Food allergy evaluation starts in primary care
Clarity in diagnosis. Confidence in patient care.
Early identification and testing are essential in managing food allergies. Food allergies are becoming increasingly prevalent, now impacting up to 1 in 10 children and adults.1
The use of ImmunoCAP™ specific IgE blood tests can provide accurate and reliable results that aid in the timely diagnosis and effective management of food allergies.
Anaphylaxis: a rising challenge in every clinic
Food anaphylaxis is increasing worldwide, especially affecting children under the age of 5 years who are most at risk of requiring hospitalization.2 It’s never been more important for healthcare providers to be able to help patients determine which allergens are dangerous to them and to develop a personalized management plan to help them avoid those dangers.
42%
of children with food allergies have experienced a severe reaction.3
51%
of adults with food allergies have experienced a severe reaction.3
Primary care clinicians are often the first point of contact for the majority of patients experiencing food-related symptoms.4
Food allergens can cause a wide variety of symptoms, and some of those allergens can cross-react with others, making it a challenge to make an accurate diagnosis. Sometimes patients will self-diagnose and will remove certain foods from their diet, but without any testing, that’s often not a great path forward.1
You play an essential role in early detection, initial testing for allergen triggers, guideline-recommended management and referral to specialists when necessary.
Early diagnosis confirmed by ImmunoCAP Specific IgE blood tests can guide appropriate intervention for food allergies.
Watch this video to learn more about the diagnosis of food allergies in 5 key steps.
ImmunoCAP Specific IgE tests are well suited for use in primary care*
- Can be used in any suspected food allergy patient, irrespective of medication, condition or season.
- Accessible to general practitioners.
- Facilitates easy assessment of patients’ sensitization.
- Provides valuable insights for long-term management and personalized care.
ImmunoCAP Specific IgE tests can be requested through pathology ordering systems**
- The lab requires 1 mL blood for up to 10 tests.
- A result ≥0.1 kUA/L indicates sensitization and should be taken into consideration with the clinical history.
- Broadly available and reimbursed in most countries. Contact your local laboratory for details.
*Depending on allergen. **ImmunoCAP Specific IgE fluoroenzyme immunoassay calibrator range 0-100 KUA/L.7,8
Uncover the true threats of food allergy with the help of ImmunoCAP Specific IgE blood tests
ImmunoCAP Specific IgE tests are easily ordered in primary care, whereas skin prick testing (SPT) usually requires a referral to a specialist. The ImmunoCAP Specific IgE test portfolio, including whole allergens and allergen components, provides reproducible, quantitative results that can strengthen your judgment and sharpen your treatment strategies.
Accurate food allergy diagnosis begins with patient history. Some examples of key elements of a clinical history include:1,5,6
- Unexplained reactions or adverse events after exposure
- History of food-related discomfort, anxiety or avoidance
- Self-restricted diets or use of online advice
- Recurrent gastrointestinal, skin or respiratory symptoms
Identify food allergy symptoms to guide accurate testing
Determining if symptoms are related to IgE-mediated reactions is fundamental for developing an effective management plan. Sensitization alone is not sufficient for a diagnosis of food allergy, but must be consistent with the patient’s clinical history and symptoms.
IgE-mediated food allergy
Onset: Usually rapid, within minutes to two hours after eating the trigger food
Symptoms:
- Skin: Hives, itching, redness, swelling (angioedema)
- Respiratory: Wheezing, difficulty breathing, coughing, sneezing
- Gastrointestinal: Vomiting, nausea
- Severe Reactions: Anaphylaxis, a life-threatening reaction involving multiple body systems
Examples: Peanut, tree nut and seafood allergies
Non-IgE-mediated food allergy
Onset: Usually delayed, appearing hours or days after ingesting the food
Symptoms:
- Gastrointestinal: Vomiting, diarrhea, abdominal pain, bloating, constipation or blood/mucus in the stool
- Skin: Eczema flare-ups
- Failure to thrive: Poor weight gain and growth in infants
Examples: Food protein-induced enterocolitis (FPIES), food protein-induced allergic proctocolitis (FPIAP) and food protein-induced enteropathy (FPE)
Key differences
Timing:
IgE reactions are immediate; non-IgE reactions are often delayed.
Occurrence:
IgE-mediated responses are reproducible; non-IgE responses are inconsistent.
