As a clinic rooted in the newest innovations for food allergies and immunotherapy, we go beyond the exhaustive list of therapies that don’t work and only consider groundbreaking solutions that fit our patients’ unique needs.
The most common practice to test for food allergies is skin prick testing. During allergy skin prick testing, we use a small drop of liquid food extract or fresh food, one for each allergen being tested, place it on your skin, and lightly prick the skin using a small plastic probe. This introduces a small amount of the food allergen to the layer just below the skin’s surface. Within 15 minutes, a red, itchy bump may appear at the prick’s site to indicate a positive result.
This test may cause some discomfort from being poked, but it is generally not painful. It does not involve any injections or bleeding and is safe for adults and children of all ages.
If it is safe to do so, medications containing antihistamines must be stopped 3 to 7 days before the test date. Our staff will discuss with you which medications must be stopped and which are okay to continue taking. If patients are unable to come off their medication, we may proceed with an allergy blood test instead. Common medications containing antihistamines include allergy medications, acid reflux medications, and tricyclic antidepressants. This list includes, but is not limited to: Claritin (loratadine), Zyrtec (cetirizine), Allegra (fexofenadine), Xyzal (levocetirizine), Astelin (azelastine), Patanase (olopatadine), Pepcid (famotidine), Zonalon (doxepin), Pamelor (nortriptyline). Benadryl (diphenhydramine) may be taken up to 48 hours before skin prick testing.
Skin test application takes about 2-3 minutes. We then wait about 15 minutes for results to appear. At this point, your healthcare provider will read and interpret your results.
Skin prick tests rarely produce "false negative" results. "False negative" means that negative results almost always mean that you are not allergic to that food. These tests, however, do produce "false positive" results at times. This means that the test shows positive results even though you are not allergic to the food being tested. This can occur due to cross-reactivity, where the immune system mistakes closely related proteins. For example, if you are allergic to birch tree pollen, your skin prick test may show a positive result for apples because of their similar proteins, though, you may not be truly allergic to apples. Even with potential false positives, skin prick tests are beneficial. As your experts in food allergy, we effectively interpret the results and provide comprehensive insight into your allergies.
Most health insurance plans cover allergy skin prick testing; however, you may still be responsible for a portion of or all of the cost. While we do our best to check benefits as a courtesy it is best to call your insurance carrier and provide them the following information:
⦁ Our tax ID: 85-0834175
⦁ The CPT code that is used to bill for skin prick testing is 95004 and we often can charge up to 80 units depending on the number of tests that is needed for you
Allergy blood tests can also be used to determine any food allergies you may have. When you have a food allergy, your immune system mistakenly identifies a protein in that food to be an intruder and overreacts by producing antibodies called Immunoglobulin E (IgE) to fight it. This process is known as sensitization. Specific IgE allergy blood tests measure the level of IgE in the blood in response to these individual food allergens. Results showing elevated levels of IgE may indicate that you are allergic to that food. There are two types of specific IgE blood tests: whole allergen and allergen components. Whole allergen blood tests show what type of food you may be sensitized to, while allergen component testing can determine what specific proteins may be causing your reaction. Knowing which particular protein you are sensitized to allows us to develop a comprehensive management plan for your food allergies
Our healthcare providers write you a lab order that is electronically sent to the lab. You will go to a lab at a location and time convenient for you, where a blood sample is taken from a vein in your arm using a small needle. The sample is then analyzed in the laboratory for IgE levels.
This test does not involve any preparation. You do not need to fast or stop taking any of your medications.
There is minimal risk involved with blood tests. You may experience mild discomfort or bruising at the needle insertion site; however, these symptoms resolve quickly.
For a specific IgE test, the cost per food allergen is $5 to $20 without insurance. Considering we outsource to third party labs ( e.g. Quest, Labcorp, etc.) for individuals who have insurance the cost is reflective of your own insurance benefits which we cannot determine. We encourage people to ask the respective labs they use and to also inquire about their lab benefits with their insurance carrier.
If a patient’s allergy skin prick or blood test results do not lead to a definitive diagnosis, we may perform an oral food challenge (OFC). OFCs are highly reliable and accurately tests that show whether the food ingested can be tolerated or triggers a reaction. During the challenge, the patient is fed the suspected food in measured and gradually increasing doses over several hours. This test is performed in a controlled and standardized clinic setting where patients are closely monitored for any signs of an allergic reaction. While OFCs are primarily conducted to confirm or exclude the diagnosis of a food allergy, they may also be used to determine if a food allergy has resolved or to identify the threshold of responsiveness (the amount of food allergen that provokes a reaction).
Yes. The patient undergoing the food challenge is under close medical supervision throughout the test's duration. The patient's vitals and symptoms are monitored for any changes that may indicate an allergic reaction. If a patient begins to experience any type of reaction, we are well-trained and fully equipped to treat them.
Antihistamines must be stopped for 3-7 days before the challenge date, depending on the type of medication. We will specifically instruct you on which medications you must stop and which are okay to continue. Additionally, make sure to bring your epinephrine auto-injector to have with you on your trip to and from our office.
You should prepare to be in the office for 4-5 hours on the date of your oral food challenge.
While both oral food challenges and oral immunotherapy involve ingesting gradually increasing amounts of a food allergen, one is used to test for food allergies, and the other is used to treat food allergies. Oral food challenges are used as a test when the food allergy is in question, and the results will either confirm or rule out the presence of an allergy. Oral immunotherapy is a treatment in which the patient eats gradually increasing amounts of food they are known to be allergic to daily, with the goal that over time, the patient will become desensitized to or tolerant of it.
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