https://publications.aap.org/pediatrics/search-results?page=...
There is extensive evidence that the incidence of severe peanut allergies is significantly increased by the practice of avoiding early exposure in the absence of particular risk indicators, which is why that practice is now advised against.(IIRC, some of the first targeted studies were motivated by observed differences in incidence between the US where early avoidance had become common and Israel where peanut-based puff snacks were a common thing to give to babies not long after starting solid food.)
Both will eventually go rancid at room temperature , though highly refined oil has a longer shelf life (both sealed and, even moreso, after the seal is broken.)
He also had a grape allergy, and reaction was quite severe, but he seemed to outgrow that by his 40s.
At some points, some things are bad luck, at least until we truly understand the mechanisms and causations.
Even though we keep an epipen around and we make sure they're not eating peanuts, we don't practice strict avoidance anymore, we don't have to worry about the "processed on shared equipment" warnings, and there's no problem if he touches/inhales/eats peanut, meaning we can eat peanuts around him.
The hygiene hypothesis is widely accepted, including by allergists, and there's definitely data supporting it, but we don't understand the mechanism, so it's hard to say that it's about any one specific thing vs. many contributing causes that correlate with hygiene and other aspects of the environment around the kid.
The advice about early exposure clearly works though, and there's data to support that early exposure even after confirming the allergy can increase the chances of outgrowing the allergy.
As lymphocytes are formed, they randomly rearrange their T-cell receptor / immunoglobulin genes, creating a random antigen specificity for each cell. [1]
Then, they get selectively killed if they react to self-antigens. [2]
Those that survive, if they ever meet their specific antigen, will selectively multiply [3] and do random mutations again [4].
[1] https://en.wikipedia.org/wiki/V(D)J_recombination
[2] https://en.wikipedia.org/wiki/Clonal_deletion
[3] https://en.wikipedia.org/wiki/Clonal_selection
[4] https://en.wikipedia.org/wiki/Somatic_hypermutation
You say they live in bubbles, but is that before or after discovering the allergy? After the allergy is discovered, some amount of bubble-ing is necessary due to how difficult it is to be certain than something is peanut-free.
https://www.sciencedirect.com/science/article/pii/S009167491...
Or maybe in your lungs.
Anaphylactic shock is extremely rare. And even in cases of anaphylactic shock, it's only fatal in an even rarer number of cases (which makes sense, anaphylactic shocks is a biological reaction of your body to save itself, not kill itself).
We really don't know how many lives emergency epinephrine has saved, but it may have only been necessary in less than 1 out of 50 cases. However, it benefitted the manufacturer to overemphasize the prevalence of dangerous food allergies and the risks of shock and encourage doctors to prescribe them in increasingly more "just in case" cases".
It's in this world that parents and doctors alike became insanely cautious and paranoid about introducing allergens. Conveniently, we saw the rise of simpler, more highly processed baby and childrens' foods at the same time.
Children of Gen X and Millenials have been ruined by their helicopter/bubble parents, they have allergies and that's that. Future generations can and must learn from their mistake, but we can't force allergic people to simply grow out of it. We're not talking itchy throats here.
Add allergies to the list of things Millenials killed I guess.
I'm absolutely NOT arguing that and I thought my post made it very clear that epinephrine does save lives.
But the overrepresented sense of fear actively made our kids less safe.
On the other hand, I've seen kids have a bad reaction to peanuts and the tiniest dose can be dramatically dangerous.
I think of how allergies to wheat were fashionable before COVID but seem to have been forgotten about in all the confusion. Now there is such as thing as a wheat allergy and I know people who eat the tiniest amount of gluten and their GI tract purges everything in both directions. I know about 10x as many people who have vague symptoms such as "bloating" or nonspecific fatigue who get told by an alternative health practitioner to go gluten free... and instead of eating traditional preparations of other cereals and pseudo-cereals (e.g. a bowl of rice) they seem to think life begins with sandwiches and ends with baked goods and eat nothing but sawdust "bread".
But, I think it may go a step further than that. If we zoom out on the timeline to the span of human evolution, eating grass seeds as a significant part of the diet is very, very, very strange. It wouldn’t surprise me if some human subpopulations, especially those who adopted agriculture later on, aren’t suited to eating grass seeds at all. And I’m just thinking about within European subpopulations. There were people roaming around the steppe when others were long settled. And beyond even that, the population increase enabled by wheat et al could plausibly produce a large enough competitive advantage for the group that some individuals having tummy problems probably would not register much on the selection pressure meter back in those days.
