Soy formula has been used for a long time in place of cow’s milk formula for allergic children. However, because of the relatively frequent development of allergy to soy milk, both American and European pediatric associations recommend the use of hydrolyzed formulae. Atopic dermatitis, gastrointestinal symptoms, and rhinitis are the most common manifestations of soy allergy. Definitive diagnosis of the condition can be reached using a placebo-controlled food challenge.
Presentation
Soy allergy can occur in both infants and adults. Soy-based formulas were introduced to replace cow milk formulas in allergic infants, but some of these children developed allergies to soy proteins. Part of the reason may be that two soy proteins (β-conglycinin and glycinin) show cross-reactivity with caseins from cow’s milk; these soy proteins were found to be diagnostic markers for the allergic reaction to soy [1]. A number of other proteins in soy extracts also contribute to allergic reactions. Allergy to proteins is not the only concern with soy products: possible hormonal effects of phytoestrogens in soy also have to be considered. Even though no developmental problems were observed in infants fed on soy milk [2], some workers advocate the lowering of phytoestrogen content of soy formulas.
In the US, the prevalence of soy protein allergy is 1.1 percent, a third of the value for cow’s milk allergy [3].
The most frequent presentation in infants is the recurrence of atopic dermatitis after a short reprieve following a switch from cow’s milk to soy formula. Gastrointestinal problems (diarrhea, vomiting) may also reappear. When allergy develops later in childhood or young adults, asthma and rhinitis are major manifestations [4]. Acute immunoglobulin E (IgE)-mediated effects have been observed with soy [5], but are less frequent than with cow’s milk. Food protein-induced enterocolitis (intensive vomiting and diarrhea) occurs frequently in patients with soy protein (and cow’s milk) allergies [6]. Other clinical consequences of soy allergy include allergic proctocolitis, constipation, and eosinophilic gastroenteritis. Anaphylaxis is infrequent. About half of children allergic to soy will outgrow the condition by the age of seven; low IgE levels are predictors of outgrowing soy allergy [7].
Patients with enterocolitis appear dehydrated and ill, whereas those with proctocolitis look quite healthy. Inflammation of the mucosa in the colon is common. Small bowel villous atrophy also occurs frequently and may result in malabsorption leading to hypoalbuminemia and deficiency in nutrients or vitamins.
Entire Body System
- Fatigue
Soy allergy symptoms may include: Acne and other skin conditions, like eczema Swelling Nasal congestion Asthma Canker sores or fever blisters Colitis and other gastrointestinal problems, including diarrhea Conjunctivitis, or pink eye Fever, fatigue, weakness [theallergykit.com]
People infected with the seasonal flu virus feel miserable with fever, chills, muscle aches, coughing, congestion, headache and fatigue for a week or so. [niaid.nih.gov]
Compart, MD, a Maryland-based developmental pediatrician and co-author of The Kid-Friendly ADHD & Autism Cookbook, symptoms of a food sensitivity can include fatigue, food cravings, stomachaches, headaches, depression, anxiety, panic attacks, ADHD symptoms [glutenfreeandmore.com]
- Weight Loss
These can include, bloody stools, vomiting, diarrhea and in severe cases weight loss or poor growth. Do children outgrow soy allergy? About 80% of children will have resolution of their soy allergy by school age. [swallergy.com]
Soy protein bars and shakes are believed to be “healthy protein sources” for weight loss and for athletes. But are they? Not these choices mentioned about. [bodyecology.com]
- Poor Growth
These can include, bloody stools, vomiting, diarrhea and in severe cases weight loss or poor growth. Do children outgrow soy allergy? About 80% of children will have resolution of their soy allergy by school age. [swallergy.com]
- Severe Pain
A baby may indicate abdominal pain or discomfort after having soy by pulling legs to chest, flailing arms and crying. Intolerance to soy protein may occur immediately or occur several days after ingestion. [livestrong.com]
Respiratoric
- Cough
[…] only, mainly: abdominal bloating gas and wind flatulence stomach cramps diarrhoea usually immediate and affecting more that one part of the body- digestion: nausea, vomiting, stomach cramps and diarrhoea skin: swelling eczema, hives airways: wheezing, coughing [foodreactions.org]
Pertussis, also known as whooping cough, is a highly contagious respiratory disease. It is caused by the bacterium Bordetella pertussis. Pertussis is known for uncontrollable, violent coughing that often makes it hard to breathe. [niaid.nih.gov]
