Peanut allergies have plummeted in children

One of my conspiracy theories that I loosely hold is that the majority of the fears that we have been sold on allergies was a direct result of marketing efforts by the inventors of the Epipen.

Anaphylactic shock is extremely rare. And even in cases of anaphylactic shock, it's only fatal in an even rarer number of cases (which makes sense, anaphylactic shocks is a biological reaction of your body to save itself, not kill itself).

We really don't know how many lives emergency epinephrine has saved, but it may have only been necessary in less than 1 out of 50 cases. However, it benefitted the manufacturer to overemphasize the prevalence of dangerous food allergies and the risks of shock and encourage doctors to prescribe them in increasingly more "just in case" cases".

It's in this world that parents and doctors alike became insanely cautious and paranoid about introducing allergens. Conveniently, we saw the rise of simpler, more highly processed baby and childrens' foods at the same time.

I could get onboard with your theory that Epipens are overused (or at least over prescribed). But I really don't agree that when someone can't breath we should "wait and see because it's the body trying to save itself", though.

Children of Gen X and Millenials have been ruined by their helicopter/bubble parents, they have allergies and that's that. Future generations can and must learn from their mistake, but we can't force allergic people to simply grow out of it. We're not talking itchy throats here.

My inclination is to say it is all hypochondria, that it's a slander against peanut farmers, etc. I know a lot of women, for instance, who don't like insects and are terrified that they might get stung by a bee or a hornet because they don't know if they are allergic to stings because they've never been stung.

On the other hand, I've seen kids have a bad reaction to peanuts and the tiniest dose can be dramatically dangerous.

I think of how allergies to wheat were fashionable before COVID but seem to have been forgotten about in all the confusion. Now there is such as thing as a wheat allergy and I know people who eat the tiniest amount of gluten and their GI tract purges everything in both directions. I know about 10x as many people who have vague symptoms such as "bloating" or nonspecific fatigue who get told by an alternative health practitioner to go gluten free... and instead of eating traditional preparations of other cereals and pseudo-cereals (e.g. a bowl of rice) they seem to think life begins with sandwiches and ends with baked goods and eat nothing but sawdust "bread".

I'm not a doctor but it feels like there are a lot of holes here.

> Anaphylactic shock is extremely rare

~5% of people in the US have experienced anaphylaxis, but I don't know your definition of rare.

> it's only fatal in an even rarer number of cases

Could this be due to epipens being commonly carried by people likely to experience anaphylaxis?

> anaphylactic shocks is a biological reaction of your body to save itself, not kill itself

Because it is an immune response? Is the implication here that anaphylactic shock is actually a good thing?

And focusing on the conspiracy part itself

> the majority of the fears that we have been sold on allergies was a direct result of marketing efforts by the inventors of the Epipen.

Implying the increase in EpiPen prescriptions caused people to be more cautious about food allergies feels exactly backwards.

> it may have only been necessary in less than 1 out of 50 cases.

Ok but who want's to be the one that needs it and can't get it?

https://www.breakingnews.ie/ireland/family-of-teen-who-died-...

>anaphylactic shocks is a biological reaction of your body to save itself, not kill itself

The idea that everything the body does is harmless natural magic that should be allowed to run it's course is killing people.

> Could this be due to epipens being commonly carried by people likely to experience anaphylaxis?

The tricky thing with the data set available to us is that anaphylactic deaths are so rare that it's hard to establish meaningful findings: https://pmc.ncbi.nlm.nih.gov/articles/PMC4382330/

We do know though that hospitalization rates are about the same for people who take epinephrine vs those that don't. The speed at which they get to the ER seems to have a bigger impact on the recovery from the reaction than the Epipens do: https://www.sciencedirect.com/science/article/abs/pii/S10811...

> Implying the increase in EpiPen prescriptions caused people to be more cautious about food allergies feels exactly backwards.

How so? Bringing awareness to risk in general makes people more cautious. Advertising crime rates in your town to sell you a security system will overall make people feel less secure.

