"What I Wish I'd Known About Anaphylaxis" – A Patient's Story with Doctor's Insights
About the Expert
Lara Gross, MD, is an allergist-immunologist at Dallas Allergy & Asthma Center, where she specializes in food allergies. She has board certifications in both internal medicine and allergy & immunology.
Key Highlights
Anaphylaxis is a life-threatening allergic reaction, but warning signs can vary widely. If you have a food allergy, experiencing a mild reaction doesn’t mean the next one won’t be serious, as one patient shares. A food allergy expert clears up epinephrine treatment misconceptions—and sheds light on a new nasal spray alternative.
Many of us quickly glance at food labels for nutritional details such as calories or fat content, but scanning for certain ingredients is a necessary task for the estimated 33 million Americans living with at least one food allergy, according to the American Pharmacists Association. “That being said, you can do all the right things and be super vigilant, and there may still be cross-contamination and things can happen,” says Lara Gross, MD, an allergist-immunologist at Dallas Allergy & Asthma Center.
The Risk of Food Labels
This risk gets even more confusing when trust in food labels gets thrown into question—such as when a recall reveals unlisted ingredients or a product has a sudden packaging change. “It’s tough and scary when one of those happens, because you think, well, what else?” Dr. Gross says. “The recalls are an issue, but so is the kind of vague labeling that is out there.”
Figuring out potential food allergens at home is one thing, but traveling can make things even trickier. Beyond potential language barriers or misunderstandings, 2024 research from the World Allergy Organization Journal, the World Health Organization (WHO) highlights how precautionary allergen labeling (“may contain”) is inconsistent around the world, calling for more regulation.
What is Anaphylaxis?
Anaphylaxis is a severe, potentially fatal allergic reaction. “And it can show up in a lot of different ways,” Dr. Gross says. You might picture someone’s throat closing up, but warning signs can range from itchy hives all over a person’s body, eye swelling, lip swelling, trouble breathing, dizziness, stomach issues, or just feeling “off.”
Continues Dr. Gross: “With milder allergies, like things out in the environment, we think of itchy eyes or sneezing. But with these anaphylactic reactions, it affects the whole body and more organs, and can have really detrimental effects.”
Additionally, anaphylaxis doesn’t look the same every time. “That’s a myth that we really try to educate about,” Dr. Gross says. A mild reaction once doesn’t guarantee the next one won’t be serious. “We don’t want people to think: ‘Oh, it’s not a big deal, it was just a little uncomfortable,'” she says. “Because the next time it could be something else—it could affect your blood pressure, it could be something more serious.”
For Chris, a 21-year-old college student, these stakes became reality while on a trip in Switzerland. Ahead, he shares how unpredictable food allergies can be—even when you think you do everything right—and how he was able to quickly treat his life-threatening anaphylaxis.
What I Learned About Anaphylaxis: You Can’t Tough It Out
As told by Chris, a college student from Ohio, to Leslie Finlay, MPA
Chris has a tree nut allergy—which can include nuts like walnuts, almonds, pecans, cashews, and more—and says he’s “always had to avoid everything related to nuts.” And it’s a risk he doesn’t take lightly. “My friends typically avoid everything related to nuts, my partner currently avoids everything related to nuts, it’s just something I’ve always dealt with.”
In spite of his best efforts, Chris says he’s previously “had small allergic reactions—it’s been something like my throat’s been itchy—but that’s been the extent.”
As Dr. Gross explains, it’s not unusual for people with severe food allergies to have these mild reactions though “we don’t really know why.” But it can make it confusing for people to understand when a reaction is serious and when to use epinephrine, the front-line treatment for severe allergic reactions.
Not Another Itchy Throat: “This Was Something Completely Different”
Chris was traveling in Switzerland and wanted to try a bar of Swiss chocolate. He first checked the label’s text using Google Translate before having a French-speaking friend take a second look. (Switzerland has four national languages, one of which is French.) “I’m always very cautious, granted those two checks were just quick,” he says. “Immediately after I took a bite, I was like, ‘This does not feel right,’ so I threw it away.” He later learned that the bar contained traces of hazelnuts.
