I paid for this test myself at full price. There is no affiliate arrangement with the laboratory and they have no idea I have written this. The one affiliate link in this post is to the antihistamine I actually take, marked where it appears. If you buy through it I may earn a small commission at no extra cost to you.
It is 3am in April and I am awake because I cannot breathe through my nose. This happens every spring. I have always filed it under hay fever, taken the tablet, and got on with it.
What I did not know, until this summer, is that the thing keeping me awake in April is ash pollen. Not grass. Not tree pollen in some vague general sense. Ash, specifically, which is the one tree I had never once considered.
I found that out from a home allergy test UK labs will sell to anyone with a credit card, and the interesting part is not the result. It is that working out which test to buy took about six weeks, and taking it took about two minutes. Most of the consumer allergy market is selling something that does not work. Separating that from the thing that does was the actual job.
Why bother at all
I take Allevia every day from roughly March to August. Fexofenadine, one tablet, and it is the difference between a functioning spring and a miserable one. I have taken it for years without ever knowing what I was taking it for.
That is a slightly odd position to be in when you think about it. I am managing a response without knowing the trigger. If you know the trigger you can sometimes avoid it, sometimes treat it properly, and occasionally get rid of it altogether. If you do not, you take the tablet forever.
That reframes allergy testing from a wellness indulgence into an actual question with an actual payoff. Allevia makes life bearable. Knowing why I need it might eventually mean needing less of it.
It took me a long time to get to Allevia, and this is the part I would most like someone to have told me twenty years ago. For years I worked along the supermarket shelf. Every own brand box, every cheap pack of cetirizine and loratadine, one after another, season after season. They took the edge off. That was about all they did. I assumed hay fever was simply something you endured at a certain level and that I had found my level.
Then a doctor prescribed fexofenadine, which is the drug in Allevia. A different tablet doing the same job in the same place, and for me a completely different outcome. Bazinga. For the first time the symptoms actually came down rather than being slightly muffled. I had spent the best part of two decades assuming hay fever was the problem, when a good part of the problem was that I had never happened to try the right tablet.
And here is the bit I would rather not write down. On the really bad days one tablet does not hold it, and I take a second. That is more than the box says and more than I have been told to take, and I do it anyway, because the alternative is writing off a day to being thoroughly miserable. I am not recommending that and I would rather you did not copy me. What I should have done years ago, and what I am finally doing now, is treat it as information rather than a workaround. Needing to double up means the thing is not properly controlled, and there are real answers to that which are better than quietly taking two. Some of them are a different dose, some are a completely different type of treatment aimed at the part of the problem an antihistamine was never going to touch. All of them start with telling a GP the truth about what you are actually taking.
There was also a funding route. My Medicash health cash plan has an Alternative Therapies allowance of about £250 a year, which I have never touched. Worth noting what else sits in that category: reflexology, reiki, homeopathy, hypnotherapy. Allergy testing is the only thing on that list with a real evidence base behind it, and it is filed alongside the rest of them.
So is Allevia actually better, or just better suited to me
I went and looked this up properly, because I had been telling people fexofenadine was better and I wanted to know whether that was true or whether I had simply got lucky.
The short version is that it is not better. It is better suited. Those are not the same thing, and the difference might save you the twenty years I spent on the wrong shelf.
What these tablets actually do
When your immune system meets something it has decided is a threat, it releases histamine. The histamine then docks with receptors around the body, and the ones behind the sneezing, the streaming and the itching are called H1 receptors.
An antihistamine does not remove the histamine. It parks in the space so the histamine cannot. That is the whole trick, and every tablet on that shelf is doing the same job in the same place. Which raises the reasonable question of why there are so many of them.
The first generation, and why they knock you out
The originals, chlorphenamine and diphenhydramine among them, work perfectly well. The problem is that they are small and fat soluble, so they do not stay where they are wanted. They cross into the brain, where H1 receptors are busy doing something else entirely involving staying awake, and they block those too.
