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Co-Factors: Things That Might Make Allergy Reactions Worse

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If you or your child has a food allergy, a doctor or allergist might have talked to you about “co-factors.”

Allergy co-factors are substances, conditions, or activities that may contribute to the onset of food reactions, or intensify them. Not everyone with food allergies is vulnerable to a co-factor.

Difficult To Determine

A few years ago an article in the journal Allergy stated that co-factors were increasingly believed to be involved in the triggering of anaphylaxis. A report out of Europe indicated co-factors were relevant in up to 30 percent of anaphylaxis cases. In one study, the frequency of co-factor involvement was significantly higher in people with severe food allergies, compared to those with mild to moderate reactions. However, it’s not always easy to determine whether someone is susceptible to a co-factor.

“Since anaphylaxis is very anxiety-provoking, a lot of times these details get lost or it’s difficult to prove or disprove,” said Dr. Dennis Ledford, a Tampa Bay allergist, and a coauthor of the World Allergy Organization's food allergy guidelines.

Common Co-Factors

One co-factor for allergy reactions is NSAIDs, a class of drug that includes ibuprofen, aspirin, and naproxen. These substances seem to pre-activate the body’s mast cells, which play a prime role in allergic responses. If someone vulnerable to this co-factor used an NSAID and was then exposed to their allergen, the reaction would be amplified. Antacids, or acid neutralizing medications, and beta blockers might also be co-factors.

The co-factor that’s been studied the most is exercise. It’s most often associated with shellfish and wheat allergies. There’s even a strange condition called Food-Dependent Exercise-Induced Anaphylaxis, where people have an allergic reaction to a specific allergen only after exercising.

Alcohol consumption is another co-factor, and studies have verified that alcohol intensifies allergic reactions in some individuals. Why this happens is unclear, but there are a couple theories. High alcohol intake may increase serum IgE levels and allergic sensitization; or, alcohol might relax certain cells in the gut, allowing increased allergen uptake.

Other factors that may worsen food responses are stressful situations, having an infection or fever, hormonal fluctuations, or having unstable asthma.

Just Be Observant

That there are food reaction co-factors is not surprising since all the systems in our body are interconnected. What touches one system influences all the others. However, it’s best not to waste energy worrying about co-factors. Instead, just be observant. By noticing as many details as possible when reactions occur a co-factor may become apparent, and that’s helpful information to have.

Sources: Allergic Living; Wiley Online Library
Photo credit: Wisconsin Dept of Natural Resources

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