A medical emergency. Adrenaline first, lie flat, call 999 — and never stand someone up.
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Anaphylaxis is a severe allergic reaction that develops rapidly and can be fatal. It affects breathing, circulation, or both, and it needs adrenaline immediately.
This page exists to make three things unmissable.
First: adrenaline is the treatment, and it goes into the outer thigh. Antihistamines and asthma inhalers do not treat anaphylaxis. Reaching for them first is the commonest fatal delay.
Second: lie the person flat, with their legs raised if they feel faint. Do not stand them up, sit them up, or walk them anywhere — deaths have occurred from exactly that. If they are struggling to breathe they may sit up, but they should never be upright and moving.
Third: call 999 every time, even if the adrenaline works. A second wave of the reaction can follow hours later, which is why hospital observation is required rather than optional.
Anaphylaxis is likely when a reaction involves the airway, breathing or circulation. Skin symptoms alone are not anaphylaxis.
Widespread hives, itching, flushing, vomiting or abdominal pain. These often come first, and they are the warning rather than the diagnosis.
Anaphylaxis can occur with no rash at all, particularly with drug and insect sting reactions — waiting for hives before acting is dangerous.
On darker skin, flushing and redness are much harder to see. Judge by breathing, voice, swelling and how the person is, not by colour.
Anaphylaxis is diagnosed on the picture: sudden onset, rapid progression, and involvement of the airway, breathing or circulation. Nothing is measured, and nothing should delay adrenaline.
A positive IgE test means sensitisation, not allergy. Plenty of people test positive to foods they eat without any problem. Testing a broad panel in someone without a matching history produces false positives, unnecessary dietary restriction, and genuine harm — which is why testing follows the history rather than replacing it.
IgG food intolerance panels, hair analysis, kinesiology and Vega testing. All are sold widely for allergy, and none of them work.
Anaphylaxis is a 999 emergency. Nothing about it can be managed by video, and we will not attempt to.
If you are reading this while someone is reacting: give adrenaline into the outer thigh, lie them flat, call 999. Close this page.
Diagnose a food allergy from a questionnaire, or order the unvalidated tests sold as allergy screens. IgG food intolerance panels and hair analysis have no role and cause real harm by prompting unnecessary food avoidance.
They must still go to hospital. A biphasic reaction can occur hours later without further exposure. This is not caution for its own sake.
Two adrenaline auto-injectors, at all times. One may not be enough, and one may fail. Check expiry dates and register for reminders with the manufacturer.
Practise with a trainer pen until it is automatic, and make sure family, friends, school and colleagues know where the pens are and how to use them. In an emergency the person reacting is often not the one who can act.
They treat itching and hives. They do nothing for airway swelling or low blood pressure. Taking one and waiting is exactly the delay that costs lives.
Go to hospital every time, and get a replacement prescribed immediately afterwards. Being without a spare, even for a day, is the gap in which the next reaction happens.
If you have had anaphylaxis, you should be under an NHS allergy service. Paying privately for testing is not a substitute, and a private test result without a specialist to interpret it can do more harm than good.
This page follows Resuscitation Council UK guidance on emergency treatment of anaphylaxis and NICE CG134, assessment and referral after emergency treatment for anaphylaxis.
Allergy testing should be directed by the clinical history. Indiscriminate panel testing produces sensitisation results without clinical relevance. IgG food antibody testing has no diagnostic validity and is not recommended.
Reviewed against Resuscitation Council UK and NICE CG134 guidance current at the date shown above.
No. Adrenaline first, always. Antihistamines do nothing for throat swelling or low blood pressure.
Taking one and waiting to see is the delay that most often proves fatal.
Give the adrenaline. Given unnecessarily it is very unlikely to cause harm; withheld when needed, it can be fatal.
Uncertainty is a reason to act, not to wait.
The middle of the outer thigh, through clothing if you need to. Not the arm, not a vein.
Hold it in place as the instructions specify, and practise with a trainer pen so it is automatic.
They may sit up if breathing is the problem, but they must not stand or walk.
Lying flat with legs raised is the position for faintness or collapse, and standing someone up during a reaction has caused deaths.
Yes, every time. A second wave can follow hours later without any further exposure.
Hospital observation is the reason people survive that second wave.
Because one dose is not always enough, and devices occasionally fail. A second is given after five minutes if there has been no improvement.
Yes, and this catches people out. Reactions to drugs and stings in particular can involve breathing or circulation with no skin signs at all.
Do not wait for hives.
No. IgG food intolerance panels, hair analysis and similar have no diagnostic validity.
They lead to unnecessary food avoidance, which in children can affect growth and nutrition. Testing should follow a history and be interpreted by someone who knows what it means.
Milk and egg allergies commonly resolve during childhood. Peanut, tree nut, fish and shellfish allergies more often persist.
Never test this at home. Any reintroduction is planned and supervised by an allergy service.
August 30, 2026
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If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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