That is the drowsiness. It is not a side effect in the sense of something unexpected going wrong. It is the same drug doing the same job in the wrong building. It is also why these turn up in night time cold remedies, where being knocked out is the selling point rather than the complaint.
The second generation, and the one that had to be withdrawn
So the next lot were built to stay out of the brain. Loratadine and cetirizine are the two you will recognise from the supermarket shelf, and they are what I spent years working through.
There was a third, and its story is the reason I now take what I take. Terfenadine, sold here as Triludan, was enormous through the 1980s and early 1990s. Then it emerged that as well as blocking histamine receptors it also blocked a potassium channel in the heart, which can stretch out the electrical cycle of a heartbeat and, rarely, tip it into a dangerous rhythm. It was worse if you were also on certain antibiotics or antifungals, or if you drank grapefruit juice, because those slow down the liver enzyme that clears it. It was withdrawn in the late 1990s.
Here is the part I find genuinely satisfying. Your liver was never really using terfenadine anyway. It converted it, almost immediately, into a different compound, and that compound was doing the actual antihistamine work. It does not touch the potassium channel at all. The danger was in the version you swallowed, not the version your body made out of it.
So they stopped selling the risky parent drug and started selling the safe end product directly. That end product is fexofenadine. The tablet I take every morning is the useful half of a drug that had to be pulled off the market, and it exists because somebody worked out exactly which part was doing the good and which part was doing the harm.
The honest comparison
Now the bit I was not especially hoping to find. On effectiveness, the evidence does not support fexofenadine being better. Head to head, standard doses of fexofenadine, cetirizine and loratadine come out roughly level for hay fever symptoms, and no second generation antihistamine has been shown to be conclusively better than the rest. If anything cetirizine edges ahead of loratadine in some studies.
Where fexofenadine genuinely does differ is drowsiness. Cetirizine can be measurably sedating at a normal dose, which surprises people who assume everything modern is equally clear headed. Loratadine tends to be fine at a normal dose and less fine above it. Fexofenadine has been found free of sedative effects even above the recommended dose, because it is the one that stays most stubbornly out of the brain.
For someone who drives a van, sails a boat and climbs on a Tuesday evening, that is not a small thing. But it is a different claim from being more effective, and I had been quietly making the wrong one.
So what actually happened to me
People do respond differently to different antihistamines, and that is well recognised rather than something I have invented to explain myself. Finding the one that suits you is a real thing, not a placebo story.
But I have to be straight about the rest. I have one person’s experience, no control, no blinding, and no record of what the pollen was actually doing in the years I am comparing. A doctor handing you a tablet also carries a weight that picking a box off a shelf in a supermarket does not, and that on its own can change how well something seems to work. I cannot separate those out and I am not going to pretend I can.
What I would say to anyone still working along that shelf is this. If the tablet you are on is not holding, the answer is not to endure it and it is not to take two. There is more than one of these, they are not interchangeable for everybody, and trying a different one is a five minute conversation with a pharmacist. I wish somebody had told me that at thirty five.
The part that took six weeks
If you search for an allergy test you will mostly be sold an IgG food sensitivity test. Two hundred foods, a colourful report, a list of things to eliminate.
These do not work. Not in the sense of being a bit unreliable. In the sense of measuring the wrong thing entirely.
IgG antibodies to a food are a normal marker of having eaten that food. The British Dietetic Association puts it plainly: a high IgG level to a food is more likely to mean you eat it regularly than that you are intolerant to it. Their position is that there is no convincing evidence for the test and it should not be used diagnostically. The NHS, BSACI and their European and North American equivalents all say the same thing.
So a test that comes back saying you are sensitive to wheat, dairy and eggs may be telling you nothing more than that you eat toast.
What you actually want is one of two things. A specific IgE blood test, or a skin prick test at a clinic. Both are clinically validated. Everything else is decoration.
Why I did not do the skin prick test
Nothing wrong with it. It failed on logistics.
