Blood draw
Nut allergy screen (mix)
A blood test for IgE against peanut, hazelnut, Brazil nut, almond and coconut together. For anyone who had a clear reaction after eating nuts.
€ 44,00
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Allergy and intolerance · Blood
Nut mix (allergy)
One IgE test for peanut, hazelnut, Brazil nut, almond and coconut together; shows whether you are sensitized to one of them, not which.
At a glance
- Measured in blood
- In 1 test panel
- No special preparation
Explanation
Nut mix (allergy): what is measured?
The test measures, in one go, IgE antibodies against a fixed mix of 5 foods: peanut, hazelnut, Brazil nut, almond and coconut. Botanically, peanut is not a nut but a legume, and according to Stichting Voedselallergie (Dutch food allergy foundation) coconut is a fruit; both are included in this mix. IgE is the type of antibody that, in an allergic reaction, triggers mast cells to release histamine; the body only makes these antibodies after it has previously been in contact with an allergen, and this is called sensitization. Because the 5 foods are tested together, the result gives one number and a verdict of positive or negative, but not which food the antibodies are directed against. Other nuts, such as walnut, cashew, pistachio, pecan and macadamia, and sesame are not in the mix.
What can it detect?
- Sensitization to at least one of the 5 foods in the mix: the body has made IgE antibodies against one or more of them
- A first indication of whether an acute reaction shortly after eating may be related to peanut or one of these nuts
Result
What does the result mean?
Positive result
A positive result means that you have IgE antibodies against at least one of the foods in the mix: sensitization. That is not the same as an allergy, and the test does not say which food the antibodies are directed against. A positive result only counts if there has also been a clear reaction shortly after eating: itching in the mouth, hives, swelling, abdominal symptoms or shortness of breath. A positive result is also often caused by cross-reaction with birch pollen; according to Stichting Voedselallergie, a nut allergy is then usually milder, with symptoms mainly in the mouth and throat. Which food it is becomes clear from separate IgE tests together with the history of the symptoms.
Negative result
A negative result means that no IgE antibodies against the 5 foods were found. An IgE-mediated allergy to peanut, hazelnut, Brazil nut, almond or coconut is then less likely, but not completely ruled out. Other nuts, such as walnut and cashew, and sesame are not in the mix; an allergy to them is missed. Symptoms after eating can also have another cause, for example an intolerance or a bowel condition.
After an abnormal result
The GP mainly looks at the history: which food, which symptoms, how soon after eating and how often. With a positive result, separate IgE tests follow if needed to see which nut it is, or whether it is peanut. With a suspected real allergy or after a severe reaction, referral to an allergist or pediatrician follows, where a food challenge is done if needed.
Reliability
How reliable is the test?
A positive IgE result shows sensitization, not allergy: it only says that there are antibodies, not that you get symptoms from that food. The Dutch medical specialists' guideline (FMS) on food challenges advises against IgE tests for many foods at once and food mixes if there is no suspicion based on a good history of the symptoms, and calls a supervised food challenge the gold standard. With peanut and nuts, cross-reaction with birch pollen often gives a positive result without a real food allergy. The mix is therefore mainly a first step after a clear reaction: a negative result makes an allergy to these 5 foods less likely, a positive result calls for separate tests.
What can affect the result?
- Sensitization without symptoms is common, mainly through cross-reaction with birch pollen; the result can only be interpreted together with the history of the symptoms.
- The test does not say which food is the cause; that requires separate IgE tests.
- The test measures all proteins per food together; testing for single proteins, such as Ara h 2 in peanut, says more about the chance of a severe reaction.
- Nuts outside the mix, such as walnut, cashew, pistachio, pecan and macadamia, and sesame are not tested.
Who it is for
Who is the test useful for?
Useful for
Useful after a clear reaction shortly after eating peanut or nuts, such as itching in the mouth, hives, swelling, vomiting or shortness of breath, when it is unclear which food is the cause. If it clearly concerns one food, a separate IgE test says more. With vague symptoms without a clear link to a meal, and in people who eat peanut and nuts without problems, the test adds little; the FMS guideline then advises against screening.
How common is it?
According to Stichting Voedselallergie, 1 to 2 in 100 people in the Netherlands have a nut allergy, both children and adults. Peanut allergy usually starts at a young age and often lasts a lifetime. Peanut and nuts can cause severe reactions, while sensitization without symptoms is much more common than the allergy itself.
Stichting Voedselallergie and the FMS guideline on food challenges
Drawbacks and risks
- A positive result without a clear reaction can lead to unnecessarily cutting out peanut or nuts; according to Stichting Voedselallergie, cutting them out for a long time actually increases the risk of an allergy that may later be more severe.
- A negative result can give false reassurance with an allergy to a nut or seed that is not in the mix.
Get tested
Nut mix (allergy): test panels
Nut mix (allergy) is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.
Evidence
Sources
This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.
More about risks and resultsMore explanations
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