144 Food Panel: IgA/IgG
The 144 Food Panel: IgA/IgG measures serum antibodies to 144 food antigens via dried blood spot, intended to guide elimination diets in functional medicine. Major allergy societies state IgG reflects exposure not pathology; the test is exploratory, not diagnostic, and results must be correlated with symptoms and rechallenge trials.
2
Biomarkers
Dried blood spot
Sample
10–14 business days
Turnaround
No
Fasting
What is the 144 Food Panel test?
The 144 Food Panel: IgA/IgG measures serum antibody responses to 144 individual food antigens, spanning common staples, grains, dairy, proteins, fruits, vegetables, nuts, seeds, legumes, spices, and additives. It is positioned as a tool to identify foods that may trigger non-IgE-mediated immune activation and contribute to chronic gastrointestinal symptoms, systemic inflammation, fatigue, skin complaints, and other functional disorders. Practitioners in integrative, functional, and naturopathic medicine order this panel when patients present with unexplained symptoms that have not responded to conventional investigation or when there is suspicion of multiple food sensitivities. The test does not diagnose IgE-mediated food allergy — that requires separate allergen-specific IgE (RAST) or skin-prick testing — and it is not endorsed by mainstream allergy or gastroenterology guidelines. Instead, it serves as a hypothesis-generating adjunct to guide structured elimination diets, with the expectation that symptomatic improvement during avoidance of high-reactivity foods, followed by symptom recurrence on rechallenge, validates the relevance of those foods. Results must be interpreted in the full clinical context, recognising that elevated antibodies to a food can reflect frequent consumption rather than pathology, and that eliminating foods based on serology alone risks unnecessary dietary restriction.
What does the 144 Food Panel test measure?
Immunoglobulin A is the principal antibody class in mucosal secretions, including the gastrointestinal tract, where it functions as a first-line defence against luminal antigens. Secretory IgA is produced by plasma cells in the lamina propria and transported across epithelial cells into the gut lumen, where it binds dietary proteins, bacteria, and other antigens without triggering inflammation. Serum IgA represents both mucosal and systemic production; elevated food-specific IgA antibodies are interpreted as evidence of repeated mucosal exposure and a local immune response to particular food antigens.
Food-specific IgA is proposed as a marker of non-IgE-mediated food sensitivity and mucosal immune activation. Proponents suggest that elevated titres reflect ongoing immune engagement with incompletely digested or abnormally presented food proteins, often in the setting of increased intestinal permeability or dysbiosis. Measurement of IgA alongside IgG is intended to capture both mucosal and systemic immune responses. The clinical significance of isolated IgA elevations without corresponding symptoms remains contested, and interpreting results requires correlation with dietary patterns, gastrointestinal symptoms, and response to elimination.
Immunoglobulin G is the most abundant serum antibody, providing long-term systemic immunity to pathogens and other antigens. IgG antibodies to food proteins are detectable in most healthy individuals as a normal consequence of dietary exposure and oral tolerance induction; they represent immunological memory rather than active inflammation. IgG has four subclasses (IgG1–IgG4), each with distinct effector functions; IgG4 in particular is associated with tolerance and is upregulated during desensitisation.
Food-specific IgG testing is widely used in functional and integrative medicine to guide elimination diets, but its clinical validity is contested. Mainstream allergy and gastroenterology societies — including the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology — state that IgG antibodies to foods reflect exposure, not pathology, and do not recommend IgG testing for the diagnosis of food allergy or intolerance. Proponents argue that patterns of IgG reactivity, particularly when correlated with symptoms and dietary trials, can identify foods contributing to chronic inflammation, gastrointestinal distress, and systemic complaints. Practitioners who order this panel typically do so to inform empirical elimination-rechallenge protocols rather than to establish a diagnosis.
Why is the 144 Food Panel test ordered?
- Patients with chronic functional gastrointestinal symptoms — bloating, abdominal pain, altered bowel habit — who have not responded to first-line therapies and in whom coeliac disease and inflammatory bowel disease have been excluded
- Individuals with recurrent or treatment-resistant dermatological complaints such as eczema, urticaria, or rosacea where dietary triggers are suspected
- Patients reporting fatigue, 'brain fog,' joint pain, or other systemic complaints attributed to diet, particularly when standard investigations are unrevealing
- Those seeking a structured, data-informed approach to elimination diets rather than anecdotal or untargeted restriction
- Practitioners working within integrative or functional-medicine frameworks who use food-antibody panels as part of a broader assessment of immune dysregulation and gut health
- Monitoring response to gut-repair protocols or probiotic interventions where practitioners wish to track changes in food-antibody patterns over time, though the evidence base for this application is limited
Sample collection and turnaround
Sample type
Dried blood spot
Fasting required
No
Collection method
Finger prick
Turnaround
10–14 business days
Collection notes
Patient self-collection via finger-prick lancet; blood is applied to a filter-paper card and allowed to air-dry. The kit includes detailed instructions, lancets, alcohol wipes, gauze, and a return envelope. Patients should wash and dry hands thoroughly before collection, allow the first drop of blood to form naturally rather than squeezing excessively, and fill all required circles on the card without layering or clotting. The dried card is stable at room temperature during postal return. Avoid collection during acute illness or within 48 hours of starting or stopping a suspected trigger food, as this may transiently alter antibody levels.
