You walk into the office, unsure of what to expect—tests, questions, maybe even surprises. But what exactly happens when you meet an allergist for the first time? Is it just about sneezing and sniffles, or something more? The truth might not be what you think. Let’s take a closer look at what your first visit really involves…
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What Do Allergists Test For During Your First Visit?
During your first visit with an allergist, one of the main steps involves running tests to identify which substances may be triggering your symptoms. The choice of test depends on your medical history and the suspected type of allergy. Below are the main types of tests an allergist may perform:
Skin Tests
These are among the most common, quick, and effective methods for detecting respiratory, food, or contact allergies.
- Prick Test: A drop of the suspected allergen is placed on your skin, usually on your arm or back, and a small scratch is made over the drop using a sterile lancet. If you’re allergic, a raised bump larger than 3 mm may form within 15 minutes.
- Intradermal Test: A small amount of allergen is injected just under the skin. This test is more sensitive and used when prick test results are unclear.
- Patch Test: Patches containing allergens are placed on your back and left for 48 hours. The skin is then checked at 48 and 96 hours to detect delayed allergic reactions, often related to contact allergies.
Blood Tests
Blood tests are used when skin testing isn’t possible.
- Specific IgE Test: Measures the amount of IgE antibodies reacting to a specific allergen.
- Total IgE Test: Measures the overall IgE level in the blood, which indicates allergic sensitivity but not to any specific allergen.
- Advanced Serological Tests: Include options like the Histamine Release Test (HRT) and Basophil Activation Test (BAT) to assess cellular immune responses to specific allergens.
Provocation Tests
These are used when other test results are inconclusive or when food allergies are suspected.
- Oral Food Challenge: Under medical supervision, you are given increasing amounts of the suspected food to monitor for reactions.
- Elimination Diet: Specific foods are removed from your diet temporarily and reintroduced one at a time to identify the allergen causing symptoms.
Review of Your Medical History
Your medical history plays a key role during your first allergist appointment. This helps the specialist understand your symptoms and identify potential triggers.
The allergist will ask detailed questions about:
Personal medical history: Past illnesses, ongoing treatments, and any immune-related conditions.
Family history: Allergies, asthma, or immune disorders in close relatives.
Previous reactions: Adverse responses to foods, medications, or insect stings.
This review helps rule out other possible causes and supports a more accurate diagnosis. A well-prepared history can improve diagnostic speed and guide more effective treatment planning.
Discussion of Symptoms
You’ll discuss your symptoms in detail with the allergist. This conversation helps begin to identify possible causes and patterns in your allergic reactions.
Topics typically include:
- Symptom duration and frequency: When they began, how often they occur, and whether they follow a pattern.
- Type of symptoms: Itching, rashes, shortness of breath, sneezing, watery eyes, etc.
- Possible triggers: Foods, medications, personal care products, pets, dust, or pollen.
- Family allergy history: To assess any genetic risk factors.
Providing accurate information at this stage can lead to a more personalized and effective treatment plan.
Physical Examination
The allergist will also conduct a physical examination to evaluate the type and severity of your allergic symptoms. This helps identify signs of allergic reactions and guides the next steps in testing and treatment.
Skin Check
The allergist may look for signs like:
- Hives or welts
- Redness
- Itchy or irritated skin
Skin tests may also be performed during the visit to check for immediate reactions.
Airway Check
Your upper and lower airways may be examined, especially if you have respiratory symptoms.
- Upper airways: The nose and throat are checked for swelling, congestion, or mucus, often linked to allergic rhinitis.
- Lung function: Tests may be done to assess breathing capacity, especially if asthma is suspected.
Eye Check
Your eyes may also be evaluated for allergy-related signs such as:
- Itching
- Excessive tearing
- Redness
- Swelling of the eyelids
These symptoms may indicate allergic conjunctivitis, especially if exposure to dust or pollen is involved.
This exam helps identify how your body is reacting to allergens and assists the allergist in choosing the right tests and treatment.
Planning Diagnostic Tests
Once your symptoms and history have been reviewed, the allergist will plan which tests to run. This decision is based on your medical background, symptoms, and current medications.
You play an active role in this step. To ensure accurate testing, you should:
- Follow any preparation instructions
- Disclose current medications that could interfere with test results
- Keep a detailed symptom log if requested
Effective test planning allows the allergist to confirm or rule out allergies and develop a tailored treatment approach.
Explanation of Treatment and Next Steps
After gathering all the information—your history, symptoms, physical exam findings, and test results—the allergist will explain the recommended treatment.
This may include lifestyle changes, medication, or allergen immunotherapy. Immunotherapy, such as allergy shots or sublingual tablets, is offered when avoidance and medication alone aren’t enough. The allergist will outline how the treatment works, how long it might take, and what results you can expect.
You’ll also be given a follow-up plan. This might include monitoring your response to treatment, adjusting medications, and further evaluations. By the end of your visit, you’ll have a clear strategy for managing your allergies and improving your quality of life.
Sources:
- Abou-Jaoude, E., Saliba, S., & Anand, R. (2022). PATIENT PERCEPTION OF THE ROLE OF THE ALLERGIST IN THE PRIMARY CARE SETTING. Annals of Allergy, Asthma & Immunology, 129(5), S69-S70.
- Ciprandi, G., Licari, A., & Marseglia, G. (2020). To prevent the allergic disease: the dream of the allergist. Acta Bio Medica: Atenei Parmensis, 91(3), e2020073.