Some Patients are Receiving AUVI-Q for $0 Out-of-Pocket

I ran across a discussion in one of my allergy Facebook groups the other day in which members were discussing the AUVI-Q  epinephrine auto-injector.  (Most of us are more familiar with the brand Epi-Pen.)  The AUVI-Q is an alternate brand of epinephrine auto-injector used to treat life-threatening allergic reactions, including anaphylaxis, in people who are at risk for or have a history of serious allergic reactions.

This brand boasts features such as a retractable needle, voice instructions, and a two-second countdown.  The most exciting part of the conversation is that people were talking about getting the auto-injector for $0 out-of-pocket. So- I thought I’d pass along the information here.  Please conduct your own research and talk to your prescriber for more information about which auto-injector is best for you.

An App to Help Find Allergens in School Lunches

Working for a company that treats food allergies, I’m always on the lookoutfor Facebook posts, allergy blogs, or practically anything related to allergies.

Nutrislice App

Today, I ran across a really cool app while reading my son’s school monthly newsletter.  Our school district has adopted the use of an app called Nutrislice.  I can digitally find the school menu for the month, and with a few clicks I’m able see a real picture of the food with a description, nutrition information, and allergen information.

For example, on Monday, my son will have the choice of a Classic Chicken Sandwich or a PB & Grape Jelly Uncrustable as a main item.  Good for him to be able to see the options, along with pictures.  Great for a mom who may be dealing with a child with food allergies.  I can tell that the chicken sandwich contains both wheat and soy, and the pb&j contains wheat, soy, and peanuts.  We can also see  the nutrition information for all of the sides, milk choices, and condiments.

For our family, this is a great tool to plan lunches for the week, and for my son to determine if school lunch really looks gross or not.  (OK- the turkey nachos don’t look appetizing, so I can’t blame him for not liking that choice!)

For food allergy families, this app could literally be a lifesaver!  Kudos to our school district for providing this app!

Research for alternative testing method for food allergies looks positive

According to a new study published in the journal Scientific Reports, researchers have developed an alternate method to more accurately detect and identify the presence and severity of peanut allergies, without directly exposing patients to the allergen.

A team of chemical and biomolecular engineers at the University of Notre Dame designed nanoparticles, or “nanoallergens”, that mimic natural allergens by displaying each allergic component one at a time on their surfaces.  These nanoallergens are used to dissect the critical components of major peanut allergy proteins and evaluate the potency of the allergic response using the antibodies present in a blood sample from a patient.

Basar Bilgicer

“The goal of this study was to show how nanoallergen technology could be used to provide a clearer and more accurate assessment of the severity of an allergic condition,” said Basar Bilgicer, associate professor of chemical and biomolecular engineering and a member of the Advanced Diagnostics and Therapeutics initiative at Notre Dame.  The goal of this new testing procedure is to replace the oral food challenge; which requires a patient to ingest small amounts of the offending food to the point of intolerance or anaphylaxis; and skin prick testing, which may have false-positive test results.

“We are currently working with allergy specialist clinicians for further testing and verification of the diagnostic tool using a larger patient population. Ultimately, our vision is to take this technology and make it available to all people who suffer from food allergies.”


Source: Novel platform uses nanoparticles to detect peanut allergies



Major League Baseball Offers ‘Peanut-Controlled’ Games

Many Major League Baseball teams are now offering ‘peanut controlled’ baseball games at their venues.  This concept is quite refreshing, and is a positive step towards the inclusion and awareness of food allergies in the sports community.

The Milwaukee Brewers have scheduled four games this season featuring ‘peanut-controlled’ sections.  Although they warn that these areas are not specifically peanut-free, they are taking great measures to create a peanut-controlled atmosphere by posting signs restricting peanut products in those specific sections and performing additional cleaning in advance. However, they do warn that they ‘cannot guarantee the absence of peanut particle and residue.’ Fans with peanut allergies should still take precautions. Their website also gives instructions as to which entrance/exit to use that will help eliminate undue exposure to peanuts.

Other MLB teams are also offering sections or sky boxes that are peanut-free or peanut-controlled.  Kudos to all of the participating teams!  It’s not always ‘peanuts and cracker jacks’ for every MLB fan.

What is allergy immunotherapy?

Allergy immunotherapy is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy.

Allergy immunotherapy treats the cause of your allergies, not just the symptoms. It builds tolerance by exposing your immune system to small amounts of what you’re allergic to on a regular basis. This can be done with weekly injections of “allergy shots,” the daily self-administration of “allergy drops” or “allergy toothpaste”, or by taking dry “allergy tablets”.

Over time, immunotherapy changes your immune system so that it is more “tolerant” of the allergens. As allergen tolerance grows, your allergies and their symptoms decrease, sometimes to the point that an allergy sufferer does not notice them anymore. Immunotherapy may also prevent conditions that often go along with allergies, like chronic sinusitis or asthma.

What are allergies?

Allergies are an overreaction of a person’s immune system to an allergen, an otherwise harmless protein that has no effect on a non-allergic person. Common sources of inhaled allergens are tree, grass and weed pollen, mold spores, dust mites, cockroaches, cats, dogs, birds, cows, horses, rabbits and rodents. The overreaction of the immune system that results from contact with one or more of these inhaled allergens may cause annoying symptoms like coughing, sneezing, itchy eyes, runny nose, and scratchy throat. A person will often have allergies to more than one allergen.

