Nestle USA Inc. — VANILLA FLAVOR SUNDAE CONE, VANILLA

One of the most commonly reactive substances on the MRT panel. Found in dairy products and many processed foods as whey, casein, or milk solids. Cross-reactive with goat and sheep milk in some patients.

Whey is a dairy-derived protein tested separately from whole cow's milk on the MRT panel. Found in protein powders, baked goods, processed cheese, and many sports nutrition products.

Cane sugar sensitivity is specific to sugarcane-derived sweeteners and is distinct from glucose intolerance. Look for it in ingredient lists as sucrose, cane juice, or turbinado sugar.

Corn derivatives are among the hardest triggers to avoid. Found as corn syrup, cornstarch, modified food starch, dextrose, maltodextrin, and citric acid in thousands of processed products.

Fructose is tested independently from cane sugar on the MRT panel. Found as high-fructose corn syrup, agave nectar, and crystalline fructose. MRT tests inflammatory mediator response, not malabsorption.

A major grain trigger distinct from celiac disease. MRT measures inflammatory mediator release to wheat protein, not IgE-mediated gluten allergy. Found in bread, pasta, and many processed foods.

Coconut is tested as an individual substance on the MRT panel. Found as coconut oil, coconut milk, coconut cream, and coconut flour — all common substitutes in dairy-free and paleo diets.

Peanut is a legume (not a tree nut) tested on the MRT panel. Peanut oil, peanut butter, and peanut flour are all included. Distinct from IgE peanut allergy testing.

Cocoa (Theobroma cacao) is tested as a standalone substance. Reactivity to cocoa affects all chocolate-containing products. Distinct from dairy or sugar reactions that often co-occur in chocolate.

Carob is an MRT-tested legume often used as a chocolate substitute. Found in health foods, carob chips, and as locust bean gum (a common thickener) in ice cream and baked goods.

Soy lecithin is one of the most ubiquitous food additives, used as an emulsifier in chocolate, baked goods, and margarine. Even small amounts can trigger mediator release in sensitive patients.

Soy-derived ingredients appear in a wide range of processed foods including soy lecithin, soybean oil, and textured soy protein. One of the most prevalent hidden triggers.