April 26, 2019

What is OIT?

So, what is OIT? You may occasionally hear about it on the news or mentioned in articles, but most people are not sure what is it is, let alone what it stands for.

OIT is short for Oral Immunotherapy Treatment. It’s an aggressive, weekly, food allergy treatment with the goal of building the patient’s tolerance up to the point where they can eat a whole serving of a food that they were originally extremely allergic to.

 For some patients, we determine if the patient is truly allergic to the food by having them go through a food challenge. This is where we essentially test for a reaction via ingestion. This is frequently done when allergy testing is low or if the patient has never had a reaction to a food they are avoiding.

How OIT starts

If it is decided OIT is a good option, we’ll bring that patient in to start giving them small amounts of the food allergen every week. As an example, let’s use a 5-year-old patient that has a severe peanut allergy. Her parents learned about her food allergy when she was 3 and had a bad reaction after eating a bite of her brother’s cookie. Since finding out about her allergy, it’s been total avoidance of anything peanut the past 2 years. Reading every label on the food they buy, double checking with wait staff at restaurants, and scanning every food that goes near their child’s mouth.

This patient would then come into the office to begin ingesting small amounts of peanut, so small that an allergic reaction doesn’t occur.

Without a doubt, this is the scariest part for most patients and parents. Putting a food in your or your child’s mouth that you’ve been trying to avoid for years is never easy.  A peanut in the eyes of this family is like looking at poison.

The first portions are so minuscule that we’ll have to mix the peanut protein in a liquid solution that we distribute via a syringe in the patient’s mouth. Gradually, we increase the amount of peanut in the dose. The peanut solution goes up to a snack that has peanut powder in it, to half of a peanut, all the way up until the patient is eating a full serving of  peanuts.

After reaching that amount, the patient has one more test via a second food challenge. Once they pass the test, they “graduate” our program and are onto a life food allergy-free. Patients will still need to take maintenance doses daily to keep up the tolerance, but that same peanut allergy patient who almost went into anaphylaxis from a peanut in their cookie is now snacking on peanut butter and jelly sandwiches.

One common question I get: Is OIT safe?

Anytime you’re directly treating allergies, there is a risk of reaction. We start off our OIT patients with microgram amounts of the food protein, well below the level most patients need for a reaction to occur.

Food allergies can be very dangerous and we treat this problem by slowly introducing the allergy more and more to the body. Most patients will see some sort of reaction during the process, but for a large number of patients there will be no treatment required or just in the form of oral antihistamines. Because food reactions can sometimes be severe, we have a full staff dedicated to our OIT patient at all times and we’re quick to respond to any sort of reaction. Reactions can be scary – especially to parents, but you or your child will be well taken care of by me and all of our staff at hand.

When we get to the point of treatment where you’ll be doing doses at home, I’ll be available 24/7 via phone or text message.

Who is right for OIT?

Physically, we’ll determine if it’s right in our first consult if OIT is an option for the patient. The tough part that families need to determine is when they’re emotionally ready. Frankly speaking the process of OIT can be rough. It requires weekly visits to our clinic where the patient battles his or her allergy and pushes their body to the limit.

That being said, I’ve seen so many patients as young as 2 years old start and complete the process (I even have a couple patients  less than 2 years old doing well). The main reason we see so many patients enroll and succeed in this program is because of the results. We see over an 80% completion rate with our patients that enroll in our OIT program.

The fact is, OIT is a life changing treatment

For someone with a food allergy to be able to eat a whole serving of a once highly allergenic food is nothing short of incredible. It’s a very new option to people who suffer from food allergies to actually treat their allergies instead of avoiding them for the rest of their lives.

The results are the reason we have patients driving from Oklahoma, Louisiana, and East Texas to our clinics in Austin and Dallas – we even have a patient that flies in from Michigan to our Dallas location. OIT is a very special program and if it’s something you’re considering for you or your child, we can help you determine if it’s right for you.

About The Author:

Stacy Silvers, MD

Dr. Silvers is a board certified allergist specializing in environmental and food allergy diagnosis, treatment and prevention. Dr. Silvers oversees our allergy program and protocols, and also leads the food allergy and oral immunotherapy (OIT) program at Aspire Allergy & Sinus. Dr. Silvers is considered an expert in the field of food allergy diagnosis and treatment. In 2019, Dr. Silvers was named Best Allergist in the Statesman's Best of the Best Contest.