This article reviews the evidence for and against specific IgE testing in allergy management prior to pharmacotherapy ('testers' versus 'treaters'). While the value of combining results of both Phadiatop inhalant and fx5 food allergy screening may improve our ability to predict clinical allergic asthma, rhinitis and eczema, evidence suggests that the cumulative load of environmental allergens to which an individual is sensitised may help to determine when allergen tolerance or clinical allergic diseases such as asthma and rhinitis are likely to occur.