Diagnosing a food allergy isn’t always simple, but the best way to do it is through an oral food challenge, according to a new study.
“It’s important to have an accurate diagnosis of food allergy so an allergist can make a clear recommendation as to what foods you need to keep out of your diet,” said study senior author and allergist Dr. Carla Davis. She is an associate professor of pediatrics at Baylor College of Medicine in Houston.
During an oral food challenge, patients are asked to eat a very small amount of a suspected allergen while under the close supervision of a specially trained doctor, called an allergist. This doctor will evaluate the person for signs of an allergic reaction.
Researchers who analyzed more than 6,300 oral food challenges found these tests were safe and caused very few people to have a serious allergic reaction. Most of these tests involved children and teens younger than 18.
Of these cases, 14% resulted in a mild to moderate reaction that involved just one part of the body, such as a skin rash. The researchers noted that 2% resulted in very severe reactions that affected multiple body systems (anaphylaxis).
The results were published Sept. 7 in the journal Annals of Allergy, Asthma and Immunology.
“Oral food challenges are a very important tool for anyone who wants to know if they have a food allergy,” said study lead author Dr. Kwei Akuete, an allergist at Texas Children’s Hospital in Houston. “Our study showed [oral food challenges] are safer than prior studies estimated, and should be routinely used to help determine if a food allergy exists.”
I use oral challenge for a majority of my Quintessential Applications (QA) testing. However, instead of waiting for an allergic reaction, QA looks for an immediate neurological response. Not only is this form of oral challenge faster, it is also safer as the patient only has to taste to substance rather than eat it.
I have had a patient suffer a gallbladder attack while tasting Betafood (organic beets), but I was able to stop the attack within two minutes with neurological stimulation. A similar reaction with migraine headaches can also occur but is also quickly corrected.
Both of my QA instructor agree that identifying food allergies is important. While I agree, I put more emphasis on the body’s immune response than the offender. Sometimes food allergies and sensitivities are from multiple sources and result from a combined effect making them difficult or impossible to identify.
The other issue is patient compliance. If wheat is an offender, it can be eliminated from the diet. However, it takes a lot of effort and patients often are still exposed to hidden sources of wheat. If they react to wheat, dairy, soy, corn and the nightshades then elimination is all that much more difficult.
The Bottom Line:
Oral challenge is the best way to diagnose a food allergy. It’s also the best way to identify inflammatory pathways, immune, digestive, and endocrine disorders. Patient history may point the way and there are lots of laboratory tests for conformation, but oral challenge is by far the most valued tool in my practice.
Source: September 8, 2017 National Institutes of Health