I need a real diagnosis on top of my self diagnosis

December 26, 2012 10:18 PM

I suspect I have a food allergy and would like confirmation from a non-woo medical practitioner. Who is this practitioner?

I am deeply leery of all forms of woo (naturopathy, chiropractics, acupuncture etc), but I'm seriously eating antihistamines like they're tic tacs and I'm at my wits end. What's the non-woo process for diagnosing a food allergy and what kind of doctor should I be seeking out?

posted by nerdfish to Health & Fitness (12 answers total)

Definitely contact an allergist.
posted by corey flood at 10:19 PM on December 26, 2012 [1 favorite]

Go to an allergist, they're real medicine, and get a skin or blood test to confirm.
posted by tau_ceti at 10:20 PM on December 26, 2012

You can start with your primary care provider. If you want to go straight to a specialist, and you're in the U.S. you want a board-certified allergist.
posted by gingerest at 10:22 PM on December 26, 2012 [2 favorites]

Allergists are real doctors. They deal with food allergies.

If you're located in NYC I can recommend a great allergist.
posted by dfriedman at 10:30 PM on December 26, 2012

The sad thing about food allergies is the tests aren't super-sensitive and aren't always accurate. For example, they're good if your reaction is automatic and severe, like your throat swells up when you eat apples or you have full-blown celiac disease. But just because you can breathe and don't crap your guts out 24/7 doesn't mean you don't have a mild allergy. So unfortunately if your symptoms aren't involving airway restriction, gut-crapping, or other severe symptoms the best non-woo method involves two steps:

1) Food diary - write down what you eat and when along with severity and timing of symptoms, followed by attempt at tracking a pattern

2) Elimination diet - if you have guesses eliminate your guesses for at least 2-4 weeks and see if you get improvement. If you have no guesses then take out all gluten and all dairy and see if that helps. If you want to be REALLY strict, eliminate EVERYTHING that isn't meat and leafy-green vegetables for two weeks. Then add non-starchy leafy-green vegetables. Then add starchy leafy-green vegetables. Then add in fruit (but not juices and added sugar products), then eggs, then dairy (but not sugary yogurts and ice cream and crap), then rice, then oats, then wheat/gluten products, then sugary products. Stay at each step for at least two weeks. When you start seeing things go crazy you know you've found a potential problem source. This method is hard but a side benefit is you'll almost certainly lose weight and your skin will probably be better than it's ever been in your entire life.

If you go to any allergist worth their salt they will at some point recommend you do a food diary and elimination diet anyway, if not at the first visit. So while investigating doctors you may as well start them now.
posted by Anonymous at 10:34 PM on December 26, 2012

Where are you?
posted by John Cohen at 10:55 PM on December 26, 2012

An allergist will give you a skin prick test, injecting small amounts of the potential allergen under your skin to see whether that causes a local reaction, and will possibly also give you a blood test to determine whether you have antibodies to certain food proteins in your system.

If those tests come back inconclusive, the allergist may do a food challenge in a safe environment -- he or she will give you a controlled amount of the food you think you are allergic to in a medical setting, with medication on hand to take care of any reaction you may show.

If you have a serious food allergy the allergist will prescribe strict avoidance of the food, and depending on the severity of your allergy, the doctor may also instruct you to avoid foods that may have been accidentally cross-contaminated with that food during cooking or manufacturing. If you have a serious food allergy the allergist will also recommend that you carry an EpiPen with you at all times (Benadryl will calm down a local reaction -- hives, itchy mouth -- but it will NOT treat anaphylaxis). You will likely also be advised to wear medical alert jewelry that explains your allergy.

If you have experienced throat swelling, difficulty breathing, or dizziness / light headedness during any of your recent reactions, you need to see an allergist AS SOON AS POSSIBLE. Like, tomorrow. You can go to the ER for those symptoms if they become severe, but sadly not all ER doctors are well-trained in how to deal with food allergies, and they may blow you off or give you bad advice, so it would be better to go see an allergist BEFORE you need an ER doctor.

(IANAD -- I am, however, the mother of a child with a food allergy.)
posted by BlueJae at 10:59 PM on December 26, 2012

Uh, that elimination sequence should read: "If you want to be REALLY strict, eliminate EVERYTHING that isn't meat and leafy-green vegetables for two weeks. Then add all other non-starchy vegetables. Then add starchy vegetables . . ." Sorry for the confusion.
posted by Anonymous at 12:40 AM on December 27, 2012

You may also want a GI specialist who will do an endoscopy with biopsies or take blood samples to test for various known food allergies.
posted by Blazecock Pileon at 1:11 AM on December 27, 2012

My experience with food allergies and going to an allergist to get tested, would be to skip the skin prick test altogether, and go straight for the blood test. Skin tests are notoriously riddled with false positives and false negatives.
posted by raztaj at 7:10 AM on December 27, 2012

Allergist & gastroenterologist. Depending on the food allergy and your reaction to it, tests may have false negatives - for example, celiac disease is not likely to test positive as allergic to wheat or gluten on a skin prick test, but a blood test or biopsy will be more accurate. If you have an allergy to something that makes you swell up in any way, you definitely want an allergist who can do a test in a controlled environment with meds handy if you have a reaction.

Good luck - food allergies can be tricky to diagnose.
posted by bedhead at 8:44 AM on December 27, 2012

The Wikipedia entry on allergy is extremely thorough, has a ton of citations, and probably answers a whole lot of your questions. At the end it notes the licensing requirements for allergists. As mentioned above, an allergist is indeed an MD.
posted by desuetude at 11:02 PM on December 27, 2012