by

I Couldn’t Swallow! When Food Allergies Cause an Allergic Esophagus

I was eating roasted chicken at a chain restaurant the first time it happened. The meat got stuck somewhere in my esophagus and wouldn’t go down. Water didn’t help; in fact, it worsened the pain. I wasn’t choking and I could breathe, but my throat and chest felt like it was exploding. Tears dripped from my eyes, my face flushed, and I gripped onto the table. My children, then still in high school, looked as scared as I felt. Luckily, after a few very long minutes, the meat finally dislodged.

I blamed the whole incident on reflux since I’d been diagnosed with gastroesophageal reflux disease (GERD) years ago. Or, I thought, it could have something to do with my hiatal hernia, the other diagnosis I got long ago when I reported pain in my chest. When other strange symptoms popped up and tests came back confirming celiac disease and myriad food allergies, I suspected something else might be causing my throat to constrict.

The fourth doctor I saw performed an upper endoscopy and diagnosed eosinophilic esophagitis (EE or EoE). In simple terms, I have an allergic esophagus. Ah ha! I am extremely sensitive to even a tiny bit of soy and the chicken in the chain restaurant was cooked with soy oil. Thinking back, I can now pinpoint what foods I consumed–that I now know I’m allergic to–that caused food to get stuck.

Eosinophil

Eosinophil (Photo credit: Wikipedia)

So what exactly is EE? Basically, it’s when the esophagus, the tube connecting the mouth to the stomach, has severely elevated levels of eosinophils, a type of white blood cell. Eosinophils can attack the gastrointestinal system and cause vomiting and difficulty swallowing food. Reviewing my many lab reports over the years, I always had high eosinophils. Hmmm.
Symptoms of EE vary from person to person. Episodes like mine—inability to swallow food or vomit food up– are common. In severe cases, food stays stuck and medical help is needed. Some people may experience heartburn-like symptoms, but the symptoms frequently do not improve with acid blocking medications.

Diagnosis is made through an upper endoscopy. A doctor looks at the esophagus, stomach, and the first part of the small bowel and takes tissue samples (biopsies) to examine under a microscope. An abnormal number of eosinophils indicates EE. Other features of EE include whitish spots, long furrows, corrugated rings, or a lining that looks like crepe paper and is easily torn.

When first diagnosed, I used a steroid inhaler (sprayed into my mouth and swallowed) to reduce the inflammation and reduce the eosinophils. According to research, relapse after treatment occurs in at least 25 percent of patients. Fortunately, by eliminating the foods I react to, my EE has been kept under control.

If you suspect you have an allergic esophagus, make an appointment with a gastroenterologist who has experience in diagnosing EE (it’s a fairly new diagnosis but becoming more and more prevalent).

Here are some other useful resources:

www.curedfoundation.org

www.youtube.com/watch?v=op5SyHob6xo
www.eosinophilicesophagitishome.org
www.mayoclinic.org/eosinophilic-esophagitis
medicalxpress.com/news/2012-06-food-diet-difficulty-swallowing-throat.html
www.scoop.it/t/food-allergies-and-eosinophilic-esophagitis

New Allergy Causes Trouble Swallowing – WDBJ7 | @scoopit http://sco.lt/5AXW0P

Related articles
by

Soup: It’s What’s for Lunch!

You may notice I changed my blog’s header this week.  The photograph was taken from my study window.  Here’s another look:

With a view like this it's hard to focus on the computer screen!

Yes, I do feel lucky to live in such a beautiful place.  While my husband puts on a suit and commutes to his office job, I grab a cup of coffee, walk up the stairs (usually still in my PJs), and begin to write.  Lucy, my thirteen-year-old llaso apso, sleeps under my desk until it’s time for lunch.

November 2011 018

This is Lucy, the best critique partner ever.

Now what was I getting to?  Oh yes, lunch . . .

Because there’s suddenly snow in Colorado, I’ve been making lots of soup for mealtimes. I discovered a few years ago that soup is a great meal for those of us with food allergies–just leave out the ingredients you’re allergic to!  Plus a bowl of soup is super easy to heat up when you’re starving and in a hurry (I tend to lose track of time when I’m writing).

The best soups I’ve created are the ones using leftovers . . . beans and ham, chicken and grilled vegetables, pureed tomatoes and flank steak.

