What kind of allergy testing does Hisential offer?

Hisential offers specific IgE blood testing (also called RAST or ImmunoCAP testing). This identifies sensitisation to specific food, inhalant, and other allergens. Skin prick testing is available at specialist allergy services and can be referred where appropriate.

Should I get allergy testing if I have no symptoms?

Generally, no. Random allergy testing without symptoms produces results that are difficult to interpret - positive results without clinical reactions are common and can lead to unnecessary food avoidance. Testing is most useful when targeted to suspected allergens based on symptoms.

What allergens are commonly tested?

Common food allergen panels include: peanuts, tree nuts, eggs, dairy, soy, wheat, fish, shellfish. Common environmental panels include: dust mites, cat dander, dog dander, cockroach, fungi, grass and tree pollens. Customised panels are arranged based on your symptom history.

What's the difference between allergy and intolerance?

Allergy is an immune-mediated reaction (typically IgE-mediated) producing symptoms like hives, swelling, breathing difficulty, or anaphylaxis. Intolerance (e.g. lactose intolerance) is non-immune, typically gastrointestinal, and not detected by IgE testing. Different tests are needed for different conditions; commercial 'food intolerance' IgG tests have very limited evidence and are not used at Hisential.

Can adults develop new allergies?

Yes. While many allergies start in childhood, adults can develop new allergies at any age. Common adult-onset allergies include shellfish, certain medications, and environmental allergens. Sudden onset of allergic symptoms in adulthood warrants medical assessment.

What happens if my test is positive?

A positive specific IgE confirms sensitisation but must be interpreted alongside your symptom history. Your doctor will discuss whether the result represents clinical allergy, what avoidance strategies are appropriate, what to do in case of accidental exposure, whether sublingual allergen immunotherapy (SLIT) is an option, and whether referral to a specialist allergy service is indicated.

Do you offer allergen immunotherapy, or do I need a specialist referral?

Hisential provides sublingual allergen immunotherapy, also known as SLIT, for proven clinical allergy, so a specialist referral is not required to start it. We offer the sublingual route only. Subcutaneous immunotherapy, venom immunotherapy and food oral immunotherapy are not provided here and are referred to a specialist allergy service where indicated.

How long does immunotherapy take, and what improvement is realistic?

A course usually runs for about three years of continuous daily treatment, and stopping early reduces the chance of lasting benefit. Improvement is measured as a reduction in symptom scores and in the amount of medication needed, rather than as a cure, and the degree of benefit varies between individuals. Long-term follow-up shows that benefit can persist for years after a completed course.

What is component-resolved diagnostics and do I need it?

Component-resolved diagnostics (CRD) measures IgE to specific protein components within an allergen rather than the whole-extract. It is most useful for distinguishing primary allergy from cross-reactivity (e.g. peanut Ara h 2 vs Ara h 8) and for risk-stratifying severity. CRD is offered through specialist allergy services where indicated; we refer when the additional information would change management.

Can allergy testing predict anaphylaxis risk?

Specific IgE level can correlate with reaction likelihood for some allergens, but it is an imperfect predictor of severity. The most informative tool remains a careful clinical history, including past reaction pattern and the dose that triggered symptoms. Severity prediction is part of the consultation rather than a number on a printout.

Should children be tested for allergies at this clinic?

We offer allergy testing from age 5 upwards. For children under 5, we can advise on appropriate paediatric allergy services in Singapore.

Are environmental allergies in Singapore really that common?

Yes. Tropical climates favour year-round dust mite exposure (notably Blomia tropicalis, common in Southeast Asia), persistent fungal allergens, and indoor cockroach exposure. Allergic rhinitis and asthma driven by these allergens are very common in Singaporean adults, often misattributed to 'sinus problems' or recurrent colds.

Allergy Testing in Singapore

Q: How is allergy testing performed?

At Hisential, allergy testing is performed via a single blood draw on-site. Specific IgE levels for the agreed allergen panel are measured. No fasting required; antihistamines do not need to be stopped (unlike skin prick testing). Results typically return within 5-7 working days.

Q: What conditions can allergen immunotherapy treat?

SLIT is not limited to hay fever type symptoms. The guideline-supported indications for a sublingual service are allergic rhinitis and rhinoconjunctivitis that remain inadequately controlled on medication, and house dust mite-driven allergic asthma as an add-on to controller therapy in patients with confirmed mite sensitisation and suboptimal control. Eczema (atopic dermatitis) with confirmed house dust mite sensitisation may also be considered, on weaker evidence, as an add-on where skin-directed treatment is not controlling it. Insect venom allergy and food allergy require immunotherapy routes we do not provide, and are referred.