I’ve come around to the idea that wheat sensitivity is probably real. I used to be quite skeptical also. I think if you told someone 30,000 years ago that the earth would be full of people eating mainly grass seeds, they would find the idea completely ridiculous.
In a lot of cases patients who think they have a gluten intolerance are actually having a bad reaction to one of the many other chemicals that typically come along with gluten. They can test this by consuming pure food-grade gluten with nothing else (not medical advice, check with your doctor).
> Anaphylactic shock is extremely rare
~5% of people in the US have experienced anaphylaxis, but I don't know your definition of rare.
> it's only fatal in an even rarer number of cases
Could this be due to epipens being commonly carried by people likely to experience anaphylaxis?
> anaphylactic shocks is a biological reaction of your body to save itself, not kill itself
Because it is an immune response? Is the implication here that anaphylactic shock is actually a good thing?
And focusing on the conspiracy part itself
> the majority of the fears that we have been sold on allergies was a direct result of marketing efforts by the inventors of the Epipen.
Implying the increase in EpiPen prescriptions caused people to be more cautious about food allergies feels exactly backwards.
The tricky thing with the data set available to us is that anaphylactic deaths are so rare that it's hard to establish meaningful findings: https://pmc.ncbi.nlm.nih.gov/articles/PMC4382330/
We do know though that hospitalization rates are about the same for people who take epinephrine vs those that don't. The speed at which they get to the ER seems to have a bigger impact on the recovery from the reaction than the Epipens do: https://www.sciencedirect.com/science/article/abs/pii/S10811...
> Implying the increase in EpiPen prescriptions caused people to be more cautious about food allergies feels exactly backwards.
How so? Bringing awareness to risk in general makes people more cautious. Advertising crime rates in your town to sell you a security system will overall make people feel less secure.
An EpiPen is not a cure, and you are told that if you use an EpiPen you should also go to the hospital. An EpiPen essentially keeps you alive long enough to receive care.
> The speed at which they get to the ER seems to have a bigger impact on the recovery from the reaction than the EpiPens do
If you have anaphylaxis without an EpiPen, the first thing the ambulance/ER will do is almost certainly inject epinephrine.
I really encourage you to ask a doctor. It is not enough to read papers and draw conclusions without understanding the broader context. I am not a doctor, but have talked to a doctor about carrying an EpiPen.
> The tricky thing with the data set available to us is that anaphylactic deaths are so rare that it's hard to establish meaningful findings
Again, could this be because there is such abundant access to life saving medication, that you are arguing against?
I'm not at all arguing that Epipens don't save lives or that doctors shouldn't prescribe them or that you shouldn't carry one.
Let me reframe my argument: Crime is a real risk no matter where you live in this country. But we should not be surprised that people that sell you security are incentivized to scare you about the risk of crime or its randomness.
I would not say people shouldn't take whatever precautions they need against crime, but don't think it's controversial to say the risk is overstated.
It's easy enough to say that never stepping outside of your house because crime exists is a silly conclusion to make. But people for some reason thought it was completely normal to deprive children of exposure to large swaths of the food pyramid despite no underlying history or diagnosis because a risk was overstated to them.
Still, I am admitting that my targeting of Epipens in particular something of a crackpot argument. But also we live in a world still reeling from the effects of the Sackler family and the marketing they used on the medical industry - would it be that far fetched if we learned in 20-30 years that the life saving ability of emergency epinephrine was overstated for profit?
What's your source here, and how many of those people actually experienced a non-allergic one-off angioedema that was misdiagnosed as anaphylaxis "just in case"? Or worse, wasn't even diagnosed, their parent saw them experience angioedema after eating something for the first time and assumed an allergy without any diagnosis ever?
> The most common triggers reported were medications (34%), foods (31%), and insect stings (20%)
https://pubmed.ncbi.nlm.nih.gov/24144575/
not a doctor but a "one off face swelling" after eating something for the first time seems like it would be much more rare than an actual allergic reaction.
What I learned from the allergist is, histamine angioedema is essentially the same thing as anaphylaxis, and is treated the same, but is different in cause in that repeat exposure to the food item will not cause a repeat episode.
I'm not a doctor either, but according to my allergist (who is), most people who think they are allergic to some random thing that most people have never heard of people being allergic to, are not in fact allergic to that thing.
Reading the full text of the article you linked it looks like their criteria cover both angioedema and anaphylaxis and add the two together.
Here's some additional info:
https://knyamed.com/blogs/difference-between/angioedema-vs-a...
Ok but who want's to be the one that needs it and can't get it?
https://www.breakingnews.ie/ireland/family-of-teen-who-died-...
