Allergy symptoms present but nothing showed up in both prick allergy test and allergy blood test

[item0]

I've had both a blood test and a prick allergy test (I don't know what the medical name for it is). Neither test showed the presence of any allergies. When I'm inside though, I have very severe allergy symptoms to the point of barely being able to breath. I only have the symptoms inside my apartment and they're greatly diminished when I open all the windows. No one else who visits my apartment even for hours seems to be affected.

The symptoms I'm experiencing are mainly stuffy, sometimes runny nose, wheezing, itchy throat causing coughing and gagging, itchy eyes and headaches but I rarely sneeze. The Allergist prescribed me a bunch of meds even though i never had any specific allergies identified. Any suggestions or clues as to what could be causing this?

Edited October 5, 2011 by item0

[saveyoursanity]

Could it be mold? Aren't there like 50 different types of mold?

[Blart752]

Yah, i'm not sure if this relates, but i took pulmicort, and for me, it screwed with my sinus, and gave me a sinus infection, I had to go on antibiotics for awhile and stop the pulmicort. But all the random sneezing cleared up and im back to feeling somewhat better.

I really cant breathe out my nose much anymore overall, cuz when i do for some reason it makes me a bit anxious, or i feel like i cant relax or breathe normal.

[item0]

I have to correct this. I actually can get the allergies in other places, if they're dusty.

[notfred]

Blood and prick tests are not exhaustive, they can't test for everything. Have you tried an antihistamine and what were the results ?

nf

[item0]

Blood and prick tests are not exhaustive, they can't test for everything. Have you tried an antihistamine and what were the results ?

nf

Yes, Benadryl. It works great except for the drowsiness.

[Guest Recluse]

Most likely, the blood test and skin-prick did not have the specific allergen that you are allergic to, or you might have had an especially non-inflammatory day. Many types of medication will effect inflammatory response, so unless you remember what you'd taken within the last like, two weeks, it would be hard to pin down why exactly nothing turned up.

Start making a list of when it happens. Note things like the following:

1. How dusty is dusty? (Can you see dust on surfaces?)

2. Do they have pets of any kind?

3. How old does the location look?

4. Is the location in a flood-prone or damp area?

5. How quick is the onset in each case?

6. What medications have you taken that day or within a few days?

See if you can narrow it down.

[smoj]

If you stayed on all of your meds prior to the test, that is probably why you did not show a positive reaction to any of the allergens in the test. A lot of different medications block histamine or work as anti-inflammatories and therefore give a false negative allergy test. Typically you would be off of any anti-depressants, muscle relaxers, antihistamines, anti-inflammatories, and sedatives for a certain number of days before your allergy test. Of course, you would need to check with your doctor before you stop taking any of these medications. Try this and get retested. Good luck!

[melissaw72]

I have allergy testing at the end of the month, and was told to NOT take any type of antihistamine a week before the testing. If it is taken the allergy tests wont be accurate in finding something that causes an allergy.

[theprinciple]

I've had both a blood test and a prick allergy test (I don't know what the medical name for it is). Neither test showed the presence of any allergies. When I'm inside though, I have very severe allergy symptoms to the point of barely being able to breath. I only have the symptoms inside my apartment and they're greatly diminished when I open all the windows. No one else who visits my apartment even for hours seems to be affected.

The symptoms I'm experiencing are mainly stuffy, sometimes runny nose, wheezing, itchy throat causing coughing and gagging, itchy eyes and headaches but I rarely sneeze. The Allergist prescribed me a bunch of meds even though i never had any specific allergies identified. Any suggestions or clues as to what could be causing this?

How allergy works is that there is at first an allergen that your body gets exposed to, and this provokes a synthesis of IgEs (E immunoglobulins) which attach themselves to mast cells. A further exposure to the allergen will cause a release of histamines, leukotrienes, prostaglandins, tromboxanes which cause the sneezing and itchiness. A few hours later, in 50% of the patients, monocytes, eosinophils, macrophages, and basophils migrate to the location of exposure (usually your nose), and cause a hypersensilisation to non-allergenic factors (cold or hot air, high humidity, smoke, strong odours, dust, etc.)