I agree with your point about eating traditional preparations of grains being less problematic and many people seemingly not thinking about that at all for some reason even when they run into problems.

But, I think it may go a step further than that. If we zoom out on the timeline to the span of human evolution, eating grass seeds as a significant part of the diet is very, very, very strange. It wouldn’t surprise me if some human subpopulations, especially those who adopted agriculture later on, aren’t suited to eating grass seeds at all. And I’m just thinking about within European subpopulations. There were people roaming around the steppe when others were long settled. And beyond even that, the population increase enabled by wheat et al could plausibly produce a large enough competitive advantage for the group that some individuals having tummy problems probably would not register much on the selection pressure meter back in those days.

I’ve come around to the idea that wheat sensitivity is probably real. I used to be quite skeptical also. I think if you told someone 30,000 years ago that the earth would be full of people eating mainly grass seeds, they would find the idea completely ridiculous.

Per TFA, it's mainly children of Boomers and Gen X and the trend is now reversing with Millenial children.

Add allergies to the list of things Millenials killed I guess.

> ~5% of people in the US have experienced anaphylaxis, but I don't know your definition of rare.

What's your source here, and how many of those people actually experienced a non-allergic one-off angioedema that was misdiagnosed as anaphylaxis "just in case"? Or worse, wasn't even diagnosed, their parent saw them experience angioedema after eating something for the first time and assumed an allergy without any diagnosis ever?

> But I really don't agree that when someone can't breath we should "wait and see because it's the body trying to save itself", though.

I'm absolutely NOT arguing that and I thought my post made it very clear that epinephrine does save lives.

But the overrepresented sense of fear actively made our kids less safe.

If they were having an active anaphylactic reaction, they should have gone to the ER, not trying to buy an Epipen. Even when an Epipen is administered as directed, it is only to buy time to get to the hospital.

> The idea that everything the body does is harmless natural magic that should be allowed to run it's course is killing people.

Not sure where you got this from my point that the risk is overemphasized.

>Not sure where you got this from

Your original post.

>which makes sense, anaphylactic shocks is a biological reaction of your body to save itself, not kill itself).

i think you misunderstood something here, anaphylactic shock is by definition a medical emergency.

> We do know though that hospitalization rates are about the same for people who take epinephrine vs those that don't

An EpiPen is not a cure, and you are told that if you use an EpiPen you should also go to the hospital. An EpiPen essentially keeps you alive long enough to receive care.

> The speed at which they get to the ER seems to have a bigger impact on the recovery from the reaction than the EpiPens do

If you have anaphylaxis without an EpiPen, the first thing the ambulance/ER will do is almost certainly inject epinephrine.

I really encourage you to ask a doctor. It is not enough to read papers and draw conclusions without understanding the broader context. I am not a doctor, but have talked to a doctor about carrying an EpiPen.

> The tricky thing with the data set available to us is that anaphylactic deaths are so rare that it's hard to establish meaningful findings

Again, could this be because there is such abundant access to life saving medication, that you are arguing against?

"Anaphylaxis in America: the prevalence and characteristics of anaphylaxis in the United States"

> The most common triggers reported were medications (34%), foods (31%), and insect stings (20%)

https://pubmed.ncbi.nlm.nih.gov/24144575/

not a doctor but a "one off face swelling" after eating something for the first time seems like it would be much more rare than an actual allergic reaction.

> Again, could this be because there is such abundant access to life saving medication, that you are arguing against?

I'm not at all arguing that Epipens don't save lives or that doctors shouldn't prescribe them or that you shouldn't carry one.

Let me reframe my argument: Crime is a real risk no matter where you live in this country. But we should not be surprised that people that sell you security are incentivized to scare you about the risk of crime or its randomness.

I would not say people shouldn't take whatever precautions they need against crime, but don't think it's controversial to say the risk is overstated.

