What’s The BEST Way to Allergy Test?

Allergy

What’s the BEST way to Allergy test?

 

The simple answer is “There isn’t a BEST way to test”.

A LOT of different ways to test for allergies are in the market place and available to medical providers and specialists for allergy testing. So the question I often receive is “What’s the best?” and “What tests do you use?”.

In my clinical practice as an allergy specialist, I employ all of the different test types from time to time.

The way I think about allergy tests and their differences is in three ways: 1. What allergens they test   2. What’s involved in running the test   3.The accuracy of the test.

So for the first, “What allergens do the different tests have available for testing?” The answer is they all have the ability to test the same things; both airborne allergens and food allergens.

And for the second, “Whats involved in running the test?” The answer is either skin testing, blood testing or finger-stick testing. (more on this later).

As for the third, “The accuracy of the test” ? The answer is they are all accepted and approved allergy diagnostic tests. Ive seen a few more false negatives in blood allergy and fingerstick tests in my clinical practice when compared side-by-side with skin testing, but overall they are valuable and applied in my patients for different reasons at different times.

So, what are the ‘different reasons’ I might choose one test over the other. A number of things factor into that decision making including cost-effectiveness, patient tolerance, necessary time-frame for obtaining results and safety.

In my clinical practice, the majority of patient’s will undergo our needle-less percutaneous(skin) testing panel of 50 airborne and animal danders or 17 food allergens. The reason for this being our mainstay is the following: immediate test results/more efficient for patients (I can counsel patients and tailor therapy at same visit without a return visit to review lab tests), cost effectiveness (I can’t control what the lab charges for similar panel to the 50 and 17 mentioned above), insurance (some insurances won’t pay for ‘non-skin’ testing such as medicaid in my home state).

What patients do I not skin test? Children with history of anaphylaxis with food exposure (blood testing safer), patients with eczema/rashes (unable to determine skin positives on testing), patient preference.

Hopefully this helps your understanding of how and why I choose the tests for allergy evaluation in my patients.

 

Jason B Sigmon, MD, FAAOA