Should the patient be on an elimination diet when the blood is drawn?

No. Testing during elimination reduces antibody titres and increases the risk of false negatives. The patient should be consuming their usual diet, including all suspect foods, for at least two weeks before collection.

Can this test diagnose coeliac disease?

No. Array 10-90 measures IgG and IgA to food proteins including wheat but does not include tissue transglutaminase or endomysial antibodies, which are the validated serological markers for coeliac disease. Suspected coeliac disease requires specific coeliac serology and, if positive, duodenal biopsy.

What if many foods come back positive?

A highly reactive panel may reflect intestinal barrier dysfunction, systemic inflammation, or polyclonal immunoglobulin elevation rather than multiple discrete sensitivities. In this scenario, address underlying gut health — permeability, dysbiosis, inflammation — and prioritise the most strongly reactive foods for initial elimination rather than instituting a broad restrictive diet.

How long does it take to receive results?

Results are typically available 10–14 business days from specimen receipt at Cyrex Laboratories, though turnaround may be longer during high-volume periods.

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Add-On: 90 Food IgG/IgA - Array 10-90

Q: Does a positive IgG result mean the patient must avoid that food permanently?

No. Positive IgG or IgA indicates immune recognition, not causation of symptoms. Results guide a time-limited elimination trial followed by systematic rechallenge to determine clinical relevance; permanent avoidance based on serology alone is not recommended and risks nutritional deficiency.

Q: Why is Array 10-90 described as an add-on test?

It is intended to complement, not replace, standard investigations such as coeliac serology, IgE allergy testing, and exclusion of organic gastrointestinal disease. The term add-on reflects its role in functional and integrative practice after baseline work-up.

Q: Are IgG food tests accepted by mainstream gastroenterology and allergy societies?

No. The American Academy of Allergy, Asthma & Immunology and the European Academy of Allergy and Clinical Immunology advise against routine IgG testing for food intolerance because IgG may represent tolerance and clinical validation is incomplete. The test is used primarily in functional and integrative medicine as an exploratory, not diagnostic, tool.

The Array 10-90 test measures serum IgG and IgA antibodies to ninety dietary proteins, offered as an exploratory tool in suspected non-IgE-mediated food sensitivity. Results guide time-limited elimination diets and rechallenge protocols in patients with chronic gastrointestinal, neurological, or dermatological symptoms; mainstream allergy societies do not endorse IgG testing for food intolerance.

Biomarkers

Blood (serum)

Sample

10–14 business days

Turnaround

Fasting

What is the Array 10-90 test?

The Add-On: 90 Food IgG/IgA - Array 10-90 test quantifies serum IgG and IgA antibodies against ninety common dietary proteins, including grains, dairy, meats, seafood, fruits, vegetables, nuts, seeds, and food additives. It is offered by Cyrex Laboratories as part of a functional immunology approach to suspected non-IgE-mediated food sensitivity. Practitioners order this array when patients present with chronic gastrointestinal symptoms, migraine, fatigue, joint pain, or skin manifestations that have not responded to standard investigations and when there is clinical suspicion that dietary antigens may contribute to immune-mediated symptomatology. The test is designated an add-on because it is intended to complement rather than replace baseline evaluations such as coeliac serology, IgE-mediated allergy testing, and exclusion of organic gastrointestinal disease. Results are used to guide time-limited elimination diets followed by structured rechallenge, not as a stand-alone diagnostic. Interpretation requires integration with symptom diaries, prior dietary exposures, and an understanding that IgG and IgA to foods are physiological responses that do not invariably correlate with clinical reactivity.

What does the Array 10-90 test measure?

IgG(Food-Specific Immunoglobulin G)

Range: Method-specific; typically reported as negative, equivocal, or positive against laboratory-derived population thresholds.Optimal: Not established; interpretation is exploratory and based on correlation with symptom diaries and elimination-rechallenge trials rather than population norms.Optical density units / Qualitative scale

IgG antibodies to food proteins represent the adaptive immune response following antigen exposure and gastrointestinal uptake. IgG production is a normal physiological response to dietary antigens; healthy individuals form IgG against frequently consumed foods. Whether elevated food-specific IgG titres reflect pathological immune activation, tolerance mechanisms, or simply antigen exposure remains contested, and the presence of IgG does not establish causation of clinical symptoms.

Food-specific IgG has been proposed as a marker of delayed or non-IgE-mediated food sensitivity, distinct from classical IgE-mediated allergy. Observational studies link elevated titres to gastrointestinal and systemic symptoms in some patients, and elimination diets guided by IgG testing have shown symptomatic benefit in subsets with irritable bowel syndrome and migraine. However, mainstream allergy and gastroenterology societies do not endorse IgG testing for food intolerance because IgG may reflect tolerance rather than reactivity, and clinical validation remains incomplete.

IgA(Food-Specific Immunoglobulin A)

Range: Method-specific; typically reported as negative, equivocal, or positive against laboratory-derived population thresholds.Optimal: Not established; results are used exploratorily alongside clinical presentation and elimination trials.Optical density units / Qualitative scale

Secretory and serum IgA form the first-line mucosal defence against luminal antigens. Food-specific IgA in serum may indicate mucosal barrier compromise or heightened mucosal immune activation. Like IgG, IgA can be present in asymptomatic individuals, and its diagnostic utility for identifying clinically relevant food reactions is not validated by consensus clinical criteria.

