IgE Food Panels

Please review IgE Food Allergy (Module #3: Above the Water).

Please listen to the audio recording.

How would you approach this client?

As discussed in IgE Food Allergy (Module 3), food-specific IgE blood tests indicate if a patient is sensitized to food (i.e., producing IgE to that food). Physicians use this information to confirm or refute a clinical suspicion of IgE-mediated allergy to a specific food.

Unfortunately, it is often used as a screening tool (blood is tested for IgE directed against several foods)– regardless of the patient’s history. Family doctors are the most common HCPs ordering IgE panels.

Sensitized ≠ Allergy

Food panels have a high rate of clinically irrelevant positive results.For example, someone might be sensitized to milk (more specifically, sensitized to an epitope within one of the milk proteins) but can drink milk without immediate symptoms.

As demonstrated in the case study, clients may want your opinion about their IgE test results.

Here are some points to keep in mind.

Interpretation is complicated:  Food-specific IgE is not a simple “yes/no” diagnostic tool. The results provide one piece of information in the big picture. Allergists (MDs with either a pediatric or internal medicine residency and an additional residency in clinical immunology) are trained to interpret the results.

Do not tell the client what they should and should not eat: If the client has eliminated a previously tolerated food after unvalidated testing, HCPs typically suggest that the client reintroduce the food.  This approach is problematic for two reasons:

  • Contradicting the doctor’s recommendation undermines your relationship with that doctor.
  • Possibility of severe reactions: Clients that are sensitized, but tolerate a food, may lose that tolerance when they eliminate it. A few cases of severe, immediate reactions when previously tolerated foods are reintroduced have been reported. In this circumstance, food reintroduction should be done under medical supervision. 

If possible, speak to the doctor who ordered the test: The client may have misinterpreted what the doctor said. It is an excellent opportunity to offer updated resources to the doctor.

Provide evidence-based written education: Written education that addresses the limitations of IgE testing (such as AD #11)  will empower your clients to advocate for themselves. The client can return to the doctor to discuss the information you gave them.

Please listen to the audio recording.