Skin prick testing needs you off antihistamines for three to seven days beforehand or you get false negatives. Coming off Allevia in the middle of the season, in a part of the country that is essentially one long hedgerow, is not something I fancied.
I did work out a way round it. We spend two weeks every summer at a caravan on Anglesey and my symptoms reliably vanish there. That is a free washout window. Stop the tablet at the coast where you do not need it anyway, then test when you get back.
Quite pleased with that, and then it turned out to be unnecessary. IgE blood tests need no washout at all. You keep taking your tablets and it makes no difference to the result. The entire problem I had just solved did not exist.
The bit where I was confidently wrong
This is the part I nearly left out, which is usually a sign it should go in.
I read the Medicash terms properly. Section 10.8 requires payment to a qualified and insured practitioner, and receipts have to show that practitioner’s name, address and qualifications. A home kit you use at your kitchen table has no practitioner. The neighbouring benefit categories explicitly exclude home testing kits and lab tests not referred by a GP or consultant.
Clear enough. Home kits are not claimable. That ruled out every postal test on the market and left me looking at private clinics.
Then I emailed them and asked. Home testing kits are claimable under Alternative Therapies.
I had built a careful, well-evidenced, entirely wrong conclusion out of a document. The wording genuinely supported my reading. The organisation that wrote it simply does not apply it that way. It cost me about a fortnight of going down the wrong road.
The lesson is not complicated and I keep having to relearn it. When a few hundred pounds is at stake and an email costs you nothing, ask the people who administer the thing rather than reasoning from their paperwork.
What I chose and why
I ended up with the ALEX3 panel from the Forensic Genomics Innovation Hub, an ISO 17025 accredited lab at Southampton Science Park. £295, against my £250 allowance. £45 out of pocket.
Three hundred parameters in a single finger prick. What matters is not the number, it is that 218 of them are molecular allergens rather than whole extracts.
A whole extract test tells you that you react to olive. A molecular test tells you which specific protein inside the olive you react to. That sounds like a technicality. It is not, and I will come back to it, because it turned out to be the single most important thing about the entire result.
One thing that made me trust them more, oddly. Their own FAQ says that an IgE response does not necessarily mean allergic disease, and that whether it is a true allergy remains a clinical diagnosis. A company actively talking down what its own product can tell you is a good sign. It is the opposite of how the IgG end of this market reads.
In which I discover I am not as tough as I thought
The kit arrives with two lancets, two alcohol wipes, a small blood tube, a stand for it, plasters and a prepaid box. It could not be more straightforward.
I sat in my office with the little clicky needle against my finger and could not push it.
Not would not. Could not. Something in my brain is hardwired to stop me deliberately hurting myself and it turns out that wiring is stronger than my opinion of myself. I kept trying. I kept stopping. At some point I started giggling, alone, at my desk, at a piece of blue plastic.
Eventually I built up to it and pushed. Nothing happened. Pushed harder. Nothing. So I gave it a proper shove and it went click, and it was a tiny scratch, and it did not hurt at all.
Then it took ten minutes of squeezing to fill the tube to the line. That is the bit nobody mentions. The needle is nothing. The ten minutes of milking your own finger into a plastic vial is a different proposition, and if you are squeamish about blood you should get someone else to do it or use a nurse.
Posted it on the Monday. Results in my inbox on the Tuesday. Medicash paid out within four days. I have had slower responses from people I live with.
The results
Total IgE came back at 182 against an adult reference of under 100. Roughly double. The report’s own summary is that allergy is likely.
Of 300 parameters, 14 were positive. Four of them were high enough to matter.
| Allergen | Source | Level |
|---|---|---|
| Ole e 1 | Olive pollen | 9.29 |
| Fra e 1 | Ash pollen | 8.21 |
| Art v 1 | Mugwort pollen | 5.19 |
| Alt a 1 | Alternaria, an outdoor mould | 4.23 |
| Phl p 5 | Timothy grass | 3.24 |
| Api g 7 | Celery | 3.01 |
| Phl p 1 | Timothy grass | 1.67 |
Below those sat ragweed, rye, maize, Bermuda grass, Bahia grass and cat, all low.
