Food Allergy Testing
Understanding allergies, testing and avoidance can be a confusing process for parents. The hard work of managing and avoiding food allergies – especially in autism – can pay off with great rewards. It is all about addressing your child’s unique needs and avoiding allergens that can play a large role in how your child feels. Food and environmental allergies, even in the smallest quantities or exposure, can wreak havoc.
This section tries to provide some suggestions and considerations to demystify the allergy process and help your child feel better by eating the right foods and avoiding environmental allergies to lead a healthier life.
How Accurate are Allergy Tests?
Allergy testing can be a tricky process. Should it be a blood test? A skin prick test? Children with special needs tend to respond better to one needle versus hundreds of pricks for traditional allergy testing. In addition, for many children, blood tests can be more accurate.
When embarking on the nutrition road to help improve a child’s health, hidden food allergies can be the enemy in achieving that goal. For many families, avoiding gluten, casein and soy (the GFCFSF diet) is just the start – Failing to uncover other potential food allergies is common and can inhibit positive results and negate the hard work the family has put in to a GFCFSF diet trial. Your doctor will guide you on interpreting the allergy test results. Allergy labs are not always 100% accurate but help a great deal in defining better food choices for your child’s unique needs.
Best Allergy Testing Labs
Ask for your doctor’s opinion on which lab you should use and what your insurance covers. Over the past decade, insurance-funded allergy panels have become more accurate but nothing is perfect. A blood test to obtain IgE and IgG food allergies is the first step. These are important markers to investigate traditional allergies and intolerances. Both food allergies and intolerances can hinder health and negate the effort and expense of providing GFCFSF food choices. There are many great allergies test panels out there, such as Labcorp, Quest, Alltess and Sage Laboratories. The food allergy panel is typically labeled: IgG and IgE Food Allergy Panel. It is important to choose an allergy panel that tests for as many food allergies as possible.
Test Results
Allergy testing is a valuable tool but not always 100% accurate. You can work with your doctor on which foods to slowly reintroduce into your “ok food list” and how often this food can be eaten. For example: your child may show a low food allergy to broccoli or chicken. To test the food allergy, the doctor may suggest a complete avoidance of these foods for at least six weeks. After six weeks, the doctor will suggest a small serving of the food once a week so you can look for behaviors or medical issues (such as rashes or constipation.) Often foods that demonstrate a lesser food allergy than others can be slowly reintroduced back into the diet on a rotation basis. (See the Rotation diet paper in this section for more information.)
Food Allergy Suspects
All foods that come up as a positive food allergy should be eliminated for a period of time. Your doctor will guide you on which ones to avoid. The most common food allergies for all people include:
- Milk
- Eggs
- Peanuts
- Tree nuts (such as almonds, cashews, walnuts)
- Fish (such as bass, cod, flounder)
- Shellfish (such as crab, lobster, shrimp)
- Soy
- Wheat
These 8 foods account for 90% of the food allergies that humans experience today.
NOTE: Gluten, casein and soy removal is important for most children on the autism spectrum according to both research and parent reports. These foods choices should be avoided and are not recommended for children that demonstrate any allergic response to these ingredients.
Reading the Allergy Test Results
Once the allergy tests results are available, schedule an appointment with your doctor to review and discuss the plan for your child. Each lab has a different way to categorize an allergic response. The lab results will provide guidelines for each food by a severity of the allergy or if no allergy is present.
After a complete avoidance of the foods that indicate an allergic response, parents can slowly rotate foods back into their child’s diet. Allergy removal is just one step towards healing and good health. Once your child’s health improves through other means or treatments, food allergies often become less of an issue.
Rotation Trial
The only “perfect” test for food allergies is called a rotation trial. You give a food for 4 days remove for 4 days and reintroduce for 4 days. During this process, charting the following ‘big 5’ issues – differences in sleep patterns, rashes, changes in stool, introduction of or amplification in self stimulatory behaviors and changes in moods. You do not introduce any new foods, therapies or treatments, during this time. If your child has a problem with a particular food, you should remove it from their diet, regardless of any test results.
For many families, they will evaluate each of these foods individually and remove them from their child’s diet. Slowly add one new food back into their diet after a six week removal. Adding one new food a week in small quantities (i.e. a quarter of a serving,) while tracking the results in a food journal can be an invaluable tool for helping your child avoid foods that aggravate their system. Parents should evaluate the following criteria in whether or not a food can be included in part their child’s regular diet: behavior, sleep patterns, stool, rashes, and learning.
The Serious Nature of Allergies
Food allergies can be deadly. Food allergies and intolerances can also greatly affect how someone feels day to day and negatively affect their overall health. A “little bit” of an allergy-inducing-food can greatly hurt and sabotage the hard work of implementing a GFCFSF diet. Being 90% compliant with your child’s diet and allergy removal is not a good way to know if this treatment will help your child. Parents, caretakers, therapists and schools must be 100% compliant in keeping foods that cause allergic responses away from children. (As defined earlier in this guide, an allergen free diet should be incorporated in your child’s IEP.)
Food Cravings
It is documented and reported from many families that a child with a food allergy or intolerance will actually CRAVE the foods they are allergic to! If you observe your child craving a particular food in excess (i.e. 6 bananas a day, bowls of rice, etc.) you may want to investigate a potential food allergy or intolerance, or other related medical issue. Food cravings can also be other treatable issues (please see references at the end of this article.)
Supplements, Prescriptions, and Allergies
It is recommended that when allergies are being evaluated, that new supplement protocols not be offered at the same time. Once the food allergy and intolerance plan is in place, work with your doctor to identify new treatments and/or supplements to use. It is also wise to review supplement labels for any potential food allergies prior to offering to your child. Often prescriptions required by your doctor can be compounded to eliminate any food allergies, and if so, may be covered by your insurance.
Documentation
Keeping a daily food and behavior journal is recommended, especially during the food allergy and intolerance evaluation process. It will help parents evaluate which foods could potentially be an issue for your child. TACA has several samples of these journals that be customized to meet your family’s unique needs.
How Often You Re-Test Food Allergies
Food allergies and intolerances can change over time. Doctors recommend allergy testing every 2 years.
