• -Natalie

Six Food Challenges Over Two Days

As of December, I have officially moved back to Israel with the intention to continue and complete my food allergy treatment with the Tolerance Induction Program at the Southern California Food Allergy Institute in Long Beach, California. I have been in the program for almost three years now.

For the past six weeks at home, I have been dosing for peanuts. Overall, I started at 1mg of peanut, but for the past six weeks specifically, I went from 8.5 peanuts to 12 peanuts. During the first week of February, I flew back to Southern California and returned to the SoCal clinic for two back to back appointments.

On the first day, I challenged three new foods that although I did not dose for them, it was determined that my body would now be able to tolerate them. The Tolerance Induction Program is based on food proteins and how they cross-react with each other, meaning that if I dose for certain foods and pass the final challenge, my body has built tolerance to proteins found in that food which may be present in other foods.

At the SoCal Food Allergy Clinic, a food challenge consists of eating a specific amount (usually a large amount) of the food while monitoring vitals. As soon as the patient finishes eating the food, they then do a five minute intensive cardio workout to raise their heart rate. Following the workout, vitals are monitored again, and if the patient experiences no symptoms, the challenge is considered successful.

The three foods I challenged during my first appointment were cooked carrots, cooked cranberry and banana. Cooked carrots is a HUGE one for me, as carrots was the very first life-threatening food allergy I ever developed, at the age of 15. As for banana, I used to eat them often as a child, but around 13/14 years old, before any of my food allergies developed, they began to give me severe stomach aches, so I cut them out of my diet ever since.

During the challenge as well as after, I did not get my usual stomachache to banana and ingested the carrots and cranberries without issue, thus I passed all three challenges and am able to freely eat these foods whenever I want, in unlimited quantities. I must eat these foods at least once a week though, which is known as maintenance dosing.

During the second day, I challenged mint, updosed to 32 peanuts, and introduced denatured soy milk. Challenging mint was not a smooth ride - I had to eat the leaves straight up, and they kept getting stuck in the back of my throat and I thought I was having an allergic reaction! It took me a while to realize that I need to drink a lot of water to get the leaves down. I ended up completing and passing the challenge, meaning that I can now drink mint tea again! I haven't drank tea in years, which made having the flu last year difficult to deal with.

I then updosed to 32 peanuts which I ate with melted chocolate. The challenge went smoothly, and I now have to eat 20-22 peanuts daily for 6 days of the week, and on the 7th day, I get to choose any food that contains peanuts, no matter how many peanuts. This means that I can simply eat something that says "may contain" peanuts, or I can eat a giant peanut butter sandwich containing more than 22 peanuts if I wish to. This will continue for four months, when I will then return to the clinic to challenge 40 peanuts.

Lastly, I reintroduced denatured soy milk. The reason I say reintroduced is because I actually dosed for soy over two years ago - it was the second food that I ever dosed for in the program. The dosing itself was fine, but when I had to challenge 8oz at the clinic, I got a severe stomach ache. I attributed it to acid reflux, which I've been dealing with long before I developed any of my food allergies. But following the challenge, when I had to drink 6oz of soy milk daily for maintenance, I was still getting extremely severe stomach aches and realized it was in fact from the soy. The soy milk was also making my stomach seem bloated!

I was instructed to lower the dose, and eventually went all the way down to eating soy butter instead of drinking soy milk at all. At the time, I was also having issues with almonds and hazelnuts, and I eventually just stopped eating all three due to anxiety and feeling uncomfortable with the minor symptoms. Since then, I have dosed for many foods without any issues at all. So now, since I'm technically at the end of treatment, my plan has come full circle and I will be dosing for these three foods once again.

The first time around, I was started on regular soy milk, whereas this time, Dr.R has me starting with denatured soy milk before moving on to regular soy milk. Denatured means the proteins themselves are broken down by heat - this is achieved by boiling the soy milk before consuming (with very specific instructions).

Although my plan technically has me dosing for denatured soy milk for five weeks, I will not be able to fly back from Israel so often, so I will maintain the highest dose after the five weeks until I am able to return to officially challenge it and move on to regular soy milk. I challenged 10mL at the clinic, but will be starting at 5mL with the dosing at home. My throat did get scratchy with the 10mL, but it ended up resolving with chewing a Starburst! I had no itchiness, no coughing, no trouble breathing, or any other symptoms.

I have also been given the ok to begin trying some foods at home if I wish, especially foods that I was safely eating at some point but then cut out due to minor symptoms. I will try the following foods again at home over the next couple of months: turmeric, potatoes, watermelon, avocado, peeled & cooked tomatoes, and strawberries.

My diet is slowly expanding and I finally feel like I'm making significant progress!

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