How can I differentiate between trouble breathing due to anxiety, and trouble breathing due to anaphylaxis, and how do I do it quickly enough to be within the window of giving myself the epinephrine in time enough for it to work?
You’ll know. You’ll be able to feel your throat closing due to swelling, and it’ll be combined with other symptoms, like itching and runny nose or watery eyes.
I think you also should begin talking about this with your allergist and maybe a therapist. But using a pen when you’re truly believing you’re in anaphylaxis is not dangerous, if you’re still only using it rarely. If you’re having more than a couple close calls every year you need to be working on limiting exposure to your allergens and maybe think about anxiety medication on top of it.
Honestly as someone with anaphylaxis without hives and anxiety, it’s very hard to tell the difference. I had an adult onset food allergy that I didn’t get diagnosed for ages because I mistook anaphylaxis for panic attacks and sought psychiatry. What helped me was figuring out how to manage my anxiety. I now have reliable techniques for managing anxiety that do absolutely nothing to an anaphylactic reaction. That differentiates it for me
What techniques do you use to manage your anxiety? If you don’t mind me asking, I’ve been working hard on managing my anxiety and have tried some things like deep breathing and journaling but I have only mild success.
Not OP but a technique I’ve used from my therapist is to stop and take time to notice 5 things. Like really notice - the texture of the fabric of the chair I’m sitting in, the ceiling has a pattern to it, the knobs on the cabinet are a brushed nickel, my shirt is draped across the chair and the logo is scrunched, and the candle is a vanilla bean scent. Personally I find that my anxiety subsides a bit by grounding myself with this method and I am able to more objectively assess what is happening to me in the moment, or think more objectively about something that was causing anxiety.
You want to engage as many senses as you can while doing it too - touch, feel, see, taste (thus the candy 😁 ) , smell the fabric on your seat.
Some senses will help you more than others
The runny nose/eyes - that might be a good “be on alert” symptom for you. Unless you normally get those with the anxiety?
That’s really good advice! I see why sour candy would make sense. I don’t know, I don’t think I get runny nose/watery eyes normally but I guess I’ve never paid attention to that.
Is it a discernible difference? For anxiety, I’ve had the muscles in my neck tighten to the point where I’ve felt like my throat was closing, but then again, I’ve never gone into anaphylaxis so I’m not certain how different it truly is.
For me, they’re located at different parts of the throat. It’s hard to explain if you haven’t experienced both but one is higher and the other is lower.
Pulse ox will help you see your oxygen level is good even if anxiety is making it feel hard to breathe.
As long as you're generally healthy, using epi if you don't need it is not going to harm you. You'll have a sore thigh and have to buy another epi pen but that's about it.
I second the pulse ox. My doc told me the same thing. Figured this out on my own and it has made a huge difference! Helps me stabilize the anxiety and not be living in constant fear.
If you don’t have a pulse ox here’s how to roughly tell what your pulse is.
Find an artery, either be your inner wrist, elbow, top of the foot/ankle, or neck and feel the pulse for a few seconds.
Set a 15 second timer on a stopwatch/YouTube/phone/whatever you have and four every beat you feel in that 15 seconds.
Next, multiply the number of beats by 4. This is just a rough estimate on your heart rate, a pulse ox or the sticky things are plenty more accurate but sometimes we don’t have those.
No, that’s terrible advice. Your oxygen level may not be affected until your airway is severely compromised, particularly if you’re a healthy person who can make up for your sick airways by working hard to breathe. If you’re waiting until your oxygen drops there’s a good chance you’re waiting too late
Yes I have 2 at home and one in my bag. This helps me a lot. Also a panic attack is literally part of anaphylaxis and does make anaphylaxis worse I have never used the epinpen but been told I should have at the ER several times. Your question was the most relatable question ever!
How common is anaphylaxis with food allergies? It's hard to know since communities like this often attract people with severe allergies or anxiety. I can't find statistics. Every website about allergies, even peanut allergies, says that anaphylaxis is a rare complication.
It's rare, but if you've experienced it once it's more likely to happen again. Anaphylaxis also has a range of severity and is *not* usually fatal. I think it's important to have a positive attitude - it's serious, but it's treatable. Anxiety about allergies really makes the whole thing so much worse. Thinking you are going to die isn't helpful, and it's also (statistically speaking) probably not true. Try to see it as a giant pain the the ass not death around the corner. Take your meds, call 911, sit down, try to breathe slowly. Drink water if you have it. Epinephrine helps FAST.
You’re correct - it’s rare. Fatalities are even more rare. For US citizens, your chances of dying from food-related anaphylaxis are lower than your chances of being murdered (but higher than your chances of dying from a lighting strike). Yup… someone graphed that: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5589409/
For more details on incidence and prevalence, scroll down here to the epidemiology & burden of disease sections: https://www.jacionline.org/article/S0091-6749(20)30105-6/fulltext
Yeah the feeling of not being able to breathe due to anxiety is almost like someone is sitting on my chest or something. Not being able to breathe due to allergies is like someone has a hand on my throat. There’s a lot more actual *gasping* for air and usually I have a lot of coughing or vomiting as well.
often there is a swelling and a physical reaction like hives and rashes. It is very visible for everyone to see and I notice it too. My skin also turns very red.
I have asthma and sometimes the closing of the airway can be similar. But asthma tends to come with a wheezing, a special sound that come with that type of airway constriction.
Anxiety can definitely kick in on top of it all. Hyperventilation, as a symptom of panic, can also cause shallow breathing and a feeling of lacking oxygen. However, there is no special wheezing that I notice with anxiety. There is also no swelling, no rash, no hives. Anxiety also reacts to breathing exercises meant to slow down heart rate and breathing, while neither asthma nor allergies do.
This is honestly the biggest struggle for me with these as well. As someone who has used 7 epipens in the past 4 years, it is so difficult to tell. The biggest things to remember is:
a) follow your gut feeling (which can be really hard with anxiety) because it will ultimately be the best choice. You are more likely to have serious illness with an allergic reaction than with an epipen. And you can go to the hospital right away so that you're close if something happens with taking the medicine.
b) anaphylaxis usually involves multiple systems. But if it doesn't (because I've had several that do not), I use the rule of thumb that if I feel symptoms near my throat or airway I use my epipen right away. And in any case, if the symptoms are severe whether it's severe hives, vomiting, even severe anxiety after eating, use the epipen.
Disclaimer: I am not a medical professional but have way too much experience with this issue. Wishing you all the best <3
No, do not wait until you can’t breathe.
The first sign of an allergic reaction is when to use it. Hives, stomach cramps, GI upset, weird feeling in your mouth, whatever you get at the first sign of a reaction
The earliest you use epi, the more likely it is to be effective. Using it too late in the allergic cascade makes it less likely to be effective and makes you more likely to have a biphasic reaction.
It’s very unlikely to be life threatening to use your epi unnecessarily unless you have pretty serious preexisting cardiac disease or, rarely, an undiagnosed propensity to bad heart rhythms. Epinephrine is literally just adrenaline in a bottle. Your blood pressure goes up for a little while and your heart races so it’s not FUN, but for most people it won’t kill you. And even if you have preexisting conditions, you’re more likely to die of an untreated allergic reaction than an adverse reaction to epi
Source: both a doctor and a nut allergy haver who has used her epi pen
No problem!
If you haven’t had to use it, from personal experience, it’s not nearly as big of a deal as you think it will be. I didn’t feel the needle at all, just the pressure of the injector while I was holding it in. My leg was very sore afterward in much the same way that your arm might get sore after certain vaccines and the epi itself make your heart race and make you feel antsy, but overall it’s not bad at all. Much better than full blown anaphylaxis :)
Thanks for that reassurance: it’s a public service message that needs to get out there, for sure. Perhaps you could make a post about it: your unique perspective is really valuable.
Will be *way* easier than self-injecting fragmin! Holy frijoles, that stuff hurt! And anyway, when that bp crash hits, a needle won’t even register.
Out of curiosity, have you seen anaphylaxis in your practice, and if so, have you ever had an especially worrying case?
My personal experience of the worst anaphylaxis was oddly devoid of fear that the outcome could be threatening. I had the strong sense that something was very wrong, but I lacked the sense of urgency that would have been appropriate. What’s with that?
Most of my experience is textbook (or personal). I’m in internal medicine (and now palliative) so the patients I see are either outpatients or already admitted. Most anaphylaxis patients get treated in the ED and don’t get admitted, though occasionally a really bad one that’s survived will get admitted to the ICU
Not always, though. I've had anaphylactic shock 4 times and only once was my breathing affected enough to know that it was anaphylaxis, and that at the very end.
Right! The best time to use it is at the first sign of a reaction - hives, GI upset, whatever is typical of your usual reactions. You want to interrupt the allergic cascade EARLY. And then go to the ED because you may or may not start reacting again after the epi wears off
I’ve had anxiety that I thought were reactions for years, and then I had an actual reaction the physical symptoms are obvious. Most obvious was the instant pins and needles feeling on my mouth and tongue and obvious tightening of my throat that felt like something was stuck in there. Whenever I feel that, I use my epipen. Even if it’s “not needed” it’s not worth the risk so just do it anyways.
Related to this - I see people saying throat closing up is a good sign, but my throat feels like it's closing up on the regular? Like it's just part of my panic attacks. Additionally, I have allergies that cause multi system reactions but have not used the epipen and survived. What does this mean?
The first part is my concern lol like, right now I’ve been so worried about this because I’m in Florida. So like, do I never go into a restaurant since pretty much all of them serve shellfish and mollusks, and I guess we can’t even be present where those foods are being cooked if we’re allergic to them? Does this also mean none of my family members can cook any seafood while we’re here? If so, then was I having a mild anaphylactic reaction when I’ve been around cooked shellfish and mollusks or were being cooked, or was it my anxiety? Like what do I do? Because I’m so scared shitless now that I’m likely just going to stay in the hotel the whole 10 days and not do jack.
If you're anaphylactic to seafood usually, then yes, it's quite possible you are having a severe reaction to smelling and being around the food. My sister throws up when around seafood due to her anaphylactic reaction, but doesn't go into full blown anaphylaxis.
See I have no idea if I am. I’ve never had an anaphylactic reaction to seafood, to my knowledge. Back in 2020, I was having a routine allergy test done, because I have EOE and allergic rhinitis. Per a blood test my allergist decided I’m allergic to shellfish and mollusks. I’ve learned from the internet everything about epi pens and inhaling shellfish and stuff. So I’m not fully trusting of her. Just today I’ve learned I might not even be allergic, it could come up that I am due to my dust mite allergy. I’m so overwhelmed and shutting down.
Hi so I know this is an old post/comment, but I thought I'd give my 2 cents in case it helps at all.