Q: Can immunotherapy help eczema?

It can be considered in some people, but the evidence is weaker than for rhinitis and mite-driven asthma. Professional guidance describes SLIT as a possible therapy for mild eczema (atopic dermatitis) rather than an established one, and it is currently best supported in people with confirmed house dust mite sensitisation. Where eczema is mite-driven and remains troublesome despite skin-directed care, SLIT can be discussed as an add-on. It does not replace emollients, topical anti-inflammatory treatment or trigger management, and suitability is decided in consultation after testing.

When does allergy testing actually help?

Allergy testing is most useful when there is a specific clinical question to answer. The right pattern is: a person experiences symptoms, suspects a particular trigger, testing is done to confirm or refine that suspicion, and the result is interpreted in the context of the symptoms.

The wrong pattern is: a person without specific symptoms gets a broad allergy panel and receives a list of "positives" that may not represent clinical allergy at all. This produces unnecessary food avoidance, anxiety, and (sometimes) genuine harm from over-restriction of diet.

Hisential's approach is targeted: testing is informed by a careful history, panels are designed around the actual clinical question, and results are interpreted with appropriate caution.

What kind of allergy testing is offered?

Specific IgE blood testing (also known as RAST or ImmunoCAP testing) is the primary allergy test offered at Hisential. This measures the level of allergen-specific IgE antibodies in your blood for individual allergens.

Advantages:

Single blood draw
No need to stop antihistamines (unlike skin prick testing)
No risk of severe reaction during testing (unlike challenge testing)
Results quantitative and reproducible

Limitations:

Detects sensitisation, not necessarily clinical allergy
Positive results without symptoms are common and require careful interpretation
Some food allergies (particularly delayed reactions) are not IgE-mediated and not detected
Specialist allergy services offer additional testing (skin prick, challenge testing, component-resolved diagnostics) where indicated; Hisential refers when appropriate

What allergens can be tested?

Common test panels include:

Food allergens

Peanuts and tree nuts
Eggs
Dairy proteins (milk)
Soy
Wheat
Fish (specific species)
Crustacean shellfish (prawns, lobster)
Other foods based on symptom history

Environmental (inhalant) allergens

House dust mites (Dermatophagoides pteronyssinus, D. farinae, Blomia tropicalis - the latter relevant in tropical climates including Singapore)
Cat and dog dander
Cockroach
Fungi (Alternaria, Aspergillus, others)
Tree, grass, and weed pollens

Other allergens

Latex
Specific drugs (selected - many drug allergies require specialist testing)
Insect venoms

Custom panels are arranged based on your specific clinical history.

Allergy vs intolerance - important distinction

Allergy is an immune-mediated reaction, typically producing symptoms within minutes to hours: hives, swelling, breathing difficulty, gastrointestinal symptoms, or in severe cases anaphylaxis. IgE testing detects most clinical allergies.
Intolerance is non-immune. Lactose intolerance is the classic example - caused by enzyme deficiency, producing gastrointestinal symptoms after dairy. Histamine intolerance, FODMAP-related symptoms, and many other patterns fall here. These are not detected by IgE testing.
Coeliac disease (gluten-related enteropathy) is autoimmune, not allergic - different testing is required.

Some commercially marketed "food intolerance" tests use IgG or IgG4 measurement. The European Academy of Allergy and Clinical Immunology's task force concluded that food-specific IgG4 is not a marker of food allergy or intolerance and should not be used as a diagnostic tool 1, so these tests are not used or recommended at Hisential.

When should adults consider allergy testing?

Worth considering if you have:

Recurrent unexplained urticaria (hives) or angioedema
Suspected food-triggered reactions, particularly involving multiple body systems
New-onset rhinitis, sinusitis, or asthma without clear cause
Suspected occupational allergen exposure
Family history of significant allergy and unexplained symptoms
A history of severe reaction (anaphylaxis) where the trigger was not clearly identified

For typical seasonal sniffles or mild symptoms with obvious triggers, testing often adds little - symptomatic management is the same regardless.

How is allergy testing performed at Hisential?