These symptoms may include vomiting, nausea, diarrhea, cramping, a runny nose, watery eyes, nasal congestion, shortness of breath, wheezing, coughing, chest tightness, hives or skin rashes. [livestrong.com]
This can cause symptoms such as: wheezing trouble breathing coughing hoarseness throat tightness belly pain vomiting diarrhea itchy, watery, or swollen eyes hives red spots swelling a drop in blood pressure, causing lightheadedness or loss of consciousness [kidshealth.org]
Gastrointestinal
- Nausea
Histamine is partly responsible for most allergic responses, including runny nose, itchy eyes, dry throat, rashes and hives, nausea, diarrhea, labored breathing, and even anaphylactic shock. [allergyaware.org]
Headaches accompanied by severe pain, sensitivity to light and sound and nausea or vomiting, known as a migraine, may also occur with soy intolerance. Symptoms of soy intolerance and a true allergy to soy may overlap. [livestrong.com]
The symptoms of food allergy may include any or several of the following: Itching Hives Eczema Tingling or swelling of the lips, tongue, or throat Chest tightness, shortness of breath, or difficulty breathing Wheezing Abdominal pain Nausea, vomiting, [my.clevelandclinic.org]
Allergic reactions are mediated by the immune system and are marked by symptoms such as hives, runny nose, rashes, nausea, diarrhea and, most seriously, anaphylactic shock. [drweil.com]
[…] symptoms may include: Acne and other skin conditions, like eczema Swelling Nasal congestion Asthma Canker sores or fever blisters Colitis and other gastrointestinal problems, including diarrhea Conjunctivitis, or pink eye Fever, fatigue, weakness, and nausea [theallergykit.com]
- Abdominal Pain
Most common symptoms are swollen face and throat, hives, abdominal pain, vomiting, diarrhea, low blood pressure. First aid should be an adrenaline injection. [breastfeedingquest.com]
The symptoms of food allergy may include any or several of the following: Itching Hives Eczema Tingling or swelling of the lips, tongue, or throat Chest tightness, shortness of breath, or difficulty breathing Wheezing Abdominal pain Nausea, vomiting, [my.clevelandclinic.org]
Symptoms of a soy allergy can include: Tingling in the mouth Hives, itching or eczema Swelling of the lips, face, tongue and throat, or other parts of the body Canker sores Wheezing, runny nose or trouble breathing Abdominal pain, diarrhea, nausea or [allergyaware.org]
Soy allergy symptoms may include: Skin reactions including hives and eczema Skin redness Tingling in mouth Swollen lips, face, tongue, throat, or other body part Runny nose and wheezing Abdominal pain Nausea, diarrhea, or vomiting Fever In rare cases, [jaxallergy.com]
- Failure to Thrive
The latter child experienced severe failure to thrive at enrollment and exhibited improved growth while receiving soy during follow-up but was diagnosed with eosinophilic esophagitis at study completion. [ncbi.nlm.nih.gov]
Small-bowel injury, a reversible celiac-like villus injury that produces an enteropathy with malabsorption, hypoalbuminemia, and failure to thrive, has been documented in at least 4 studies. 70 – 73 In case series of infantile food protein-induced enterocolitis [doi.org]
Flattening and atrophy of the villi lead to malnutrition and failure to thrive, with a clinical picture very similar to that found in children and adults afflicted with celiac disease. 95–97 Celiac disease is a serious mal-absorption syndrome most commonly [bibliotecapleyades.net]
Cardiovascular
- Hypotension
Symptoms of soy allergy The reported symptoms of soy allergy include: acne, angioedema, rhinitis, anaphylaxis, asthma, atopic dermatitis, bronchospasm, colitis, conjunctivitis, diarrhea, diffuse small bowel disease, dyspnea, eczema, enterocolitis, fever, hypotension [soya.be]
Skin
- Eczema
Dietary antigen avoidance by lactating mothers of infants with atopic eczema may reduce the severity of the eczema, but larger trials are needed. [doi.org]
The worse the child's eczema and the earlier it started, the more likely they are to have a food allergy. [nhs.uk]
Soy is more often a trigger for mild allergy symptoms, such is eczema, but can cause severe reactions and anaphylaxis. If you are worried that you or your child has a soy allergy, seek your GP’s advice and see an allergy specialist if necessary. [allergy.org.nz]
The atopic patch test does show clinical relevance for the implication of food allergy in eczema and in constipation. [symptoma.com]
Neurologic
- Dizziness
Anaphylaxis causes more extreme signs and symptoms including: Constriction of airways, including a swollen throat or a lump in your throat, that makes it difficult to breathe Shock, with a severe drop in blood pressure Rapid pulse Dizziness, lightheadedness [allergyaware.org]