Last week, the start of the lenten season (no-meat Fridays), I made Manhattan Clam Chowder. Kudos to Max Johnson, executive chef of the Sea Pines Country Club in Hilton Head, South Carolina, for sharing this recipe in the club newsletter.

 

Manhattan Clam Chowder

2 6.5 oz cans of chopped clams

Manhattan Clam Chowder

Manhattan Clam Chowder (Photo credit: I Believe I Can Fry)

1 bottle of clam juice1 cup chopped celery

1/3 cup yellow onion

1/4 cup chopped carrots

1 tbsp canola oil

2 cups cubed organic potatoes

1 tsp dried thyme

1 14.5 oz can of organic diced tomatoes (not drained)

6 strips of cooked bacon, diced or crumbled (I used Hormel Natural Choice)

Salt and pepper to taste

In a large pot, heat oil and cook bacon until crisp.  Add celery, onions and carrots and cook until tender.  Stir in thyme and clam juice.  Bring to a simmer and add tomatoes with juice and clams.  Bring to a boil.  Now add potatoes and cook until tender.  Season to taste.

Delicious by the fireplace on a cold Colorado day!

What is your favorite wintertime soup?

by

I’m a Picky Eater! And Proud of It!

There I was at a pizza party grazing off the veggie platter when a friend–for the sake of my future social life let’s call her Deborah–leaned across the table and announced loudly that her daughter who has celiac disease doesn’t need to be nearly as careful as I do.

“Well she kind of does,” I explained good-naturedly while the other guests rolled out homemade pizza dough.

“But her symptoms aren’t nearly as bad as yours,” Deborah said. (Oh, and did I mention Deborah is a nurse?) “At our house, we use the same toaster, the same utensils, the same cutting board, and my daughter is just fine.”

Maybe I was just being overly sensitive that night, but it felt like Deborah was announcing to all the other guests, as well as the lovely hosts, that I was just being a picky eater.

picky_eater_tshirtp235548244182528100zw44d_400

Guess what?  I am a picky eater! I have to be. Otherwise, I’ll end up spending the evening in the restroom and the following day in the fetal position on the sofa.

Yes Deborah, I really can’t eat the gluten-free pizza dough that’s been rolled out with a rolling pin covered in flour. Nor can I cook the gluten-free pizza in the really cool pizza oven because it’s also been contaminated with flour.

My husband doesn't have CD enjoyed the pizza!

My husband doesn’t have CD enjoyed the pizza!

There was no convincing this woman that her daughter with mild symptoms should follow strict contamination guidelines. She didn’t want to change her cooking habits or reorganize her kitchen. I went to bed that evening worrying about her young daughter who could possibly develop serious complications from uncontrolled celiac disease later in life.

According to Peter Green, MD, author of Celiac Disease: A Hidden Epidemic, “Many patients who do not have diarrhea think that there is no need for treatment. But the longer individuals have celiac disease, the more like they are to get other autoimmune diseases. Even without symptoms, patients need to be treated to prevent further damage.”

As those of us with CD know, “treatment” involves removing all gluten out of our diet and avoiding cross contamination. For those newly diagnosed or who are cooking for a loved one with CD or gluten sensitivity, learning to avoid cross contamination takes patience and practice. Following are some basic guidelines; even if you are an experienced gluten-free eater, it’s a good idea to review these.

  • Always wash cooking utensils with dish soap and water before using—you never know where that fork has been!
  • Maintain designated non-wheat cutting boards, strainers, and toasters. Color code if possible; at my house, gluten-free cookware is apple green. I also label items with a Sharpie and keep a gluten-free cupboard for my supplies. In our vacation home, I label everything I cook with, and when I think guests won’t follow the rules, I lock my cookware in an owner’s closet.
  • Never double dip. If a contaminated spoon has been dipped into the peanut butter, don’t eat the PB. If the flour tortilla has been sunk into the salsa, don’t eat the salsa. If it looks like the crouton spoon at the salad bar has been swapped with the cucumber spoon, pass on the cucumbers.
  • Clearly label the jars that you eat out of (for example, “Amy’s Jam”). I especially find this helpful since I have lots of food allergies and my food is expensive. My husband can eat the cheaper brands. :)
  • When eating food that’s typically cooked in oil, such a French Fries, ask if breaded items are cooked in the same oil. Some restaurants, such as Red Robin, are now cooking gluten-free fries in separate oil.
  • Don’t be afraid to ask the server or chef lots of questions—whether eating at a restaurant, at a wedding, or at a friend’s house. Be specific about your needs. Can you cook my salmon on foil to avoid contamination? Can you leave the pasta out of my minestrone?
  • If you are still getting sick even after taking cross-contamination steps, keep a food diary and consult a nutritionist/dietician. Gluten hides in so many products and can easily contaminate foods–don’t be afraid to ask for help!

