Does anyone have info on Elisa blood test?

17 replies [Last post]
By Adele on Tue, 04-19-05, 19:18

I hope I didn't just blow $144. Today there was a screening lab at the local pharmacy, including allergy testing. As it is considerably cheaper than the allergist, and I've only been checked for 7 or 8 things, I decided to have it done. It included 45 'regional inhalant allergens' and a comprehensive food panel of 90 allergens. I assumed it was a RAST test, but found out after the fact that it was an ELISA test.

I just checked the forums and google and read conflicting information. I'd like to know what the PA.com experts think of the ELISA blood test! Thanks in advance...
cheers, Adele

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By Gilli011 on Tue, 04-19-05, 19:54

Hi Adele,
Funny you should post this. I posted earlier today about the ELISA test. It is apparently the only blood test available to my dd in our province. I don't know anything about it either and would like to find out more. My friend works in the lab and says they reccommend that test over the caprast, so much so they don't do caprast. They say it is more effective and reliable. It bothers me though that I have never read here about anyone else having that test...hope we can find some answers.
Gilli

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By Adele on Tue, 04-19-05, 20:09

Hi Gilli,
I read your post first hoping you might have an answer on the ELISA test. Looks like we're both in the dark.

The information I found when I googled 'Elisa blood test' wasn't very reassuring. One article called it 'questionable'.
Others recommended it.

But if it is the only blood test available to you in your province and if you lab friend considers it more reliable than RAST....maybe I don't blow my $144 after all.
A search of the old forums is fruitless and it brings up lots of posts by Elisa and Elisabeth, both members.

Hopefully we'll find out something positive...
cheers, Adele

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By Love my babies on Wed, 04-20-05, 00:40

I have never heard of the ELISA test, but I went on Yahoo and entered ELISA allergy test and some sites came up. It seems comparable to the RAST test, but check it out for yourself. Good Luck!!!

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By rebekahc on Wed, 04-20-05, 03:44

When my DD was reacting to spandex but we weren't positive, our allergist suggested the ELISA test because it tested for many environmental chemicals and dyes. We never did have it done because we finally isolated the spandex by calling manufacturers of the different things she was reacting to. Our allergist is very well respected in our metropolitan area and we absolutely love her. The fact that she suggested the ELISA leads me to believe it's okay - however she never used it for any "regular" allergies (always skin and CAP RAST) just the chemical because it was the only test available.

Rebekah

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By Adele on Mon, 05-02-05, 21:07

Just received the results on an ELISA blood test that I had done at one of these 'health fairs'. I think I wasted $144. I know from a scratch test at the allergist's that I am very allergic to cats. ELISA results for cat were 0. It gave me a '2' for PN (yet I'm anaphylactic to PN and had a positive scratch test) but I also received a '2' for beef, veal, lamb (I'm a Kiwi...I LIVE on lamb) and pork and 2's on a huge list of other things, including egg white. My brother had the same test done and his test results showed 0 for shrimp...yet he reacts to shrimp.

So if anyone is wondering about ELISA, my unprofessional opinion is that it is not very accurate.

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By Kaviraj on Tue, 02-26-08, 01:33

Originally Posted By: AdeleJust received the results on an ELISA blood test that I had done at one of these 'health fairs'. I think I wasted $144. I know from a scratch test at the allergist's that I am very allergic to cats. ELISA results for cat were 0.

They are two totally different tests. The ELISA test measures [b]delayed[/b] immunological reactions. It measures IgG (only symptom provoking IgG), IgA, and IgM antibodies, immune complexes, and T cell mediated immunity.

The ELISA test does [b]not [/b]measure IgE antibodies, which produce [b]immediate [/b]symptoms.

In contrast, the allergy test you had done (which showed sensitivity to cats) measured IgE antibodies, which are not measured by the ELISA test.

So you have immediate reactions to cats (according to the IgE allergy test), but you don't have delayed reactions to cats (according to the ELISA test).

For more information click [url="http://www.peanutallergy.com/boards/ubbthreads.php?ubb=showflat&Board=1&Number=253799&Searchpage=1&Main=6841&Words=ELISA%2FACT&topic=0&Search=true#Post253799"]here[/url]

Quote: It gave me a '2' for PN (yet I'm anaphylactic to PN and had a positive scratch test)

This means that you have[i] both[/i] immediate (IgE-mediated) [i]and [/i]delayed reactions/sensitivity to PN.

I'm not sure what you mean by "2". Can you elaborate please?

Quote: but I also received a '2' for beef, veal, lamb (I'm a Kiwi...I LIVE on lamb) and pork and 2's on a huge list of other things, including egg white.

So you have [b]delayed[/b] reactions to those food proteins. Symptoms can take a long time to appear (from several hours to several weeks).

Quote: My brother had the same test done and his test results showed 0 for shrimp...yet he reacts to shrimp.

