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Food allergy testing is completed by a doctor or allergist in a doctor’s office. When someone has a food allergy, their body initiates an immune response when the trigger food is present. The immune response is the release of the antibody immunoglobulin E (IgE), so to determine if someone has a food allergy, a doctor or allergist may complete an IgE blood test. After the blood is drawn, it is sent to a laboratory where different foods can be introduced and tested for the IgE response. If increased IgE is recorded when a food is introduced, the individual has a food allergy.

You can also use a skin test to detect food allergies. A skin test is done by lightly pricking or scratching the skin and then applying a small drop of food liquid on the skin. If the skin becomes irritated from the exposure to food liquid, this can indicate that you are allergic to that food. This is a common test that is accepted as reliable.

Unfortunately, food intolerance tests and food sensitivity tests that can be purchased online or over the counter are not as clear as food allergy tests. Unlike food allergy tests, which detect immunoglobulin E (IgE), sensitivity or intolerance tests typically look for the presence of immunoglobulin G (IgG). IgG antibodies have not been proven to be a reliable marker for identifying food intolerances or sensitivities. This is because most people produce IgG antibodies when they eat any food, and so the results often show the individual’s most commonly eaten foods as foods to avoid.1 For example, if you eat two eggs with whole grain toast every morning, there is a high probability that eggs and wheat will both come back as foods to avoid. There is also a possibility that an individual with a diagnosed allergy will use an IgG test and be led to believe that they no longer have that allergy. This could prompt the individual to include the food and increase their risk of reaction.

Allergists, doctors, and professional organizations that specialize in food allergy treatment do not use or recommend IgG testing due to the lack of evidence to support clear and consistent results.2,3 This is also why insurance companies will not cover the cost of food sensitivity or food intolerance testing.

That being said, food intolerances or sensitivities do exist. Unfortunately, there is not yet a researched-backed test that can identify which foods you should consider avoiding.

Many people struggle with food sensitivities and intolerances, and for some it has been easy to identify foods that cause bloating, GI distress, headache, brain fog, etc. The common trigger foods include dairy and gluten, and even a few raw vegetables like garlic, onions, and green peppers. If this is the case for you, avoid the food as best as you can or aim to include only very small amounts of the food at a time to assess if there is a tolerable amount of the food that you can include without uncomfortable effects.

The next factor to consider is the health of the gut microbiome. The gut microbiome plays an important role in digesting and absorbing food, and when the gut microbiome is damaged it can lead to a more permeable intestinal lining. An intestinal cell lining that is more permeable than it should be will allow undigested food particles to leak through. This can cause a heightened immune response that causes GI distress, pain, inflammation, brain fog, and symptoms similar to a food allergy or intolerance. To support the gut, aim to include a variety of fiber-rich vegetables, high-quality proteins, and healthy fats. Also, you should avoid processed foods and excessive alcohol because both will damage the gut and can lead to a severe bacterial dysbiosis, or imbalance. Consider introducing a probiotic, following a good sleep schedule, and moving your body daily.

Finally, the best way to identify if you have a food sensitivity or intolerance is through an elimination diet. An elimination diet first excludes all possible irritants for several weeks and then slowly reintroduces one food at a time, allowing you to assess whether or not it causes adverse side effects. Although this approach takes commitment and patience, it is the best way to uncover food intolerances and will allow the gut to heal during the elimination phase. If you are looking to start an elimination diet, consider following a low FODMAP diet, especially if you struggle with IBS, IBD, or other GI conditions. If you are interested in removing foods that may be affecting autoimmune disorders like pain from arthritis and thyroid disorders, as well as GI conditions, consider following the Autoimmune Protocol (AIP) for 4–7 weeks, assessing how you feel, and then slowly introducing one food at a time back into your diet.

Before starting an elimination diet, it is best practice to reach out to a dietitian, physician, or health care professional. Health care professionals will be able to offer you guidance and support on how to follow an elimination diet and still maintain normalcy.

If you are considering an elimination diet, you may first want to try keeping a 7–10 day food diary that lists all the foods you eat as well as the days and times that you feel discomfort or other symptoms. This can also help you identify the foods that you absolutely need to avoid and the ones that you tolerate well.

Be patient with yourself as you get started. It is challenging to follow an elimination diet perfectly and you will have slip-ups. Don’t dwell on mistakes; just do your best to stay on track.

1. Gordon, B. (2019, August 20). Are Food Sensitivity Tests Accurate? Retrieved June 17, 2020, from https://www.eatright.org/health/allergies-and-intolerances/food-intolerances-and-sensitivities/are-food-sensitivity-tests-accurate.
2. Kelso, J. (2018, March 07). Unproven Diagnostic Tests for Adverse Reactions to Foods. Retrieved June 18, 2020, from https://www.sciencedirect.com/science/article/abs/pii/S2213219817307043.
3. Kleine-Tebbe, J., & Herold, D. A. (1970, January 01). Ungeeignete Testverfahren in der Allergologie. Retrieved June 19, 2020, from https://link.springer.com/article/10.1007/s00105-010-1969-9.
4. Konijeti, G. G., Kim, N., Lewis, J. D., Groven, S., Chandrasekaran, A., Grandehe, S., . . . Torkamani, A. (2017, November 23). Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease. Retrieved June 17, 2020, from https://pubmed.ncbi.nlm.nih.gov/28858071/.