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Food allergy 

A food allergy is when the body's immune system reacts unusually to specific foods. Although allergic reactions are often mild, they can be very serious.

Symptoms of a food allergy can affect different areas of the body at the same time. Some common symptoms include:

  • an itchy sensation inside the mouth, throat or ears

  • a raised itchy red rash (urticaria, or "hives")

  • swelling of the face, around the eyes, lips, tongue and roof of the mouth (angioedema)

  • vomiting

Anaphylaxis

In the most serious cases, a person has a severe allergic reaction (anaphylaxis), which can be life threatening.

If you think someone has the symptoms of anaphylaxis – such as breathing difficulties, lightheadedness, and feeling like they're going to faint or lose consciousness – call 999.

Ask for an ambulance and tell the operator you think the person has anaphylaxis or "anaphylactic shock".

What causes food allergies?

Food allergies happen when the immune system – the body's defence against infection – mistakenly treats proteins found in food as a threat.

As a result, a number of chemicals are released. It's these chemicals that cause the symptoms of an allergic reaction.

Almost any food can cause an allergic reaction, but there are certain foods that are responsible for most food allergies.

In children, the foods that most commonly cause an allergic reaction are:

  • milk

  • eggs

  • peanuts

  • tree nuts

  • fish

  • shellfish

Most children that have a food allergy will have experienced eczema during infancy. The worse the child's eczema and the earlier it started, the more likely they are to have a food allergy.

In adults, the foods that most commonly cause an allergic reaction are:

  • peanuts

  • tree nuts – such as walnuts, brazil nuts, almonds and hazelnuts

  • fruits – such as apples and peaches

  • fish

  • shellfish – such as crab, lobster and prawns

It's still unknown why people develop allergies to food, although they often have other allergic conditions, such as asthma, hay fever and eczema.

Read more information about the causes and risk factors for food allergies.

Types of food allergies

Food allergies are divided into three types, depending on symptoms and when they occur.

  • IgE-mediated food allergy – the most common type, triggered by the immune system producing an antibody called immunoglobulin E (IgE). Symptoms occur a few seconds or minutes after eating. There's a greater risk of anaphylaxis with this type of allergy.

  • non-IgE-mediated food allergy – these allergic reactions aren't caused by immunoglobulin E, but by other cells in the immune system. This type of allergy is often difficult to diagnose as symptoms take much longer to develop (up to several hours).

  • mixed IgE and non-IgE-mediated food allergies – some people may experience symptoms from both types.

Oral allergy syndrome (pollen-food syndrome)

Some people experience itchiness in their mouth and throat, sometimes with mild swelling, immediately after eating fresh fruit or vegetables. This is known as oral allergy syndrome.

Oral allergy syndrome is caused by allergy antibodies mistaking certain proteins in fresh fruits, nuts or vegetables for pollen.

Oral allergy syndrome generally doesn't cause severe symptoms, and it's possible to deactivate the allergens by thoroughly cooking any fruit and vegetables.

Some people with pollen-food syndrome may have more severe symptoms.

The Allergy UK website has more information on oral allergy syndrome.

Treatment

The best way of preventing an allergic reaction is to identify the food that causes the allergy and avoid it.

Research is currently looking at ways to desensitise some food allergens, such as peanuts and milk, but this is not an established treatment.

Read more about identifying foods that cause allergies (allergens).

Avoid making any radical changes, such as cutting out dairy products, to your or your child's diet without first talking to your GP. For some foods, such as milk, you may need to speak to a dietitian before making any changes.

A type of medication called an antihistamine can help relieve the symptoms of a mild or moderate allergic reaction. A higher dose of antihistamine is often needed to control acute allergic symptoms.

Adrenaline is an effective treatment for more severe allergic symptoms, such as anaphylaxis.

People with a food allergy are often given a device known as an auto-injector pen, which contains doses of adrenaline that can be used in emergencies.

Read more about the treatment of food allergies. 

When to seek medical advice

If you think you or your child may have a food allergy, it's very important to ask for a professional diagnosis from your GP. They can then refer you to an allergy clinic if appropriate.

Many parents mistakenly assume their child has a food allergy when their symptoms are actually caused by a completely different condition.

Commercial allergy testing kits are available, but using them isn't recommended. Many kits are based on unsound scientific principles. Even if they're reliable, you should have the results looked at by a health professional.

Who's affected?

Most food allergies affect younger children under the age of three. It's estimated around 1 in every 14 children of this age has at least one food allergy.

Most children who have food allergies to milk, eggs, soya and wheat in early life will grow out of it by the time they start school.

Peanut and tree nut allergies are usually more persistent. An estimated four out of five children with peanut allergies remain allergic to peanuts for the rest of their lives.

Food allergies that develop during adulthood, or persist into adulthood, are likely to be lifelong allergies.

For reasons that are unclear, rates of food allergies have risen sharply in the last 20 years.

However, deaths from anaphylaxis-related food reactions are now rare. There are around 10 deaths related to food allergies in England and Wales each year.

Food allergy and intolerance myth buster

There are many myths about food allergies and intolerances – can you tell fact from fiction? And what is the difference between the two? 

 

What is food intolerance?

