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It would be amazing to be able to take a simple at-home food allergy test to discover what foods could be causing unwelcome symptoms. Unfortunately, it’s not that easy.
Things get even trickier when you have to distinguish between food allergies and food intolerances. In this post you’ll learn the differences and how you might go about diagnosing them.
The ultra convenient at-home food allergy testing kits have been growing in popularity. But can you actually trust them? Might they actually be doing more harm than good?
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First off, it’s important to know what exactly you are testing.
It’s very easy to confuse food sensitivities or intolerances with food allergies. So let’s talk about the differences.
A food allergy is an immune-mediated response, and symptoms are typically immediate.
According to the Food Allergy and Research Education foundation (FARE):
“A food allergy is a medical condition in which exposure to a food triggers a harmful immune response. The immune response, called an allergic reaction, occurs because the immune system attacks proteins in the food that are normally harmless. The proteins that trigger the reaction are called allergens.”
In a true food allergy, the body develops antibodies to what it detects as an antigen. And this reaction is measured through something called an immunoglobulin E- or IgE- response.
FARE distinguishes, “the symptoms of an allergic reaction to food can range from mild (itchy mouth, a few hives) to severe (throat tightening, difficulty breathing).”
According to the Mayo Clinic, the most common symptoms include:
For milder allergies, you may only see skin manifestations like hives and itchy skin, which are not necessarily an emergency. But you should still contact your pediatrician to address any potential issues. It is possible to have a less severe reaction the first time a child eats an allergen, and then a more severe reaction the next time. So it’s best to get it checked out as soon as you see a reaction, even if it is mild.
There are officially 9 top recognized allergens. (Big caveat: this doesn’t mean these are the only 9 things you can be allergic to! You can be allergic to any food. It’s just that these 9 are most common and have labeling requirements associated with them).
The top 9 most common food allergens are:
You might notice that a couple of these look similar- tree nuts and peanuts, shellfish and fish. But people can actually have allergies to one and not the other pretty often, so we differentiate between them.
Milk, eggs, wheat, and soy are the most common allergies to be outgrown after childhood, whereas peanuts, tree nuts, and shellfish are more likely to be lifelong.
According to the Asthma and Allergy Foundation of America:
A food sensitivity or intolerance is a gastrointestinal response that causes discomfort. The immune system is not involved.
While a food sensitivity and an intolerance are technically different things, there is NO formal definition of food sensitivity, nor is it a medical diagnosis. That doesn’t mean food can’t produce symptoms.
A food intolerance or sensitivity might produce gas, bloating, diarrhea, or other unpleasant GI symptoms. These are often painful and uncomfortable, but not usually a medical emergency. Symptoms like this may sometimes be an indication of a problem like IBS (Irritable Bowel Syndrome).
The most common food intolerance is lactose intolerance. It is when the body has difficulty digesting lactose, due to a deficiency in the enzyme that “breaks down” lactose.
Symptoms of lactose intolerance may include bloating, stomach cramping or pain, excess gas or burping, diarrhea, and loud bowel sounds.
Lactose intolerance in infants is quite rare. Most instances of lactose intolerance occur in adults. But if you think your child might be lactose intolerant, this is a good article to check out by the American College of Gastroenterology.
It’s best to talk to the pediatrician if your child has frequent GI symptoms. They may refer you to a Gastroenterologist for further testing. And, a dietitian may help with elimination diets to resolve symptoms.
But if a person is NOT experiencing any symptoms, it is unlikely they are experiencing a food intolerance or sensitivity.
People often want to point the finger at certain foods as the cause of symptoms. But sometimes, it’s an underlying condition instead that cannot be solved by removing specific foods from the diet.
This is why it’s always best to go to a doctor vs. trying to self-diagnose at home.
For example, eczema is a fairly common skin condition. It sometimes can be related to food, but it often is not. Eczema can be triggered by irritants like soap and detergents, environmental factors like cold and dry weather, or environmental allergens like dust, pollen, and mold.
You could eliminate dairy, gluten, eggs, and nuts, and see no change in the eczema. Diet IS easier to control than environmental irritants, so it would be nice, in a way, if it was diet-related. But just know you’re not doing something wrong if you tried eliminating certain food groups, and the symptoms didn’t change.
If you have a four month old, 5 month old, 6 month old, or 7 month old and you’re unsure where to start with solids, check out my free Simply Solids Guide!
I also wrote a post dedicated to early introduction of food allergens that you can find here.
I want to touch on a couple other (related) conditions to know about with food allergies.
FPIES stands for Food Protein-Induced Enterocolitis Syndrome. It is a more delayed allergic response. You wouldn’t see symptoms immediately after eating, but more so in the few hours after. It is an allergic reaction in the GI system that involves immune cells, but not necessarily IgE like a traditional food allergy.
How do you know if your child might have FPIES? An allergist or immunologist would diagnose this condition. The symptoms typically include severe vomiting and diarrhea, after eating problematic foods. Common trigger foods include milk, grains, and soy.
EoE is the abbreviation for eosinophilic esophagitis. It is a digestive disorder that manifests as inflammation of the esophagus. Eosinophils are a particular type of white blood cells, and their buildup is to blame for this inflammation. This is an immune reaction, although it is different from the food allergies we have been discussing in this post.
What are the signs? Infants and toddlers may refuse to eat or not grow properly. School-aged children often have decreased appetite, recurring abdominal pain, and trouble swallowing or vomiting.
It’s difficult to determine which foods trigger a reaction because the reaction is delayed. Dairy, wheat, egg, and soy are the most common triggers for EoE. Unfortunately, skin testing, blood allergy testing, and patch testing do not reliably identify food triggers of EoE. An upper endoscopy helps diagnose EoE.
