Advanced Allergy Testing, Explained Test by Test

Testing is only as good as the doctor choosing and interpreting the tests

There is a testing and treatment option for every condition and every patient — but ordering everything is not the same as ordering the right thing. The optimal number of tests are applied for effective diagnosis and treatment decisions. At Sher Allergy Specialists, your allergy skin tests are personally measured and read by a physician or physician assistant, with physician oversight and interpretation, rather than simply recorded by a technician or medical assistant for later review.

That is also why the specialty matters. All allergic reactions are the result of an immune system disorder, and a trained and board-certified pediatric and adult Allergist/Immunologist is best qualified to safely perform and interpret allergy testing and manage allergy treatment.

Below is the full diagnostic menu offered at our Largo office, described plainly so you know what to expect before you arrive.

Allergy Skin Testing — scratch/prick, intradermal

Allergy skin tests provide maximum information vital to ruling in or ruling out an allergic condition with minimum discomfort and risk. They can usually be completed during the initial visit. The testing is essentially painless, is administered quickly, and patients remain comfortable during the testing.

A scratch or prick test places a small amount of allergen on the surface of the skin. This is used for testing of airborne and environmental allergens and foods. An intradermal test introduces a small amount just under the skin when greater sensitivity is required, and is useful for airborne or environmental allergens but not done for foods.

We are happy to demonstrate testing on those parents whose young children are being tested, so a child can watch it happen to an adult first. Certain medications, especially antihistamines, interfere with skin test results and need to be stopped in advance — ask our office team for the Allergy Testing Dos and Don’ts when you schedule.

Allergy Skin Testing- Comprehensive contact patch testing

At Sher Allergy Specialists, we offer comprehensive contact patch testing for up to 70 of the most common contact allergens. These include substances found in cosmetics and personal-care products, fragrances, preservatives, metals, cleaning products, hair products, rubber, adhesives, and topical medications. Small patches containing these allergens are placed on the back and left in place for 48 hours. The patches are then removed, and the skin is examined over several visits for delayed allergic reactions that can help identify what may be causing your dermatitis or eczema.

Allergy Blood Testing

The Sher Allergy experts order the most advanced allergy and immunologic blood testing. This helps patients avoid expensive and unproven tests with minimal value — a real problem in a market full of mail-order panels that produce long lists of foods and no usable diagnosis.

In addition to blood tests for life-threatening food allergy, state-of-the-art testing is ordered for food allergies that cause multiple system symptoms, including:

• Celiac disease
• Food component testing including milk, peanut, tree nuts and egg
• Mast cell disorders (allergic cell hypersensitivity)
• Alpha-gal (meat allergy)

Nitric Oxide (FeNO) Testing

FeNO is a simple breath test that determines the amount of lung inflammation, identifying activity for asthma and eosinophilic bronchitis. You breathe out steadily into a handheld device; there are no needles and nothing to swallow.

It answers a question a symptom diary cannot: whether there is measurable inflammation in the airway right now. That matters when deciding whether to start, adjust or step down asthma therapy, and when a cough has no obvious cause.

Oral Food Challenge

Oral food challenge (OFC) is a very accurate and safe diagnostic test for food allergies. Sometimes it is performed after skin prick and blood tests to confirm a food allergy diagnosis. The patient is fed an increasing dose of a suspected problem food protein to see if there is a reaction, and to measure the amount of protein that can be eaten before reacting.

Oral food challenges must be performed by a trained and board-certified Allergist, as they are the only doctors specially trained in monitoring the immune system’s response during the food challenge and addressing emergencies. This is the single clearest reason not to attempt a food challenge at home: the value of the test is the medical supervision wrapped around it.

A negative challenge can return a food to a family’s kitchen after years of avoidance. That is often the most life-changing result we deliver all week.

Spirometry (Pulmonary Function Testing)

Lung function tests evaluate how well your lungs work. They determine how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs add oxygen to the bloodstream. The tests add valuable information for the diagnosis of asthma and other lung problems, can be used after medication is given to assess its effect, and can measure progress in treatment.

Pulmonary function tests generally involve breathing into a sterile mouthpiece connected to a recording device. Our team will analyze the results of your PFT and see how you are doing by comparing them to predicted values normal for a person your age, size and sex. A pulmonary function test may be performed during your visit.

Rhinoscopy

Rhinoscopy is a test in which our physicians use a flexible fiberoptic scope attached to a bright light to look into the nasal passages, back of the throat and larynx (voice box). This minimally invasive examination allows for a more thorough look at the nose, throat and larynx in order to diagnose problems that are otherwise difficult to visualize.

This procedure, along with physical examination, is very helpful in evaluating persistent or chronic cough, acid reflux, sinusitis, recurrent ear infections, chronic headaches and chronic postnasal drip. The physician can also determine whether there are any fixed blockages in the upper airway, such as a deviated septum or nasal polyps. Rhinoscopy allows us to directly examine the larynx and vocal cords in patients with persistent hoarseness, voice changes, chronic cough, or unexplained shortness of breath. It can identify vocal cord problems, inflammation, or more significant abnormalities such as a growth or mass. It can also help diagnose vocal cord dysfunction, which can cause breathing difficulties that may mimic asthma or other lung disease. Dr. Sher is one of the nation’s leading Allergists specially trained in Rhinoscopy.

A word about at-home and direct-to-consumer test kits

Alternative DIY testing and treatment kits are expensive, often produce inaccurate results, and leave you on your own to interpret the implications and action steps. A list of foods with numbers beside them is not a diagnosis, and acting on one can mean removing safe foods from a child’s diet for no reason — or worse, keeping a dangerous one in.

Our approach to controlling allergy is rooted in safe, evidence-based, FDA-approved, insurance-covered services, with a board-certified Allergist interpreting every result in the context of your actual history.

Common questions about allergy testing