On the Importance of Breathing Tests in Managing Asthma
Dr. John Overholt • May 12, 2018
The More You Know....
Imagine you are cooking dinner for a big family get-together at Thanksgiving. Roast turkey with stuffing, green bean casserole, rolls and pie for dessert. It’s a big undertaking. Now imagine doing it without an oven thermometer.
Think about playing a round on your favorite golf course ever. You’ve got a long shot over the water to a tiny green. Now imagine that shot without yard markers or a range finder. Golf is hard enough already.
Numbers are important. Data and objective information help guide us through our daily lives. They let us know the true measure of things so we do not have to rely on intuition or guesswork.
Numbers are important in asthma, too. Often there is a large disconnect between how people perceive their asthma severity and what the objective numbers tell us.
Numbers are important in asthma, too. Often there is a large disconnect between how people perceive their asthma severity and what the objective numbers tell us. Lung function in asthma is measured with a test called spirometry. Spirometry measures the bellows function of the lungs- how well we move air in and out. Spirometry can be used to diagnose asthma, to help us gauge asthma severity, and to monitor response to asthma therapy. Spirometry is critical to the diagnosis and management of asthma. It is so important that the AAAAI lists it as one of their most important recommendations to physicians in their Choosing Wisely initiative.
At The Allergy, Asthma & Sinus Center, all of our locations have the ability to perform spirometry and all of our board-certified physicians are trained in using it to diagnose and manage asthma. If you have asthma or have symptoms such as cough, chest tightness, wheezing or shortness of breath, a simple spirometry test might provide you with valuable information to help improve or maintain your health.
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If you spend any time browsing the internet or social media, you’ve likely seen advertisements for mail-in allergy kits. They promise to test for hundreds of food intolerances and environmental sensitivities using just a few strands of your hair or a quick saliva swab. It sounds incredibly convenient, painless, and comprehensive. But if it sounds like a gimmick, it probably is. While these mail-in tests are heavily marketed, they often lack scientific backing and can leave patients feeling more confused than comforted. The Science of Allergy Testing. What Are We Looking For? To understand why hair and saliva tests don't work, we have to look at how the immune system reacts to allergens. When you have a true allergy, your body produces a very specific type of antibody called IgE (Immunoglobulin E) . These antibodies bind to mast cells (allergy cells), which are on high alert to protect you from perceived invaders like pollen, dust mites, or specific food proteins. The fundamental flaw with mail-in hair and saliva kits comes down to basic biology: Wrong Locations: Mast cells and IgE antibodies are not traditionally found in your hair follicles or saliva. Unreliable Results: Because these testing methods are looking in the wrong place, they are highly unstandardized and unvalidated. You are highly likely to get a flood of false positives or false negatives that are impossible to interpret accurately. What the Experts Say: Major medical organizations strongly advise against these methods. The National Institute of Allergy and Infectious Diseases (NIAID) explicitly recommends against using hair analysis for food allergy evaluations due to a lack of diagnostic value. Furthermore, the American Academy of Allergy, Asthma & Immunology (AAAAI) and the American College of Allergy, Asthma & Immunology (ACAAI) have issued strong practice guidelines stating that hair analysis should not be used to evaluate food allergies. The Big Misconception: IgE vs. IgG Many mail-in companies charge anywhere from $150 to upwards of $600 for "sensitivity" panels. When patients produce these multi-page reports, the testing is almost always checking for IgG (Immunoglobulin G) antibodies, not IgE. There is a massive difference between the two:
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