Q: My 12-year-old with legume allergies had only had mild reactions. Then recently she ate food that turned out to contain soy flour and experienced anaphylaxis. Could this have to do with hormonal changes, since she has only recently hit puberty?
Dr. Sharma: As your daughter’s case illustrates, food allergy reactions are unpredictable, and severe reactions can still occur even if all previous reactions have been mild.
There are several factors that might amplify the severity of a given food allergy reaction. These include: the amount of food allergen consumed; whether the allergic person recently exercised; taking certain medications; or consuming other foods or substances (for instance, alcohol) that might increase the risk of a severe reaction.
In addition, it has been noted that adolescent girls and women may have a heightened risk of severe reaction related to their menstrual cycle, specifically during the premenstrual or ovulatory phases. Presumably, hormonal changes associated with these phases of the menstrual cycle can alter the threshold for a reaction.
Aside from these factors, age is also important, in that severe reactions are more common in teens and young adults. This may be related to increased risk-taking, independence in decision-making, and peer pressure at this stage of life. I’d recommend the Allergic Living article “Food Allergy Meets the Teenage Brain” for more on the age considerations.
Dr. Sharma is an allergist, clinical researcher and associate professor of pediatrics. He is Chief of the Division of Allergy and Immunology at Children’s National Medical Center in Washington D.C. and Director of the Food Allergy Program. He co-authors “The Food Allergy Experts” column in Allergic Living magazine. Questions submitted will be considered for answer in the magazine.Submit a Question View all posts by this medical expert.