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Health24.com | ‘I am allergic to coffee and this is what happens when I drink it’

Having a caffeine allergy is no joke. It also means that coffee isn’t the only thing you have to avoid as caffeine is also found in sodas, tea and even chocolate.

Imagine not being able to consume any of these… 

‘I’m allergic to caffeine’

According to an article in the Asia Pac Allergy journal, anaphylaxis caused by caffeine is rare. However, having an extreme allergic reaction to caffeine is possible. The article reports on a 27-year-old woman who was admitted to hospital with anaphylaxis.

She experienced no previous allergic symptoms and had no family history of allergies.

Before the dangerous reaction, she’d eaten a sweet that contained 42mg of caffeine – she was driving and did not want to feel drowsy. Prior to going into anaphylaxis, her throat began to itch, she had difficulty breathing and then broke out in hives.

Although she recovered, doctors could not understand what had triggered the reaction. Five days later, she experienced an itchy throat in the morning after drinking Japanese green tea and then again in the afternoon after eating coffee jelly.

A positive skin test suggested that her allergy was caused by an IgE-mediated hypersensitivity reaction to caffeine.

She stopped consuming caffeinated foods and drinks and had no further episodes. 

Understanding the allergy

If you’re allergic to a food, you’ll usually notice a reaction within 30 minutes after consuming the allergen. However, a reaction can also occur within five or 10 minutes, or up to four to six hours later.

Common allergic reactions to caffeine are typical symptoms associated with an allergy. They include:

  • Hives or eczema
  • Sneezing
  • Swelling of the throat and mouth
  • Heart palpitations
  • Dizziness
  • Shortness of breath or difficulty breathing

“These physical cues are often accompanied by psychiatric responses,” Mariska van Aswegen previously told Health24.

She says that depending on how much caffeine is consumed, “symptoms of a caffeine allergy – also termed by some as a cerebral allergy – can range from mild to severe which include lack of concentration and comprehension, aggression, hyperactivity and disorganised thought processes”.

Where caffeine is found

According to the International Food Information Council Foundation, the average cup of instant coffee contains about 95mg of caffeine, while an espresso has 60mg. And don’t be fooled by the word “decaffeinated” – decaf coffee still contains about 3mg of caffeine per cup.

Black tea averages about 47mg per cup, while green tea comes in at 25mg. A can of soda has about 40mg. Chocolate also contains caffeine – 28g of solid milk chocolate contains about 6mg, while dark chocolate has a bit more at 20mg.

Moderate caffeine consumption is considered between 300 to 400mg per day.

Image credit: iStock

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Health24.com | Popular morning sickness drug might not work

One of the more unpleasant aspects of pregnancy is morning sickness, involving nausea and vomiting that can start as early as six weeks, and usually peaks at around the eighth or ninth week.

Now a new report contends that the most commonly prescribed medicine for morning sickness may not work.

FDA should reconsider approval

The drug, Diclegis, failed to meet minimum effectiveness goals in the clinical trial relied upon by the US Food and Drug Administration for its approval in 2013, Canadian researchers reported.

“There was a very small difference between the women who got a placebo and the women who got this medicine,” said Dr Nav Persaud, a researcher and family physician at St. Michael’s Hospital in Toronto.

The study was published online in the journal PLOS ONE.

Given that, the FDA should reconsider its approval of Diclegis, Persaud said.

Is it effective?

Diclegis is available in South Africa.

The MCC (Medicines Control Council of South Africa) is committed to ensure that all medicines/medical devices/IVDs that are registered are of the required quality, safety and efficacy, and is committed to the consideration of data regarding the any recalls of medicines.

No communication has been issued regarding the withdrawal of Diclegis from the South African market.

“I think medications should only be approved and prescribed if they’re proved to be effective,” Persaud said. “The very basic question that needs to be answered is if it’s effective. If the medication is not effective, it doesn’t matter if it’s safe or not.”

But one of the nation’s leading medical associations, the American College of Obstetricians and Gynecologists (ACOG), responded to the new paper with the equivalent of a yawn.

A combination drug

Just this month, ACOG updated its practice guidelines for treating nausea and vomiting during pregnancy, maintaining that Diclegis “is safe and effective and should be considered first-line pharmacotherapy,” said Dr Mark Turrentine, chair of ACOG’s Practice Bulletin Obstetrics Committee.

“If the US Food and Drug Administration, the authors of the original studies, or the drug manufacturer correct or retract any of the evidence used to develop ACOG’s guidance, we will reassess and consider the conclusions at that time,” Turrentine said in a statement.

Diclegis is the combination of an antihistamine, doxylamine succinate, with a form of vitamin B6 called pyridoxine hydrochloride.

This combination drug had been available for in the United States starting in the 1950s, but was voluntarily pulled from the market in the 1980s over concerns that it was linked with birth defects.

But lawsuits related to those claims were eventually dismissed, and efforts began in the 2000s to get the drug back onto the US market, Persaud said. The drug has always been available in Canada and is currently sold there as Diclectin.

A previous Health24 article reported on the removal of Diclegis from the market some 30 years ago and its return to favour. 

In 2015 Kim Kardashian got into trouble with the FDA by claiming in an Instagram post that Diclegis is completely safe and carries no risks for the baby. The post was subsequently deleted from her account

Persaud and his colleagues reviewed the 9 000-page clinical study report submitted by the drug’s manufacturer, Duchesnay Inc., based in Quebec, Canada. Results of the short two-week trial, which involved 187 women at six US medical centres, were published in 2010.

A 2014 NCBI article confirms the substantial amount of safety data accumulated over the years on Diclegis, making it one of the few drugs that qualify for FDA Pregnancy Category A status

Image credit: iStock

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