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Brit1988 08-29-2012 07:40 AM

Nut allergy & elevated IgE levels
I got blood test results back to day for a nut allergy. It turns out I'm allergic to Brazil nuts (to a life threatening degree), Almonds (to a moderate degree) and Hazel nuts (to a high degree). I'm not allergic to peanuts. The results also show I have very highly elevated levels of IgE in my blood.

This correlates with my past experiences of eating peanuts for years without a reaction. But at the start of 2012 I suffered Anaphylaxis after eating a mixed nuts bar containing Brazil nuts and Almonds.

Ever since that experience I've been having a lot of respiratory problems coming and going. Symptoms have included difficulty breathing (especially when laying down or leaning over), chest pain, a rubbing feeling like fluid moving around my lung (externally, not internally), burning sensations and more recently almost constant indigestion. A chest X-Ray in April ruled out lung cancer. The only symptoms that I have right now, today, are a wheezy cough and a strange rumbling sensation when I inhale, a bit like a wheeze without the noise.

Unfortunately it has been a bit of a guessing game getting to the bottom of this. One GP gave me antibiotics, another Naproxen, and today my GP prescribed a 'Seretide 50 Evohaler' for my respiratory symptoms. These are all 'best guesses' as to the underlying condition, but I'd really like to *know* for sure what is going on. I feel a lot closer with these test results in hand, as they point to elevated IgE levels which makes asthma sound a likely candidate. I had childhood asthma but then didn't experience it again for a decade, so these changes surely reflect a shift in my biology that can be tamed, at least to a degree.

But I want to tackle the underlying cause, not plaster over symptoms for the rest of my days. Here are my questions:
[LIST=1][*]What are healthy IgE levels?[*]What are ku/L and kUA/L in U/ml? I can only find guideline levels in the latter unit but my test results are in the former units.[*]Is there anything that can be done to lower my IgE levels?[*]Could this be anything other than a recurrence of asthma? Taking asthma pumps so far hasn't made an impact on many of the physical sensations, though it does seem to help reduce wheezing[/LIST]

Titchou 08-29-2012 03:44 PM

Re: Nut allergy & elevated IgE levels
Getting tested by a pulmonologist would be your best bet to rule out asthma. Not sure how difficult that is to get done in England though.

janewhite1 08-29-2012 05:01 PM

Re: Nut allergy & elevated IgE levels
In the US, a normal IgE level for a person with no allergies at all is 5. 30 is mildly elevated, 100 is normal for someone with asthma, and 1,000+ is very uncommon. Of course, your test may have used different units.

Yes, IgE levels can be lowered in two ways. The cheapest is allergy shots, to desensitize you and reduce your allergic response. Currently we have allergy shots for things like dust, cats, and pollen, but not for nuts. (Scientists are working on it.)

The other way is with a drug called Xolair, but it's so expensive that it's usually only used in people who have severe asthma that can't be controlled through other means.

If you do have asthma, the Seretide should help, although it'll take a couple weeks to see the full benefit.

Brit1988 08-29-2012 05:44 PM

Re: Nut allergy & elevated IgE levels
My IgE level was 492 ku/L, it's unclear whether that's the same units you are using but it sounds about right. My doctor seemed quite concerned when conveying the information to me!

janewhite1 08-29-2012 07:05 PM

Re: Nut allergy & elevated IgE levels
If it is the same unit, an IgE count of 492 would be someone who's very allergic to something, although it really isn't abnormally high for an allergic person.

One thing that might help is skin scratch testing, to identify any other allergies you have. Blood tests are best for food allergies, but skin tests are best for air allergies like pollen.

Brit1988 08-29-2012 07:27 PM

Re: Nut allergy & elevated IgE levels
I'm having trouble sleeping tonight.

I went for a jog today and put quite a bit of stress on my chest, perhaps stupid but I was just fed up with being paralysed by this condition. I felt good when I was doing it, but it's the first proper physical activity in a couple of weeks. I also started with the new inhaler taking it 2 times twice today.

But this evening and especially now my right lung seems to be tighter than it was earlier. I can't take a full breath, and it's making me anxious and a bit light-headed. A moment ago I got chills and started shivering, but I put a dressing gown on, made a cup of tea and put the heating on, which has brought that under control. There was a cool breeze coming in but it's still 23 celcius, nothing so cold I should be shivering.

Edit: Bah this sucks. I try to breathe and my right lung feels like a stretched muscle being used. When I breathe I feel all this rumbling going on in there like something isn't right. I cough and I wheeze... what is this?! It's so frustrating. To top it off I think this shortness of breath may have triggered a panic attack which is what prompted me to make this post.

Being on here makes me feel better than laying in bed did though...

ladybud 08-29-2012 08:53 PM

Re: Nut allergy & elevated IgE levels
Asthma normally doesn't cause one sided symptoms. I think it would be wise to have a repeat chest xray now to rule out something going on in the right lung. Particularly if you are having chills. I would also check your temp after chills to see if you actually have a fever. A pulmonologist would want to do pulmonary function tests and possibly a CT scan of your chest. The constant indigestion could be related to food allergies, and I would get checked for other food allergies and gluten intolerance. The best way you lower your IGE is to avoid all allergens, as much as possible. That of course requires identifying all allergens and controlling your environment and food intake accordingly. The IGE is an immunoglobulin (antibody) made by your immune system in response to exposure to things you are sensitive to. Your results indicate you are probably allergic to many things or have severe allergies to some things, obvious by your nut allergy. I would recommend you get an RX for an Epipen and carry Benadryl with you at all times in the event you accidently ingest something with brazil nuts again.