Mylan’s EpiPen Recall in the United States

Many of our patients have been prescribed epinephrine in case of a rare anaphylactic reaction to their allergy drops, so I wanted to pass along some information about a voluntary recall of Mylan’s popular brands of epinephrine: EpiPen 2-Pak® and EpiPen Jr 2-Pak®.
If you or someone you know were prescribed one of these medications, please click on the link below for more information about the lot numbers of the recalled products and for replacement information.   If your lot number matches one of the recalled products, you will need to contact Stericycle at 877-650-3494. If not, your EpiPen product is not affected by the recall and there is no further action necessary.
EpiPen Recall

Autism Spectrum Disorders and Food Allergies

In honor of the upcoming World Autism Awareness Day on April 2, I wanted to share some information regarding autism spectrum disorders (ASD) and food allergies.


General Information:

IgE-mediated allergic diseases (e.g., allergic rhinoconjunctivitis, atopic asthma and food allergy) are among the most common chronic conditions worldwide, and are continuing to rise each year.  In addition to easily recognized symptoms, such as a runny nose, itchy eyes, sneezing and coughing, allergic diseases can cause neuropsychiatric symptoms, such as irritability and hyperactivity, in otherwise healthy individuals. This is also likely to occur in children with autism spectrum disorders (ASD). Moreover, the discomfort and pain associated with allergic diseases could aggravate behavioral symptoms in ASD children. [1]  This may be due the child’s inability to communicate or fully understand or explain his or her discomfort.


Allergy Testing:

Autism spectrum disorder children are known to suffer from additional issues, with gastrointestinal (GI) and sleep disorders being the most common. It may be useful to test for food allergies to confirm or rule out allergies as a cause for GI issues.  Allergy testing can be done by skin testing or blood work.  Many times these tests indicate that children do, in fact, have true allergic responses to foods. Other times, the tests come back “negative” for food allergies.


Allergy Treatment:

If a patient tests positive for food allergies, they can be treated with sublingual immunotherapy (allergy drops), by avoiding the allergy-inducing foods altogether, or a combination of both.


For more information about World Autism Awareness Day, please go to:  Wear blue on April 2 to show your support of the Light It Up Blue national campaign.



Oral Allergy Syndrome

Have you ever eaten an apple and had an itchy mouth or throat?  Or perhaps you’ve eaten a big watermelon chunk, and you’re ears feel tingly inside.  (This is what happens to me with watermelon.  It’s very annoying to think you’re eating healthy, only to be plagued with itchy inner-ears.)  The reason for this is likely Oral Allergy Syndrome.  It is also called pollen-food allergy syndrome.  These symptoms; itching, tingling, and swelling of the mouth, lips, and throat and sometimes itchy ears; happen because your immune system can’t tell the difference between the proteins in these food and pollen.

Triggers for Oral Allergy Syndrome:

Although not everyone with a pollen allergy will experience oral allergy syndrome when eating the foods listed below, they are known to be associated with the allergens listed.  Basically, if you are allergic to ragweed, you may have a similar allergic reaction to watermelon, melon, oranges, tomatoes, potatoes, and peanuts.  If you eat these foods during the height of ragweed season, your reaction may be more severe.

Allergen Foods
Birch Pollen Apple, pear, cherry, nectarine, apricot, plum, kiwi, hazelnut, almond, celery, carrot, potato
Mugwort (Sage) Pollen Celery, carrot, spices, sunflower, honey
Grass Pollen Melon, watermelon, orange, tomato, potato, peanut
Ragweed Pollen Watermelon, melon, orange, tomato, potato, peanut
Sycamore (Plane tree) Pollen Hazelnut, peach, apple, melon, kiwi, peanuts, corn, chick pea, lettuce, green beans
Plantain (English) Pollen Melon, watermelon, tomato, orange, kiwi
Dust Mite Shrimp, snail

Treatment Options:

  • Avoid the trigger foods altogether
  • Cook the foods, as heat tends to break down the proteins
  • Sublingual immunotherapy drops for food or inhalant allergies

Why am I being treated for a cat allergy when I don’t have a cat?


We were sitting around the conference table the other day at our staff meeting, chatting about allergies, when a great topic came up.  Cat allergy.  Now, I don’t claim to be an expert in allergies.  I don’t have any of the fancy letters after my name, like my colleagues: DO, RPh, RN.  I don’t need to worry about educating prescribers or patients on the ins and out of allergy.  So, I ended up learning something by listening to this conversation that I thought was worth passing along.


We have had patients ask why they are being treated for their cat allergy even though they don’t own any cats.  Here’s what I learned: cat dander can stick to things.  It can stick to the clothes of a cat owner, and be transferred to the clothes or furniture of a cat-allergic person.  It can stick to the backpack of a child and be brought to school to be shared with cat-allergic classmates.  I think you’re getting the picture.


According to the American College of Allergy, Asthma & Immunology (ACAAI), “in a home that previously had cats, it may take up to 20 to 30 weeks before the cat allergen concentration is reduced to the levels found in animal-free homes.”  Other researchers have said that cat dander could last in a home for several years after a cat has been removed.


In summary, non-cat-owner patients who are allergic to cats are often treated for their cat allergy due to the potential ‘exposure’ to cat dander.  You never know when you might be exposed to cat dander…you may want to stay away from my house for the next 20 weeks-several years!