Oral Immunotherapy: A True Lifesaver
Updated: Aug 3, 2022
Of course, there is no available cure for food allergies–otherwise, this site would not exist. However, there are ways to lessen the severity of allergies, perhaps the most prominent of which being Oral Immunotherapy.
Oral Immunotherapy (OIT) is founded upon the concept that one can train their body to not overreact when exposed to an allergen. Allergic reactions occur when one’s body views an allergen, such as a peanut, as a harmful antigen, even when it is not. In its effort to combat the actually harmless allergen, the body’s immune system overreacts, causing an allergic reaction. In OIT, one purposefully takes minute doses of their allergen, which are theoretically not large enough to cause an allergic reaction, but do get one's body used to the allergen. Then, once one’s body has fully adapted to that dose, the dose is slightly increased, so that the body can adapt to the new dose. The process is repeated until one can ingest a sizable amount of their allergen with no reaction.
Those who undergo OIT cannot suddenly consume their allergen as often as they like; someone who has been immunized to, say, peanuts cannot start to eat Reese’s at their leisure. Rather, in the event that they accidentally eat a peanut or two (not including the daily dose they take, of course), the reaction will most likely not be life-threatening. Furthermore, they no longer have to worry about such dangers as cross-contamination; as long as a certain meal, or snack, or whatever it may be does not contain the allergen as an actual ingredient, those who are successful in OIT should be able to eat it. To put it another way, a product that "may contain" or that is "processed in the same facility as" one's allergen would be fine, but if it "contains" the allergen, it would still be off limits.
However, the journey is not yet over after the escalation in doses. Once a desired dosage is attained, one must continue to consume that portion as frequently as on a daily basis in order to maintain their immunity. If they fail to do so, their immune system will get less used to the allergen, meaning it will view it as more of a threat, making the severity of the allergy return.
It is very important to note that OIT can only be done under an allergy doctor’s program or trial. It is extremely dangerous, as one literally ingests their allergens when doing it; even participants in trials overseen by doctors are liable to get life-threatening allergic reactions. Therefore, one should not attempt to do OIT by themselves, lest they accidentally have too large a dose in too short a time, or if their body simply cannot handle OIT, which unfortunately is often the case.
There are a number of other precautions one must take when undergoing OIT. During the escalation in dosage, one cannot travel, because even other hospitals do not guarantee one’s safety: only one’s allergy doctor can. Furthermore, one cannot experience a significant change in body temperature in close proximity to taking their dose; so, exercising, hot showers, and anything else of that nature are not permitted for two hours before and after the dose, for a total of four. Finally, although OIT is found to be most effective when the patient is a child or teenager and their immune system is still developing and impressionable, those doing OIT will, unless some other treatment or cure is created, have to do it for the rest of their lives if they want to keep their immunity. Once the patient exceeds the age of 21, they should refrain from consuming alcohol on the same day that they do OIT, which, for many, is everyday (they should, of course, not drink under the age of 21 either, for reasons excluding OIT, and it is also advisable to not drink even if one is above the age of 21 and does not do OIT). Such precautions must be taken because a change in body temperature or consumption of alcohol lowers the threshold for an allergic reaction.
Although OIT can be difficult, it is a truly life-changing experience, as I am lucky enough to attest to. To read my personal story with OIT, look for the article titled “My OIT Journey,” under the “Stories” section.