Don’t Expect Mail-Order Tests to Diagnose Your Food Allergies

Sorry, EverlyWell. Photo by TechCrunch.

“You are what you eat. What is slowing you down?” reads a sales page for EverlyWell’s food sensitivity tests ($199 and up). It would be great if any vague complaints you had about your body could be detected with a simple test and fixed at your next meal. Too bad that’s not how it works.

The first problem is that food “sensitivities” may not be a thing. AC Shilton reports at Outside that the term was coined for people who didn’t have celiac disease but were pretty sure they felt sick when they ate food with gluten. Since then, other sensitivities have been proposed, but there’s no clear definition of what a sensitivity is or how it might work.


Allergies, by contrast, are better understood. We don’t always know why some people get them and not others, but at least doctors and researchers can explain what goes on in your body during an allergic reaction. A key part of that reaction involves antibodies, which recognize substances in your body. There are different kinds of antibodies, and allergies involve the type called IgE.

But direct-to-consumer tests like EverlyWell’s typically test IgG antibodies, which are different. If you have IgG antibodies in your blood that react to wheat proteins, that doesn’t mean you’re allergic to wheat. It just means that your body has seen wheat at some point. But even IgE tests aren’t accurate enough to be allergists’ go-to tool.

The European Academy of Allergy and Clinical Immunology published an opinion in 2008 saying that IgG4 tests should not be used to diagnose food sensitivities. The American Academy of Allergy, Asthma & Immunology then put out a statement agreeing wholeheartedly, and noting that no serum antibody test, even the IgE ones that are sometimes helpful, can diagnose an allergy. They say flat-out: “The presence of antibody does not indicate disease.” Plus, an antibody that doesn’t show up on the test might be at undetectable levels, but that doesn’t mean it’s not there; you could still have an allergy to that food.


The Canadian Society of Allergy and Clinical Immunology weighed in a few years later saying specifically that direct-to-consumer tests are a waste of money. They didn’t mince words:



These organizations aren’t just annoyed that the tests are useless. They point out that the next step after taking the test is supposed to be eliminating the identified foods from your diet, and if you had positive results to a bunch of different foods, you could be left with very little that makes up a healthy diet. Dr. Robert Wood, an allergist at Johns Hopkins Children’s Center, told STAT that IgG tests “are completely useless and do dramatic harm.”

EverlyWell optionally packages their blood test with a DNA test, which seems like it should give you extra information—but according to their website, it looks like the extra tests are for some simple traits that you don’t really need a test for. Are you genetically likely to be lactose intolerant, to be strongly affected by caffeine, or to be deficient in B12 or magnesium?


You probably already know how you react to dairy and caffeine. And if you wanted to know if you are deficient in some vitamin or mineral, you should get tested for the deficiency itself, not for a genetic predisposition to that deficiency.

So, what’s slowing you down? I don’t know, but I doubt the folks at these testing services do either.


A ‘Shark Tank’-funded test for food sensitivity is medically dubious, experts say | STAT

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