[…] of food allergy may include any or several of the following: Itching Hives Eczema Tingling or swelling of the lips, tongue, or throat Chest tightness, shortness of breath, or difficulty breathing Wheezing Abdominal pain Nausea, vomiting, or diarrhea Dizziness [my.clevelandclinic.org]
Food allergy signs and symptoms can include: Constriction and tightening of airways A swollen throat or a lump in your throat that makes it difficult to breathe Shock, with a severe drop in blood pressure Rapid pulse Dizziness, lightheadedness or loss [web.archive.org]
You may feel lightheaded, dizzy and mentally confused. If you experience any of these symptoms after consuming guar gum, call 911. Treatment Your doctor is the most qualified medical professional to recommend treatment options. [livestrong.com]
Anaphylaxis is a life-threatening allergic reaction that may include any of the following symptoms: wheezing or other breathing problems; vomiting, diarrhea or stomach cramps; face, mouth, or throat swelling; or signs of shock, including low blood pressure, dizziness [swallergy.com]
- Headache
Soy intolerance may cause headaches in susceptible people. Headaches may be mild and occur soon after eating soy. [livestrong.com]
It's great to get actual proof - because then you know for life - and can avoid all those awful foggy days of headache and illness. Soy is now contained in thousands of processed fods and can be difficult to avoid without assistance. [foodintol.com]
People infected with the seasonal flu virus feel miserable with fever, chills, muscle aches, coughing, congestion, headache and fatigue for a week or so. [niaid.nih.gov]
- Confusion
Therefore you may be confused as which one is causing yours. [foodintol.com]
Soy is a very common ingredient used in baby food that can often be very confusing. The biggest source of confusion erupts when soy is used in baby formula. Some babies are lactose intolerant. [momjunction.com]
You may feel lightheaded, dizzy and mentally confused. If you experience any of these symptoms after consuming guar gum, call 911. Treatment Your doctor is the most qualified medical professional to recommend treatment options. [livestrong.com]
In addition, seeing this kind of precautionary labelling on products that have been available without such labelling for many years, and whose formulation has not changed, would likely be confusing. [canada.ca]
- Hyperactivity
[…] tongue, or face Trouble breathing or swallowing A feeling of faintness and anxiety A sudden impending sense of doom and weakness Extreme paleness Drop in blood pressure Loss of consciousness Rapid heart beat Vomiting Severe cramps or diarrhea Extreme hyperactivity [choosingvoluntarysimplicity.com]
[…] developmental pediatrician and co-author of The Kid-Friendly ADHD & Autism Cookbook, symptoms of a food sensitivity can include fatigue, food cravings, stomachaches, headaches, depression, anxiety, panic attacks, ADHD symptoms (decreased attention, hyperactivity [glutenfreeandmore.com]
[…] progress to anaphylaxis Non-IgE mediated – characterized by an immune response not involving immunoglobulin E; may occur hours to days after eating, complicating diagnosis IgE and non-IgE-mediated – a hybrid of the above two typesAllergic reactions are hyperactive [en.wikipedia.org]
Workup
The diagnosis of soy intolerance is not straightforward. Problems arise due to difficulties in evaluating tests, because of cross-reactivity between soy proteins and other plant proteins, and due to lack of correspondence between levels of IgE and clinical symptoms [8]. Other tests, (such as skin tests, radioallergosorbent assay tests, or skin prick tests) also fail to show high prognostic value for food allergies. The atopic patch test does show clinical relevance for the implication of food allergy in eczema and in constipation [9] [10].
Because allergy tests are sensitive but lack specificity and therefore show false positive results, the testing has to be directed by the patient's history. The most rigorous test –the gold standard- is a challenge with the presumed allergen, performed under placebo-controlled conditions when both the patient and the healthcare provider are blinded to the content of the test material (double-blind placebo-controlled food challenge). This procedure carries the risk of a serious allergic reaction.
Esophagogastroduodenoscopy and colonoscopy are sometimes used to identify pathological changes, such as eosinophil infiltration or villous atrophy in the mucosa. The results obtained with these procedures are mostly non-specific to soy allergy.
