Have you ever wondered whether your child really needs an allergy test? Or have you been tempted by those flashy direct-to-consumer kits, this conversation is a must-listen. Let’s tackle the rise of at-home “food sensitivity” tests, the difference between IgE and IgG, and why a detailed history matters more than any panel of results. 

In this episode, I’m joined once again by pediatric allergist Dr. Dave Stukus to break down what parents really need to know about allergy testing. From food allergies to seasonal sniffles, we dive into when testing is actually helpful—and when it leads to confusion, false positives, and unnecessary food restrictions. 

We discuss: 

• Why most at-home food sensitivity tests are misleading—and what to do instead

• When allergy testing is truly helpful (and when it backfires)

• How to tell the difference between food allergies, intolerances, and sensitivities

To connect with Dr. Dave Stukus follow him on Instagram ⁠@allergykidsdoc⁠, check out all his resources at ⁠https://www.nationwidechildrens.org/find-a-doctor/profiles/david-r-stukus⁠

00:00 – Intro

01:16 – Why History Matters More Than Tests

03:00 – When Should You Test?

05:26 – False Positives and the Limits of Testing

07:03 – Blood vs. Skin Testing: What’s the Difference?

09:07 – Eczema in Infants: To Test or Not to Test?

11:01 – Seasonal Allergies and the Right Time to Test

12:08 – Myth: “Allergy Tests Aren’t Reliable in Infants”

14:20 – The Problem with Food Sensitivity Tests

17:13 – The Red Flags of Unvalidated Testing

20:07 – The Real Harm of Over-Testing

22:35 – Final Takeaway: Ask Questions, Follow the Science

23:27 – The Truth About Panel Testing

25:10 – Can You Test for Seasonal Allergies Year-Round?

26:05 – Where to Follow Dr. Stukus

26:53 – Dr. Mona’s Reflection and Wrap-Up

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We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on the ⁠PedsDocTalk Podcast Sponsorships⁠ page of the website. 

00;00;00;06 – 00;00;24;29

Dr. Dave Stukus

Now. Allergy tests are not screening tests. Pause for dramatic effect. No allergy. Allergy tests were never designed to be screening tests. Meaning you can’t just test for everything and see what comes back. We get lots of false positives, both on skin testing and blood testing. And just because you have detectable IgG. So IgG is the allergy antibody. So these tests are designed to detect IgG.

 

00;00;25;01 – 00;00;31;01

Dr. Dave Stukus

Just because you find some IgG doesn’t mean that person actually is allergic or not. We need to go back and see what happens upon exposure.

 

00;00;31;04 – 00;00;53;28

Dr. Mona

Welcome to the show. It’s me, Doctor Mona, your trusted pediatrician, online confidant and mom friend here to support you through every twist and turn of parenting. Yes, even the parts of parenting that have you scratching your head while your kids scratching everything else. Seriously, why are they so itchy? You’re listening to the PedsDocTalk podcast, where we dive into honest conversations that empower your parenting journey, and today we’ve got a real treat.

 

00;00;53;28 – 00;01;16;00

Dr. Mona

I’m joined by none other than Doctor Dave Stukus, renowned allergist and immunologist aka Ally Kids doc here to bust some major myths about allergy testing. We’re getting into the nitty gritty when to test what those tests actually mean, and why those flashy at home kits might be better used as a paperweight. Doctor. Stuckus is also talks about how testing isn’t just about a lab result.

 

00;01;16;06 – 00;01;37;24

Dr. Mona

It’s about listening to the full story, because no tests can replace a good history, and a doctor who actually listens. We’re also digging into why some tests, like those food sensitivity ones, are more likely to create confusion than answers. And how to be a savvy advocate for your kid when navigating allergy testing and management. So whether you’re new here or you’ve been hanging with me for a while, you’re going to want to stick around.

 

00;01;37;28 – 00;02;00;03

Dr. Mona

Doctor stuck is brings the science and the laughs, and you’ll leave this episode with a whole new understanding of how to advocate for your kid’s health without wasting time, money or resources, or unnecessary testing. Make sure to subscribe and download this episode. It really helps us to keep bringing you these amazing chats that really matter. Let’s get into it.

 

00;02;00;05 – 00;02;02;21

Dr. Mona

Thank you so much for coming back on the show again.

 

00;02;02;24 – 00;02;05;14

Dr. Dave Stukus

Oh, it’s my pleasure. This is gonna be a lot of fun. Thanks for having. Yeah.

 

00;02;05;14 – 00;02;26;20

Dr. Mona

Our last episode was great again. We talked about myth busting around food allergies. So if any of you are listening and you’re like, I don’t know about facing food, when to introduce allergenic foods, it’s a great conversation. So make sure you search my podcast for that. But like I said, I get a lot of families coming in who want testing, whether it’s for seasonal allergies, for food.

