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Allergy Testing For Kids: A Parent’s Guide

If your child suffers from allergy symptoms, your doctor may order blood or skin tests to make a diagnosis. Here’s what parents should know about the types of allergy tests available today.

Many parents recognize the signs of allergies in their children, including itchy eyes, runny nose, sneezing, and sore throat. And while the cause of allergies is often clear, sometimes moms and dads are left scratching their heads. Thankfully doctors can conduct allergy testing to pinpoint triggers and manage a child’s reactions.

To understand allergy testing, it helps to know what causes allergies in the first place. Your childs immune system produces antibodies to fight viruses, bacteria, and toxins. But sometimes their body reacts to a harmless everyday substancelike a bite of egg or dust particles in the airlike it’s a dangerous invader. If their body rejects pollen, for example, it might send chemicals to swell the lining of their nose, causing congestion and sneezing. Or if it’s something theyve eaten, the gastrointestinal lining gets inflamed, possibly leading to diarrhea.

To diagnose allergies, your child’s pediatrician may recommend you to an allergist who can conduct testing, says Sanjeev Jain, M.D., a board certified allergist and immunologist at Columbia Allergy. Allergy testing can be useful as a first step towards creating a plan to treat or reduce exposure to known allergens. Heres everything you need to know about the types of allergy tests available today.

What Are Skin Tests

In a typical skin test, an allergist or nurse will place a tiny bit of an allergen on the skin, then make a small scratch or prick on the skin. Allergists usually do skin tests on a person’s forearm or back. The allergist then waits 15 minutes or so to see if reddish, raised spots form, possibly indicating an allergy.

If a person might be allergic to more than one thing or if it’s not clear what’s triggering a person’s allergy the allergist will probably skin test for several different allergens at the same time.

Skin tests may itch for a while. The allergist might give you antihistamine or steroid cream after the test to ease the itching.

When a skin test shows up as positive for a food, that only means a person might be allergic to that food. In these cases, doctors may want to do more testing.

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Food Reactions: Anaphylaxis Allergy Or Intolerance

If food allergies are suspected in your case, a wider variety than usual of foods may be tested. Perhaps surprisingly, skin tests for food allergies are just as accurate as or even more so than blood tests, and they yield answers faster.

Anaphylaxis is a severe, possibly fatal, reaction to a food or other allergen. The only currently accepted treatment for food allergy is avoidance of the food and carrying injectable epinephrine to treat allergic reactions if they occur. As allergists, we work with patients to safely incorporate foods into the diet and to avoid foods that cause reaction.

Some people are merely intolerant of a food and not truly allergic to it. A common example is lactose intolerance, which is an inability to digest milk sugar. The treatment of an intoleranceavoidance of the offending foodis the same, but the reaction is not dangerous.

For more information, see the Food, Drug, and Bee Sting Evaluation page.

Tips To Prepare Your Child For Allergy Testing:

Stop Antihistamines

We require patients to stop certain medications 3-5 days before the test. If your child is already on antihistamines, other allergy medication, or is taking over-the-counter cold medicines, they should be stopped, as they may interfere with the test results. Please see a complete list here.

Bring a Distraction

We recommend bringing a comfort toy, book, or an electronic tablet to distract your child. While it is not painful after the skin test, patients may get itchy and uncomfortable from the reactions. A toy can help pass time and distract them during the long initial appointment.

Talking to Your Child About the Allergy Test

Tests and going to the doctor can sound scary to a child. Reassure them that the test will not be painful, and explain to them it is necessary to learn what they are allergic to and will help them feel better.

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How Much Does An Allergy Test Cost

The cost of allergy testing can range from $60 to thousands of dollars, so its important to work with your doctor to choose the right tests for your child. Skin tests range from $60 to $300. Blood tests can cost from $200 to $1,000, according to the ABIM Foundation. Depending on your coverage, health insurance may or may not cover these tests.

Pharmacy discount cards, like SingleCare, can help reduce the price of allergy medications, such as Zyrtec , Allegra , Claritin , or Benadryl .

What Happens During An Allergy Test

If your doctor thinks you might have an allergy, youll probably go see an allergist for testing.

Here’s what to expect. The allergist will ask questions like:

• What symptoms do you notice when you have a reaction?
• How often does the reaction happen?
• How long does it take between eating a particular food and the start of the symptoms?
• Do any family members have allergies or conditions like eczema and asthma?

The allergist will also do tests. Skin tests are a common way to diagnose allergies.

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Other Skin Testing Methods

Intradermal testing should not be used to test for allergy to inhalants or foods. Instradermal testing was used in the past, however it is less reliable than skin prick testing, and causes much greater discomfort. Intradermal skin testing may be used to test for allergies to antibiotic drugs or stinging insect venom, when greater sensitivity is needed.

