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ALLERGIES 101 — THE BASICS

Let's cover the basics, one step at a time

Understanding allergies is the first step towards recognising them, managing them and supporting those who live with them. Below, we explain what allergies are, the different types of allergic diseases, and how allergies develop.

What is an allergy?

An allergy happens when the immune system reacts to a substance that is normally harmless. This substance is called an allergen.

In simple terms:

  • Your immune system protects your body from things that can make you ill, such as germs.
  • With an allergy, the immune system mistakenly sees a harmless substance as a threat.
  • This can include foods such as peanuts, eggs or milk, as well as things like pollen, dust mites or animal dander.
  • The immune system then releases chemicals that cause allergy symptoms.
  • This is called an allergic reaction.

Types of allergic diseases

Allergies can affect different parts of the body and cause a wide range of symptoms. Some allergic conditions are mild, while others can be serious.

Common allergic conditions include:

  • Hay fever (allergic rhinitis) – sneezing, runny or blocked nose, itchy or watery eyes
  • Food allergy – an immune reaction to specific foods such as peanuts, tree nuts, milk, eggs, wheat, soy, fish, shellfish and sesame
  • Atopic dermatitis (eczema) – dry, itchy and inflamed skin
  • Allergic asthma – wheezing, coughing or difficulty breathing triggered by allergens
  • Insect venom allergy – allergic reactions to stings from insects such as bees and wasps
  • Drug allergy – an allergic reaction to certain medicines, such as some antibiotics

Different types of allergens

Allergic reactions can be triggered by many different substances, including:

  • Food: peanuts, tree nuts, milk, eggs, fish, shellfish and other foods
  • Airborne allergens: pollen, house dust mites and animal dander
  • Insect venom: bees, wasps and other stinging insects
  • Contact allergens: substances such as nickel or certain ingredients in cosmetics and detergents
  • Medicines: certain antibiotics and other medications

Allergy vs. intolerance vs. anaphylaxis

  • Allergy: An immune system reaction to a normally harmless substance. It can cause symptoms affecting different parts of the body and can sometimes be life-threatening.
  • Intolerance: A reaction that does not involve the same immune response as an allergy. It often causes digestive symptoms and is generally not life-threatening.
  • Anaphylaxis: A severe, potentially life-threatening allergic reaction that can develop quickly. It requires immediate treatment with adrenaline when prescribed.
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QUICK TIP

Anaphylaxis doesn’t always look the same. If you suspect anaphylaxis, act quickly – don’t wait for symptoms to become severe.

EU REGULATION

The 14 allergens that must be declared in food

Milk

Lupin

Celery

Fish

Gluten

Eggs

Crustaceans

Molluscs

Mustard

Tree Nuts

Peanuts

Sesame

Soya

Sulphites

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DID YOU KNOW?

The EU recognises 14 allergen groups that must be declared when present in food. But people can be allergic to many other foods too. The list of 14 is a legal labelling requirement – it is not a list of all foods that can cause allergies.

Want to know more?

Find detailed information about allergen labelling, the 14 regulated allergens and your rights as a consumer on the Luxembourg Food Safety Authority website.

DIAGNOSING A FOOD ALLERGY

Diagnosing a food allergy starts with a detailed medical history and an assessment of the symptoms and circumstances surrounding a reaction. Your allergist may then use one or more tests to help confirm the diagnosis.

Skin prick test

A skin prick test can help identify whether your immune system has produced IgE antibodies to a particular allergen.

  • A small amount of the suspected allergen is placed on the skin.
  • The skin is gently pricked so the allergen can enter the surface.
  • If you are sensitised, a small, itchy swelling may develop.
  • Results are usually available within 15–20 minutes.
  • A positive test shows sensitisation, but does not necessarily mean that you have a clinical food allergy.

Blood test

A blood test can measure food-specific IgE antibodies.

  • A blood sample is taken and analysed for IgE antibodies to specific allergens.
  • It can be useful when skin testing isn’t suitable or when additional information is needed.
  • As with a skin prick test, a positive result shows sensitisation and does not automatically confirm a food allergy.
  • Your allergist will interpret the result together with your medical history and symptoms.

