What is OIT?

This is just a brief summary and overview. Be sure to see our FAQs / Q&A page, Top 10 OIT Myths, and our Research & Learn page for much deeper information.

imageOIT stands for “Oral immunotherapy” or oral desensitization for food allergies. OIT is a medical treatment guided by a board-certified allergist with a payoff of lifetime freedom from food fear and stress.  The immune system is re-trained to tolerate food proteins/allergens through regular eating of small amounts of food.

OIT has been studied in clinical trials for well over a decade and traces back even to medieval times when kings would ingest tiny bits of arsenic to protect themselves from being poisoned. Allergy shots are a form of immunotherapy and desensitization called SCIT or subcutaneous immunotherapy. Allergy shots have been used for over 100 years (since 1911) with a strong track record of safely desensitizing people from environmental allergies.

OIT has an 85+% success rate in clinical trials. Patients must have a documented Ige-mediated food allergy. Two contraindications are previous EOE or uncontrolled asthma (asthma must be brought under control before OIT begins. The allergist must also be sure you can take the protocol as seriously as it needs. A call to the office can clarify a specific protocol they use and insurance/costs. 84% of patients also have had insurance coverage for this treatment.

The key to understanding OIT is that there is low level of allergen an allergic person can safely eat without a reaction. It’s invisible to the body. Then it’s raised slightly and the body still doesn’t react. The “threshold of tolerance” is gradually increased over time. The immune and digestive systems adapt, as they are meant to do.

The first day of treatment is a build-up day, starting with a minute amount of allergen ( i.e.1/10,000th of a peanut) totaling up to a tiny amount that day with a few doses spaced out. You are sent home and take less or equal to than the “safe dose” once or twice daily. You return to office in 1-2 weeks to increase the dose under their watchful eye. Usually it’s a minimum of 12-14 at-home doses. However, many physicians are flexible with spacing out appointments to 3-4 weeks for travel and/or financial reasons. Since we are naturally desensitizing the body, going slowly is often a benefit.

Desensitized Continuum to TolerantAfter each dose there is a 1-2 hour observation period with no core body temperature elevation while the body digests and metabolizes the peanut. In maintenance, many take their daily dose about an hour before bed. Dosing just becomes part of your life much like brushing your teeth. Regular dosing ensures your body stays desensitized and you get visible proof of protection every time you easily ingest the allergen.

The treatment process can take 6-12 months with 15-25 “updoses” reaching a daily serving of the allergen being eaten with no symptoms. After a period of time, usually 3 months to 12 months at this dose, there is a final “challenge” of about double or triple what the daily amount is (i.e a 20-peanut challenge when eating 10/day). This challenge simulates “unlimited” eating and that the patient is “fully desensitized” to their allergen. From that point, you go into maintenance where   X amount per day is eaten to keep the body recognizing the allergen.

For many, the dosing will continue for life. Perhaps not daily, but regularly like 3-5 times a week in a normal diet. “When the children’s blood and skin-prick tests become negative to the allergens, which happens somewhere between six months and three years on the maintenance dose, Dr. Nadeau believes that a small amount of the allergens (for example, one peanut a day or the amount of egg and milk in one pancake) will be enough to prevent the allergy from returning.

In other positive news, it appears that OIT also brings along positive epigenetic / DNA results. In a NY Times article: “Research in Nadeau’s lab has found that treating allergies actually changes the genes by epigenetics (a chemical modification of the genes that does not affect the actual DNA sequence), so desensitizing children may reduce the likelihood that they will pass on the disease to their children. One day, perhaps, fatal anaphylaxis may become a sorrow associated with an earlier age, like dying of appendicitis or polio.”

There are 70+ board-certified allergists around the country offering this to patients for peanut, milk, egg, wheat, tree nuts and other allergens. Our Facebook support groups have thousands of old posts to read–it can be your own private “OIT Google”!

imageCongratulations on taking the first step to learn what OIT is. Where to go next on our site?

Research & Learn Library: over 400 news stories, media coverage and medical journal articles.

FAQs / Q&A: answers to common questions about OIT

Top 10 OIT Myths: the things we explain over and over

Join our OIT Community: our Facebook OIT Support Groups have over 10,000 members and show you what OIT is really like
Find an OIT board-certified allergist:  See the Google map and find an allergist near you
OIT Success Stories: read real stories from patients who have completed OIT




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