Specimen requirements
Fully saturated dried blood spots on the provided filter-paper card. Incomplete or insufficient samples may be rejected or yield indeterminate results. Note that a dried-blood-spot specimen yields lower total antibody concentrations than venous serum, so reference ranges are specific to the collection method and cannot be compared to serum-based assays.
What can affect 144 Food Panel results?
IgG and IgA antibodies rise with repeated exposure, so foods eaten frequently are more likely to show elevated titres; this reflects exposure, not necessarily intolerance, and can lead to false-positive interpretation if the clinical context is ignored.
Conditions that compromise the gut barrier — coeliac disease, inflammatory bowel disease, intestinal infection, non-steroidal anti-inflammatory drugs, alcohol — allow intact food proteins to reach the lamina propria and stimulate antibody production, potentially elevating antibody titres to multiple foods.
Approximately one in 300–700 individuals has selective IgA deficiency, resulting in undetectable or very low serum IgA; in these patients IgA results are not interpretable and IgG or IgE testing should be relied upon instead.
Corticosteroids, biologics, chemotherapy, and primary immunodeficiencies blunt antibody responses, potentially yielding false-negative results even in the presence of clinically relevant food reactions.
Proteins in botanically or taxonomically related foods (for example, different tree nuts, or various legumes) may share epitopes, leading to antibody binding across multiple foods; this can appear as polysensitisation on the panel but may reflect reactivity to a single dominant antigen.
Food-antibody assays are not standardised; results and reference ranges differ between laboratories and cannot be compared directly. Serial testing should use the same laboratory and methodology.
What do 144 Food Panel results mean?
Elevated
Elevated IgA or IgG to a specific food indicates immune recognition and antibody production against that antigen. In functional-medicine interpretation this is taken as a signal to consider temporary elimination of the food, with reintroduction after a defined period (commonly 4–12 weeks) to assess whether symptoms improve and then recur. The pattern of reactivity — whether isolated or widespread, and whether IgA and IgG are concordant — informs the elimination strategy. Multiple high-level reactivities may suggest increased intestinal permeability or dysbiosis rather than specific food intolerance, prompting broader gut-health interventions. Crucially, elevated antibodies do not equate to clinical intolerance; correlation with symptoms and dietary rechallenge is essential.
Normal
A 'normal' result — minimal reactivity across the panel — suggests that immune-mediated food sensitivity is unlikely to be the primary driver of the patient's symptoms. Other causes should be explored, including small intestinal bacterial overgrowth, bile-acid diarrhoea, pancreatic insufficiency, and functional gastrointestinal disorders. A normal panel does not exclude IgE-mediated allergy, which requires separate testing.
Reduced
Low or absent antibodies to the tested foods indicate either infrequent exposure to those antigens or an effective tolerance mechanism. Widespread low reactivity is typical in individuals who have already restricted their diet or who have robust oral tolerance, and it does not exclude food intolerance mediated by non-antibody pathways (for example, enzymatic deficiencies such as lactase deficiency, or direct histamine release).
Note: This panel is exploratory and not a stand-alone diagnostic tool. Major allergy societies do not endorse IgG testing for food intolerance, and the presence of antibodies can reflect exposure rather than pathology. Results must be integrated with a detailed dietary and symptom diary, and elimination should be followed by structured rechallenge to confirm clinical relevance. Avoid indiscriminate or prolonged restriction of multiple foods based on serology alone, as this risks nutritional deficiency and disordered eating. Patients with suspected IgE-mediated allergy require separate allergen-specific IgE or skin-prick testing and should not undergo home rechallenge of high-risk allergens.
Frequently asked questions
IgE mediates immediate allergic reactions (anaphylaxis, urticaria) and is the validated standard for diagnosing food allergy. IgA and IgG are proposed markers of non-IgE food sensitivity; IgA reflects mucosal exposure, IgG reflects systemic exposure and is present in healthy individuals as a marker of tolerance. Mainstream allergy societies do not endorse IgG testing for intolerance.
How to access the 144 Food Panel test
The 144 Food Panel reference page is free and open to all practitioners. Create a free practitioner account to see pricing, save tests to your list, and generate requisition forms. Verification takes 1–2 business days.
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Published: October 7, 2026
Last reviewed: October 7, 2026
- Stapel SO, et al. Testing for IgG4 against foods is not recommended as a diagnostic tool: EAACI Task Force Report. Allergy. (2008)
- Canonica GW, et al. A WAO–ARIA–GA²LEN consensus document on molecular-based allergy diagnostics. World Allergy Organ J. (2013)
- Bischoff SC, et al. EAACI position paper: Food allergy and anaphylaxis guidelines. (2014)
- Carr S, et al. CSACI position statement on the testing of food-specific IgG. Allergy Asthma Clin Immunol. (2012)
This content is for licensed healthcare practitioners only and does not constitute medical advice. Clinical decisions should be based on the full clinical picture and not on any single test result.