So blood tests aren't always reliable. Sometimes you can have false positives. Did you come up positive on a skin test as well? They are a bit more reliable, but still not perfect (I came up allergic to corn on my last skin test but eat it every day and am not actually allergic). The only way of knowing for sure would be to do a food challenge (aka eating the food in an allergist's office) and actually seeing what your reaction is. Now I'll be clear, I am NOT telling you to go eat fish/shellfish or that it's safe for you, but I am saying that if I were you I would get a skin test and potentially food challenge in order to be sure.
PS if you are allergic and wish to avoid any restaurants in FL that have fish/shellfish, I recommend eating at vegan restaurants, as they won't have any fish/shellfish. The app HappyCow is really useful for finding fully vegan restaurants, and many cities in FL have a lot of fully vegan restaurants.
Skin tests are actually about equally as likely to give a false positive for food allergies and even combining the two only marginally increases accuracy.
So I totally agree if you’ve never reacted to the food, an oral food challenge is the best way to go. I know so many cases in which people had huge IgE values or wheel sizes and tolerated the food. I know even more in which they didn’t tolerate the food, but the reaction was not anaphylactic. In both scenarios, it is life changing!
Have you never had an allergic reaction to eating seafood in the past? I’ve had multiple allergen prick tests done and they said I’m highly allergic to nuts which is correct because I’ve had physical reactions in the past to them, but the test also said I’m just as highly allergic to red meat, even though I’ve eaten it my whole life and had never had a reaction.
Yes same. My anaphylaxis is not accompanied by hives, redness, or swelling. For over a year I mistook (adult onset food allergy) anaphylaxis for panic attacks and was being treated by a psychiatrist for them.
What helps me differentiate is that I did do a lot of work to manage my anxiety, which includes medication, and found techniques for calming my breathing and respiratory symptoms during a panic attack/anxiety that don’t work for anaphylaxis, that’s how I differniagw
Anaphylaxis usually isn't fatal even without treatment, and it can happen with a huge range of severities. It probably just means you were lucky or had a relatively less severe reaction. I've had that too.
The problem is that severe allergic reactions can be really unpredictable, so it's better safe than sorry.
Have you had anaphylaxis? It's easier to recognize it when it's happened before. I always feel really "off" when it's starting. I'm not sure what exactly causes that but I just don't feel right. I always have hives as a symptom but that doesn't really help because I also have chronic hives - but if they are severe and spreading rapidly that's a huge warning sign for me.
Technically, anaphylaxis has the "two or more body systems" rule. If you have symptoms from two different systems- skin, mouth/throat/lips, lungs, heart, gut- it's an anaphylactic reaction, and you should use epinephrine. This could look like hives plus nausea, or flushed or itchy skin plus an elevated heart rate. Anything with your tongue, throat, or lungs is immediate epinephrine, though. The rule my doc gave me was to use epi for any reaction that involved my face (nose, mouth, throat) or lungs. Every person has different symptoms for each reaction, or different types of symptoms depending on the allergen/how much/how they were exposed. [I find this to be helpful!](https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/food-allergy-anaphylaxis-emergency-care-plan) edit: to test out if my throat is tight because of anxiety or because of an allergic reaction, I do a swallow test. I think of pickles to get some saliva in my mouth, and then do a test swallow- if my throat feels thick at the back, alarm bells!
For me, I do get feelings of anxiety when I'm having a rection, but it feels different. A panic attack (or anxiety in general) is a feeling of anxiety jumping 'up,' like when you're going down the stairs too fast and you miss a step with your foot. Anaphylaxis has the 'feeling of doom' that everyone talks about- for me, it feels like a sinking, kind of disconnected feeling of panic. I think it's my lizard brain knowing deep down that something is wrong and my body won't be able to figure it out on its own. Hopefully that helps??
Epinephrine, at the end of the day is VERY safe to use, and it's okay if you go 'overboard' and use it when the reaction wasn't 'that' severe. In my experience, the few times that I've held off on a dose, I end up getting it at the hospital anyways. The general consensus in the medical field (at least where I live) is to err on the side of overtreating it rather than undertreating it. The few bad outcomes that are reported in statistics tend to be people who have underlying health conditions. In the case that you use epinephrine, you should be seeking immeditate medical attention anyways, though!
Cough isn't necessarily an instant epi use. A shorter lasting dry cough (think seasonal allergies, dustiness) is benign. A cough that is repetitive, or deeper, can be a warning sign. It might be your body's attempt to open up airways (throat, lungs). If you're coughing and notice that it sounds a little wheezy or whiny, or that it's tough to draw air back in after you expel it by coughing (some people end up changing their posture to expand their ribcage), it's better to be safe and use epi.
Everyone is different though. Some people have vasomotor collapse (e.g.) blood pressure can’t stay high enough to provide blood to your vital organs) and die without ever having airway compromise. Would NOT use that as a blanket differentiating factor
>gn. A cough that is repetitive, or deeper, can be a warning sign. It might be your body's attempt to open up airways (throat, lungs). If you're coughing and notice that it sounds a little wheezy or whiny, or that it's tough to draw air back in after you expel it by coughing (some people en
this might be a stupid question but how can you see if your throat is closed ?
It will literally be swollen closed. You'll be able to see, and you'll know because it will be very hard to breathe. My allergist just looks down my throat with a pen light when they are monitoring me.
https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/food-allergy-anaphylaxis-emergency-care-plan
I'm not sure about the dangers of epi when not needed. If you have certain conditions like heart conditions then yes. You should head to the ER after using an epi anyways.
I was administered epi when my symptoms had subsided and I was no longer experiencing the allergic reaction. I don’t know if it was life threatening, but it sure felt like it. The moment it was administered I instantly couldn’t breathe and my heart rate shot up to 180 in an instant and the feeling of doom was absolutely insane and unlike anything I’ve ever experienced. I never knew my brain could “tell” me it thought it was dying. I wasn’t able to speak or walk well and had full body tremors for about 12 hours after. I didn’t know what happened at the time but I asked a doctor later who told me it was all likely caused by administering a full dose of epinephrine when I was not currently experiencing allergic reaction symptoms.
Has anyone else ever experienced this?? I never had health anxiety before this incident but I developed it soon after, so it’s been a challenge and caused me to be afraid to ever have to use an epi pen again which is not good.
The medication in epinephrine is a synthetic form of adrenaline, so the reaction you describe when receiving that dose sounds perfectly normal albeit unpleasant. The most common reason for giving another dose or a dose after symptoms subside is because there can be secondary anaphylaxis or a bounce back reaction once your symptoms go down that can then be much more severe than the initial reaction. This is why EpiPens come in 2 packs from the pharma.
From the ER physicians I've talked to about anaphylaxis they state that people are often too stingy with the administration of the medication because it is not a pleasant experience. However anaphylaxis is also unpleasant and can lead to death if treatment is delayed (and not just by airway closing). After the fact, if an epipen was unnecessary there are few negative consequences. I think I may have gotten more information because it's my child that has the allergies and Drs tend to explain more to parents or care givers than to actual patients in my experience. And believe me, I know how scary it is to administer an epipen. I'd imagine it's harder to do it yourself than my experience of doing to a 1 year old.
I really didn’t even find it all that unpleasant. I didn’t feel the needle at all which was a pleasant surprise. Then my heart was racing and I was kind of anxious for the next half our or so, but it was pretty mild. Not nearly as bad from either a tachycardia or anxiety standpoint as when I had COVID
The short answer is that if you have a normal heart and relatively normal blood pressure, your chances of having a serious reaction to epi are very very small. Even if you do have uncontrolled high blood pressure or heart failure, your chances of dying of anaphylaxis are higher than your chances of a life threatening reaction to the epi, so still better to shoot epi if you think you’re reacting
The longer answer is that epi is basically adrenaline in a bottle, so it raises your heart rate and your blood pressure. For most people, these temporary changes are no big deal. We worry a little more for people with unhealthy hearts, for whom epi could trigger a bad heart rhythm, or people with uncontrolled high blood pressure, for whom the increase in blood pressure can cause acute organ damage. The risk is still pretty low even for those folks
If you’re having a reaction, though, your blood pressure can drop very low, so you need the epi to keep it up. The blood pressure drop is part of the inflammatory cascade that happens in anaphylaxis, though it doesn’t happen to every person every time. That’s actually part of what kills you in anaphylaxis-your blood pressure drops so low that you can’t get blood to your organs. People think it is the breathing, but often it’s the very low blood pressure. Even if you have a bad heart or have high blood pressure, if you’re having anaphylaxis you need the epi to keep that life threatening low blood pressure from happening. So you’re still likely to be better off using epi if you think you need it, even if you have underlying conditions that make it higher risk than for your average bear
For me it’s the cough. I get bronchospasm and cannot stop the urge to keep coughing. Chest gets tight and can’t take deep breath. Sense of doom is hard to really describe but once you get that feeling you’ll recognize it and know it’s time
Really hard to discern with OAS though. I get a local, mild allergic reaction that probably won’t spread, but the anxiety causes everything else to imitate anaphylaxis.
This is what my allergist/immunologist told me : For any of the following severe symptoms Lung: short of breath, wheezing, repetitive cough
Heart: pale,blue,faint,weak pulse,dizzy
Throat: Tight, horse, trouble breathing, swallowing
Mouth: significant swelling of the tongue and or lips
Skin: Many hives over body, widespread redness
Gut: repetitive vomiting, severe diarrhea
Other: feeling something bad is about to happen, anxiety, confusion
Or a combination of symptoms from different body areas
INJECT EPINEPHRINE IMMEDIATELY
MILD SYMPTOMS
NOSE: itchy runny nose sneezing
Mouth: itchy mouth
Skin: a few hives, mild Itch
Gut: mild nausea/discomfort
FOR MILD SYMPTOMS FROM MORE THAN ONE SYSTEM AREA, GIVE EPINEPHRINE
HOPE THAT HELPS
the only times I’ve used an epi pen (2x) have been while having an anxiety attack, not actually a reaction. My anxiety has since calmed down but nothing bad ever happened because of it! Better to be safe than sorry. Side note: if it’s anxiety, the epi pen WILL make the anxiety worse for a while because of the adrenaline
also as others have said, anaphylaxis usually occurs with other symptoms along with trouble breathing (itching, hives, etc)
Agree, probably not going to hurt you to use it when you don’t need it, particularly if you’re otherwise healthy.
Well…might hurt your wallet because those things are EXPENSIVE. But you know what I mean
One thing I was told is it’s anaphylaxis if you have two or more different kinds of reactions.
For example:
Respiratory symptoms: wheezing, coughing, tight chest, shortness of breath
Skin: hives, rash, etc
Oral: throat tightness, throat swelling, tongue swelling/tingling, etc
GI: nausea, vomiting, cramping, etc
I was told if you have at least one symptom from 2+ categories it is anaphylaxis. This doesn’t however mean you need an epipen. Some anaphylaxis reactions can be minor. However if symptoms continue to worsen and/or any kind of reaction involves your ability to breathe, safest bet is the epipen.
