Allergies

allergy1ALLERGIES:
Allergies can hinder everyday life. But rest assured there are viable and healthy solutions!
At Associates MD we specialize in Allergy Testing and treatment. Our physicians and physician extenders have undergone extensive training and credentialing to assure our patients that they will get the highest quality primary care and service. We are highly trusted and are the leaders in providing care options.
In regards to Allergy Testing & Treatment, here is some additional information on the procedures.

Diagnosis
Allergy Testing: The Physical Exam
Food Allergy Testing
Allergy Symptom Diary
Elimination Diet

Tests
Allergy Skin Test
Blood Test for Allergies
For additional information or to schedule a consultation with one of our physicians, simply contact Associates MD to schedule your appointment today. Click Here

Allergy Testing: The Physical Exam
The first thing your doctor will do is talk to you. He will examine you and ask questions about your symptoms and your family’s history ofallergies, such as:
• What kinds of symptoms do you have?
• How long have you had them?
• When symptoms happen, how long do they last?
• Do your symptoms come and go throughout the year, or do they last year-round?
• Do your symptoms happen when you are outdoors, or indoors — like when you clean your house?
• Do they get worse when you are around pets? Do you have any pets?
• Do you smoke? Does anyone in your family smoke?
• Do your symptoms keep you from doing things, or from sleeping at night?
• What makes your symptoms better? What types of treatments have you tried? What allergy drugs are you taking now? Do they help?
• What other medications are you taking, including prescription and over-the-counter drugs, vitamins, and herbal supplements?
• What kind of heating system do you have? Do you have central air conditioning?
• Do you have any other health conditions, such as asthma or high blood pressure?
• Do you have problems with your sense of smell or taste?
• Do you get better on the weekend and worse when you go back to work?

Your doctor may suggest that you see a board-certified allergist who specializes in diagnosing and treating allergies, or he may recommend medication. If an allergist is recommended, he may do allergy testing to find out exactly what you’re allergic to, so together you can create the right treatment plan.

Questions for Your Doctor
• What’s causing my allergies?
• What allergy symptoms should I be concerned about? When should I call the doctor?
• What allergy medications or other treatments are available? What are the benefits and side effects of each treatment?
• Will I need allergy shots?
• Should I take medicine all the time or only when my allergy symptoms get worse?
• Should I stop exercising outside?
• What types of plants are better to put in my yard if I have allergies?
• What can I do around my house to reduce allergies?
• What can I do to decrease allergy symptoms when I have to go outside?
• How can I tell the difference between allergies and a cold or the flu?
• Will changing my diet help?
• How often should I come in for follow-up appointments?

allergy2 Food Allergy Testing
The nation’s major allergy organizations agree on how best to diagnose and manage food allergies. The "practice parameters," from a panel ofallergy experts, are a state-of-the-art guide on how to detect and treat food allergy.
Food allergies are common — and commonly misunderstood by doctors as well as patients, says panel co-chairman Jay M. Portnoy, MD, who is chief of allergy, asthma, and immunology at Children’s Mercy Hospital in Kansas City, Mo., and vice president of the American College of Allergy, Asthma & Immunology.
"I see patients all the time who go to a doctor, skin-test positive for lots of different foods, and are advised to avoid all of these foods," Portnoy tells WebMD. "It makes their life miserable. And it turns out they are not truly allergic to all these foods after all."
Portnoy’s complaint rings true with patient advocate Anne Muñoz-Furlong, founder and CEO of Food Allergy Research & Education (FARE).
"Some parents never suspect food allergies until their child ends up at the emergency room — where they might be told it is a food allergy, or they might not," Muñoz-Furlong tells WebMD. "Or if the child first has mild symptoms, like eczema, they may not realize it is a food allergy. And then the entire family suffers until a diagnosis is made and the food is eliminated from the diet."

The Most Common Food Allergies
Food allergies occur when a sensitive person eats, inhales, or comes into contact with even tiny amounts of certain foods. These reactions occur with exposure to proteins called allergens and can be very mild or may be life-threatening.
Food allergies are becoming more and more common. There has been an increase in severe food allergy cases in the last 10 years, mostly driven by peanut and tree nut allergies.

In children, the most common food allergies are:
• Cow’s milk
• Hen’s eggs
• Peanuts
• Tree nuts
• Soybeans
• Wheat
In adults, the most common food allergies are:
• Peanuts
• Tree nuts
• Fish
• Crustaceans (such as shrimp, crabs, and lobster)
• Mollusks (such as clams, oysters, and mussels)
• Fruits
• Vegetables
Symptoms tend to occur just after eating, inhaling, or coming into contact with the offending food. Symptoms may include reddening of the skin, hives, itchy skin, swollen lips or eyelids, tightness of the throat,wheezing, difficulty breathing, coughing, vomiting, or diarrhea.

Allergy Symptom Diary
You may know exactly which foods you’re allergic to. But if you or your child have food allergies and aren’t sure which foods are to blame,allergy testing can help you identify them.
Make an appointment with a board-certified allergist. First the doctor will ask you questions about what you think you’re allergic to and your symptoms. Sometimes that’s enough to identify the problem food, or he may suggest allergy testing.
Allergy testing can help your doctor figure out what you’re allergic to, but it’s not foolproof. After your tests are done, you’ll need to work with your doctor to get the right diagnosis.

