Anaphylaxis – an overview

Nutritionist Margaret Moss give an overview of this frightening condition

It is frightening to know that you, or someone you love, has had an anaphylactic reaction. Anaphylaxis can kill, but luckily this does not happen very often. Lots of people die of heart attacks and cancer, and not many from lightning strikes. Even less die from anaphylaxis than from lightning. The key is to be really disciplined in taking precautions. Manchester keeps the national registry on anaphylactic deaths, in order to study why they occur. Usually they could have been prevented.

Anaphylaxis occurs because of allergy involving immunoglobulin E, or IgE.  IgE causes rapid reactions, which can be alarming, but at least it is easier to identify the trigger, than with other types of reactions that can occur days after exposure. Reactions due to IgE may be mild, moderate, or dangerous.


It is possible to have a mild reaction one day, followed by a severe one another day. This makes it hard to predict who should be given an adrenaline injector, like an Epipen.

If you are given an autoinjector, it needs to be long enough to go through your fat layer - especially relevant if you are a woman as women – even slim ones– have more adipose tissue on their thighs. For details on long needles see Emerade.


Allergic people, their families, their teachers, nurses, doctors and their carers need to be trained properly by someone who is knowledgeable, and they need to be retrained regularly. Temporary staff, like supply teachers, need to know who is at risk, and what to do. An allergic person must keep their autoinjector close by all the time, not just some of the time.


Even if using the injector seemed to work, the person must go to A and E. Allergic reactions can occur in two phases – called biphasic. You may have dealt with the first phase with the injector, but A and E care is needed, or a second phase of the reaction could kill. It would be terrible to think, “If only she had taken the Epipen out to the games field, instead of leaving it in the locker.” “If only he had called for an ambulance, instead of thinking the Epipen had been enough.” “If only the usual teacher had been there that day.”

Quantity counts

Minute amounts can trigger anaphylaxis.

peoples' immune systems can be trained to tolerate small amounts. This is done by feeding minute amounts, for example a tiny fraction of a peanut and gradually increasing the amount, to train the immune system to accept as much as a whole peanut.

However, this must be be done in a medical clinic. It would be very dangerous to try doing it at home.

If you can cope with a whole peanut, then you should be able to cope with a small amount of accidental contamination, for example if your peanut free loaf of bread was put down where some peanut biscuits had been.

Cooking for yourself and reading labels

Cooking your own food from raw ingredients protects you from such contamination. Labels are useful, but be wary. When the recipe was changed, was the label changed at the same time, or were the old labels used until they ran out?


How could such severe allergies be prevented? Babies should start life experiencing a variety of foods in the womb, from the mother’s varied diet. This should be followed by six months of exclusive breastfeeding, while the mother continues a varied diet. Then the mother’s diet should be liquidised, and fed to the baby.

This way the baby is introduced to many foods, while the immune system is being programmed to accept them as normal. Putting off introducing foods till later is counter-productive. If the immune system hasn’t met those foods early enough, it will regard them as suspect, and may go on the attack.

Normal birth, through the birth canal, gives the baby the advantage of picking up the mother’s helpful bacteria. Breastfeeding allows the baby to collect useful bacteria from the breast.

Vitamin D3 protects against allergies. A vitamin D3 deficient mother gives birth to a vitamin D3 deficient baby, with brittle bones and a susceptibility to allergy. There isn’t much sun in Britain, to use to make our own vitamin D3. So take vitamin D3 supplements through pregnancy and breastfeeding. Unfortunately, many babies do not have the advantages of normal birth, breastfeeding, and adequate vitamin D3.

Cross reactions

Foods which appear unrelated may contain similar chemicals, and cross-react. Birch pollen allergy is fairly common, and may lead to a burning feeling in the mouth after eating apple, avocado, carrot or celery. This is known as oral allergy syndrome.

Where possible, prevent allergies by vitamin D supplements, normal births and breastfeeding. Introduce foods the mother eats, for which the baby has been prepared.

If a severe allergy problem still develops, make sure an autoinjector is available close by at all times. Make sure the needle is the right length. Ask for regular training for yourselves and others who may need to use the Epipen.


For more in depth investigation into anaphylaxis see this 2010 article by Dr Richard Pumphrey on Researchgate - An Epidemiological Approach to Reducing the Risk of Fatal Anaphylaxis

If you found this article interesting, you will find many more articles on anaphylaxis here, and reports of research into anaphylaxis here.
You can also find articles on peanut and tree-nut allergy here, cow's milk allergies here, egg allergy here, histamine intolerance hereand articles on a wide range of other allergic and intolerance reactions to a wide range of other foods here.


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