Can food allergies be undiagnosed?

October 29, 2014 Kevin Dooms, MD

With food allergies on the rise in the past several years, you probably know at least one person who is allergic to cow’s milk, eggs, soy, wheat, nuts, or seafood. Individuals with a food allergy typically experience symptoms every time they eat a particular food. These symptoms range from relatively mild like hives and swelling to more severe such as coughing, vomiting, or loss of consciousness.

Unfortunately, there are no approved treatments for food allergies today. Individuals cope by avoiding the food and having proper medications nearby in case of an allergic reaction. As most children eventually outgrow some food allergies, it’s important to get tested for an accurate diagnosis.

To diagnose a food allergy, allergy specialists usually combine the patient’s clinical history and test results (usually skin or blood tests). One limitation to these tests is a significant “false positive” rate -- the test is “positive” even though the patient is not actually allergic to that food.  Food allergy experts caution against over-testing since it can lead to incorrect or over-diagnosing food allergies.
A reevaluation every 6-12 months is recommended. If testing is less positive or there is suspicion that a patient is not actually allergic to a specific food, the patient may be a candidate for an oral food challenge (OFC), the most reliable food allergy test. During an OFC, the patient is given increasing doses of the suspected food in a supervised medical setting.  If there is a reaction, then the food allergy is confirmed and the patient’s symptoms are treated.  However, if there is no reaction, then the patient is not allergic and is effectively “undiagnosed” of their food allergy.
If you suspect that you may be allergic to a certain food, but have never been tested (or haven’t been tested since childhood), consider seeing an allergy specialist today who can perform a definitive test for proper diagnosis or undiagnosis. Undiagnosing a food allergy can lead to improved quality of life for patients and families alike.

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