OIT stands for Oral ImmunoTherapy. Just like allergen immunotherapy for environmental allergies, which has been around since 1911, oral immunotherapy works using the same methodology. It takes a small dose of the allergen and introduces it to the body by mouth, not injections like traditional immunotherapy (allergy shots). Because the dose is so small, the body cannot recognize the invader and therefore, does not create an allergic response. It flies under the radar, if you will.
OIT starts with day 1 escalation, where the dose is offered in microscopic amounts and slowly increases to a starting point, a very tiny amount of the allergen. OIT is started slowly to ensure patient safety.
What happens if you have a reaction on day 1? You would stop the escalation process. The last dose you took safely would become your starting point for OIT. It is important to note that if you do have a reaction, it will most likely be mild because the dose is so small: mild itching of the tongue or a mild skin rash, etc.
When we started milk OIT, I was convinced Noah would react within the first few doses, after all, he had contact reactions from just touching milk. But, to my surprise, he did great on day 1 and got to the standard starting point.
After day 1, you will take your dose every day until your next doctor’s appointment to increase your allergen dose, called an updose. You will follow a tested protocol, which has been used for a minimum of ten years in oral immunotherapy, until you “graduate”. Most OIT protocols take about 20-24 updoses. If you updose every 2 weeks, you can calculate a treatment plan that will take you a minimum of 10-12 months to graduate.
I like to tell people that OIT is a similar approach to a frog in boiling water. When you slowly turn up the water the frog doesn’t recognize the rising temperature. With OIT, you slowly turn up the allergen until you have successfully fooled the body. Soon, the body is tolerating the very thing it is allergic to.
The end goal of OIT is desensitization. You are not cured from your food allergy, but rather desensitized to your allergen. Meaning, you will need to continue taking your maintenance dose daily, so your body doesn’t react to your food allergen as a foreign invader ever again. This is key and a huge part of OIT. You are in it for the long haul, or at least until science comes up with a different option.
After graduation you can eat the allergen freely in your diet. This varies slightly doctor to doctor, but most OIT providers follow a free eating plan in maintenance. This is the life changing part! My son, Noah, can enjoy an ice cream cone, a slice of birthday cake at his friend’s party, a special snack at the holiday event at school. The protection from OIT is amazing, but the inclusion it has brought for him has been life-changing!
Can he potentially react to his food allergen after graduating OIT? Yes, yes he can. This is why a person is desensitized and not cured.
A lot of people I talk to about OIT are deterred by that risk, but if you have a reaction, it will most likely to be mild in nature and there is typically a trigger that causes the reaction. Common triggers include:
- Illness (When sick, your immune system is geared up to fight.)
- Growth spurts or puberty.
- Not following a rest period. (You cannot exercise right after eating your allergen. Elevating your body temperature and heart rate may trigger an immune response.)
Following a set of instructions from your physician will help protect you from reactions.
We have been in maintenance for 2 years since graduating milk OIT, and have had zero reactions from milk. If my son did have a reaction, it was so mild, we didn’t even recognize it. What a contrast from the countless reactions he had prior to OIT. We went from ER’s and hospitals to ice cream shops!
Don’t misunderstand me, we have had illness and have held our dose and dairy intake during a stomach virus or cold, but again, we have not had reactions. You still have to be aware. You still have to watch your body and be tuned in to triggers, but we have done this successfully.
Food allergies are a part of our life. They will always be a part of our life, but to have a chance at making them better. Making them less. Making his reactions more mild. All of this far outweighs the risk and work of maintaining OIT for the foreseeable future.
OIT has changed our lives. It has protected my son. It has brought peace in the place of crazy anxiety.
Has it been work? Yes. Has it always been easy? No. But, would I do it again? Absolutely!!
If you want to research more about OIT, go to oit101.org, there you can also find a list of OIT providers in your state.
If you have questions about OIT, please read more about our journey. I am happy to help in any way I can. I am passionate about others experiencing the freedom and healing that we have!