Oral Immunotherapy to Multiple Foods

By: Ross I. Palis, MD

Ross I. Palis, MD

Approximately 32 million people in the United States have food allergies, including 1 in 13 children (about 2 per classroom), and the prevalence of childhood food allergy has sharply risen over the past few decades.  Furthermore, a recent study of nearly 5600 patients registered in the Food Allergy and Research Education (FARE) database showed that 82% reported having multiple food allergies, with the most common foods being peanut, tree nuts, cow’s milk and egg [reference 1].

Colorado Allergy and Asthma Centers has been offering food oral immunotherapy (OIT), a procedure designed to gradually desensitize individuals to their allergenic food(s) via ingestion of precise amounts of food proteins, since 2019.  OIT is not a cure for food allergies, but rather a way to induce tolerance to enough of the allergenic food to protect against having a severe reaction to an accidental ingestion (“bite protection”).  We are currently treating patients with life-threatening allergies to peanut, cashew, walnut and egg.

Earlier this year, we began offering OIT to treat multiple food allergies simultaneously.  This may seem like a scary idea, but it’s actually quite logical.  When we treat patients with immunotherapy (“allergy shots”) for their environmental allergies, we do not first desensitize their cat allergy, then their grass allergy, then their dust allergy, etc.  Everything is treated all at once!  So, why can’t that work for foods?

The answer is that it can!  Back in 2020, some of our food allergist colleagues in Florida published their experience with multi-food OIT [reference 2].  Compared to their experience with peanut OIT, they found that a similar percentage of patients receiving multi-food OIT reached their protective food protein doses and with similar rates of adverse events during the OIT procedure.  Given the fact that it typically takes 5-6 months to reach the protective dose for single-food OIT, treating multiple food allergies at once can save our patients and families significant amounts of time.

Oral immunotherapy, whether to one food or multiple foods, is not for everyone.  To learn more about this food allergy treatment option, you can read more here. or schedule a visit with one of our many knowledgeable allergy providers.

  1. Raimundo K, et al.  Ann Allergy Asthma Immunol 2021;127(5, Suppl):S40.
  2. Gasich L, Fergeson J, Ly J.  J Allergy Clin Immunol 2020;145(2, Suppl):AB133.

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