Immune mechanism:
IgE reactions are mediated by immunoglobulin E antibodies, while non-IgE reactions involve other parts of the immune system.
Severity & outcome:
IgE-mediated reactions can be severe and fatal (anaphylaxis), whereas non-IgE reactions are typically less acute, though they can significantly impact quality of life and growth.
Diagnosis:
IgE allergies can often be diagnosed with the help of skin prick or blood tests. Non-IgE allergies are harder to diagnose and often require an elimination diet and challenge to identify the culprit food.
Peanuts
Tree nuts
Wheat
Eggs
Milk
Sesame
Soy
Shellfish
Fish
90% of food allergies are caused by nine allergen families, called the “Big 9”9
Because a large number of people react to the Big 9, they are deemed major allergens and must be declared on food labels in Europe, along with five* others considered to pose a high risk for severe allergic reactions.9, 10
Consult the Allergen Encyclopedia for more information on the 9 food allergens.
*5 additional common food allergens include: celery, mustard, sulfur dioxide and sulfites, lupin, and mollusks.10
Accurate food allergy diagnosis builds the foundation for effective management
Management of food allergy has evolved from a “wait and see” approach to more active interventions.5
You can provide dietary guidance and an initial treatment plan with the help of specific IgE whole allergen or allergen component test results. The molecular profile supports decisions about the safety of re-introducing a food, conducting an oral food challenge and prescribing immunomodulatory treatments.
ImmunoCAP Specific IgE tests can help patients feel secure about what’s safe
Accurate testing begins with the patient’s history. EAACI* food guidelines emphasize that allergy testing should be guided by history and discourage indiscriminate use of large panels6 that can generate clinically irrelevant results. Non-selective tests with large numbers of allergens increase the risk of clinically irrelevant false positives.11
ImmunoCAP tests provide a clear, stepwise approach:
ImmunoCAP™ whole allergen tests:
If a specific food is implicated by the patient’s history, whole allergen tests can be ordered to support the identification of sensitization to specific allergens.
We offer the broadest selection of approximately 500 specific IgE whole allergens and allergen mixes – including foods, pollens and more – providing clinicians a higher level of diagnostic certainty.
ImmunoCAP™ Allergen fx5, Food test:
If the clinical history is unclear but food allergy is suspected, consider starting with the (fx5) mix. The test includes a mixture of egg white, milk, fish, wheat, peanut and soybean allergens. The results for this combination of allergens are reported as positive or negative, meaning that a negative result indicates that these six common food allergens are unlikely to be a cause of the symptoms that prompted testing.12
Clarity in diagnosis. Confidence in patient care.
In patients with suspected IgE-mediated food allergy, start with a physical examination and a detailed medical history to identify potential allergens, guiding the choice of allergen tests based on history, symptoms and triggers.6
This structured pathway ensures testing remains clinically relevant, avoids unnecessary dietary restrictions and provides clear results that guide appropriate management.
Reference 13: Werfel T, et al. Position paper of the EAACI: food allergy due to immunological cross-reactions with common inhalant allergens. Allergy. 2015;70(9):1079-1090.
Testing with allergen components: Seeing past the surface
- Component-resolved diagnostics (CRD) plays a key role in refining diagnosis, understanding risk and developing a management plan in line with EAACI* guidelines.6 Refer to a specialist for allergen component testing in high-risk or complex cases.
- The results of CRD testing are essential for targeted administration of oral immunotherapy (OIT), a disease-modifying treatment for allergies.14
You have the power to make a difference.
Explore more about component resolved diagnostics here.
An overview of ImmunoCAP Specific IgE tests
Specific IgE testing is one of the first-line diagnostic recommended by EAACI* guidelines.2
Supports patient management
ImmunoCAP allergen component tests aid in patient management by helping to identify which molecules a patient may be reacting to in whole allergens, such as peanuts, tree nuts, milk, eggs, pets and more.15
Safe and accessible
Irrespective of age, skin condition, antihistamine use or pregnancy, ImmunoCAP Specific IgE tests can be used for a variety of patient types and, unlike skin-prick testing, carry no risk of anaphylaxis.16,17
Guideline-driven
Testing for sensitization to single food allergens is endorsed by EAACI* guidelines for targeted, patient-centered care.