That means he does [b]not [/b]have [b]delayed[/b] immunological reactions to shrimp (which means that when he eats shrimp, his immune system does not fire symptom-provoking IgG, IgA, IgM, immune complexes, and T cell mediated immunity -- the three types of delayed immune reaction). [b]But [/b]he could still have immediate reactions (either IgE or metabolically mediated -- or perhaps another type of immediate reaction I'm not familiar with), or maybe a different kind of delayed reaction (poor digestion, IBS, etc.).

With respect, you're [b]un[/b]intentionally confusing different tests here. Don't feel bad though; I've seen doctors get confused about this too.

I wish you good things

-- Pat

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By lakeswimr on Wed, 02-27-08, 00:56

ELISA is not supposed to be reliable. Sorry. I tried it for myself. I have delayed reactions. It didn't work. People at kidswithfoodallergies.org have posted a study that showed it isn't reliable. I wouldn't go by the results *at all*.

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By Kaviraj on Thu, 02-28-08, 14:34

Lakeswimr, my response here will cover every point you made. I'd love some feedback afterwards.

Originally Posted By: lakeswimrELISA is not supposed to be reliable.

Actually, after 20+ years of research, the false positive rate has consistently been less than 3%, which means that while false positives are [i]possible[/i], they're very [i]unlikely[/i]. So the test is reliable in the sense that it accurately measures all three pathways of delayed [b]immune-mediated [/b]reaction (but as I note below, the test does not measure every possible pathway of physical reaction).

People (including doctors) need to keep in mind what exactly the test measures and doesn't measure. It's certainly possible to have a particular type of reaction that is [i]not[/i] measured by the test. The test doesn't measure every possible form of reaction (it doesn't test for metabolically mediated reactions, or IgE mediated reactions, or other mysterious reactions).

The test not only is "[i]supposed[/i] to be reliable", it also [b]is[/b] reliable. The lab has been doing ongoing research for more than 20 years with data published in various peer reviewed journals, accepted by insurance companies (who would not pay for a test that they could find a problem with), and these data have survived a good amount of peer review.

Click [url="http://www.peanutallergy.com/boards/ubbthreads.php?ubb=showflat&Board=1&Number=253799&Searchpage=1&Main=6841&Words=ELISA&topic=0&Search=true#Post253799"]here[/url] for more information.

Quote: Sorry. I tried it for myself. I have delayed reactions. It didn't work.

Please elaborate. You said that you have delayed reactions, so you were probably expecting to see them on the test. But when you didn't see them on the test, you concluded that the test is unreliable. There are a few difficulties here:

First,[i] how [/i]do you know that you have delayed reactions in the first place? Delayed reactions usually aren't diagnosed through observation because the reactions often take such a long time to develop. I know of a case when a patient observed delayed reactions, but the reactions showed up on the LRA test by ELISA/ACT Biotechnologies.

Second, again, keep in mind that people can have genuine reactions that aren't measured by the LRA/ELISA test. It all depends on which pathways are responsible for the reactions. The ELISA test measures [i]only[/i] the following: Immune complexes, T-cell mediated direct immunity, IgG (only symptom-provoking IgG), IgA, and IgM. But the test does [b]not[/b] measure IgE, metabolically mediated reactions, [i]other[/i] forms of delayed reaction, etc.

I'm not saying that you don't have genuine reactions. I'm simply saying that your reactions are probably not mediated by the pathways tested by the ELISA test. That doesn't mean the test is unreliable!

[b]Or, perhaps, your results were a false negative. Were you given a list of detaliled instructions to follow for at least 2 days prior to the test?? [/b]

Finally, onto this:

Quote: People at kidswithfoodallergies.org have posted a study that showed it isn't reliable. I wouldn't go by the results *at all*.

I assume you're referring to the article written by Robert Wood, which isn't a study at all, but is instead a polemic with no references (not even irrelevant references). I have a detailed response to the article [url="http://www.peanutallergy.com/boards/ubbthreads.php?ubb=showflat&Board=1&Number=253799&Searchpage=1&Main=6841&Words=ELISA&topic=0&Search=true#Post253799"]here[/url]. With respect to you and to Dr. Wood, the arguments contained in that article really don't hold water and shouldn't be used to denounce the test.

And wrongly claiming that the test isn't supposed to be reliable at all could potentially turn some patients away from a test that they need.

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By lakeswimr on Thu, 02-28-08, 16:34

Hi Kaviraj,

I am certainly no expert but what I know from reading at kidswithfoodallergies is that ELISA isn't reliable. BAstyr did a study and found ELISA IgG testing is not valid and that a healthy person will test positive to many foods even though they do not have 'allergies' or any problems with those foods.

Here is a link that I think it good...

[url="http://www.tldp.com/issue/174/IgG%20Food%20Allergy.html"]http://www.tldp.com/issue/174/IgG%20Food%20Allergy.html[/url]

Dr. Sicherer, the famous allergist from Mt Sinai Food Allergy Institute says that everyone makes IgG to things we eat.

