Ask the Pharmacist: Stay safe by identifying hidden food and drug allergies

Suzy Cohen

Adults can tell easily if they react to a specific food, but it may go unrecognized in kids.

Symptoms associated with food allergies vary greatly from individual to individual. Most people know about skin rash, hives, itch or tingly sensation in the mouth and lip/tongue swelling. Also, abdominal cramps or swelling of the throat and/or vocal cords. Here are some other symptoms:

  • Flushed or hot skin
  • Diarrhea
  • Nausea (or vomiting)
  • Coughing, sneezing or wheezing
  • Dizziness
  • Fainting or lightheadedness

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If you experience any of these symptoms, get help. Taking Benadryl isn’t the answer for everyone, some people need emergency medical care, an inhaler to help breath or an EpiPen,  and/or a Medrol Dosepak (or steroid equivalent). Here are some common food allergens to look out for: 


Peanuts are highly allergenic to millions of people, so I’ve always thought it was in poor taste to serve them on planes. Southwest Airlines stopped doing on August 1, 2018. Good for them! There is peanut oil in the medication “Prometrium” and Depakene® (Valproic Acid, a drug used for seizures and nerve pain). Hidden sources of peanuts include marzipan, beer nuts, nougat and weirdly, artificial nuts! FYI, the first peanut antidote type of medication was just FDA approved (January 2020) and it is called Palforzia.


Obviously, you can avoid eggs for breakfast as well as quiche, but did you know you should also read labels and probably avoid many baked goodies, some canned soups, frosting, mayonnaise, marshmallows, meatloaf and certain brands of coffee drink foam and ice cream! The surgical sleep-inducing anesthetic called “propofol” contains egg proteins (as well as -based ingredients).

The Lobster Place touts "the largest selection of seafood on the East Coast" with fish, shellfish, lobster, crab, caviar and oysters available.

Fish and shellfish

This type of allergy usually causes breathing difficulties and can be very severe. Hidden sources of fish-based ingredients are found in Worcestershire sauce, Caesar dressing, surimi and caviar. As for shellfish, think of lobster, crab, prawns, shrimp and crawfish. You will need to avoid glucosamine as well, because this is derived from shellfish. Tropomycin is the most predominant compound in shellfish that people are allergic to, and may cause you to feel faint, lightheaded, dizzy or foggy. This may ruin your appetite for lobster and crab but just, so you know, tropomycin is also common in cockroaches. 

A stock image of rows of plastic milk containers in a supermarket.


Allergies to milk are due to the protein called “casein.” Milk alternatives on occasion have dairy-derived whey protein in them, which fools people into thinking their safe when they’re laden with milk-derived proteins. So, check your label on pea, oat, soy, almond, coconut or flax milk just to be 100% sure it doesn’t have any milk-derived allergens in it.

You know the obvious ones to avoid like cow’s milk, ice cream, butter, cow’s milk based cheese, sour cream, cream cheese and yogurt. But dairy hides in deli meats, gravy, baked goods and batter-fried foods.

Some breathing medications/inhalers such as Advair Diskus, Flovent Diskus, Asmanex and Pulmicort contain lactose monohydrate which contains milk proteins like casein. So be aware of this if you’re treating a milk/dairy allergic reaction with an inhaler that contains trace amounts of it.

For a more comprehensive list of food and drug allergens, read the longer version of this article at my website,

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Suzy Cohen is a registered pharmacist. The information presented here is not intended to treat, cure or diagnose any condition. Visit