What is Oral Immunotherapy?
Oral immunotherapy (OIT) is an advanced treatment for food allergies that retrains the immune system to tolerate foods that once caused allergic reactions. By introducing very small, carefully measured doses of the allergenic food each day, the body gradually becomes desensitized. Over time, this greatly reduces the risk of severe reactions and accidental exposures.
Which Foods Can Be Treated with Oral Immunotherapy?
At Freedom Allergy, we specialize in multi-food oral immunotherapy, designing individualized treatment plans for each patient's safety. We offer OIT for:
- Peanut
- Tree Nuts (almond, pecan, walnut, hazelnut, cashew, pistachio, brazil nut, macadamia nut, pine nut, etc.)
- Milk
- Egg
- Wheat
- Sesame & other seeds
- Soy
- Legumes (peas, chickpeas, lentils
- Fish & Shellfish
- Garlic and other less common allergens
Not every combination is started together. Our allergists create a personalized plan based on sensitivites and medical history.
What is the Goal of OIT?
- Lowering the risk of life-threatening reactions (anaphylaxis)
- Allowing patients to tolerate accidental exposures and even freely eat the food in many cases
- Reducing anxiety around cross contamination and dining out
- Improving overall quality of life for both children and adults
How Long does OIT Take?
- Most patients reach their maintenance dose within 6-8 months
- After approximately one year on maintenance, many can safely reduce dosing to 3-5 times per week.
- Over time, frequency may decrease further
- If a patient enjoys the food and can tolerate it , daily consumption or even larger amounts can be discussed with your allergist.
Does OIT Cure Food Allergies?
No - OIT does not cure food allergies. Instead, it provides desensitization, meaning the body builds protection against reactions as long as treatment continues. Early initiation of OIT ( especially with young children) may support the outgrowth of food allergies later in life. Research shows that many children who start OIT early are able to freely eat their allergen years later.
Does OIT Lead to "Free Eating"?
We are often asked whether our approach to OIT allows patients to eventually eat their allergenic foods freely. The truth is that every patient is unique. In our clinic, we have treated hundreds of patients who have successfully reached full freedom from food allergies, enjoying foods like milk, eggs, peanuts, and tree nuts without restriction.
At the same time, some children and families find that the maintenance dose provides sufficient protection and prefer not to increase to the highest dose. This may be a personal choice or due to the patient's specific allergy sensitivity. Over time, many of these restrictions gradually decrease, and if the patient wishes, they can eventually progress to full, unrestricted free eating.
The idea that OIT never leads to free eating is a common misconception. Both achieving complete food freedom and maintaining a protective dose are considered successful outcomes, because the ultimate goal is safety, confidence, and freedom from constant fear.
Who Can Benefit From OIT?
- Children and adults with IgE-mediated food allergies
- Patients with a history of severe allergic reactions or anaphylaxis
- Families seeking relief from the stress of strict food avoidance and cross-contamination fears.
-OIT can begin as early as 6 months of age. No one is considered "too allergic" to start - patients with severe allergies may progress more slowly.
Who Should Not Do OIT?
OIT may not be recommended for:
- Patients with uncontrolled asthma
- Patients with eosinophilic esophagitis (EOE), though exceptions may apply
- Patients unable to commit to daily dosing and follow-up care
Allergies, asthma, eczema, and hay fever (environmental allergies) do not prevent OIT - they just need to be well managed beforehand.
Safety & Side Effects
Most reactions are mild and manageable, including:
- Itchy mouth or throat
- Abdominal discomfort, reflux, or nausea
- Skin symptoms (hives, mild rash)
Severe reactions are rare but possible. For safety patients must:
- Take doses on a full stomach
- Avoid exercise, hot showers, or sleep for 2 hours after dosing
- Always carry an epinephrine auto-injector
Preparing for OIT
- Ensure asthma and other allergies are well controlled
- Bring past test results to your first consultation
- Supportive care such as probiotics or vitamin D3 may be recommended.
Why Choose Freedom Allergy for OIT
- Led by Dr. Ruchir Agrawal, triple board-certified in Allergy/Immunology, Pediatrics, and Integrative Medicine
- Experience treating children and adults across Georgia and the world
- Expertise in multi-food OIT and personalized treatment plans
- Flexible scheduling and family-centered care
- Proven track record of helping patients achieve freedom, confidence, and a better quality of life
Take the first step toward food allergy freedom. Call us now to see if OIT is right for you.