What to expect at an appointment?
I shall take a detailed history of your problem and medical history. Please ensure you have a list of your current medications with you. If you have any photographs of any rashes, swellings etc. then please bring them along to the appointment.
I use 2 types of allergy tests to investigate your potential allergy but it may not be necessary to undertake any tests at all.
Skin prick tests. This involves using a lancet to introduce a tiny amount of the potential allergen just into the skin on your arm usually. It feels similar to pressing a sharp pencil to your skin. It is uncomfortable at worst. If your skin recognizes this it will react and form a little wheal/bump, which is itchy. I would examine your arm after 10 minutes. The benefit of this test is that it gives an immediate result.
Blood tests. This involves having blood taken in the normal fashion. This is then sent off to the laboratory where they look for antibodies (part of your immune system), which are targeted against the potential allergen. This test takes a few days to return.
Neither of these tests are foolproof.
Tests can be positive but you may not be allergic (that is actually having symptoms when exposed to it). Also you may have negative tests and still be allergic.
I wish this was not the case!
Testing for lactose intolerance involves a breath test. This can be done at home and requires you to drink a sweet substance called lactulose then provide 4 breath samples into a home testing kit.
I can, if indicated, test your skin to the common substances that can cause allergic eczema/dermatitis. This requires you to attend my clinic on 3 occasions in one week to undertake patch testing.
If necessary I can prescribe medication but you would need to pay the full cost of this at a pharmacy as it would not be provided by the NHS. I could also make written recommendations to you and your GP.
In certain situations, for hay fever, I would consider administering an intramuscular steroid injection (Kenalog or allergy shot) to control your symptoms but this does have potential side effects and is not a longterm management option.
If required I can provide you with written information regarding your condition and direct you to further resources.
I shall always write a letter summarizing our meeting, any test results, diagnosis and management plan. I shall send this to you via post or email.
Occasionally it is still not clear after tests whether you can tolerate a food or not. In these circumstances you would need a supervised food challenge in hospital (this is being given the food in increasing quantities). In this case I would advise that you are referred to a local NHS clinic but I would write you a covering letter to support this.