 

00;02;26;20 – 00;02;37;14

Dr. Mona

Everyone wants blood work, but I know there can be some limitations to that. But before we get into that conversation, tell everyone a little bit more about yourself if they’re not familiar with who you are.

 

00;02;37;16 – 00;02;56;08

Dr. Dave Stukus

Yeah, so I love being a pediatric allergist because allergic conditions such as asthma and allergic rhinitis and eczema and food allergies are extremely common, unfortunately. And, I get to work with families that have, you know, concerns that are impacting their children on a regular basis sometimes, you know, decreasing their quality of life and interfering with their sleep.

 

00;02;56;08 – 00;03;15;25

Dr. Dave Stukus

And, more often than not, I can provide some, some real help and solutions to them and make their children feel better. And it makes me feel good to, to try to, to offer that, it’s it’s a field that evolves all the time. We sort of talked about that last time I got together. And, you know, the things I’m recommending now, I wasn’t recommending six months ago or a year ago, and hopefully I’m not practicing the same way a year from now.

 

00;03;15;25 – 00;03;18;29

Dr. Dave Stukus

It truly exciting times in the world of pediatric allergy.

 

00;03;19;01 – 00;03;39;09

Dr. Mona

Yep. And that’s why it’s called practicing medicine, right? There’s always evolution in terms of what we’re learning, not only in the allergy world, but of of course, you know, as general pediatricians, I’m constantly learning about all these different areas myself. So I love when I get to have a guest like yourself who’s obviously a specialist in pediatric allergy, because, you know, many things that I don’t know.

 

00;03;39;09 – 00;03;59;06

Dr. Mona

So I get to learn from you as well. And we get to teach our listeners, too. So thanks for coming back on the show. And I already mentioned this, that again, a lot of people come in asking for bloodwork. So let’s chat about, you know, when is testing in general recommended. And then we’ll go into more details on maybe some testing modalities and whatnot.

 

00;03;59;06 – 00;04;04;02

Dr. Mona

But when would you say that a parent should ask for testing or testing is warranted?

 

00;04;04;04 – 00;04;19;19

Dr. Dave Stukus

Yeah, I this is a great question. A good place to start. I like to clarify the diagnosis because unless we know exactly what the diagnosis is, then how do we know what we’re dealing with here? So if you have concerns that you know your child has food allergy or environmental allergies, we can do testing that can provide us a guide.

 

00;04;19;19 – 00;04;42;17

Dr. Dave Stukus

And we’ll talk about how that’s just a guide, not a yes or no answer as to what may be going on here. One thing that’s really important for, I think, for all your listeners is all of the symptoms that can occur due to allergies and allergic reactions can absolutely occur for non allergic reasons. And if we end up trying to, you know, gas or, or treat somebody that we think has allergies but actually has another condition, not only are we not going to make them feel better, but it’s going to delay the time until they get the proper diagnosis and management.

 

00;04;42;23 – 00;04;47;28

Dr. Dave Stukus

So just clarification, the diagnosis is usually the most, you know, the best indication to consider testing.

 

00;04;48;01 – 00;05;14;10

Dr. Mona

Yeah. And I often get parents coming in you know just say their child has hives okay. Let’s use that as an example. So the child has hives. The parent comes in and says I want to be tested and I say, okay, let’s talk about the hives. Let’s talk about what had happened. Let’s talk about exposures. How long have the has been going on for this whole this whole desire for wanting testing and especially a lot of parents want testing for everything, like, using even like seasonal allergies as an example.

 

00;05;14;10 – 00;05;26;01

Dr. Mona

They’re like, I just want to be tested. Where is there nuance there. Why is that not always possible? What do we need to know more of in that situation? And then how would we gear that towards our testing that we choose?

 

00;05;26;04 – 00;05;47;18

Dr. Dave Stukus

Yeah, I think just people don’t understand the limitations of the test that we have. So the best test to diagnose allergy, especially food allergy, is always the clinical history. So you need to come to me with the story. And I’m going to ask you lots of detail questions, because the answer to every one of those questions is going to change my little algorithm as to whether or not I think you have allergies or not, because the history helps give us that pretest probability.

 

00;05;47;18 – 00;06;08;03

Dr. Dave Stukus

So before we even do testing, we should be able to predict what the results are going to show or have a plan in place based upon what the results show us. Now, allergy tests are not screening tests. Pause for dramatic effect. No allergy. No allergy tests were never designed to be screening tests, meaning you can’t just test for everything and see what comes back.

 

00;06;08;05 – 00;06;25;24

Dr. Dave Stukus

We get lots of false positives, both on skin testing and blood testing. And just because you have detectable IgG. So IgG is the allergy antibody. So these tests are designed to detect IgG. Just because you find some IgG doesn’t mean that person actually is allergic or not. We need to go back and see what happens upon exposure. Yeah.