A food intolerance isn't the same as a food allergy.

People with food intolerance may have symptoms such as diarrhoea, bloating and stomach cramps. This may be caused by difficulties digesting certain substances, such as lactose. However, no allergic reaction takes place.

Important differences between a food allergy and a food intolerance include:

  • the symptoms of a food intolerance usually occur several hours after eating the food

  • you need to eat a larger amount of food to trigger an intolerance than an allergy

  • a food intolerance is never life threatening, unlike an allergy

Symptoms of a food allergy 

The symptoms of a food allergy almost always develop a few seconds or minutes after eating the food.

Some people may develop a severe allergic reaction (anaphylaxis), which can be life threatening.

The most common type of allergic reaction to food is known as an IgE-mediated food allergy.

Symptoms include:

  • tingling or itching in the mouth

  • a raised, itchy red rash (urticarial) – in some cases, the skin can turn red and itchy, but without a raised rash

  • swelling of the face, mouth (angioedema), throat or other areas of the body

  • difficulty swallowing

  • wheezing or shortness of breath

  • feeling dizzy and lightheaded

  • feeling sick (nausea) or vomiting

  • abdominal pain or diarrhoea

  • hay fever-like symptoms, such as sneezing or itchy eyes (allergic conjunctivitis)

Anaphylaxis

The symptoms of a severe allergic reaction (anaphylaxis) can be sudden and get worse very quickly.

Initial symptoms of anaphylaxis are often the same as those listed above and can lead to:

  • increased breathing difficulties – such as wheezing and a cough

  • a sudden and intense feeling of anxiety and fear

  • a rapid heartbeat (tachycardia)

  • a sharp and sudden drop in your blood pressure, which can make you feel lightheaded and confused

  • unconsciousness

Anaphylaxis is a medical emergency. Without quick treatment, it can be life threatening. If you think you or someone you know is experiencing anaphylaxis, dial 999 and ask for an ambulance as soon as possible.

Non-IgE-mediated food allergy

Another type of allergic reaction is a non-IgE-mediated food allergy. The symptoms of this type of allergy can take much longer to develop – sometimes up to several days.

Some symptoms of a non IgE-mediated food allergy may be what you would expect to see in an allergic reaction, such as:

  • redness and itchiness of the skin – although not a raised, itchy red rash (urticarial)

  • the skin becomes itchy, red, dry and cracked (atopic eczema)

Other symptoms can be much less obvious and are sometimes thought of as being caused by something other than an allergy. They include:

  • heartburn and indigestion caused by stomach acid leaking up out of the stomach (gastro-oesophageal reflux disease)

  • stools (faeces) becoming much more frequent or loose – though not necessarily diarrhoea

  • blood and mucus in the stools

  • in babies – excessive and inconsolable crying, even though the baby is well fed and doesn't need a nappy change (colic)

  • constipation 

  • redness around the anus, rectum and genitals

  • unusually pale skin

  • failure to grow at the expected rate

Mixed reaction

Some children can have a mixed reaction where they experience both IgE symptoms, such as swelling, and non-IgE symptoms, such as constipation.

This can happen to children who have a milk allergy.

Exercise-induced food allergy

In some cases, a food allergy can be triggered after eating a certain food and then exercising. This can lead to anaphylaxis in severe cases, sometimes known as food-dependent exercise-induced anaphylaxis.

Drinking alcohol or taking an non-steroidal anti-inflammatory drug (NSAID) such as aspirin or ibuprofen may also trigger an allergy in people with this syndrome.

 

Causes of a food allergy 

A food allergy is caused by your immune system handling harmless proteins in certain foods as a threat. It releases a number of chemicals, which trigger an allergic reaction.

The immune system

The immune system protects the body by producing specialised proteins called antibodies.

Antibodies identify potential threats to your body, such as bacteria and viruses. They signal your immune system to release chemicals to kill the threat and prevent the spread of infection.

In the most common type of food allergy, an antibody known as immunoglobulin E (IgE) mistakenly targets a certain protein found in food as a threat. IgE can cause several chemicals to be released, the most important being histamine.

Histamine

Histamine causes most of the typical symptoms that occur during an allergic reaction. For example, histamine:

  • causes small blood vessels to expand and the surrounding skin to become red and swell up

  • affects nerves in the skin, causing itchiness

  • increases the amount of mucus produced in your nose lining, which causes itching and a burning sensation

In most food allergies, the release of histamine is limited to certain parts of the body, such as your mouth, throat or skin.

In anaphylaxis, the immune system goes into overdrive and releases massive amounts of histamine and many other chemicals into your blood. This causes the wide range of symptoms associated with anaphylaxis.

Non-IgE-mediated food allergy

There's another type of food allergy known as a non-IgE-mediated food allergy, caused by different cells in the immune system.

This is much harder to diagnose as there's no test to accurately confirm non-IgE-mediated food allergy.

This type of reaction is largely confined to the skin and digestive system, causing symptoms such as heartburn, indigestion and eczema.

In babies, a non-IgE-mediated food allergy can also cause diarrhoea and reflux, where stomach acid leaks up into the throat.