Detailed history. Symptom pattern, suspected triggers, family history, response to any avoidance attempts, current medications.
Examination focused on relevant systems (skin, respiratory, gastrointestinal).
Test panel design. Targeted to the clinical question rather than indiscriminate.
Single blood draw on-site.
Results return within 5-7 working days.
Results consultation. Every positive interpreted in context. Avoidance strategies discussed where allergy is confirmed. Action plan for accidental exposure (including emergency adrenaline auto-injector where appropriate). Referral to specialist allergy services if needed.

What does management look like after testing?

Depending on the findings:

Avoidance strategies for confirmed clinical allergies
Allergic action plan including what to do if exposure occurs
Emergency medication prescription (antihistamines; adrenaline auto-injector for anaphylaxis risk)
Symptomatic management for environmental allergies (intranasal steroids, antihistamines, allergen-reduction in the home)
Vaccination considerations where relevant (e.g. flu vaccine in egg allergy)
Sublingual allergen immunotherapy (SLIT) for confirmed, clinically significant IgE-mediated allergy that is not adequately controlled by avoidance and symptomatic medication. This is provided at Hisential, so no specialist referral is required to start it. We offer the sublingual route only.
Specialist referral for complex cases (severe reactions, occupational allergy, and immunotherapy routes we do not provide)

What SLIT involves, what it treats, and how well it works

Sublingual allergen immunotherapy, usually shortened to SLIT, works by giving controlled, repeated doses of the allergen you react to, taken under the tongue, so the immune response to it gradually changes. It is the only current treatment that modifies the underlying allergic response rather than only suppressing symptoms while it is being taken 4.

What it treats. It is not limited to rhinoconjunctivitis. The guideline-supported indications relevant to a sublingual service are allergic rhinitis and rhinoconjunctivitis that remain inadequately controlled on optimised medication 4, and house dust mite-driven allergic asthma as an add-on to controller therapy in patients with confirmed mite sensitisation and suboptimal control 7.

Eczema (atopic dermatitis). SLIT is also discussed for eczema, and here the evidence is weaker. Professional guidance describes SLIT as a possible therapy for mild eczema rather than an established indication 9, and the signal is clearest in people with confirmed house dust mite sensitisation. Where eczema is mite-driven and remains troublesome despite skin-directed care, SLIT can be considered as an add-on. It does not replace emollients, topical anti-inflammatory treatment, or reducing mite exposure at home, and whether it is reasonable in your case is decided in consultation after testing.

What is not offered here. Insect venom immunotherapy, whose evidence base is subcutaneous, and food oral immunotherapy, which is a specialist service. Both are referred rather than provided.

Key facts on effect:

Course length. Treatment is taken daily and typically continues for about three years; stopping early reduces the likelihood of benefit persisting afterwards 4.
Rhinitis. In a randomised, double-blind, placebo-controlled phase III trial of the house dust mite sublingual tablet in mite-driven allergic rhinitis, treated participants had lower rhinitis symptom and medication scores than placebo over the treatment period 5.
Asthma. In a randomised clinical trial of the house dust mite sublingual tablet in adults with mite-driven allergic asthma, the tablet reduced the risk of a moderate to severe asthma exacerbation during inhaled corticosteroid reduction compared with placebo 6.
Durability. Long-term follow-up of grass pollen immunotherapy showed that benefit was maintained for several years after a completed course was stopped 8.

These are group averages from trial populations, not a prediction for any one person. The realistic goal is fewer symptoms and less reliance on daily medication, not a guaranteed cure, and response varies between individuals. Whether immunotherapy is appropriate for you depends on your test results, your symptom history, and how well current treatment is working, and is decided in consultation.

How much does allergy testing cost in Singapore?

Consultation: S$50 after GST
Teleconsultation (follow-ups): S$50 after GST
Test panel cost: Depends on the number of allergens; discussed transparently before testing

There are no hidden charges.

Patient pathway and follow-up

A complete clinical episode at Hisential is structured around four clearly-defined stages, so patients understand what to expect at each visit and how decisions are made.

Stage 1 - Pre-consultation triage

Before your first appointment for allergy testing, our care coordinators take a brief history by WhatsApp or phone to determine whether teleconsultation, an in-clinic visit, or a same-day workup is most appropriate. This avoids unnecessary travel for issues that can be triaged remotely, and ensures patients with urgent presentations are prioritised. Where laboratory tests, imaging, or fasting are likely to be needed, we explain the requirements in advance so the first visit is productive rather than purely exploratory.

Stage 2 - In-clinic assessment

The first consultation includes a structured medical history, focused examination, and - where clinically indicated - point-of-care or laboratory investigations. Doctors document findings in our digital records system and walk patients through the rationale for each test. Costs are confirmed before any chargeable investigation is performed; nothing is added without consent.

