tree nut source??

[Therese's Mommy]

Hi allergy board ladies!  I haven't been around these parts in a while.  After a bad stretch with my dd last year I just had to step back.  We just went to our regular check up with the allergist today.  Things had started to look up at our last appt 6 months ago, but it appears that those reactions were for some reason artificially low as we were right back pretty much where we started.  Oh well.  We did test for all the tree nuts today as she is almost 4 and the allergist feels confident that if we get negative skin and blood test that I could do at home challenges.  But, the problem is that she was positive for some (hazlenut and walnut) and negative for the rest.  I still have to wait for the blood work, but the allergist is not confident that I can find sources for tree nuts that she is ok with (potentially almond, brazil nut, cashew, pecan, and pistachio) that are not possibly contaminated with the ones she is not ok with (and also peanut and sesame).  Do such sources exist?  What if the nuts are in their shells?(this is something I will be asking her as well, like could I wash the shells before shelling the nuts?)  Any experience or direction you can share will be greatly appreciated.

Thanks!

Beth

[sbgrace]

All the allergists I know (and all the allergy books I've read) generally recommend on tree nut allergy is considered an allergy to all because with cross contamination you have to avoid all in day to day life anyway. Further, she is allergic to two tree nuts, peanut, and sesame...I'd assume exposure to other nuts might lead to sensitization at this point. So I don't see any point in trying to figure out if she reacts to the remaining nuts. She's tree nut allergic. I'd leave it at that personally. Do you have epi pens? I assume

FWIW, sesame cross contaminates with pistachio and cashew in some people as they all share a protein. They are the worst/most severe anaphylactic reactions of any foods to my knowledge. My son's anaphylaxis is to those. He had a biphasic reaction to cross contamination (we assume one of those) in a nut he's not allergic to at all.

Sesame is also tough to avoid. Did the allergist tell you it's cross contaminated in all commercial bread (save Berlin Bakery Spelts) and all commercial crackers? It also makes eating out even more complicated than the nuts. And then it's not labeled by law in the US either. I wish we didn't have sesame! I guess I'm saying if you don't suspect sesame (she's had it safely in the past) I wonder if an in office challenge might be worth it given the difficulty in avoiding. She's not positive to cashew or pistachio...I'd want to know if sesame might be a false positive. Disregard if you ever saw any reaction of course.

[Therese's Mommy]

Thanks for the response.  Avoidance is not an issue for us in any way.  Her list of allergies is so long that she is unable to eat any food that isn't prepared by me.  Eating out???  Yeah, in some sort of fantasy world   Yes, we have been carrying epi pens for 3 years now.  

I am not looking to feed her anything that has been prepared with these nuts, but the actual nut itself.  I did do some Googling tonight and came across justalmonds.com  It seems they may be as their name says, *just* almonds.  Of course, I would do some extensive questioning before I gave her any.  Right now I am just looking for some possible sources.  I will not be giving her any without more discussions with her allergist along with negative blood work.  Today's test was the second time she tested negative via scratch test for almond.  Previously she had tested negative for sesame, but that was probably 2 years ago when she was under 2 and now that is positive.  Her diet is incredibly limited, I am desperate for some high protein and/or healthy fat foods to put in her diet, especially for snacks.  She is my kid that needs more snacks and fruit just doesn't cut it and there are just so many rice cakes with sunbutter that a kid can eat in a day.  Thanks!

Beth

[sbgrace]

Your rice cakes likely have sesame cross contamination. Might not be enough I guess depending on the allergy level.

I guess my take is that she shows a propensity to nut allergies. I would think that feeding her almonds might cause her to become allergic to almonds? I don't know...my son is allergic to six tree nuts. You have much less likely chance of outgrowing with multiple nut allergies.

I get the struggle on food. I've had to be really "inventive" here. I was so glad when we got dairy back.