A physician-supervised food challenge is often needed to determine whether someone is truly allergic.

If you suspect that you or your child have food allergies, you may want to visit an allergist. “Unfortunately, food allergies are often over-diagnosed. For example, approximately 9 percent of the U.S. population tests positive for peanut allergy, yet only 2 percent are truly allergic,” says Dr. Jessica Savage, an allergist who sees both adults and children in the Department of Allergy and Immunology at Brigham and Women’s Hospital.

If you test positive for a food allergy, your allergist may recommend a food challenge: eating the food under physician observation. Because food allergy testing is imprecise, this is often needed to truly determine if you are allergic or not, or if you have outgrown your allergies. After a successful food challenge, it is generally safe to reintroduce the suspect food into the diet.

Food avoidance – and carrying self-injectable epinephrine in case of an accidental food exposure – is the mainstay of treatment for food allergies, but it can be incredibly challenging. “Imagine having to avoid all traces of wheat. This can significantly affect your quality of life,” says Dr. Savage. She advises that an allergist can help you differentiate between food  “sensitization” – testing positive for food allergy, but being able to eat the food safely – and true food allergy, which requires a strict avoidance diet because accidental consumption may cause severe symptoms.

Food allergies can start as a child or an adult, though most begin in early childhood, before age two. In the past, children were expected to outgrow their food allergies by age five, though today many are holding onto them longer. “We’re seeing more kids go to high school and college with food allergies. We’ve even observed food allergies persist into the late teens and early twenties,” says Dr. Savage. However, she adds, even among young adults, there is a chance they may outgrow their allergies, so it is worth revisiting your allergist periodically.

Looking to the future, Dr. Savage believes that desensitization, or oral immunotherapy, may eventually be proven as an effective treatment for those with food allergies. Using oral immunotherapy, which is still considered experimental, allergic patients are desensitized to a particular food by receiving very small amounts every day, increasing very gradually over an extended period of time. Eventually, patients become tolerant or desensitized to the food. Though this process can take years, it has shown success in research studies conducted so far.

To learn more about food allergies:

- Jamie R.

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