Pseudoallergy – Causes, Symptoms & Treatment


Pseudo -allergies, which cause typical allergic reactions without antibodies being present against the substance in question, lead to just as great a level of suffering as genuine allergies . Diagnosis is difficult, however, as there are countless triggers for the symptoms. However, once suffering from a pseudoallergy, this does not mean a lifelong renunciation.

What is a pseudoallergy?

Antibodies are not involved in pseudoallergies . Instead, the pseudoallergic reaction occurs either via histamine or via mast cells.

Typical symptoms are identical to those of a real allergy. Those affected may experience skin rashes, hives, hives , swelling, and reddening of the skin . The digestive tract can also be affected. Those affected then complain of itching in the mouth or throat, stomach pain , nausea and diarrhea.

Other symptoms are asthmatic attacks, headaches , circulatory problems and a runny nose. Pseudoallergies are not preceded by a sensitization phase. This means that symptoms can arise as soon as you come into contact with a certain substance.

Furthermore, the reaction is highly dependent on the amount that the affected person has consumed. Small amounts can be tolerated without any problems, although higher amounts can also lead to life-threatening conditions.


At first glance, the causes of pseudoallergies are numerous, but they are always triggers contained in medication or food, which is why it is also referred to as pseudoallergic food intolerance.Drugs and food additives are very often responsible for the pseudoallergic reaction. The food additives can be coloring agents such as quinoline yellow. Preservatives, flavor enhancers and sweeteners are also possible triggers. Another group of triggers are biogenic amines, which are contained, for example, in matured hard cheese, wine and chocolate.

A third group are salicylates. Salicylates are found in a variety of fruits, vegetables, and spices, as well as some medications. In addition, natural flavorings can also trigger a pseudoallergic food intolerance. The triggers mentioned non-specifically activate mast cells, triggering the reaction.

Distinguishable from these triggers is a reaction due to the histamine contained in food. If it cannot be broken down due to an enzyme deficiency, the characteristic allergy symptoms also occur here. However, this is called histamine intolerance and not pseudoallergy.

Symptoms, Ailments & Signs

A pseudoallergy is associated with symptoms similar to those of a conventional allergy. When the patient comes into contact with an allergen, they develop a runny nose , cough and asthmatic symptoms . Redness and itchy wheals develop in the skin area , mostly on the arms and legs as well as on the face and neck. In addition, nasal polyps form, which can cause breathing difficulties .

They also lead to nasal speech in the patient. Nausea , vomiting and diarrhea often occur in the gastrointestinal tract . This is accompanied by headaches and the patient often feels very unwell. Severe allergic reactions lead to circulatory problems such as tachycardia , high blood pressure and dizziness through to circulatory failure .

Normally, however, a pseudoallergy has mild symptoms. The patient therefore often mistakes the symptoms for a harmless intolerance. After prolonged contact with the triggering substance, however, the symptoms increase. As a result, the patient’s quality of life decreases and there is a risk that mental problems will develop. A chronic pseudoallergy can cause breathing difficulties, permanent organ damage and skin changes. Those affected usually have a sickly appearance with pale skin, swollen eyes and a stuffy nose.

Diagnosis & History

The diagnosis of a pseudoallergy is difficult due to the many differential diagnoses. An allergy, an enzyme deficiency or insufficient digestion of the intestine can also be present.

In contrast to the diseases mentioned, there are no simple tests available that can be used to detect a pseudoallergy. In addition, many hours can pass before the symptoms appear, which makes it even more difficult to find the cause of the symptoms. For the diagnosis of a pseudoallergy, the differential diagnoses based on skin tests, blood tests and breath tests should first be ruled out.

A waiting period of several weeks must then be carried out during which possible triggers must be avoided. After that, provocation tests are carried out, which should be done under medical supervision.


A pseudoallergy is incorrectly referred to as intolerance or intolerance. Even if there is no real immune reaction in pseudoallergic reactions, pseudoallergies can lead to complications. For example, pseudoallergic reactions to drugs or food additives can potentially lead to the same symptoms as an allergy to one of the active ingredients.The problem with pseudoallergies, the trigger of which cannot be determined, is that they often only receive symptomatic treatment. However, symptom suppression does not always work. The symptoms can subsequently become chronic, for example chronic pruritus, chronic urticaria or irritable bowel syndrome. Diet-related pseudoallergies can cause periodic or persistent diarrhea and intestinal disorders.

