Before we prescribe your herbal medicine or you purchase OTC products, it is crucial to know all your allergies and biomedical conditions with medications that are being taken, including listing food allergies and sensitivities.
What is food allergy?
Food allergy is an immune system reaction that occurs soon after eating a certain food. The eight major food allergens include;
Milk, Egg, Fish, Crustacean shellfish, Tree Nuts, Wheat, Peanuts, and Soybeans
What are the most common signs and symptoms of the food allergy?
Hives, itching or eczema, tingling in the mouth
Swelling of the lips, face, tongue, and throat or other parts of the body
Wheezing, nasal congestion
Abdominal pain, diarrhea, nausea, or vomiting
Dizziness, lightheadedness, or fainting
Anaphylaxis (life-threatening, requiring emergency medical attention)
o Constriction of the airways, swollen throat that makes it difficult to breathe
o Shock with a severe drop in blood pressure, rapid pulse, loss of consciousness
Do herbal medicines carry allergens?
Herbs carry the eight major food allergens which may cause adverse drug reactions (ADRs) with immediate allergic reactions. In many cases, an allergic response will happen within two hours of ingestion an herb. Symptoms can range from a mild rash to severe anaphylaxis.
Commonly used Chinese herbs with potential allergens
Gluten :
Fu Xiao Mai (Triticum aestivum), Wheat
Mai Ya (Hordeum vulgaris), Malt sprouted barley
Shen Qu (Massa Fermentata), fermented wheat/malt
Seeds :
Bai Jie Zi (Semen Sinapis Albae), Mustard Seed
Hu Ma Ren (Semen Sesami Nigrum), Sesame
Crustacean Shellfish & Mollusks
Hai PiaoXiao (Endoconcha Sepiae), Cuttlefish tone
Mu Li (Concha Ostreae), Oyster
Zhen Zhu Mu (Concha Margaritifera), Mother of pearl
Tree Nuts:
Bai Guo (Semen Ginkgonis Bilobae), Ginkgo
Hu Tao Ren (Semen Juglandis), Walnut
Li Zhi He (Semen Litchi Chmensis), Leechee Nut
Xing Ren (Semen Armeniacae), Apricot
Soy (potentially processed with soya-bean oil):
Dan Dou Chi (Semen Sojae Preparatum), Prepared Soybean
Ragweed (herbs in the Asteraceae (daisy) family)
Ju Hua (Flos Chrysanthemi) Chrysanthemum Flower
Latex:
Du Zhong (Cortex Eucommiae), Eucommia Bark
Animal & Insect:
Di Long (Pheretima), Earthworm
How can I know if I have a food allergy?
A blood test can measure your immune system's response to a particular food, and a skin prick test can determine reactions.
Write a Food Diary. Write notes about what symptoms you have after eating certain foods. By doing it, your doctor will find out if you have a food allergy or a food sensitivity.
Write down all symptoms experienced during the day or night. Note if symptoms are absent, mild, moderate, or severe.
Record date and time that symptoms start and end, such as “20 minutes after eating pancakes, I had hives all over the body and swollen lips”.
Where on OTC product label to find information on food allergy?
The Food Allergy Labeling and Consumer Protection Act (FALCPA) requires the top eight food allergens to be listed separately on the ingredients label.
Case study:
Dry eyes with Oral Allergy Syndrome
A 30-year-old female patient visited our clinic for dry eyes and blurred vision. She has night sweat, a red tongue with little coating, and a rapid, thin pulse.
During the intake, she says she is sensitive to Ragweed pollen and raw fruits and vegetables such as melons and cucumbers. She experienced itching and swelling of the mouth and tongue with those foods. She can eat them cooked. Her skin prick test diagnosed Oral Allergy Syndrome (Pollen Food Syndrome). Her sensitization to Ragweed pollen has been linked with allergic reactions to bananas, cucumber, melons, watermelon, sunflower seed, and zucchini. (Pollen & Food cross-reactivity)
Our TCM diagnosis was: Dry eyes due to Liver and Kidney Yin deficiency.
The formula we selected; Qi Ju Di Huang Wan (Lycium Fruit, Chrysanthemum, and Rehmannia Pill).
Herbs:
Lycii Fructus (Gou Qi Zi) 9g
Chrysanthemi Flos (Ju Hua) * Remove
Folium Mori (Sang Ye) 9g *Add
Radix Rehmanniae Preparata (Shu Di Huang) 15g
Corni Fructus (Shan Zhu Yu) 9g
Radix Dioscoreae (Shan Yao) 6g
Poria (Fu Ling) 6g
Cortex Moutan (Mu Dan Pi) 6g
Rhizoma Alismatis (Ze Xie) 6g
Modification: Due to her sensitization to Ragweed pollen, we removed Ragweed-related Ju Hua (Flos Chrysanthemi) and added Folium Mori (Sang ye).
Method of Preparation: Decoction.
Herbal medicine practitioners must ensure their prescriptions carry allergen labels for the ’major eight’ allergens.
Chinese herb formulas may contain potential allergens not typically recognizable to consumers and not currently required by the FDA. But patients have the right to know what ingredients are in their prescription. Medicine that derives from a potential allergen must label that allergen source.
At the same time, practitioners should provide information to patients to better understand food allergens and discuss their allergy status for safe practices.
To find a Qualified Practitioner, Please visit:
https://www.nccaom.org/find-a-practitioner-directory/
References:
1. Anaphylaxis, Symptoms & Causes, October 2021
https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc- 20351468
2. Chinese Herbs & Allergens, Labeling With Caution, Shellie Rosen DOM, LAc, February 2018 https://www.acupuncturetoday.com/digital/index.php?i=720&a_id=33435&pn=21&r=t&Page=21
3. Adverse Reactions to Alternative Medicines, 2019
https://www.allergy.org.au/patients/drug-allergy/adverse-reactions-to-alternative-
medicines
4. Z-P Zeng and J-G Jiang, Analysis of the adverse reactions induced by natural product-derived drugs, 2019
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2850395/pdf/bph0159-1374.pdf