Foods

In children, the foods that most commonly cause an allergic reaction are:

  • eggs

  • milk – if a child has an allergy to cow's milk, they're probably allergic to all types of milk, as well as infants' and follow-on formula

  • soya

  • wheat

  • peanuts

In adults, the foods that most commonly cause an allergic reaction are:

  • peanuts

  • tree nuts – such as walnuts, brazil nuts, almonds and pistachios

  • fish

  • shellfish – such as crab, lobster and prawns

However, any type of food can potentially cause an allergy. Allergic reactions have been reported in association with:

  • celery or celeriac – this can sometimes cause anaphylactic shock

  • gluten – a type of protein found in cereals

  • mustard

  • sesame seeds

  • fruit and vegetables – these usually only cause symptoms affecting the mouth, lips and throat (oral allergy syndrome)

  • pine nuts (a type of seed)

  • meat – some people are allergic to just one type of meat, while others are allergic to a range of meats; a common symptom is skin irritation

Who's at risk?

Exactly what causes the immune system to mistake harmless proteins as a threat is unclear. However, a number of risk factors for food allergies have been identified, which are outlined below.

Family history

If you have a parent, brother or sister with an allergic condition – such as asthma, eczema or a food allergy – you have a slightly higher risk of developing a food allergy. However, you may not develop the same food allergy as your family members.

Other allergic conditions

Children who have atopic dermatitis (eczema) in early life are more likely to develop a food allergy.

The rise in food allergy cases

The number of people with food allergies has risen sharply over the past few decades and, although the reason is unclear, other allergic conditions such as atopic dermatitis have also increased.

One theory behind the rise is that a typical child's diet has changed considerably over the last 30 to 40 years.

Another theory is that children are increasingly growing up in "germ-free" environments. This means their immune systems may not receive sufficient early exposure to the germs needed to develop properly. This is known as the hygiene hypothesis.

Food additives

It's rare for someone to have an allergic reaction to food additives. However, certain additives may cause a flare-up of symptoms in people with pre-existing conditions.

Sulphites

Sulphur dioxide (E220) and other sulphites (E221, E222, E223, E224, E226, E227 and E228) are used as preservatives in a wide range of foods, especially soft drinks, sausages, burgers, and dried fruits and vegetables.

Sulphur dioxide is produced naturally when wine and beer are made, and is sometimes added to wine. Anyone who has asthma or allergic rhinitis may react to inhaling sulphur dioxide.

A few people with asthma have had an attack after drinking acidic drinks containing sulphites, but this isn't thought to be very common.

Food labelling rules require pre-packed food sold in the UK, and the rest of the European Union, to show clearly on the label if it contains sulphur dioxide or sulphites at levels above 10mg per kg or per litre.

Benzoates

Benzoic acid (E210) and other benzoates (E211, E212, E213, E214, E215, E218 and E219) are used as food preservatives to prevent yeasts and moulds growing, most commonly in soft drinks. They occur naturally in fruit and honey.

Benzoates could make the symptoms of asthma and eczema worse in children who already have these conditions.

 

Diagnosing food allergy  

If you think you or your child has a food allergy, make an appointment with your GP.

They will ask you some questions about the pattern of your child's symptoms, such as:

  • How long did it take for the symptoms to start after exposure to the food?

  • How long did the symptoms last?

  • How severe were the symptoms?

  • Is this the first time these symptoms have occurred? If not, how often have they occurred?

  • What food was involved and how much of it did your child eat?

They'll also want to know about your child's medical history, such as:

  • Do they have any other allergies or allergic conditions?

  • Is there a history of allergies in the family?

  • Was (or is) your child breastfed or bottle-fed?

Your GP may also assess your child's weight and size to make sure they're growing at the expected rate.

Referral to an allergy clinic

If your GP suspects a food allergy, you may be referred to an allergy clinic or centre for testing.

The tests needed can vary, depending on the type of allergy:

  • if the symptoms developed quickly (an IgE-mediated food allergy) – you'll probably be given a skin-prick test or a blood test

  • if the symptoms developed more slowly (non-IgE-mediated food allergy) – you'll probably be put on a food elimination diet

There is more information on these tests below.

Skin-prick testing

During a skin-prick test, drops of standardised extracts of foods are placed on the arm. The skin is then pierced with a small lancet, which allows the allergen to come into contact with the cells of your immune system.

 

Occasionally, your doctor may perform the test using a sample of the food thought to cause a reaction.

Itching, redness and swelling usually indicates a positive reaction. This test is usually painless.

A skin-prick test does have a small theoretical chance of causing anaphylaxis, but testing will be carried out where there are facilities to deal with this – usually an allergy clinic, hospital, or larger GP surgery.

Blood test

An alternative to a skin-prick test is a blood test, which measures the amount of allergic antibodies in the blood.

Food elimination diet

In a food elimination diet, the food thought to have caused the allergic reaction is withdrawn from the diet for two to six weeks. The food is then reintroduced.

If the symptoms go away when the food is withdrawn but return once the food is introduced again, this normally suggests a food allergy or intolerance.

Before starting the diet, you should be given advice from a dietitian on issues such as:

  • the food and drinks you need to avoid

  • how you should interpret food labels

  • if any alternative sources of nutrition are needed

  • how long the diet should last

Don't attempt a food elimination diet by yourself without discussing it with a qualified health professional.

