The first step in the management of allergic disease is identifying the allergen/s causing the problem. In some cases, the allergen/s may be obvious. However in other cases, it may require medical evaluation using proven investigational tools. Once the allergen/s are identified, steps can be taken to limit exposure to the causative allergen(s).
Keeping a record of symptoms is important
Diagnosing an allergy can be quite a difficult process, requiring considerable medical expertise, since the symptoms may often be similar to other conditions. For instance, many people suffer from a repeated sore throat and runny nose which they think is a recurrent cold, when in fact they may be suffering from allergic rhinitis (hay fever). Allergy may be responsible for other conditions such as asthma, upset stomach and skin rashes.
If you think you may be allergic to something and do not know what it is, you should start to keep a record of your symptoms. This will help you to find out what you may be allergic to. Once you have found this out you can then take steps to minimise your exposure to the allergen.
Aeroallergen minimisation and food allergen avoidance information is available from the ASCIA website: www.allergy.org.au/patients/ascia-education-resources
It is then important to keep a regular diary of when your symptoms occur. It is also useful to make a note of the general patterns of your symptoms. The following information may be useful to your doctor:
- Do your symptoms occur when you are inside the house, outside the house or both inside and outside?
- Do you suffer more at night time or during the day?
- Do you wake up with symptoms in the morning?
- Do you only get symptoms at certain times of the year?
- Does exposure to animals bring on your symptoms?
- Do you think that any food or drink brings on your symptoms?
It is important to seek medical advice
If you think you are suffering from an allergy, visit your doctor or pharmacist for advice.
They will want to know the history of your complaint, so the more information you can give them, the better.
If your allergy becomes a real problem, your doctor may do some tests to determine the cause of your allergy or may recommend that you visit a medical specialist (clinical immunology/allergy specialist) for further investigation and treatment. In some cases, identifying the cause of allergic symptoms can be difficult and may require a lot of time and expertise. Investigation of food allergy can be a particularly involved procedure. However, once the offending allergen is identified, avoidance measures can be taken.
There are two different kinds of medically and scientifically proven allergy tests used
by medical practitioners in Australia and New Zealand. The tests that assist in diagnosis include:
- Skin prick test – This involves putting drops of a commercially produced allergen extract of the suspected allergens (for example pollen, dust mites, pet dander, mould, foods) on the forearm or back, then lightly pricking the skin through the drop with a lancet. Sensitivity to a particular allergen will show itself with an itchy, red, raised lump (wheal). Skin prick tests are an excellent way of checking sensitivity to inhaled allergens such as pollen or dust mite and are commonly used to detect sensitivity to foods.
- Blood tests for allergen specific IgE antibodies (formerly known as RAST) – This blood test determines sensitivity to suspected allergens. Whereas the skin prick test result is available immediately, blood test results are often not available for a few days and may be more expensive than skin testing. However, blood testing is a useful alternative when skin prick testing is not possible.
Both skin prick tests and blood tests should be interpreted in conjunction with a physical examination and medical history. For food allergy, medically supervised oral allergen challenge testing may also be indicated.
Unorthodox allergy tests are unproven
There are several methods of unorthodox 'tests' for allergy which have no scientific basis, are unreliable and hence have no role in the clinical assessment of allergy and asthma. These tests include cytotoxic food testing, Vega testing, kinesiology, iridology, pulse testing, Alcat testing and Rinkel's intradermal skin testing.
What if the allergy tests are negative?
If skin prick tests or blood tests are negative, it could mean that either:
• You are taking a medication that interferes with the tests; or
• You are not suffering from an allergy.
Effective prevention and treatment options for allergy are available
You do not have to put up with the suffering and inconvenience of hay fever and allergy, as effective prevention and treatment options are available. If you think you may be suffering from an allergy, your doctor or pharmacist can advise you what to do. If your condition does not improve, consult your doctor as a referral to a medical specialist may be required.
© ASCIA 2013
The Australasian Society of Clinical Immunology and Allergy (ASCIA) is the peak professional body of clinical immunology and allergy specialists in Australia and New Zealand.
Postal address: PO Box 450 Balgowlah, NSW Australia 2093
This document has been developed and peer reviewed by ASCIA members and is based on expert opinion and the available published literature at the time of review. Information contained in this document is not intended to replace medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner.
The development of this document is not funded by any commercial sources and is not influenced by commercial organisations.
Content last updated February 2013