A Graded Oral Food Challenge (GOFC) is the “gold standard” to confirm specific food allergies, or that you’ve reached tolerance following treatment. If your provider believes you are a candidate based on your history, exam, testing, and previous treatment, a GOFC may be recommended.

The Graded Oral Food Challenge is valuable to help answer questions about your treatment progress, whether you should avoiding certain foods, or if you can safely reintroduce a food in your diet.

The Graded Oral Food Challenge will help your provider:

  • Determine how allergic you may be to a specific food
  • Evaluate allergy drop treatment effectiveness
  • Verify you/your child has outgrown a food allergy

The challenge also gives your medical team data that guides how they adjust your treatment.

During a challenge, we test only one food at a time using a detailed protocol and designated food challenge suite that your trained medical team will closely monitor. We will give you the specified food in timed intervals at pre-calculated amounts.

Our challenge protocol integrates the best practices from leading food allergy centers that provide food challenges. Our team and facility are equipped with state-of-the art technology and training to address the many facets of food challenges in a safe, comfortable environment.

Talk with your provider at your next visit for details about the Graded Oral Food Challenge and whether you might be a candidate.


Graded Oral Food Challenge Reports

April 2023 GOFC Report

Allergy Associates of La Crosse initiated a Graded Oral Food Challenge (GOFC) program in spring 2016.

The objective of challenges, which typically take 3-4 hours, is to eat a full serving of a food in graded increments, with detailed patient observations before, during, and after the challenge.


As of spring 2023, a total of 1,235 challenges have been performed that provide the data for this report:

  • Passed = 86.3%
  • Partial Pass = 4.8%
  • Failed = 7.6%
  • Not conclusive results = 1.4%

When including partial pass challenges into the results, an impressive 91.1% success rate has been achieved.

Patient selection is driven by detailed metrics of their conditions (comorbidities), history of testing and treatment including: Specific IgE, Total IgE, skin prick testing, treatment duration/level, history of severe reactions, several other measured criteria, and provider judgement.

Key Report Findings


A KEY finding of our program is the large number of patients with a history of food anaphylaxis (n=438 or 35.5% of all challenges):

  • 1% of the patients with any history of anaphylaxis passed their challenge
  • 1% partially passed
  • 3% failed

Of the 438 with anaphylaxis, 142 patients were challenged directly to their anaphylactic food (n=142):

  • 5% passed their challenge
  • 6% partially passed
  • 3% failed their challenge

General results of the program challenges:

Basic demographics of challenge patients:

  • Age: Average patient age = 14 years. The youngest is 2; oldest is 91.
  • Gender: 817 Males, 418 Females
  • Average years of sublingual immunotherapy at time of challenge: 4.41 years

Most Common Foods Tested:

  1. Almond — 176
  2. Peanut — 163
  3. Hazelnut — 126
  4. Cashew —123
  5. Walnut — 101
  6. Egg (cooked) — 75
  7. Egg (baked) — 72
  8. Pecan — 72
  9. Milk (baked) — 49
  10. Shrimp — 40

Safety Statistics

From a safety standpoint in all challenges, epinephrine use occurred four times (0.32%). No patients required or reported follow-up at an Emergency Center, and no patients were admitted to a hospital.

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Success Stories

“I’ve been coming here for a long time, since I was really little, because I couldn’t eat peanuts, and if I touched certain foods, my skin would break out. I was allergic to cats and dogs. “I had to avoid lots of different places because they might have stuff that I might be allergic to.…
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