Alternative tests

There are several shop-bought tests available that claim to detect allergies, but should be avoided.

They include:

  • vega testing – claims to detect allergies by measuring changes in your electromagnetic field

  • kinesiology testing – claims to detect food allergies by studying your muscle responses

  • hair analysis – claims to detect food allergies by taking a sample of your hair and running a series of tests on it

  • alternative blood tests (leukocytotoxic tests) – claim to detect food allergies by checking for the "swelling of white blood cells"

Many alternative testing kits are expensive, the scientific principles they are allegedly based on are unproven, and independent reviews have found them to be unreliable. They should therefore be avoided.

Questions to ask

If your child is diagnosed with a food allergy, or you're an adult who has just been diagnosed with a food allergy, you may want to ask questions such as:

  • What type of allergy is it?

  • What are the chances of having a severe allergic reaction?

  • Will the allergy have an impact on other areas of my or my child's health, such as diet, nutrition and vaccination? Some vaccines contain traces of egg protein.

  • Is my child likely to grow out of their allergy and, if so, when?

Treating a food allergy 

There are two main types of medication that can be used to relieve the symptoms of an allergic reaction to foods:

  • antihistamines – used to treat mild to moderate allergic reaction

  • adrenaline – used to treat severe allergic reactions (anaphylaxis)

Antihistamines

Antihistamines work by blocking the effects of histamine, which is responsible for many of the symptoms of an allergic reaction.

Many antihistamines are available from your pharmacist without prescription – stock up in case of an emergency. Non-drowsy antihistamines are preferred.

Some antihistamines, such as alimemazine and promethazine, aren't suitable for children under the age of two.

If you have a younger child with a food allergy, ask your GP about what types of antihistamines may be suitable.

Avoid drinking alcohol after taking an antihistamine as this can make you feel drowsy and affect your ability to drive.

Adrenaline

Adrenaline works by narrowing the blood vessels to counteract the effects of low blood pressure and opening up the airways to help ease breathing difficulties.

You'll be given an auto-injector of adrenaline to use in case of emergencies if you or your child is at risk of anaphylaxis or had a previous episode of anaphylaxis.

Read the manufacturer's instructions that come with the auto-injector carefully and train your child how to use it when they are old enough.

Using an auto-injector

If you suspect that somebody is experiencing the symptoms of anaphylaxis, call 999 and ask for an ambulance. Tell the operator that you think the person has anaphylaxis.

Older children and adults will probably have been trained to inject themselves. You may need to inject younger children or older children and adults who are too sick to inject themselves.

There are three types of auto-injectors:

  • EpiPen

  • Jext

  • Emerade

All three work in much the same way. If anaphylaxis is suspected, you should remove the safety cap from the injector and press firmly against the thigh, holding it at a right angle, without using the thumb at the end.

A "click" indicates the auto-injector has been activated, and it should be held in place for 10 seconds. Ensure you're familiar with the device and know the correct end to place against the thigh.

The injections can be given through clothing. This will send a needle into your thigh and deliver a dose of adrenaline.

If the person is unconscious, check their airways are open and clear, and check their breathing. Then put them in the recovery position. Putting someone who is unconscious in the recovery position ensures they don't choke on their vomit.

Place the person on their side, making sure they're supported by one leg and one arm. Open the airway by tilting the head and lifting the chin.

If the person's breathing or heart stops, cardiopulmonary resuscitation (CPR) should be performed.

Owning an auto-injector

As a precaution, the following advice should be taken: 

  • Carry the auto-injector at all times or encourage your child to do so if they're old enough. You may be prescribed two injectors – check with your GP or the doctor in charge of your care. You may also be given an emergency card or bracelet with full details of your child's allergy and the contact details of their doctor to alert others. They should wear this at all times.

  • Extreme temperatures can make adrenaline less effective. Don't leave an auto-injector in places like your fridge or the glove compartment of your car.

  • Check the expiry date regularly. An out-of-date injector will only offer limited protection.

  • The manufacturers offer a reminder service, where you can be contacted near the date of expiry. Check the information leaflet that comes with the medication for more information.

  • If your child has an auto-injector, they'll need to change over to an adult dose once they reach a weight of 30 kilos (4.7 stone). Depending on the shape and size of your child's body, this could be anywhere between the ages of 5 and 11 years old.

  • Don't delay injecting if you think you or your child may be experiencing the start of anaphylaxis, even if the initial symptoms are mild. It's better to use adrenaline early and find out it was a false alarm than delay treatment until you're sure your child is experiencing severe anaphylaxis. 

 Living with a food allergy  

The advice here is primarily written for parents of a child with a food allergy. However, most of it is also relevant if you're an adult with a food allergy.

Your child's diet

There's currently no cure for food allergies, although many children will grow out of certain ones, such as allergies to milk and eggs.

The most effective way you can prevent symptoms is to remove the offending food – known as an allergen – from their diet.

However, it's important to check with your GP or the doctor in charge of your child's care first before eliminating certain foods.

Removing eggs or peanuts from a child's diet isn't going to have much of an impact on their nutrition. Both of these are a good source of protein, but can be replaced by other, alternative sources.