Brit1988 08-30-2012 03:37 AM

Re: Nut allergy & elevated IgE levels
Thanks for the tips. I couldn't get to sleep until about 3:30am and only got 4-5hrs sleep. I got about 2hrs then woke up, then another 3hrs and woke up again. It feels a lot clearer this morning than it did when I went to sleep, but not cleared entirely.

Do you think it'd be a good idea for me to take a hayfever tablet each day? We have some in the cupboard which also suppress reactions to dust and mould, which are also likely candidates for the irritation. It should be okay to combine that with the asthma pump?

Edit: Just so you know, that was by far the worst night I've had in ages. It was getting better for the week or two prior to last night, then suddenly got worse. I'm wondering if running or using the asthma pump may have caused that, because my diet and environment didn't change much, but those were two new elements introduced yesterday.

Titchou 08-30-2012 05:16 AM

Re: Nut allergy & elevated IgE levels
Absolutely take an antihistamine every day. Zyrtec - cetirizine over there - is a very good across the board one.

ladybud 08-30-2012 08:57 AM

Re: Nut allergy & elevated IgE levels
Loratidine and fexofenadrine are good anti-drowsy antihistamines, OTC as well. Fexo is a little stronger (Allegra). It is possible that running exaccerbated your asthma, as many people have asthma that is induced by exercise. You can ward that off by using your inhaler a few minutes prior to exercising, do slow warm-up, keep exercise moderate and steady, rather than very strenuous with sprint-like pushes, and avoid excercise outdoors on polluted days or days when pollen count very high, cold and damp weather.

Brit1988 08-30-2012 11:17 AM

Re: Nut allergy & elevated IgE levels
I took an allergy tablet a couple of hours ago (Piriteze, which is similar to Zyrtec).

Though I wouldn't expect instant results, there's still a weird sensation when inhaling in my right lung. I can only describe it like a muscle grinding against other muscle or a bone, it resembles the vibrations you'd expect from a kind of friction. It's painless, but definitely doesn't feel right and stops me short of completing a deep breath.

I'll be contacting a respiratory clinic tomorrow to see if I can book an appointment for a specialist diagnosis. I'll also keep this thread updated as things progress and hopefully it can save others going through as many delays and misdiagnosis as I have!

Edit: @'ladybud' - there's a reason I don't think it's that kind of activity-induced asthma. It doesn't affect me at all during the activity or even for hours afterwards. It feels more like the "jolts" my lung gets from the running are what is doing the damage. When I was a child I had asthma induced by physical activity, and that used to feel totally different to this. I would have to stop during the activity because my airway would be closing up. But when I was running yesterday I felt fine during that and even for a good 6 hours afterwards. If anything I felt better during the activity than when I was sat at home.

ladybud 08-30-2012 02:36 PM

Re: Nut allergy & elevated IgE levels
Ok, I agree. The friction you are feeling could be pleurisy or a pleural effusion (fluid) collection. That usually causes pain with a deep breath, and should definitely be checked out with a listen to lungs and xray. It can occur for a variety of reasons, so I am glad you are making an appt.

janewhite1 08-31-2012 12:02 AM

Re: Nut allergy & elevated IgE levels
Keep in mind, sometimes folks get an asthma attack during exercise, but sometimes it comes a few hours later, when the body relaxes AFTER exercise.

Or, there could be something else going on. I have no way to know.

Brit1988 09-25-2012 05:18 PM

Re: Nut allergy & elevated IgE levels
Okay. So I promised I would update this thread with my progress... I did not see the private clinic in the end, they were too expensive.

But as per the OP, the new stronger asthma pump (Seretide 50, which I'm told has steroids in it) and allergy tablets combined have had an amazing effect over time. It is at the stage where I have forgetten to take the pump and tablets on occasion. Unfortunately today I'm feeling some of the old symptoms (some shortness of breath) and I woke up with a swollen / sore throat this morning so the two may be linked.

Hopefully this current feeling clears up by the morning, and I'm quietly confident it will. But overall I'm happy to report that I've been able to lead a completely normal and symptom/anxiety free life for about a month now. Appreciating the things I do have a lot more, I made great use of that time and packed as much fun and events in to it as I could. It's partly because I'm feeling some symptoms now that I remembered to update this thread. The problem and anything related to it hasn't been on my mind at all for the last few weeks.

BubblBoy 11-04-2012 01:35 PM

Re: Nut allergy & elevated IgE levels
My sons IgE level is 8088 and I still don't understand. I have put up a post about this cos from my knowledge he is not having anything he is allergic to. In NZ the normal rate is between 0-150. I find doing a RAST test AND skin ***** test is best. His dairy, dog and soy allergy does not show on a skin ***** test but does on a RAST. Good luck

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