Stage 3 - Diagnosis, plan, and shared decision-making

Once results are available, the doctor reviews them with the patient in plain language, including normal ranges, areas of concern, and the level of evidence behind any proposed intervention. For allergy testing, treatment options are framed in terms of expected benefit, realistic timelines, side-effect profile, and cost. Patients are encouraged to ask questions and may request a second appointment to consider their options before starting treatment - there is no pressure to decide on the day.

Stage 4 - Follow-up and continuity

Follow-up intervals are agreed at the end of the first visit and depend on the condition: chronic management is typically reviewed every 3-6 months, while acute episodes may be reviewed within 1-4 weeks. Teleconsultation (from S$50 after GST) is offered for routine follow-ups where physical examination is not required. Records are retained securely and remain accessible to the patient on request, including for onward referral or coordination with another doctor.

What we will not do

Hisential does not sell unproven therapies, does not recommend tests without a clinical indication, and does not extend treatment courses beyond what the evidence supports. If a condition falls outside our scope - for example, requiring inpatient care, surgical sub-specialty input, or oncology services - we say so and refer appropriately. Honest scope is part of the standard.

Reading an allergy test report intelligently

A specific IgE result is a number, not a diagnosis. Interpreting it well requires context:

Sensitisation vs. clinical allergy. A positive IgE means your immune system has produced antibodies to that allergen. It does not, by itself, mean you will react clinically. Many sensitised people consume the food without symptoms.
Magnitude. Higher IgE levels generally correlate with higher likelihood of clinical reaction, particularly above defined thresholds (which vary by allergen). But the threshold is statistical, not absolute.
Cross-reactivity. IgE can react to similar protein structures across foods or pollens (e.g. birch pollen and apple in oral allergy syndrome). Component-resolved diagnostics helps disentangle this where it matters.
History dominates. A negative test in someone with a clear, reproducible history of reaction does not necessarily exclude allergy - there are non-IgE mechanisms and false negatives.

The right interpretation comes from combining the test result with your symptom history, not reading the printout in isolation.

Common Singaporean allergy presentations we see

In our clinic population, several patterns recur:

Persistent rhinitis with year-round exposure - usually dust mite (including the tropical species Blomia tropicalis), often combined with cockroach and fungal allergens. House dust mite sensitisation is the dominant driver of allergic rhinitis in young adults studied in Singapore 2, and mite sensitisation is established early in Singaporean children 3.
Adult-onset shellfish allergy - particularly to crustacean (prawn, lobster, crab). Once established, often severe and lifelong.
Drug hypersensitivity - most commonly to certain NSAIDs, beta-lactam antibiotics, or contrast media. Most drug allergies require specialist testing rather than serum IgE alone.
Latex allergy in healthcare workers and others with frequent exposure.
Food-exercise-induced anaphylaxis - typically to wheat or shellfish, where the food is tolerated alone but reacts on exertion. Easily missed without a careful history.

When to escalate to a specialist allergy service

Hisential provides primary allergy assessment, testing, interpretation, and management. We refer to specialist allergy / immunology services when:

Anaphylaxis has occurred or is plausible based on history
The diagnosis remains unclear after structured testing
Subcutaneous immunotherapy, venom immunotherapy or food oral immunotherapy is required
Drug allergy clarification requires controlled challenge testing
Component-resolved diagnostics or specialist food challenges are needed
Occupational allergy or work-related symptoms need formal investigation

Referral pathways are managed transparently, and we do not refer reflexively - only when the specialist input genuinely changes management.

Related services

Book an allergy assessment

Hisential Clinic Orchard - 333A Orchard Road, #04-13 Mandarin Gallery, Singapore 238897 (across from 313@Somerset, Somerset MRT). Open weekdays 10:00 AM - 7:00 PM, Sat-Sun 10:00 AM - 5:00 PM.

The information on this page is for general educational purposes and does not constitute medical advice. MOH HCSA Licence L/24M2064/MDS/001/242.

How Hisential approaches your care

Every Hisential patient is paired with a Personal Health Concierge - one named contact who coordinates your screening, doctor visits, follow-up tests, and treatment plan end-to-end. We start with a structured intake, agree clear clinical thresholds for action, and only escalate to medication, imaging, or specialist referral when the data supports it. Results are explained in person, not emailed. Recalls, repeat tests, and referrals are scheduled for you so nothing slips between providers - consistent care from one point of contact.