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Nutrition and Diet Counseling in All Allergies and Intolerances

Nutrition Counseling in Allergies and Intolerances — Elimination and Reintroduction Protocols

Individualized elimination and balanced nutrition planning for true IgE-mediated food allergies as well as pseudoallergies, lactose, fructose, and histamine intolerances.

Indication

  • IgE-mediated food allergies diagnosed by a physician (milk, egg, nuts, shellfish, etc.)
  • Lactose intolerance (digestive system complaints)
  • Fructose malabsorption
  • Histamine intolerance / pseudoallergic reactions
  • FODMAP intolerance (accompanied by irritable bowel syndrome)
  • Multiple food allergies diagnosed in childhood and transition processes
  • Food-related gastrointestinal diseases such as eosinophilic esophagitis

Preparation

  • Allergy tests performed by a physician (specific IgE, prick test) or breath test (lactose/fructose) results
  • Detailed symptom diary (food-time-symptom)
  • Records if there is a history of elimination trials
  • Information on accompanying anaphylaxis history and epinephrine auto-injector use

How it's performed

  1. The dietitian clarifies the distinction between true allergy and pseudoallergy according to the diagnosis; acts in line with the physician's report
  2. Elimination of suspected foods is planned for 2-6 weeks
  3. After the elimination period, individual tolerance is determined with controlled rechallenge
  4. Food label reading education (hidden allergens — casein, lactose, gluten, soy) is provided
  5. Cross-reactivity (e.g., birch pollen-apple) and cross-contamination risks are taught
  6. Nutritional adequacy with alternative sources (calcium, iron, B12) is ensured during elimination

Post-procedure

  • Follow-up every 2 weeks during elimination
  • Weekly follow-up during the reintroduction phase
  • Annual evaluation with growth-development parameters in children
  • Coordinated follow-up with allergy specialist / immunology physician

Risks

  • Food challenge in IgE allergies with anaphylaxis risk should be performed only in a controlled environment with a physician
  • Risk of nutritional deficiency and eating disorder in extensive elimination protocols
  • Possibility of growth retardation in children
  • Over-stimulated interpretation — unnecessary restriction with assumption of non-existent allergy

FAQ

Are allergy and intolerance the same thing?

No. Allergy is a reaction mediated by the immune system (IgE); intolerance is a digestive/metabolic condition that does not involve the immune system.

Are the IgG tests I see online reliable?

Physician and dietitian professional organizations do not clinically recommend IgG-based food intolerance tests; diagnosis is made through detailed history, elimination-reintroduction, and IgE/breath tests when needed.

How long does elimination last?

Generally planned for 2-6 weeks; the decision for permanent elimination is made according to individual tolerance after reintroduction.

Will my child's milk allergy resolve?

A significant portion of childhood milk and egg allergies develop tolerance by school age; controlled oral provocation is planned with a physician.