Skin Testing or Skin Prick Test
Skin testing is the most common and quickest food allergy test. Your doctor can test you for several foods at the same time.
First, the doctor puts a very small drop of liquid containing the food on your skin and pricks it. Then the doctor will watch for a reaction – a small bump that may get red like a mosquito bite.
If your skin reacts, you’re likely allergic to that food. You’ll want to avoid it and your doctor can talk with you about other treatment options. If you don’t react, good news! You’re probably not allergic to that food.

Elimination Diet

This method for figuring out possible food allergy takes time — several weeks. It’s not a good idea for people who have had severe allergic reactions or anaphylaxis. If you have, it is important for you to find out your trigger food as soon as possible so you can avoid it. Talk with your doctor.

How does the elimination diet work?
The most common types of elimination diet involves removing specific foods or ingredients from your diet because you and your doctor think they may be causing allergy symptoms. Common allergy-causing foods include milk, eggs, nuts, wheat, and soy. Your doctor will supervise this diet over a few weeks. There are usually several steps to this diet.
1. Stop eating suspicious foods.
During this time, you will need to:
• Carefully read food labels and ask how foods are prepared at restaurants so you can be sure to avoid possible triggers.
• Keep a food diary to record the foods you are eating.
If you remove a certain food and the allergy symptoms go away while following this diet, your doctor can usually confirm that that food may be the cause of your problems.
While on this diet, make sure you eat other foods that provide the samenutrients as those you’re avoiding. (For example, try tofu-based foods instead of dairy products.) A dietitian can help you plan meals.

2. Slowly add back in suspicious foods, one at a time.
After eliminating or taking foods out of your diet, your doctor will ask you to gradually reintroduce into your diet the foods you were avoiding. You’ll add them one at a time over time. This process helps link allergy symptoms to specific foods.
Carefully record any allergy symptoms that you get as you add each food back in. If symptoms return after eating a food, your doctor can usually confirm that this is a trigger.

3. Last, you will be asked to once again to stop eating the foods (one at a time) that you and your doctor think are causing your allergysymptoms. The list should be smaller this time. The goal is to see if the symptoms clear up for good.
The elimination diet is not a sure thing. Other factors can affect the results. For example, if you think you’re sensitive to a food, you could have a response to it, but it may not be a true allergy.
Before making big changes in your diet, always talk to your doctor. If you randomly remove foods from your diet, you may not have abalanced diet — and that can cause other health problems. You may also become frustrated because it may seem that everything you eat is causing a reaction.

Tests
Allergy Skin Test
If you want to avoid an allergic reaction, it helps to know what you’re allergic to. Skin testing is a safe and fairly easy way for your doctor to try to figure out or confirm what’s causing your symptoms.
Skin tests use extracts — a concentrated liquid form — of common allergens like pollen, mold, dust mites, animal dander, and foods. Once the allergen gets in your skin, it could trigger a rash. Your skin will get irritated and may itch, like a mosquito bite.
That reaction is how the doctor can tell you’re allergic to a substance. When you have an allergy, your immune system will make antibodies and set off chemicals to fight the unwelcome invader.
What Happens During a Skin Test?
The steps vary depending on what type of test you’re having. There are three main ways to get allergens to react with your skin.
Scratch test, also known as a puncture or prick test: First, your doctor or nurse will look at the skin on your forearm or back and clean it with alcohol. They’ll mark and label areas on your skin with a pen. Then they’ll place a drop of a potential allergen on each of those spots. Next, they’ll prick the outer layer of your skin to let the allergen in. (It’s not a shot, and it won’t make you bleed.)
Intradermal test: After they look at and clean your skin, the doctor or nurse will inject a small amount of allergen just under your skin, similar to a tuberculosis test.
Patch test: Your doctor could put an allergen on a patch and then stick that on your arm or back.
Plan for an hour-long appointment. The pricking part of scratch and intradermal tests takes about 5 to 10 minutes. Then you’ll wait about 15 minutes to see how your skin reacts.
Patch tests take more time, and two visits to your doctor. You’ll have to wear a patch for about 48 hours in case you have a delayed reaction to the allergen.
Tell your doctor about all medicines you’re taking, including over-the-counter products. Some drugs can interfere with the results, so your doctor will give you a list of medicines to avoid before the test.
If you can’t stop taking amedication, your doctor or nurse may do a separate test to find out if that drug will interfere with the results.
Since allergy medicines, such as OTC antihistamines, stop allergic reactions, you shouldn’t take them for a few days before your test. You need to let your body react to the allergens in the test.

Is It Safe?

