Food OIT FAQs

Q: Where do patients go for OIT?

A: As of now, Dr. Shah and Dr. Mayer are among a very few, select board certified allergists who have knowledge, skills and resources to offer OIT. The number of practices offering it is growing, however, and may become mainstream in coming years. Dr. Shah and Dr. Mayer are in the forefront and leading the way by teaching other allergists at the national conferences. If you are considering OIT, it is best to review the success rate and experience of the OIT team.

Q: How long will the entire process take?

A: The first day’s procedure will take about 6-8 hours. The time to reach the top maintenance is about 6-8 months, depending on any symptoms during the build-up dosing.

Q: What age does my child need to be to participate.

A: We are offering OIT to children 4 years of age and older due to compliance. Some younger than 4 years have been successfully desensitized with OIT. We have completed OIT for adults as well.

Q: Should routine allergy medications be stopped before the first day procedure?

A: No, it is not necessary.

Q: What is the timeline for the months after the first day?

A: Exactly how it goes, depends on each individual child/adult. Patients will come in every week for build-up dosing. If they are having any symptoms we may not increase the dose, or even decrease until better tolerated.

Q: What are the most common symptoms during build-up.?

A: By far, gastrointestinal symptoms are most common. Upset stomach, nausea and less frequently, vomiting. Also, patients may complain of an itchy throat after their dose. Though it is very rare, severe allergic reactions or anaphylaxis can happen during OIT.

Q: How often can the dose be increased?

A: The interval between dose increases is a minimum of six-seven days.

Q: What should be eaten before dosing?

A: It is important to consume a largely carbohydrate meal before doses are given, either at the Center or at home. Suggestions of foods to eat include bagels, waffles, pancakes, breakfast sandwiches, and fresh fruits on the morning of a visit. The goal is not to dose on empty stomach.

Q: What time of day should home doses be given?

A: When dosing once a day, the AM dosing at a fixed time is preferred. Each next day, +/- 2 hours time variation is allowed.

Q: What precautions should be taken dosing?

A: Avoiding exercising or hot showers just prior and, more importantly, after the dose is given is imperative. The patient should wait at least 2 hours after dosing before exercising. Also, if the patient has a febrile illness we ask that the home dose be held during the illness. Allergic reactions can more commonly occur under these circumstances.

Q: How many days can doses be skipped at home and resumed safely afterwards?

A: Doses can be held at home for up to 2-3 days after which dosing can be resumed. If doses need to be held any longer than 3 days, please contact the Center for advice on how to proceed. We may require you to come into the Center to receive the next dose.

Q: What about home dosing on the day of the office visit for dose increase?

A: The dose should not be given at home that day. NEVER increase the dose on your own at home.

Q: If there is a reaction at home, what should I do?

A: Treat the reaction the same way you would any food reaction; antihistamine if there are mild symptoms (slight rash, itchy mouth or throat, a stomach ache). Give epinephrine (Epi-Pen) if there are other symptoms of anaphylaxis, or above symptoms appear to be progressing. Call us after the appropriate immediate intervention. We will give instructions on future dosing.

Q: At what point will we buy our own food?

A: Usually when the patient has reached the 2-3 peanut (or other allergic food) dose. As each case is different, we will inform you during your process. Prior to that we will provide all necessary supplies.

Q: What if I need additional doses for travel?

A: Please inform us at least two weeks ahead of travel time and we will accommodate your needs to the best of our abilities.

Q: When should we perform a food challenge?

A: Most patients who are desensitized should eventually be able to consume as much of the allergic food as a full serving size portion. For most patients, it is done at the completion of the OIT process.

Q: What is the goal of this process?

A: The goal of therapy is to desensitize patients to an allergic food. This helps reduce the risk, frequency, and severity of anaphylaxis from accidental exposure. OIT helps increase the reactivity threshold so that higher amount of allergenic food can be tolerated without allergic reactions. The first target goal is to eliminate the risk of reaction with accidental exposure and cross contamination.

Q: What is the follow up schedule when a full portion of the food is being eaten?

A: When the full dose has been reached, we schedule follow ups after 1 month, 3 months, 6 months, and then once a year.

Q: What is the success rate in desensitizing patients?

A: The average reported desensitization success rate is 80-95%.

Q: What is the cost of the procedure? Do you accept insurance?

A: Yes, we participate with most major health insurance plans and likely accept your insurance. The consultation, testing and oral challenges are usually covered services by most health plans. As OIT is considered an elective process at this point, the coverage and reimbursement varies widely among various commercial insurances. As OIT is not considered a standard of care by health insurance companies, most patients have some cost sharing for OIT. Please check with our OIT coordinator to get the estimate on the out of pocket costs related to OIT. Please call our billing manager at 631-446-1436 for details.

Q. If a patient has multiple food allergies, will completing OIT for one food help treat other food allergies?

A: Each food OIT process is food specific. Completing one program does not treat other food allergies. Some patients have shown benefits in cross reactive food allergies. Peanut, milk, and egg OIT are done individually. Some foods can be combined based on our clinical decision. Multiple tree nuts now can be combined in one protocol. We combine foods for OIT based on individual patient’s needs and family’s commitments to the process.