers/ascia-oral-
           | immunotherap...
        
       | grecy wrote:
       | When I worked at a wilderness summer camp I had a kid in my group
       | that was deathly allergic to peanuts, so weeks before we had to
       | rid the camp of them.
       | 
       | He was about 13, and said when he was little they did that
       | scratch allergy test on his arm and he was in a coma for six
       | months. He carried and Epipen around but told me not to stress.
       | If someone ate a snickers then touched a door knob, and he
       | touched it days later he would be dead on the ground before I had
       | the cap off the pen anyway.
       | 
       | Cool kid, he just took it in stride.
        
         | lupusreal wrote:
         | Sounds like obvious bullshit. His story I mean, not yours. If
         | his allergy were as bad as he claimed he would be a bubble boy
         | or dead. It's not as if all of society around him could be
         | cleansed of peanut residue as the camp supposedly was. If he
         | went anywhere public without a bubble then by his account he'd
         | be dead.
        
           | grecy wrote:
           | He was extremely careful not to touch much, and after meeting
           | his parents they lived in constant terror
        
         | viraptor wrote:
         | Slight tangent: How do people with an allergy that severe find
         | out they have an allergy? For example people who know even
         | someone's breath after eating peanuts would threaten their
         | lives. Accidental exposures are likely much worse than that, so
         | how do you end up learning about this severity without dying in
         | the first place? Just running a full allergy test after an
         | unexplained exposure to traces of "something", or... ?
        
           | ljf wrote:
           | For my son, it was another child kissing him on the head when
           | my child was about 6 months old, the child had eaten peanut
           | butter for breakfast. His face started to swell, and my wife
           | ran him to a local GP - and with wiping down and plenty of
           | breast milk he was OK. A month or two later he was at a
           | toddler party and rolled in a little hummus - and the same
           | thing happened. We were already on the list for an allergy
           | appointment, but they wouldn't see him until he was 18 months
           | old - so we found a private hospital who would see him.
           | 
           | ---
           | 
           | In terms of 'cause' - we don't know, one or two other
           | children of my sons generation in our family have food
           | allergies, and an older brother thought he was allergic to
           | fish though never tested.
           | 
           | We noticed the reaction after he had a round of antibiotics
           | after he had infected eczema, quickly followed by my wife
           | needing antibiotics which we are sure got to him through her
           | milk, as he'd groan after breast feeding - before that we had
           | plenty of nuts, sesame, milk and eggs in the house, without
           | noticing an issue for him. But that is just a pet theory.
        
       | Andaith wrote:
       | Here's the participating hospitals:                 * The Royal
       | Children's Hospital in Victoria       * Perth Children's Hospital
       | * Fiona Stanley Hospital in Western Australia       * Queensland
       | Children's Hospital       * Women's and Children's Health Network
       | in South Australia       * Sydney Children's Hospital, Randwick
       | * The Children's Hospital at Westmead       * John Hunter
       | Children's Hospital        * Campbelltown Hospital        * Royal
       | Prince Alfred Hospital in NSW
       | 
       | From this article, which has a bit more info:
       | https://www.abc.net.au/news/2024-07-31/peanut-allergy-nation...
        
       | ahstilde wrote:
       | Immunotherapy works. I run a company (YC w21) that wants to
       | eliminate allergies forever. It's ancient medicine to manage
       | symptoms with antihistamines when we can remove the root cause
       | completely.
       | 
       | Right now, we fix cat, dog, pet, pollen, and dust allergies. In a
       | few years, we'll be doing nuts.
       | 
       | Our launch HN: https://news.ycombinator.com/item?id=26227807
       | 
       | company: https://www.wyndly.com/
       | 
       | book a visit with a doc: https://www.wyndly.com/products/allergy-
       | doctor-consult-onlin...
       | 
       | Or just start with an allergy test:
       | https://www.wyndly.com/products/at-home-allergy-test
       | 
       | US Only right now. If you can help us expand into your country,
       | contact me at aakash@wyndly.com
        
         | snowpid wrote:
         | Can you show us any peer reviewed paper ?
        
           | KennyBlanken wrote:
           | I tried searching pubmed but turns out there are a lot of
           | Mana Shahs working in bio research and pharma.
           | 
           | The big question for me is whether this is a permanent fix or
           | if you have to keep taking their tablets (at $99-ish a month,
           | it looks like?)
           | 
           | Unfortunately this doesn't look to be covered by my insurance
           | as the at-home test is not administered by a doctor.
        
             | snowpid wrote:
             | My insurance in Germany only accepts peer reviewed stuff
             | anyway so I keep waiting.
        
         | helloworld42024 wrote:
         | This is a brilliant idea. The product and system also look
         | extremely well put together.
        
         | KennyBlanken wrote:
         | How is this different or better compared to diagnostics and
         | treatments available from allergists? At least one office in my
         | area says they do immunotherapy and desensitization.
        
       | a_c wrote:
       | In the book Immune by Philipp Detter, creator or YouTube channel
       | Kurzgesagt, it was mentioned that parasite might been a link in
       | developing allergy (or was it autoimmune disease, can't remember
       | exactly)
        
       | bb123 wrote:
       | It is not well known but this also works for adults too. I'm 28
       | and recently completed oral immunotherapy therapy for my
       | extremely severe peanut allergy. I used to go anaphylactic from
       | single milligram exposure and now I'm eating multiple peanuts a
       | day. As an adult you have to go slower and be more careful but
       | absolutely can be done and is life changing.
        