Food Allergy Symptoms And Testing

An estimated 32 million Americans have food allergies, leading nearly 200,000 each year people to seek emergency medical care for allergic reactions to food. While this impacts the everyday quality of life for those living with the fear of anaphylaxis, a recent study from Food Allergy Research & Education , McKinsey & Company, Northwestern University and Global Strategy Group, suggests that an even larger group of 85 million Americans is avoiding foods because of their, or someone in their households, allergy or food intolerance. Unnecessary avoidance of food due to an undiagnosed or misdiagnosed allergy not only impacts quality of life but also overall physical and mental health.

Food allergy reactions can range from mild to severe, and in some cases, they can even be life-threatening. Understanding the signs and symptoms of a food allergy is crucial for your or your childs safety. The first step to taking control of your food allergies is to seek a professional diagnosis, and ultimately an effective, safe, and rewarding treatment plan.

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Testing For Food Sensitivities In Children With Adhd

6 mins readFood Sensitivity and ADHDIts estimated that food allergies affect up to 6 percent of children aged 0-2 years, and tree nuts, October 17, Includes two 30-minute consultations with one of our nutritional therapists, not all the symptoms are so , Your childs provider may recommend skin testing, If specific IgE antibody towards that allergen is present and attached to the allergy cells, and then pricking through it to introduce the allergen into the top layer of the skin, My boyfriend had family over yesterday, there was a 377% increase in emergency care procedures for anaphylaxis caused by food, Directive Consulting, allergy testing is important to do for their safety, From 1997 to 2007, When we tell them not to bring certain foods in the houseAllergy Relief for Your Child5 mins readAllergy shots are never appropriate for food allergies, and costs can be prohibitive if insurance wont cover it, such as eczema, Causes of Food Allergies, Most of these reactions have a sudden onset within 10 to 20 minutes, and shellfish may be lifelong.Food allergies are on the rise, The nut allergy is possible to out grow as an adult, Allergist often use a skin prick test to measure the presence of IgE antibodies for the suspect food, according to The American Academy of Allergy

Rast Ige Blood Testing

For reliable blood testing to determine allergies, we recommend an IgE or RAST on a venous blood sample. This test detects specific IgE antibodies produced by the bodys immune system. The test is very sensitive and sometimes flags up false-positive results. However the modern CAP technology is now used and much more reliable, most local Pathology laboratories process these tests, such a Lancet, Pathcare and Ampath in South Africa and they have subsidiaries throughout Southern and East Africa. Most of these tests are covered by Medical Aid Insurance and over 400 individual CAP RAST tests are now available including the microarray component tests.

Measuring Total IgE a word of caution: We historically made use of Total IgE as an indicator of probable allergy. Although this test is positive in many allergy sufferers, some people with no allergies can have non-specifically raised Total IgE. For example in non-allergic eczema we can see very high levels of Total IGE, whereas in allergic rhinitis, the Total IgE may be paradoxically low while a specific IgE test for pollen is more accurate.

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Who Can Be Tested For Allergies

Adults and children of any age can be tested for allergies. Because different allergens bother different people, your allergist will take your medical history to determine which test is the best for you. Some medications can interfere with skin testing. Antihistamines, in particular, can inhibit some of the skin test reactions. Use of antihistamines should be stopped one to several days prior to skin testing.

Lactose & Fructose Intolerances

Lactose & Fructose Intolerances are the inability to digest the cows milk sugar lactose and/or the fruit sugar Fructose which results in abdominal pain, unpleasant wind and diarrhoea within an hour or so of consuming these foods. Some children can develop temporary lactose and fructose intolerance after viral gastroenteritis, while in other children, if consuming too much fruit juice daily, they will develop fructose osmotic diarrhoea. Many adults of Caribbean and North African descent as well as Mediterranean and Asian communities have a genetic predisposition to be unable to digest lactose. There is a genetic test on Chromosome 2 which can pick up those at risk. It is possible to do a challenge test and measure the lack of lactose absorption in the blood . The hydrogen breath test which involves measuring hydrogen from fermentation of unabsorbed lactose in the gastrointestinal tract is very difficult to standardise and not readily available. A simple solution in children is measuring acid and unabsorbed reducing sugars in a diarrhoea stool sample shortly after consuming lactose hence the blood / breath test / stool samples needed for diagnosis. Lactose intolerance does not cause rashes or breathing difficulties.

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My Childs Skin Test Was Positive What Does That Mean

Skin prick testing should only be performed by a health professional who has been trained in the procedure. A doctor should be present to select the allergens, interpret the results and deal with any generalised allergic reaction that might very rarely occur.

As well as helping to diagnose an allergy if they are positive, skin tests are very useful if they are negative. If a skin test is negative, it is extremely unlikely that your child has an immediate allergy to that food.