As for Deborah’s daughter, I hope she learns to be a picky eater. It’s nothing to be ashamed of.

Related articles
by

Could Wheat Have Caused My Son’s Early Birth?

During an ultrasound the doctor told my husband and me that our son was too small for his gestational age.  I’ll never forget his words: “Your baby isn’t growing; the placenta looks old.”  He sent me home on strict bedrest. But being a couch potato didn’t last long. Within a week my blood pressure and weight spiked and my feet and hands bloated like water balloons. A visit to my OB confirmed what I’d already self-diagnosed from reading What to Expect When You’re Expecting.  I had toxemia and needed to go to the hospital immediately.

The minutes, hours, weeks and months that followed were like riding on a frightening rollercoaster without breaks.  Uncontrollable vomiting (all over the staff!), dizziness, and a pounding headache.  A noisy ambulance ride to a second hospital with a better neonatal intensive care unit.  My husband’s ashen face and shaking hands when a doctor we had never met before said matter-of-factly, “If the baby isn’t delivered now, both your wife and son will die.”

Daniel arrived three months early weighing one pound 11 ounces (a baby his age should weigh over two pounds).  He could literally fit in the palm of my hand.  I’ll never forget the overwhelming feelings of guilt and failure when I first saw my son.  His chicken-size body was covered in a web of wires and a respirator breathed for him.  I fled the NICU.

Throughout my pregnancy I’d done everything right: no alcohol, daily prenatal vitamins, exercised and ate right.  So why did this happen?

Twenty-two years later, it breaks my heart to learn something as simple as eating wheat could have caused our son’s early delivery as well as my other pregnancy complications.  (Prior to Daniel, I’d had a late miscarriage followed by rare life-threatening bleeding during a D&C. Our second son, Steven, arrived after complications and bedrest.  Pregnancy and my autoimmune system are incompatible, to say the least.)

I wasn’t diagnosed with celiac disease until long after my childbearing years.  Funny, what first popped into my head when I learned gluten wasn’t my friend was how I reacted to wheat during pregnancy–I craved starch and carbs and ate lots of spaghetti, lasagna, and bread!  Mealtimes often ended with stomach pains, diarrhea, heartburn, and indigestion, which the nurse practitioner said were “common symptoms of pregnancy.”

I now know these are signs of celiac disease, too.   In fact, they were probably my first symptoms.  Experts say that CD symptoms often first appear during pregnancy.  Too bad I didn’t have a doctor who knew that.

While some studies have found little or no connection between CD and pregnancy problems, recent data supports a link.  An ongoing large study by Thomas Jefferson University in Philadelphia, still to be published in a peer-reviewed journal, indicates women with celiac disease report a higher likelihood than other women of having difficulty with conception and pregnancy, including a greater chance of preterm birth.  Surveying 1,022 women, they found:

* 43 percent of women with CD reported miscarriages prior to CD diagnosis compared to 37 percent without celiac disease, and

* 23 percent of CD women gave birth prematurely compared to 14 percent of non-CD women.

A 2010 Danish study found that mothers with untreated celiac disease gave birth to smaller babies and delivered early compared with women who didn’t have CD.  On the positive side, after mothers were treated for CD with a gluten-free diet, they had healthy deliveries.

Of course, these women needed to be diagnosed with CD first.

I can’t help but wonder how things might have turned out differently for my children if I’d know about my disease. While Daniel is a healthy college senior now, his childhood was plagued with respiratory illnesses, surgery, hospitalizations, and developmental therapy.  (Ironically, it’s our full-term child Steven, now a college student, who has celiac disease.)

And what about the baby we lost?  Could something as simple as eliminating gluten from my diet have saved him or her?

Soon after Daniel and Steven’s births I wrote and published two books, Your Premature Baby and Child and The Pregnancy Bed Rest Book.  During substantial research and interviews, I never came across untreated celiac disease being a risk factor for infertility, low birthweight and preterm birth.  This needs to change!  Obstetricians must recognize the symptoms of celiac disease and listen to their patients–not just brush aside a woman’s complaints as pregnancy related!  Books, websites and other literature should inform pregnant women of the risk of untreated celiac disease during pregnancy (keep in mind, 1 in 133 people have CD!).