It's easy enough to say that never stepping outside of your house because crime exists is a silly conclusion to make. But people for some reason thought it was completely normal to deprive children of exposure to large swaths of the food pyramid despite no underlying history or diagnosis because a risk was overstated to them.

Still, I am admitting that my targeting of Epipens in particular something of a crackpot argument. But also we live in a world still reeling from the effects of the Sackler family and the marketing they used on the medical industry - would it be that far fetched if we learned in 20-30 years that the life saving ability of emergency epinephrine was overstated for profit?

Most gluten sensitivities aren't allergies. There is no histamine reaction.

In a lot of cases patients who think they have a gluten intolerance are actually having a bad reaction to one of the many other chemicals that typically come along with gluten. They can test this by consuming pure food-grade gluten with nothing else (not medical advice, check with your doctor).

That's what I thought too, until I had a one off face swelling and throat closing event after eating a new food and went to an allergist, only to learn I was not allergic and have had successful re-eatings of that food.

What I learned from the allergist is, histamine angioedema is essentially the same thing as anaphylaxis, and is treated the same, but is different in cause in that repeat exposure to the food item will not cause a repeat episode.

I'm not a doctor either, but according to my allergist (who is), most people who think they are allergic to some random thing that most people have never heard of people being allergic to, are not in fact allergic to that thing.

Reading the full text of the article you linked it looks like their criteria cover both angioedema and anaphylaxis and add the two together.

Here's some additional info:

https://knyamed.com/blogs/difference-between/angioedema-vs-a...

https://emcrit.org/ibcc/angioedema/#diagnosis_of_angioedema

Anaphylaxis is only fatal in ~0.3% of cases that required hospitalization.

https://www.jacionline.org/article/S0091-6749(13)02738-3/ful...

"Although anaphylactic reactions are potentially life threatening, the probability of dying is very low for those cases that require ED or hospital attention, and is likely much lower when all anaphylactic reactions are considered."

I think you misunderstood me. The risk of your immune system going haywire and killing you is a real risk and worthy of medical attention. But I think we are really overstating the prevalence of how many people have an immune system ready to self-destruct them.

yes i think i did misunderstand a little.

Anecdotally a relative recently found out they have a gluten intolerance and while a lot of people would think it's a fad kids latch onto (implied by someone elsewhere in this topic), it actually took a while for it to be identified.

The assumption was they just had anxiety which was causing physical symptoms until they had a blood test that identified the antibody.

Seeing a lot of "illness X is fake" on here and elsewhere lately so i wrongly perceived it here.

I don't know about this one, sounds a bit like anaphylactic shock isn't a big deal because we've made good strides in actually helping people manage and treat it. Which is a good thing, but we can't understate its severity.

Also, our bodies are good at doing things which are technically trying to save us, but actually kill us that doesn't mean we sit idle and do nothing about it, the same is for fevers.

Anaphylactic shock is the body reacting to protect itself against something that isn't actually harmful, but it is doing so to such an extreme that in many cases it kills you.

It's easy to look back at something as a conspiracy when the very impact of it has been mitigated for the average person due to proper healthcare.

It's partly due to certain doctors deciding to tell parents NOT to give peanuts to kids until much later. Even after peanut allergies spiked 3x, they wouldn't change their recommendation - until they had studies to prove the recommendation they were giving was wrong (which they based on no study, "let's try banning peanuts for toddlers...").

see https://www.preventallergies.org/blog/why-are-peanut-allergi...

The bloating and non-specific fatigue you mention are symptoms of Celiac disease or gluten insensitivity.

Rather than go to an alternative health practitioner people should just go to an actual doctor and ask them to schedule a blood test. It's an easy thing to test for, so if the doctor won't do it then find another doctor or just go to a lab.

Yes? It's silly to think Big Epipen is out to get you. I don't even know what you think your point is.

We do the best with the information we have. If in 30 years, the standard of care changes due to new consensus, that's a good thing. It doesn't mean everyone is an eeeeeevil moneygrubbing whatever, it just means we have more information.