Food Allergies: Over-Diagnosed?

I know I'm probably lighting a fire with that discussion title, but I was really intrigued to read Tara Parker Pope's newest article about food allergies, and I'm looking forward to hearing what the community thinks of it.

You can read her full article here.

She's quick to point out that "while the increase (in food allergies) appears to be real, so does the increase in misdiagnosis."

While I fear this post might bring the Food Allergy Naysayers out of the woodwork again, I think the information here might give some parents hope. The bulk of the article isn't about whether or not food allergies exist (they do, they do!) but whether most people are using the appropriate diagnostic tools.

I was a little surprised to read that people were entirely eliminating foods based solely on blood tests. We've had many conversation here on WEGO Health about the various forms of allergy testing and it appears that, unfortunately, the best diagnostic tool out there continues to be the challenge test.

If you're not familiar with what an allergy challenge looks like, be sure to check out Janeen's posts about her son's recent dairy allergy challenge:

The Prep
The Challenge

So what do you think? Would you eliminate something from your diet (or your children's) without having had a reaction. When does "better safe than sorry" become too much of a hassle?

Tags: allergy, diagnosis, food allergy

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Replies to This Discussion

Permalink Reply by Suzygraysdaycare on February 3, 2009 at 1:08pm

We just found out last october that my daughter was allerigic to cashews and almonds really high number never tested postive before so they told us to eliminate all tree nuts and peanuts.They are thinking that she has been allergic to the nuts for a while she was first tested at 3 than at 6 and now at 11.She also has severe persisant asthma so they think some of her asthma problems are from food allergies.If the doctor tells me to eliminate something i'm going to.We thought we wouldn't listen to the doctor when she was 3 and took her off all of her meds and she got really bad and ended up in the hospital for a few days so now i always give her the meds no matter what.This is just my imput.

Permalink Reply by Janeen on February 3, 2009 at 2:30pm

We've eliminated peanuts from my sons diet even though his numbers are low and even though we've never seen a reaction. This was on the doctors advice. We found out about his food allergies when he was 10 months old (he had an anaphylactic reaction to wheat). He then tested positive to rye, barley, egg and peanut. We had not seen a reaction to those but removed them from the diet on this doctors advice. He then reacted to milk and we pulled it too. We did do an egg challenge the following year (right before he was 2 yrs old. Any child under the age of 1 shouldn't eat egg, allergies or not any way) and he had an anaphylactic reaction to that also. So reaction to wheat, egg, and milk still avoiding rye, barley and peanut with no reaction. Then he reacted to tree nut so add that to the mix. He reacted through skin testing to the rye, barley and peanut and his numbers via the RAST test for barley and rye are similar to that of wheat so conventional wisdom suggests that since his reaction to wheat was so severe he would probably react to those 2 items in some way also (and lets face it, how hard is it to avoid barley and rye?). So that left peanut. Again, in the scheme of food allergies, it's really not that hard to avoid but it is one of the most severe. So we avoid because of his history. But now that he will be 5 years old. The doctor is thinking we should challenge it. He's old enough to be able to tell us if his throat is closing or if his tongue feels funny. We will be discussing this on February 9th.
The only TRUE way to know if you are allergic to something is to do a challenge or to see a reaction. Blood testing and skin testing can give you things to go on, but you won't know for sure unless you eat it (and for the record, they do not tell you how severe a reaction will be just how likely you are to react). That's why we did the egg challenge on my son at 20 months (and believe me when I say that I've gotten raised eye brows and snarky comments from people in the food allergy community because we challenged it with a positive test result. But we needed to know for sure).
Yes, I do think there may be some false positives out there, but a child most likely isn't tested unless they have reacted or is suspected to have reacted to some food. That doesn't necessarily mean there are less children with food allergies. Maybe that there are less incidents of multiple food allergies.