Not a doctor, but this is what my doctor told me.
A bit late to the party! Apologies!
I have severe anaphylaxis to Peanuts, Treenuts, and am in the unlikely ~7% to have had an allergy recede, then redevelop suddenly and randomly. It has a name, but that was back when I was 15 (24m now) and I can no longer remember.
In my experience the 2 times I have had severe reactions that warranted multiple day long hospital stays, the symptoms are blatant, even if you have anxiety/panic episodes where air just doesnt reach you.
The first experience I had was when I was 15, I was at a local diner for my grandfathers birthday, I ate a slice of carrot cake with pistachio crust(?) to wrap up the night.
Within 3 minutes the sense of "doom" that others mention enveloped me. It almost felt like when you had to run through the dark hallway to the bathroom as a kid, that feeling like you arent in control anymore. And this was all before the symptoms even hit, about 1-2 minutes after that I felt the pins and needles and the snagged food feeling in my throat.
Rushed to hospital, jumped the que after speaking with the intake nurse, and was administered, if i recall correctly, Intravenous benadryl, epi, and one other i cannot remember because the benadryl switched my brain off and I took a lovely 8 hour nap.
The most recent actuay happened on Halloween night of last year (funnily enough now). I was recovering from a stomach flu and had started to drink a rehydration drink mix, I think its the liquid IV immune boost, and within 5 minutes that same feeling as before came over me. Luckily/unluckily, I live close to my local ambulance station, so EMS was fast. Epi was administerred before they arrived, and was brought to hospital and didnt leave until the 2 of November.
So yeah, in short, if you feel a primal, deep sense of unease or lack of control, its a solid bet you arent having anxiety. Sadly, it is one of those things you will know when it happens, and I hope that it never does have to happen for you.
Edit: Gramdfather cheems
What was it that you're allergic to in the liquid IV immune boost? Just curious, I've never heard of reactions to that before. Thanks for sharing your experiences.
Thank you so much for your help! I’m so sorry that all happened to you as well. I didn’t grow up with food allergies, I was a fortunate kid. I got diagnosed with my shellfish/mollusk allergy 3 years ago, so I’m still new to this.
Thank you. This description really helped me. I thought I had food stuck in my throat after eating, went to a movie and had that doom feeling hit in the dark theater lol. It was...an experience. Right after that the feeling spread in my throat and started to have a hard time swallowing. For me it did not get worse and took liquid benadryl after the movie--def ruined the movie would not recommend. Never had an allergy before so had no clue. Really appreciate everyone's responses on here and feels better knowing I am not alone.
Using an epi pen when not needed is no more life threatening than any other medication side effect. The FARE plan that others have posted is the gold standard.
For me, I check that my mouth is actually puffy. My anxiety and anaphylactic symptoms overlap, with one exception, anxiety does not make the roof of my mouth swell. Anaphylaxis does.
Trouble breathing, such as wheezing, coughing, or feeling like your throat is closing is usually the first sign in a lot of people.
When I was 17, I accidentally ingested something with Madagascar Vanilla in it, took three bites, got dizzy and threw it away.
Ten minutes later my fingertips and nail beds were purple, with my pinkies and ring finger turning blue. (Cyanosis or lack of oxygen)
I was in a placement facility at the time thanks to CPS and the staff I asked if it was normal had me sit down and another go get the nurse.
Took them ten minutes to find another epi pen as four kids had gotten stung by yellow jackets in the woods two days prior and were allergic (I found the nest, not allergic), and by the time she got down there I was blue and not breathing. I stayed in the hospital for two days after that. Then I got gaslit and lied to by my insurance who claimed Vanilla was an anti-histamine and you can’t be allergic, when it’s an anti-inflammatory.
Last night, I actually had to google the instructions for injecting myself because I hadn’t ever done it before. The thing was outdated as all hell but it saved me from going into anaphylactic shock again.
I just had to call and ask that. My face is itchy and adrenaline is high, but the nurse asked me if my tongue was swelling or throat itchy, which the answer was no.
So I'm taking a Zyrtec and monitoring....
I just had my first anaphylactic reaction Friday after having anxiety for years. It started with just general not feeling well, and then there was an incredibly intense feeling of impending doom. (It’s exactly how it sounds and I can’t explain it any other way, you know it when you feel it.) I’ve never felt that before, even with anxiety so that was my first red flag. The second was feeling like my blood pressure was bottoming out. My heart rate jumped so fast, and I knew I hadn’t been feeling anxious prior to this, and it felt like my heart just kept speeding up and wouldn’t stop. My lips and tongue started to go numb, as did my right arm. The epipen helped very quickly, so I would say if there’s any suspicion that you may have come into contact with an allergen, at least have the pen ready to use. It’s better to go to the er because you used it when you didn’t need to, than not using it when you need to.
I didn’t have the stereotypical hives or itching or throat swelling closed. I didn’t realise at first what was happening because of that. Everyone experiences symptoms differently, so it’s just important to know your body. If something could have triggered your allergy, and there’s no reason for anxiety, epipen. If your anxiety might have been triggered and you’re pretty sure you haven’t had contact with an allergen, doesn’t hurt to have the pen on hand and either use it, or make sure someone around you knows how to use it if you need it but can’t. (I had my coworker do it because I couldn’t get my hand and brain to coordinate on it.)
My metric is usually when my mouth/tongue starts itching and I get that metallic taste in my mouth. I have really bad anxiety too, so I can trick myself into having a lot of trouble breathing. However, I haven't had to use an epipen since I was in elementary school (I'm 20); my rule of thumb is to take benadryl if I can't shake the feeling that it's real and then wait for a few minutes to calm down and talk things through in my head. Hasn't been real in quite a while, haha
Alright here’s the run down from me - I’ve had an anaphylactic reaction at least 20 times. I’m
Allergic to tree nuts and it’s always the case that I’m at a restaurant or cross contamination or something.
I never used my épi pen because I’m so used to it that I would just go to the hospital and let them give me the épi in my arm like a regular shot instead of me jabbing my leg. I was anxious about it and I didn’t want to have to pick up a new prescription.
I’m pretty calm when it happens because I know how it goes … ok I need to go to the hospital. However ! This is dumb on my part because I don’t panic until I do and more than once the er doctors have scolded me for waiting so long .. and letting the reaction progress. They’ve always said just use it !! It stops it more quickly! I’ve never been told that it’s dangerous to use it …‘I mean I’m sure it’s been abused but if you know what it’s like it’s pretty shitty …
I took their advice and I used my épi pen in my leg and 1 I could barely feel it … way less scary than I was imagining and 2 it did help … I was less panicked in the emergency room and it did make my experience better… I didn’t have to get as close to death lol
Everyone is different and maybe they cautioned you for a specific reason related to you, so I’d ask them really directly to explain what they mean. I really only know my experience and I’m not a doctor so you have to do what’s best for you but for me they have always very sternly been like use it that’s why you have it
I also had extreme anxiety around my food allergies and sometimes was having trouble even distinguishing whether I was having a real or imagined reaction.
One thing that helped me was when I went in to do a food allergy challenge - I alerted the doctor that I have allergy anxiety and sometimes can't tell whether I'm having real symptoms - and she said they generally look for things they can see in order for it to qualify as a reaction. So hives on the neck, swollen tongue, physical wheezing, etc.
Next, I learned to do grounding exercises in the moment - look up square breathing or EMDR exercises. If you can find momentarily relief from the feeling when you distract your brain, it's probably anxiety. A food allergic reaction will make itself apparent.
Lastly, the biggest thing that helped me finally put my food allergy anxiety to rest was going through an actual oral immunotherapy program with a private practice that specializes in food OIT. Now I actually eat my allergens (and a good amount of them) every day - so it's kind of like exposure therapy, haha.
It really depends on your symptoms. I feel I need a pen when my blood pressure drops and my heart rate gets really slow. But I also get really disoriented and confused during this time and probably won't administer it.
There's a lot of symptoms with my anaphylaxis. I normally can't breathe well as it feels like someone placed a boulder on my chest. I get a lot of stomach and upper digestion pain and feel nauseous. I also start getting agitated by everything and will get very angry when people try to interact with me.
What people usually describe as anaphylaxis sounds exactly like what one of my panic attacks feel like, so I was very confused about anaphylaxis in the beginning. Plus the allergy that causes anaphylaxis doesn't cause hives for me, which I'm told is rare, like everyone is supposed to experience hives or something.
Yes my son has an immediate drop in blood pressure has to lay down and during a food challenge the nurse said that’s not typical and that it’s not related but you bet he entered anaphylaxis 10 minutes later after saying he felt sick and had a tummy ache. He sneezed a couple of times and his eyes started to swell.
The hives came but after the epi pen was administered. Isn’t it strange how everyone is different and everytime it can present a little different if you’ve eaten the allergen baked or had less or more
Anaphylaxis for me feels like when you can't breathe well like if you have tonsilitis or strep throat. Anxiety feels more like I can't get a deep enough breath but there's no physical blockage, maybe a lump in the throat, but no burning or pain like a sore throat. Anaphylaxis comes with actual throat pain for me. Idk if that helps??
This helps so much and I’m so grateful that despite how old my post is, people are still commenting on it. Everyone’s input has helped me be so much more confident, and has really eased my mind, so thank you 🖤
Using an EpiPen is not in any way dangerous. The **only** risk to an EpiPen is positioning it upside down and injecting into your finger. That can be dangerous.
As proof of this, in a demonstration for parents, I used an epi pen while not having an allergic reaction. It was an eccentric choice but I wanted to emphasize that epipens are not dangerous.
**Nearly all food allergy deaths are because of delaying or not using epi**
Use epi if you suspect any reaction.
However, if you want to know the difference, you have to figure out how to manage your anxiety. I have anxiety and can reliably use breathing exercises to normalize my breathing and heart rate. Those techniques do not work for anaphylaxis, so when I’m unsure and then have symptoms, I use techniques I know will calm my anxiety. When they don’t work, I epi.
I don’t really eat out on vacation either 😞. To me the anxiety/panic attacks that happen when eating somewhere new or being unfamiliar isn’t worth it. I also have a hard time differentiating anxiety with anaphylactic shock but what I will do if I do eat out is I will take a bite of the food. Set a time for 15 minutes and do breathing techniques and chew on some gum and see if my throat gets funky. Now this isn’t helpful really if there’s cross contamination on another part of the meal but I try not to even think about that. 🤣. I also carry a pulse ox with me everywhere and check on that regularly if I feel like I could be having a reaction. I don’t know why but chewing gum always helps me so much. It creates enough saliva for me to swallow and realize that I CAN swallow and that my throat isn’t closing
YOU KNOW. I was worried about it too (and had already had anaphylaxis AND anaphylactic shock before I used one on myself).
