Rachel Hardy, 38 was given a long list of food allergies she had developed despite being free of them throughout her childhood
Offer Rachel Hardy a fruit salad and she will have to decline. It’s not that she doesn’t like fruit — for years they were among her favourite foods — but these days a bite of a juicy peach or nectarine could make her seriously ill; even kill her.
After experiencing numerous frightening reactions, at the age of 38 Rachel has recently been told there is a list of foods to which she is so highly allergic that they could trigger a potentially fatal anaphylactic attack: as well as peaches and nectarines nuts and figs are off limits for her.
For years she had eaten these without a problem — but that changed during Christmas ten years ago when she helped herself to a handful of nuts.
‘I’d only eaten a couple when suddenly my mouth felt strange,’ recalls Rachel. ‘My throat started itching madly and my mouth felt as if it was swelling. I can only describe it as if I had an entire boiled egg in my throat and couldn’t shift it.’
Rachel ran to the kitchen to drink some milk. ‘I then ran upstairs and brushed my teeth frantically. As I did, the swelling seemed to subside. I was so relieved, but it was very scary.’
A few weeks later, Rachel, who runs her own cleaning business in Southwell, Nottinghamshire, had another reaction after eating a nut.
‘I didn’t understand it,’ says the mother of three — aged 17, 14 and eight. ‘I’d never been allergic to nuts in my life. I’d been asthmatic as a child and still had an inhaler. I’d also had hay fever.
‘But food had never caused me any problems. So why was it happening to me as an adult?’
Her GP gave her antihistamines and told her to avoid nuts. Then she reacted after eating a peach and, a few weeks later, after she’d given birth to her third child, Rachel was eating a fig when she felt her throat tighten and itch.
For years she had eaten all sorts of foods without a problem — but that changed during Christmas ten years ago when she helped herself to a handful of nuts (file photo)
‘This was worse than any other reaction,’ she says. ‘I felt my airways close, as if I couldn’t breathe. I felt dizzy and had to lie down. I felt my blood pressure plummet.’
Rachel is one of an increasing number of people who develop a food allergy as an adult, not as a child, as people tend to think happens.
New research by the American College of Allergy, Asthma and Immunology found that almost half of the 40,000 adults with a food allergy surveyed said one or more of their allergies started in adulthood.
Holly Shaw, nurse adviser at the charity Allergy UK, says that it has had an increase in the number of adults ringing its helpline with adult-onset allergy symptoms and concerns.
An allergy occurs when the body mistakes something harmless — such as a nut protein — as harmful, prompting the immune system to produce antibodies and other chemicals such as histamine that tries to rid the body of the perceived invader by, for example, prompting the production of mucus, triggering symptoms such as sneezing, or by increasing blood flow to the affected area, leading to a rash or the urge to itch, depending on the area affected.
However, food allergies have the potential to cause anaphylaxis — which rather than affecting just one area, affects the whole body, and can lead to a dramatic drop in blood pressure as blood vessels swell. It can be fatal.
‘Some allergies start in childhood and are often outgrown, typically with egg and milk allergy, says Dr Zoe Adhya, a consultant in immunology and allergy at King’s College Hospital, London.
‘It may be that a higher level of exposure to these foods leads to a tolerance. Reactions such as peanut allergy normally start in childhood and persist into adulthood in about 80 per cent of people
‘But there are other allergies — such as seafood — that are more likely to develop in adulthood.’
In fact, about two per cent of adults — or one in 50 — have a food allergy, (although some will have had these from childhood).
Quite why more adults should be developing food allergies is unclear. Having asthma or hay fever, as Rachel did, puts you at increased risk of developing a food allergy at any stage in life, as does having eczema.
One theory why adults specifically develop food allergies is that in our clean environment the immune system that once would have been fighting off frequent infections switches to causing allergy, says Dr Adhya — the immune system needs ongoing exposure to parasites and other bugs in order to work properly.
Another theory is that it’s due to a lack of vitamin D because we spend so much time inside — or slather ourselves in sunscreen when outside. The vitamin is known to have a role in regulating the immune system and a lack of it could trigger an allergy.