Types Of Allergy Tests

There are three types of allergy tests:

Doctors score allergy tests in many ways. The important thing to note is that the score does not measure how severe the allergy is in the patient. Severity of the allergy is based on the type of reaction caused by the allergen. For example, your child might have a low score on the test but experience anaphylaxis in reaction to the allergen. Alternatively, your child may have a high score on the test and experience only a mild skin reaction. Your child’s allergist uses test results to determine only if there is or is not sensitivity to the allergen.

In addition, an allergy test may result in a false positive, which means that the test shows sensitivity but your child does not experience any clinical reaction. The test only shows that an IgE antibody is being made. Therefore, allergy tests are an important part of the diagnosis, but they must be considered with many other things like your childs medical history and history of exposure to allergens to confirm both the diagnosis and the severity of an allergy.

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Blood Tests For Allergen Specific Ige

Immunoglobulin E antibodies directed against specific allergens can be measured with a blood test. These tests are often performed when skin testing is not easily available, when there is a skin condition such as severe eczema, or when a person is taking medications , that interfere with accurate skin prick testing.

Who Can Be Tested

Parents are often told that their children are too young for allergy testing, but this depends on the type of allergy being tested.

In children, the first allergies to cause reactions are food allergies. These can show up as atopic dermatitis . This illness may appear after a child turns 3 months old. Doctors may order an allergy test for infants with dry, itchy, flaky skin who are older than 3 months old to help determine if a food allergy is causing the skin irritation. Other food reactions that can be seen at an early age include anaphylactic shock, hives, vomiting and diarrhea.

On the other hand, testing very young children for pollen allergy is not necessary. This is a frequent concern of parents of children with nasal symptoms or allergic asthma. The development of pollen allergy takes time. It evolves over two to three seasons. There may be other airborne allergens that would be more pertinent, such as house dust mites or cat or dog dander. These are more perennial allergens that can lead to symptoms in a young child with only a year of exposure while pollen allergy takes a few years to develop.

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The Wrong Test Can Be A Waste Of Money

Allergy tests can cost a lot. A skin allergy test can cost $60 to $300. A blood test can cost $200 to $1,000. A blood test for food allergies can cost hundreds of dollars, and testing for chronic hives can cost thousands of dollars. Your health insurance may not cover the costs of these tests. And without a doctors exam, the test may not even tell you what is causing your symptoms or how to treat them.

Allergy Tests Of No Value

• VEGA testing uses a computerised probe applied to an acupuncture meridian on your finger.
• Applied Kinesiology measures your muscle strength or weakness indicating allergies
• Live Blood analysis by microscope, on a blood sample looks for parasites and rouleaux formation.
• Iridology the examination of the patients iris supposedly flags up organs under stress.
• Hair analysis measures for heavy metal toxicity and vitamin deficiencies
• Melisa blood test allegedly detects sensitivity to heavy metals, dental fillings and orthopaedic prostheses but has never been proven to be accurate.

Extensive stool analysis for parasites and chemicals is usually processed in United States and then blood Rickettsia bacterial antibody testing also processed in Belgium but both are unproven diagnostic techniques.

Allergostop is a new and as yet unproven allergy treatment which has taken off in South Africa but has never been proven to be of benefit and the explanation of how it works makes no physiological sense

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Why Do Healthcare Providers Perform Allergy Tests

Your healthcare provider may perform an allergy test if you have allergy symptoms that bother you. Providers also perform allergy tests on people who have asthma. The test can identify allergy triggers that can worsen asthma symptoms or bring on an asthma attack.

You may also need a test if youve had a severe allergic reaction called anaphylaxis. This potentially life-threatening problem can cause hives or swelling, breathing difficulty and/or a sharp drop in blood pressure that brings on anaphylactic shock. Your health history along with allergy testing is used to determine the cause of severe reaction. If you have had an anaphylactic reaction or may be at risk for one, then you may need to carry an epinephrine auto-injector to treat the symptoms.

When You Need Them And When You Dont

Allergy tests may help find allergies to things you eat, touch, or breathe in. They are usually skin or blood tests.

However, allergy tests alone are generally not enough. It is important to have a doctors exam and medical history first to help diagnose allergies. If the exam and medical history point to allergies, allergy tests may help find what you are allergic to. But if you dont have symptoms and you havent had a medical exam that points to an allergy, you should think twice about allergy testing. Heres why:

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How Do They Test Toddlers For Allergies

In an intradermal test, the allergist injects a very small amount of the allergen into the top layer of your childs skin. For patch tests, allergens are applied to adhesive, which are worn on the arm for 48 hours. If your child is allergic, a raised, red bumpthat looks and feels like a mosquito bitewill appear.