Summary

Any diagnostic tests only supplement the impression or information already gained from history taking and examination.

The most well-defined mechanism of food allergy is that due to a Type I immunological reaction, mediated by the specific antibodies, IgE. There are other mechanisms of food allergy or intolerance that are much less well defined.

Most well-validated tests have been developed to identify the presence of specific IgE to food allergens either in vivo or in vitro. Even with these well-validated tests there are still problems in particular with their specificity.

There are diagnostic tests that are unproven, diagnostic tests that are experimental and have yet to move beyond the research arena, and tests which, though valid, have no place in the diagnosis of food intolerance and allergies.

Double-blind placebo-controlled food challenges remain the 'gold standard' test in use when investigating food allergies and intolerances.

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