Food and Tree Nut Allergy Panel

The Food and Tree Nut Allergy Panel test contains 1 test with 17 biomarkers .

Brief Description: 

The Food and Tree Nut Allergy Panel is a comprehensive blood test designed to detect and measure allergen-specific immunoglobulin E (IgE) antibodies associated with a range of common food and tree nut allergens. This panel helps healthcare providers identify potential allergic sensitivities and better understand how a patient’s immune system may be reacting to specific dietary triggers.

Food allergies can provoke a variety of symptoms, from mild skin irritation and digestive discomfort to severe respiratory distress or anaphylaxis. Tree nut allergies, in particular, are associated with severe allergic reactions and are frequently lifelong. This panel is often ordered for patients experiencing allergic symptoms after eating certain foods or for those with a family history of food allergies. The blood-based nature of the test offers a safer diagnostic method compared to skin prick testing, especially for patients with a history of severe reactions.

Collection Method: Blood Draw 
Specimen Type: Serum 

Test Preparation: No preparation required

When and Why the Food and Tree Nut Allergy Panel May Be Ordered

The Food and Tree Nut Allergy Panel may be ordered when a patient reports symptoms suggestive of food allergies, such as hives, swelling, itching, digestive issues, respiratory symptoms, or even anaphylaxis. It is especially useful when symptoms appear after consuming common allergenic foods such as nuts, shellfish, dairy, wheat, or eggs.

Healthcare providers may also order the panel if a patient has a personal or family history of atopic conditions such as asthma, eczema, or allergic rhinitis, all of which can increase the likelihood of food allergies. In some cases, the panel is used to monitor food sensitivities over time, especially in children who may outgrow certain allergies.

This panel helps pinpoint which specific foods or tree nuts are causing IgE-mediated immune responses. By identifying these triggers, the healthcare provider can offer more precise dietary guidance and help the patient avoid unnecessary dietary restrictions, particularly in cases of suspected cross-reactivity between different allergens.

What the Food and Tree Nut Allergy Panel Checks For

The Food and Tree Nut Allergy Panel measures allergen-specific IgE antibodies in the blood. The presence of these antibodies indicates that the patient’s immune system recognizes certain food proteins as potential threats, triggering an immune response. Each test within the panel focuses on a specific food or tree nut allergen. Below is an in-depth explanation of each:

Almond IgE
This test measures the presence of IgE antibodies targeting proteins found in almonds. Almonds are a common tree nut allergen, and allergic reactions can range from mild oral itching to life-threatening anaphylaxis. Almond proteins are heat-stable, meaning that even processed almonds can provoke allergic responses.

Brazil Nut IgE
This test detects IgE antibodies to Brazil nut proteins, which are potent allergens known to cause severe reactions, sometimes even to trace amounts. Brazil nut allergy often requires strict avoidance due to the risk of cross-contamination in mixed nut products.

Cashew Nut IgE
Cashew allergy is frequently associated with severe reactions and is one of the most common tree nut allergies. This test identifies IgE antibodies to cashew proteins, which are also found in cashew butter, nut blends, and processed foods. Cashews share allergenic proteins with pistachios, leading to common cross-reactivity between the two.

Codfish IgE
This test measures IgE antibodies against cod proteins, which are highly allergenic. Cod allergy, like many fish allergies, often triggers symptoms that include hives, asthma, or anaphylaxis. Cooking does not eliminate cod allergens, so both raw and cooked cod can provoke reactions.

Cow's Milk IgE
Cow's milk allergy, one of the most common food allergies in children, involves an IgE-mediated reaction to milk proteins such as casein and whey. This test measures IgE antibodies to these proteins, helping differentiate milk allergy from lactose intolerance, which does not involve the immune system.

Egg White IgE
Egg allergy, particularly to egg white proteins such as ovomucoid and ovalbumin, can cause skin, digestive, and respiratory symptoms. This test measures IgE antibodies to egg white proteins, which tend to be more allergenic than egg yolk proteins.

