Food Allergies and Intolerances
What Is It?
IgE-mediated food allergies (peanut, tree nuts, shellfish, fish, milk, egg, wheat, soy, sesame) cause immediate hypersensitivity reactions. Food intolerances (lactose, fructose) are non-immune mechanisms causing GI symptoms.
How Is It Diagnosed?
Skin prick test and specific IgE blood testing (ImmunoCAP) for IgE-mediated allergy. Oral food challenge (gold standard). Component testing (peanut Ara h 2) for risk stratification. Hydrogen breath test for carbohydrate malabsorption.
How Is It Treated?
Strict avoidance of trigger foods. Epinephrine auto-injector (EpiPen) for patients at risk of anaphylaxis. Oral immunotherapy (OIT) for peanut allergy (Palforzia). Antihistamines for mild reactions. Allergy specialist referral.
Tests and Imaging Typically Needed
Skin prick test, specific IgE panel, component allergen testing, total IgE, complete allergy evaluation.
Approximate Self-Pay Costs
Office visit: $95-$150. IgE panel: $100-$300. Allergy consultation: $200-$500. EpiPen: $30-$100 (with coupon). OIT program: significant cost.