I can’t do anything about the outcomes of my pregnancies, but I might be able to make a difference in the life of another young woman and her family.  You can too. Please won’t you join me in getting the word out about celiac disease and pregnancy?

Further Reading

The National Foundation for Celiac Awareness, “Pregnancy and Celiac Disease,” by Amy Burkhard, MD, RD

Celiac Disease Awareness Campaign, “Women with Celiac Disease More Likely to Have Trouble Conceiving, Pre-Term Births”

Living Without, “Why Can’t We Have a Baby? Unexplained Infertility and Celiac Disease” by Christine Boyd

by

The Flu Shot and Egg Allergies

Flu Shot

My mother called last night to make sure we all got our flu shots; she’d been watching the frightening news reports of this season’s widespread and deadly flu. I had to confess to her that only one out of four of us had gotten the flu shot. I’d encouraged Steven, our youngest son in college, to do so because he’d b een sick all semester.  (I swear starting college is like starting preschool when it comes to spreading germs and sharing colds! As for the rest of us . . . well, we just hadn’t gotten around to it.

Also, I have to admit I’m a bit reluctant because my oldest son Daniel and I have egg allergies. The flu vaccine is made using eggs.  Dan and I avoid baked goods and medicines with tiny amounts of egg so why would we forcefully stick egg protein, even miniscule amounts, into our bodies?

What’s worse? Having a severe reaction to the flu shot, or getting the flu?

No eggs!

For the past few years, the flu season passed without me getting vaccinated. Fortunately, I didn’t get the flu. Daniel did get a shot last year and didn’t have a reaction. But that doesn’t mean the next time egg protein enters his body, he won’t react, and his allergies seem to have gotten worse this past year.

But, because this year’s flu season is one of the worst the country has seen in 10 years, reported by my mom as well as the Centers for Disease Control and Prevention, and because the TV reports of schools being closed, hospitals being inundated with flu patients, and flu-related deaths —one heartbreaking one showing a teen boy dying from complications of the flu—I decide I better learn more about egg allergies and the flu shot.

What I learn is that while it was once suggested that those of us with egg allergies avoid the flu vaccine, this is no longer true (studies show reactions to the tiny bit of egg in the vaccine are quite rare). In fact, reputable organizations, such as the American College of Allergy, Asthma and Immunology (ACAAI) and The CDC’s Advisory Committee on Immunization Practices (ACIP), encourage those of us who react with only hives after exposure to eggs get the preventative shot (note: this recommendation does not apply to nasal spray flu vaccine).  Precautions should be taken though: the healthcare professional administering the flu shot should be familiar with the potential manifestations of egg allergy and should monitor for at least 30 minutes for signs of a reaction.  Those with severe allergies to egg (i.e., anaphylaxis) should seek an allergy specialist to administer the vaccine.

Some physicians recommend skin testing with the flu vaccine or splitting the vaccine into two dosages (using the first smaller dose as a test), but the 2013 guidelines say this is unnecessary.  If someone reacts to the flu shot previously and are high-risk, there are medications that can be taken within 24 hours of developing symptoms to alleviate or prevent the flu’s progression.

Reprinted from Allergies: A Leickley Story

Reprinted from Allergies: A Leickley Story

Since Dan and my reactions to egg are mild, I now feel comfortable getting our shots from a medical professional familiar with allergic reactions.  However, I’m not so sure I’d risk the flu shot if either of us had ever experienced a severe reaction, or if my son was younger (he’s twenty-two).  Even with the reassurance that reactions are rare, I understand reluctance by parents, like those of the four-year-old boy in New Jersey. You may have read about Jeremy.  He can’t go to school now because New Jersey state law requires all children six months to five years be vaccinated against the flu to be eligible for licensed daycare or Pre-K.  Jeremy has an egg allergy and his parents aren’t willing to take a risk of a severe reaction.

I can’t blame them.

Do you agree or disagree with Jeremy’s parents?  What are your experiences with egg allergies and the flu shot?