 

00;06;25;26 – 00;06;44;28

Dr. Dave Stukus

Allergies involve an immune response through this IgG antibody. It causes cause and effect symptoms. If you are allergic to something and you’re exposed to it, you should have symptoms every time you’re exposed to it. If you think you’re allergic to something and you’re exposed to it and you don’t have symptoms, you’re probably not allergic. If you still have symptoms despite not being exposed to it, you’re probably not allergic.

 

00;06;44;28 – 00;06;47;13

Dr. Dave Stukus

So that’s why the history matters the most.

 

00;06;47;16 – 00;07;03;22

Dr. Mona

Very important. And in terms of testing modalities, you already mentioned, you mentioned blood testing versus skin testing. Is there a reason why one would be preferred or another? Obviously, I’m sure there’s some situational differences, but what would you explain to maybe a parent who has no idea what testing may happen?

 

00;07;03;26 – 00;07;22;15

Dr. Dave Stukus

Yeah. So both of the skin tests and blood tests require, expertise in interpreting the results. That’s usually the number one pitfall we see from medical professionals. They don’t know what to do with the information they get. So with skin testing, that’s something Allergists can offer in the office. That’s something, you know, it’s easy to do where we place drops of liquid allergen on the skin, usually the back of the forearm.

 

00;07;22;22 – 00;07;41;24

Dr. Dave Stukus

We place a gentle little scratch through the allergen to introduce it to those allergy cells in the top part of the skin. So there’s no needles, no blood, no shots. And then we wait and see about 15 minutes. If that person has that IgG allergy antibody towards the allergen attached to those allergy cells in the skin called mast cells, it’ll open up those mast cells and release histamine, which causes a hive.

 

00;07;42;01 – 00;08;01;04

Dr. Dave Stukus

So the size of the hive, based upon where the allergens placed in the case, the likelihood that that person is allergic. Yeah. And negative results tend to tell us that they’re not allergic. Now, blood testing measures levels of the IgG antibody in the blood, typically for on a scale of like 0.1 to 100, there’s a lot of people out there that have no detectable IgG but aren’t allergic.

 

00;08;01;04 – 00;08;18;10

Dr. Dave Stukus

In fact, if we tested yeah, this goes back to the Nhanes trial of tens of thousands of children, where they did blood samples, 40% of all children were walking around with detectable IgG to milk, eggs, shrimp or peanut, but only 5% are actually allergic. So that’s the best example I can think of, of how we get tons of false positives.

 

00;08;18;10 – 00;08;36;23

Dr. Dave Stukus

So we can’t rely on testing alone. Neither skin test or blood test tells us anything about the severity of the allergy that somebody has, and they are not a yes no answer. So just because you have a, you know, an elevated level does not definitively mean that somebody has allergies, it only is a guide. And the testing can mean different things for different foods and different allergens.

 

00;08;36;23 – 00;08;48;09

Dr. Dave Stukus

So there’s a lot that goes into the interpretation of this. But rule number one, we can’t just test for everything and see what comes back. That’s not how we properly diagnose allergy. In fact, that’s the backwards way of doing it because we’re going to overdiagnosed the vast majority of people that way.

 

00;08;48;11 – 00;08;51;01

Dr. Mona

Right? Because then there could be a lot of false positives like you mentioned.

 

00;08;51;07 – 00;09;07;20

Dr. Dave Stukus

Yeah, yeah. And that’s why these at home tests are so terrible because it skips the most important part. The most important part is what’s the clinical history. Instead they do a bunch of tests and then anything that comes back where they quote, you know, quote unquote positive, then diagnosed as having allergy, which may not be present in the first place.

 

00;09;07;22 – 00;09;27;18

Dr. Mona

And what about infants. So you know, sometimes we’ll see infants who have moderate to severe eczema and you know, they’ll sometimes be recommended to see an allergist. Is there utility in testing children in that infancy period or children with eczema. Is there any utility in doing any sort of allergy testing on a child with eczema?

 

00;09;27;18 – 00;09;37;09

Dr. Mona

Because I know that actually used to be a really strong recommendation to send all our, you know, all eczema children to an allergist before introduction of solids, what is the current recommendation around that?

 

00;09;37;16 – 00;09;55;24

Dr. Dave Stukus

Yeah, the current recommendation is don’t especially for foods, because we know that kids with eczema have the highest risk of having false positives, and that’s going to lead to unnecessary avoidance. And actually, maybe even, contribute to the creation of allergy. So if you take an infant who is sensitized, meaning you find some IgG, but they haven’t had a reaction, we don’t know if they’re allergic or not.