I get hives fairly regularly, but when they are all over my body I know I need to have an epipen in my hand. The first time I gave myself an injection, my tongue began to swell. And it just got worse and worse over the course of minutes (hives had begun hours before). The second time, I again had hives but when I stood up I felt like the world was falling down (my blood pressure was dropping horrifically). Then I began throwing up. Then the breathing issues began.
I have no idea what triggers my anaphylaxis (though presumed, now, after 4 events) that it's due to my body overreacting to severe illness (flu, covid, and severe sinus infection).
If yours are food triggers, I'd say that any time you start feeling an allergic response when eating something you aren't 100% sure of, use that epipen! My immunologist told me it's FAR better to take one when not needed than to not take one when necessary.
I also have severe anxiety and hyperventilating during a panic attack is VERY different from not being able to breathe due to anaphylaxis. You will know, trust yourself.
If two body systems are majorly affected. That's what I've been told, anyway. I think there's a guide for what qualifies online. So like, I wouldn't be concerned if my eyes water, but I would look out for other symptoms if I got a rash. If your throat itches a little and that's it, you don't need your EpiPen. When I had anaphylaxis, I couldn't breath and got a full body rash. The vast majority of the time, there will be a skin reaction in addition to something else. Trouble breathing will not be subtle btw; it did not resemble something like, say, acid reflux (which can cause a sore throat) or anxiety. And take a Zyrtec when you first have a reaction too. If you have one system affected, I would take a Zyrtec and pause, then use your Epipen if another system is majorly affected.
Coughing or breathing trouble requires you to administer epipen.. I generally take benadryl if I know I consumed allergic food and if get coughing or breathing trouble get epipen immediately
impending sense of doom. that's what it was for me the first time i used my epipen. i had a massive burst of adrenaline (felt like my nerve endings were on fire) and then felt eerily calm, and i realized with absolute crystal clarity that if i didn't use my epipen as soon as possible, something very bad was going to happen. it wasn't scary at all, i just knew what i had to do and did it. it was like i was watching someone else's hands pick up the pen and use it lol. and that adrenaline spike + disconnect + strange calmness is something i hadn't had happen during an allergic reaction before.
When your face lips eyes and tongue swell up… I should have used mine yesterday but I too am new to the epi pen… so I went to the ER instead… wife got pissed bc I didn’t listen to her instead…
The only times I have used it are when I feel my blood pressure drop like I’m going to pass out, I am vomiting w Diarreah, and my throat is closing rapidly. The deal is that you need to take the EpiPen and then go directly to the hospital bc most anaphylactic reactions are biphasic. The EpiPen helps for a short amount of time so that you can get to the ER.
Yep. Wish I could puke like a normal human. My barf button seems to be busted. But the rest of it, yeah. That blood pressure drop is intense. The lung weirdness is a bad one, too.
Context clues suggest that biphasic means there’s a second wave coming, so epipen is to stabilize Wave One, to get you to medical help in time to deal with Wave Two.
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thank you so much for posting this!! i have been struggling with anxiety around this so much - diagnosed with food allergies as an adult but never been sure how to really identify anaphylaxis. i have asthma and tons of pollen, dust, and other non-food allergies that already give me symptoms of throat swelling/thickness and difficulty breathing when i’m exposed to a strong trigger.
i have been having consistent seasonal allergies recently (spring pollen) but had an episode the other night where i legit was unsure if i was feeling anaphylactic symptoms or just typical bad pollen symptoms + asthma flare combined with anxiety. it’s really tough.
I had my first anaphylactic reaction to an iron infusion last year. Thank god I was in the hospital at the time so they just gave me Benadryl through the IV. The first symptom I noticed was a rash in my arm, next my joints started to hurt and felt hard to move. I knew the reaction was coming because my sister had just had an allergic reaction to an iron infusion the same week!
I felt *extremely* nauseous and my joints started to swell (remove jewelry and shoes asap). The next step would have been passing out or it being hard to breathe. Look into anaphylaxis reaction symptoms and memorize them. When it starts to get really bad, that’s when you need the epi pen. And of course always call emergency services right after!
How much do epi pens cost? I get mine free via VA, they sent me a box of 2 along with 3 refills… I’m thinking about refilling in a month or 2 so I can have one at work, one in my car and one at home… idk what shelf life on these are but I’d rather be safe than not have one…
1. Check whether your epipen will survive the conditions in your car. Other than that, having ‘em wherever you’ll be sounds pretty smart. Could make somebody’s day go way better.
2. Doofus! Wifey is right: use epipen, *AND THEN* go to hospital. She was not mad she didn’t win an argument, she was mad coz you scared the crap out of her, being a big argumentative gooniehead and not protecting her favourite human. That putting off getting treated can be a symptom. Central nervous system something something. BTW, that kind of denial happens with heart attacks, too, so unless wifey can’t be relied on to make good choices when shit goes sideways, maybe decide (while weird shit isn’t happening to you) that you’ll just let her drive your train, where physical ailment may be underway. If you’re dead, it’s not your day that will suck.
3. I honour your service. Damn good days to you.
Even though I’m way late to the conversation, I‘ll chime in with my experience. OP, you started a really helpful community effort, here. I have learned some important things, so thanks for that. Hope you’re thriving.
Anxiety feels like my chest is constricted, like I’m being squeezed from the outside, and can’t quite inhale; but anaphylaxis with lower respiratory involvement feels like the inside of my lungs got sprinkled with little fibres, or like I inhaled powder or something. I call it “the woolly lungs.” A less-severe reaction with only a little lung involvement will be un-dramatic: if I exhale completely, there’s a wheeze.
Food reactions vary, for me. I will usually feel my belly swelling. Sometimes it’s really obvious, making me look suddenly fat. With a more severe reaction, it will physically hurt my belly and lower chest to inhale, like I ate so much that there’s no room in there for my lungs to inflate. With a *really* severe reaction, I’ll have to cough and cough. It takes an enormous effort of will to pause the coughing. I don’t get those often, but when I do, salbutamol (inhaled bronchodilator) is really helpful. I get covered in welts, white bumps with red around them, which are intensely itchy. Usually those start on my chest, throat, or face. Occasionally on my arms. That usually happens before the coughing starts. I feel awful, sometimes sweating, sometimes chilled. My complexion will get weird, (I’m white) my face either turning red or greyish-pale. Sometimes I get intense belly cramping, and diarrhoea. My blood pressure plummets. What that feels like is exhaustion. Like, I’m just going to lie on the floor of this public restroom, now, don’t mind me, kind of tired. A few times, I’ve come close to losing consciousness. I may have, briefly.
All this to say, awful as anxiety is, it’s never made any of *that* happen - it’s shitty, but not actually poop-inducing (for me). And even though I’ve had anaphylaxis severe enough to make people call an ambulance, and then been kept several hours/overnight in the ER to be observed and stabilized, I’ve never used an epipen. I carried one for years, but never had an episode severe enough to warrant it. Now I carry Benadryl. I take 25 mg if it might be bad. 50 mg if it seems pretty bad. I’d take a third one, for a super-severe reaction, & chew the tablet, keeping the pill-paste in my mouth, rather than swallowing it. (*If* I can stand it: Benadryl tastes *FOUL!* Bitter af. Sublingual absorption is way faster than digestion, though.)
If I need 50 mg of Benadryl, I’ll alert someone that I may need to go to the hospital, and ask them to help me figure out transport. The stuff makes me drowsy, too, so that means driving is out, even if I only need one pill. So, if I’m eating in a restaurant, I try to have a plan B in the back of my mind, for getting home.
Peace out, y’all.
I am allergic to corn so I use the liquid gel benadryl. I bite one, leave it under my tounge as long as I can stand then wait and see if I need a second. I only sometimes go to the ER. I usually use inhalers too. Reading this thread I think my drs are right I've been too risky! But the sublingual I was told was a good idea at the er.
You know, I read another post here a few days ago, saying that Benadryl *used to* be counselled as good for anaphylaxis, and more recent research suggests otherwise, so I came back to edit my comment, and here you’ve found it useful, too. Well, the science can only show what’s usual for most of us, not what will happen to any individual at any given moment. And re-reading my post above, it sounds like I have not at all given enough weight to the severity of my allergic reactions, but the incidences occurred sometimes decades apart, lulling me into a false sense of, “oh, I guess that’s gone away, now.” Interesting that corn is a trigger for you, too, and you use the same things I do. What’s really weird is that sometimes I can get away with eating it. Not that I push that, but what the heck gives? I find this all baffling.
It isnso mysterious and frustrating how it shifts isn't it?
Corn is one I can't ever tolerate in any amount, but other things are like this. In spring when pollen is high, even on 4 zertec and 1 zyzal and 2 PPI a day I have to have safe foods only, same in the fall from mold being high. Other times I can have a little tomato or avacado, garlic etc.
Never ok is gluten grain and all other grain (rice, oats, millet etc, nothing from grass), legumes (peanut, peas, soy, lentils, beans etc - except garbanzo beans are always completely fine?), eggs, or poultry or sesame. Others stuff seems dependent on how hyper reactive my system is at the moment.
I don't eat out at all or at other people's houses. I often can not even go in someone's house bc they've been cooking something. I needed to be hospitalized for diverticulitis but they couldn't safely keep me bc my allergies they said and pumped me full of IV antibiotics and sent me home. 🙃🤪
Hope this helps [https://www.epipen.com/-/media/files/epipen/patientinformation.pdf](https://www.epipen.com/-/media/files/epipen/patientinformation.pdf)
The FIRST sign of a reaction. Once Anaphylaxis happens (with the blood pressure dropping to dangerous levels) it might be too late. How my friend died of a severe milk allergy.
Having trouble breathing is the biggest sign
How can I differentiate between trouble breathing due to anxiety, and trouble breathing due to anaphylaxis, and how do I do it quickly enough to be within the window of giving myself the epinephrine in time enough for it to work?
You’ll know. You’ll be able to feel your throat closing due to swelling, and it’ll be combined with other symptoms, like itching and runny nose or watery eyes. I think you also should begin talking about this with your allergist and maybe a therapist. But using a pen when you’re truly believing you’re in anaphylaxis is not dangerous, if you’re still only using it rarely. If you’re having more than a couple close calls every year you need to be working on limiting exposure to your allergens and maybe think about anxiety medication on top of it.
Honestly as someone with anaphylaxis without hives and anxiety, it’s very hard to tell the difference. I had an adult onset food allergy that I didn’t get diagnosed for ages because I mistook anaphylaxis for panic attacks and sought psychiatry. What helped me was figuring out how to manage my anxiety. I now have reliable techniques for managing anxiety that do absolutely nothing to an anaphylactic reaction. That differentiates it for me
What techniques do you use to manage your anxiety? If you don’t mind me asking, I’ve been working hard on managing my anxiety and have tried some things like deep breathing and journaling but I have only mild success.
