So you’ve heard about OIT (Oral Immunotherapy), and now you’re curious about the risk factors.

You may have heard that there is no risk involved with OIT, or you may have been told the opposite: that in your case, OIT is too risky to attempt.

With so much information out there, it may be hard to know what’s true and what is not.

We’re here to clear up any misconceptions or confusion you may have. We’ll cover:

  • What OIT is,
  • How it can change your life,
  • And what to consider before talking to an allergist about the treatment.

When it comes to food allergies, the treatment options are slim. The standard medical advice – and probably the advice that you were given – is total allergen avoidance. Unfortunately, in our fast-paced society, strict avoidance isn’t easy.

Approximately 32 million people living in the US struggle with food allergies daily. Before the end of the year, 15% – or a little over 225,000 people – will have an allergic reaction. Roughly 200,000 will be hospitalized. Among children, the risk of reaction is higher with nearly 38% reporting a history of a severe reaction.

These numbers indicate that the strict avoidance protocol, which has been the norm for many years, is not as successful as one might hope.

On top of its propensity for failure, strict avoidance creates a stressful lifestyle for both allergic patients and their families.

The entire responsibility of protection rests with parents, children, and adults living with food allergies.

Strict Avoidance Is Not The Only Option

OIT can make that responsibility a lot easier to handle. Though before we get too far into the details of OIT, we must present you with three truths:

Truth 1: No matter what the illness is, all medical treatments come with some degree of risk. The job of your doctor – allergist in this case – is to weigh the risks and benefits of each treatment option and present you and your family with the best solution.

Truth 2: Allergen avoidance is a treatment option. Just like any other medical plan, allergen avoidance requires lifestyle changes. It has its own list of pros and cons,  risks and benefits.

Truth 3: Deciding on a treatment option for you or your child’s food allergies starts with comparing the risks, benefits, and lifestyle changes that are involved in both allergen avoidance and OIT.

Let’s start with a comparison of the two options, and get a better understanding of what OIT actually is.

Allergen Avoidance

A course of treatment in which allergic patients avoid eating, touching, or inhaling the substance they are allergic to. Any interaction with the allergen may cause an allergic reaction, including anaphylactic reactions.


  1. Cross-contamination: although some foods may not contain the allergen as a primary ingredient, trace amounts may be present. In some cases, this may be enough to cause an allergic reaction.
  2. Accidental consumption: although you may be diligent in screening all food, accidental consumption may still occur.
  3. Either of the above situations can cause anaphylaxis.

Oral Immunotherapy (OIT)

A course of treatment in which patients slowly become desensitized to the food to which they are allergic. Under medical supervision, patients ingest the allergen in incremental doses until they have achieved a “bite- proof” state. 


  1. There is some risk of mild reactions during OIT treatment.
  2. Whenever an allergen is purposely administered to an allergic individual, there is potential for a body-wide allergic reaction. This is why each updosing is scheduled with a licensed allergist present.

One of the many misconceptions about OIT is that the treatment can result in patients becoming more allergic to the allergen. We are happy to tell you that this is inaccurate.

At the beginning of OIT treatment, IgE levels do increase, which has lead to the misconception that patients become more sensitive to the allergen. However, the food-specific IgG4, or blocking antibody, rises faster. IgE levels will return to baseline and fall as treatment continues while IgG4 continues to rise.

Lifestyle Challenges

Both Oral Immunotherapy and strict allergen avoidance require changes in habits and lifestyle.

Check out the infographic below for a quick comparison of the pros and cons of each.

The History of OIT

Oral immunotherapy is not a new concept. Interest in oral immunotherapy has grown in recent years, but the concept and use has been around since 1908. Here is a brief overview of the history of Oral Immunotherapy.

Von Pirquet coined the term “allergy.”

The same year, Dr. Lancet began his study into desensitization to peanuts.


AT Schofield successfully desensitized a boy to egg and published his achievement in the Lancet.


John Freeman taught thousands of patients how to safely administer grass pollen injections every day for 54 days with excellent results.


Meglio successfully desensitized 15 out of 21 children to peanut allergies. Of the remaining 6 children who participated in the study, 3 were not completely desensitized but could tolerate small amounts and were no longer in constant danger of a reaction.  


Alabama Allergy and Asthma Center has achieved desensitization with 100% of our OIT graduates.


National Success Rate


Our Success Rate

Our team strives to provide the best in care to all of our patients. We understand the stress, worry, and fear that comes from living with a food allergy and how that impacts the decision of parents and individuals to pursue treatment.

During OIT, all participants will have access to 24-hour support. A member of our team is always on call to answer any questions and address any concerns.

Without OIT people affected by food allergies are required to make substantial life adjustments in order to live safely. But with the help of board-certified allergist and a dedicated team, OIT can change you and your families life.