 

00;09;55;24 – 00;10;09;07

Dr. Dave Stukus

They may actually be tolerant, but if you tell them to avoid for a period of time, then they’re going to develop allergy. So it’s like in this alternate timeline universe right. Like we don’t know what timeline they’re on. But if we catch them at the right time and get them to eat the food and keep in their day, that’s how we prevent food allergy.

 

00;10;09;13 – 00;10;37;17

Dr. Dave Stukus

So we don’t want to go fishing during that testing. Now, as far as environmental allergens, it’s possible that some indoor allergens may be contributing. Typically we don’t see outdoor allergies develop until children about 3 or 4 years of age. They have to be exposed for a couple of seasons to develop allergies to tree pollen, grass pollen. But if a child with, you know, truly persistent eczema, lives in a house with cats and dogs, for instance, and they also, if they also have some, you know, rhinitis symptoms or sneezing or runny nose, we can test for cat, dog dust mite, maybe even rodents, that sort of thing.

 

00;10;37;17 – 00;10;44;02

Dr. Dave Stukus

But typically eczema is going to be more of a skin issue that we can, approach in a variety of ways with good skin care.

 

00;10;44;05 – 00;11;01;02

Dr. Mona

And, you know, you alluded to seasonal allergies. Thank you so much for bringing up the age. I know this is not a topic, an episode solely on seasonal allergies, but yes, I get it often about the outdoor seasonal allergies, like my two year old, you know, has pollen allergy during the spring and or like, let’s say even younger, like a one year old.

 

00;11;01;06 – 00;11;22;08

Dr. Mona

Thank you for talking about how you have to have repetitive exposure. Speaking about, seasonal allergies though, is there a certain time that it is recommended to actually get that testing done, or do you usually recommend doing management first before testing? Or what is your sort of approach with like a child who comes to you with seasonal allergies?

 

00;11;22;10 – 00;11;47;06

Dr. Dave Stukus

Yeah, it goes back to, you know, can we clarify the diagnosis? So I think it’s very reasonable, you know, is it is can every child with, you know, seasonal runny nose and stuffy nose be seen by a board certified allergist? No. That’s unreasonable. There’s there’s millions of children that fit that description. So for primary care pediatricians or family practitioners and whatnot, it’s very reasonable to, you know, do a trial of, say, a non stating any histamine or even a, an over-the-counter nasal steroid spray.

 

00;11;47;09 – 00;12;08;20

Dr. Dave Stukus

If that fixes their symptoms, that’s great. If they continue to have symptoms despite that, that’s where testing may help, you know, clarify the diagnosis because maybe it’s not actually due to allergy, which will explain why they’re not improving with the antihistamines or certainly if they have more severe allergies. Anybody that we’re considering long term treatment options like allergy shots or immunotherapy, that’s when we definitely want to clarify the diagnosis and do some testing as well.

 

00;12;08;22 – 00;12;18;07

Dr. Dave Stukus

You know, one other thing that we should go back to is you mentioned with infants. So a lot of people have been told incorrectly that allergy testing is isn’t reliable until children are a certain age.

 

00;12;18;07 – 00;12;22;12

Dr. Mona

Oh, we can ask that. Thank you. Oh, yeah. Great. Great. Yeah, I love it.

 

00;12;22;12 – 00;12;24;12

Dr. Dave Stukus

I didn’t I didn’t mean to jump the gun, but you did.

 

00;12;24;13 – 00;12;27;07

Dr. Mona

So you were on the same page I was yeah. That’s wonderful.

 

00;12;27;09 – 00;12;44;05

Dr. Dave Stukus

So as we mentioned so allergy test detect this Ige antibody. If we’re doing Ige testing and somebody who’s symptoms are not caused by IgG allergies then the tests are going to be negative as they should be negative. If you’re old enough to develop food allergies, you’re absolutely old enough to have a test that confirms that you have those food allergies.

 

00;12;44;07 – 00;12;53;11

Dr. Dave Stukus

So why are tests negative in infants? Because more often than not, these tests are being used inappropriately for infants that have symptoms due to non allergic conditions. So there’s my there’s my answer to that one.

 

00;12;53;11 – 00;13;07;04

Dr. Mona

Sorry I jumped again I love it. No that is exactly what I was going to say because we know I was going to ask you. You know we talk about false positive, right? So I was going to also ask like, for anyone who is not familiar, false positive means that it’s telling you you’re allergic when you actually may not be right.

 

00;13;07;04 – 00;13;24;07

Dr. Mona

So do we that was my my other question was, is there a certain higher incidence of false positive under a certain age versus over because of what you just said? Right. Like that? Is there unreliability just based on a child’s age? But the answer is no. False positives exist in all ages.