>anaphylactic shocks is a biological reaction of your body to save itself, not kill itself
The idea that everything the body does is harmless natural magic that should be allowed to run it's course is killing people.
> The idea that everything the body does is harmless natural magic that should be allowed to run it's course is killing people.
Not sure where you got this from my point that the risk is overemphasized.
Your original post.
>which makes sense, anaphylactic shocks is a biological reaction of your body to save itself, not kill itself).
i think you misunderstood something here, anaphylactic shock is by definition a medical emergency.
https://www.jacionline.org/article/S0091-6749(13)02738-3/ful...
"Although anaphylactic reactions are potentially life threatening, the probability of dying is very low for those cases that require ED or hospital attention, and is likely much lower when all anaphylactic reactions are considered."
I think you misunderstood me. The risk of your immune system going haywire and killing you is a real risk and worthy of medical attention. But I think we are really overstating the prevalence of how many people have an immune system ready to self-destruct them.
Anecdotally a relative recently found out they have a gluten intolerance and while a lot of people would think it's a fad kids latch onto (implied by someone elsewhere in this topic), it actually took a while for it to be identified.
The assumption was they just had anxiety which was causing physical symptoms until they had a blood test that identified the antibody.
Seeing a lot of "illness X is fake" on here and elsewhere lately so i wrongly perceived it here.
I know people have peanut allergies all over the world. But the significance of the allergy is definitely different in the US than most other places imo.
"breathing into a brown paper bag"? An anaphylatic reaction is literally a life-threatening event requiring prompt medical intervention. It's not "anxiety".
And funnily enough, the breathing in a paper bag is _absolutely_ a recommended treatment for anxiety attacks by doctors. My father is one, and had my wife do it when she had a panic attack during a particularly rough airplane landing recently.
So again: it's a standard and normal thing, which is in the regular medical parlance.
The reason to do it is your trigger to breathe is based on CO2 acidity, not oxygen - you can't detect O2 (hence why inert gas asphyxiation is a huge hazard) but can detect CO2. But if you start shallow breathing very rapidly you end up in feedback loop. Rebreathing the air ups the CO2 content, which encourages the body to take deeper breathes, which in turn helps with the anxiety and ensures you do get enough oxygen (since you can wind up passing out, and low O2 wipes out the reasoning center of thought very quickly).
[1]: https://www.uclahealth.org/news/article/breathing-into-a-pap...
Are there other modern conditions born from the same "zero-tolerance prevention leads to unintended consequences due to failing to provide the body a robust means to develop"?
I'm almost certainly indexing too heavily on the ideas in birch pollen cross reactivity. But I see basically no reason not to think that same process generalizes quite well into a lot of the things we used to gladly pollute into our environments.
And yes, I know we can still get better at pollution management; but I think people should probably acknowledge just how much progress we have made. Especially in the US. Our air quality is amazingly clean today compared to just 60 years ago. Strikingly so.
aerostable_slug•4h ago
Generate a miasma of benign pestilence in your child's crib, mimicking the protective inoculations provided by early exposure to peanuts and other potential allergens, "farm" air, and the like. It could be packaged with Flonase for sneezing parents and an 'essential oils' scent dispenser to cover the barnyard smell.
Use AI to tailor the precise blend of aerosolized rodent feces and tree nut dust to optimize your child's immune system, and et voila: funding!
johnea•3h ago
ibejoeb•3h ago
all2•3h ago
hangonhn•3h ago
And like sibling comment said, you can just also just take them outside and let them be kind of outdoorsy.
ErikCorry•3h ago
alex_c•2h ago
woah•3h ago
mauzy•2h ago
4gotunameagain•2h ago
At least here we have some exceptions, with some deeply knowledgeable people. But to offset that we have software "engineer" hubris.
tines•2h ago
bodiekane•2h ago
michaelt•27m ago
As far as I can tell, there's no level of satire so heavy-handed and unsubtle that it won't get a reply taking it seriously. If anything, the more obviously ridiculous your suggestion, the more urgently HNers want to disagree.
oblio•15m ago
Things are different when you actually know people but we killed that when we killed forums.
ASalazarMX•6m ago
New business idea: Allergen Feeder
alliao•2h ago
croes•2h ago
evanjrowley•53m ago
viraptor•2h ago
IncreasePosts•32m ago
Something interesting is that peanut allergies in Israel are far lower than for Jews living in Spain, central europe, etc...
One of the most popular snacks in Israel? Bambas - peanut butter puffs.
sfgunn•1h ago
politelemon•1h ago