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Allergy tests: the facts

There is a wide selection of tests for food allergy and intolerance, but only a few are effective.

If you think you might have a food allergy or intolerance, speak to your GP or a dietitian first. Do not take a test without proper medical advice or you could be wasting your money. Here are the main tests that are available. Only a few have been shown to be effective at identifying food allergies.

Skin prick testing (SPT)
Drops of diluted foods suspected of causing allergy are placed on to your arm or back. Then the skin is pierced, through the drop, using a small needle. Itching, redness and swelling indicate a positive reaction.
Tests for: food allergy.
Pros: cost-effective. Safe for all ages. Negative results are 95% accurate.
Cons: a positive SPT is only around 55% accurate because often a patient will test positive to a food which does not cause a problem.
Further information: available on the NHS, although there may be a waiting list.

IgE blood tests
These measure levels of IgE antibodies to specific foods in the blood.
Tests for: food allergy.
Pros: negative results are fairly reliable (around 90%).
Cons: false negatives are possible, especially if you have stopped eating the food already. Positive tests are about 55% accurate.
Further information: available on the NHS, although there may be a waiting list. Some private laboratories offer IgE blood tests.

Food challenge testing
This tests your response to consuming a small amount of a food.
Tests for: food allergy and any other acute sensitivity.
Pros: double blind challenging is the ‘gold standard’ in allergy testing. This is where neither you nor the tester knows which food sample is being given.
Cons: time-consuming, costly and sometimes risky. It cannot be performed on people with asthma or those at risk of a severe allergic reaction.
Further information: available on the NHS.

Hydrogen breath test
In this test, a patient is given a mixture of milk and water. The breath is then tested to measure for hydrogen levels and a rise suggests a lactose intolerance.
Tests for: lactose intolerance and other, rarer, sugar intolerances.
Pros: good accuracy.
Cons: time consuming. False positive and false negative results are possible.
Further information: available on the NHS and in some private clinics.

Commercial coeliac test
These are tests you can do yourself at home, by pricking your finger with blood. They provide a result in 10 minutes.
Tests for: coeliac disease only.
Pros: They are around 95% accurate.
Cons: 5% of undiagnosed coeliac disease sufferers will test negative. Patients testing positive may require a biopsy of the intestine to confirm the diagnosis. A blood test is available through your doctor.

Dietary exclusion and reintroduction
Conducted by a dietitian, foods which may be causing you a problem are removed from your diet until symptoms disappear. Then each food is individually reintroduced and reactions recorded.
Tests for: food intolerance.
Pros: the reintroduction of a food followed by the return of symptoms strongly suggests an intolerance to that food.
Cons: high motivation required to stick to the strict diet and routine.
Further information: available on the NHS. To find a dietitian privately, try dieticians unlimited website on right. To check that your dietitian is registered, see the Health Professions Council link on the right hand side.

Commercial blood tests
A small blood sample is submitted to a private laboratory for analysis of IgG antibodies.
Tests for: food intoelrance
Pros: Supported by Allergy UK
Cons: Expensive (£250) Limited evidence that they work. May leave patients on an inadequate diet.

Kinesiology tests
This claims to find ‘imbalances’ in the body by testing the strength of your muscles. If food intolerance is suspected, the patient’s skin will be exposed to different foods for signs of weakness in the muscles.
Tests for: all food sensitivities, including psychological ones.
Pros: no needles or blood samples are needed.
Cons: only available privately (at a rate of about £40-60 an hour). Regarded by mainstream allergists as unreliable and unscientific.

Vega testing
A programme of elimination and re-introduction of foods partly based on the patient’s diet and on the results of Vega testing. In this test, changes in the skin’s resistance in response to exposure to different foods are monitored within an electrical circuit.
Tests for: food sensitivities, except those to peanut and gluten.
Pros: widely available. Non invasive.
Cons: No evidence of effectiveness in diagnosing food sensitivities.

Commercial antibody test
Food extracts are combined with blood samples and then examined. Changes to size, shape and quantity of white blood cells are said to suggest a problem food.
Tests for: food and chemical sensitivities not caused by antibodies.
Pros: several modest trials show the technique may be worthy of closer investigation.
Cons: no study has ever shown the test to be accurate.

Last reviewed: 11/12/2007

Next review due: 11/12/2009

What are these?

rewleices said on 26 May 2009

The test you discribed is called 'patch testing' and is done here, as I've had to have it twice in less than 6 months. They don't give you a 'passport' as such, but I got information sheets on all the samples I reacted to, both alergic reactions and contact skin reactions. It isn't mentioned in this article because it focuses on food allergies and patch testing doesn't cover food stuffs.

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User207980 said on 18 March 2009

In Switzerland the local city hospital dermatology walk-in clinic had another test in addition to those mentioned here. As well as doing skin prick and blood tests they did a contact test where small amounts of substances were attached to skin on my back held in place by large plaster sheet. This had to be kept in place for around 48 hours, no baths nor showers. The number of substances tested was sufficient to cover the area from just below the shoulders to almost the waist. After this test I was told I was allergic to Scent Mix no. 2, Cobalt Chloride, Potassium Dichromate & Nickel Sulphate - constituents of many cosmetics, household & industrial substances, cleaning agents, plastics, paints, detergents, industrial processes ad infinitum. After this I was given an Allergy Passport detailing what I was allergic to. Neithe test nor allergy passport seem to be available here in UK?

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Allergy Dan said on 06 November 2008

I have heard of an inexpensive allergy test available in some pharmacies. It just requires a small finger-prick sample of blood and the results are available in 30 minutes - Having read the literature I believe it is most similar to the IgE test described above. Are these tests reliable, and are they available on the NHS?

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Anonymous said on 30 May 2008

Specific IgE testing is available from over 100 NHS hospital laboratories in the UK. There is a range of over 550 allergen avialable
All patients theoretically have access to this service via their GP

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Suzi said on 16 May 2008

Information on testing for all allergy types rather than just food related ones would've been helpful here.

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teresa said on 09 May 2008

Keith, try contacting your trading standards, I know somebody who bought a leather suite last year & ended up in hospital due to an allergic reaction. There are apparently court cases pending.

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Eleanor said on 31 March 2008

How much does it cost to have a full allergy test done by a doctor?

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