Hazelnut IgE
This test detects IgE antibodies to hazelnut proteins, which are common triggers for tree nut allergy. Hazelnut allergy often coexists with birch pollen allergy due to shared protein structures (cross-reactivity), especially in individuals with pollen-food syndrome.

Macadamia Nut IgE
Although macadamia nut allergy is less common than other tree nut allergies, it can still provoke serious allergic reactions. This test identifies IgE antibodies to macadamia proteins, aiding in the diagnosis and management of this potentially severe allergy.

Peanut IgE
Peanut allergy is among the most common and dangerous food allergies, especially in children. This test detects IgE antibodies to peanut proteins, which can trigger life-threatening reactions even from trace exposures. Unlike tree nuts, peanuts are legumes, but they share some allergenic proteins with tree nuts.

Salmon IgE
This test measures IgE antibodies to salmon proteins, which can provoke severe allergic reactions. Fish allergies, including to salmon, are often lifelong, and reactions can occur even with exposure to cooking fumes or residues.

Scallop IgE
Scallops are a common trigger for shellfish allergy. This test detects IgE antibodies to scallop proteins, which can cause reactions ranging from mild hives to severe respiratory symptoms. Shellfish allergies tend to persist into adulthood and often include cross-reactivity with other mollusks and crustaceans.

Sesame Seed IgE
Sesame allergy is increasingly recognized as a significant and potentially severe allergy. This test identifies IgE antibodies to sesame proteins, which are present in seeds, oils, tahini, and various processed foods. Sesame allergy can cause anaphylaxis and is often lifelong.

Shrimp IgE
Shrimp allergy is the most common shellfish allergy. This test detects IgE antibodies to shrimp proteins, which can trigger severe allergic reactions. Cross-reactivity with crab, lobster, and other crustaceans is common, requiring broad dietary avoidance for many patients.

Soybean IgE
Soy allergy is common in infants and young children, though some outgrow it. This test detects IgE antibodies to soy proteins, which are found in soy milk, tofu, soy sauce, and many processed foods. Symptoms can range from mild to severe.

Tuna IgE
Tuna allergy, like other fish allergies, can provoke severe reactions and may co-occur with other fish allergies. This test measures IgE antibodies to tuna proteins, which remain allergenic even after cooking.

Walnut IgE
Walnut allergy is a leading cause of severe tree nut allergy, and this test identifies IgE antibodies to walnut proteins. Walnuts share allergenic proteins with pecans, leading to frequent cross-reactivity between the two nuts.

Wheat IgE
This test measures IgE antibodies to wheat proteins, including gliadin. Wheat allergy can cause skin, respiratory, and digestive symptoms. It is distinct from celiac disease, which involves a different immune mechanism (autoimmune rather than IgE-mediated).

How a Healthcare Professional Would Use the Results of the Food and Tree Nut Allergy Panel

Healthcare providers interpret the Food and Tree Nut Allergy Panel results in the context of the patient’s clinical history and reported symptoms. Positive IgE results indicate sensitization to specific allergens, but sensitization alone does not always mean the patient will experience clinical symptoms upon exposure. Combining test results with patient history helps determine whether true allergy is present and whether the patient needs to avoid specific foods.

If the results reveal multiple food sensitivities, healthcare providers may recommend dietary modifications, patient education on allergen avoidance, and possibly referral to an allergist for further evaluation. In cases of severe food allergy, patients are often prescribed emergency medications such as epinephrine auto-injectors and given clear instructions on how to respond to accidental exposures.

The results may also guide ongoing management, particularly for children, where periodic testing can track whether certain allergies are being outgrown. For adults, the results help solidify long-term dietary guidelines and identify potential cross-reactivity patterns, particularly between tree nuts and pollen or between shellfish species.

The Food and Tree Nut Allergy Panel is a critical tool for identifying food allergies and guiding individualized dietary and medical management plans. By identifying specific IgE antibodies associated with food and tree nut allergens, healthcare providers can offer clear and personalized guidance to help patients safely navigate their dietary choices. Early identification and appropriate management of food allergies significantly improve quality of life and reduce the risk of severe allergic reactions, ensuring better long-term health outcomes.