Treatment for Peanut Allergies : Oral Immunotherapy (OIT)

peanut allergy Atlanta GA

What is a Peanut Allergy?

A Peanut Allergy is one of the most common Allergies that causes severe allergy attacks. Some peanut allergies can be life-threatening (anaphylaxis). For some people with a peanut allergy, even a tiny amount of peanuts or smell can cause a serious allergic reaction.


What Causes a Peanut Allergy?

A Peanut allergic reaction occurs when your immune system overreacts and releases chemicals, including histamine, into your blood. These chemicals can then affect different tissues in someone’s body, such as the skin, eyes, nose, airways, intestinal tract, lungs, and blood vessels. It’s not yet discovered why peanuts trigger this response in some people.

Symptoms of a peanut allergy can be mild to severe. People who are allergic to peanuts may have a life-threatening reaction called anaphylaxis.  If not treated, death can be a result. Anaphylaxis usually occurs within minutes but can occur up to several hours after eating peanuts or peanut products. Symptoms of all peanut allergies, can start within a few minutes to a few hours after eating peanuts or peanut products, or come into contact with peanuts.

What reactions Do You Get if You have a Minor Peanut Allergy?

  • Stomachache
  • Runny nose
  • Itchy eyes
  • Hives
  • Tingling in your lips or tongue

What reactions Do You Get if You have a Severe Peanut Allergy?

  • Stomachache
  • Runny nose
  • Itchy eyes
  • Hives
  • Tingling in your lips or tongue
  • Tight throat
  • Hoarse voice
  • Wheezing
  • Coughing
  • Feeling sick to your stomach

What reactions Do You Get if You have a Life-Threatening (anaphylaxis) Peanut Allergy?

  • Problems breathing
  • Swallowing
  • Vomiting
  • Diarrhea
  • Dizziness
  • Swelling of the lips
  • Swelling of the tongue
  • Swelling of other parts of the body
  • Loss of consciousness
  • Constriction of airways
  • Swelling of the throat that makes it difficult to breathe
  • A severe drop in blood pressure (shock)
  • Rapid pulse
  • Light-headedness


How is a Peanut Allergy Diagnosed?

To diagnose a peanut allergy, your doctor, Dr. Chacko, will start with looking into your medical history and complete a physical exam. Dr. Chacko will need to know about any family food allergies, especially if you have a sibling with peanut allergies. Dr. Chacko will ask detailed questions about what symptoms you’re experiencing, how soon your symptoms began after you ate the food or came into contact with it, and if any over-the-counter allergy medicines like an antihistamine were ever helpful to stop the symptoms. Dr. Chacko will also have asked if other people also got sick when you experienced your symptoms, how the food was prepared, and what other foods were eaten.

It’s important to find out whether you have a possible food allergy or just a food intolerance. Dr. Chacko may ask you to keep a record or journal of all the foods you eat and any reactions you may have towards what you have eaten. Dr. Chacko may ask you to try an elimination diet, an oral food allergy challenge, to see if elimination of some food will cause the symptoms to stop. This technique also helps find out what you may be allergic to. This test is considered the best way to diagnose a food allergy.

In an elimination diet, you avoid eating foods that may be causing your allergic reaction and see if your symptoms go away. If symptoms come back when you eat the food again, your doctor can confirm your food allergy. The elimination diet can take 2-8 weeks.

You may also have allergy tests, like as skin tests or blood tests, to determine what foods you are allergic to after you have been diagnosed with having a food allergy.


How is a Peanut Allergy Treated?

If you accidentally eat a peanut or come into contact with peanuts, follow your doctor’s instructions. For a mild reaction, you may only need to take an antihistamine, to reduce or stop your symptoms. If you have had a severe reaction your doctor has probably prescribed a medicine called epinephrine. If you have symptoms in more than one body area, such as mild nausea and an itchy mouth, you would need to give yourself an epinephrine shot.

Even if you feel better after giving yourself a shot, symptoms of anaphylaxis can recur or suddenly appear hours later. You need to be observed in a hospital for several hours after your symptoms go away. If you do not have epinephrine and are having a severe allergic reaction, call your doctor immediately or go to the hospital.


How do I Give Myself an Epinephrine Shot (EpiPen Shot)?