My concern with these tests is that I know many people who have had them, gotten long lists of positive results and then avoided these foods unnecessarily. This can cause nutritional problems. There was an article that discussed this recently in one of three case studies and then discussed the validity and reliability of alternative testing. Senna et all did a study looking at 87 patients who had used various alternative food allergy testing methods. They looked at IgG testing, hair analysis, cytotoxic test, VEGA testing, kisesiology, iridology, provocation-neutralization and pluse testing. Of the 87 people tested 79 of the 87 didn't have any food allergies as judged by skin prick test. The 8 of the 87 who did have food allergies had allergies *different* than what the alternative testing had shown. Now, I don't know how many of the 87 used IgG testing but at least some did.

I have not read anything that indicates it is reliable other than from companies that do the test. Can you point me to the 20+ years of research that show the 3% false positives rate? I will click on the link you provided and look.

I am for sure sensitive to soy but other foods, not soy, came back as positive on my ELISA test and I do not have any problems with those foods. Similarly, a friend who has a child who actually has Celiac came back with a list of over 25 foods but no mention of wheat, barley, or rye (gluten-containing foods.) All his health issues stopped when he was finally accurately diagnosed as having Celiac and he can eat all those 25 foods from the test just fine. I have another friend who has a child with life-threatening food allergies. She had ELISA testing done instead of seeing an allergist. Her child tested positive to nearly 30 foods. She was breastfeeding so they both avoided these foods for 2 years. She then went to an allergist and found her child has life-threatening food allergies to 2 foods. So she was needlessly avoiding all those other foods for years. Also, she wasn't prepared for any life-threatening reactions with epi pens, etc because she didn't see a real allergist.

I know I have delayed reactions because when I eat soy the next day it takes me about 45 min to have a bowel movement and the whole time I pass very watery stool. Then I will have another 20 min and sometimes a 3rd 20 min bought of this later in the day. This has happened to me almost every day since I was a teenager (basically since I started eating soy daily.) I was diagnosed as having IBS. When I stopped eating soy the problem was gone and i had normal bowel movements. Pretty amazing and it is a for sure delayed reaction to soy.

No, I wasn't talking about the article by Dr. Robert Wood. I actually hadn't seen it until today. I do agree that it isn't a study but I'd take the word of Dr. Robert Wood on the reliability of ELISA. I respect him very much. I do think he is probably closed to some alternative things that *do* work but I dont' think this test is one of them.

Just as you think that wrongly claiming ELISA doesn't work, I think claiming it does could steer people in the wrong direction. People like my friend who didn't see an allergist because she got ELISA tested were putting their child in danger by not having epi pens and also by avoiding so many foods needlessly. The article I mentioned above that had the study of the 87 food allergic people also discussed *serious* nutritional deficiencies they are seeing in people who are avoiding large #s of foods due to alt testing or incorrect interpretation of CAP RAST and skin testing results. Serious problems can result from avoiding foods needlessly.

I think this is just a topic on which we are not going to agree. I advise anyone who thinks they are having food allergies to see a good board certified allergist for testing. My son could have died because we got incorrect info from my naturopath who I love and who is expert in many things but *not* food allergies. He wasn't diagnosed until 2 because we fooled around seeing her and also because the ped gave us all wrong info so at 2 he had anaphylaxis and we were not prepared. I don't want that to happen to anyone else. ELISA testing IMO could lead to just that situation.

In any case, I'm not offended in the least by your post and wish you the best.

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By Kaviraj on Thu, 02-28-08, 17:04

Lakeswimr, please see my article, which I posted in this forum [url="http://www.peanutallergy.com/boards/ubbthreads.php?ubb=showflat&Board=1&Number=253799&Searchpage=1&Main=6841&Words=ELISA&topic=0&Search=true#Post253799"]here[/url] . You appear to have replied to me without first reading my article. As a result, your post above makes several errors about the test (including confusing IgE allergies with delayed immune reactions, which are separate pathways. The IgG argument is also discussed below, as well as in my article)

Originally Posted By: lakeswimrHi Kaviraj,

I am certainly no expert but what I know from reading at kidswithfoodallergies is that ELISA isn't reliable.

Please elaborate. I didn't find anything on that site to substantiate the claim that the LRA is unreliable. The published research contradicts that claim (see my article [url="http://www.peanutallergy.com/boards/ubbthreads.php?ubb=showflat&Board=1&Number=253799&Searchpage=1&Main=6841&Words=ELISA&topic=0&Search=true#Post253799"]here[/url] ). And the only thing I found at that site (by doing a search for "ELISA") was Dr. Wood's article, which I interacted with (and I think refuted) in the link I provided.

Quote: BAstyr did a study and found ELISA IgG testing is not valid and that a healthy person will test positive to many foods even though they do not have 'allergies' or any problems with those foods.

For anyone who's interested, you can learn more about the Bastyr study [url="http://www.tldp.com/issue/174/IgG%20Food%20Allergy.html"]here[/url].

