Does the allergy industry bring you out in a rash?

You may be intolerant to something one day and not the next - confused? Allergy and food tolerance testing has become a huge …

You may be intolerant to something one day and not the next - confused? Allergy and food tolerance testing has become a huge industry. But does it work, asks Sylvia Thompson.

Has food allergy testing become a commercial endgame rather than a means to discovering the real cause of and cure for patients' symptoms?

This is a question that is being asked more and more often by an increasing number of orthodox medicine allergy specialists and some alternative health practitioners.

It is a complex area not only because the debate continues over what is an allergy and what is a food intolerance (see panel) but also because there is an array of allergy tests - some of which are widely accepted by both orthodox and complementary healthcare practitioners and others which are perceived to be "pseudo scientific" by some and yet believed to be reliable tests by others.

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The tests used by orthodox medical practitioners to check for allergic reactions range from blood tests for IgE allergies (i.e. those allergens which cause the antibody IgE to stimulate an immune system response to it), skin prick tests (thought to work best for airborne allergies such as animal hair and some food allergens) and patch tests (often used to detect allergies to certain chemicals).

Another group of tests used mainly by alternative or complementary healthcare practitioners include IgG tests (which test for a wide range of food intolerances which stimulates an immune system response to the presence of IgG antibodies), kinesiology or muscle testing and electoacupuncture according to Voll (EAV), sometimes known as Vega testing.

It is the latter group of tests which causes the most controversy, not least because these tests are sometimes carried out by practitioners with few qualifications and inadequate clinical experience.

Another area of concern is that some of the food intolerance tests are available as DIY kits, resulting in some patients eliminating many foods from their diets without adequately addressing other physiological or psychological causes of their problem.

Eliminating a wide range of foods from the diet without correcting the resulting nutritional imbalance is another related problem.

"The problem with tests such as those which test reaction to certain foods using IgG food intolerance tests is that you can get completely different results at different times. Also, some people are put on very restricted diets with no advice given on what foods they should substitute for the foods they have eliminated," says Paula Mee, a dietician with a special interest in allergies.

"I've no doubt that a lot of intolerance to certain foods is a lifestyle condition and there is a whole industry masking the problem with books, medical opinion and laboratory testing," says Martin Healy, a Dublin-based acupuncturist who specialises in allergy issues.

He has become disillusioned with food allergy testing. "I have always been aware of the inconvenience and dangers associated with long-term restrictive diets and I believe many food allergies are nothing more than a physical manifestation of the level of stress a person is under," he adds.

Healy is particularly concerned about the promotion of expensive DIY food intolerance tests which he believes is encouraging "neurotic food vigilance and avoidance".

"People love the mystery of the 'Sherlock Holmes' style search for what food is causing their allergy but the cause of their problem is stress and worry from work, financial problems, violence, bereavement or disappointment in love, work or friendship," he says.

Healy concedes that eliminating the trigger foods can alleviate symptoms but the patient can then become intolerant to other foods instead if the underlying cause is not dealt with. He does, however, believe that treatment with acupuncture can unblock some of the body's energy while the patient sets out to deal with the underlying cause of their stress.

One provider of food intolerance tests is Mark Goulding of Yorktest Ireland. He says: "Yorktest food intolerance tests are the only scientific tests that I am aware of that have been subjected to a proper, controlled, clinical trial. The results of this trial were recently published in GUT, the gastroenterologists journal.

"Analysis of the tiny finger-prick blood sample takes place at Yorktest's laboratory. The tests are designed to give people information to help them to identify food intolerances. We view the test results as complementary advice that people will get from their doctor and nutritionist."

Many clients have benefited from the tests including people with conditions such as Irritable Bowel Syndrome, migraine and skin complaints, he adds.

Another Dublin-based natural medicine practitioner, Tony Hughes, believes however that a lot of time and effort is wasted on food allergy testing.

"I use a technique known as electroacupuncture according to Voll [EAV] which uses an electrical current instrument to test patients' reactions to various substances which may be causing dysfunction. The tests are performed on various acupuncture points which give specific information about organs and physiological function.

"If a patient is allergy tested only for a range of foods and told to go off these foods, their allergic reaction will diminish but the body will react to other foods instead unless you treat the real cause based in the stomach, the liver, the small or large intestine or the endocrine system," Hughes adds.

Most medical allergy specialists - of which there are very few in the Republic - completely disregard what is sometimes called "the food sensitivity bandwagon".

Many believe it has developed in the absence of a clearcut medical route to dealing with allergies in Ireland. There are no consultant allergists in the public health system and few private clinics which specialise in allergies. An increasing number of alternative health practitioners are also using more comprehensive approaches when treating food allergies.

Meanwhile, the public needs to be aware of the broad distinction drawn between food allergies and food intolerances and seek out appropriate professional treatment for their condition rather than attempting to become the expert of what can be a complex complaint with a range of physiological and psychological causes.