Exposure to new foods and air pollution such as diesel fumes may also be implicated.
‘In most cases it is unknown why a previously healthy adult will suddenly start making allergic antibodies against a particular allergen,’ says Dr Adhya.
Rachel is one of an increasing number of people who develop a food allergy as an adult, not as a child, as people tend to think happens (file photo)
‘However, there are rare cases that can illustrate how the immune system gets primed.’
One example, says Dr Adhya, is where a tick bite can cause a meat allergy. The tick bite primes the immune system to make antibodies against alphagal, a carbohydrate found in the cells of mammals we eat, such as cows and pigs, which is also present in the tick from feeding on mammals’ blood. The person then has an allergic reaction the next time they eat red meat.
After Rachel reacted to the nuts and peach, her doctor gave her a list of foods to avoid and prescribed her an EpiPen — an adrenaline injection to use if she ever got a reaction. ‘I felt at last he was taking me seriously. But there was still no official reason why I was suddenly allergic to foods I’d eaten all my life,’ says Rachel.
EpiPens cause the blood vessels to constrict, which helps to raise blood pressure during a severe reaction. Yet Rachel was still finding more and more things she was allergic to.
‘One day, in 2015, I took my youngest child and her friend on a picnic. We sat outside and ate cherries. I love cherries and had eaten them all my life. I suddenly felt my throat tighten and my blood pressure plummet. I hurried the kids into the car, raced home and took some antihistamine. It was terrifying.’
Nine years after Rachel first had food allergy symptoms, this latest attack prompted her GP to send her for skin prick tests at the local hospital. There, tiny amounts of typical allergenic substances are tested on the skin, the gold standard for diagnosing food allergies.
‘Testing can be done by scratching the surface of the skin with a tiny amount of the food and looking for a skin reaction such as hives or rashes,’ says Dr Adhya.
‘When we think someone has outgrown their allergy we may introduce them to that food by giving them a small amount to eat.’
Rachel’s tests showed she was highly allergic to fruits, including peaches, figs, cherries, nectarines apples, cherries, honeydew melon, kiwi and also nuts.
‘It was a relief to have a diagnosis, but also terrifying. I was at risk of anaphylaxis from so many everyday foods.’
Even with a diagnosis and an EpiPen, Rachel still encountered difficulties. ‘I can’t eat anything that’s even been near fresh fruit as it can still affect me.
‘I’ve had to tell my eight-year-old that if I give her a sign, it means I’m having an anaphylactic shock and she should call an ambulance. It’s a huge responsibility for a young child.’
And when her children eat fruit, she makes sure she goes to a different room.
The good news, says Dr Adhya, is that, just as children can outgrow allergies, so can some adults.And, she says, that the type of allergy Rachel has — Oral Allergy Syndrome — is one of the types of allergy that can be outgrown.
She says: ‘Pollen allergy, which causes hayfever, and oral allergy syndrome — an allergy to fresh fruit and vegetables linked to the pollen allergy — often peak when adults are in their 20s and declines when patients reach their 40s and 50s.’
Meanwhile, Rachel lives in fear of having a potentially deadly anaphylactic reaction. ‘If it’s something I can outgrow, I hope it happens soon,’ she says. ‘Because at the moment it rules my life.’
FLY IN THE OINTMENT
The amazing discoveries found using fruit flies. This week: body clock rhythms.
The discovery of the gene in fruit flies that regulates the biological clock in all living things won the Nobel prize in Physiology or Medicine last October for three U.S. scientists; Jeffrey Hall, Michael Rosbash and Michael Young.
The gene, called ‘period’, has proved crucial to our understanding about how the light from computer screens can damage our health — increasing the risk of illnesses such as diabetes and cancer. This is because the light knocks our body clock out of synch.
Research on fruit flies found that light entering their eyes sets the body clock’s rhythm so that it accords with night and day — but tests have shown that even brief pulses of light during the night can wrongly reset the clock.