I was recently visiting with some docs at a local walk-in clinic, talking about allergies and asthma, making sure our clinic was doing a good job handling their referrals, etc. During our chat, one of the docs remarked, “Well, really, the only reason we send a patient to you is to start shots.” This, of course, is a gross oversimplification. Allergists see lots of patients who aren’t immunotherapy candidates, such as people with food allergies, hives, and eczema, and not everybody who’s allergic needs immunotherapy. The most glaring problem with this physician’s statement was this: she felt she could accurately diagnose people based on history alone. Any allergist will tell you that accurate diagnosis of allergies is just not possible without testing. One of the most important things we do is answer the basic question: Are you or are you not allergic?
Several years ago I went through a random sample of my clinic charts and found that about 35% of patients who came to me for nasal and sinus symptoms wound up being non-allergic. Since then, I periodically pull charts to reassess this and the percentage has remained the same. That number may be surprising to many people, especially since 100% of the people who came to me thought they had allergies and were sick enough to seek treatment. This illustrates some important points: First, there are huge numbers of people who are being needlessly treated for allergies. Second, history is not a good predictor for allergies. Proper diagnosis is critical to prevent people from wasting money on improper medications and to prevent them from wasting time and quality of life feeling sick.
A recent study in the Journal of Allergy and Clinical Immunology bears out my old chart review. In this study, British subjects were asked whether they were sensitive to 5 common allergens: dust mites, cat, dog, tree pollen and grass pollen. They were then had a standardized formal allergy history taken focusing on the same allergens. The results prove that patient reports and history alone are very poor predictors of true allergy. The number of falsely identified sensitivities to the individual allergens were: cat- 32%, dog- 27%, grass- 48%, tree- 54%, and dust mites- 75%. These are remarkable findings and they tell us that large numbers of people are wasting time, energy, and money avoiding things they really aren’t allergic to.
As you can see, wanting to start shots is not the only reason to visit an allergist. Allergy testing is critical to making proper avoidance recommendations and in guiding the proper selection and timing of medications. It also may tell you you’re not allergic at all! Don’t waste time guessing what you’re allergic to, visit your local allergist and find out for sure. It will save you time and money and help you feel better faster.