What is the best food sensitivity test that is not a scam?

Short answer: there isn’t a single, validated “food sensitivity” blood test that reliably identifies non‑allergic food intolerances. The tests that are evidence‑based depend on the suspected problem (true allergy, celiac disease, lactose/fructose intolerance, SIBO/IBS). Avoid commercial IgG panels and similar direct‑to‑consumer “food sensitivity” tests — they’re not supported by good evidence and often lead to unnecessary restriction.

Recommended, evidence‑based options (and brands/labs)

1. If you have immediate allergic reactions (hives, swelling, anaphylaxis)

• What to get: skin‑prick testing by an allergist and/or serum specific IgE testing.
• Trusted brand/lab: ImmunoCAP (Thermo Fisher) is the standard assay many allergists and clinical labs (Quest Diagnostics, LabCorp, ARUP) use.
• Why: Validated for IgE‑mediated allergy and interpreted by a clinician.

1. If you suspect celiac disease or gluten‑related disease

• What to get: tissue transglutaminase IgA (tTG‑IgA) plus total IgA; possibly deamidated gliadin peptide (DGP) IgG if IgA deficient.
• Where: standard labs (Quest, LabCorp, ARUP).
• Why: These serologies are the accepted diagnostic tests for celiac disease. Important: do NOT start a gluten‑free diet before testing.

1. If you suspect carbohydrate malabsorption (lactose, fructose) or SIBO

• What to get: hydrogen/methane breath tests (lactose breath test, fructose breath test, or glucose/lactulose breath test for SIBO).
• Where: GI clinics or labs that run breath testing (many hospitals and gastroenterology centers; QuinTron makes common testing equipment).
• Why: Breath testing (with correct prep and interpretation) is the clinically used method for these problems.

1. If you have IBS or non‑IgE food triggers

• What to do: a structured elimination and reintroduction trial (for example low‑FODMAP), ideally guided by a registered dietitian experienced in GI disorders.
• Why: Many “sensitivities” are triggered by FODMAPs or other food groups; controlled elimination/rechallenge is the best diagnostic method.

Tests and services to avoid (or use with caution)

• IgG food antibody panels sold direct‑to‑consumer (Everlywell, YorkTest, Vibrant Wellness, many clinic panels): Evidence shows IgG antibodies often reflect exposure, not harmful sensitivity. These tests can be misleading.
• ALCAT / MRT / some leukocyte‑activation tests and many multiplex “food reactivity” arrays (Cyrex arrays fall into more experimental category): poor or limited evidence for clinical usefulness; can generate unnecessary dietary restrictions.
• Broad “microbiome” testing or unvalidated biomarker panels claiming to identify food sensitivities — useful for research, not for diagnosing sensitivities.

Practical next steps

• If you get acute/possibly dangerous reactions (difficulty breathing, lip/tongue/throat swelling): see an allergist or emergency care immediately.
• For ongoing GI or suspected sensitivity symptoms: start with a clinician visit (allergist or gastroenterologist) and/or an RD. Ask for evidence‑based tests above (ImmunoCAP/skin prick for allergy; tTG for celiac; breath tests for carbohydrate malabsorption).
• If you already have results from a commercial IgG panel, bring them to a clinician — but expect they will recommend confirmation via elimination trials or validated testing rather than acting on IgG results alone.

If you want, tell me the symptoms you’re getting (timing, type of reaction, consistency) and I’ll suggest the most appropriate next test or the specialist to see.