 

00;13;24;14 – 00;13;41;08

Dr. Dave Stukus

Yeah. All ages. As I mentioned, if they have eczema especially, they’re going to have a ton of false positives. So we have to be very careful about about what testing we do and how we interpret false negatives are more rare. They can occur. But again, if you have a really good story for food allergy and you have a negative skin test, we’re going to be doing an oral food challenge.

 

00;13;41;08 – 00;13;52;25

Dr. Dave Stukus

We’re going to follow that up with a blood test. So we’re not going to let that go. If your story isn’t really good for food allergy, and with a negative test that confirms what we already thought, that you probably don’t have a food allergy.

 

00;13;52;27 – 00;14;20;22

Dr. Mona

Now let’s take a quick break to hear from our sponsors who support helps us keep bringing you this show. Oh love this. And you know, you already alluded to the whole social media. We talk about social media a lot. We talked about it in our last episode as well, but about a lot of food sensitive tests, not only people using them, but also the marketing behind, hey, buy this at home test to check for allergies, but also intolerances.

 

00;14;20;24 – 00;14;32;24

Dr. Mona

Can you can you explain the difference between one what these food sensitivity tests even mean? And what is that even mean to be sensitive versus truly allergic and I don’t think a lot of people understand that there’s a difference there. And is there.

 

00;14;32;24 – 00;14;53;18

Dr. Dave Stukus

Oh yeah. Yeah. Huge difference. Yeah. So I’ll start by saying that legitimate, diagnostic tests don’t require flash sales. So we don’t need to offer Mother’s Day sales on, you know, good tests. All right. So a food allergy, we sort of talked about that. You have this IgG antibodies. So you’re going to have rapid onset reproducible symptoms every single time you use the food.

 

00;14;53;18 – 00;15;09;14

Dr. Dave Stukus

If you’re allergic to milk, you won’t be able to eat cheese or yogurt or ice cream because you’re going to have combinations of hives swelling, vomiting, anaphylaxis, that sort of thing. Intolerances do not involve the immune system. This is difficulty with digestion. This can kind of come and go over. Time is more delayed. The classic story would be a lactose intolerance.

 

00;15;09;14 – 00;15;29;14

Dr. Dave Stukus

And for people who are unable to digest that lactose sugar found in dairy, then, you know, later that day or the next day, they’re not gonna feel so good because they’re going to bloating, diarrhea, constipation, more GI symptoms. So there’s no good readily available test to diagnose intolerance other than a very careful elimination diet to see if symptoms fully resolve, and then eat the food again to see if they come back again, because a lot of times they don’t.

 

00;15;29;16 – 00;15;51;26

Dr. Dave Stukus

And then we have this diagnosis of quote unquote food sensitivity, which really isn’t a true medical diagnosis. So there’s no, you know, established criteria to determine who has a food sensitivity. There’s no ICD ten diagnostic code for food sensitivity. There’s no test that says you have a food sensitivity, but a lot of these tests measure, food specific IgG antibody in the blood.

 

00;15;51;29 – 00;16;17;11

Dr. Dave Stukus

Now, IgG is very different than IgG. Causes immediate allergic reactions IgG is a memory antibody. In fact, it’s a marker of tolerance. A normal immune system forms IgG to foods after we eat them. Right? So when these tests measure IgG levels, the foods all they’re showing you are foods you’ve eaten at some point in the past. It’s really important to understand that these IgG tests have never been validated, which is really important.

 

00;16;17;11 – 00;16;33;27

Dr. Dave Stukus

So, all the tests that we use as physicians and medical professionals, there’s validation there, meaning we know what happens if we do this test in somebody who has a condition versus somebody who doesn’t. We should see very different results. We should also see the same results reproduced in the same person with the condition. Every time that test is done.

 

00;16;33;29 – 00;16;54;17

Dr. Dave Stukus

And we also should have some range of what constitutes a normal value so that we know what’s abnormal. These IgG tests lack all three of those. So, you know, all the evidence shows there’s position statements going back a decade from the allergy organizations. There is no indication to do IgG testing. Are there some studies out there that show that, you know, you can, you know, tease out IgG tests and things like that?

 

00;16;54;22 – 00;17;13;06

Dr. Dave Stukus

Yeah, there’s some some pretty small studies with really bad methodology and people with like migraines or maybe irritable bowel. But all of them are flawed. So should we be using this on the general population? Absolutely not. And then one last thing, and then I’ll I’ll step off my soapbox. You heard me mention in a very dramatic fashion that IgG tests are not screening tests.

 

00;17;13;08 – 00;17;24;07

Dr. Dave Stukus

Well, then why on earth would UN validated exams be screening tests? They’re not so Savior. Savior. Couple hundred dollars. And, you know, go see a board certified allergist instead.