A skin test may be mildly irritating, but most people say it doesn’t hurt. Although you’re coming into contact with things you could be allergic to, they’re very small amounts. An allergy skin test is safe when done the right way.
Whole-body reactions to skin testing are rare, but let your doctor know right away if you have:
• Fever
• Lightheadedness
• Trouble breathing
• A widespread rash
• Swelling on your face, lips, or mouth
• A hard time swallowing

After Your Test
The doctor or nurse will clean any extracts and ink marks off your skin with alcohol. You may need to apply a mild cortisone cream to relieveitching.
If you’re having a patch test done, you’ll go home with bandages on your skin. Don’t get these areas wet — no baths or swimming. When you go back to the doctor in a couple of days, he’ll take another look at your skin.
Your doctor or allergist will use the results of your test to come up with a treatment plan for you.

BloodTests for Allergies
For this test, your doctor will take a sample of your blood and expose it to different types of allergens. You won’t learn the results right away. This test is often sent to a lab and results could take a week or more.
Doctors don’t use it as often. They may use it if they have an idea of what you’re allergic to and it is only one or two specific things. Or they use this test if they are worried you have a severe allergy. That way, you don’t have to be exposed to the possible trigger.
Neither skin nor blood tests can accurately predict how severe a food allergy reaction may be.
This test isn’t done very often because it is dangerous for people with severe food allergies.
When is it useful? Doctors will sometimes use this test to confirm a skin or blood test, or to see if a child has outgrown an allergy. It can be used to eliminate one specific food from the list, too. Why? Sometimes your skin might react to a food, but you wouldn’t have symptoms if you ate it.
Finally, in some cases a blood test may not be sensitive enough to find out your food trigger. A controlled food challenge can help sort it out.
For this test, you’ll go to your doctors’ office or a hospital. That way you can be watched closely in case you have a severe allergy attack.
Your doctor will give you food samples and watch you for a reaction. Or you may take capsules — some with an allergen in it, some without. That way the doctor can be sure that it is the food causing the reaction. Never try a food challenge on your own because it can be very dangerous.

Types of Allergy Blood Tests
Allergy blood tests detect and measure the amount of allergen-specific antibodies in your blood. When you come into contact with an allergy trigger, known as an allergen, your body makes antibodies against it.
The antibodies tell cells in your body to release certain chemicals. These chemicals are what cause allergy symptoms. Immunoglobulin E (IgE) is an antibody that’s strongly linked to the body’s allergy response.
Allergy blood tests usually screen for at least 10 of the most common allergy triggers, including dust, pet dander, trees, grasses, weeds, and molds related to where you live. They are also particularly helpful in diagnosing food allergies.
Allergy blood tests may be referred to as immunoassay tests and include:
• Enzyme-linked immunosorbent assay (ELISA, or EIA)
• Radioallergosorbent test (RAST)
The ELISA test measures the amount of allergen-specific antibodies in your blood.
The RAST test also looks for specific allergen-related antibodies in order to identify your allergy triggers. Since the introduction of the ELISA test, RAST testing has not typically been used.

Allergies can cause an increase in certain types of white blood cells. Blood tests to check your white blood cell counts, including a count of a type of white cell called an eosinophil, may also be done if your doctor thinks you have allergies. However, it is important to keep in mind that many other health conditions can cause an increase in white blood cells.
Other blood tests may be ordered that measure the release of chemicals responsible for allergic reactions.

Why Allergy Blood Tests Are Done
Allergy skin testing is the preferred method, but in some cases blood testing may be ordered.
Allergy blood testing is recommended if you:
• Are using a medicine known to interfere with test results and cannot stop taking it for a few days. This would include antihistamines, steroids, and certain antidepressants.
• Cannot tolerate the many needle scratches required for skin testing.
• Have an unstable heart condition.
• Have poorly controlled asthma.
• Have severe eczema, dermatitis, psoriasis, or another severe skincondition.
• Might have an extreme reaction during skin testing or have a history of life-threatening allergic reaction called anaphylaxis.
Your doctor may also order blood testing to determine how well yourallergy treatments (immunotherapy) are working. Blood testing may also show whether you have outgrown an allergy.

Pros and Cons of Allergy Blood Tests
Advantages of allergy blood tests include:
• Can be done at any time, regardless of any medicationsyou are taking.
• Requires only one needle stick (unlike skin testing). This may be more attractive for people who are afraid of needles. Allergy blood testing is the preferred test for infants and very young children.

Disadvantages of allergy blood tests include:
• More expensive than skin testing. Many health insurers do not cover allergy blood tests.
• May be less sensitive than skin tests.
• Takes days or weeks to get results because the blood sample must be sent to a laboratory for evaluation. Skin testing provides immediate results.

Allergy Blood Test Results
A positive result means allergy-specific antibodies were detected in your blood. This is usually a sign of an allergy.
The blood test will reveal what exactly you are allergic to. However, you can test positive for something but never have had an allergic reaction to it.
A negative result means you probably do not have a true allergy. That means your immune system probably does not respond to the allergen tested. However, it is possible to have a normal (negative) allergy blood test result and still have an allergy.
Allergy blood test results should be interpreted with caution by an allergy specialist. Your doctor will also consider your symptoms and medical history when diagnosing a specific allergy.

Side Effects of Allergy Blood Tests
Allergy blood testing is relatively safe. Side effects are usually minor and may include:
• Swelling and redness at the site where the needle was inserted
• Pain
• Bleeding at the site where the needle was inserted
• Some people may faint during blood testing.

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