What Is the Most Accurate Test for Food Allergies?
15 Dec 2025 · 11 min
Podcast episode in which JJ Virgin answers a listener asking "What is the most accurate test for food allergies?" JJ distinguishes immediate true food allergies (diagnosed with skin/scratch tests and IgE/IgM mechanisms) from delayed food sensitivities/intolerances. She explains that delayed sensitivities are tied to gut permeability (zonulin, dysbiosis) and immune complexes, and that the IgG4 blood test is her preferred assay for delayed reactions. Her recommended clinical approach: first follow an elimination/healing protocol (the "Virgin Diet")—removing common suspects (eggs, dairy, corn, soy, peanuts, processed foods, gluten/sugar/artificial sweeteners that increase permeability), implement gut-healing (nutrients, enzymes, stress management) for several weeks to months, then use IgG4 testing after ~6–12 weeks (she often suggests 4–6 weeks minimum, ideally ~3 months of healing) if symptoms persist. The episode also includes multiple sponsor ad reads.
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What is the most accurate test for food allergies? This is JJ Virgin four time New York Times bestselling author, celebrity nutrition expert and Fitness hall of Famer. I've been on a lifelong quest for answers to the toughest health questions, and now I'm sharing what I found with you. Welcome to Ask the Health Expert. Maddie from Facebook asks, what is the most accurate test for food allergies? Ah, this seems like an easy question, but it's actually a little more detailed than you'd realize. I will be right back with the answer.
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Okay, so I still remember when I was writing the Virgin Diet and we were sitting around talking about it, the editor, my agent, and they were trying to decide what to call it, because not the book, but food intolerances or food sensitivities. Because I was like, it's not an allergy. It's not an allergy. And I'm going to guess, Maddie, that you're actually not asking about true food allergies. You're asking about testing for either an intolerance or a sensitivity. A true food allergy is an immediate reaction, and that's where they'll do the scratch test. And you've heard about that, where they'll scratch you, like, prick you with these different things and see if you react. It's where, you know, someone on the plane has the peanut allergy and they can't open peanuts up because they'll go into anaphylactic shock. That's a very different thing than a food. A delayed food sensitivity. And so I am guessing that that is what you're talking about. Now, when I wrote the Virgin Diet and, you know, I kept saying, it's not a food allergy, it's an intolerance or an. Or a sensitivity. Now, there is a piece with food intolerance, gluten intolerance. There's a genetic component there. So sometimes intolerances could be like lactose intolerance, gluten intolerance could be genetic. But I still love the umbrella term of an intolerance. And I look at food intolerance, and I look at it in a couple different ways. And I'll tell you how you can test and a couple different things you can do to test. But when I look at intolerance, I'm thinking, you know, there's a variety of ways I could become intolerant to a food. The most classic thing that a food sensitivity test looks at, and my favorite type of food sensitivity test is one called an IgG4 test. IgM is immediate, and IgG is going to look at delay, but the length of delay is the IGG4. It's going to give you more a longer period. So it will show. Has this been going on for a while? Ultimately, though, Remember, you're only going to show up for foods you're actually eating. So if you never eat the thing and it's been six months, it's not going to show up. Right? But ultimately, this test is really a test of your gut permeability. You see, food sensitivities happen because your gut, your small intestines become more permeable. It's a semi permeable membrane than it should be. And food, especially food that you haven't digested well. So maybe if you've been under stress or you're 35 or older, you have lower stomach acid, you don't have great chewing hygiene, and food goes into your small intestine, it's a little more permeable than it should be. Things pass out to circuit into your bloodstream where they don't belong. And your body goes, what the heck is that? And it sends out invaders. It sends out because it sees it as a foreign invader, not a helpful food item and not helpful nutrients. And it sends out a little antibody after it. So the protein from the food, the antigen, the antibody grabs a hold of it and says like, and creates an immune complex. Now, if there's just a couple of these, your body has macrophages just like Pacman that eat it up and get rid of it. The problem is our gut becomes more permeable. These things get out. And it's generally the biggest culprits are those things we tend to eat every single day. And then these immune complexes build up and they create symptoms like gas and bloating and headaches and joint pain and fatigue and rashes and autoimmune diseases. So what I like to do before I do an IGG food sensitivity test, personally, I feel that the best thing that we could do is do an elim. That is what the virgin diet was written about. I was looking at a lot of these food sensitivity tests and what I noticed was the top foods that people were responding to were, number one, eggs and dairy, number two, corn, soy, peanuts. Now, gluten is another type of test. You can see wheat in a food sensitivity test, but not gluten. So I was looking at that differently. And then sugar and artificial sweeteners were also not there. But the reason I pulled out gluten and sugar and artificial sweeteners is because they can contribute to gut permeability. In fact, gluten can cause release of something called zonulin. And zonulin makes your gut more permeable, fructose makes your gut more permeable, and of course, we know artificial sweeteners and sugar can perturb your gut, microbiome, cause gut dysbiosis. So those things were just creating more problems. So what I highly recommend is the first thing that you do is do the virgin diet, pull out those most likely foods. It was really a revamp of the elimination diet that's been around for decades. But what I recognized was what we.
Were pulling out of the elimination diet.
For so many of us. I was like going, these aren't the foods that I'm seeing showing up. So let's pull out the most likely suspects. Let's take out the things that make your gut more leaky. So those, a lot of things that do that, pain medications, foods that are ultra processed, I call them dirty processed foods, inflammatory foods. And then let's heal your gut. You know, big culprit here, stress. Stress makes your gut more permeable. So let's heal your gut by pulling out the hurting food, swapping them for healing foods, and getting in some stress management, right? Doing some nutrients that can help heal the gut. I have a product called Healthy Gut Support that can help there and using digestive enzymes. Then we go back and we check in with each of those foods. After three weeks or longer, my preference is more like four to six weeks. You see how each food works for you. You connect the dots and at that point, if you're still noticing, hey, I got joint pain, headaches, brain fog, you know, weight loss, resistance, then go do the other test. But we want to start to heal the gut first. And I would actually argue, like, I'd like to see you three months in where you've really done the gut healing before you do the test. Because if you do a test right away and you have tons of responses, you're going to be, I have nothing to eat. But really the reality is it's not about that. It's about you need to heal your leaky gut and we need to pull out the most likely suspects. So where I like to use this food sensitivity test, an IgG4 test is after about, you know, at least six weeks to 12 weeks after you've done the virgin diet, you've pulled those foods out, you've done some gut healing. If you need more gut healing on your score on the food and tolerance test, you go longer. And at that point, if you're not feeling absolutely fabulous, spectacular, this is a great time then to go and use that test, the food sensitivity test. And again, the IGG4 is my favorite. I feel it is the most accurate. And then of course, if you get that test and you see all sorts of positives, you go, holy smokes, I've got to really figure out what's going on with my gut. Right? That's what it's really measuring your gut integrity. Okay, hope that was helpful to you. I know you thought this was going to be an easy answer. Sometimes there just are no easy answers. I'll see you next time. This is JJ with Ask the Health Expert. I answer your questions weekly, plus I interview the top experts in health and wellness, so make sure you never miss a show by going to subscribe. Subscribe to JJ.com Yep, it's that easy. I'll see you next time.
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