 

00;17;24;07 – 00;17;33;03

Dr. Mona

I’m just shocked then. I mean, so there I don’t know this because I don’t buy any of them or research them, but are there any at home tests that are IGI. No, they’re all.

 

00;17;33;04 – 00;17;44;07

Dr. Dave Stukus

There are. So that’s there. So they are right now doing direct to consumer IgG tests, which is very problematic because as you mentioned, they’re not taking into account the clinical history. And this is something a lot of false positives. Yeah.

 

00;17;44;09 – 00;18;02;24

Dr. Mona

So either way it’s like I mean already we know that these IgG ones you wish would just be off the market right. Oh yeah. And it’s and then the IgG ones that we’re talking about, if you were to buy one that’s getting marketed by the time this episode comes out. Again correlation with the clinical picture I mean I, I agree.

 

00;18;02;24 – 00;18;23;12

Dr. Mona

I mean there’s so much a not even just in the allergy world, by the way. I get so many parents coming in. If their kid has a virus or like a fever, right? And they’re like, I want blood work. And I’m like, well, can we talk about the symptoms? Like there’s nothing about your child or maybe there is, but I’m going to get some blood work and it shows me maybe, you know, an elevated white count or maybe something happening there.

 

00;18;23;15 – 00;18;41;27

Dr. Mona

But I’m always going to correlate the blood work with the clinical picture. I mean, that’s what the goal of blood work is. It’s not blood work. And then that’s it. Even using I know you’re not a GI doc, but using gluten, celiac, right. We take we do blood work, but then we correlated to symptoms and then we take them to a GI doc.

 

00;18;41;27 – 00;18;58;28

Dr. Mona

We’ll do a scope to do the confirmatory diagnosis. So we have to understand that these tests I agree with you. I see it doing more harm than good, especially the food sensitivity, the amount of people telling me that their their gluten and gluten sensitive when they took an at home test, I’m like, well, did you see a GI doc?

 

00;18;59;04 – 00;19;17;29

Dr. Mona

And they’re like, no. And I’m like, well, you have to actually go see a GI doc to get a definitive diagnosis from, you know, for, for celiac. Right. But it is it is very interesting because it could, like you said, we eliminate food. And then the other thing and I see a lot of is, well, this food makes my, my belly hurt.

 

00;19;17;29 – 00;19;36;23

Dr. Mona

And I’m like, well, that’s not an allergy. That’s not technically a sensitivity. I if I eat too much chocolate, my belly hurts. It’s like, maybe that’s just how you response. I think again, there’s it could be situational, but really knowing that these tests I agree, are a waste of money. And also just a, you know, also unnecessary stress.

 

00;19;36;23 – 00;19;58;05

Dr. Mona

I mean, then you get this test, you don’t know how to interpret it. Then you’re panic calling your doctor who now has to interpret this new test that, you know, you already said that clinicians like us, we don’t even we already, have a hard time sometimes, interpreting the tests that we have in our office, let alone some random third party company that’s doing an ECG test, telling you that you’re sensitive to a gazillion things.

 

00;19;58;05 – 00;20;07;08

Dr. Mona

Right. It’s it’s a really it can lead to a lot of strain on everybody. The medical system as well as family is just being worried and eliminating things that are not necessary.

 

00;20;07;11 – 00;20;24;22

Dr. Dave Stukus

Yeah, I agree these are harmful, not just from a financial standpoint because they cost a lot of money, but the way they catch people is so they will attribute any symptom imaginable to being due to a quote unquote, food sensitivity. So if you go to this website, you’ll see it. Wow, I do have dry skin or I had a poor night’s sleep last week, or sometimes my knee feels a little creaky.

 

00;20;24;29 – 00;20;43;01

Dr. Dave Stukus

Those are that’s not food sensitivity. How can this sensitivity cause any symptom? Imagine. Yeah, it can’t. And then, you know, a very real phenomenon, as you alluded to, is. So what happens when you get this list? Because you get a list back of it’s elevated to everything and they give you these weird scales of like, you know, high, moderate, low or whatever, but none of them are negative.

 

00;20;43;03 – 00;20;58;21

Dr. Dave Stukus

And then if you have a list now of like 20 foods that you’re being told from a test that you already spent hundreds of dollars on, that you want to believe in, these are 20 foods you have to avoid. What does that do to your life? It upends it. It creates disordered eating habits. It creates, you know, emotional problems.

 

00;20;58;21 – 00;21;04;12

Dr. Dave Stukus

If you have a hard time finding safe foods to eat, what do you think are safe? These are really problematic.

 

00;21;04;15 – 00;21;26;19

Dr. Mona

Well, we alluded to that in our other episode when we talked about the, food allergy myth busting. Right. And I know we talked about allergy testing with food allergies, and all of that, you know, and especially with children with eczema and how parents, especially a lot of our listeners have, children that are young. If you start doing these testing on yourself and especially your children, you are eliminating a lot of food.

