Did I outgrow my allergies?

[xybcza]

22  year old here. When I was a baby I was diagnosed with eggs, peanuts, and treenuts, and sesame allergies. However, back then, in the 2000s, I was primarily diagnosed with blood and skin tests being positive - without a reaction history. The allergist decided to test the top 10 allergens after a reaction to eggs as a baby.

Going forward, eggs was the only thing I ever had a reaction to. Never ever in my life have I ingested sesame, tree nuts or peanuts, or had a reaction attributed to them, but I always tested pretty solidly in the 'positive' range for skin tests, so the doctor just told me to avoid. They basically told me I was SOL and would never outgrow any of my allergies, so I gave up and didn't go to an allergist for 10+ years.

I decided to get a skin test and blood test, and these were the results:

Every tree nut was completely negative (0mm) except for Walnuts (6mm) which was equal to the histamine control (6mm) and eggs (5mm) which was less than the histamine control by a bit. Peanuts was also completely negative at 0mm, with Sesame being the largest at 9mm. Note that I have never ingested Peanuts, Tree Nuts, or any sesame.

As for my blood test, Sesame was 2.7 kU/L, Eggs was 1.0 kU/L,Peanuts was 0.3 kU/L, and most of the tree nuts I tested were in the 1-2 range (however they were all negative on the SPT). Note that I have never skin tested or blood tested milk, wheat, or soy, but I suspect if I did they would also come up as low positives even though I consume these allergens regularly with no issue.

I know allergy testing is very unreliable so what are your guys' thoughts here? It is also interesting to note in my skin test, the negative control reacted with a wheal of 2mm and from what I've seen that should be 0.. I have sensitive skin it appears and I know that can skew the results as well...

The last time I had a reaction to egg was over 10 years ago.

From when I inquired with the allergist, he said basically the only way to diagnose any of these allergies is to eat the foods trial and error. I do wonder though, if I continue to wait even longer, will my numbers drop even further? They have certainly dropped significantly since my last test 10+ years ago, and I'm wondering if I just go ahead and wait another 5 years, then I have a higher chance of outgrowing the allergens than risk a potential reaction now. My allergist told me the longer you go without a reaction - the better as your immune system can completely forget the allergen - but I have also heard avoidance makes it worse?

What are your guys' thoughts? I would really like to rule some of these foods out because it is just becoming such a hassle on my everyday life - it seems like most of my levels/results are quite low as it is, to the point where passing food challenges would be reasonably high probability.

[xybcza]

Also I kind of suspect the walnut skin test could be a false positive since every other tree nut was negative - as well as pecans which I know pecans and walnuts are linked. If the tests are much more accurate for a negative test than a positive one - then wouldn't this mean walnuts may be a false positive?

I think a lot of this food allergy testing is a crapshoot... if even the saline prick generated a 2mm wheal on my skin I think it really makes things hard to interpret

[GoingNuts]

Welcome!

I'm not sure whether further avoidance would increase your chances of success; I'm not doubting it, I truly don't know. What I would suggest is if you want to try these foods that you do a supervised challenge with a board certified allergist present. (You sound well informed, so I'm sure you wouldn't try it on your own. Just wanted to be clear.)

I wish you lots of good luck, and hope you have truly outgrown these pesky allergies.

[rebekahc]

One thing you might look into is the positive predictive value for your test results for each allergen. Some allergens are more likely to be a true allergy with a smaller wheal or a lower blood test result than other allergens. You can often find negative predictive values, too. If your test results are lower than the negative predictive value, then you likely will not have a reaction. If your test results are higher than the 95% positive predictive value, then you're pretty likely to react. If you're somewhere in between, then you might consider an office food challenge - especially if your in between number is closer to the negative predictive value.

[xyzbca]

One thing you might look into is the positive predictive value for your test results for each allergen. Some allergens are more likely to be a true allergy with a smaller wheal or a lower blood test result than other allergens. You can often find negative predictive values, too. If your test results are lower than the negative predictive value, then you likely will not have a reaction. If your test results are higher than the 95% positive predictive value, then you're pretty likely to react. If you're somewhere in between, then you might consider an office food challenge - especially if your in between number is closer to the negative predictive value.