The AAAAI just published new guidelines regarding food allergy. The text is 60-odd pages of dense reading, but it does contain some new stances and one, in particular, that I’ve been harping on for some time. I’ll quote the text:
“[Skin prick tests] and measurements of sIgE antibodies to detect
sensitization to foods provide very sensitive means of identifying
foods that may be responsible for IgE-mediated
food-induced allergic reactions. However, these tests have
poor specificity and show relatively poor overall correlation
with clinical reactivity. Consequently, if used alone, they
lead to a gross over-diagnosis of clinical allergic reactivity.“
Much of our current food allergy “epidemic” is really an epidemic of bad food allergy testing.
The expert panel also recommends against utilizing standard panels containing large numbers of food allergens for the same reasons outlined in the above quote. Foods selected for testing should be based on an individual’s medical history and carried out by someone knowledgeable in the selection and interpretation of such tests. In other words, leave food testing to the allergists and stop routinely ordering food tests.