Non-conventional approaches to allergy testing: reconciling patient autonomy with medical practitioners’ concerns

It may be difficult for patients to distinguish current concepts of immune function from other, non-conventional explanations of illness

Each year, as many as 50%–70% of adults and children with allergic disease consult alternative practitioners.1-3 Some will undergo unproven diagnostic “allergy testing” as used by some alternative (and some conventionally trained) medical practitioners. The potential for adverse outcomes from using unproven diagnostic techniques is not only insidious but also potentially more serious than the more commonly debated issues surrounding costs,1 or the risks and benefits of alternative therapies such as naturopathy, chiropractic, acupuncture, homoeopathy or so-called “allergy elimination therapy”.4,5 Particular concerns arise when “positive test results” are followed by advice to restrict diet, a practice that our combined clinical experience tells us occurs not infrequently, regardless of the presenting problem — even in cases of asthma, allergic rhinitis or recurrent infection in which food allergy is not considered to play a pathogenic role. Such advice may unnecessarily delay more appropriate therapy and sometimes impair nutrition and growth.6