Oral immunotherapy involves consuming very small, gradually increasing daily doses of a food allergen—starting well below the threshold for reaction—under medical supervision. Over months to years, the immune system learns to tolerate the allergen. The goal is desensitization: raising the threshold so that accidental exposure to small amounts of the allergen no longer triggers a severe reaction.
OIT does not cure a food allergy or allow unrestricted consumption. Rather, it builds a safety buffer that reduces the consequences of accidental exposure—one of the most feared aspects of living with food allergy. However, there is a critical treatment window in young children: when OIT is started in the first years of life, there is a higher rate of remission due to immune plasticity.
What Foods Can Be Treated with OIT?
We currently offer OIT for young children with nut allergies, including:
- Peanut
- Tree nuts (e.g., cashew, walnut)
Our physicians will evaluate your specific allergy profile, reaction history, and current test results to determine whether OIT is appropriate and which protocol is best suited for you or your child.
How Does the OIT Program Work?
OIT is a structured, multi-phase program:
- Initial Evaluation: Allergy skin testing, blood testing, and often oral food challenges to introduce foods with borderline test results.
- Buildup Phase: You begin with a very small dose and return to the office regularly (typically every 2 weeks) for supervised dose increases. Each escalation is observed in our office for approximately 1 hour before you continue the new dose at home daily.
- Maintenance Phase: Once your target dose is reached, you take a daily maintenance dose at home. Regular follow-up appointments monitor for reactions and adjust the plan as needed.
Who Is a Candidate for OIT?
OIT may be a good option for:
- Children with confirmed IgE-mediated food allergies
- Patients with anxiety related to accidental exposure
- Those who want to improve quality of life and reduce dietary restrictions
- Patients who have not outgrown a food allergy
OIT is not appropriate for everyone. Patients with poorly controlled asthma, certain immune conditions, or other medical factors may need to address those issues first. Our physicians will conduct a thorough evaluation to confirm candidacy.
What Are the Risks?
OIT carries a risk of allergic reactions during dose escalations and daily dosing. Most reactions are mild (hives, stomach discomfort), but severe reactions can occur. To reduce risk, doses should be taken after eating a meal, and strenuous exercise should be avoided for approximately 2 hours after each dose. Patients and families are trained in epinephrine auto-injector use and given a clear action plan.
Ready to Schedule?
Call us at (408) 286-1707 or request an appointment online. Offices in San Jose, Los Gatos, Mountain View, and Redwood City.
Frequently Asked Questions
How long does OIT take?
The buildup phase typically takes 6–12 months depending on the allergen and the patient’s response. The maintenance phase generally continues indefinitely to sustain desensitization; however, studies in young children have shown remission can be achieved even after a period of avoidance.
Is OIT covered by insurance?
Coverage varies by insurance plan. Our team will help you understand your benefits and any out-of-pocket costs before starting the program.
Can adults do OIT?
Yes. While many studies focus on children, adults with food allergies can also benefit from OIT. Our physicians currently offer OIT programs for pediatric patients. For adult patients, we can review options such as Xolair or refer to another practice offering adult OIT.