Peanut Allergy: Is it Possible to Have a MILD Peanut Allergy?

Twice in the last week, someone I've come in contact at school with has brought up the concept of having a 'mild' peanut allergy. Is there such a thing?

Case 1:
We have this thing in B's class where parents bring in a snack that corresponds to a letter - so someone will bring blueberries for 'b' day, apples for 'a' day, you get the picture. So it's c day and I find out what the snack is (hoping for canteloupe). It's corn muffins - rats. So I ask if the parent has brought in a label or ingredient list. B's teacher says 'B should be able to have them - X's mom made them and he has a peanut allergy too. But his is mild, unlike B's'. I was about to give her a speech about how there are no mild nut allergies, but I shut my trap. (I've come to find out that this boy doesn't have an epi or any meds in class either - avoids peanuts, but still has mixed nuts, Planter's I suspect, in his lunch on a regular basis. yikes. That's fodder for a whole other post though.) Did I let her have the muffin? Nope. She got a treat from her treat bag.

Case 2:
B had another substitute teacher. Her first sub had a daughter with a peanut allergy (such a relief!). Today's sub was fine when I told her about B. She mentioned that her daughter is allergic to bees and is well versed in the epi (another relief!). She asked me the level of B's allergy. Was it mild? This time I did explain that there is no mild allergy, at least in my opinion. But I showed her where B's epi was in class and she was prepared. No snack today (kids bring their own most days) so I stressed to her that there shouldn't be an issue and just stressed the meds were there just in case (that's when I discovered the kid from case 1 didn't have meds in class).

So my stance is that there are no Mild Peanut Allergies. That being said, REACTIONS can be classified as mild, but a peanut allergy itself? I wouldn't go there. You can have a mild seasonal allergy but with a nut allergy, all bets are off. I haven't done a tremendous amount of research on the subject, so I can't send you to the scientific literature on pubmed, but I can say without a doubt that you can have mild reactions for years and then experience anaphylaxis, and death due to peanut ingestion. I'm just a few degrees of separation from someone who learned it the hard way.

And that's not a chance I want to take (I know - I'm so boring). So to whom it may concern: B has a severe allergy. Until that skin test and food challenge comes back negative, let's keep it that way.

In my personal opinion, people who treat their nut allergy as mild are playing with fire. What do you guys think? Has your allergist described your (or your child's) allergy to nuts as mild? Ours errs on the side of severe, no matter what the numbers say.

Allergy vs. Intolerance

Since Bella's PA diagnosis I've been super sensitive about allergies - making sure that I accommodate folks who come for meals and make sure snacks or treats I bring to daycare are safe for all the kids.

But I have also become more aware of folks who tell me how allergic they are to something when they really just have an intolerance. For example, someone I know gets a little crampy if they have a certain type of cheese - but she tells me she's allergic. It drives me a little crazy (ok I need to say it - it drives me nuts- hee hee). I think to myself - does she have any idea what being allergic really means?

But then I thought to myself - do I?

So I went a' searching and here's what I found, courtesy
of the Mayo Clinic:

Food intolerance vs. food allergy: What's the difference?

ANSWER
Although many people have adverse reactions to certain foods, true food allergy — a reaction triggered by the immune system — is uncommon. Only about 2 percent of adults and 6 percent of children have a true food allergy. Far more people have a food intolerance, unpleasant symptoms triggered by certain foods. Unlike a food allergy, a food intolerance doesn't involve the immune system.

Lactose intolerance is one example of a food intolerance. People with lactose intolerance lack the enzyme lactase needed to digest milk sugar (lactose) in milk and other dairy foods. This inability to break down lactose during digestion may cause diarrhea, gas, bloating and abdominal pain.

In a food allergy, your immune system mistakenly identifies a specific food or a component of a food as a harmful substance. Your immune system triggers certain cells to produce immunoglobulin E (IgE) antibodies to fight the culprit food or food component. The next time you eat even the smallest amount of that food, the IgE antibodies sense it and signal your immune system to release histamine and other chemicals into your bloodstream. Signs and symptoms of a food allergy may include tingling in the mouth, hives, swelling of the lips, face, tongue and throat, wheezing or breathing difficulties, and dizziness or fainting.

It's important to distinguish food intolerance from food allergy. If you have a food allergy, eating even the tiniest amount of the food may trigger a serious allergic reaction. By contrast, if you have a food intolerance, you usually can eat small amounts of the food without a reaction.

If you have a reaction to a particular food, tell your doctor about it. Tests can help determine whether you have a food allergy.

So now you know. Have you encountered folks saying they are allergic to something and they are really intolerant? Should we treat an intolerance with the same seriousness? Even though it bugs me a bit, I still respect it as I wouldn't want someone else to brush off Bella's true allergy (and by true I mean life threatening). But how would you respond to someone? I told my friend she had an intolerance and she was adamant she was allergic - ah well.