The top result is not real
My highest number is olive pollen.
I live in Buckley, in North Wales. There are no olive groves in Flintshire. There are no olive groves within several hundred miles of Flintshire. Whatever is making me sneeze in April, it is not an olive tree.
Olive and ash are closely related, and the specific proteins measured here, Ole e 1 and Fra e 1, cross-react heavily with each other. My immune system cannot really tell them apart. So the olive result is a reflection of the ash result. Ash is the real one, and ash is a tree that grows in enormous quantities all over this part of the country.
This is the entire argument for paying more for a molecular test. A cheaper whole extract panel would have handed me a high olive number with no way to tell it was a mirror. If I ever pursue immunotherapy, which is a multi-year commitment, being pointed at the wrong tree would be an expensive mistake in both time and money.
The same logic sorts out the grass. I have positives for timothy, Bermuda, Bahia and maize, which looks like four separate grass allergies and is not. Two different timothy proteins came back positive, which the report treats as the marker of genuine grass sensitisation, and the rest are shadows cast by it.
A long list of positives is usually not a long list of problems. It is a short list of real ones, repeated.
The calendar matches almost exactly
Here is where it stopped being a list of numbers and started being useful.
Ash pollinates from late March into May. Grass takes over June and July. Alternaria spores peak from July through autumn. Mugwort runs August into September.
You can check what the air is actually doing where you are. The Patient.info pollen map grades current levels region by region, low through to very high, and it updates through the season. What it will not tell you is which pollen. A high day in April and a high day in June look identical on the map and are two completely different problems for me, and until this year I had no way of knowing which one I was looking at.
My symptoms run March to August. The biochemistry predicts late March to October. That is a good enough match that I sat looking at it for a while.
The March start is the tell. Birch, alder and hazel are the usual early spring suspects and all three came back negative for me. A March onset with no birch sensitisation points straight at ash, which is exactly what the numbers say.
The thing I was not looking for
I ordered this test about hay fever. The result that actually matters is the mould.
Alternaria is an outdoor mould. Damp vegetation, leaf litter, grass cuttings, compost, long wet grass. It is the mould most consistently linked with severe asthma flare-ups, and with thunderstorm asthma, where storms burst the spores into fragments small enough to get deep into your lungs.
I get asthma symptoms during hay fever season. I have always treated that as part of the hay fever. And I spend an enormous amount of time on exactly the ground where this stuff lives, since between the dogs, the walking, three or four runs a week and the van we are outdoors on wet grass constantly.
Seasonal sneezing plus seasonal wheezing is one airway, not two separate annoyances. An antihistamine does nothing for the lower half of it. That went on the list for a proper GP conversation rather than being folded into hay fever and ignored for another decade.
The negatives were worth the money too
House dust mite, all seven species tested, negative. Every dog protein on the panel, negative. Cujo and Blaze are entirely in the clear, which I was quietly worried about.
All nuts, peanut, sesame, milk, egg, nineteen species of fish and shellfish, wheat and every grain, latex, venoms. All negative. No red meat allergy. No birch protein, which means no broad pollen and food crossover.
On a three hundred allergen panel, exactly one food came up.
Why the caravan works
Two weeks every summer at a caravan on the Anglesey coast, and my symptoms reliably go away. Every year. I had never had an explanation for it beyond sea air being nice.
The test explains it. Onshore winds off the Irish Sea carry air with far lower pollen and spore loads than anything inland. And because I have zero dust mite sensitisation, a caravan does not punish me the way it would someone whose problem is indoors. If mites were my issue, an enclosed damp textile-filled box would be the worst place I could take myself.
I am also outdoors more in Anglesey, not less. So it is not that I am hiding from the air. It is different air.
The lab result and a thing I noticed on holiday arrive at the same answer from opposite directions. Neither would have convinced me alone.
Where I think this test is oversold
Two honest problems, and I would rather raise them than let you find them.
