If in doubt on what food intolerance test to do and you are still eating the suspect foods, choose the Precision Allergy 88 Test (serum) and you can now do it in fingerprick too. You can order those using those links or here on the shop.

You can read a lot more about Allergy and Intolerance testing and see my P88 video here.

Note: if you need to test gluten, the best is the Cyrex 3x on the Cyrex page.

The Precision Allergy 88 Test is a great all-in-one as it measures IgE, IgG, IgG4 and complement (C3d) reactions to 88 of the most common foods. The report sorts your results to help you determine if certain food groups (eg. grains, seafood etc) or types of intolerance could be your issue eg. oxalates, histamines, lectins, phenols, salicylates, amines, nitrite, glutamates and FODMAP foods.

It includes an Immune Index which totals up your four types of intolerance and gives you a top foods to avoid list. Really clever. You can see a sample report here. It looks complicated, but actually makes sense when you go through it. I can always help too, of course. For more info, see this useful handout. By far the best food test I’ve seen over 30 years of doing this, I have to say! I whooped.

Do bear in mind that you have to be eating a food regularly for an antibody to show up on testing. After a couple of weeks, the antibody levels start to drop so you won’t find them!

The report gives you a couple of diet options to follow, depending on your severity and situation. Generally, in my clinical experience, you do the test, knock out the highest offending foods from the Immune Index for minimum 8 weeks (preferably 12), re-test to see if the immune complexes have come down sufficiently and, when they have, you reintroduce one at a time, noting symptoms. You then retest if you wish again (or just enjoy your new-found energy and health!) and make sure that the immune complexes are not rising again.

If you still react to something, you need at least a year off it, by which time the inflammation complexes should have reduced sufficiently (the average seems to be 10.5 months according to some experts), then start the reintro and retest process again.

In general, anti-inflammatory treatment should be done alongside the removal of the foods to help lower the systemic inflammation in the body. And investigate any of the possible sensitivity types they highlight ie. histamine, lectins etc.

Note that the PP Allergy 88 serum samples need centrifuging, so choose a phlebotomy service that does that – often a Nuffield - or use the fingerprick test instead.

For gluten testing or alternative testing, I also like to use Cyrex. Note that the Cyrex 3x is the best to test for gluten issues and that the Cyrex 4 or the P88 can be used to look for gluten cross-reactive foods - where the body reacts to it as if it has seen gluten. Cyrex 10 measures a whole load of foods, both raw, cooked and combined, an excellent test. Check the Cyrex page out for more on these.

Environmental Allergy

If you suspect eg. dust, pollen, dander etc, use the Genova Inhalants test, which looks for IgE (classical allergy) to 25 substances and also gives a total IgE score. They also do a Mould IgE Test, which looks for classical allergy to 15 mould types and gives total IgE. You can order those direct using my code A42RS, or via the shop here.

Histamine Tests

The main approach here is to try and find if you have an excess of histamine in your system and, if so, whether you have enough of the key DAO and HNMT enzymes needed to break it down. Note that histamine will rise after a meal as it is needed to release gastric acid into the stomach so best to take your sample in between meals. Use the Nordic Histamine Intolerance Test, which gives an overall marker of the likelihood of HIT (histamine intolerance). Collection instructions are here. If that is positive, then check your genes by using the simple Nordic DAO and HNMT Genetic Test. Or, I prefer the more comprehensive Lifecode Histamine test. Those will show you where there might be problems and how to treat effectively.

MCAS (Mast Cell Activation Syndrome) Tests

I've listed MCAS tests as they are just so hard to get hold of! For MCAS, the standard tests are Tryptase, Urinary Methyl Histamine, Prostaglandins D2, DM and F2 alpha, Chromogranin A (CgA) and Leukotriene E4 (LTE4). Quite a few of the MCAS markers need very careful temperature handling so you often get false results. I favour doing CgA, LTE4 and Tryptase as the most effective way of testing and the test I have listed includes total histamine, tryptase, cysteine leukotrienes and Chromogranin A. You can see a sample report here. There is some debate about when is the best time to take the tests. In general, I think you should probably do a baseline test (ie. when not in the middle of a reaction) and one at the start of a reaction (within 30 mins to 2 hours). Then compare them - there is a formula for tryptase of >20% over baseline + 2 is positive.

Quite a few MCAS sufferers get negative test results and that doesn't mean you don't have MCAS; it just reflects how difficult MCAS is to 'catch' and that samples may not have been viable. If you do get positives, it answers a lot of questions and is useful for your GP/consultant, who should sit up and take some notice.

Note that CgA can also be raised by liver and heart failure, use of PPIs (proton pump inhibitors), chronic atrophic gastritis and neuroendocrine cancer, and may also be high in IBDs like colitis or Crohn's. So, if those are not an issue in your case, you can reasonably assume mast cell activation if CgA is elevated. If you are on a PPI, test after at least 5 days off it, with permission from your health professional, of course.

Do bear in mind Colab shipping charges (to get the kit to you and have samples collected from you by courier and shipped abroad) can be quite high as they use Medical Express often to make sure the sample you send is as fresh and viable as possible, which is important with their complex type tests. I'll advise you of shipping costs before I place an order just to check if I think it is high.

Testing Tips…

Q: What else could cause a high IgE other than allergy?

A: A high IgE result can signify a parasitic infection too, check the gut tests for help if you suspect that.

Q: Can I do the Cyrex Tests if I am off the foods?

Generally, you need to be eating the food regularly to get a positive antibody test, although Cyrex do advise a way forward if you wish to re-introduce foods for testing (not that I necessarily agree with that but it’s an option..). There is a whole load of testing hints and tips for the Cyrex tests in the Gluten Tests Overview, so do read those fully and it should answer your questions – towards the bottom of that section.

Q: Can I do allergy or intolerance testing for my child?

A: It depends on their age really and the type of testing you are planning.

IgE classical allergy testing can be done reliably from about 9 months onward. This is because babies do not have a fully developed IgE response until about 6-12 months. The same therefore goes for reliable skin prick testing in my view as that is looking for IgE responses too.

The usual issue with blood tests for little ones is getting the blood. For these tests to be processed the lab needs 1 full serum tube (8-10ml) of blood which can be challenging to draw from children as young as 2 or 3 years old. Some phlebotomy clinics are reluctant to take blood draws from children at such a young age.

Cyrex testing is suitable as long as they are eating gluten or the allergens being tested, but the issue is with getting enough blood as per.

PP Allergy 88 test can be done preferably from 9 months on, but they said: “if for example there is a baby who is having terrible eczema, or gut pain, or other issues that you think are food-related, if the symptoms are bad enough, you should still consider testing.”

Q: Will steroids affect my results?

They could do, yes. If you have been on a short course of steroids (inhalers or tabs), then the labs usually say test after a few days off them: at least five. If you are on long-term steroids, your results could be affected. It doesn’t necessarily mean you can’t have tests done but you would have to bear in mind your immune system is likely to be suppressed and therefore any results might show lower than they really are. Read the various test information pages for any specific instructions and do talk to your health professional for advice. PP Allergy 88 say off steroids for 72 hours (doctor-allowing, of course).