In your case there seems to be no sneezing, so it's a hypersensitivity allergic reaction.

[edited out information on specific dosing information and exactly what prescriptions the OP should ask their doctor for.  We do not give out medical advice here as this is a peer support site.  No one here is allowed to give knowledge out as a medical professional.

 

theprinciple, I STRONGLY suggest you read your private messages.]

Edited May 29, 2013 by saveyoursanity

[larkasaur]

It's not uncommon to have allergies that are localized in the nose, so they don't appear on skin or blood tests.  This is called "local allergic rhinitis".  See http://www.jiaci.org/issues/vol20issue5/cme.pdf

Allergy tests can give false negatives or false positives. 

 

 

. A few hours later, in 50% of the patients, monocytes, eosinophils, macrophages, and basophils migrate to the location of exposure (usually your nose), and cause a hypersensilisation to non-allergenic factors (cold or hot air, high humidity, smoke, strong odours, dust, etc.)

The late-phase allergic reaction in human beings seems to be independently initiated - it's not an "allergic cascade" triggered entirely by mast cells.  It's caused by FceR1 IgE receptors on the surface of dendritic cells, which are extremely efficient at binding to IgE.  So the late-phase reaction can be extremely sensitive. 

That's how my dog allergy can be so sensitive.  I'm not that incredibly sensitive in an immediate way.  If there's an intense dog exposure I can have an allergic reaction immediately.  But when there's a small exposure, like a dog inside a car going past me, I only slowly start to get foggy-headed. 

Rodents don't have this independently-initiated late-phase allergic reaction, so researchers didn't know about it until recently.  Here's a research article about this:  "High-Affinity IgE Receptors on Dendritic Cells Exacerbate Th2-Dependent Inflammation"  http://www.jimmunol.org/content/187/1/164.full.pdf

I've been reading various research articles about allergies. 

Edited June 14, 2014 by larkasaur

[Stickler]

 

Interesting stuff, thanks for posting it.

 

Once again, don't remember where I read it...*smacks forehead*  but I remember reading that eosinophils get into cerebrospinal fluid and actually cause accelerated breakdown of serotonin in the synaptic clefts.

 

This helps to exacerbate pre-existing depression if you've got it.

 I read this in the context of studying my chronic sinusitis.  It was found that something like 1 in 5 sinusitis sufferers also matched the diagnostic criterion for major depression when evaluated.  Way over statistical average.

Though once again, I forget the sample size of that study...AND if I have the numbers right.

 

(My brains have apparently turned into PTSD-laden goo...and I obviously need to have a place to store all my tasty links at so I stop losing them.)

 

 

[larkasaur]

I remember reading that eosinophils get into cerebrospinal fluid and actually cause accelerated breakdown of serotonin in the synaptic clefts.

 

That's interesting.  I have been reading research articles trying to understand my delayed-onset food allergies.  They're a kind of food allergies that don't show up in the standard skin or blood allergy tests.  That kind of allergy is real - it has passed blind challenges in research studies.  But little is known about the mechanism. 

There's a Dr. Antonio Carroccio who's researching non-celiac wheat sensitivity (NCWS).  He found many people with NCWS have multiple food hypersensitivities - with symptoms similar to what I've had from the delayed-onset food allergies.

He says these people have excess eosinophils in their gut, that's the main change that has been seen in biopsies.  Excess eosinophils might be from chronic allergic inflammation in the gut. 

When I eat these foods I tend to get more irritable, more emotionally reactive.  I get "triggered" a lot.  I've found that taking cromolyn (a mast cell stabilizer) beforehand helps a lot with the emotional aspects of the food reaction. 