How to use an EpiPen Atlanta GA

  1. Your epinephrine (EpiPen) injector may have a black or orange tip. Grasp the injector in your hand with the black (or orange) tip pointing down. Form a fist around the injector. Do not touch the tip.
  2. With the other hand, pull off the gray (or blue) cap.
  3. Hold the black or orange tip close to your outer thigh. Jab the tip firmly into the thigh. Jab through clothing if you must, but bare skin gives the best results. The injector should go straight into the skin, at a 90-degree angle to the thigh. Do not give the shot into a buttock or a vein.
  4. Keep the injector in your outer thigh for 10 seconds. Note: It is normal for most of the liquid to be left in the injector. Do not try to inject the remaining liquid.
  5. Remove the injector, and place your hand over the area where the medicine entered. Rub the area for about 10 seconds.
  6. Put the used injector, needle-end first, into the storage tube of your injector. Do not bend the needle. Go to the emergency room right away, and take the used injector with you.

Symptoms can come back after the EpiPen shot. So, go to the emergency room right away, even if you’re feeling better.

you should feel the effects of the medicine almost right away. These may include a rapid heartbeat and nervousness as well as improved breathing. The benefits of the shot usually last 10 to 20 minutes.


How can I Prevent an Allergic Reaction to Peanuts?

  1. Understand your allergy. Read food labels or ask the staff at restaurants if there are peanuts or peanut oils in any of the foods you order. Some people are severely allergic to peanuts that being near them or breathing air that contains peanut residue can cause an allergic reaction.
  2. Let others know that you have a peanut allergy. Make sure that everyone that you see within a day (such as school administrators, teachers, babysitters, friends, coworkers, and coaches) Know what the symptoms of an allergic reaction look like.
  3. Know where the epinephrine shot is kept and how to give it.
  4. Have a plan to get to the hospital if you have an allergic reaction.
  5. Wear a medical alert bracelet. This will alert emergency response workers if you have a severe allergic reaction.
  6. Keep your EpiPen with you at all times. Talk with your doctor or pharmacist if you are unsure how to give yourself the shot.
  7. Keep other medicines such as antihistamines with you for mild reactions if your doctor recommends it.


What Causes an Allergic Reaction to Peanuts?

  • Direct contact. The most common cause of peanut allergy is eating peanuts or foods containing peanuts. Sometimes direct skin contact with peanuts can trigger an allergic reaction.
  • Cross-contact. This is the unintended introduction of peanuts into a product. It’s generally the result of a food being exposed to peanuts during production.
  • An allergic reaction may occur if you inhale dust or aerosols containing peanuts, from a source such as a peanut flour or peanut oil cooking spray etc.


Do Peanut Allergies Ever go Away?

Physicians used to think that peanut allergies, particularly severe symptoms, always lasted a lifetime. Over the last decade, however, studies have shown that about 20 percent of children with peanut allergies can overcome the sensitivity.

By looking at allergy blood tests, which show IgE levels, doctors can even characterize your chances of outgrowing food allergies.


How Many People are Diagnosed with Weanut Allergies?

Allergy Testing Atlanta GA

Approximately 15 million Americans have been diagnosed with food allergies. Peanuts are the most common source of these allergies, with reactions ranging from minor skin rashes to life-threatening anaphylactic shock. About 8 percent of those with food allergies are children, and most never outgrow them. So far, the only approved treatment for food allergies is avoidance; however, Dr. Thomas Chacko from Northside Allergy is taking a different approach.


What is Peanut Oral Immunotherapy?

Dr. Chacko is using a process known as oral immunotherapy, or OIT, to gradually desensitize patients to their allergens, so they no longer suffer allergic reactions. This therapy has been used to desensitize hundreds of patients.

The process is similar to that used to treat environmental allergies, such as hay fever. Instead of avoiding peanuts, children are given carefully measured amounts of peanut protein mixed with pudding, yogurt, or applesauce. The starting dose is typically around 0.1 mg. The dose is gradually increased to approximately 6 mg over several hours. If the patient is able to tolerate the protein, they are sent home with individual containers of the dose, which they must take every day. Patients must return to the clinic every couple of weeks where they receive ever-increasing doses. Eventually, patients graduate to eating peanut M&Ms or whole peanuts. Patients are considered desensitized when they can eat about 10 peanuts a day without a reaction. . Patients are required to continue on

OIT for food allergies is not without its critics. OIT has not been approved by the Food and Drug Administration (although there are some products that will likely get FDA approved in some years). There are also questions regarding the long-term effectiveness of the treatment. The process is currently being evaluated in several clinical trials.