Within seconds, Chris’s throat started tingling—a symptom he’s experienced before from nut exposure. “But this was something completely different. I just started feeling more and more nauseous; I felt like I could collapse at any moment.”
He was going into anaphylactic shock, which Johns Hopkins Medicine says is another term for anaphylaxis. “I really tried to tough it out, because normally in the past, I’d take Benadryl and I’m fine,” Chris says.
Clearing Up Common Misconceptions
Chris says he has always carried epinephrine with him in case of a severe allergic reaction, and as his symptoms worsened, he used it for the first time. “I felt pretty much immediate relief,” and Dr. Gross says it potentially saved his life.
Epinephrine, also known as adrenaline, is both a medication and a hormone, according to the Allergy & Asthma Network. Your adrenal glands produce the hormone, which helps the body regulate organ functions—and, if you’ve ever experienced the feeling of “fight or flight,” that’s from the hormone. But as a medication—such as a pre-filled auto-injector—it “reduces or reverses severe [anaphylaxis] symptoms very quickly” by opening airways, maintaining blood pressure, and more, according to the organization.
“Unfortunately, when we see mortalities from food allergies, typically it’s when there’s a delay in epinephrine,” Dr. Gross says. She says that this often stems from:
- Not knowing if a reaction is “bad enough” to use ephinephrine.
- Concern about having to go to the hospital after.
- Hesitancy to inject themselves (or others) with a needle.
These are common misunderstandings, according to Dr. Gross. For starters, she encourages using it if you think there’s a need. “We run into trouble when people don’t get it when they should,” she says.
A trip to the emergency room is no longer required, either. “Ephinephrine is not harmful to give, we want people to give it,” she says. “So if someone is on the fence, going to the hospital shouldn’t be a deterrent.”
She also says there’s a new way to treat anaphylaxis that experts hope will reduce dangerous delays in care.
An Easier Way to Treat Anaphylaxis
Fear of self-injection substantially affects the use of life-saving epinephrine, according to 2025 research published in The Journal of Allergy and Clinical Immunology: In Practice. Dr. Gross explains that until recently, the only treatment available was with a needle-based auto-injector (such as an EpiPen). “Understandably, a lot of people are hesitant to give themselves or their child a shot, especially in a very stressful situation,” she says.
In 2024, the U.S. Food and Drug Administration (FDA) approved Neffy, a nasal spray version of epinephrine. Dr. Gross explains it as “the same epinephrine that’s in the auto-injectors, except instead of an injection in the thigh, it’s just a single-use spray in the nose.”
“It works quickly and it’s effective, and I’m thrilled to have a non-needle option available,” she says. “Chris is not a unique case—no fault of his—but I’m not sure that he would have done an injection.”
Chris says she’s probably right, and he’s glad he had a Neffy device with him in Switzerland. “I do have a fear of needles. Getting to that point where I’d have to stick a needle in myself—that would have taken me a long time,” he admits. “But with the Neffy, the instructions are very, very clear. I remember thinking immediately after, ‘Did I do it correctly?’ It felt too easy, but it genuinely made an immediate difference.”
Lessons Learned After Anaphylaxis
After his anaphylaxis experience, Chris admits he “was pretty annoyed with himself,” saying, “I give myself leeway, but my main takeaway is to be cautious and careful.” He highlights it’s important not to assume that food labeling regulations are the same everywhere.
For example, manufacturers in the U.S. are not legally required to disclose potential cross-contamination. Statements on product labels such as “may contain traces of” or “made in a facility that also produces” are voluntary, according to 2025 research published in Allergy, Asthma & Immunology Research. Meanwhile, other countries around the world have varying requirements in food product labeling.
Chris also urges others to be open about their allergy and medication. “I communicate with everyone I’m traveling with, whether or not I really know them or not,” he says. “As I was having my allergic reaction, the person who was with me helped a lot and did what he could. And it was literally the first day we’d met.”