         | tomcam wrote:
         | What a relief! Thank you for sharing.
        
         | ljf wrote:
         | Wonderful to hear - my son took part in a milk desensitisation,
         | which has been really successful - but he also has a good few
         | other food allergies. We haven't yet been able to get him onto
         | other trials, so I was worried that if we didn't do it while he
         | was young, we'd miss the 'window'.
         | 
         | Brilliant to hear it still works well in adulthood - if we can
         | get peanuts, sesame and egg under control - so that he can eat
         | 'May Contain' food, that would be a huge change for him.
        
         | rmccue wrote:
         | How long did your therapy take to get to this point?
        
           | bb123 wrote:
           | About a year overall but I started to have meaningful
           | protection after about 6 months. There is no one in the UK
           | currently offering it for adults so I had to travel to a
           | specialist clinic Atlanta a few times.
        
       | trueismywork wrote:
       | Thus has been the norm in Indian culture for centuries now.
        
       | agp2572 wrote:
       | There is a theory that if your body is not exposed to enough good
       | bacteria and other pathogens then it will build up an army to
       | fight out non important things like pollen and peanuts. I would
       | recommend giving kids probiotics and also not keeping environment
       | so clean with wipes and excessive hand washing that they never
       | get exposed to good and some bad germs.
        
         | amelius wrote:
         | Can someone confirm that theory and provide evidence?
        
           | rajup wrote:
           | There are plenty of studies linked here:
           | https://en.wikipedia.org/wiki/Hygiene_hypothesis
        
           | hwbehrens wrote:
           | This correlation is often referred to as the 'hygiene
           | hypothesis' by researchers. The underlying cause is still
           | being understood; you can find an article comparing two
           | theories here [0].
           | 
           | [0]: https://www.nature.com/articles/nri35095579
        
         | xeromal wrote:
         | The grow up eating dirt hypothesis.
        
       | odiroot wrote:
       | Hey, maybe at some point we can get back our free peanuts on
       | flights!
        
       | cwoolfe wrote:
       | Nuts are a very good and healthy natural snack; it's a shame they
       | are banned by most daycares and schools now. It would be great if
       | this became so common they could be allowed again. Without
       | nuts...what do we have instead? Chips. granola-bars. These are
       | highly processed foods that have other issues. Raisins or apples
       | maybe? but they are mostly sugar. None of these options have
       | healthy fat & protein like nuts do. What healthy snacks do you
       | feed your children?
        
         | blackeyeblitzar wrote:
         | Yep, the banning of normal foods from these spaces is a
         | detriment to everyone else. I feel it is a bit unfair, in that
         | everyone else has to "subsidize" the few rare people with
         | allergies. Shouldn't the burden be on them to avoid public
         | spaces if they're that sensitive?
        
           | rospaya wrote:
           | > Shouldn't the burden be on them to avoid public spaces if
           | they're that sensitive?
           | 
           | Depends how emphatic you are to your fellow human being.
           | Peanuts aren't as important in most people's lives as actual
           | people.
        
             | heavenlyblue wrote:
             | However since we're currently seeing that allergies are
             | treated by exposure, by removing these from canteens we are
             | strengthening everyone's allergies for the sake of the few.
             | In essence these few unlucky ones, including those who
             | don't want to take the risk, are making us all more ill in
             | the long run.
        
             | Zach_the_Lizard wrote:
             | On the other hand, avoiding peanut exposure can cause an
             | increase in allergies, so there's a feedback loop at play.
             | 
             | The children who now have allergies, but wouldn't with past
             | exposure levels, are more inconvenienced than the kid who
             | can't eat a peanut butter sandwich at school.
             | 
             | Attempting to make life better for all has unexpected
             | twists and turns
        
         | t0mas88 wrote:
         | Oh wow, are nuts banned from US schools? Never heard of that in
         | NL or UK. The only food requests we get from daycare and
         | primary school are to provide healthy snacks for birthday
         | celebrations instead of sugary. And that's a friendly request
         | not a rule.
        
       | purpleblue wrote:
       | We introduced our child to peanuts relatively early as well.
       | Peanuts, macadamia nuts, cashews, hazelnuts, almonds, eggs,
       | wheat/gluten, you name it, we gave it to him.
       | 
       | Turns out he is anaphylactically allergic to walnuts and pecans.
       | It took us a long time to figure out what was going on because we
       | thought he was fine with nuts. So exposing kids to peanuts isn't
       | the panacea that they think it is.
       | 
       | At this point I'm convinced that the adjuvants in vaccines are
       | the cause of food allergies. Adjuvants are designed to promote a
       | strong immune response from the body and guess what? That's
       | exactly what a food allergy is, an overreaction to the antigens
       | found on particular foods. My son took every single vaccine,
       | including COVID plus booster, but after reading on up this and
       | figuring out his severe allergy, I'm convinced this is the
       | problem.
       | 
       | The Amish community, which doesn't vaccinate, has almost no food
       | allergies at all and I think if someone does a proper study, I
       | will bet that the adjuvants used to trigger a strong response
       | such that vaccines work also have unintended side effects which
       | is food allergies.
        
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       (page generated 2024-08-02 23:00 UTC)