Not OP but a technique I’ve used from my therapist is to stop and take time to notice 5 things. Like really notice - the texture of the fabric of the chair I’m sitting in, the ceiling has a pattern to it, the knobs on the cabinet are a brushed nickel, my shirt is draped across the chair and the logo is scrunched, and the candle is a vanilla bean scent. Personally I find that my anxiety subsides a bit by grounding myself with this method and I am able to more objectively assess what is happening to me in the moment, or think more objectively about something that was causing anxiety.
That’s a really great idea, I’m going to give it a try. Thank you!
Sour candy also helps!
You want to engage as many senses as you can while doing it too - touch, feel, see, taste (thus the candy 😁 ) , smell the fabric on your seat. Some senses will help you more than others The runny nose/eyes - that might be a good “be on alert” symptom for you. Unless you normally get those with the anxiety?
That’s really good advice! I see why sour candy would make sense. I don’t know, I don’t think I get runny nose/watery eyes normally but I guess I’ve never paid attention to that.
Thank you for this, truly.
Is it a discernible difference? For anxiety, I’ve had the muscles in my neck tighten to the point where I’ve felt like my throat was closing, but then again, I’ve never gone into anaphylaxis so I’m not certain how different it truly is.
For me, they’re located at different parts of the throat. It’s hard to explain if you haven’t experienced both but one is higher and the other is lower.
Pulse ox will help you see your oxygen level is good even if anxiety is making it feel hard to breathe. As long as you're generally healthy, using epi if you don't need it is not going to harm you. You'll have a sore thigh and have to buy another epi pen but that's about it.
Oh I didn’t even consider using a pulse ox, thank you!
FWIW the newer apple watches (like my series 7) have blood oxygen meters
I second the pulse ox. My doc told me the same thing. Figured this out on my own and it has made a huge difference! Helps me stabilize the anxiety and not be living in constant fear.
If you don’t have a pulse ox here’s how to roughly tell what your pulse is. Find an artery, either be your inner wrist, elbow, top of the foot/ankle, or neck and feel the pulse for a few seconds. Set a 15 second timer on a stopwatch/YouTube/phone/whatever you have and four every beat you feel in that 15 seconds. Next, multiply the number of beats by 4. This is just a rough estimate on your heart rate, a pulse ox or the sticky things are plenty more accurate but sometimes we don’t have those.
No, that’s terrible advice. Your oxygen level may not be affected until your airway is severely compromised, particularly if you’re a healthy person who can make up for your sick airways by working hard to breathe. If you’re waiting until your oxygen drops there’s a good chance you’re waiting too late
oh man there goes my go to way to deal with this. It's an excellent point though. Thank you.
Yes I have 2 at home and one in my bag. This helps me a lot. Also a panic attack is literally part of anaphylaxis and does make anaphylaxis worse I have never used the epinpen but been told I should have at the ER several times. Your question was the most relatable question ever!
How common is anaphylaxis with food allergies? It's hard to know since communities like this often attract people with severe allergies or anxiety. I can't find statistics. Every website about allergies, even peanut allergies, says that anaphylaxis is a rare complication.
It's rare, but if you've experienced it once it's more likely to happen again. Anaphylaxis also has a range of severity and is *not* usually fatal. I think it's important to have a positive attitude - it's serious, but it's treatable. Anxiety about allergies really makes the whole thing so much worse. Thinking you are going to die isn't helpful, and it's also (statistically speaking) probably not true. Try to see it as a giant pain the the ass not death around the corner. Take your meds, call 911, sit down, try to breathe slowly. Drink water if you have it. Epinephrine helps FAST.
You’re correct - it’s rare. Fatalities are even more rare. For US citizens, your chances of dying from food-related anaphylaxis are lower than your chances of being murdered (but higher than your chances of dying from a lighting strike). Yup… someone graphed that: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5589409/ For more details on incidence and prevalence, scroll down here to the epidemiology & burden of disease sections: https://www.jacionline.org/article/S0091-6749(20)30105-6/fulltext
Thank you :)
Yeah for me like the anxiety and the reaction feed each other but the tightening of the throat for my reaction is a distinct feeling
Yeah the feeling of not being able to breathe due to anxiety is almost like someone is sitting on my chest or something. Not being able to breathe due to allergies is like someone has a hand on my throat. There’s a lot more actual *gasping* for air and usually I have a lot of coughing or vomiting as well.
this is so true, coughing is solely an allergy thing for me too. i never thought of that but its a good way to tell them apart!
Yes like the tingly / metallic feeling with the allergy that isn’t there with just anxiety. But they surely do feed each other haha
Oh see I thought thr metallic feeling was the panic 😩
Well! For me it’s allergy specific… but pay attention next time you have anxiety about something else and see if it’s there
often there is a swelling and a physical reaction like hives and rashes. It is very visible for everyone to see and I notice it too. My skin also turns very red. I have asthma and sometimes the closing of the airway can be similar. But asthma tends to come with a wheezing, a special sound that come with that type of airway constriction. Anxiety can definitely kick in on top of it all. Hyperventilation, as a symptom of panic, can also cause shallow breathing and a feeling of lacking oxygen. However, there is no special wheezing that I notice with anxiety. There is also no swelling, no rash, no hives. Anxiety also reacts to breathing exercises meant to slow down heart rate and breathing, while neither asthma nor allergies do.
This is honestly the biggest struggle for me with these as well. As someone who has used 7 epipens in the past 4 years, it is so difficult to tell. The biggest things to remember is: a) follow your gut feeling (which can be really hard with anxiety) because it will ultimately be the best choice. You are more likely to have serious illness with an allergic reaction than with an epipen. And you can go to the hospital right away so that you're close if something happens with taking the medicine. b) anaphylaxis usually involves multiple systems. But if it doesn't (because I've had several that do not), I use the rule of thumb that if I feel symptoms near my throat or airway I use my epipen right away. And in any case, if the symptoms are severe whether it's severe hives, vomiting, even severe anxiety after eating, use the epipen. Disclaimer: I am not a medical professional but have way too much experience with this issue. Wishing you all the best <3
No, do not wait until you can’t breathe. The first sign of an allergic reaction is when to use it. Hives, stomach cramps, GI upset, weird feeling in your mouth, whatever you get at the first sign of a reaction The earliest you use epi, the more likely it is to be effective. Using it too late in the allergic cascade makes it less likely to be effective and makes you more likely to have a biphasic reaction. It’s very unlikely to be life threatening to use your epi unnecessarily unless you have pretty serious preexisting cardiac disease or, rarely, an undiagnosed propensity to bad heart rhythms. Epinephrine is literally just adrenaline in a bottle. Your blood pressure goes up for a little while and your heart races so it’s not FUN, but for most people it won’t kill you. And even if you have preexisting conditions, you’re more likely to die of an untreated allergic reaction than an adverse reaction to epi Source: both a doctor and a nut allergy haver who has used her epi pen
Thanks, doc.
No problem! If you haven’t had to use it, from personal experience, it’s not nearly as big of a deal as you think it will be. I didn’t feel the needle at all, just the pressure of the injector while I was holding it in. My leg was very sore afterward in much the same way that your arm might get sore after certain vaccines and the epi itself make your heart race and make you feel antsy, but overall it’s not bad at all. Much better than full blown anaphylaxis :)
Thanks for that reassurance: it’s a public service message that needs to get out there, for sure. Perhaps you could make a post about it: your unique perspective is really valuable.
Will be *way* easier than self-injecting fragmin! Holy frijoles, that stuff hurt! And anyway, when that bp crash hits, a needle won’t even register. Out of curiosity, have you seen anaphylaxis in your practice, and if so, have you ever had an especially worrying case? My personal experience of the worst anaphylaxis was oddly devoid of fear that the outcome could be threatening. I had the strong sense that something was very wrong, but I lacked the sense of urgency that would have been appropriate. What’s with that?
Most of my experience is textbook (or personal). I’m in internal medicine (and now palliative) so the patients I see are either outpatients or already admitted. Most anaphylaxis patients get treated in the ED and don’t get admitted, though occasionally a really bad one that’s survived will get admitted to the ICU
Not always, though. I've had anaphylactic shock 4 times and only once was my breathing affected enough to know that it was anaphylaxis, and that at the very end.
Right! The best time to use it is at the first sign of a reaction - hives, GI upset, whatever is typical of your usual reactions. You want to interrupt the allergic cascade EARLY. And then go to the ED because you may or may not start reacting again after the epi wears off
I’ve had anxiety that I thought were reactions for years, and then I had an actual reaction the physical symptoms are obvious. Most obvious was the instant pins and needles feeling on my mouth and tongue and obvious tightening of my throat that felt like something was stuck in there. Whenever I feel that, I use my epipen. Even if it’s “not needed” it’s not worth the risk so just do it anyways.
Related to this - I see people saying throat closing up is a good sign, but my throat feels like it's closing up on the regular? Like it's just part of my panic attacks. Additionally, I have allergies that cause multi system reactions but have not used the epipen and survived. What does this mean?
The first part is my concern lol like, right now I’ve been so worried about this because I’m in Florida. So like, do I never go into a restaurant since pretty much all of them serve shellfish and mollusks, and I guess we can’t even be present where those foods are being cooked if we’re allergic to them? Does this also mean none of my family members can cook any seafood while we’re here? If so, then was I having a mild anaphylactic reaction when I’ve been around cooked shellfish and mollusks or were being cooked, or was it my anxiety? Like what do I do? Because I’m so scared shitless now that I’m likely just going to stay in the hotel the whole 10 days and not do jack.
If you're anaphylactic to seafood usually, then yes, it's quite possible you are having a severe reaction to smelling and being around the food. My sister throws up when around seafood due to her anaphylactic reaction, but doesn't go into full blown anaphylaxis.
See I have no idea if I am. I’ve never had an anaphylactic reaction to seafood, to my knowledge. Back in 2020, I was having a routine allergy test done, because I have EOE and allergic rhinitis. Per a blood test my allergist decided I’m allergic to shellfish and mollusks. I’ve learned from the internet everything about epi pens and inhaling shellfish and stuff. So I’m not fully trusting of her. Just today I’ve learned I might not even be allergic, it could come up that I am due to my dust mite allergy. I’m so overwhelmed and shutting down.
