Can you test negative for a food allergy but actually, be allergic?
Can you test negative for a food allergy but actually be allergic?
False negative test results can occur, but they're pretty rare, thankfully. So, especially when somebody doesn't have a very good history of having reactions to foods, we tend to believe our negative test results in both skin testing and blood testing.
The gold standard to diagnose food allergy or to rule it out, is the oral food challenge. So, when the clinical history is indeterminate, or the testing is indeterminate, or we have somebody with known food allergy, and we feel that they may have developed tolerance over time, through repeat testing, the best test is to have a supervised graded oral food challenge, where you eat gradually increasing amounts of the food, in the presence of an allergist. If no symptoms occur after you've ingested the predetermined serving size, then it's very unlikely that you're allergic to that food and you can include it in your diet.
So, if you have concerns about food allergy and you have a negative test, please talk about next steps with your allergist. On the flip side, if the history is not very suggestive for food allergy either because somebody has never knowingly eaten a food or experienced a reaction to a food and we have a negative test result, then yes, we should believe those results almost all the time.
Diagnosis, Food Allergy
David Stukus, MD, is a Professor of Clinical Pediatrics in the Division of Allergy and Immunology, Director of the Food Allergy Treatment Center, and Associate Director of the Pediatric Allergy and Immunology Fellowship Program at Nationwide Children’s Hospital and The Ohio State University College of Medicine. He is board certified in allergy/immunology and pediatrics.
Dr. Stukus has devoted his career to communicating evidence-based medicine and best clinical practice to colleagues, medical professionals of all backgrounds, patients, and the general public. In addition to providing clinical care for children with all types of allergic conditions, he participates in clinical research, quality improvement, patient advocacy, and medical education.
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