Here’s what could really be causing those troubling symptoms…

If you escaped allergies as a child or a young adult, then you’re home free now, right? Well…maybe not. And if you have had allergies for years, then you surely know exactly what triggers a reaction, right? Not necessarily.

These are just two of the instances when people can get walloped by hidden allergies. 

NEVER TOO OLD

Contrary to popular belief, a first-time allergy can occur at any age. While the reasons are not completely understood, it’s believed that adult-onset environmental allergies can occur when people move to a new area (and get exposed to different allergens)…or when a genetic predisposition to react to an environmental or food allergen finally kicks in after years of being exposed to it.

Takeaway: If you have typical allergy symptoms, including sneezing, coughing and itchy eyes (telltale signs of, say, springtime allergies)…or nausea, diarrhea and itchy hives (common red flags for food allergies), do not rule out allergies just because you’ve never suffered from them before. See your doctor for advice and possible allergy testing.

COMMON ALLERGY MIX-UPS

Allergies are a tricky health problem—largely because people tend to self-diagnose based on what they believe to be their allergic trigger. But that can lead to mix-ups, as allergies, related to those below, go undetected…

Tree pollen. While most hay fever sufferers have zeroed in on tree pollen as the culprit, they often fail to realize that having this allergy means that they may also react to tree fruits, such as apples, pears or peaches, and tree nuts, such as walnuts. For these people, exposure to tree fruits or tree nuts can set off the same immune response as pollen. This so-called oral allergy syndrome (OAS) may cause swelling and irritation in the mouth, lips and throat.

What to do: Cooking these fruits may help. Otherwise, avoiding these fruits and nuts (as well as melons, which also may cause symptoms) is the simplest solution.

Pet fur. People who get watery eyes or start sneezing around pets often assume that they’re allergic to the pet’s fur…and look for a dog or cat breed that’s touted as “hypoallergenic”—a loosely defined term that usually suggests the animal’s fur produces fewer allergens.

But this often does not help, because animal fur is typically not the allergen—it’s almost always pet dander (shedding skin flakes) and/or saliva, each of which contains proteins that trigger the allergic immune response. Even hypoallergenic pets produce at least some dander—and all pets groom themselves, leaving bits of saliva on their fur.

What to do: If you are allergic but want a pet, try grooming the animal frequently, isolating the pet to certain areas of the house and using a high-efficiency particle arresting (HEPA) air-filtration system.

Chocolate. If a piece of chocolate causes symptoms, such as a rash or trouble breathing, the actual culprit may be one of its ingredients, such as soy lecithin, milk or nuts.

What to do: Get checked to see if you’re allergic to cocoa, the health-promoting substance in chocolate. If you’re not, get further testing to reveal the true source of your allergy, which then can be avoided.

Alcohol. Many people who drink wine, beer and/or hard liquor experience flushed skin, itching, nasal congestion and even an elevated heart rate. For some individuals, protein residues from the alcoholic beverage cause the reaction.

But for many others, the trigger is actually sulfites, chemicals that act as a preservative and prevent the growth of mold or bacteria. Other examples of foods and drinks that may contain sulfites: Dried fruits…soft drinks…cookies…crackers…noodle or rice mixes…and shellfish. For a more detailed list, go to: Sulfites.org/sulfite-foods/.

What to do: If testing shows that you are allergic to sulfites, read labels and avoid products that contain this additive. It can also be listed on the label in one of various forms, such as potassium bisulfate…sulfur dioxide…and potassium metabisulfite. Note: Alcoholic beverages also may contain contaminants, such as gluten and yeast, that may require further testing by a doctor.

BEST TESTING OPTIONS

The only way to know for sure that you have an allergy is to undergo allergy testing. If you are truly allergic to something, your immune system mistakes an otherwise harmless substance for an intruder, producing immunoglobulin E (IgE) antibodies. Two main types of tests identify environmental allergies (such as pollen, dust, mold, etc.) and food allergies (such as peanuts, eggs, soy, milk, etc.)…

Skin tests. A suspected allergen is introduced into the body by pricking, scratching or injecting it into the skin—or by applying a skin patch coated with it.

Blood tests. These tests can be used if the doctor is concerned about a dramatic skin reaction that could cause a severe allergic response…or if a person has psoriasis or some other skin condition that could be aggravated by skin testing.

For example, with the radio allergosorbent test (RAST), a sample of your blood is exposed to a suspected allergen.

Note: Sometimes you may not have an actual allergy, but rather a sensitivity that produces allergy-type symptoms when you are exposed to the substance. A separate test is needed to identify an environmental or a food sensitivity.

THE RIGHT DOCTOR TO SEE

To get an accurate diagnosis, it’s fine to start with a family physician who is well versed in allergies. If you suspect a food allergy, be sure the doctor is experienced in this problem. Other options…

Allergists/immunologists may be the best choice for difficult cases. To find one near you, consult the American Academy of Allergy, Asthma & Immunology, AAAAI.org.

Integrative medicine physicians, who identify allergies as an aspect of overall health, are another choice. To find one near you, check the American Board of Integrative Holistic Medicine website, ABIHM.org, and search “allergy/immunology” in the specialty field.

Naturopathic physicians can also be helpful, especially in offering guidance on diet and the use of supplements (such as butterbur and quercetin). To find a naturopathic physician, consult the American Association of Naturopathic Physicians, Naturopathic.org.