Is allergy testing worthwhile?

[LadyCad]

Does it work?

DD has had an awful summer. Headaches, sickness, constant runny nose. She suffers from asthma and I suspect hay fever, maybe other allergies too. She's usually largely unaffected but it has been particularly bad this year (she's 9).

I really want to get to the bottom of it now. We have a visit with the GP this afternoon and I'm wondering whether to book her in with a private "allergy clinic" as well.

Are the results reliable? I have no experience whatsoever of this kind of thing.

Some private "allergy clinics" can offer methods of diagnosis and testing which are dubious and might result in, e.g. advice to exclude food groups when, in reality, this is not necessary. Dr Adrian Morris has a list on his website of tests of no proven value, so if any clinic is offerning these, I would be wary.

Hope you have a good discussion with GP and find something that helps, these conditions can be miserable. Another source of advice might be the Asthma UK adviceline - free from a BT landline 9-5 Mon-Fri 0800 121 6244

Hi Claire, it would seem the headaches may well be related to eye strain so we're dealing with several different things here.

The GP was refreshingly straightforward.I asked him whether allergy testing is worthwhile and he replied with a straightforward "No". He went on to explain the reasons why (false positives/negatives, unnecessarily exluding food groups as you have mentioned).

Hi LadyCad,

yes, it's possible the symptoms are not all allergy related and I hope your GP will be helpful about getting to the bottom of things so your DD can soon feel better. That said, there can be a tendency in the UK to dismiss too readily the relevance of allergies in asthma, which I don't think is correct either. Did your GP discuss with you the significance of allergic rhinitis alongside asthma? It can make the asthma more difficult to control during the pollen season. A current hot topic in allergy is the "unified airway" theory, which recommends that diseases of the upper airways (rhinitis, sinusitis) need to be propely diagnosed and treated to optimise asthma outomes. So if she is starting to suffer from hayfever, this is something to discuss with your GP and asthma nurse.

The attitude towards desensitisation/allergen immunotherapy in the UK is still relatively conservative in comparison to mainland European countries and the US. In the NHS this treatment is normally available for very severe hayfever and animal allergies and for severe systemic reactions to wasp and bee stings. Mind you, this is probably also connected to the severe lack of specialist allergy clinics here, where such treatments should be carried out. There is ongoing research into oral/sublingual desensitisation for peanut and other food allergies but the consensus is that this is still at the experimental stage and should not be attempted outside the research context.

Desensitisation injections actually used to be given to asthmatics - including my husband - in GP surgeries in the UK ("to the wrong patients, in the wrong place and by the wrong people", as it has been expressed), and there were a number of anaphylaxis deaths, leading to it being more or less abandoned from the mid-80s. This was unfortunate because the evidence is that in properly selected patients (i.e. not those with poorly controlled or severe asthma) and carefully administered in the proper setting (a specialist allergy clinic) it is useful. With the newer and apparently safer sublingual form, there in renewed interest in immunotherapy, particularly regarding the prevention of progress from allergic rhinitis to asthma. I don't think it is accurate to say that Dr Morris doesn't seem to know about desensitisation, as he has rather a lot of experience, rather I think his article reflects the cautious attitude which prevails here.