Oral food challenge

An Oral Food Challenge (OFC) is a medically supervised procedure used to confirm or rule out a food allergy or to determine whether someone has developed tolerance.

How it works:

  • The patient is given small, gradually increasing amounts of the suspected food.
  • The food is given under strict medical supervision.
  • The patient is monitored closely for signs of an allergic reaction.
  • Emergency treatment is immediately available if a reaction occurs.

An oral food challenge is considered the reference standard (gold standard) for diagnosing food allergy when the diagnosis cannot be established with the medical history and other tests alone.

⚠️ An oral food challenge should never be attempted at home. It must be carried out by appropriately trained healthcare professionals in a setting equipped to manage an allergic reaction.

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DID YOU KNOW?

The EU recognises 14 allergen groups that must be declared when present in food. But people can be allergic to many other foods too. The list of 14 is a legal labelling requirement – it is not a list of all foods that can cause allergies.

PREVENTION & TREATMENT

Early Allergen Introduction

Introducing allergenic foods during complementary feeding can help reduce the risk of developing food allergies.

  • Current evidence supports the early introduction of peanut and egg, with CHL recommending the introduction of food allergens between 4 and 6 months.
  • Other allergens, including tree nuts and sesame, can also be introduced during the first year of life, in an age-appropriate and safe form.
  • Do not unnecessarily delay the introduction of allergenic foods once complementary feeding begins.
  • Babies with an increased risk of allergy – for example, those with a parent or sibling with a food allergy, asthma, allergic rhinitis (hayfever) or atopic dermatitis – may benefit from individual medical advice.
  • Babies with significant atopic risk (eczema) may be offered allergy testing before introducing allergens, under the guidance of their healthcare team.
  • Good skin-barrier care is also important, particularly for babies with eczema or very dry skin.


Did you know?
Your skin can play a role in food allergy.
Babies with eczema have a weakened skin barrier, which can make it easier for food proteins to come into contact with the immune system through the skin and contribute to sensitisation.

For example, food proteins left on a baby’s skin after someone has eaten peanut may contribute to sensitisation, particularly when the skin barrier is damaged.

This is one reason why protecting the skin barrier and treating eczema are important parts of food allergy prevention.



Oral Immunotherapy (OIT)

Oral Immunotherapy (OIT) is a medical treatment that can reduce sensitivity to certain food allergens.

  • Small, gradually increasing amounts of the allergen are given according to a structured treatment protocol.
  • The aim is to increase the amount of allergen that can be tolerated and reduce the risk from accidental exposure.
  • OIT is not a cure, and protection generally depends on continuing treatment.
  • It can cause allergic reactions, so it should only be undertaken with appropriately trained healthcare professionals.
  • Your allergist can advise whether OIT is appropriate for you or your child.

New treatments & Research

Food allergy research is moving faster than ever. Scientists are exploring new ways to prevent food allergy, reduce allergic reactions and potentially change the underlying immune response. Current areas of research include:

  • Biologics: medicines that target specific parts of the allergic immune response. Omalizumab, an anti-IgE biologic, has already been approved in the US for reducing reactions from accidental exposure to one or more foods in certain people with food allergy. 
  • New forms of immunotherapy: researchers are studying oral, patch-based (epicutaneous) and sublingual approaches to food allergen immunotherapy. 
  • The microbiome: researchers are investigating how the bacteria living in our gut may influence immune tolerance and food allergy, and whether the microbiome could eventually help predict or improve treatment responses. 
  • Biomarkers and personalised medicine: researchers are looking for better ways to predict who will develop food allergy, who may outgrow it and who is likely to respond to treatment.
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DID YOU KNOW?

There is no cure for food allergy yet, but research is moving fast. New treatments and exciting discoveries are giving us more reasons to be hopeful.

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DID YOU KNOW?

If your baby has severe eczema, an existing food allergy or a strong family history of allergy, talk to your paediatrician or allergist before introducing allergens. They can help you decide on the safest approach.