When Should You Get an Allergy Test?
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For the 40 to 50 million people in the U.S. with allergies or asthma, relief can be hard to come by. Over-the-counter medications can sometimes relieve basic seasonal allergy symptoms, but that may not always be the case. If sneezing, sniffles, itchiness, or even more severe symptoms are causing concerns, the American College of Allergy, Asthma & Immunology (ACAAI) says your best bet is to go see an allergist. 
Is it time to get tested?
Many people with allergies may only experience them at certain times of the year, and only when exposed to specific situations, such as spending time outdoors. But even if you only have occasional mild symptoms, the American Academy of Allergy, Asthma & Immunology (AAAAI) says that testing can be valuable. They recommend asking your doctor for a referral to an allergist in the following situations:
- Red, itchy or watery eyes
- Runny, itchy, or congested nose
- Itchy throat
- Itchy skin, hives, or other skin concerns
- Severe reactions to insect stings
- Diarrhea or abdominal pain when eating specific foods
Gary I. Kleiner, M.D., Ph.D., a pediatric allergy and immunology specialist with the University of Miami Health System, adds trouble breathing due to wheezing or anaphylaxis to this list. These can be potentially severe allergic reactions and need medical diagnosis and treatment as soon as possible.
“I see a lot of kids with food allergies or severe reactions to insects, and testing is very important,” he says. “It lets us determine the right treatment and also provide education to the parents and children on how to use medications like inhalers or EpiPens.”
Which allergy test is best?
The AAAAI says that there are four types of allergy tests:
- Skin tests
- Intradermal tests
- Blood tests
- Challenge tests
Your allergist will likely recommend the most common type, skin testing. This involves applying a small amount of allergen to an area of your skin that is pricked or scratched to see if a reaction occurs. If you react to the allergen, the area will experience some swelling and itchiness.
In his practice, Dr. Kleiner typically relies on skin tests first, possibly followed by a blood test if more information is needed.
“In terms of looking at the symptoms, the skin tests give us a yes or no answer as to whether you are allergic,” he says. “More advanced blood tests for food allergies give us a little more information about the seriousness of the allergy. It also helps us with counseling and education.”
If he suspects a food allergy, Dr. Kleiner will typically use a challenge test as well. These involve having the patient eat or inhale a tiny amount of a suspected allergen in the controlled setting of the doctor’s office, with rescue medication present.
This provides the family and the allergist with more information in a safe setting to move forward with a diagnosis.
Allergy tests are helpful but not foolproof.
The AAAAI does not recommend using at-home allergy tests or free screenings at supermarkets or drugstores that are performed without an allergist present. These tests may be unreliable — or even lead to false positives — causing you to modify your behavior or take treatments that are not necessary.
While allergy testing with an allergist is more reliable, it is not 100% accurate. An allergist will ensure you receive a proper assessment of the test results and the correct diagnosis.
“It’s important that people understand that allergy testing doesn’t prove or disprove allergies,” he says. “A lot of patients are on restrictive diets or have a food allergy that is not clinically relevant, which can have ramifications on the quality of life. We have to equate it to the actual symptoms.”
The bottom line, says Dr. Kleiner, is that allergy testing paired with your allergist’s expertise is your best bet for getting the proper allergy diagnosis and treatment.
The allergist will use the results of your test along with a thorough medical exam, medical history, and symptoms to get a complete picture of your allergies and the potential treatments that might help you.
Wyatt Myers is a contributing writer for UMiami Health News.