Further reading

The 2012-2013 Influenza Season in the August 17 issue of the Morbidity and Mortality Weekly Report

Algorithm from Dr. Leickly

Kids with  Food Allergies

Related articles

by

Celiac Disease Wasn’t a Part of the College Plan

Within weeks of my celiac disease diagnosis, I had my two sons tested. Both grew up with “sensitive stomachs” so I was surprised—yet relieved—when their blood tests came back negative for CD. I knew firsthand the difficulties of cutting gluten out of a diet (along with soy, dairy, corn and a host of other foods for me), and I was glad my kids could continue their youth grazing on bagels, pizza, chicken nuggets, and burgers.  While my oldest is lactose intolerant, he simply takes a pill to help him digest dairy.

Unfortunately, there are no magic pills for those of us with celiac disease.

Fast forward five years. Sons are in college.

college life

The youngest comes home for Thanksgiving break looking gaunt. He blames the cafeteria’s food, insisting they put laxatives in the food to keep kids from getting food poisoning (a popular urban myth, I learn through a quick investigation on the Web).  My son’s had a bad cold most of the semester and no amount of sleep makes him feel rested.  (This sounds all too familiar, I think.) When he says his diet consists of bagels, sandwiches and pizza, a red flag not only goes up but waves crazily in the air.  I suggest he eliminate wheat from his diet and see if he feels better.   But he shrugs me off; did I mention he’s nineteen? :)

By Christmas break, he’s even thinner, paler, more exhausted, says he feels achy and dizzy much of the time.  Without any prompting from me, he decides to go a few days without wheat. Voila!  Practically overnight, he feels new and improved. One mistake–oysters Rockefeller with a smattering of breadcrumbs on New Year’s day–sends him back five steps, and we are both positive he’s inherited my CD genes (I have the pleasure of having both the DQ8 and DQ2 genes).

Surprisingly, neither my son nor I pout or panic. Okay, he pouts a little when he realizes beer and pizza are officially off-limits (he’s a college student and a guy after all), and I feel some mother’s guilt for passing my defective genes onto my child, but we’re both optimistic that he’ll enjoy college much more when he says good riddance to grains.

GOODBYE GLUTEN, HELLO GLUTEN-FREE!!!

Goodbye gluten!Hello Gluten-Free!

 

Since my son has been a part of my gluten-free lifestyle change from the start, he already knows all the rules, such as never put a wheat-contaminated fork into a shared serving dish and use a separate toaster for GF toast.  He likes the staples of a celiac’s menu: quinoa, hummus, fresh vegetables and fruit, meat and fish, rice bowls, and stir-fry.  He knows to check the ingredients on everything from cold medicines to gum and to stick to the golden rule: If it doesn’t say gluten-free on the package, don’t eat it.  After years of watching me struggle in restaurants (I’m a much better advocate for my family than for myself), I am certain my son will articulate clearly with wait staff.  Are the french fries cooked with breaded foods?  Please don’t just remove the croutons on my Caesar salad; make me a new salad. Can you grill my burger on foil?

A sign you don't see often.

A sign you don’t see often.

Still, I worry.  Going gluten-free in college won’t be easy.  Like many universities, his college food service is not allergy-friendly (past parent visiting days confirmed that), and there are few restaurants within walking distance.  But my boy already has a plan: buy his own bread and get the GF-free meat and cheese from the school deli, make weekly trips to the grocery store, keep his room stocked with gluten-free snacks.   I can’t help but feel proud.  Without any objection, he takes the fastfood menus I’ve printed out and circled the GF foods.  (Yes, we know the contamination risks at such places, but a guy’s got to eat!).  Before he goes back to school in a few days, I’ll take him to our local healthfood store and show him myriad GF options that now line the shelves.  And, of course, I’ll send monthly gluten-free care packages; I’ve already made a favorites list on my computer of GF mail order companies.

Celiac disease wasn’t a part of my son’s college plan–or my plan for him. But as he’s learning, life is full of bumps.  I’m just glad he’s prepared to take this one head on.

HEalthy Life

For more reading:

College Student with Celiac Blog

A Guy Talks about Gluten

Growing Up Gluten Free

Celiacs at College

Celiac Students take College to Court 

by

What is this in my cheese?

Everywhere I go this holiday season, huge festive plates of crackers and cheese tease my allergic taste buds. BA (before allergies), I loved cheese! After all, I grew up in Vermont, the state that has more cows per capita than humans. As if it was yesterday, I remember enjoying thick cheddar on apple pie, melted Swiss on rye crackers, cream cheese swirled in broccoli, ricotta lasagna, parmesan sprinkled on spaghetti.

Glorious Cheese!

Then I was diagnosed with a dairy allergy.  Sigh.