A milk allergy can have more of an impact as milk is a good source of calcium, but there are many other ways you can incorporate calcium into your child's diet, including green leafy vegetables. Many foods and drinks are fortified with extra calcium.

See your GP if you're concerned that your child's allergy is affecting their growth and development.

Reading labels

It's very important to check the label of any pre-packed food or drinks your child has in case it contains ingredients they're allergic to.

Under EU law, any pre-packed food or drink sold in the UK must clearly state on the label if it contains the following ingredients:

  • celery

  • cereals that contain gluten – including wheat, rye, barley and oats

  • crustaceans – including prawns, crabs and lobsters

  • eggs

  • fish

  • lupin (common garden plants) – seeds from some varieties are sometimes used to make flour

  • milk

  • molluscs – including mussels and oysters

  • mustard

  • tree nuts – such as almonds, hazelnuts, walnuts, brazil nuts, cashews, pecans, pistachios and macadamia nuts

  • peanuts

  • sesame seeds

  • soybeans

  • sulphur dioxide and sulphites (preservatives used in some foods and drinks) – at levels above 10mg per kg or per litre

Some food manufacturers also choose to put allergy advice warning labels – for example, "contains nuts" – on their pre-packed foods if they contain an ingredient known to commonly cause an allergic reaction, such as peanuts, wheat, eggs or milk.

However, these aren't compulsory. If there's no allergy advice box or "contains" statement on a product, it could still have any of the 14 specified allergens in it.

Look out for "may contain" labels, such as "may contain traces of peanut". Manufacturers sometimes put this label on their products to warn consumers that they may have become contaminated with another food product when being made.

Read more detailed information about allergen labelling on the Food Standards Agency website.

Some non-food products contain allergy-causing food:

  • some soaps and shampoos contain soy, egg and tree nut oil

  • some pet foods contain milk and peanuts

  • some glues and adhesive labels used on envelopes and stamps contain traces of wheat

Again, read the labels of any non-food products your child may come into close physical contact with.

Unpackaged food

Currently, unpackaged food doesn't need to be labelled in the same way as packaged food. This can make it more difficult to know what ingredients are in a particular dish.

Examples of unpackaged food include food sold from:

  • bakeries – including in-store bakeries in supermarkets

  • delis

  • salad bars

  • "ready-to-eat" sandwich shops

  • takeaways

  • restaurants

If you or your child have a severe food allergy, you need to be careful when you eat out.

The following advice should help:

  • let the staff know – when booking a table at a restaurant, make sure the staff know about any allergies. Ask for a firm guarantee that the specific food won't be in any of the dishes served. The Food Standards Agency (FSA) offers chef cards that provide information about allergies, which you can give to restaurant staff. As well as informing the chef and kitchen staff involved in cooking your food, let waiters and waitresses know so they understand the importance of avoiding cross-contamination when serving you.

  • read the menu carefully and check for hidden ingredients – some food types contain other foods that can trigger allergies, which restaurant staff may have overlooked. Some desserts contain nuts (such as a cheesecake base) and some sauces contain wheat and peanuts.

  • prepare for the worst – it's a good idea to prepare for any eventuality. Always take anti-allergy medication with you when eating out, particularly an adrenalin auto-injector. Read more about treating food allergies with a auto-injector.

  • use what's known as a taste test in older children – before your child begins to eat, ask them to take a tiny portion of the food and rub it against their lips to see if they experience a tingling or burning sensation. If they do, it suggests that the food will cause them to have an allergic reaction. However, the taste test doesn't work for all foods, so it shouldn't be used as a substitute for the above advice.

Further advice

Here's some more advice for parents: 

  • notify your child's school about their allergy – depending on how severe their allergy is, it may be necessary to give the staff at their school an emergency action plan in case of accidental exposure. Arrange for the school nurse or another staff member to hold a supply of adrenalin. Food allergy bracelets, which explain how other people can help your child in an emergency, are also available.

  • let other parents know – young children may easily forget about their food allergy and accept food they shouldn't have when visiting other children. Telling the parents of your child's friends about their allergy should help prevent this.

  • educate your child – once your child is old enough to understand their allergy, it's important to give them clear, simple instructions about what foods to avoid and what they should do if they accidentally eat them. 

Can food allergies be prevented?

It used to be thought that avoiding eating peanuts during pregnancy and when breastfeeding could help reduce the risk, but this theory has now been questioned.

There's some evidence that introducing peanuts early in life may reduce the risk of peanut allergy, but this may not apply to all children and requires confirmation from further studies.

It's important to follow the standard recommendations for pregnancy and breastfeeding, whether or not you have a family history of food allergies.

A range of different E numbers and additives, which perform different functions in foods, have been linked to allergic reactions. Some of the common suspects include:

  • Food colourings, such as tartrazine, carmine, saffron and annatto.

  • Antioxidants, such as butylated hydroxyanisole and butylated hydroxytoluene.

  • Emulsifiers and stabilisers, such as lecithin, xanathan and carageenan.

  • Flavourings and taste enhancers, such as monosodium glutamate (MSG) and aspartame.

