Adventures of an Allergist Mommy

I've recently started offering oral immunotherapy for foods in my practice. I debated with myself for almost a year before implementing protocols for this therapy, because it was incredibly important to have strict and detailed procedures in place, given the serious risks associated with food challenges in highly sensitive individuals. I take food allergy extremely seriously, and it isn't something one "dabbles in". So, it was beyond gratifying to have the following conversation with a patient a few weeks ago: Me: "You're doing really well with advancements in dosing. If we keep moving along at this pace, pretty soon, you'll be dosing with wheat bread instead of capsules!" Patient: "Awesome..." Me: "Don't get too excited. It is going to start with a tiny little morsel of bread, not a sandwich!" Patient: "You have no idea. I am going to glorify that little morsel! I have been waiting for this for such a long time....

With the awareness of food allergies increasing, there is expanded interest in the various methods of diagnosing food allergy. Of course, the skin test vs. blood test debate is ongoing. (I have more trust in the skin test, in case you're wondering.) There are also plenty of proponents of what I call "weird science". These are unproven methods that might make someone feel like they're getting an answer (and are certainly enriching the practitioner), but do very little to diagnose actual food hypersensitivity and, more often than not, lead to unnecessarily restrictive diets. However, there's decidedly less discussion about what is considered the most definitive way to diagnose food allergy- the oral food challenge. A food challenge is a test that involves giving a patient incrementally larger doses of a specific food by mouth over a period of time, all the while monitoring the patient for signs and symptoms of an allergic reaction. Because the risk of an acute ...