Those kinds of symptoms, I've heard, may result from low serotonin. 

I had a kind of psychological revolution after eliminating the foods I was allergic to.  I found them by a series of elimination diets followed by food challenges.  My gluten and milk allergies I found in the first phase.  I had intense reactions to gluten, dairy and a few other foods, and after eliminating those, my vision stopped being quasi-hallucinatory and became just vision.  Before that I was swamped with anxiety and apprehension. I would get enraged over little things - extreme irritability.  And my muscles were very tense.  I would take long hot baths often to try to soak away the tension, but that only helped a little.  Those things went away after I quit eating those foods. 

Then later I found many more delayed-onset food allergies.  When I quit eating those foods, a lot of chronic depression and anxiety went away.  I'm a lot more cheerful and even-tempered now. 

[larkasaur]

I had this condition for awhile.

I used to have many reactions to allergy skin testing.  I would be positive to most of the allergists' test panels. 

Then - while I was getting sicker - my allergy testing gradually became negative.  So I was really sick - I couldn't think well, I had a hard time getting out of my house to go shopping.  It was pretty consistent with how my allergies feel.  So I saw allergists.  But, they told me to look for answers besides allergies.  I asked one allergist if I could be allergic to my dog with a negative allergy test for dog allergy.  He mumbled a lot, look embarrassed, and finally said "no". 

I did look for other answers, but nothing else helped.

I finally solved it by slow and painful stages, with self-experimentation.  I was actually sick from both mold and dog allergies.  First I eliminated some mold that had been getting into my food - which can make me very sick. 

Once I had done that, I went away from my house to live in a no-pets hotel.  After about a week, I got well!!! For the first time in 18 months, my mind was clear and alert! 

Then I visited the SPCA.  I spent 4 hours cuddling dogs there.

Slowly, I got very sick.  I went back to the hotel and spent the next several days mostly in bed. 

I tried the same experiment later with dogs in a different situation, just to be sure.  I got sick again. 

But I only found this out after 4 years of being sick.  I had an allergic reaction that went on literally for years.

With long and arduous efforts at dog-avoidance, I have gotten better.  Now after a dog exposure, I'm just sick for 2 days, not 5 days.

Also, after all the dog-avoidance, I got allergy testing again.  My allergy tests had gone back to positive.  Just for a few molds, although there was one mold that I had a reaction to on the skin-prick test - less sensitive than intradermal allergy testing. 

I found - again, after a lot of effort - a really good allergist in NYC who's willing to do allergy shots for me, including allergens I didn't test positive to.  So FINALLY I'm getting the treatment I need.  FINALLY I have an allergist who's flexible enough and smart enough to help me! 

Many allergists won't do this.  They think they can gauge how bad someone's allergies are, by the results of their allergy testing.

This might be true most of the time.  It's not true for me. 

I have a very, very severe late-phase reaction to dogs, from being chronically exposed to dog allergen. 

I have a guess about the mechanism.

The late-phase reaction can be extremely sensitive, because the dendritic cells are very very good at binding to IgE. 

So good, they might scavenge all the IgE out of the blood - so the allergy wouldn't show up in the skin or the blood. 

So I relate my skin and blood tests going negative, to having an extremely sensitive allergy. 

This isn't an idea I invented - something similar was in a research review article I read.

Edited June 17, 2014 by larkasaur

[larkasaur]

Also, intradermal allergy testing is more sensitive than skin-prick testing.  Allergies can show up in intradermal testing that don't show up in blood allergy tests. 

Some very conservative allergists just do skin-prick testing.  The original poster seems to have run into a very conservative allergist.  A less conservative allergist might explain their problems.

The results of intradermal allergy testing need to be evaluated alongside the patient's experience of allergic reactions.  The intradermal allergy testing can also give false positives and false negatives, so it isn't the final word on one's allergies either. 

Edited June 17, 2014 by larkasaur