Miller's paper is not about the LRA by ELISA/ACT Biotechnologies. The test I'm talking about is not simply an enzyme linked immunosorbent assay (aka ELISA). It's a combination of an ELISA with a lymphatic response assay (LRA) and another test. And there are three issues here:

First, IgG can be either neutral or symptom-provoking. The LRA by ELISA/ACT Biotechnologies does[b] not [/b]measure neutral or protective IgG antibodies. It is a functional test that measures only [b]symptom-provoking [/b]IgG. Miller's paper doesn't talk about this test.

Secondly, aside from the IgG, [b]the LRA/ELISA test also measures IgA, IgM, immune complexes, and direct T-cell immunity -- and you haven't commented on any of those yet. [/b] Miller's paper briefly comments on IgA, but quickly goes back to IgG. Her paper makes no mention of immune complexes, IgM, or the fact that it's possible to measure only symptom-provoking IgG. The paper does not once mention the LRA by ELISA/ACT Biotechnologies.

Third, even if IgG testing were always invalid ([b]which is not what Miller's paper suggests[/b]), that still would not discredit the LRA/ELISA test because that test also measures two other pathways and two other antibodies.

The paper concludes, in part, with the following:

Quote: In conclusion, food allergy testing by IgG ELISA/EIA panels is a convenient and easy way to diagnose food allergies in a patient. It is, however, a testing method that is questionable in both its theory and validity. It is also costly and may not be reliable, depending on which laboratory you use.

Again, Miller overlooks IgM, IgA, immune complexes, direct T-cell mediated immunity, and the fact that ELISA/ACT Biotechnologies developed a test that enables them to detect symptom-provoking IgG. Miller does not once mention that test or the lab behind it. [b]Therefore, Miller's study cannot be used to discredit the LRA by ELISA/ACT Biotechnologies. [/b]

I actually already covered these arguments in the link that I provided (although the link doesn't discuss Miller's paper). Have you read it yet? Did you read it before replying to me?

Quote: Here is a link that I think it good...

[url="http://www.tldp.com/issue/174/IgG%20Food%20Allergy.html"]http://www.tldp.com/issue/174/IgG%20Food%20Allergy.html[/url]

Dr. Sicherer, the famous allergist from Mt Sinai Food Allergy Institute says that everyone makes IgG to things we eat.

Yes, true, but those are neutral antibodies that are [b]not [/b]measured by the LRA/ELISA test. The LRA/ELISA test measures symptom-provoking IgG, as well as two other antibodies and two other pathways of reaction (immune complex and direct T cell immunity).

Additionally, I want to differentiate between allergy testing and the LRA/ELISA testing. Standard allergy tests look for IgE reactions, which are immediate and are not measured in the LRA/ELISA test. An allergy is IgE-mediated mast cell degranulation in response to an antigen, but that pathway is not measured by the LRA/ELISA test, which measures other pathways.

Again, I discussed these issues in more detail in the link that I provided. [url="http://www.peanutallergy.com/boards/ubbthreads.php?ubb=showflat&Board=1&Number=253799&Searchpage=1&Main=6841&Words=ELISA&topic=0&Search=true#Post253799"]Click here[/url]

Quote: My concern with these tests is that I know many people who have had them, gotten long lists of positive results and then avoided these foods unnecessarily.

That's begging the question. They aren't avoiding the items needlessly [b]if[/b] the test reliably measures genuine reactions, which is what we're discussing. Secondly, there are usually alternative foods that can be eaten. Third, the patient can also take multi-vitamins (including the cheap supplements from CVS or Rite Aid) to replace lost nutrients. There may be a few extreme cases where much more is required to replace lost nutrients, but that still doesn't actually provide evidence against the test itself.

Chemotherapy causes all kinds of problems, but that doesn't mean there's anything wrong with the tests that indicate cancer. The side effects of the treatment don't necessarily have anything to do with the accuracy of the diagnosis.

Quote: This can cause nutritional problems. There was an article that discussed this recently in one of three case studies and then discussed the validity and reliability of alternative testing. Senna et all did a study looking at 87 patients who had used various alternative food allergy testing methods. They looked at IgG testing, hair analysis, cytotoxic test, VEGA testing, kisesiology, iridology, provocation-neutralization and pluse testing.

Those are all separate from the LRA by ELISA/ACT Biotechnologies, affirming research on which has been published in the International Journal of Integrative Medicine and several other journals (see my article [url="http://www.peanutallergy.com/boards/ubbthreads.php?ubb=showflat&Board=1&Number=253799&Searchpage=1&Main=6841&Words=ELISA&topic=0&Search=true#Post253799"]here[/url] ).

Quote: I have not read anything that indicates it is reliable other than from companies that do the test. Can you point me to the 20+ years of research that show the 3% false positives rate? I will click on the link you provided and look.

The link has a few references at the bottom.

