Alternative allergy testing

-any benefit to our patients?

Alternative tests

• Vega testing

• Hair analysis

• Applied kinesiology

• York Laboratories - IgG testing

Alternative Tests

• What the test involves

• ? Valid and evidence based

• Cost of testing

Applied Kinesiology -introduced in 1964

• Kinesiology is the study of movement.

• Applied kinesiology claims to detect changes in muscle strength, as a sign of disturbance in the bodies energy fields, to particular foods and substances.

Claims to diagnose allergic conditions including adverse

food and drug reactions.

• Weakness in a muscle confirms a problem with a food or given substance.

• Maintained muscle strength indicates that the substance is beneficial.

• Surrogate testing

Research findings

• 3 practitioners tested 11 subjects, all made significantly different assessments.

Kenny JJ et al. Journal of American Dietetics Association 1988; 88:698-704.

• No difference between test substance and placebo.Triano,JJ. Journal of Manipulative & Physiological Therapeutics 1982; 5:179-182.

Hair Analysis

• Hair sample sent from nape of neck to measure mineral, vitamin and nutritional status.

Research findings

• No evidence that low concentrations of elements detected in hair reflected low body stores. Lasar P. JAMA 1974; 229:1908-1909.

• Levels of minerals are affected by gender, hair growth, dyes and geographical location -not a reliable diagnostic technique.Hambridge KM. AJCN 1983;36:943-949.

Vega Testing-developed by Helmut Schimmel

Involves an electrical circuit via a hand held electrode and a Vega probe attached to a toe to complete circuit.

• Test substances are placed in honeycomb and changes in conductance are recorded on the galvanometer

• Low readings indicate need to avoid a given food or substance.

• Dietary avoidance/advice is offered based upon these results.

Research findings

• DBPC study with HDM, cat and distilled H20• 15 atopics (SPT pos) vs 15 non atopics (SPT neg) • Each tested with 6 substances by 3 operators on 3

occasions, i.e. 54 items per participant• No correlation between SPT and Vega test• Vega test could not distinguish between atopic and

non atopic participants i.e. cannot diagnose allergy to common aeroallergens. Lewith GT et al. BMJ 2001;322:131-134.

York Laboratory testing

• Their Hypothesis - Immune reaction in the gut allows incompletely digested food to enter the circulation due to increased permeability and IgG antibodies are formed causing food reactions.

• Finger prick blood sample on absorbent wand, sent in post, tested in an ELISA.

• No IgG to foods = no food avoidance • Moderate IgG to foods = rotating food group• High IgG to foods = avoid food group

Research

• Studies have reported food specific IgG in serum of normal healthy subjects.Husby S et al. Int Arch Allergy Appl Immunol. 1985:77;416-422

• ELISA - no significant difference between control subjects and food sensitive patients.

Lessof M et al. Allergy Proc.1991:12;305-7

York Nutritional Laboratory Audit 2000

• 4,200 surveyed Feb 98 -Aug 99. • Response rate 1,761 (42%), with 68.7%(1217)

reporting chronic illness >3yrs.• 50% (880) reported some improvement.• 75% (660) reported benefit lasting >1yr (37% of

respondents).• Degree of benefit corresponded with adherence to

dietary advice

University of York for BAF/Allergy UK in 2000

• Chronic symptoms fluctuate

• Placebo effect

• 70% reported improvement in chronic symptoms

• Could not prove benefit of IgG ELISA

• Need for a randomised control trial• Remains unproven

Approximate cost implications

• Kinesiology - £40.00-50.00, plus FU appt and cost of advised food supplements

• Hair analysis - approx £30.00 plus food supplements.

• Vega testing - approx £50.00 plus FU appt and supplements

• York Laboratory - £100.00 - 42 food scan £250.00 - 113 food scan

Australia has suspended the production licence of Pan Pharmaceuticals

• Makes 70% of vitamins, minerals and herbal medicines

• Also makes OTC painkillers and cold preparations

• Systematic and deliberate manipulation of quality control test data