 

00;21;26;19 – 00;21;36;27

Dr. Mona

And already there’s so much mental load on what to feed your kid. And now you’re like having to worry. And I don’t think any of them are being marketed towards children as of yet. Right. They’re all mainly towards adults. Or do you know, I think.

 

00;21;36;28 – 00;21;37;10

Dr. Dave Stukus

That’s.

 

00;21;37;15 – 00;21;38;28

Dr. Mona

That’s yeah. What’s going on. Us too.

 

00;21;39;02 – 00;21;58;03

Dr. Dave Stukus

So it’s, it’s now delving into that. So this is we’ve seen this, we see this with the anti-vaccine propagandists. Fear based marketing. Right. It’s all fearmongering. All of these things talk about hidden food sensitivities. And it really taps into a parent’s deepest fears of that. We’re missing something with our children that’s causing harm. That is not the case.

 

00;21;58;10 – 00;22;16;26

Dr. Dave Stukus

If you read something online that generates a lot of emotion or fear, that’s the first red flag that maybe that’s not trustworthy, especially if they’re selling you a test. And especially if anybody’s talking about hidden anything. You know, there’s nothing hidden that we need to worry about. Things present themselves. That’s why we have symptoms, and that’s why we have, you know, evaluate and things like that.

 

00;22;16;28 – 00;22;35;26

Dr. Mona

Yeah. And that’s why we have, like you said, evidence continuously coming out, research continuously coming out in this world of allergy, you know, food allergies, seasonal allergies, all of this so that we can provide the best resources, resources for our, patients and their families. So I agree completely. Now, what would be your final message for everyone tuning in today?

 

00;22;35;29 – 00;22;55;23

Dr. Dave Stukus

Oh, I think I said this last time, you know, follow the science. Don’t fall for the marketing, especially in this realm. Oh my gosh, there’s so much marketing out there. And all right, here’s the dark side of what some of my colleagues may not really appreciate. So the dark side of allergy immunology is that some of my colleagues are not up to date with the current evidence based care.

 

00;22;55;23 – 00;23;13;09

Dr. Dave Stukus

So you can go see a legitimate allergist. And they may still be doing panel testing for foods and things like that. It’s really sad and there’s no easy answer to this. It just takes a long time for evidence to get translated into practice. So this is part of what makes it really challenging is because sometimes people are actually going to allergist and getting misdiagnosed.

 

00;23;13;11 – 00;23;27;10

Dr. Dave Stukus

But, you know, I think it it behooves everybody to just ask questions, understand, you know, if if somebody recommends a large amount of testing, ask them why. Ask them what we’re going to benefit from. And, yeah, hopefully you find somebody that you trust and that can give you the, the guidance that you need.

 

00;23;27;12 – 00;23;41;07

Dr. Mona

Well, I was going to end it, but now I have a follow up about that panel testing. So panel testing like you mentioned earlier, is when someone is testing for a variety of different foods, for example, all at once, even if it’s not clinically indicated. Is that what panel testing is?

 

00;23;41;14 – 00;23;58;00

Dr. Dave Stukus

Yeah, these are widely marketed to even general pediatricians and it’s something online. So hey, wouldn’t it be great if you could tell your families exactly like it do with one easy test? Or we can scan for 60 different food allergens. Now we actually got rid of panel testing for foods at our institution five years ago. This was like the greatest accomplished in my career.

 

00;23;58;03 – 00;24;08;05

Dr. Dave Stukus

Because we published research in a in a major medical journal that showed the harm that came from these panels. Now, can people still order specific food IgG tests? Absolutely. You just have to be thoughtful about what food you’re ordering and why.

 

00;24;08;08 – 00;24;27;00

Dr. Mona

So we actually the reason I’m asking and I’m taking it back, even after you did, the final message was in our in our practice we have specific IgG for certain foods like. So for example, if a child comes in they have peanut. We do a specific test for that. We don’t have pan testing for food, but we do have panel testing for respiratory allergies.

 

00;24;27;04 – 00;24;45;29

Dr. Mona

Is that something that you consider maybe should also fall off from the clinical practice? I’m curious what your thoughts are like. You know, we have a panel that does ragweed pollen, dog and or cat and or like a, a multi listed lot of different things. And yeah, it’s a pan testing. I’m curious your thoughts.

 

00;24;46;01 – 00;25;01;10

Dr. Dave Stukus

Yeah. It’s great point. We have that as well. And that’s a very different scenario. Right. So a lot of times when we’re doing these tests because children have chronic symptoms and it’s, it’s, it’s valid to actually test and see if, you know, different pollens at different times of year. And the reason why is because the results should absolutely guide management.