Quote: I am for sure sensitive to soy but other foods, not soy, came back as positive on my ELISA test and I do not have any problems with those foods.

First, are you saying you have a delayed reaction to soy [i]or[/i] an immediate reaction to soy (or somewhere in the middle)? Immediate reactions could be IgE allergic reactions (which can actually take a while to manifest, sometimes 30 minutes or even 10 hours -- but that's unusual), or some other pathway of immediate reaction (for one example, consider porphyria reactions, which occur immediately but are not caused by the immune system).

Secondly, the negative LRA reaction to soy means that you don't have [b]delayed immunological [/b]reactions to soy (unless it's a false negative). [b]But you could still have another type of delayed reaction that isn't mediated by your immune system. It could be metabolic or some other pathway.[/b] Some people have metabolic reactions that do not show up on IgE allergy tests, but that doesn't mean that standard allergy tests are unreliable[/b]. Likewise, differences between the LRA/ELISA test and IgE allergy tests do not mean that the LRA/ELISA test is wrong. [b]It just means that different pathways have different reactions. [/b]

Third, you suggested that the positive LRA/ELISA reactions were false positives. But how do you know that? Reactions take a long time to appear (sometimes several weeks). You could ingest soy, and then develop symptoms three weeks later, at which point you might not think to connect the symptoms to the soy. Also, was your reaction to soy moderate or strong?

Quote: Similarly, a friend who has a child who actually has Celiac came back with a list of over 25 foods but no mention of wheat, barley, or rye (gluten-containing foods.)

Once again, the LRA/ELISA test does not look for every pathway of reaction. Celiac disease is not caused by delayed immunological reactions: Immune complexes, antibodies (IgA, IgM, and symptom-provoking IgG), and T cell immunity do not cause celiac disease. [b]Those pathways are not responsible for celiac disease. So of course the disease won't show up on the LRA/ELISA test. [/b]

Quote: All his health issues stopped when he was finally accurately diagnosed as having Celiac and he can eat all those 25 foods from the test just fine.

Again, symptoms can take a long time to develop, and when they finally appear, the person might not think to connect them to foods eaten (or chemicas they were exposed to) days or weeks beforehand. Additionally, as I said before, false positives sometimes occur. [b]The false positive rate for the LRA test is about the same as the false positive rate for HIV testing.[/b]

Quote: I have another friend who has a child with life-threatening food allergies. She had ELISA testing done instead of seeing an allergist. Her child tested positive to nearly 30 foods. She was breastfeeding so they both avoided these foods for 2 years. She then went to an allergist and found her child has life-threatening food allergies to 2 foods. So she was needlessly avoiding all those other foods for years.

Please read my link. The allergist above found only 2 IgE- mediated allergies, which are not measured by the LRA/ELISA test. Those are separate pathways. IgE testing does not measure delayed reactions, and delayed-reaction testing does not measure IgE. [b]Those are separate tests. [/b] I covered this in my link.

Quote: Also, she wasn't prepared for any life-threatening reactions with epi pens, etc because she didn't see a real allergist.

That is not an argument against the reliability of the test. Secondly, many "real allergists" (not even sure what that means) affirm the test and use it. The test is used by many internists, allergists, and other medical doctors. It's not fringe stuff.

Quote: I know I have delayed reactions because when I eat soy the next day it takes me about 45 min to have a bowel movement and the whole time I pass very watery stool. Then I will have another 20 min and sometimes a 3rd 20 min bought of this later in the day.

Thanks for the information. But that isn't caused by delayed immune reactions. That's a separate delayed reaction. The LRA/ELISA test measures IgG (only symptom-provoking IgG and not neutral IgG), IgA, IgM, immune complexes, and T-cell immunity, which are not the cause of your above-described symptoms.

So your experience does not demonstrate a false negative on the LRA/ELISA test. But even if it did, that still wouldn't be evidence against the test. It's over 97% accurate, but it's not 100% accurate. Very few medical tests are 100% accurate, which means that false negatives/positives will occur once in a while.

Quote: No, I wasn't talking about the article by Dr. Robert Wood. I actually hadn't seen it until today. I do agree that it isn't a study but I'd take the word of Dr. Robert Wood on the reliability of ELISA.

I'm concerned that you haven't read my article. I dealt with Wood's claims in detail. Briefly, Wood's unreferenced article confuses IgE allergies with delayed immune reactions, overlooks published data contradicting Wood's claims, and his argument about white blood cells overlooks actual features of the test.

Quote: I think this is just a topic on which we are not going to agree.

With respect, you're confused about the test. I don't mean that in a condescending way. But you repeatedly made false comparisons between the LRA/ELISA test and IgE allergy testing. Dr. Wood made the same error. This is a common problem that I keep running into. People have positive [i]IgE[/i] allergy results to certain foods, then they have negative LRA/ELISA results to those same foods, and then they claim that LRA/ELISA test must be mistaken. [b]But those are separate tests that measure separate pathways. [/b]

Quote: I advise anyone who thinks they are having food allergies to see a good board certified allergist for testing.

