Now What?

In a few of my recent posts I mentioned the health problems I am currently going through, as a small update I had a follow-up appointment with my Doctor today to discuss my test results and my suspicions have been confirmed, I do in fact have an allergy to rapeseed oil. It's been about 12 hours now since I had this confirmed and I've been mulling over the ramifications and it still hasn't fully sank in.

I'm no stranger to allergies as a concept, I've struggled with hayfever for as long as I can remember, it's just part of my life and something I learned to work around. I'm also allergic to ginger which I found out when I had sushi for the first time and went into Anaphylactic Shock later that day. This is different though, this is a little more insidious.

When it comes to hayfever that is quite ubiquitous, without giving precise details as to where I live I can simply say there is a lot of greenery around my city, there is a clean air ordinance due to the presence of an Observatory and Planetarium, with tight restrictions on pollutants which even includes lights much to my chagrin - our street lights are shit to be quite honest because they are designed to be directional, they illuminate what is below them with limited light above to limit light pollution. The point is, there are a lot of trees here, and a lot of wide open spaces that are covered in lawns so tree pollen and grass pollen are pretty much present all year round.

As for ginger, since discovering my allergy to it some 16 years ago now, I have found that quite easy to avoid. There have only been a few instances of exposure to it. As for foods that I enjoy that would normally include it as an ingredient, Thai food, Indian food, and Chinese food, I have been able to avoid it in all of these thanks to the restaurants I normally order from not including it in their recipes, in the case of the Thai food in particular our local Thai place uses Galangal which I don't have a reaction to thankfully.

Rapeseed oil however [known as Canola in the US] is going to be very difficult to avoid entirely, as I explained in a previous post Sunflower Oil was present in a lot of our food in the UK but three quarters of Europe's sunflowers were grown by Ukraine and supply chains were disrupted due to the war; in an effort to relieve supply chain pressure most European countries started growing their own or importing them, with a climate that isn't conducive to mass production in the UK and an exchange rate that makes it difficult to source the ingredient at scale most UK manufacturers switched to rapeseed oil as the flower it is made from can be grown in the UK. There's actually a farm that I can see from my bedroom window that grows it. In addition as I explained in a previous post, the Food Standards Agency in the UK, roughly equivalent to the FDA in the US, authorised UK food producers to switch Sunflower oil for Rapeseed Oil without having to change the labelling on their foods. Which makes it difficult for me to avoid entirely.

So what exactly happens when you have an allergic reaction? Well in the simplest terms your body releases chemicals called Histamines, these flood the cardiovascular system and circulatory system and aid the immune system's attempts to counteract the allergen. When they are present in high numbers they cause the symptoms we associate with allergies - coughing, sneezing, rashes, itching, nausea, vomiting, diarrhoea, difficulty breathing, and in some instances they can trigger Anaphylaxis which is a condition where the immune response overwhelms the body and prevents normal function.

The most common symptom of Anaphylaxis is vasoconstriction found in 8 out of 10 people - your veins and arteries contract increasing blood pressure in turn creating hypertension, this usually manifests as a headache, which can be pretty bad. If the allergic reaction is extreme, found in 1 in every 150 people, this vasoconstriction can lead to an intense pain all over your body that feels like you are being stabbed by a million knives all at once and makes movement without excruciating pain impossible - this is what happened to me when Ginger triggered Anaphylaxis. Other symptoms are less common, but the one most people will know if is constriction of the airways, in particular the throat making it difficult to breathe which in extreme cases can lead to suffocation and death. This is rare, and happens in every 1 out of 300 people. It's important to state that, most people who have allergies might not be aware that they have them, and might not associate their headaches or pains with food.

Another important point to make about Anaphylaxis is that the level of exposure to an allergen needed to trigger the reaction can vary, both from person to person, and from reaction to reaction. So a small amount may cause a reaction one day, and a larger amount the next day may not cause any reaction at all, it depends on a lot of factors most of which are internal and out of your control. Like the fire alarm in a building, one day someone may see smoke and trigger the alarm, another day nobody might notice the fire is present until they see the flames. Once a reaction has been triggered, increased exposure does not increase the reaction. So if it takes a small bite of a food containing an allergen to cause a reaction, eating more without realising won't make the reaction worse, this is because histamine release within the body is like the fire alarm being pulled, once the alarm is going off you can't trigger it again until it stops.

There is one good thing about having experienced Anaphylaxis however, and that is precedent. Your Anaphylactic response will usually be consistent - that is to say if you go into Anaphylactic Shock, the symptoms you experience during it are the symptoms you will have in future if you are exposed to the same allergen - the only variance in instances of Anaphylactic Shock on an individual level come as a response to different allergens. Each allergen has its own response - going back to the building analogy, whilst there's only 1 fire alarm that can be pulled there may be other alarms present, like a burglar alarm, or a Carbon Monoxide alarm etc, each one with its own siren. This is the only instance where Anaphylaxis can be layered and the extremity increased after it has been triggered.

I know what happens when I eat ginger without realising it, I get intense headaches, and pains all over my body which I can take painkillers for, remain hydrated and just try not to move until it passes. I know what happens now when I eat Rapeseed Oil having this allergy confirmed it causes nausea, vomiting, and diarrhoea. I've been prescribed Omeprazole to take to alleviate the symptoms of diarrhoea if they occur. As for the nausea and vomiting, that can't really be prevented at all. There are anti-nausea medications you can take but these deal with nausea caused by different underlying issues, they won't have an affect on an allergic reaction.

Unfortunately there is no drug that you can take to prevent an allergic reaction, or to reduce one when it happens. Drugs like epinephrine found in EpiPens are used to increase adrenaline they are prescribed to patients whose airways close during Anaphylaxis as a short term measure so the patient can get to a hospital to receive treatment to alleviate the symptoms, an EpiPen does not stop or reverse an allergic reaction however.

As for drugs like Loratadine, Cetirizine, Claritin et al, these have no effect on allergic reactions caused by something you ate. They help relieve symptoms related to nasal and sinus congestion problems related to the allergic reaction but again, they do not stop the underlying reaction. These drugs are classed as antihistamines and do not inhibit histamine production but instead block its receptors, this doesn't relieve gastrointestinal distress.

I've been advised to keep a diary for the next four weeks of everything I eat and drink to see if any other patterns emerge as it is possible there is more than one allergen. My own experimentation and selective elimination and reintroduction of foods to my diet up until now has helped me narrow it down to Rapeseed Oil as a culprit, that much has now been confirmed, but figuring out if there's anything else may take some time. At the very least I know I am not gluten intolerant as I can eat cereal without issues and that also eliminates lactose intolerance since I eat cereal with whole milk.  Time will tell if there's any other allergen I need to avoid.

Further investigation is needed.