The first is the celery result. Api g 7 at 3.01 is a real number, it is tied to my mugwort sensitisation, and unlike some food reactions it does not break down with cooking. The report’s stated reaction range for it runs from a tingly mouth all the way to anaphylaxis, with talk of avoidance and adrenaline pens.
I have never once reacted to celery. Not in fifty five years.
Sensitisation is not allergy. Plenty of people carry this antibody and eat celery happily forever. Acting on that number would mean cutting out stock cubes, soups, stuffing and half the spice blends in the cupboard on the strength of a lab value and nothing else. I have noted it and moved on, and I will revisit it the day my mouth tingles and not before.
Which leads to the second problem. Testing three hundred things when you have symptoms for four of them is exactly the practice allergy specialists warn about. Panel testing produces false positives, and false positives produce unnecessary restriction and unnecessary anxiety. My celery result is a live example sitting in my own report.
If you go into this expecting a tidy list of things to avoid, you will come out worse off than when you went in. It gives you a pile of raw material, some of which is noise.
The one thing it could not explain
The only food I have ever noticed reacting to is Marmite.
Three hundred allergens and it is not on there. Marmite is yeast extract, and the yeast species involved is not part of the panel. The only yeast tested is a skin one, and it came back negative.
Given how clean the rest of the food section is, a classic allergy seems unlikely. Yeast extract is also one of the highest tyramine foods there is, very high in free glutamate, and carries a serious amount of salt, any of which can cause flushing and a stuffy head without involving allergy at all.
So I do not know. A test that answered questions I had been carrying for a decade cannot tell me about the one food I actually noticed. I quite like that as an ending. It keeps the thing honest.
The bit that matters most
The report itself has no idea what is wrong with me.
The interpretation software recorded no symptoms in every single category, because nobody asked me for any. So every page reads some version of sensitisation detected, symptoms not recorded. The lab measured antibodies. It could not measure allergy.
Everything useful in this post came from putting the numbers next to things the lab never saw. A symptom calendar going back years. The fact that I live in North Wales and not the Mediterranean. Two weeks a year at a caravan. Nine years of sleep and respiration data from a watch.
That is the same lesson I keep running into whenever I put my own health data together in one place. A single measurement is nearly useless on its own. It becomes worth something when you have three things pointing at the same answer.
A £295 test measuring three hundred parameters was necessary and nowhere near sufficient. It did not produce an answer. It produced the raw material for one.
Would I do it again
Yes, and I would do it in exactly this order. Work out which test is real first, which is where nearly all the effort goes. Then take it. Then, crucially, sit down with the result and everything you already know about yourself, because the result on its own is just a column of numbers.
What changed for me. I know my season now, and roughly which allergen owns which month. I know the caravan works and why. I know the dogs are innocent. I know the wheezing is its own thing and needs treating as such, which is the single most useful sentence in this entire post. And immunotherapy, which trains your immune system to tolerate a specific allergen, has gone from something I had never considered to something worth asking about.
One practical footnote for anyone else managing blood pressure. A lot of over the counter hay fever combination products contain decongestants that push blood pressure up, so they are not for me. Plain non-sedating antihistamines and steroid nasal sprays do not have that effect. Worth checking the box rather than assuming, and worth asking a pharmacist if you are on anything for the same reason I am.
None of this is medical advice. I am a bloke who bought a test and read the results carefully. Take any report like this to your GP or an allergist before changing anything, and particularly before changing medication.
I test this stuff on myself and publish either way
Sometimes it works and sometimes it does not. I recently ran a pre-registered beetroot trial on my own blood pressure and the answer was no change at all, which I published in full. Subscribe and I will send you the next one.
I’m Pete Harrison. I’m 55, I run a business, and I have a mild case of insomnia that means I spend a lot of time at 3am reading about gadgets, gear and ways to make life work better. Things I Learnt at 3am is where I write honestly about the things I’ve actually bought, tested and lived with. No fluff, no rehashing the spec sheet. Just the real verdict from someone who uses this stuff every day.