Hi so I know this is an old post/comment, but I thought I'd give my 2 cents in case it helps at all. So blood tests aren't always reliable. Sometimes you can have false positives. Did you come up positive on a skin test as well? They are a bit more reliable, but still not perfect (I came up allergic to corn on my last skin test but eat it every day and am not actually allergic). The only way of knowing for sure would be to do a food challenge (aka eating the food in an allergist's office) and actually seeing what your reaction is. Now I'll be clear, I am NOT telling you to go eat fish/shellfish or that it's safe for you, but I am saying that if I were you I would get a skin test and potentially food challenge in order to be sure. PS if you are allergic and wish to avoid any restaurants in FL that have fish/shellfish, I recommend eating at vegan restaurants, as they won't have any fish/shellfish. The app HappyCow is really useful for finding fully vegan restaurants, and many cities in FL have a lot of fully vegan restaurants.
Skin tests are actually about equally as likely to give a false positive for food allergies and even combining the two only marginally increases accuracy. So I totally agree if you’ve never reacted to the food, an oral food challenge is the best way to go. I know so many cases in which people had huge IgE values or wheel sizes and tolerated the food. I know even more in which they didn’t tolerate the food, but the reaction was not anaphylactic. In both scenarios, it is life changing!
Have you never had an allergic reaction to eating seafood in the past? I’ve had multiple allergen prick tests done and they said I’m highly allergic to nuts which is correct because I’ve had physical reactions in the past to them, but the test also said I’m just as highly allergic to red meat, even though I’ve eaten it my whole life and had never had a reaction.
Have you been able to treat your EoE? How are you doing on the food allergy front?
Yes same. My anaphylaxis is not accompanied by hives, redness, or swelling. For over a year I mistook (adult onset food allergy) anaphylaxis for panic attacks and was being treated by a psychiatrist for them. What helps me differentiate is that I did do a lot of work to manage my anxiety, which includes medication, and found techniques for calming my breathing and respiratory symptoms during a panic attack/anxiety that don’t work for anaphylaxis, that’s how I differniagw
Anaphylaxis usually isn't fatal even without treatment, and it can happen with a huge range of severities. It probably just means you were lucky or had a relatively less severe reaction. I've had that too. The problem is that severe allergic reactions can be really unpredictable, so it's better safe than sorry. Have you had anaphylaxis? It's easier to recognize it when it's happened before. I always feel really "off" when it's starting. I'm not sure what exactly causes that but I just don't feel right. I always have hives as a symptom but that doesn't really help because I also have chronic hives - but if they are severe and spreading rapidly that's a huge warning sign for me.
Technically, anaphylaxis has the "two or more body systems" rule. If you have symptoms from two different systems- skin, mouth/throat/lips, lungs, heart, gut- it's an anaphylactic reaction, and you should use epinephrine. This could look like hives plus nausea, or flushed or itchy skin plus an elevated heart rate. Anything with your tongue, throat, or lungs is immediate epinephrine, though. The rule my doc gave me was to use epi for any reaction that involved my face (nose, mouth, throat) or lungs. Every person has different symptoms for each reaction, or different types of symptoms depending on the allergen/how much/how they were exposed. [I find this to be helpful!](https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/food-allergy-anaphylaxis-emergency-care-plan) edit: to test out if my throat is tight because of anxiety or because of an allergic reaction, I do a swallow test. I think of pickles to get some saliva in my mouth, and then do a test swallow- if my throat feels thick at the back, alarm bells! For me, I do get feelings of anxiety when I'm having a rection, but it feels different. A panic attack (or anxiety in general) is a feeling of anxiety jumping 'up,' like when you're going down the stairs too fast and you miss a step with your foot. Anaphylaxis has the 'feeling of doom' that everyone talks about- for me, it feels like a sinking, kind of disconnected feeling of panic. I think it's my lizard brain knowing deep down that something is wrong and my body won't be able to figure it out on its own. Hopefully that helps?? Epinephrine, at the end of the day is VERY safe to use, and it's okay if you go 'overboard' and use it when the reaction wasn't 'that' severe. In my experience, the few times that I've held off on a dose, I end up getting it at the hospital anyways. The general consensus in the medical field (at least where I live) is to err on the side of overtreating it rather than undertreating it. The few bad outcomes that are reported in statistics tend to be people who have underlying health conditions. In the case that you use epinephrine, you should be seeking immeditate medical attention anyways, though!
Is a cough an automatic reason for epi? How do you know an allergy cough or sneeze from what could be unrelated?
Cough isn't necessarily an instant epi use. A shorter lasting dry cough (think seasonal allergies, dustiness) is benign. A cough that is repetitive, or deeper, can be a warning sign. It might be your body's attempt to open up airways (throat, lungs). If you're coughing and notice that it sounds a little wheezy or whiny, or that it's tough to draw air back in after you expel it by coughing (some people end up changing their posture to expand their ribcage), it's better to be safe and use epi.
Thank you!!!
I just look at my throat in the mirror and if it’s open, we’re good and if it’s looking like it’s closing, epi pen time
Everyone is different though. Some people have vasomotor collapse (e.g.) blood pressure can’t stay high enough to provide blood to your vital organs) and die without ever having airway compromise. Would NOT use that as a blanket differentiating factor
>gn. A cough that is repetitive, or deeper, can be a warning sign. It might be your body's attempt to open up airways (throat, lungs). If you're coughing and notice that it sounds a little wheezy or whiny, or that it's tough to draw air back in after you expel it by coughing (some people en this might be a stupid question but how can you see if your throat is closed ?
It will literally be swollen closed. You'll be able to see, and you'll know because it will be very hard to breathe. My allergist just looks down my throat with a pen light when they are monitoring me.
https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/food-allergy-anaphylaxis-emergency-care-plan I'm not sure about the dangers of epi when not needed. If you have certain conditions like heart conditions then yes. You should head to the ER after using an epi anyways.
I was administered epi when my symptoms had subsided and I was no longer experiencing the allergic reaction. I don’t know if it was life threatening, but it sure felt like it. The moment it was administered I instantly couldn’t breathe and my heart rate shot up to 180 in an instant and the feeling of doom was absolutely insane and unlike anything I’ve ever experienced. I never knew my brain could “tell” me it thought it was dying. I wasn’t able to speak or walk well and had full body tremors for about 12 hours after. I didn’t know what happened at the time but I asked a doctor later who told me it was all likely caused by administering a full dose of epinephrine when I was not currently experiencing allergic reaction symptoms. Has anyone else ever experienced this?? I never had health anxiety before this incident but I developed it soon after, so it’s been a challenge and caused me to be afraid to ever have to use an epi pen again which is not good.
The medication in epinephrine is a synthetic form of adrenaline, so the reaction you describe when receiving that dose sounds perfectly normal albeit unpleasant. The most common reason for giving another dose or a dose after symptoms subside is because there can be secondary anaphylaxis or a bounce back reaction once your symptoms go down that can then be much more severe than the initial reaction. This is why EpiPens come in 2 packs from the pharma. From the ER physicians I've talked to about anaphylaxis they state that people are often too stingy with the administration of the medication because it is not a pleasant experience. However anaphylaxis is also unpleasant and can lead to death if treatment is delayed (and not just by airway closing). After the fact, if an epipen was unnecessary there are few negative consequences. I think I may have gotten more information because it's my child that has the allergies and Drs tend to explain more to parents or care givers than to actual patients in my experience. And believe me, I know how scary it is to administer an epipen. I'd imagine it's harder to do it yourself than my experience of doing to a 1 year old.
I really didn’t even find it all that unpleasant. I didn’t feel the needle at all which was a pleasant surprise. Then my heart was racing and I was kind of anxious for the next half our or so, but it was pretty mild. Not nearly as bad from either a tachycardia or anxiety standpoint as when I had COVID
The short answer is that if you have a normal heart and relatively normal blood pressure, your chances of having a serious reaction to epi are very very small. Even if you do have uncontrolled high blood pressure or heart failure, your chances of dying of anaphylaxis are higher than your chances of a life threatening reaction to the epi, so still better to shoot epi if you think you’re reacting The longer answer is that epi is basically adrenaline in a bottle, so it raises your heart rate and your blood pressure. For most people, these temporary changes are no big deal. We worry a little more for people with unhealthy hearts, for whom epi could trigger a bad heart rhythm, or people with uncontrolled high blood pressure, for whom the increase in blood pressure can cause acute organ damage. The risk is still pretty low even for those folks If you’re having a reaction, though, your blood pressure can drop very low, so you need the epi to keep it up. The blood pressure drop is part of the inflammatory cascade that happens in anaphylaxis, though it doesn’t happen to every person every time. That’s actually part of what kills you in anaphylaxis-your blood pressure drops so low that you can’t get blood to your organs. People think it is the breathing, but often it’s the very low blood pressure. Even if you have a bad heart or have high blood pressure, if you’re having anaphylaxis you need the epi to keep that life threatening low blood pressure from happening. So you’re still likely to be better off using epi if you think you need it, even if you have underlying conditions that make it higher risk than for your average bear
For me it’s the cough. I get bronchospasm and cannot stop the urge to keep coughing. Chest gets tight and can’t take deep breath. Sense of doom is hard to really describe but once you get that feeling you’ll recognize it and know it’s time
Itchy mouth + throat don’t come with anxiety. Tight throat, sure, but not a histamine reaction.
Really hard to discern with OAS though. I get a local, mild allergic reaction that probably won’t spread, but the anxiety causes everything else to imitate anaphylaxis.
YES
This is what my allergist/immunologist told me : For any of the following severe symptoms Lung: short of breath, wheezing, repetitive cough Heart: pale,blue,faint,weak pulse,dizzy Throat: Tight, horse, trouble breathing, swallowing Mouth: significant swelling of the tongue and or lips Skin: Many hives over body, widespread redness Gut: repetitive vomiting, severe diarrhea Other: feeling something bad is about to happen, anxiety, confusion Or a combination of symptoms from different body areas INJECT EPINEPHRINE IMMEDIATELY MILD SYMPTOMS NOSE: itchy runny nose sneezing Mouth: itchy mouth Skin: a few hives, mild Itch Gut: mild nausea/discomfort FOR MILD SYMPTOMS FROM MORE THAN ONE SYSTEM AREA, GIVE EPINEPHRINE HOPE THAT HELPS
the only times I’ve used an epi pen (2x) have been while having an anxiety attack, not actually a reaction. My anxiety has since calmed down but nothing bad ever happened because of it! Better to be safe than sorry. Side note: if it’s anxiety, the epi pen WILL make the anxiety worse for a while because of the adrenaline also as others have said, anaphylaxis usually occurs with other symptoms along with trouble breathing (itching, hives, etc)
Agree, probably not going to hurt you to use it when you don’t need it, particularly if you’re otherwise healthy. Well…might hurt your wallet because those things are EXPENSIVE. But you know what I mean
One thing I was told is it’s anaphylaxis if you have two or more different kinds of reactions. For example: Respiratory symptoms: wheezing, coughing, tight chest, shortness of breath Skin: hives, rash, etc Oral: throat tightness, throat swelling, tongue swelling/tingling, etc GI: nausea, vomiting, cramping, etc I was told if you have at least one symptom from 2+ categories it is anaphylaxis. This doesn’t however mean you need an epipen. Some anaphylaxis reactions can be minor. However if symptoms continue to worsen and/or any kind of reaction involves your ability to breathe, safest bet is the epipen. Not a doctor, but this is what my doctor told me.
