From the Research
IgE testing on steroids is not recommended as corticosteroids can potentially suppress allergic responses and lead to false negative results. If IgE testing is necessary, it's best to discontinue oral corticosteroids (like prednisone) for at least 7-10 days before testing when medically feasible, as supported by the study on the effect of corticosteroids on immunoglobulins 1. For inhaled or topical steroids, discontinuation may not be necessary as their systemic effects are minimal. However, high-dose inhaled steroids might still affect results, as shown in the study on inhaled steroid inhibition of total and mite IgE development 2. If steroids cannot be discontinued due to medical necessity, this should be noted when interpreting test results. The reason for this recommendation is that corticosteroids work by suppressing immune responses, including those mediated by IgE antibodies, which are what allergy tests measure. Testing while on steroids may underestimate the true allergic sensitivity, potentially missing clinically relevant allergies. Always consult with the allergist or immunologist performing the test for specific guidance on medication management before testing.
Some key points to consider:
- Corticosteroids can suppress immune responses, including those mediated by IgE antibodies 1
- Inhaled corticosteroids can inhibit the development of total and mite IgE 2
- Discontinuation of oral corticosteroids for at least 7-10 days before testing is recommended when medically feasible
- High-dose inhaled steroids may still affect IgE test results
- Consultation with an allergist or immunologist is necessary for specific guidance on medication management before testing
It's also important to note that the use of corticosteroids, even for short-term periods, can have significant adverse effects, as highlighted in the study on short-term systemic corticosteroids 3. Therefore, the decision to discontinue or continue corticosteroids before IgE testing should be made with caution and under the guidance of a healthcare professional. Additionally, alternative treatments, such as anti-IgE antibodies, may be considered for patients with documented steroid allergy, as mentioned in the study on immunoglobulin E-mediated reactions to corticosteroids 4.