I advise anyone to see board certified medical doctors that are familiar with the literature and don't make false claims about the test. Allergists usually look for IgE allergies, which are not measured by the test. However, many allergists are aware of this and actually do perform the test. They realize that the results do not reflect IgE allergies.

Quote: Just as you think that wrongly claiming ELISA doesn't work, I think claiming it does could steer people in the wrong direction. People like my friend who didn't see an allergist because she got ELISA tested were putting their child in danger by not having epi pens and also by avoiding so many foods needlessly.

First, that has nothing to do with the reliability of the LRA/ELISA test. LRA/ELISA test results have nothing to do with IgE allergy test results. Epinephrine pens are for IgE allergies, not delayed immune reactions.

Second, parents who mistakenly think that the LRA/ELISA test measures IgE allergies the are responsible for putting their children at risk. And beyond that, the doctors who make the same mistake are even more responsible because they mislead patients. Saying that the LRA/ELISA test results reflect IgE allergies is akin to saying that a negative cancer test means that the person is free of HIV. HIV test results can't tell you whether the person has cancer, and vice versa. Likewise, LRA/ELISA test results cannot tell you whether you have IgE allergues and vice versa.

All doctors are aware of the differences between IgE reactions and delayed immune reactions. The problem occurs when they mistakenly think that the LRA/ELISA test looks for IgE allergies, or when they get confused about the type of IgG antibodies measured by the test (which also overlooks the fact that the test measures two other antibodies and two other pathways). But in my experience, most healthcare practitioners actually (and thankfully) don't make those mistakes when they first learn about the test.

Frankly, I think it's outrageous that [i]any[/i] doctor could get so confused about this. The lab's description of the test is [i]so[/i] clear that anybody who actually reads it could not possibly think that the test looks for IgE allergies or neutral IgG antibodies (of course, even if it did look for neutral IgG antibodies, people still need to keep in mind that the test also looks for [i]two other[/i] antibodies and [i]two other [/i]pathways of reaction). Thankfully, I've seen only two doctors make these mistakes (Barrett and Wood -- but there could be others). But two doctors is still too many (it's two too many).

There's a reason why most doctors who consult for insurance companies approve of the test -- because it's reliable. In my experience, Cigna and Optimum Choice are extremely narrow insurance companies. If they could find someting wrong with the test (even something superficial or silly), then they wouldn't cover it. But they do (well, they did until the lab stopped accepting insursance). And again, the test has passed the peer review staffs of many medical journals, and other forms of peer review.

Quote: The article I mentioned above that had the study of the 87 food allergic people also discussed *serious* nutritional deficiencies they are seeing in people who are avoiding large #s of foods due to alt testing or incorrect interpretation of CAP RAST and skin testing results. Serious problems can result from avoiding foods needlessly.

I agree. But most people who follow the recommendations of ELISA/ACT Biotechnologies do not have any nutritional problems. And this is more question begging. If the test accurately detects delayed immune reactions, then avoiding those reactants would not be "needless".

This means that we should be pretty sure that the LRA/ELISA test works before accepting results. But that question has already been extensively researched.

best wishes to you

-- Pat

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By lakeswimr on Thu, 02-28-08, 17:52

I'm sorry, Pat. I don't have any more time to put into this. I do not think ELISA is reliable from what I have read. I did look over your link. I respect that you feel differently. I know there are food related conditions that food allergists do not treat and don't know much about. For some of these it is a good idea to see a good board certified GI doctor. For some (like my issues) it is good to work with a naturopath (or my naturopath anyway. She helped me a lot.) My big worry is that for people who have life-threatening food allergies ELISA testing can put them at risk. I know you disagree.

Again, very best wishes!

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By lakeswimr on Thu, 02-28-08, 17:54

Oh, and if you actually join kidswithfoodallergies.org you can see many treads there on this topic and they talk about the Bastyr study. But they are not going to allow you to discuss this topic there to the depth you would probably want to discuss it as the terms of service bans much talk about anything that they feel isn't proven by science and ELISA testing falls into that category.

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By Kaviraj on Thu, 02-28-08, 18:33

Originally Posted By: lakeswimrI'm sorry, Pat. I don't have any more time to put into this.

No worries. Maybe in the future we can have correspondance.

Quote: I do not think ELISA is reliable from what I have read.

I'm sorry if this seems pushy, but I've refuted what you read. I refuted the IgG argument (IgG is only [i]one[/i] part of [i]one [/i]pathway measured by the test, and they test only symptom provoking reactions). I refuted the allergy test argument (allergies are different from delayed immune reactions, the tests that measure these reactions are separate from each other, and therefore the test results are separate from each other as well -- and so the results of an IgE allergy test cannot be used to judge the results of the LRA/ELISA test, and vice versa).