Treatment
Treatment The best way to prevent an allergic reaction is to identify the food that causes the allergy and avoid it. [nhs.uk]
Speak with an allergist about diagnosis and treatment options. Schedule an appointment today to know for sure if you or a loved one is suffering from a soy allergy. [jaxallergy.com]
Potential future treatments A number of treatments are in clinical trials. [drugs.com]
Treatment may involve any of the following: Avoiding the food (this is the most effective treatment). Desensitization, during which you eat a small amount of the food each day. This must be done under an allergist's guidance. [medlineplus.gov]
Prognosis
Non‐IgE‐GI‐FA have a favorable prognosis, with majority resolving by age 3–5 years. Diagnosis relies on the recognition of symptoms pattern in FPIAP and FPIES and biopsy in FPE. [doi.org]
Autoimmune Disease When undiagnosed and untreated, autoimmune diseases are associated with a poor prognosis for the patient. Learn more about best practice in the identification and management of rheumatoid arthritis, celiac disease, and more. [thermofisher.com]
Prognosis/Outlook for Soy Allergy If you work in a factory that produce soy products or any product which is relatable to soy product then sudden consumption of it or daily exposure to the product may develop the soy allergy in you. [epainassist.com]
Etiology
The etiology of small and fresh rectal bleeding in not-sick neonates: should we initially suspect food protein-induced proctocolitis? Eur J Pediatr. 2012;171:1845–9. CrossRef PubMed Google Scholar 35. [doi.org]
The genes that have been associated with the development of systemic lupus erythematosus provide important clues to the etiology of the disease 13-5. Antibody and T cells can cause tissue damage in autoimmune disease 13-6. [ncbi.nlm.nih.gov]
Epidemiology
This review examines the epidemiology, pathogenesis, clinical features, natural history, and diagnosis of cow's milk and soy allergy. Cross-reactivity and management of milk allergy are also discussed. [ncbi.nlm.nih.gov]
Intervention Reviewa Corresponding Author E-mail address: [email protected] Departments of Pediatrics and Epidemiology, Biostatistics andOccupationalHealth,McGillUniversity Faculty ofMedicine,Montreal, Canada Michael S Kramer, Departments of Pediatrics [doi.org]
Different Types of Allergies Old Friends Hypothesis Allergies and the Hygiene Hypothesis Epidemiology of Allergies [news-medical.net]
Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. 2018 Jan;141(1):41-58. Kattan JD, Sicherer SH. Optimizing the diagnosis of food allergy. [thermofisher.com]
Pathophysiology
Additional studies are needed for these conditions to elucidate pathophysiology, search for diagnostic markers, and understand natural history. [doi.org]
Food hypersensitivity and atopic dermatitis: pathophysiology, epidemiology, diagnosis and management. Allergy Clin Immunol, 1999, 104, 3, (3 pt 2) S114-122. 102. [bibliotecapleyades.net]
Prevention
Prescott, Developing Primary Intervention Strategies to Prevent Allergic Disease, Current Allergy and Asthma Reports, 15, 7, (2015). Tuyet Ann Nguyen, Stephanie A. Leonard and Lawrence F. [doi.org]
Breastfeeding may help prevent allergies. Otherwise, there is no known way to prevent food allergies. [medlineplus.gov]
Prevention There's no way to prevent a food allergy. If you have an infant, breast-feeding instead of using a soy-based or milk-based formula may help. If you're allergic to soy, the only way to avoid a reaction is to avoid soy products. [drugs.com]
Prevention Prevent a soy allergic reaction by reading product labels and being aware of what you are eating and drinking. The U.S. [livestrong.com]
References
- Holzhauser T, Wackermann O, Ballmer-Weber BK, et al. Soybean (Glycine max) allergy in Europe: Gly m 5 (beta-conglycinin) and Gly m 6 (glycinin) are potential diagnostic markers for severe allergic reactions to soy. J Allergy Clin Immunol. 2009;123(2):452-458.
- Andres A, Cleves MA, Bellando JB, Pivik RT, Casey PH, Badger TM. Developmental status of 1-year-old infants fed breast milk, cow's milk formula, or soy formula. Pediatrics. 2012;129(6):1134-1140.
- Johnstone DE, Roghmann KJ, Pless IB. Factors associated with the development of asthma and hay fever in children: the possible risks of hospitalization, surgery, and anesthesia. Pediatrics. 1975;56(3):398-403.
- Ballmer-Weber BK, Holzhauser T, Scibilia J, et al. Clinical characteristics of soybean allergy in Europe: a double-blind, placebo-controlled food challenge study. J Allergy Clin Immunol. 2007;119(6):1489-1496.
- Mittag D, Vieths S, Vogel L, et al. Soybean allergy in patients allergic to birch pollen: clinical investigation and molecular characterization of allergens. J Allergy Clin Immunol. 2004;113(1):148-154.
- Sicherer SH, Eigenmann PA, Sampson HA. Clinical features of food protein-induced enterocolitis syndrome. J Pediatr. 1998;133(2):214-219.
- Savage JH, Kaeding AJ, Matsui EC, Wood RA. The natural history of soy allergy. J Allergy Clin Immunol. 2010;125(3):683-686.
- Magnolfi CF, Zani G, Lacava L, Patria MF, Bardare M. Soy allergy in atopic children. Ann Allergy Asthma Immunol. 1996;77(3):197-201.
- Cudowska B, Kaczmarski M. Atopy patch test in the diagnosis of food allergy in children with atopic eczema dermatitis syndrome. Rocz Akad Med Bialymst. 2005;50:261-267.
- Syrigou EI, Pitsios C, Panagiotou I, et al. Food allergy-related paediatric constipation: the usefulness of atopy patch test. Eur J Pediatr. 2011;170(9):1173-1178.