 

00;25;01;10 – 00;25;10;09

Dr. Dave Stukus

What if we find out that your symptoms are only due to allergies in the spring? Okay. That changes things in the summer, in the fall, in the winter, and so on and so forth. So yeah, that that’s absolutely valid.

 

00;25;10;12 – 00;25;30;02

Dr. Mona

Wonderful. And then I guess my last question on that point about seasonal allergy testing is just like someone does have something that’s more seasonal and they’re testing in the fall on something that something that may be actually more of a trigger in the spring for that person with the testing still show up, even if it’s not active at that moment in their system.

 

00;25;30;04 – 00;25;37;05

Dr. Dave Stukus

Yeah. So we don’t like, turn our allergies on or off, you know, throughout the year. Right. So that’s a great question. So the person as always I get that.

 

00;25;37;05 – 00;25;38;20

Dr. Mona

They’re all a lot, which is why I was yeah yeah.

 

00;25;38;20 – 00;25;57;20

Dr. Dave Stukus

Yeah yeah. So they’re always producing the allergy antibody but they’re not exposed to it. They’re going to be asymptomatic. So you can you’re always going to have that sensitization of the IgG towards tree pollen. But and you’re not going to be exposed except in the springtime. Yeah. So that’s valid. But now what we do see is you can actually see seasonal increases in the level of IgG during that season.

 

00;25;57;20 – 00;26;04;26

Dr. Dave Stukus

So as as your immune system ramps up with exposure, those levels can actually be higher during that particular season. But they should never go to completely negative.

 

00;26;05;03 – 00;26;17;22

Dr. Mona

Makes complete sense. Again, thank you so much for joining me. I loved recording this episode with you, and also that episode we had about food allergy myth busting. Where can people go to stay connected, share your social handles again?

 

00;26;17;25 – 00;26;31;03

Dr. Dave Stukus

So I’m mainly on Instagram at Allergy Kids, doc, and hopefully, I’m providing evidence based information to help you make decisions. I will never give you specific medical information or advice, nor should anybody on social media.

 

00;26;31;05 – 00;26;53;19

Dr. Mona

Yes. And, you know, I learn so much from my colleagues on social and also obviously with my peers that I practice with. But I mentioned this on my other episode as well with, Doctor Sturgis, that I whenever there’s a major update in the allergy world, I’ll go and look at all of my favorite allergy accounts and see what they’re saying about whatever medication or whatever study that was released, because I like to learn from my colleagues who are more specialized.

 

00;26;53;19 – 00;27;10;26

Dr. Mona

And I think, again, it makes me a better pediatrician. I love having this podcast and connecting with you because I get to learn more. And also our listeners get to learn more and be better advocates for themselves so that when they go to a clinician that may say, yeah, let’s just do this panel testing, they can say, you know what?

 

00;27;10;28 – 00;27;25;23

Dr. Mona

I listen to Doctor Dave and Doctor Mona say that it might not be so useful. So thank you for taking the time today and all the work that you do on social, even amidst your busy life clinically and obviously your personal life as well. It means so much, for me as a fellow educator online as well.

 

00;27;26;00 – 00;27;37;21

Dr. Dave Stukus

Yeah. Well, thank you so much for having me. I really appreciate all that you do. And, with your platform, which is so, so widespread, it’s just amazing all the great work you’re doing. So it’s a pleasure to be here. Thank you.

 

00;27;37;23 – 00;28;01;23

Dr. Mona

That’s a wrap on today’s episode with Doctor Dave Stukus’s, aka Allergy Kids. Doc and I love getting to have specialists on my show who know their area way better than I could as a general pediatrician, because I get to learn, I get to remind myself on how I need to advocate for patients, how I need to approach these conversations, and also how to improve my management of things like allergies with testing or without testing.

 

00;28;01;25 – 00;28;21;10

Dr. Mona

I love to hear from you. What part of our conversation resonated most with you? What’s one thing you’re taking away that’s going to help you cut through the noise? When it comes to allergy testing? Head over to my socials at PedsDocTalk, at the PedsDocTalk podcast, and at Allergy Kids Doc, and make sure to tag us, but join the conversation on our latest post about this episode.

 

00;28;21;15 – 00;28;39;04

Dr. Mona

And if you found today’s chat as Eye-Opening and downright fun as I did talking about medicine, share it on your stories and tag at the PedsDocTalk podcast and at Allergy Kids doc, because you never know who in your circle might be dealing with these same questions. Thank you for tuning in and for being part of this amazing growing community.

 

00;28;39;04 – 00;28;54;15

Dr. Mona

We still are in the top 30 podcast in parenting in the United States, so don’t forget to subscribe and download. Those downloads really do mean a lot to us, and it’s how our show continues to grow. Have an amazing week ahead and I’ll see you all back here next week with another guest. Stay well.