So with respect, you really haven't provided any reason for disregarding the LRA/ELISA test. You're simply taking the skepticism of a few people (skepticism that has not yet been justified) and applying it to yourself. A few people (e.g. Wood) have raised some points, but I've replied to those points in detail. So at this point, if you continue to regard the LRA/ELISA test as unreliable, then I think it would reflect an a priori bias. I don't mean any disrespect by that though!

Quote: I did look over your link. I respect that you feel differently. I know there are food related conditions that food allergists do not treat and don't know much about. For some of these it is a good idea to see a good board certified GI doctor. For some (like my issues) it is good to work with a naturopath (or my naturopath anyway. She helped me a lot.) My big worry is that for people who have life-threatening food allergies ELISA testing can put them at risk. I know you disagree.

It depends on what you're saying. You could be saying one of two things here:

Either

1. Positive LRA/ELISA test will force people to eat alternative foods (alternatives to LRA/ELISA-reactive foods), but some of those people might have life-threatening IgE allergies to the alternative foods they eat. Good point.

Or

2. The LRA/ELISA test is bad because negative test results will make people think that they don't have IgE allergies to items that could kill them upon exposure.

If you're suggesting #2, then that's just not true. The problem there would be with the doctors who don't know anything about the test and mistakenly conclude that the patient is free of IgE allergies, despite the fact that the LRA/ELISA test has nothing to do with IgE allergies. Those doctors need to either (a) refer patients to more knowledgable doctors or (b) do more research. But this point has nothing to do with whether or not the test itself is reliable.

If you're suggesting #1, then of course I [i]do[/i] agree. And that's a reasonable concern. But like #2, it has nothing to do with whether the test itself is reliable.

[b] At any rate, my answer to #s 1 and 2 is the same: Patients should have both the LRA/ELISA test [i]and [/i]standard IgE allergy testing. That way they avoid eating foods that could make them miserably and chronically ill (delayed reactions), but they also avoid foods that could kill them (immediate IgE reactions). [/b] How does that sound? I know you don't have time to say much, but could you please at least tell me your thoughts on this idea?

Quote: Again, very best wishes!

Thanks, and best wishes to you as well.

-- Pat

P.S. You posted two replies in a row, and in the second reply you wrote:

Quote: Oh, and if you actually join kidswithfoodallergies.org you can see many treads there on this topic and they talk about the Bastyr study.

Again, that study has almost nothing to do with the LRA by ELISA/ACT Biotechnologies. See my last reply. First. Miller's paper says that standard IgG testing may be unreliable, but it fails to mention the LRA under discussion. The LRA under discussion measures symptom-provoking IgG. But even if the test measured neutral IgG, critics would have to keep in mind that it also measures two other antibodies and two other pathways of reaction, which brings me to my second point. Second, the paper fails to discuss IgA, IgM, immune complexes, and direct T cell immunity, all of which are detected by the LRA under discussion. There's a very brief mention of IgA, but then the discussion quickly goes back to IgG. The article is irrelevant to our discussion.

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By lakeswimr on Thu, 02-28-08, 23:25

Hi Pat,

I do appreciate the time and thought you put into these posts and I apologize that I can't do the same right now.

As for the last thing you asked me to respond to...if Elisa testing is accurate then I would agree that someone with food issues should use it and/or CAP RAST/spt to help determine which foods are the cause (and I would choose the test depending on the symptoms and timing of symptoms.)

I think that doing an elimination diet and journaling are the best way to determine a food sensitivity. I am doing it myself and had success after not having success any other way. I find it very difficult for some reasons you mentioned. Delayed reactions are tricky to figure out but it can be done this way and the accuracy is easily tested and confirmed.

Maybe one day I can come back to this. :)

Take care. :)

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By Kaviraj on Sat, 03-01-08, 10:19

Hi again, I'm really not trying to have the last word, but I have a few additional comments to make.

First, there seems to be some confusion about the difference between ELISA IgG and the LRA by ELISA/ACT Biotechnologies. As I noted earlier, the test I'm talking about is [i]not[/i] simply an enzyme linked immunosorbent assay (aka ELISA). [b]It's a combination of an ELISA with a lymphatic response assay (LRA) and another test. [/b]

Second, as I've said several times already, the LRA/ELISA test measures [b]symptom-provoking [/b]IgG, [i]while the standard IgG tests measure all IgG antibodies (including those that are neutral). [/i] Additionally, as I also said earlier, the LRA/ELISA test measures two other antibodies and two other pathways of reaction.

Dismissing the LRA/ELISA test because it detects IgG antibodies is, frankly, silly. It's silly for reasons described above and discussed in several other posts of mine. It seems like my actual points have been glossed over.

What you're saying is that people with delayed immune reactions are not really suffering from genuine food intolerances (or that their chronic ailments are not caused by the intolerances), which dismisses the hardship they have to go through. They don't want or enjoy avoiding the foods they love, and to call their treatment "needless" is actually insulting to some of them. [b]They [i]wish [/i]it were needless[/b].