Seeking help at the healthfood store, I discovered the most common alternative to dairy cheese is vegan cheese . . . made from soy.

I’m allergic to soy.

So I turned to nut cheeses. I’m not allergic to nuts. Nut cheese will do in a pinch (and some allergic foodies love them), but honestly I don’t find cheeses made from almonds and cashews and hazelnuts all that flavorful (I do like almond yogurt flavored with fruit though!).

This allergic foodie did a happy dance when she discovered cheese made from goat’s and sheep’s milk (this was a few years back, before goat cheese became so popular). I thought the goats and sheep had saved me

goat

until I got sick, really sick, after eating a goat cheese salad.  Imagine my disappointment when I read that many allergic foodies who can’t eat dairy also can’t eat goat’s or sheep’s milk.  C’mon!  Can’t a cheese-loving allergic foodie get a break?!

According to The Complete Idiot’s Guide to Food Allergies, “If you are allergic to one food group, you may also be allergic to another food in the same family because they share similar proteins.”   The authors include cow and goat under the listing of “dairy proucts.”  The Food Allergy and Anaphalaxis Nework states on their web site  that goat milk is not a safe alternative to cow’s milk.  Many other foodies I’ve talked with say they are indeed allergic to both cow and goat and sometimes sheep.

Cover of

Cover via Amazon

Go Dairy Free: The Guide and Cookbook for Milk Allergies, Lactose Intolerance, and Casein-Free Living provides some more positive info.  The author writes, “Goat milk is slightly closer in composition to human milk than cow milk is, with proteins that may be easier to digest. It is estimated that 20 to 40% of milk allergic individuals do not react to goat milk [my emphasis].” However, she goes on to say, “Milk allergic individuals should obtain an allergy test prior to trialing, as most people who are allergic to cow milk have similar reactions to goat milk. Plus, a rare few are in fact more allergic to [the casein or whey in] goat milk.”

cheese making

Ah ha.  Maybe it wasn’t the goat part I was allergic to, but rather the other strange-sounding and -looking stuff in my cheese.  I dug out my massive allergy-testing paperwork from ImuPro, as it’s been a few years since I’ve read the results. Under the category of “milk products,” I had no allergic reaction to camel’s milk and mare’s milk–those should be easy to find on the grocery shelf!–and [insert drum roll here] I had no reaction to SHEEP’S MILK AND CHEESE.

Reading on . . . it appears I have a slight reaction to goat cheese (blame my allergy-induced brain fog for not remembering that one!).  I am also quite allergic to halloumi, rennet, kefir, and whey.  Huh?  I’ve often seen these ingredients listed on the labels of dairy products, but since I’m not sure what they are, I put on my investigative hat. I discovered a lot of ingredient and allergy crossover, which probably explains my reactions to most types of cheeses.

Halloumi is a semi-hard and unripened brined cheese made from a mixture of cow’s, goat’s and sheep’s milk (gotta read those labels carefully).  It is set with rennet.  Trader Joe’s has a handy list of rennet definitions.  Basically, animal rennet is an enzyme that comes from the stomach (yuck!) of a suckling calf, lamb or goat; vegetable rennet is derived from plants (soy alert!); and microbial rennet is derived from microorganisms (fungi and bacteria; mold alert!) through a process of fermentation.

Kefir, according to my ImuPro test, is a thick and slightly alcoholic fermented milk product that is often used for milk mix drinks, sweets or sauces.  I’ve seen kefir advertised lately as a health benefit, but certainly not for those of us who are allergic to it.  Finally, whey is the watery liquid that separates from the solid part of milk when it turns sour or when enzymes are added in cheese making.

Wow.  Cheese is not my friend.*  My best guess is that when I developed leaky gut, I was eating a lot of cheese and crackers with my wine.  This holiday season I’ll be grabbing the grapes.

* In Italy, I ate mozzarella made from water buffalo–no reaction!

Resources:

Food Allergy & Anaphylaxis Nework

Go Dairy Free

What Is This In My Food?

Cow’s milk can be disguised under the labels of:

  • Buttermilk
  • Butter (Many restaurants I’ve encountered don’t realize butter is dairy!)
  • Casein
  • Hydrolysed milk
  • Lacatalbumin
  • Lactoglobulin
  • Lactoserum
  • Milk proteins
  • Whole milk, dried whole milk, concentrated milk
  • Sour cream

(Note: Lactic Acid is not derived from dairy.)