OAS is oral allergy syndrome. This is a type of food allergy, but it is actually confined to the mouth, lips, and throat. Itchy mouth and scratchy throat are the hallmarks of OAS. It most commonly happens with raw fruits and vegetables.
If your child is allergic to pollens, they are more likely to experience OAS. For example, those with reactions to ragweed might have symptoms when eating raw banana, cucumber, melon, or zucchini.
This type of allergy typically does NOT lead to anaphylaxis. However, it’s wise to report to the doctor, especially if your child experiences these symptoms with nuts.
So what’s the deal with the testing kits? Are at-home food allergy test kits or food sensitivity/intolerance test kits accurate? They seem like a no-brainer – an easy way to get information and peace of mind about food allergies. Well, first of all, they’re not cheap- usually $100+. And second of all, the science doesn’t EXACTLY check out.
True food allergies can be life threatening, and you should not determine results at home. A board certified allergist is the best person to do allergy testing and determine a treatment plan.
The American Academy of Allergy, Asthma, and Immunology (AAAAI) does not recommend testing at home.
Most at-home food sensitivity test kits use immunoglobulin G (IgG) antibodies to ‘identify’ food sensitivities. But studies show that the presence of IgG is an unreliable marker of food allergies or sensitivities.
So, people will then assume to avoid all sorts of random foods from pineapple to garlic to cilantro. When really, none of those foods are actually causing an immune-mediated allergic response in their system. There just may be detectable IgG after their consumption.
I hear this all the time… people take one of these at-home tests, and it shows a reaction to the foods they eat ALL the time. That does NOT mean you need to eliminate those foods! It just means that they have been detected in your system. Which makes perfect sense, if you are eating them regularly.
These websites will claim they use a SPECIFIC type of IgG testing that is more accurate. They are essentially lying to you. Why? Because they want to make money. These tests are simply not accurate or reliable.
No.
Their food allergy test measures IgE reactivity to common food allergens, which IS the same type of blood test an allergist would use. HOWEVER, a board-certified allergist uses more information than just the results of this one blood test alone.
A positive test result to a specific food does not always indicate that a patient will react to that food when it’s eaten.
An at-home blood test for food allergy is NOT conclusive. You should not use it to self-diagnose whether or not a food allergy is present.
No.
The type of IgG test they use isn’t proven to show food sensitivities or intolerances. And the antibodies measured in those tests are produced as part of the immune system’s normal response to foods. They haven’t been shown to correlate with symptoms or intolerances. It more so shows a reflection of what you have eaten.
There’s only one type of test validated to diagnose certain intolerances, and it’s a breath test. Which is not part of what everlywell offers. Gastroenterologists can use a breath test to diagnose certain intolerances, like those to lactose or fructose.
For food allergies: The gold standard for diagnosis of food allergies is working with a board certified allergist to accurately determine which foods are causing an immune response in your child.
This is usually done by testing specific foods at designated intervals, not a whole array of random foods on a list.
For food sensitivities or intolerances: start by discussing symptoms with the pediatrician. Stomach pain can mean many things, and it’s not necessarily related to a food intolerance or sensitivity. But if the doctor suspects it IS food-related, they should send you to a Registered Dietitian. The dietitian will help with proper elimination diets, ensuring nutritional adequacy, and reducing symptoms.
Oftentimes the at-home kits will direct you to an unnecessarily strict elimination diet where you basically eradicate every “potential” problem food from the diet and slowly add them back in until you can supposedly determine what is causing your issue.
Elimination diets CAN be useful, but only when done under the direction and supervision of a dietitian or physician. When done on your own, they can also be dangerous, restrictive, unnecessary, and nutritionally inadequate. So they’re not the first thing we want to turn to if we suspect a child is having an issue with food.
And going on strict elimination diets based on results of at-home testing kits is definitely not an accurate or specific enough course of treatment.
At-home allergy testing kits are not specific enough or accurate enough to serve as a diagnostic tool for food allergies. The convenience and proposed benefits may be alluring, but you might be left with inaccurate information and more questions than answers.
Trained professionals like pediatricians, allergists, and dietitians can help you tackle these topics and get all the information you need to keep your kids safe. I highly recommend consulting those trained professionals near you and undergoing the correct, most thorough testing to identify or rule out potential allergies. And then you’ll have the clearest guidelines for how to move forward!
Some of you might be wondering if there IS anything I recommend for introducing common food allergens to babies. Here are the current guidelines:
There are a couple of pre-made, mix-in type products on the market that I like for helping you introduce all the allergens. This can be helpful if someone else in the home has food allergies so you avoid buying particular foods. It also can be helpful for parents who aren’t able to get all the variety in their child’s diet right away but still want to cover their bases with allergens.
On my vitamins/supplements Amazon board, I’ve linked a couple of different products (Spoonful One, Lil Mixins, and Ready Set Food). They all have the goal of introducing small amounts of each of the top allergens to your baby in a controlled and trackable way.
Want more specifics on introducing top allergens to babies? Read this post.
If you’re trying to juggle picky eating, feeding multiple kids, or just are short on time, check out my Meal and Snack Survival Guide. In this guide, I touch on nearly every food category and give my specific product recommendations, as well as tons of healthy meals and snack ideas!
3 Comments
Anonymous · February 15, 2024 at 10:47 pm
1′”
Anonymous · February 15, 2024 at 10:45 pm
1
Jess · January 10, 2024 at 11:46 pm
Thanks, Kacie! You couldn’t have posted this at a better time! My 3 year old has been having GI issues and we were going to do food sensitivity testing but now we’ll try eliminating dairy first!