Provocation testing involves the administration, intradermally (injected with a tiny needle into the skin), of a very small dose of a specific food (or other substance) to test a patient's reaction to it. Since the dose is given by injection, it is rather like a patient eating a large quantity of a food and immediately assimilating it. Most patients with problems caused by foods will exhibit actual symptoms from specific foods when they are tested in this way. These symptoms may include severe fatigue, congestion, abdominal discomfort, headache, coughing and practically any other symptom (or sign, such as red ears, red eyes, etc.) you could imagine. Then further injections of the same food are given but at different dosages, and there is usually a specific dose of the same food that will make the symptoms miraculously disappear.
No, we don’t have a clear idea why P/N works, but I’ve used it in my practice since 1975 and there is no question that it does. Many physicians who use P/N then use that "neutralizing" dose to administer to the patient to prevent or treat symptoms when the patient eats that food. I use LDA immunotherapy, since it covers far more ground than administering specific food mixtures. Besides, LDA is given only every two months or less often, not daily or several times a week as neutralization must be. Additionally, if a patient has severe food intolerances, many foods must be tested and treated with P/N. This can be a lengthy and expensive proposition. Since food sensitivities change over time - and so do patients' neutralizing doses - retesting must occur fairly frequently in most cases, an added and often ongoing expense.
We will test up to six foods (dairy, wheat, egg, corn, soy and yeast) in our office. P/N Food testing takes 2-4 hours, depending on how many foods we test, since patients must wait 10 minutes between each dose and record their symptoms. I use the results from this testing both to show patients graphically which foods may bother them (and as a result, foods they may want to avoid for awhile) and to help determine the dose of their LDA treatment.
We also use P/N testing in our office to test and treat certain hormones and neurotransmitters (seratonin and others).
The “gold” standard of determination of food allergy is the multiple elimination diet that we often use in my office to perform small miracles for patients who are ill. We often use this diet for our new patients to get them feeling better quickly, before we begin other types of treatment, such as LDA.
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Santa Fe Center for Allergy and Environmental Medicine