In the event of nutrition-related complications, those affected try to exclude certain suspected substances from their diet, mostly as a self-help measure. These can be foods with a high proportion of biogenic amines. Alternatively, those affected may consider additives such as dyes or preservatives to be the cause of their problems.

They then avoid all foods that contain these substances. As a result, the diet can become one-sided and unbalanced. This can lead to nutritional disorders and serious deficiency symptoms . In order to prevent further complications, a complex search for the triggering substance would be necessary. However, this is only undertaken if a drug-related pseudoallergy is suspected.

When should you go to the doctor?

Asthmatic symptoms, circulatory reactions and gastrointestinal symptoms indicate a pseudoallergy. A doctor should be consulted if symptoms do not resolve within a few days. If the symptoms get worse and have a very negative effect on your well-being, we recommend a visit to the doctor. People who regularly take certain medications (e.g. non-steroidal anti-inflammatory drugs or opiates) are particularly at risk. Risk groups also include people who are sensitive to preservatives, acidifiers or radiological contrast media.

If there is a suspicion of a pseudoallergy, these people should always call in their family doctor and have the symptoms clarified and, if necessary, treated. If the prescribed antihistamines or ointments do not have the desired effect, the doctor must be informed. A pseudoallergy is treated by the family doctor, an ENT doctor or a specialist in allergic diseases. In the event of severe circulatory reactions, skin changes or even an allergic shock, you should call the emergency services. In any case, the affected person must be treated medically in order to avoid complications.

Treatment & Therapy

If a pseudoallergy has been identified, the trigger or triggers must initially be avoided until the symptoms have subsided.

Only then can an increasing amount of the trigger be slowly integrated into the daily diet. In this way, the individually tolerable limit value can be determined. Because they can usually tolerate a small amount of the triggering substance, those affected do not have to abstain from it for life. However, they must check all pre-packaged goods to ensure that the relevant trigger is included.

Other goods, such as baked goods at the bakery or the portion of French fries at the fast food restaurant, can also contain the trigger. Caution is also advisable with medication. In some cases, however, the pseudoallergy disappears over the course of life and those who were formerly affected are no longer restricted in their choice of food.

In the case of acute symptoms, medication can also be taken to alleviate the symptoms. A specialist doctor can prescribe the respective medication. It is possible, for example, to administer antihistamines in the case of pseudoallergic reactions.


Pseudoallergies cannot be prevented. Nevertheless, a diet with the freshest possible food and avoiding food additives is advisable.


Follow-up care for the pseudoallergy is not generally necessary or required over a longer period of time. Since the symptoms of an allergy occurred in the patient and had to be treated, the pseudoallergy can recur. In order to rule out a recurrence of the disease, it should be determined what triggered this reaction.

The allergic reaction was not activated by activating the antibodies, but non-specifically, which makes treatment and follow-up care more difficult. In many cases, special follow-up care or long-term therapy cannot be provided for the patient. However, it is known that certain substances can trigger non-specific activation and thus limit the causes.

These are certain drug groups and food ingredients. The acute treatment is in the foreground and is often ensured by the use of antihistamines. The follow-up care here refers primarily to patient information and not to drug treatment or check-ups, since it is not possible to examine antibodies in the blood.

Knowing about the pseudoallergy, the patient should be advised to record the food and medication he or she has eaten so that the cause can be limited and avoided if it occurs again.

You can do that yourself

A pseudoallergy can be prevented with the help of various measures and resources from the home and nature. First of all, however, it is necessary to diagnose the triggering substance. Appropriate measures can then be taken to specifically dispense with the triggering products.

People suffering from a pseudoallergy should avoid contact with the trigger if possible. It is advisable to study all lists of ingredients and ingredients carefully in order to avoid contact and the associated allergic reaction. However, should a reaction occur, a doctor must be consulted. In the event of acute symptoms, the appropriate emergency medication must be taken.

A healthy diet with fresh food reduces the risk of developing a pseudoallergy. Sufficient sleep and regular exercise also have a positive effect on the clinical picture. In addition, people suffering from a pseudoallergy should follow the doctor’s instructions. The medical professional will initially recommend avoiding contact with the triggering substances. Depending on the trigger, this can be achieved by wearing appropriate clothing or by changing jobs. In the case of food allergies, the diet must be changed.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.