That being said, I want to add something that I didn't include in my last response. You wrote:

Quote: But they are not going to allow you to discuss this topic there to the depth you would probably want to discuss it as the terms of service bans much talk about anything that they feel isn't proven by science and ELISA testing falls into that category.

Again, that's not true. The LRA/ELISA test has been subject to many studies, the data from which have been published in several peer reviewed journals and/or presented at conferences. Whether something is scientific depends on whether it's been researched with scientific methods. And the LRA/ELISA test certainly has been. So if that website (as a whole) is claiming that the LRA is not scientific, then that would be very irresponsible and unwarranted. If they have concerns about the test, then why not contactthe lab itself? Why not discuss these issues with Dr. Jaffe (who developed the LRA in 1984)? Jaffe would be more than willing to share data and answer questions.

So far, not a single piece of evidence has been given against the test. The only things you've cited so far were irrelevant (the IgG argument and the research discrediting [i]separate[/i] tests).

I think that your personal experiences might be clouding your judgment here, which would be very understandable because those experiences sound awful. But I'm hoping you'll realize that your position is discredited by the available data.

Quote: I do appreciate the time and thought you put into these posts

Thanks for reading them!

Quote: and I apologize that I can't do the same right now.

no problem

thanks for the opportunity to add thoughts on this subject!

oh my, it's 5 AM. bed time!

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By efaith2 on Sat, 07-27-13, 05:30

I strongly agree with Kaviraj. I took the test years ago and it changed my life. I was turned away by allergy specialists and told that there is no way to test or quantify food sensitivities.

I had been dealing with symptoms my entire life, none of which I knew the cause until I took this test. You see, a regular allergy test would not have sufficed in my case either because I do not have "allergies" to these foods. I do not go into anaphylactic shock when I eat certain foods. Instead I eat cinnamon, and I get a canker sore EVERY time...otherwise I am canker sore free. I eat lemon or corn syrup and I struggle with light headedness, fatigue, and sore throat (with corn syrup). Since removing these foods, my reactions disappeared overnight.

Last year I attended graduate school at Northwestern's Medill School of Journalism. I am highly interested in health and science journalism and decided to do an in-depth piece on the the ELISA/ACT LRA test and compared it to other IgG tests. The difference is what was mentioned before: it is an assay test that ALSO looks at the reaction from your lymphocytes, not found on these single IgG tests.

EVERY single M.D. I spoke with said the difference is that with IgG antibody, there is no way anyone can tell if the person who took the test is tolerant or intolerant to foods. Then these people are most likely removing foods that are potentially very healthy for them.

So, my solution???? I wrote an article describing the difference between the LRA tests. Like every other product on the market, there are copy cats and products being sold that do not meet quality standards. I assure you the LRA by ELISA/ACT Biotechnologies is not one such product or test.

Here is the link to the article I wrote:

http://news.medill.northwestern.edu/chicago/news.aspx?id=206458&terms=erin%20massey

I would love thoughts on this matter.

Thank-you for your time.

P.S. I want to note that I heard about this test from two women in my church (both of which did not know about the other; we have separate regions in different states) and it changed their lives as well. The woman in the video from the link I sent would be immobile for days after eating wheat (this is before she knew the culprit) and a regular allergy test--which looks at the IgE antibody did not show a problem with it.

After taking the ELISA ACT/LRA, her symptoms of extreme fatigue (not being able to get out of bed for days and Fibromyalgia completely disappeared).

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By joeching on Mon, 08-12-13, 09:03

I took the RAST test, and by overwhelming recommendation, i decide to double check my problem with eczema by taking the ELISA TEST.

i have read much of the debate about the ELISA test. after a 6 month battle with eczema, i feel the whole debate is the negative impact of eczema on the patients and those friends and relatives who care for them. the impact is in the form of a witch hunt, or scapegoating every possible food and incident as potential cause of flareup.

for example, people who's arguing against ELISA's reliability, have catch the typical eczema syndrome -- they wont trust anything by now, the way how evasive eczema behaves. for my personal case, just a bad control of my body temperature is the sureliest way of causing a flareup. so, seems any irritation, physical or mental.

and the one who painstakingly argue for ELISA, seems like someone who truly cared to salvage a little advantages that certain good intentional people who try to solve this unsolvable problem of eczema. especially, i my own experience, there r more people try to exploit an eczema victims than those conscientiously try to do some good.

well, enough bullshits. let me just throwing my own 2 cents here before bowing out:

1. try noni lotion and noni juice(the hawaii kind, i think).
2. try our asian approach of letting all disease take its course and listen to the message it try to convey, as ur own body is helping u not hurting u. just imagine had not for eczema's warning, something much worse could hit u, like cancer, if u continue ur dangerous and unhealthy life style.
3. finally, i should be ur own body's resistance that should cure ur eczema, not some external means, that could very well usher in the real big hit awaiting around the corner.

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