A food allergy is an immune system response to a food that the body mistakenly believes is harmful. Once the immune system identifies a particular food as harmful, it creates specific antibodies (specific IgE) to it. The next time the individual eats that food, the IgE attached to a cell (mast cell) stimulates the release of massive amounts of chemicals, including histamine, in order to protect the body. These chemicals trigger a cascade of allergic symptoms that can affect the respiratory system, gastrointestinal tract, skin, or cardiovascular system. This is an overreaction of the immune system not a weakness or immune deficiency. In allergic reactions the immune system is working normally. The abnormality is with an error in recognizing the food protein as foreign.
IgE, mast cells and other components of the allergic cascade are an important part of our immune system. These components are how we fight off parasitic diseases.
Immediate reaction (usually within 2 hours, but can happen up to 24 hours after exposure):
Early childhood allergies to milk, egg, wheat and soy resolve in approximately 80%. Peanut allergy resolves in 5% of children by age 5 (it may reoccur) and 20% by teenage years. Typically food allergies with significant reactions (i.e. anaphylaxis) resolve at a much lower rate.
Food Intolerances are Common:
Food poisoning: derived from food contaminated with bacteria and bacterial toxins.
Histamine toxicity: high levels can be found in cheese, some wines, and fish in the scromboid family (tuna, mackerel).
Scromboid poisoning: Fish from the scromboid family is not refrigerated properly and contaminated by a bacteria. This bacteria feeds on the meat and produces histamine.
Lactose intolerance: due to lactase deficiency (an enzyme in the GI tract). The lack or deficiency of lactase inhibit the ability to break down lactose (the sugar in milk). Undigested lactose is digested by bacteria causing gas production, abdominal pain and diarrhea.
Food additives: MSG and sulfites are two examples.
Children (6%-8% of all children have food allergies):
*Sesame seed is now a member of the most common food allergies.
*Reactions to Fruits and Vegetables are common (5%) but are usually not severe.
*A person can be allergic to just about any food.
*Many reactions to foods are not an allergy but an intolerance.
Any patient with a confirmed food allergy. The confirmation of the food allergy can be by a strong history or a combination of history and laboratory studies including skin/specific IgE testing. Together we will work to establish a definitive diagnosis.
Currently we are starting at the age of 1 and no maximum age. We have treated dozens of adults and teenagers.
Any other disease process (example: Asthma) needs to be under good control before starting the OIT process.
There is no “too allergic.“ Many patients have specific IgE blood levels >100, a history of severe anaphylactic reactions, biphasic reactions (anaphylactic reactions that reactivate), and protracted anaphylactic reactions (requiring intensive care unit and epinephrine drips).
Any food can be treated as long as together we believe the treatment will significantly improve quality of life. As of 2020 we have treated: Peanuts, almonds, Brazil nuts, cashews, hazelnuts, pecans, pistachios, walnuts, milk, egg, soy, wheat, sesame seeds, sunflower seeds and shrimp.
We do offer treatment of multiple foods at one time. This will be dependent on history of reactions and laboratory studies. Many people tolerate more than 1 food being treated at the time. There is a slight increase in side effects (the most common is gastrointestinal discomfort), that would require slowing of the progression through the protocol and further customization of the treatment.
Dr. Mayer and staff are available 24/7 via phone and WhatsApp to help guide you through the oral immunotherapy process.
As with all medical procedures there are risks.
The most common side effects are gastrointestinal. The most common symptoms are mild to moderate reflux, mild to moderate abdominal pain, nausea and vomiting. Approximately 30% of patients will develop some type of gastrointestinal symptoms. Most of the 30% are very mild. Up to 1–2% of patients have very severe symptoms necessitating discontinuation of the therapy.
Studies have identified approximately 1–2% of patients will develop eosinophilic esophagitis due to the introduction of the allergenic food into the diet (5% of patients treated for cows milk allergy). Most all patients developing eosinophilic esophagitis will resolve/go into remission once the food has been removed from the diet.
We do have experience using Xolair (an immune modulator that binds IgE). For patient to qualify for Xolair (moderate to severe asthmatics and patients with chronic hives), Xolair can significantly reduce the time required to complete the protocol. Multiple foods (up to 5 different foods) can be treated at the same time in that much shorter protocol.
See The Process by clicking here.
94% of patients who start the peanut OIT protocol finished the process. Other foods have between an 85% and 90% completion rate.
For additional information you can call us at (248) 363-3232.
If you desire you may continue to see your current allergist for treatment of other allergic disorders (asthma, seasonal allergies, etc). For patients who travel long distances it is preferable that you have a local allergist for treatment of asthma or any other chronic illness.