Food-specific IgA is hypothesised to reflect mucosal immune activation and intestinal permeability. Some functional and integrative practitioners interpret elevated IgA as evidence of ongoing barrier dysfunction or early-stage reactivity. Evidence supporting IgA-guided dietary intervention is limited to pilot and observational studies; it is not recognised by standard allergy diagnostic algorithms.

Why is the Array 10-90 test ordered?

Patients with chronic or relapsing gastrointestinal symptoms — bloating, altered bowel habit, abdominal discomfort — in whom coeliac disease, inflammatory bowel disease, and IgE-mediated allergy have been excluded
Investigation of suspected non-coeliac gluten or wheat sensitivity when standard coeliac serology and biopsy are negative yet symptoms persist on a gluten-containing diet
Chronic migraine or tension-type headache with suspected dietary triggers, particularly when standard elimination diets have been inconclusive
Unexplained chronic urticaria, eczema, or other dermatological manifestations where an immune-mediated dietary component is hypothesised
Systemic symptoms — fatigue, arthralgia, cognitive complaints — attributed by the patient to food intake and where an empiric broad elimination is being considered
Functional or integrative practice settings where food-specific antibody testing is used to personalise and focus elimination-rechallenge protocols rather than institute permanent avoidance

Sample collection and turnaround

Sample type

Blood (serum)

Fasting required

Collection method

Venipuncture at patient service centre

Turnaround

10–14 business days

Collection notes

Phlebotomy required. The patient should be consuming their usual diet, including all suspect foods, for at least two weeks before collection; testing during an elimination diet reduces sensitivity. Specimen is shipped to Cyrex Laboratories under controlled conditions per the laboratory's kit instructions.

Specimen requirements

Approximately 5 mL serum (exact volume per Cyrex kit insert). Centrifuge and separate serum promptly; freeze if shipping is delayed. Follow cold-chain and packaging requirements specified in the Cyrex Array 10-90 collection kit to ensure antibody stability.

What can affect Array 10-90 results?

reducesRecent or current elimination diet

Removal of an antigen from the diet reduces circulating antibody titres over weeks to months, so testing during elimination may yield false-negative results; the test is most informative when the patient is consuming their usual varied diet.

reducesSystemic immunosuppression or immunoglobulin deficiency

Glucocorticoids, biologics, or primary antibody deficiencies lower IgG and IgA production, potentially masking antibody responses and rendering the test uninterpretable.

elevatesGastrointestinal infection or acute inflammatory flare

Acute barrier compromise and systemic inflammation can transiently increase antibody titres to multiple foods, reducing specificity; testing is ideally performed in a stable clinical state.

variableCross-reactivity between related food proteins

Homologous epitopes shared by botanically or taxonomically related foods (e.g., cow and goat dairy; wheat, barley, rye) can produce co-positive results that do not reflect independent sensitivities.

elevatesHigh total immunoglobulin levels

Polyclonal hypergammaglobulinaemia from chronic infection, autoimmunity, or liver disease can elevate food-specific antibodies non-specifically; correlating with total IgG and IgA aids interpretation.

What do Array 10-90 results mean?

Elevated

Elevated IgG or IgA to one or more foods indicates immune recognition of those antigens but does not confirm causation of symptoms. Positive results are used to prioritise foods for a time-limited (typically 4–6 weeks) elimination trial, followed by systematic rechallenge to determine clinical relevance. The number and intensity of positive reactions guide the scope of elimination; highly reactive panels may reflect barrier dysfunction or systemic inflammation rather than multiple discrete sensitivities.

Normal

A negative or minimally reactive panel suggests that IgG/IgA-mediated food reactions are unlikely contributors to the patient's symptoms. Other mechanisms — fermentable carbohydrates, direct pharmacological effects (histamine, salicylates), gut dysbiosis, visceral hypersensitivity — should be explored, and empiric dietary trials may still be warranted based on clinical suspicion.

Reduced

Absent or uniformly low antibodies may occur in patients on restrictive diets, those with immunodeficiency, or individuals with genuinely low antigen exposure. A negative result does not exclude non-immune food intolerances (e.g., lactose intolerance, FODMAP sensitivity) or IgE-mediated allergy, which require separate testing.

Note: IgG and IgA to foods are not diagnostic tests; they are exploratory tools whose clinical validity is debated. Mainstream allergy societies, including the American Academy of Allergy, Asthma & Immunology and the European Academy of Allergy and Clinical Immunology, advise against routine IgG testing for food intolerance because IgG may represent tolerance. Use results to inform, not dictate, dietary trials, and always correlate with symptom response. Permanent broad elimination based on serology alone risks nutritional deficiency and disordered eating; rechallenge is essential.

Frequently asked questions

Traditional allergy testing measures IgE antibodies, which mediate immediate reactions such as hives, angioedema, and anaphylaxis. IgG and IgA food testing is proposed for delayed or non-IgE-mediated sensitivity, but this use is not validated by mainstream allergy societies because IgG can reflect normal exposure or tolerance rather than reactivity.

How to access the Array 10-90 test

The Array 10-90 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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About this page

Published: October 7, 2026

Last reviewed: October 7, 2026

References:

Stapel SO, et al. EAACI task force report: testing for IgG4 against foods is not recommended as a diagnostic tool. Allergy. (2008)
Biesiekierski JR, et al. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology. (2013)
Atkinson W, et al. Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial. Gut. (2004)
Ligaarden SC, et al. IgG and IgG4 antibodies in subjects with irritable bowel syndrome: a case control study in the general population. BMC Gastroenterol. (2012)
Carroccio A, et al. Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity. Am J Gastroenterol. (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.