Post-COVID food allergies

July 19, 2021 Delainne B.

Many people with Long COVID are finding that they have new food allergies and sensitivities through post COVID immune system disruption that causes the overproduction of histamines and leads to inflammation of nerves causing organ dysfunction. Gastrointestinal issues are challenging, and it can be difficult to identify what may be causing you distress.

A food allergy is the body's immune response where an allergy antibody binds to an allergy cell. The allergy cell releases histamines that cause a reaction, typically within a few minutes to a few hours after exposure to the allergen. The most typical allergic reactions include itching, hives, rash, or an anaphylactic reaction, where breathing becomes impaired. Symptoms can include extreme bloating, fullness, abdominal pain or cramping, brain fog, headaches, and altered stool patterns of loose stools or constipation.

The most common allergens are peanuts, tree nuts, fish, shellfish, wheat, soy, sesame, milk, and eggs.

A food intolerance or sensitivity is when someone has difficulty processing or digesting a food properly. This is related to how people break down components or enzymes of what they eat. Lactose intolerance is a common sensitivity. People who are sensitive to lactose lack the enzymes to break down the lactose in dairy products, which will cause symptoms.

In most situations, a food allergy will cause a more immediate reaction. Food sensitivities may develop 30 minutes up to four or five hours later - the average time it takes for food to move from the stomach.

It can be challenging for some people to determine if they have a food allergy or a sensitivity, and a health care professional should make the diagnosis.The Mayo Clinic lists these anaphylaxis symptoms that may not all be immediately life threatening like your airway closing up, but repeated exposures threaten your health in the short and long term:

WHOLE BODY: fainting, lightheadedness, low blood pressure, dizziness, or flushing
RESPIRATORY: difficulty breathing, rapid breathing, shortness of breath, or wheezing
SKIN: hives, swelling under the skin, blue skin from poor circulation, or rashes
GASTROINTESTINAL: nausea, vomiting, diarrhea
ALSO COMMON: tachycardia, fast heart rate, feeling of impending doom, itching, tongue swelling, difficulty swallowing, facial swelling, mental confusion, nasal congestion, or impaired voice.

At an extreme, there is evidence that wheat intolerance can be involved in psychiatric disorders including depression, anxiety, bipolar disorder, hyperactivity, ADHD, and in some cases, schizophrenia. Other foods have not been studied to the same extent as wheat, however, there is a strong chance that other foods pose the same risk for those who cannot tolerate them.

Many doctors miss or dismiss the complaints of people who claimed to be sensitive to foods containing gluten but did not have celiac disease, a well-documented autoimmune disease triggered by exposure to the dietary protein found in wheat, rye, and barley. A study in August 2020 out of Columbia University Irving Medical Center shows that people with non-celiac gluten sensitivity, like those with celiac disease, produce a high level of anti-gluten antibodies, but the two conditions differ in the types of antibodies produced and the inflammatory responses these antibodies can instigate.

In addition to Celiac Disease, non-celiac wheat sensitivity (NCWS) is another gluten-related disorder with incidence increasing over the years, defined as a non-allergic, non-autoimmune condition characterized by intestinal and/or extra-intestinal symptoms resulting from gluten-containing grains, with symptoms that resolve once these grains are removed from the diet. NCWS affects between 3% to 6% of the general population with a higher incidence in females than in males.

It may be difficult for doctors and providers to identify nutrition and food allergies as the root cause for long COVID or psychiatric disorders including depression, anxiety and more disabling disorders like schizophrenia. Nutrition and self-care may be the key components in recovery from long COVID and other post viral syndromes.

You can easily test this concept at home. Start a good-symptom-activity journal and look for patterns. Food reactions may show themselves in a few minutes but could take hours to develop, so look at your entire 24-hour trends.

The next step would be an elimination diet, where you start with just the basics like chicken and rice and add one new food every 2-3 days to see what you tolerate and what causes problems.

For gluten, you can try a wheat/gluten free diet (including beer, barley and other grains) for 1-4 weeks to see if gluten is causing fatigue, pain, and bloating. If you see a change in these symptoms, you may want to extend your gluten free trial a little longer to see if the psychiatric symptoms change. Be sure to keep that journal going to show you what has changed.

Feel free to print these articles out for your doctor if they are not aware of this situation. Try it and see if it helps you.

Things you can do to help yourself

Minimizing physical & psychological stressors is essential in recovery from Long COVID.

Nutrition: Try to eat protein and fresh vitamin rich foods daily and avoid chemicals, preservatives, sugars, fast foods, prepared foods and high histamine foods.
Don’t skip meals. Your body needs protein, vitamin C, and vitamin D to heal from any injury or illness. A low histamine or low carbohydrate (sugar) diet is recommended by doctors treating Long COVID (PASC), and many people report a reduction in symptoms within 1-3 days of the diet change, including decreases in sneezing, itching or hives, irritable bowel syndrome, body pain, along with a reduction in swelling and inflammation.
Hydration: A minimum of eight 8 oz glasses of plain water daily is recommended.
Avoid drinks with chemical additives. You can easily make a fresh electrolyte drink yourself by adding a dash of mineral rich Epsom salt and a piece a fruit like a raspberry for flavor instead of spending money on commercial drinks like Gatorade that contain chemicals and sit in plastic bottles for long periods of time. Remember that caffeine and alcohol have dehydrating effects.
Sleep hygiene: Getting 7-9 hours of sleep so your body can repair itself. You need at least 4 hours of uninterrupted sleep to get into the restorative phase of sleep.
Avoid stimulating activities after dinner like thrilling movies or books, arguments, negative news or frustrating stimuli.
If you wake up frequently or with a startle, you may be experiencing drops in your oxygen level, which signal your brain to release adrenaline to force you to take a breath. This could be a temporary inflammation issue or more enduring sleep apnea. Ask your doctor for a sleep study to evaluate your need for a CPAP or BiPAP, a machine that pushes air into your lungs when it senses an apneic episode (periods of not breathing).
Stress management: Stress effects every component of your life.
The only thing you can control about stress is your reaction to it. Try to avoid or minimize your exposure to stressful situations: Turn off the news, make family visits that end unpleasantly short, wait for the morning to have intense discussions, let go of things that annoy you but don’t really matter in the big scheme of things, avoid intense conversations or entertainment in the evening.
Exercise within tolerance: Pace yourself and do not push your body to extremes in any way.
For some this may mean seated breathing exercises, walking to the mailbox. Rest when your body says to slow down. Gradually build on your activity endurance as your body cues you to progress. This can be hard to gauge, because when you feel good you naturally do more, but if you do too much you may experience symptom flare ups 1-3 days later as the post exertion inflammation builds. Some people describe this as post exertional malaise, others experience severe recovery set backs.
Breathwork: You can literally stop the fight or flight reaction by taking slow deep breaths.
Deep slow breathing shuts down the adrenaline flow, slows your heart rate, lowers your blood pressure and decreases stress related histamine release. When you do this, your blood reroutes back to your brain and nervous system to allow you to think clearly. It also allows your body to use its energy and oxygen to heal your inflamed nerves and organs.

Keep moving, keep breathing.

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