The relationship between food allergies and emotional stress

The current consensus among the global allergology community is that emotional stress itself will not directly cause you to develop a certain food allergy, but it will affect the frequency, severity, and recovery speed of allergies in both directions. The relationship between the two is the result of the joint action of the three major systems of nerves, endocrine, and immunity.

Not long ago, I met a 28-year-old Internet operator girl when I was following up in the allergy department. She has been allergic to mangoes for five or six years. In the past, she accidentally ate a bite and the area around her mouth became red and itchy. Apply ointment and it will go away in half a day. That time, she worked overtime for seven days in a row. When she was working overtime in the early morning, her colleague handed her a cup of poplar nectar. She drank less than half of the cup without noticing. Within ten minutes, she was out of breath, and her face was swollen with only a slit left for her eyes. Finally, she called 120 and was taken to the emergency room before she recovered. Later, we rechecked her allergen-specific IgE (the antibody in the body that specializes in allergic reactions). The value was almost the same as when we first checked half a year ago. The only variable was the high-pressure state during that period. Even she laughed and said, "The string was almost broken in those days, and the body's defense also collapsed."

Current mainstream research has attributed this connection to the logic of the "brain-gut-immune axis": when a person is under long-term high pressure, the hypothalamus will continue to secrete cortisol. Short-term cortisol is supposed to help the body fight inflammation, but if it is stretched for too long, the cortisol receptors in the body will be "numb", and the immune response that could have been suppressed will get out of control. The reaction that could be suppressed by the immune system when exposed to a small amount of allergens will explode directly. In addition, 80% of the immune cells on the market stay in the intestines. When you are stressed, the permeability of the intestinal mucosa will increase. Undigested food allergen proteins are more likely to penetrate into the blood and contact immune cells, which is equivalent to giving a green light for allergic reactions.

However, not everyone agrees with this statement. Last year at the National Allergy Annual Conference, a group of public health scholars put forward the completely opposite idea: they tracked the attack data of 1,200 adult food allergy patients for three years and found that the so-called "allergy is more likely to occur when you are stressed" is essentially a result of stress. The resulting behavioral changes are blamed for this - when people are busy, they don't even bother to look at the food ingredient lists, allergens are hidden deeper in the processed foods they eat, stay up late, drink more coffee, and eat less fruits and vegetables. These factors themselves will reduce the body's tolerance to allergens, and have nothing to do with emotional stress itself. Speaking of which, I have actually encountered a similar case. There was a young man who was taking the postgraduate entrance examination and was allergic to wheat gluten. He usually ate the low-gluten bread he made at home just fine. However, he kept getting hives while preparing for the exam. In the end, I found out after reviewing that he was buying the hand cakes downstairs every day to save time. The crust had extra gluten additives added to it, and the gluten content was three times higher than ordinary flour at home. Do you think this is a pressure cooker, or a cooker that doesn't pay attention to diet? Both groups' studies are now supported by data, but the results have not yet been fully concluded.

But one thing is recognized by both sides: food allergies themselves can in turn increase emotional stress and can easily form a vicious cycle. I met a 16-year-old high school student who was severely allergic to nuts. He didn’t even dare to go near the nut section of the supermarket. Last time, the fried rice he ate in the school cafeteria was mixed with some chopped peanuts. His larynx was swollen and he was sent to the emergency room. For the next six months, he didn’t dare to eat out, even at school dinners. I hid and ate boiled vegetables at home every day, and my mood was so bad that I needed psychological consultation. As a result, even if I ate ordinary apples at home during that time, my mouth would occasionally swell, and no new allergens were found after a search. Finally, I received psychological counseling for three months, and the frequency of allergic attacks gradually decreased. Think about it, you have to worry about whether what you eat will kill you every day. When you go out to eat, you have to ask the waiter seven or eight times "Are there nuts/milk/seafood?" This long-term anxiety itself is chronic stress, which will naturally lower the body's tolerance threshold.

My own clinical experience is that whether it is a direct or indirect effect of stress, it never hurts to give allergy patients some tips on emotional management. There is no need for everyone to quit their high-pressure jobs or completely eliminate stress. After all, everyone has to catch up on projects, take exams, and deal with urgent matters. Even if you take 10 minutes a day to go downstairs for a walk and do 5 minutes of deep breathing before going to bed, don't let yourself be tense 24 hours a day. We have previously tracked more than 300 adult allergy patients. Those who can smoke three times a week and completely put down work and study for half an hour each time can reduce the frequency of allergy attacks by about 30% on average over the course of a year. The effect is more obvious than taking half an extra anti-allergic drug.

Of course, there are still many questions that have not been thoroughly studied: For example, to what extent does pressure trigger the allergy threshold? Why do some people's allergies not get worse no matter how stressed they are, while others get them after staying up late? These academic circles are still trying to figure out the answer. For ordinary allergy patients, there is actually no need to pick so carefully. There is no need to worry about "did I eat wrong or am I thinking too much" every time I have an allergy? Paying more attention to your body's signals is much more useful than dwelling on allergen values.