  • Preservatives, such as sulfites, nitrites, nitrates, sorbates, sorbic acid and benxoates.

If you think you could be suffering from either an allergy or intolerance, then it’s advisable to see a doctor for advice. They may be able to prescribe medication for you to take should a reaction occur, such as an anti-histamine or recommend another form of action. If your allergic reaction is severe, and you could be at risk of suffering from anaphylaxsis, then you may be supplied with an emergency treatment kit for such situations.

Ultimately, if you are found to have allergic reactions that are triggered by consuming E numbers and additives, then the best way of reducing the risk of reactions and ill effects may be to try and avoid the products they’re contained in completely. Although it can be very difficult, if you swap processed foods for homemade and homecooked food, you can significantly reduce your exposure to unwanted additives.

E Numbers To Avoid

The following are still ones you may prefer to avoid:

E621 – monosodium glutamate

Otherwise known as MSG, Monosodium Glutamate, E621 is a flavour enhancer that’s commonly used to pep up food products and make them taste better. Unfortunately, it is known to cause problems for some people – and certain people seem to more sensitive to its effects than others. Amongst the known side effects, MSG can cause symptoms such as headaches, nausea, dizziness, muscle pain, palpitations and even pain.

E951 – aspartame

Aspartame, E951 is an artificial sweetener that’s commonly used as a sweetening ingredient. In particular, it’s often found in products aimed at dieters or diabetics, such as desserts, low-fat foods, low sugar drinks, snacks and sweets. It’s well known to be linked to problems in people who suffer from the condition PKU, and they are well advised to avoid it completely. But aspartame has become a concern to other people too and side effects, such as headaches, have often been reported.

E211 – sodium benzoate

E211, sodium benzoate, is an E number that’s used as a preservative and is found in products such as margarine, salad dressing, soy sauce, sweets and soft drinks. Studies have found that it’s linked to hyperactivity in children, plus it may cause reactions in people have allergic conditions or asthma.

E151 – black PN / brilliant black BN

Black PN, E151 is a form of black synthetic dye that is used as a food colouring in some products. However, concerns have been raised in other countries, as it’s been linked to allergic reactions in some people. It is already banned in Australia, Austria, America, Germany, Norway, Sweden, Switzerland, Belgium and France.

E133 – brilliant blue FCF

Brilliant blue, E133 is another synthetic blue colouring dye, which adds a blue colour to some products. Some people have been found to experience allergic reactions after consuming products containing E133 and this E number is already banned in Austria, Sweden, Switzerland, France, Germany and Norway.

E213 – calcium benzoate

Calcium Benzoate, E213 is a form of preservative that’s used to lengthen the shelf life of foods and drinks. It’s often found in low sugar products, but it has been linked to side effects in people who have allergic conditions.

 

Complete List of ENumbers

Allergy UK

·         The Anaphylaxis Campaign

·         British Society for Allergy and Clinical Immunology (BSACI)

·         Food Standards Agency (FSA)

Colours

E100

Curcumin

E101

(i) Riboflavin

 

(ii) Riboflavin-5'-phosphate

E102

Tartrazine

E104

Quinoline yellow

E110

Sunset Yellow FCF; Orange Yellow S

E120

Cochineal; Carminic acid; Carmines

E122

Azorubine; Carmoisine

E123

Amaranth

E124

Ponceau 4R; Cochineal Red A

E127

Erythrosine

E129

Allura Red AC

E131

Patent Blue V

E132

lndigotine; Indigo Carmine

E133

Brilliant Blue FCF

E140

Chlorophylls and chlorophyllins

E141

Copper complexes of chlorophyll and chlorophyllins

E142

Green S

E150a

Plain caramel

E150b

Caustic sulphite caramel

E150c

Ammonia caramel

E150d

Sulphite ammonia caramel

E151

Brilliant Black BN; Black PN

E153

Vegetable carbon

E155

Brown HT

E160a

Carotenes

E160b

Annatto; Bixin; Norbixin

E160c

Paprika extract; Capsanthian; Capsorubin

E160d

Lycopene

E160e

Beta-apo-8'-carotenal (C30)

E161b

Lutein

E161g

Canthaxanthin

E162

Beetroot Red; Betanin

E163

Anthocyanins

E170

Calcium carbonate

E171

Titanium dioxide

E172

Iron oxides and hydroxides

E173

Aluminium

E174

Silver

E175

Gold

E180

Litholrubine BK

 

 

 Preservatives

 

E200

Sorbic acid

E202

Potassium sorbate

E203

Calcium sorbate

E210

Benzoic acid

E211

Sodium benzoate

E212

Potassium benzoate

E213

Calcium benzoate

E214

Ethyl p-hydroxybenzoate

E215

Sodium ethyl p-hydroxybenzoate

E218

Methyl p-hydroxybenzoate

E219

Sodium methyl p-hydroxybenzoate

E220

Sulphur dioxide

E221

Sodium sulphite

E222

Sodium hydrogen sulphite

E223

Sodium metabisulphite

E224

Potassium metabisulphite

E226

Calcium sulphite

E227

Calcium hydrogen sulphite

E228

Potassium hydrogen sulphite

E234

Nisin

E235

Natamycin

E239

Hexamethylene tetramine

E242

Dimethyl dicarbonate

E243

Ethyl lauroyl arginate

E249

Potassium nitrite

E250

Sodium nitrite

E251

Sodium nitrate

E252

Potassium nitrate

E280

Propionic acid

E281

Sodium propionate                                 

E282

Calcium propionate

E283

Potassium propionate

E284

Boric acid

E285

Sodium tetraborate; borax

E1105

Lysozyme

Antioxidants

 

