Adverse Reactions to Food Additives
Randhawa and Bahna carried out a review on hypersensitivity reactions to food additives, diagnosis, and management.
One of things they found is that there is little information available in the world of medical literature and speculate that this may be due to the difficulties with diagnosing problems with food additives. [It is my own experience of reviewing the literature – and I suspect that food additives as a cause of symptoms is rarely considered by most medical professionals.]
They recommend that food additives should be suspected as the culprit in individuals who report a history of reactions to a number of unrelated foods or to a certain food when commercially prepared but not when prepared at home.
The major problem in dealing with reactions to additives is the identification of the offending agent(s). They argue that apart from a careful history taking, allergy skin testing or in-vitro testing are rarely useful. Trials of elimination and reintroduction may be more helpful. Once the offending additive is confirmed, the only treatment is avoidance.
Because accidental exposure often happens, they recommend that individuals with a history of severe reactions should have self-injectable epinephrine and wear MedicAlert identification
[One way of helping identify a food additive problem is to keep a very detailed food diary.]
Randhawa S, Bahna SL.
Hypersensitivity reactions to food additives.
Curr Opin Allergy Clin Immunol. 2009 Jun;9(3):278-83.