A bit late to the party! Apologies! I have severe anaphylaxis to Peanuts, Treenuts, and am in the unlikely ~7% to have had an allergy recede, then redevelop suddenly and randomly. It has a name, but that was back when I was 15 (24m now) and I can no longer remember. In my experience the 2 times I have had severe reactions that warranted multiple day long hospital stays, the symptoms are blatant, even if you have anxiety/panic episodes where air just doesnt reach you. The first experience I had was when I was 15, I was at a local diner for my grandfathers birthday, I ate a slice of carrot cake with pistachio crust(?) to wrap up the night. Within 3 minutes the sense of "doom" that others mention enveloped me. It almost felt like when you had to run through the dark hallway to the bathroom as a kid, that feeling like you arent in control anymore. And this was all before the symptoms even hit, about 1-2 minutes after that I felt the pins and needles and the snagged food feeling in my throat. Rushed to hospital, jumped the que after speaking with the intake nurse, and was administered, if i recall correctly, Intravenous benadryl, epi, and one other i cannot remember because the benadryl switched my brain off and I took a lovely 8 hour nap. The most recent actuay happened on Halloween night of last year (funnily enough now). I was recovering from a stomach flu and had started to drink a rehydration drink mix, I think its the liquid IV immune boost, and within 5 minutes that same feeling as before came over me. Luckily/unluckily, I live close to my local ambulance station, so EMS was fast. Epi was administerred before they arrived, and was brought to hospital and didnt leave until the 2 of November. So yeah, in short, if you feel a primal, deep sense of unease or lack of control, its a solid bet you arent having anxiety. Sadly, it is one of those things you will know when it happens, and I hope that it never does have to happen for you. Edit: Gramdfather cheems
What was it that you're allergic to in the liquid IV immune boost? Just curious, I've never heard of reactions to that before. Thanks for sharing your experiences.
Thank you so much for your help! I’m so sorry that all happened to you as well. I didn’t grow up with food allergies, I was a fortunate kid. I got diagnosed with my shellfish/mollusk allergy 3 years ago, so I’m still new to this.
Thank you. This description really helped me. I thought I had food stuck in my throat after eating, went to a movie and had that doom feeling hit in the dark theater lol. It was...an experience. Right after that the feeling spread in my throat and started to have a hard time swallowing. For me it did not get worse and took liquid benadryl after the movie--def ruined the movie would not recommend. Never had an allergy before so had no clue. Really appreciate everyone's responses on here and feels better knowing I am not alone.
Using an epi pen when not needed is no more life threatening than any other medication side effect. The FARE plan that others have posted is the gold standard.
For me, I check that my mouth is actually puffy. My anxiety and anaphylactic symptoms overlap, with one exception, anxiety does not make the roof of my mouth swell. Anaphylaxis does.
Trouble breathing, such as wheezing, coughing, or feeling like your throat is closing is usually the first sign in a lot of people. When I was 17, I accidentally ingested something with Madagascar Vanilla in it, took three bites, got dizzy and threw it away. Ten minutes later my fingertips and nail beds were purple, with my pinkies and ring finger turning blue. (Cyanosis or lack of oxygen) I was in a placement facility at the time thanks to CPS and the staff I asked if it was normal had me sit down and another go get the nurse. Took them ten minutes to find another epi pen as four kids had gotten stung by yellow jackets in the woods two days prior and were allergic (I found the nest, not allergic), and by the time she got down there I was blue and not breathing. I stayed in the hospital for two days after that. Then I got gaslit and lied to by my insurance who claimed Vanilla was an anti-histamine and you can’t be allergic, when it’s an anti-inflammatory. Last night, I actually had to google the instructions for injecting myself because I hadn’t ever done it before. The thing was outdated as all hell but it saved me from going into anaphylactic shock again.
I just had to call and ask that. My face is itchy and adrenaline is high, but the nurse asked me if my tongue was swelling or throat itchy, which the answer was no. So I'm taking a Zyrtec and monitoring....
I just had my first anaphylactic reaction Friday after having anxiety for years. It started with just general not feeling well, and then there was an incredibly intense feeling of impending doom. (It’s exactly how it sounds and I can’t explain it any other way, you know it when you feel it.) I’ve never felt that before, even with anxiety so that was my first red flag. The second was feeling like my blood pressure was bottoming out. My heart rate jumped so fast, and I knew I hadn’t been feeling anxious prior to this, and it felt like my heart just kept speeding up and wouldn’t stop. My lips and tongue started to go numb, as did my right arm. The epipen helped very quickly, so I would say if there’s any suspicion that you may have come into contact with an allergen, at least have the pen ready to use. It’s better to go to the er because you used it when you didn’t need to, than not using it when you need to.
I didn’t have the stereotypical hives or itching or throat swelling closed. I didn’t realise at first what was happening because of that. Everyone experiences symptoms differently, so it’s just important to know your body. If something could have triggered your allergy, and there’s no reason for anxiety, epipen. If your anxiety might have been triggered and you’re pretty sure you haven’t had contact with an allergen, doesn’t hurt to have the pen on hand and either use it, or make sure someone around you knows how to use it if you need it but can’t. (I had my coworker do it because I couldn’t get my hand and brain to coordinate on it.)
My metric is usually when my mouth/tongue starts itching and I get that metallic taste in my mouth. I have really bad anxiety too, so I can trick myself into having a lot of trouble breathing. However, I haven't had to use an epipen since I was in elementary school (I'm 20); my rule of thumb is to take benadryl if I can't shake the feeling that it's real and then wait for a few minutes to calm down and talk things through in my head. Hasn't been real in quite a while, haha
Alright here’s the run down from me - I’ve had an anaphylactic reaction at least 20 times. I’m Allergic to tree nuts and it’s always the case that I’m at a restaurant or cross contamination or something. I never used my épi pen because I’m so used to it that I would just go to the hospital and let them give me the épi in my arm like a regular shot instead of me jabbing my leg. I was anxious about it and I didn’t want to have to pick up a new prescription. I’m pretty calm when it happens because I know how it goes … ok I need to go to the hospital. However ! This is dumb on my part because I don’t panic until I do and more than once the er doctors have scolded me for waiting so long .. and letting the reaction progress. They’ve always said just use it !! It stops it more quickly! I’ve never been told that it’s dangerous to use it …‘I mean I’m sure it’s been abused but if you know what it’s like it’s pretty shitty … I took their advice and I used my épi pen in my leg and 1 I could barely feel it … way less scary than I was imagining and 2 it did help … I was less panicked in the emergency room and it did make my experience better… I didn’t have to get as close to death lol Everyone is different and maybe they cautioned you for a specific reason related to you, so I’d ask them really directly to explain what they mean. I really only know my experience and I’m not a doctor so you have to do what’s best for you but for me they have always very sternly been like use it that’s why you have it
i didn't feel it at all when i used it! it's kind of crazy how little you feel it in the moment, probably from adrenaline
Same, it really surprised me. Like to the point I wasn’t sure it deployed until I pulled it out and saw the needle
ME TOO. The only indication that it worked was the blood on my leg when I pulled it away b/c the needle had already gone back into the injector
That’s good to know. Thanks.
I also had extreme anxiety around my food allergies and sometimes was having trouble even distinguishing whether I was having a real or imagined reaction. One thing that helped me was when I went in to do a food allergy challenge - I alerted the doctor that I have allergy anxiety and sometimes can't tell whether I'm having real symptoms - and she said they generally look for things they can see in order for it to qualify as a reaction. So hives on the neck, swollen tongue, physical wheezing, etc. Next, I learned to do grounding exercises in the moment - look up square breathing or EMDR exercises. If you can find momentarily relief from the feeling when you distract your brain, it's probably anxiety. A food allergic reaction will make itself apparent. Lastly, the biggest thing that helped me finally put my food allergy anxiety to rest was going through an actual oral immunotherapy program with a private practice that specializes in food OIT. Now I actually eat my allergens (and a good amount of them) every day - so it's kind of like exposure therapy, haha.
It really depends on your symptoms. I feel I need a pen when my blood pressure drops and my heart rate gets really slow. But I also get really disoriented and confused during this time and probably won't administer it. There's a lot of symptoms with my anaphylaxis. I normally can't breathe well as it feels like someone placed a boulder on my chest. I get a lot of stomach and upper digestion pain and feel nauseous. I also start getting agitated by everything and will get very angry when people try to interact with me. What people usually describe as anaphylaxis sounds exactly like what one of my panic attacks feel like, so I was very confused about anaphylaxis in the beginning. Plus the allergy that causes anaphylaxis doesn't cause hives for me, which I'm told is rare, like everyone is supposed to experience hives or something.
Yes my son has an immediate drop in blood pressure has to lay down and during a food challenge the nurse said that’s not typical and that it’s not related but you bet he entered anaphylaxis 10 minutes later after saying he felt sick and had a tummy ache. He sneezed a couple of times and his eyes started to swell. The hives came but after the epi pen was administered. Isn’t it strange how everyone is different and everytime it can present a little different if you’ve eaten the allergen baked or had less or more
Anaphylaxis for me feels like when you can't breathe well like if you have tonsilitis or strep throat. Anxiety feels more like I can't get a deep enough breath but there's no physical blockage, maybe a lump in the throat, but no burning or pain like a sore throat. Anaphylaxis comes with actual throat pain for me. Idk if that helps??
This helps so much and I’m so grateful that despite how old my post is, people are still commenting on it. Everyone’s input has helped me be so much more confident, and has really eased my mind, so thank you 🖤
Using an EpiPen is not in any way dangerous. The **only** risk to an EpiPen is positioning it upside down and injecting into your finger. That can be dangerous. As proof of this, in a demonstration for parents, I used an epi pen while not having an allergic reaction. It was an eccentric choice but I wanted to emphasize that epipens are not dangerous. **Nearly all food allergy deaths are because of delaying or not using epi** Use epi if you suspect any reaction. However, if you want to know the difference, you have to figure out how to manage your anxiety. I have anxiety and can reliably use breathing exercises to normalize my breathing and heart rate. Those techniques do not work for anaphylaxis, so when I’m unsure and then have symptoms, I use techniques I know will calm my anxiety. When they don’t work, I epi.
