When people think of anaphylaxis, they often associate it with food allergies (peanuts, shellfish) or insect stings. However, many lesser-known triggers can cause life-threatening allergic reactions, sometimes catching people off guard. Let’s explore these hidden anaphylaxis triggers and how to stay prepared.
Lesser-Known Triggers of Anaphylaxis
- Medications (Beyond Penicillin)
While penicillin is a well-known cause of drug-induced anaphylaxis, other medications can trigger severe reactions, including: ✔️ NSAIDs (Ibuprofen, Aspirin, Naproxen) – Common pain relievers can cause anaphylaxis, especially in those with aspirin-exacerbated respiratory disease (AERD). ✔️ Contrast Dye (Used in CT Scans and MRIs) – Some people react to iodine-based contrast agents used in imaging studies. ✔️ Muscle Relaxants (Used in Surgery & Anesthesia) – A leading cause of perioperative anaphylaxis. ✔️ Biologic Medications (e.g., Monoclonal Antibodies) – Some newer treatments for asthma, autoimmune disease, and cancer can trigger reactions.
- Exercise-Induced Anaphylaxis (EIA)
Occurs during or after physical activity. ✔️ Sometimes linked to eating specific foods before exercise (e.g., wheat, shellfish, nuts). ✔️ Can range from mild hives to full anaphylaxis. ✔️ Prevention: Avoid exercise after eating known triggers and carry epinephrine.
- Alcohol-Induced Anaphylaxis
Alcohol itself (beer, wine, spirits) can trigger reactions in some individuals. ✔️ Can also enhance allergic responses to food or medications. ✔️ Sulfites in wine and beer may be a factor. ✔️ Prevention: Avoid specific alcohols that trigger symptoms and consider allergy testing.
- Cold-Induced Anaphylaxis
Exposure to cold temperatures, icy drinks, or cold water immersion can trigger anaphylaxis. ✔️ Common in cold urticaria (a rare condition where hives appear with cold exposure). ✔️ Prevention: Avoid extreme cold, wear protective clothing, and carry epinephrine.
- Idiopathic Anaphylaxis (Unknown Cause)
Some people experience repeated episodes of anaphylaxis with no identifiable trigger. ✔️ Possible causes include undiagnosed mast cell disorders or immune system dysfunction. ✔️ Requires evaluation by an allergist to rule out hidden triggers.
How to Stay Safe If You Have Hidden Triggers
✔️ Carry two epinephrine auto-injectors at all times.
✔️ Wear a medical alert bracelet if you have a history of severe reactions.
✔️ Work with an allergist to identify hidden triggers through testing.
✔️ Keep a symptom diary to track potential patterns in reactions.
✔️ Inform doctors before medical procedures if you’ve had reactions to medications or contrast dyes.
FAQ: Hidden Anaphylaxis Triggers
Q: Can stress trigger anaphylaxis?
A: Stress alone doesn’t cause anaphylaxis, but it may worsen symptoms in people with mast cell disorders.
Q: How do I know if I have exercise-induced anaphylaxis?
A: If you develop hives, swelling, or breathing issues during exercise, especially after eating, see an allergist.
Q: Can anaphylaxis happen the first time you’re exposed to a trigger?
A: Yes! Some people have a severe first-time reaction, while others develop sensitivity over time.
A Personal Story
My patient, Sarah, had her first anaphylactic reaction after taking ibuprofen—something she had used before without issues. After allergy testing, we confirmed she had an NSAID allergy. Now, she avoids NSAIDs and carries epinephrine, ensuring she’s prepared for any future reactions.
The Bottom Line
Anaphylaxis isn’t just caused by food or insect stings—hidden triggers exist. If you’ve had unexplained severe allergic reactions, see an allergist to uncover potential causes and create a personalized emergency plan.
What are you waiting for? If you or your child need help controlling allergies or if you think you need testing or treatment or that you might be a good candidate for allergy shots, Dr. Wendt and her team staff at Relieve Allergy, Asthma & Hives would love to help. Call for testing or treatment today!
Call 480-500-1902 or request an appointment at https://relieveallergyaz.com/contact now! Begin your allergy testing journey with Dr. Wendt at Relieve Allergy in Scottsdale, Arizona—It’s time to take care of yourself!
Learn more about Dr. Wendt and Relieve Allergy Asthma & Hives at www.relieveallergyaz.com or connect with us: https://www.facebook.com/RelieveAllergy/, https://www.linkedin.com/in/julie-wendt/, https://x.com/RelieveAllergy, https://www.instagram.com/relieve_allergy/ or https://www.youtube.com/@JulieWendt-qx7jm.
Did you know? Dr. Wendt wrote the book on allergies. Buy it NOW!
Relieve Allergy Asthma & Hives is located near Kierland Commons, 21803 N. Scottsdale Road Ste. 200, and has convenient evening and morning hours to accommodate your schedule. Dr. Wendt is also available for telemedicine appointments as appropriate. Most insurance plans are accepted.
DISCLAIMER: This blog is not meant to substitute for medical care by an Allergist-Immunologist nor is it intended to provide medical advice or imply a Physician-Patient relationship with its readers or their family. It is intended to provide guidance, direction, and moral support from someone experienced in testing and treating allergies. This is also not meant to be a “do-it-yourself” manual or a “how to” overcome your allergies. Some of the issues mentioned, whether allergic or look-a-like, can be dangerous or if left unchecked, deadly. Please develop a relationship with a Physician you trust to help you with diagnosis, advice, questions, and treatment regarding your and your family’s medical conditions.
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