My life with food allergies and sensitivities has often been filled with “no.”
No, I don’t think that’s safe for you to eat.
No, sorry. We’re not sure about the ingredients.
No, you can’t have that.
My dining patterns are defined by diligence—check ingredients, take care at restaurants and when in doubt, steer clear of anything potentially dangerous. For those with severe food allergies, avoidance is the cornerstone of safety. In my lifetime, there has simply been no other way.
But things are starting to change.
As immunologists gain better understanding of the pathogenesis of allergy, doctors are viewing food allergies in a different light. Notable strides are now being made in immunotherapy, the treatment of gradually increasing an allergic person’s exposure to an allergen, desensitizing them over time. It’s now being demonstrated in medical literature: Desensitization offers something akin to a cure.
The notion of finally being free of my food allergies is elating…and difficult to imagine.
What would it be like to leave precautions behind? To grab an appetizer from any hors d’oeuvre platter, to eat out anytime, anywhere without advanced planning, to sit down at a meal with nothing on my mind but enjoying the company of family and friends?
It takes my breath away.
Should I undergo immunotherapy in the future? I have mixed feelings. Despite advanced blood tests that flag those who might have an anaphylactic reaction and despite new adjunct therapies that make the process safer and more effective, there are still potential risks and unknowns: Will I have a reaction during the process? Are the strategies and supplementary medications truly safe? Will it produce a long-lasting cure? Researchers are busy working on these issues.
At 28, I’ve lived with food allergies my entire life, so long that they’ve become a part of me. My immunological quirks are woven into my identity. Double-checking product labels, avoiding dangerous foods and explaining my dietary restrictions to waitstaff, family and friends are all second nature. I’m used to living this way.
Moreover, food allergies were ingrained in my experience of growing up and learning to navigate the world. They taught me to be detailed-oriented, to be responsible and to speak up for myself.
Would I be the same person today without these experiences?
With the advent of immunotherapy and promising new treatment strategies, I wonder what my life will be like just a few short years from now. Yes, there are still many questions about immunotherapy and it is currently only performed as part of research studies. Yet this medical advance offers those of us with food allergies something we haven’t had before: hope.
Immunotherapy could open up our world, making it a safer and more welcoming place, a world full of “yes.”
Joshua Feblowitz, MD, lives in Boston and is specializing in emergency medicine. In our next issue, he interviews Wesley Burks, MD, one of the nation’s leading experts in pediatric food allergy and lead author of the landmark study on egg-allergy desensitization via oral immunotherapy.