E300

Ascorbic acid

E301

Sodium ascorbate

E302

Calcium ascorbate

E304

Fatty acid esters of ascorbic acid

E306

Tocopherols

E307

Alpha-tocopherol

E308

Gamma-tocopherol

E309

Delta-tocopherol

E310

Propyl gallate

E311

Octyl gallate

E312

Dodecyl gallate

E315

Erythorbic acid

E316

Sodium erythorbate

E319

Tertiary-butyl hydroquinone (TBHQ)

E320

Butylated hydroxyanisole (BHA)

E321

Butylated hydroxytoluene (BHT)

E392

Extracts of rosemary

E586

4-Hexylresorcinol

 Sweeteners

 

E420

(i) Sorbitol

(ii) Sorbitol syrup

E421

Mannitol

E950

Acesulfame K

E951

Aspartame

E952

Cyclamic acid and its Na and Ca salts

E953

lsomalt

E954

Saccharin and its Na, K and Ca salts

E955

Sucralose

E957

Thaumatin

E959

Neohesperidine DC

E960

Steviol glycoside

E961

Neotame

E962

Salt of aspartame-acesulfame

E964

Polyglycitol syrup

E965

(i) Maltitol

(ii) Maltitol syrup

E966

Lactitol

E967

Xylitol

E968

Erythritol

E969

Advantame

 Emulsifiers, Stabilisers, Thickeners and Gelling Agents

 

E322

Lecithins

E400

Alginic acid

E401

Sodium alginate

E402

Potassium alginate

E403

Ammonium alginate

E404

Calcium alginate

E405

Propane-1,2-diol alginate

E406

Agar

E407

Carrageenan

E407a

Processed eucheuma seaweed

E410

Locust bean gum; carob gum

E412

Guar gum

E413

Tragacanth

E414

Acacia gum; gum arabic

E415

Xanthan gum

E416

Karaya gum

E417

Tara gum

E418

Gellan gum

E425

Konjac

E426

Soybean hemicellulose

E427

Cassia gum

E432

Polyoxyethylene sorbitan monolaurate; Polysorbate 20

E433

Polyoxyethylene sorbitan mono-oleate; Polysorbate 80

E434

Polyoxyethylene sorbitan monopalmitate; Polysorbate 40

E435

Polyoxyethylene sorbitan monostearate; Polysorbate 60

E436

Polyoxyethylene sorbitan tristearate; Polysorbate 65

E440

Pectins

E442

Ammonium phosphatides

E444

Sucrose acetate isobutyrate

E445

Glycerol esters of wood rosins

E460

Cellulose

E461

Methyl cellulose

E462

Ethyl cellulose

E463

Hydroxypropyl cellulose

E464

Hydroxypropyl methyl cellulose

E465

Ethyl methyl cellulose

E466

Carboxy methyl cellulose

E468

Crosslinked sodium carboxy methyl cellulose

E469

Enzymatically hydrolysed carboxy methyl cellulose

E470a

Sodium, potassium and calcium salts of fatty acids

E470b

Magnesium salts of fatty acids

E471

Mono- and diglycerides of fatty acids

E472a

Acetic acid esters of mono- and diglycerides of fatty acids

E472b

Lactic acid esters of mono- and diglycerides of fatty acids

E472c

Citric acid esters of mono- and diglycerides of fatty acids

E472d

Tartaric acid esters of mono- and diglycerides of fatty acids

E472e

Mono- and diacetyltartaric acid esters of mono-
and diglycerides of fatty acids

E472f

Mixed acetic and tartaric acid esters of mono-
and diglycerides of fatty acids

E473

Sucrose esters of fatty acids

E474

Sucroglycerides

E475

Polyglycerol esters of fatty acids

E476

Polyglycerol polyricinoleate

E477

Propane-1,2-diol esters of fatty acids

E479b

Thermally oxidised soya bean oil interacted with mono­ and diglycerides of fatty acids

E481

Sodium stearoyl-2-lactylate

E482

Calcium stearoyl-2-lactylate

E483

Stearyl tartrate

E491

Sorbitan monostearate

E492

Sorbitan tristearate

E493

Sorbitan monolaurate

E494

Sorbitan monooleate

E495

Sorbitan monopalmitate

E1103

Invertase

 Others

 Acid, acidity regulators, anti-caking agents, anti-foaming agents, bulking agents, carriers and carrier solvents, emulsifying salts, firming agents, flavour enhancers, flour treatment agents, foaming agents, glazing agents, humectants, modified starches, packaging gases, propellants, raising agents and sequestrants.