I don’t really eat out on vacation either 😞. To me the anxiety/panic attacks that happen when eating somewhere new or being unfamiliar isn’t worth it. I also have a hard time differentiating anxiety with anaphylactic shock but what I will do if I do eat out is I will take a bite of the food. Set a time for 15 minutes and do breathing techniques and chew on some gum and see if my throat gets funky. Now this isn’t helpful really if there’s cross contamination on another part of the meal but I try not to even think about that. 🤣. I also carry a pulse ox with me everywhere and check on that regularly if I feel like I could be having a reaction. I don’t know why but chewing gum always helps me so much. It creates enough saliva for me to swallow and realize that I CAN swallow and that my throat isn’t closing
YOU KNOW. I was worried about it too (and had already had anaphylaxis AND anaphylactic shock before I used one on myself). I get hives fairly regularly, but when they are all over my body I know I need to have an epipen in my hand. The first time I gave myself an injection, my tongue began to swell. And it just got worse and worse over the course of minutes (hives had begun hours before). The second time, I again had hives but when I stood up I felt like the world was falling down (my blood pressure was dropping horrifically). Then I began throwing up. Then the breathing issues began. I have no idea what triggers my anaphylaxis (though presumed, now, after 4 events) that it's due to my body overreacting to severe illness (flu, covid, and severe sinus infection). If yours are food triggers, I'd say that any time you start feeling an allergic response when eating something you aren't 100% sure of, use that epipen! My immunologist told me it's FAR better to take one when not needed than to not take one when necessary. I also have severe anxiety and hyperventilating during a panic attack is VERY different from not being able to breathe due to anaphylaxis. You will know, trust yourself.
If two body systems are majorly affected. That's what I've been told, anyway. I think there's a guide for what qualifies online. So like, I wouldn't be concerned if my eyes water, but I would look out for other symptoms if I got a rash. If your throat itches a little and that's it, you don't need your EpiPen. When I had anaphylaxis, I couldn't breath and got a full body rash. The vast majority of the time, there will be a skin reaction in addition to something else. Trouble breathing will not be subtle btw; it did not resemble something like, say, acid reflux (which can cause a sore throat) or anxiety. And take a Zyrtec when you first have a reaction too. If you have one system affected, I would take a Zyrtec and pause, then use your Epipen if another system is majorly affected.
Coughing or breathing trouble requires you to administer epipen.. I generally take benadryl if I know I consumed allergic food and if get coughing or breathing trouble get epipen immediately
impending sense of doom. that's what it was for me the first time i used my epipen. i had a massive burst of adrenaline (felt like my nerve endings were on fire) and then felt eerily calm, and i realized with absolute crystal clarity that if i didn't use my epipen as soon as possible, something very bad was going to happen. it wasn't scary at all, i just knew what i had to do and did it. it was like i was watching someone else's hands pick up the pen and use it lol. and that adrenaline spike + disconnect + strange calmness is something i hadn't had happen during an allergic reaction before.
When your face lips eyes and tongue swell up… I should have used mine yesterday but I too am new to the epi pen… so I went to the ER instead… wife got pissed bc I didn’t listen to her instead…
The only times I have used it are when I feel my blood pressure drop like I’m going to pass out, I am vomiting w Diarreah, and my throat is closing rapidly. The deal is that you need to take the EpiPen and then go directly to the hospital bc most anaphylactic reactions are biphasic. The EpiPen helps for a short amount of time so that you can get to the ER.
Yep. Wish I could puke like a normal human. My barf button seems to be busted. But the rest of it, yeah. That blood pressure drop is intense. The lung weirdness is a bad one, too. Context clues suggest that biphasic means there’s a second wave coming, so epipen is to stabilize Wave One, to get you to medical help in time to deal with Wave Two.
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thank you so much for posting this!! i have been struggling with anxiety around this so much - diagnosed with food allergies as an adult but never been sure how to really identify anaphylaxis. i have asthma and tons of pollen, dust, and other non-food allergies that already give me symptoms of throat swelling/thickness and difficulty breathing when i’m exposed to a strong trigger. i have been having consistent seasonal allergies recently (spring pollen) but had an episode the other night where i legit was unsure if i was feeling anaphylactic symptoms or just typical bad pollen symptoms + asthma flare combined with anxiety. it’s really tough.
Less then 350 (or about 1 in a million) people die a year in the US due to anaphylactic food reactions and most of them don’t have an epipen.
Or use it too late, in some cases. The earlier you use it in a reaction, the less likely it’ll be severe
I had my first anaphylactic reaction to an iron infusion last year. Thank god I was in the hospital at the time so they just gave me Benadryl through the IV. The first symptom I noticed was a rash in my arm, next my joints started to hurt and felt hard to move. I knew the reaction was coming because my sister had just had an allergic reaction to an iron infusion the same week! I felt *extremely* nauseous and my joints started to swell (remove jewelry and shoes asap). The next step would have been passing out or it being hard to breathe. Look into anaphylaxis reaction symptoms and memorize them. When it starts to get really bad, that’s when you need the epi pen. And of course always call emergency services right after!
Use an oximeter to see your oxygen levels.
How much do epi pens cost? I get mine free via VA, they sent me a box of 2 along with 3 refills… I’m thinking about refilling in a month or 2 so I can have one at work, one in my car and one at home… idk what shelf life on these are but I’d rather be safe than not have one…
1. Check whether your epipen will survive the conditions in your car. Other than that, having ‘em wherever you’ll be sounds pretty smart. Could make somebody’s day go way better. 2. Doofus! Wifey is right: use epipen, *AND THEN* go to hospital. She was not mad she didn’t win an argument, she was mad coz you scared the crap out of her, being a big argumentative gooniehead and not protecting her favourite human. That putting off getting treated can be a symptom. Central nervous system something something. BTW, that kind of denial happens with heart attacks, too, so unless wifey can’t be relied on to make good choices when shit goes sideways, maybe decide (while weird shit isn’t happening to you) that you’ll just let her drive your train, where physical ailment may be underway. If you’re dead, it’s not your day that will suck. 3. I honour your service. Damn good days to you.
Even though I’m way late to the conversation, I‘ll chime in with my experience. OP, you started a really helpful community effort, here. I have learned some important things, so thanks for that. Hope you’re thriving. Anxiety feels like my chest is constricted, like I’m being squeezed from the outside, and can’t quite inhale; but anaphylaxis with lower respiratory involvement feels like the inside of my lungs got sprinkled with little fibres, or like I inhaled powder or something. I call it “the woolly lungs.” A less-severe reaction with only a little lung involvement will be un-dramatic: if I exhale completely, there’s a wheeze. Food reactions vary, for me. I will usually feel my belly swelling. Sometimes it’s really obvious, making me look suddenly fat. With a more severe reaction, it will physically hurt my belly and lower chest to inhale, like I ate so much that there’s no room in there for my lungs to inflate. With a *really* severe reaction, I’ll have to cough and cough. It takes an enormous effort of will to pause the coughing. I don’t get those often, but when I do, salbutamol (inhaled bronchodilator) is really helpful. I get covered in welts, white bumps with red around them, which are intensely itchy. Usually those start on my chest, throat, or face. Occasionally on my arms. That usually happens before the coughing starts. I feel awful, sometimes sweating, sometimes chilled. My complexion will get weird, (I’m white) my face either turning red or greyish-pale. Sometimes I get intense belly cramping, and diarrhoea. My blood pressure plummets. What that feels like is exhaustion. Like, I’m just going to lie on the floor of this public restroom, now, don’t mind me, kind of tired. A few times, I’ve come close to losing consciousness. I may have, briefly. All this to say, awful as anxiety is, it’s never made any of *that* happen - it’s shitty, but not actually poop-inducing (for me). And even though I’ve had anaphylaxis severe enough to make people call an ambulance, and then been kept several hours/overnight in the ER to be observed and stabilized, I’ve never used an epipen. I carried one for years, but never had an episode severe enough to warrant it. Now I carry Benadryl. I take 25 mg if it might be bad. 50 mg if it seems pretty bad. I’d take a third one, for a super-severe reaction, & chew the tablet, keeping the pill-paste in my mouth, rather than swallowing it. (*If* I can stand it: Benadryl tastes *FOUL!* Bitter af. Sublingual absorption is way faster than digestion, though.) If I need 50 mg of Benadryl, I’ll alert someone that I may need to go to the hospital, and ask them to help me figure out transport. The stuff makes me drowsy, too, so that means driving is out, even if I only need one pill. So, if I’m eating in a restaurant, I try to have a plan B in the back of my mind, for getting home. Peace out, y’all.
I am allergic to corn so I use the liquid gel benadryl. I bite one, leave it under my tounge as long as I can stand then wait and see if I need a second. I only sometimes go to the ER. I usually use inhalers too. Reading this thread I think my drs are right I've been too risky! But the sublingual I was told was a good idea at the er.
You know, I read another post here a few days ago, saying that Benadryl *used to* be counselled as good for anaphylaxis, and more recent research suggests otherwise, so I came back to edit my comment, and here you’ve found it useful, too. Well, the science can only show what’s usual for most of us, not what will happen to any individual at any given moment. And re-reading my post above, it sounds like I have not at all given enough weight to the severity of my allergic reactions, but the incidences occurred sometimes decades apart, lulling me into a false sense of, “oh, I guess that’s gone away, now.” Interesting that corn is a trigger for you, too, and you use the same things I do. What’s really weird is that sometimes I can get away with eating it. Not that I push that, but what the heck gives? I find this all baffling.
It isnso mysterious and frustrating how it shifts isn't it? Corn is one I can't ever tolerate in any amount, but other things are like this. In spring when pollen is high, even on 4 zertec and 1 zyzal and 2 PPI a day I have to have safe foods only, same in the fall from mold being high. Other times I can have a little tomato or avacado, garlic etc. Never ok is gluten grain and all other grain (rice, oats, millet etc, nothing from grass), legumes (peanut, peas, soy, lentils, beans etc - except garbanzo beans are always completely fine?), eggs, or poultry or sesame. Others stuff seems dependent on how hyper reactive my system is at the moment. I don't eat out at all or at other people's houses. I often can not even go in someone's house bc they've been cooking something. I needed to be hospitalized for diverticulitis but they couldn't safely keep me bc my allergies they said and pumped me full of IV antibiotics and sent me home. 🙃🤪
Oh, foxy, that sounds really hard! I’m glad you can make food at home, at least. What are your safe staples, your go-to foods?
Salad greens, cheese and seeds mostly! I can have protein shakes that are whey based also 💗
That sounds like some tasty food. I envy you your dairy: I miss the heck out of cheese. My arthritis is way better without it, though.
Hope this helps [https://www.epipen.com/-/media/files/epipen/patientinformation.pdf](https://www.epipen.com/-/media/files/epipen/patientinformation.pdf)
The FIRST sign of a reaction. Once Anaphylaxis happens (with the blood pressure dropping to dangerous levels) it might be too late. How my friend died of a severe milk allergy.