It isn’t uncommon for patients to experience some symptoms during treatment but that they are usually minor. He states that less than 10 percent of patients have experienced a systemic or anaphylactic reaction. Patients are also advised to take certain precautions to reduce their risk of a severe reaction.

OIT is a good option to explore for peanut allergic patients.Call Dr. Thomas Chacko today at 404-256-7532.


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If you feel as if your allergy symptoms are becoming worse and lasting longer, you are probably right. Roughly 80 percent of allergy sufferers experience some degree of symptoms all year long. If you count yourself among the 50 million Americans who suffer from nasal allergies, the following tips may help you relieve some of the worst of your symptoms.

Allergic Shiners:

Dark circles and bags under the eyes are a common indication of severe nasal allergies. “Allergic shiners” occur when the histamine produced in response to an allergen causes the tiny blood vessels around the eyes and nose to leak, which makes the eyes appear bruised. Placing cold compresses or ice packs over your eyes several times a day for 10 to 15 minutes at a time can help reduce the swelling. Taking a daily antihistamine when your symptoms are at their worst can help prevent the circles and bags from recurring.

The Allergic Crease:

A light crease across the bottom half of the nose is a common sign of long-standing allergies. It occurs when you repeatedly rub your nose with palm to get rid of the persistent itching. Although you cannot get rid of the crease, you can keep it from getting worse by using over-the-counter or prescription allergy medications to control your symptoms and by remembering to blow your nose instead of wiping.

Congestion Headache:

When your nasal passages become inflamed, mucus and air can become trapped in the sinuses and cause a migraine-like headache. If your headache is accompanied by postnasal drip or blocked ears, it is most likely caused by allergy congestion. An allergy medication with both an antihistamine and decongestant can help constrict the blood vessels and help relieve the pressure.

Itchy Skin:

The same allergy exposure that causes you to sneeze can also irritate nerve ending in your skin and cause you to itch all over. A lukewarm shower along with a lotion designed specifically for itchy skin can help alleviate the irritation. In extreme cases, the doctor may prescribe a topical steroid cream.

Food Tastes Bland:

Our ability to taste food is closely linked to our sense of smell. If your allergies cause your nasal passages to become congested, even the spiciest dish may taste like sawdust. You can try using saline sprays to clear the sinuses and relieve the inflammation.

If your allergy symptoms persist after trying these simple remedies, be sure to contact Dr. Thomas Chacko for an evaluation.

Approximately 2 percent of American children have some form of peanut allergy. The fact that some peanut allergies are so severe that they can lead to a life-threatening reaction known as anaphylaxis has led many parents to avoid giving peanut products to their children. Despite the over-abundance of caution, the incidence of peanut allergies appears to be growing. New guidelines published in the Journal of Allergy and Clinical Immunology challenges the idea that avoiding peanut products during infancy is the best policy.

Large-Scale Study Regarding Peanut Allergy Prevention:

The study was developed by researchers from the Immune Tolerance Network after observing that infants in Israel had a much lower incidence of peanut allergies than infants in other parts of the world. The researchers wanted to determine if there was a correlation between the lower incidence of peanut allergies and the common practice in Israel of feeding infants a peanut-containing snack during infancy.

The study followed more than 600 children who were at high risk of developing peanut allergies. One group was given a small amount of a food containing peanuts three times a week starting in infancy and continuing until the age of 5. The second group did not receive any peanut products before the age of 5. At the end of the study, each group of children was given peanuts. Approximately 18 percent of the children who had abstained from peanuts had an allergic reaction compared to only 1 percent of those who had been introduced to peanuts early in life. The peanut challenge was repeated the following year, and the children who did not have a peanut allergy initially were still free of peanut allergies. The researchers concluded that introducing peanut products while the immune system is still developing can prevent up to 80 percent of peanut allergies.

Guidelines for Introducing Peanut-Containing Foods to Infants:

• High-Risk Children

Infants with egg allergies, asthma, or a family history of peanut allergies are the most likely to develop peanut allergies. The new guidelines for high-risk infants recommend that parents either introduce a small amount of a peanut-containing food at 4 to 6 months of age or consult an allergist for a skin or blood test to determine if their child is allergic.

• Moderate-Risk Children

Children who have mild to moderate eczema are considered to have a moderate risk of developing peanut allergies. Parents are encouraged to give these children peanut-containing foods starting at 6 months of age.

• Low-Risk Children

Children without food allergies, eczema, or a family history of peanut allergies can be given peanut-containing foods at any age.