Ordering ImmunoCAP tests is easy
Order an ImmunoCAP Specific IgE test
Follow the typical procedures you normally use when ordering laboratory blood tests.
Speak to an expert about ordering.
Let the laboratory analyze
The laboratory will process the ImmunoCAP test on Phadia™ Laboratory Systems.
Receive test results
Assess and interpret ImmunoCAP test results to personalize allergen management. Refer to an allergy specialist for additional diagnostics or advanced treatments.
Explore our ImmunoCAP™ allergy diagnostics
Results interpretation guide for primary care
Access practical tools and insights to help you recognize and manage food allergy symptoms with step-by-step support, including a comprehensive results interpretation guide.
Contact our allergy team for guidance on ImmunoCAP tests, result interpretation and educational resources for primary care.
Relevant resources
Tools to aid in your diagnosis and patient management
*The EAACI (European Academy of Allergy and Clinical Immunology) and the AAAAI (American Academy of Allergy, Asthma & Immunology) are leading international organizations dedicated to advancing research, education, and clinical care in allergy and immunology.
- Onyimba F, et al. Food allergies and intolerances: a clinical approach to the diagnosis and management of adverse reactions to food. Clin Gastro Hepatol. 2021:1-11.
- Koplin JJ, et al. An update on epidemiology of anaphylaxis in children and adults. Curr Opin Allergy Clin Immunol. 2011;11(5):492-496.
- Allergy & Asthma Network. Anaphylaxis statistics. Accessed 16 Aug 2025. https://allergyasthmanetwork.org/anaphylaxis/anaphylaxis-statistics/
- Demoly P, et al. Development of algorithms for the diagnosis and management of acute allergy in primary practice. World Allergy Organ J. 2019;12(3):100022.
- Santos AF, et al. EAACI guidelines on the management of IgE-mediated food allergy. Allergy. 2025;80(1):14-36.
- Santos AF, et al. EAACI guidelines on the diagnosis of IgE-mediated food allergy. Allergy. 2023;78(12):3057-3076. (p. 3061)
- Johansson SGO. ImmunoCAP Specific IgE test: an objective tool for research and routine allergy diagnosis. Expert RevMol Diagn. 2004;4(30:273-279.
- Casas ML, Esteban Á, González-Muñoz M, Labrador-Horrillo M, Pascal M, Teniente-Serra A. VALIDA project: Validation of allergy in vitro diagnostics assays (Tools and recommendations for the assessment of in vitro tests in the diagnosis of allergy). Adv Lab Med. 2020;1(4):20200051.
- Food Safety and Inspection Service. Food Allergies: The “Big 9” | Food Safety and Inspection Service. (n.d.). https://www.fsis.usda.gov/food-safety/safe-food-handling-and-preparation/food-safety-basics/food-allergies-big-9
- European Food Safety Authority. Safe2Eat | Food Allergens. https://www.efsa.europa.eu/en/safe2eat/food-allergens
- Portnoy JM. Appropriate allergy testing and interpretation. Mo Med. 2011;108(5):339-343.
- Hawarden D. 2014—Guideline for diagnostic testing in allergy. Allergy Society of South Africa. Accessed 17 Nov 2025. https://allsa.org/allsa-position-statements-guidelines/
- Werfel T, et al. Position paper of the EAACI: food allergy due to immunological cross-reactions with common inhalant allergens. Allergy. 2015;70(9):1079-1090.
- Barber D, Diaz-Perales A, Escribese MM, et al. Molecular allergology and its impact in specific allergy diagnosis and therapy. Allergy. 2021;76(12):3642-3658.
- European Academy of Allergy and Clinical Immunology (EAACI). Molecular Allergology User’s Guide 2.0 (MAUG 2.0). 2022; chapters A03 (p. 40, 42), B06 (Furry animals), B10 (Cow’s milk allergy), B11 (Allergy to egg), B18 (Peanut allergy), B19 (Tree nut and seed allergy).
- Gupta N, Agarwal P, Sachdev A, Gupta D. Allergy testing - an overview. Indian Pediatr. 2019;56(11):951-957.
- Pali-Schöll I, Namazy J, Jensen-Jarolim E. Allergic diseases and asthma in pregnancy, a secondary publication. World Allergy Organ J. 2017;10(1):10.
