Does Your Child Really Have Food Allergies?

Here’s a common scenario in my office:  A parent has taken their child to the primary care physician’s office to talk about possible allergies.  The physician sends off a “screening allergy panel” blood test which contains a few common airborne allergens like pollens, dust mites and cat dander.  The panel also contains tests for common foods like peanuts, milk, eggs, and soy.  A few of the food tests come back as positive and the parents are told their child has food allergies and needs to see an allergist.  The parents have heard horror stories about food allergy reactions and are scared stiff that their child may have one, even though he has always tolerated these foods in the past.  What do you do next?

Melinda Beck at the Wall Street Journal recently wrote an excellent article on this conundrum.  You can find it here. I highly recommend it.  It reiterates what allergists have been telling patients all along:  blood tests can be poor predictors of true food allergy.  A test is just a number, a patient is a person.  There’s a big difference.  In some studies, over 50% of kids tolerated foods they had been told to avoid.

These problems could largely be solved with a few simple steps.  First, and this is directed to the primary care physicians, STOP ORDERING FOOD ALLERGY TESTS INDISCRIMINATELY.  Sorry to all-caps and bold that, but I can’t stress this enough.  If the history does not suggest food allergy then there is no indication for ordering food allergy tests.  Simple rhinitis, sinusitis, otitis, and asthma are not food allergy related and foods have no place on a screening panel of allergy tests when evaluating these disorders.  To quote from Ms. Beck’s article, ““Are these blood tests being overused? Possibly. Misinterpreted? Absolutely,” says Robert Wood, director of Pediatric Allergy and Immunology at Johns Hopkins Hospital…”

Second, and this is directed at the labs running the tests: Stop putting foods in your screening allergy panels and stop marketing such panels to primary care docs.  This practice wastes money on needless tests and causes confusion and anxiety for countless families.  In short it is irresponsible.

Third, if you have questions about allergies, see you local board certified allergist.  In most cases a simple history will be enough to tell true food allergy from false positive blood tests.  Allergists have years of specialized training and experience in the proper selection and interpretation of allergy tests and the management and treatment of allergy problems.  They are best suited to help you solve these issues.