Wednesday, January 27, 2010

Confusion in Testing for Food Allergies?

The Wall Street Journal ran an article yesterday on the front page of the Health and Wellness section titled “Is Your Kid Truly Allergic? Tests Add to Confusion.” The title of Melinda Beck's article really sent my antennas up. And while I’m happy to see the topic of food allergies being reported on more frequently, I was troubled by the piece.

The article accurately portrays the difficulties families with food allergies face, especially in determining which foods they are allergic to. But at the same time, Beck writes that experts suggest that food allergies diagnosed on the basis of blood tests may not be accurate, and the only way to know for sure is with a food challenge test. Huh? She does go on to state that the most accurate information in making a diagnosis is history, and the patient’s reaction when they encounter the food allergen. Applause here.

So why am I concerned?

My son was eleven before he was accurately diagnosed with food allergies. We received incorrect diagnosis after incorrect diagnosis. Traditional allergy specialists did skin tests and declared him free of food allergies. If it were not for a very persistent gastro-intestinal specialist who diagnosed his eosinophilic esophagitis, and the blood test to determine the food allergens that trigger it, we’d still be searching for an answer. A food challenge test would have been useless in our situation.

Let’s make sure we look at the other side of this story.

Sometimes the results of the blood tests will indeed be accurate – they were in my son’s case. Sometimes those blood tests may be the only way to discover which foods cause the allergies – they were in my son’s case. I find it distressing that the experts are minimizing the results of the simplest, least painful, and cheapest test for food allergies that we have.

If there is confusion over food allergies, the article itself just might be adding to that confusion. What do you think?


Anonymous said...


My wife, Carol Ann, during pregnancy with our son, was very thin and at one point the infant was not developing adequately. The doctor who examined her advised her to increase her diet with a substantial amount of pasta. Pasta was very 'fashionable' 21 years ago... The matters turned worse as Carol Ann was constantly sick with chronic migraines and losing more weight. When our son was born he looked like an emaciated Yoda, but I loved him dearly as we are wired to do so - fortunately. So the first two weeks he spent in the incubator and I fed him patiently while Carol Ann was fighting to recover.
A series of allergy test were (finally) suggested and a few weeks later it was discoverer that she had Celiac disease... (Pasta, basta!)
She recovered amazingly fast once she was not eating pasta, breads and other gluten laden foods. The our son benefited from her breast milk and grew up faster as well.
What is interesting is that Carol Ann develops periods allergies (for example, she couldn't eat shrimp for a while)while other allergies seem to be permanent: tune, sardines, almonds, etc). But perhaps the most serious consequnce of all these aspects of her diet was that she developed fibromyalgia.

I am fortunate to have only one allergy: LOC (Lack of Cash).

Back on a more serious note, I listened to a speech by a pretty sensible allergist who basically (in meta-talk) said that allergies are a relatively new development for humankind, only about three-four thousands years (sic) and that they were cause by (sudden) change of habitat (migrations, conquered populations, etc...) We eat things that were not 'natural' to our native habitat and some people respond better than other to this kind of stress.
Many years ago I had a friend who was the son of a Sephardic father and an Ashkenazi mother. When he came for dinner at our house there was only so much I could cook for him: mutton, squash, apricots and even soy milk was debatable... Luckily I am a good cook, but when he went to Israel I was worried for him about he food he had to eat during his emerging/adaptation period. He managed though and now he has a family of his own.

Best of luck with your son,

Chris Cozea

Colette said...

Chris, thanks so much for sharing your story. I agree that our understanding of allergies is relatively immature. I, for one, also believe that many allergies are undiagnosed. What I know for sure is that people are much healthier and happier when they avoid the foods they can't tolerate or are allergic to. Happy eating!

Anonymous said...

A blood test is valuable in determining IGG food allergic reactions, which may not manifest themselves for up to 72 hours after the offending food is consumed. If it were not for this test, I would not have been able to pinpoint my multiple food allergens. Keeping a food diary did not help a whole lot. Only after the blood test was I able to review my diary and experience the "aha!" moments.