Allergy doctor shares new treatment options for food desensitization

Until recently, most people with food allergies had only a few options for dealing with them: avoid the food and keep an emergency epinephrine pen on hand at all times.

Now, Dr. Carolyn Comer with the Alabama Allergy & Asthma Center said, both kids and adults can undergo desensitization treatments enabling them to eat their allergy-triggering food with no risk of a reaction.

Comer was the Homewood Chamber of Commerce's featured speaker at the June 18 chamber luncheon.

She said about one in 10 adults and one in 13 kids have a food allergy, and allergy care costs about $4,184 per child each year. The most common allergens are milk, eggs, peanuts, tree nuts, shellfish, soy and wheat, though Comer said many other foods can also cause allergic reactions.

Families of a person with food allergies often have to deal with fear of a dangerous reaction and being limited in activities and social interaction, Comer said. Many kids also experience bullying from classmates.

In recent years, desensitization treatments have become more common and accessible. Alabama Allergy & Asthma began offering oral immunotherapy treatment (OIT) in fall 2016 and opened the Food Allergy Treatment Center in December 2017.

OIT is available for anyone ages 4 and up and offers the "freedom and peace of mind" to handle accidental ingestion of allergens, Comer said, so families can go to restaurants that were previously off-limits and "quit reading food labels." The treatment is available for peanuts, tree nuts, milk, eggs, soy, sesame and wheat.

After a physical exam and testing, Alabama Allergy & Asthma gives the patient a microscopic dose of the allergen to start building up their tolerance. The starting dose for peanut allergies, Comer said, is equal to about 1/125,000 of a single peanut.

Over a period of months, the patient slowly increases the dosage and maintains that with an at-home regimen. The clinic has safety procedures in case of an anaphylactic reaction and they have around-the-clock availability to answer patient questions, Comer said.

The goal is to reach a "maintenance" diet with daily consumption of the allergen. Comer said while the "primary goal" is to prevent adverse reactions from accidental exposure, many families can incorporate a glass of milk, an egg or peanut butter candy into their regular diets.

Patients do have to continue their maintenance diet and have follow-ups at the clinic, as most food allergies never completely disappear, Comer said.

"It's not a cure. ... The child is still allergic, they're just desensitized and protected," Comer said.

About 40% of their patients travel from other cities and states for treatment, Comer said.

In April, Alabama Allergy & Asthma added an early introduction treatment for infants at high risk for allergies. By exposing children to the allergen before they reach one year old, Comer said the allergies can be reduced.

This July, the clinic is adding a sublingual allergy drop therapy, which is suitable for anyone over a year old. Comer said the sublingual drops have fewer rules for at-home treatments and are safe at a younger age, but the lower dose means slower results.

Comer said the work of the Food Allergy Treatment Center is all about giving families "freedom and control and hope" for more regular interaction with everyday foods.