Outgrowing an allergy (especially a food allergy) happens. And it
happens often. Often enough that many doctors think it's the standard
course of events. They've seen enough cases where early reactions
disappear later. It is such a widespread phenomenon that it's viewed
as an almost certainty. And it's held up as hope when doctors can do
nothing about the worry and anxiety that parents feel as they try to
safely raise their allergic children.
Outgrowing is statistical, not absolute. There are always a few
people - referred to as "the allergic 2%" - for which the
conventional wisdom doesn't hold. For these, the allergies may never
go away, or may get worse, or may get better only to get worse later.
Trouble is, it's very hard to predict who's in the allergic 2%. Most
of us think that the severity of the reaction means that the child
*must* be one of those. But there are some, I understand, who truly
do outgrow their reactivity. It's always safest to assume that they
will not, and to re-test periodically. If the tests show no
reactivity, a controlled oral challenge at a doctor's office or a
hospital is something to consider trying. Even then, there's risk.
Some reactions are so severe that the patient - your child or spouse
- cannot be brought back from it. So the oral challenge has to be
done with highly competent medical supervision, and when it's
believed to be lower risk and worth it.
Another trouble is that a lack of observable reaction is not
necessarily a lack of reaction. There may be "sub-clinical" reactions
that are either mild enough not to be visible, or that are internal
and not visible, or take some other form (as in behavioral changes).
When you add back a food and see no reaction, but you see a pattern
of, e.g., worsening asthma, hay fever, bacterial sinusitis, etc., it
may be because the allergen is inflaming the airways, sinuses, etc.,
in a way that make you more susceptible to these conditions. So an
apparently trouble-free reintroduction may not be trouble-free.
And yet-another trouble is a temporary respite from symptoms, e.g.,
during puberty, with a resurgence later.
Complicated territory.
Mark
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