Treatment for Peanut Allergies : Oral Immunotherapy (OIT)

August 17, 2017
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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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Dr. Chacko and Dr. Sanjay Gupta on CNN. See the video here.