Exclusion diet or blood tests for diagnosing allergies?

[APlaceOnTheCouch]

I'm trying to work out the best way to proceed with DS.

Bit of background: There are lots of allergies in our family and we've always been concerned that DS had some too. Last year after a run of 'viruses' (ie temp spikes; being very irritable; runny stools and being extra sleepy) he was referred to a consultant. After weighing, measuring and generally looking him over the consultant signed him off and said she didn't think he had a wheat allergy or coeliac's so she wouldn't send him for blood tests.

I've been monitoring his diet and his reactions seem to be connected to dairy. I don't know if he's lactose intolerant; has a dairy allergy or is responding to something else in milk, cream, etc. Is the best idea to just try different exclusion diets or book private blood tests for him?

TIA

the symptoms you mention dont appear to indicate any allergy.

how old is your DS?

He's 7. The school nurse who was regularly sending him home - thought he had coeliac's (which tbh is what DH thought too since DH exhibited similar symptoms when he was little and has since been diagnosed with wheat and dairy allergies).

The consultant was unconvinced so wouldn't refer for blood tests or allergy testing.

To me his 'reactions' seem to be more related to dairy rather than wheat but I'm not sure if he just has an intolerance rather than an allergy.

Exclusion diet. Tests will only pick up ige allergies and you may think you are clear when you possibly actually have a non ige allergy. If you do an exclusion diet and diary the whole process then it seems clear you have an allergy, you can take the diary evidence to the gp and get a referral to allergy clinic. They will confirm if it is ige or non ige.

Ds' Allergy specialist has refused ds blood tests for his allergy. They are doing an exposure test to assess his allergy. He has a history of Ige allergy too.

An exclusion diet would allow to you assess things yourself. And might throw up some surprising things. Nightshade plants trigger a coeliac type response for me so I have to avoid them. Wouldn't have known if I hadn't done the exclusion diet route.

Tbh avoiding milk protein and lactose is easy enough and there are plenty alternatives. So I would just exclude it (watch out for hidden milk products in stuff - eg gravy) and see if he improves.

But just keep in mind last year was a very bad year for bugs in school and most kids were off sick a lot so it could just be that he is more prone as his immune system is not yet so well developed. A multi vit might be of benefit for him in that respect.

There is a gene blood test for ceoliac available from GP.

try seeing another gp in practice and mention possible hereditary factor.

I take it other possible causes have been ruled out?

Double check re exclusion diet and the tests though. I have a lingering thought that if you are due to have tests there are a number of times when exclusion is not recommended first. Other times when exclusion is. It is a mine field

Thanks, everyone

YesEinstein he takes a multivitamin every day. But yy your point about not excluding if having blood tests was another part I was finding confusing. The GP said just try an exclusion diet but then the nurse had said it they were ultimately going to use blood tests then you shouldn't exclude first.

How long should we exclude for?

Depends. Different exclusion diets work differently. Also with kids they can be reluctant for an exclusion diet without supervision. You need to clarifying whether you are doing a proper exclusion diet which removes virtually everything for about a month before adding stuff back in or just a milk exclusion diet which will involve removing stuff for a month (including the hidden so you will need to check vitamin tablets/ inhalers/meds/ and pretty much every food stuff from gravy to sweets and crisps) it is a fucking nightmare honestly

Some people just remove the most obvious milk stuffs and that is ok for them. But because it can take a couple of weeks depending on the substance and the tests. You need to figure this one out very very carefully. IF they are talking about doing tests in the next couple of months and it is low level issues then I would avoid messing about and ride it out.

It really is a mine field. And there are so many different opinions on this and which route to take I would recommend proper medical advice for a child so young to prevent unnecessary restrictions and messing about. Basically I would advise you need to read and and go back to your gp to figure out what route they want to take with the different options available. Especailly as the proper full exclusion diet would be totally emotionally intollerable to a child unless there was clear medical need for it as it so incredibly restrictive.

My concern is that we've had conflicting medical opinion. One GP in the practice felt DS was just having a run of different low level illnesses - the other GP felt there was an underlying problem and referred him to the consultant. The school nurse thought it was coeliac's. The consultant thought it wasn't coeliac's. DH (having lived with allergies for years) thinks there is an underlying allergy.

DH was diagnosed as an adult after an exclusion diet where they removed almost everything and then re-introduced items. My nephew was diagnosed in his late teens after a raft of blood tests. None of us have experience of a child as young as DS being diagnosed. It sounds as though I just need to continue keeping a diary and then go back to the GP. I just don't know what I should expect the GP to do, or which direction I should be trying to push him in.

I think the reason why I said go back is that you need clarification as to whether they will be doing the blood tests in the near future or if they want you to do an exclusion and then re include to confirm via blood. You need to have a clear plan because if you chose to exclude and the GP then goes actually lets do bloods you it is possible to get false results. If you can establish clearly the plan of action in this regard it will make your choice much easier. Go back and see the GP who thought there was an underlying problem if you can.

It is possible although very rare to be diagnosed with allergies from under 3months old so allergy in 7yo is more than possible especially if it is an inherrited intollerance. All you need from the GP is clarification about exclusion (full/partial) and any impact of removing before bloods and which route they prefer to take. Simply ask this question. You should get an answer which helps.

Aplaceonthecouch, It seems to me as if you think the symptoms are dairy related. I'd just go straight to removing ALL dairy (including the hidden stuff, which you are probably familiar with spotting given the allergy history in the family)... and diary it. Then diary the reintroduction (and consider lactose free for a while to see if that sorts it).

My DS2 had allergies from about 2 weeks old. The GP was not only useless but gave completely the wrong advice. I food diaried (on my eating; i was breastfeeding), and with diet change, reduced the symptoms massively based on what was clearly evident. When we finally got a referral to a specialist (about 8 months old), we added some further items which were ige reactions, based on skin prick tests. I food diaried until about 18 months old, when we finally cleared out pretty much all the symptoms (we have several non ige as well as the ige allergies). Now we still have reactions, but only when we have contamination, or when i am feeding him small amounts of known allergens (to build his tolerance).

as far as i understand the only test for which you need to continue to eat the food is coeliac. if you have a family history of allergy then its more likely to be that (particularly since you have already noted concern over dairy). WRT the genetic testing, this will not tell you if you are coeliac, just if you are more likely to be than the average person.

Best of luck.

You need to see a paediatrician not a GP ask them to refer you, do not do an exclusion diet unless advised and are seeing a dietitian as taking things out of diet can do more harm than good sometimes! Also you need wheat in diet for a coeliac test, just tell your GP you must see a specialist! They will have to do something to help you! Hope you get sorted