 

E260

Acetic acid

E261

Potassium acetate

E262

Sodium acetate

E263

Calcium acetate

E270

Lactic acid

E290

Carbon dioxide

E296

Malic acid

E297

Fumaric acid

E325

Sodium lactate

E326

Potassium lactate

E327

Calcium lactate

E330

Citric acid

E331

Sodium citrates

E332

Potassium citrates

E333

Calcium citrates

E334

Tartaric acid (L-(+))

E335

Sodium tartrates

E336

Potassium tartrates

E337

Sodium potassium tartrate

E338

Phosphoric acid

E339

Sodium phosphates

E340

Potassium phosphates

E341

Calcium phosphates

E343

Magnesium phosphates

E350

Sodium malates

E351

Potassium malate

E352

Calcium malates

E353

Metatartaric acid

E354

Calcium tartrate

E355

Adipic acid

E356

Sodium adipate

E357

Potassium adipate

E363

Succinic acid

E380

Triammonium citrate

E385

Calcium disodium ethylene diamine tetra-acetate;
calcium disodium EDTA

E422

Glycerol

E423

Octenyl succinic acid modified gum Arabic

E431

Polyoxyethylene (40) stearate

E450

Diphosphates

E451

Triphosphates

E452

Polyphosphates

E459

Beta-cyclodextrin

E499

Stigmasterol-rich plant sterols

E500

Sodium carbonates

E501

Potassium carbonates

E503

Ammonium carbonates

E504

Magnesium carbonates

E507

Hydrochloric acid

E508

Potassium chloride

E509

Calcium chloride

E511

Magnesium chloride

E512

Stannous chloride

E513

Sulphuric acid

E514

Sodium sulphates

E515

Potassium sulphates

E516

Calcium sulphate

E517

Ammonium sulphate

E520

Aluminium sulphate

E521

Aluminium sodium sulphate

E522

Aluminium potassium sulphate

E523

Aluminium ammonium sulphate

E524

Sodium hydroxide

E525

Potassium hydroxide

E526

Calcium hydroxide

E527

Ammonium hydroxide

E528

Magnesium hydroxide

E529

Calcium oxide

E530

Magnesium oxide

E535

Sodium ferrocyanide

E536

Potassium ferrocyanide

E538

Calcium ferrocyanide

E541

Sodium aluminium phosphate

E551

Silicon dioxide

E 552

Calcium silicate

E553a

(i) Magnesium silicate

(ii) Magnesium trisilicate

E553b

Talc

E554

Sodium aluminium silicate

E555

Potassium aluminium silicate

E556

Aluminium calcium silicate

E559

Aluminium silicate; Kaolin

E570

Fatty acids

E574

Gluconic acid

E575

Glucono delta-lactone

E576

Sodium gluconate

E577

Potassium gluconate

E578

Calcium gluconate

E579

Ferrous gluconate

E585

Ferrous lactate

E620

Glutamic acid

E621

Monosodium glutamate

E622

Monopotassium glutamate

E623

Calcium diglutamate

E624

Monoammonium glutamate

E625

Magnesium diglutamate

E626

Guanylic acid

E627

Disodium guanylate

E628

Dipotassium guanylate

E629

Calcium guanylate

E630

lnosinic acid

E631

Disodium inosinate

E632

Dipotassium inosinate

E633

Calcium inosinate

E634

Calcium 5'-ribonucleotides

E635

Disodium 5'-ribonucleotides

E640

Glycine and its sodium salt

E641

L-leucine

E650

Zinc acetate

E900

Dimethylpolysiloxane

E901

Beeswax, white and yellow

E902

Candelilla wax

E903

Carnauba wax

E904

Shellac

E905

Microcrystalline wax

E907

Hydrogenated Poly-1-Decene

E912

Montan acid esters

E914

Oxidised Polyethylene wax

E920

L-Cysteine

E927b

Carbamide

E938

Argon

E939

Helium

E941

Nitrogen

E942

Nitrous oxide

E943a

Butane

E943b

Iso-butane

E944

Propane

E948

Oxygen

E949

Hydrogen

E999

Quillaia extract

E1200

Polydextrose

E1201

Polyvinylpyrrolidone

E1202

Polyvinylpolypyrrolidone

E1203

Polyvinyl alcohol

E1204

Pullulan

E1205

Basic methacrylate copolymer

E1206

Neutral methacrylate copolymer

E1207

Anionic methacrylate copolymer

E1208

Polyvinylpyrrolidone-vinyl acetate copolymer

E1209

Polyvinyl alcohol-polyethylene glycol-graft- co-polymer

E1404

Oxidised starch

E1410

Monostarch phosphate

E1412

Distarch phosphate

E1413

Phosphated distarch phosphate

E1414

Acetylated distarch phosphate

E1420

Acetylated starch

E1422

Acetylated distarch adipate

E1440

Hydroxyl propyl starch

E1442

Hydroxy propyl distarch phosphate

E1450

Starch sodium octenyl succinate

E1451

Acetylated oxidised starch

E1452

Starch aluminium Octenyl succinate

E1505

Triethyl citrate

E1517

Glyceryl diacetate (diacetin)

E1518

Glyceryl triacetate; triacetin

E1519

Benzyl alcohol

E1520

Propan-1,2-diol; propylene glycol

E1521

Polyethylene glycol

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