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It's not easy. I lived 11 years with symptoms. 4 states and dozens of doctors later, a fill-in dermatologist saw a spot on my leg and ordered a biopsy from Mayo Clinic.
A bone marrow biopsy can be a determining procedure. They can also measure your blood counts in a Tryptase and run a urinalysis to determine levels of factors. There is no one test that can determine and your body can give false negatives.