Of course, you should never give whole peanuts to infants since they pose a significant choking hazard.

What This Means for Other Food Allergies:

It is unclear if a similar approach can be used for other common food allergies. Researchers advise that more evidence-based studies are needed before they can issue guidelines regarding other allergies; however, determining if the approach is applicable for other allergies is a logical next step.

Vasomotor rhinitis is a condition in which the blood vessels inside your nose dilate. This swelling can cause nasal congestion and increased mucus drainage. The condition is not life-threatening; however, it can be uncomfortable and annoying leading to decreased production at work, nosebleeds, nasal dryness, drowsiness, and repeated doctor’s visits.

What Causes Vasomotor Rhinitis?

In many cases, the exact cause of the inflammation is not clear; however, there are certain factors that may trigger an inflammatory reaction, including

• smoke, perfume, strong odors, smog, and other environmental irritants,
• viral respiratory infections,
• weather changes,
• certain medications,
• strong emotions,
• alcohol, and
• hot or spicy foods or beverages.

Who is at Risk of Developing Vasomotor Rhinitis?

Although vasomotor rhinitis can affect anyone at any age, it is most common among women over the age of 20. Approximately 19 million Americans suffer from vasomotor rhinitis compared to roughly 58 million who experience allergic rhinitis.

Symptoms of Vasomotor Rhinitis:

The symptoms of vasomotor rhinitis may be intermittent or constant. The most common symptoms include a runny or stuffy nose and excessive mucus production or postnasal drip. Unlike allergic rhinitis, most patients with vasomotor rhinitis do not experience an itchy nose, itchy or watery eyes, or a scratchy throat.

Vasomotor rhinitis can cause complications similar to allergic rhinitis, including chronic sinusitis, ear infections, a decreased sense of smell, obstructive sleep apnea, and even asthma.

Diagnosing Vasomotor Rhinitis:

Skin and blood tests may be performed to rule out allergies and to make sure that your immune system is functioning properly. A nasal endoscopy or CT may also be performed to check for polyps or other problems with the sinuses and nasal passages.

Treatments for Vasomotor Rhinitis:

Over-the-counter remedies are often effective in alleviating the symptoms of vasomotor rhinitis. These remedies include saline nasal sprays, oral decongestants and antihistamines, and corticosteroid nasal sprays. If your symptoms are especially severe, you may require prescription medications such as mometasone, azelastine, olopatadine hydrochloride, or ipratropium. Surgery may be required if you have an underlying health condition, such as a deviated septum or nasal polyps, that is exacerbating your symptoms.

Preventing Vasomotor Rhinitis:

If you can identify specific triggers for your symptoms, you should try to avoid them. If this is not possible, you may need to follow a daily treatment regimen recommend by your doctor to reduce your symptoms as much as possible. It is important to consult a doctor before using decongestants. Long-term use of these medications may actually cause your symptoms to worsen, and certain decongestants may cause rebound congestion. Individuals with hypertension should avoid decongestants since these medications are known to increase blood pressure.

Keeping a constant temperature in your home and using a humidifier to add moisture to the air may help reduce rhinitis symptoms. You should also try to keep your home free of dust, smoke, and other allergens and environmental irritants. Exercise may also help you temporarily relieve your symptoms. Physical activity stimulates the sympathetic nervous system, which can constrict blood vessels for up to 30 minutes.

If you spend the holiday season sniffling and sneezing because of allergies, the culprit may be your Christmas tree. According to a research study presented recently at the annual meeting of the American College of Allergy, Asthma & Immunology, live greenery can raise the mold levels in your home by as much as five times within just a couple of weeks.

Reducing Christmas Tree Allergy Symptoms:

The best option for keeping allergy symptoms in check is to avoid bringing live trees and greenery into your home. If this is not possible, you may be able to reduce your symptoms by cleaning your tree before bringing it into your home.

• Shake out as much of the debris from the branches as possible.
• Rinse the tree with a sprayer or hose, and then leave the tree outdoors to dry a couple of days.
• Try to limit the amount of time that the tree is in your home to no more than 7 days.

Another option is to purchase an artificial Christmas tree, but even artificial trees are not without their problems. Trees that are improperly stored can collect dust and mold that can also trigger allergy symptoms. Artificial trees should be stored in waterproof containers that will help protect them from dust and mold and cleaned before they are brought into the house.

Regardless of the type of allergies that you may experience, we can create a customized treatment plan to help alleviate your symptoms. Contact us today for a consultation.