ALCAT

Short answer: There is no single, clinically validated “food sensitivity” blood test that reliably diagnoses non‑allergic food intolerances. Tests that are well supported depend on what you suspect: If you suspect a true food allergy (fast, repeatable hives/angioedema/ breathing problems): see an allergist for skin‑prick testing and/or serum specific IgE testing (ImmunoCAP by Thermo Fisher is the most widely used and validated lab method). The allergist may do a medically supervised oral food challenge — the gold standard. If you suspect celiac disease: get lab testing for tissue transglutaminase IgA (tTG‑IgA) plus total IgA (and deamidated gliadin peptide IgG if IgA deficient). These are standard tests offered by major labs (Quest Diagnostics, LabCorp, hospital labs) and are evidence‑based. If you suspect lactose/fructose malabsorption or small intestinal bacterial overgrowth (SIBO): hydrogen (or hydrogen/methane) breath testing performed through a gastroenterologist or reputable GI lab is the appropriate test. (Many clinics use QuinTron analyzers; quality depends on proper prep and interpretation.) If you suspect non‑IgE, non‑celiac “food sensitivities” (for example, foods that seem to trigger IBS symptoms): there is no validated blood test. An elimination diet with structured reintroduction — ideally supervised by a registered dietitian — or a trial of a proven therapy (for IBS, a low‑FODMAP elimination guided by a dietitian; see Monash University FODMAP resources) is the evidence‑based approach. What to avoid IgG antibody panels marketed as “food sensitivity” tests (Everlywell, YorkTest, Cyrex, Alcat/MRT and similar) are not supported by consensus guidelines. IgG often reflects exposure to foods and tolerance, not harmful sensitivity, and using those results to restrict foods can lead to unnecessary diets and nutrient gaps. Major allergy/gastroenterology societies advise against using IgG testing to diagnose food intolerance. Practical next steps If you have immediate allergic symptoms (hives, swelling, breathing trouble), see an allergist right away. If you have chronic GI symptoms (bloating, diarrhea, gas, abdominal pain), start with your primary care or gastroenterologist to rule out celiac (tTG‑IgA), order appropriate breath tests for lactose/SIBO, and consider a supervised elimination (low‑FODMAP) with a dietitian. If you want testing for IgE‑mediated allergy but not a clinic with skin tests, ask for ImmunoCAP (specific IgE) from a reputable lab (Quest/LabCorp) and get interpretation from an allergist. If you tell me your symptoms (timing of reactions, GI vs skin/respiratory, how long this has been happening), I can recommend the most appropriate first test and whether you should see an allergist, GI, or a dietitian.

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Short answer: there is no single reliable consumer “food sensitivity” test sold direct-to-consumer. The only evidence‑based testing depends on what problem you actually have — immediate (IgE) food allergy, celiac disease, or an intolerance — and should be done by a clinician using validated assays and/or supervised food challenge. What to use, by problem (with brand/lab names): Suspected immediate (IgE) food allergy (hives, swelling, anaphylaxis, wheeze, vomiting soon after eating) Best approach: evaluation by a board‑certified allergist who will do skin prick testing and/or serum specific IgE testing and, if needed, a supervised oral food challenge (the gold standard). Serum test: ImmunoCAP (Thermo Fisher/Phadia) is the widely used, validated sIgE assay used by major labs (Quest Diagnostics, LabCorp, ARUP). These are clinically meaningful when interpreted by an allergist. Suspected celiac disease (diarrhea, weight loss, anemia, etc., or family history) Best tests: tissue transglutaminase IgA (tTG‑IgA) plus total IgA; if IgA deficient, deamidated gliadin peptide (DGP) IgG. Reputable labs: Quest Diagnostics, LabCorp, ARUP — ask for standard tTG/DGP assays. Don’t start a gluten‑free diet before testing. Suspected carbohydrate intolerance (lactose, fructose, small intestinal bacterial overgrowth) Best test: hydrogen (and methane) breath test, performed by a GI clinic using clinical equipment (QuinTron is a commonly used clinical system). Some reliable GI labs/centers do these in‑clinic. Non‑celiac gluten sensitivity, histamine intolerance, or vague “food sensitivity” There is no validated laboratory test. Diagnosis is by careful elimination diet and symptom re‑challenge under medical/dietitian supervision. What to avoid (scams or low‑value tests) IgG or IgG4 food panels sold direct‑to‑consumer (Everlywell, YorkTest, Pinnertest, many others) or proprietary tests such as ALCAT, Mediator Release Test (MRT)/LEAP are not supported by allergy and gastroenterology societies for diagnosing food intolerance or sensitivity. IgG often simply reflects exposure and does not predict harmful reactions — acting on these results can lead to unnecessary and nutritionally harmful diets. Practical recommendation If you have concerning symptoms (hives, breathing problems, GI distress, weight loss, anemia), see an allergist or gastroenterologist. Ask for ImmunoCAP/skin testing for allergy, tTG/DGP for celiac, or a clinician‑supervised hydrogen breath test for suspected lactose/SIBO issues. If you want, tell me your symptoms and I can recommend the most appropriate test and how to find a local specialist or lab.

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