7 ms·

Our son is very allergic to peanuts and less so to cashew, and sesame. We went through oral immunotherapy and it's been absolutely life changing. He used to nee

• gobins 2y ago
  Wow that is really good to hear. I am on immunotherapy for a different type of allergy and can't stop talking about its effectiveness. It has been life changing.
  • sva_ 2y ago
    I did a whole immunization against dust mites and I feel like it didn't work at all. q.q I've been wondering if there's something else causing me to be allergic to them, like something I eat or so, idk. But I'll have to get tested again
    • gobins 2y ago
      I do a skin prick test every year and make sure I update allergens. It takes about 6 months to see the results and whole treatment could take upto 3-5 years. I took a break from the treatment during covid and the allergies came back. So it is important to get monthly shots.
    • pantalaimon 2y ago
      As a child I was diagnosed with a dust mite allergy too, but much later found out I’m actually allergic to certain pollen and cats.
• ugh123 2y ago
  > It's been difficult finding an allergist in Germany that's willing to accept this and move forward What are they saying? They don't believe in oral immunotherapy?
  • n_plus_1_acc 2y ago
    Even if they believe it, there's a list of treatments and procedures for each diagnosis that insurances are required to cover and oral immunatherapy might not be on said list.
    • mastazi 2y ago
      Is health insurance a common thing in Germany? Don't they have universal health care?
      • pantalaimon 2y ago
        Universal Health care is via public health insurance. You can pick from several public providers, but the price is basically fixed and deducted directly from your salary/payed by the state if you’re unemployed. There is a 2nd system of private insurance providers. Those tend to get you preferential treatment at doctors because they pay them more than the public insurance which has fixed rates, but they will hike prices as you get older and you can’t go back to the public System.
        • mastazi 2y ago
          Interesting, thanks for explaining
  • onli 2y ago
    They tend to be critical against immunotherapy in general, if it's not for those allergies where the therapy has a good chance of working and is without risk. Otherwise avoidance of the allergen is preached. We encountered that with a cat hair allergy, treatment was refused.
    • ekianjo 2y ago
      > avoidance of the allergen whats the point of the allergist then?
• mmikeff 2y ago
  Our daughter too, she’s been on a maintenance dose equivalent to two peanuts, once a week. It’s been life changing. She’s had several trips to A&E before the treatment but after a few years she was able to tolerate a dose equivalent to ten peanuts (although that still made her quite nauseous).
• dminor 2y ago
  I asked our allergist about oral immunotherapy for my daughter and he cited a study that found that avoidance was more effective in preventing severe reactions.
  • justinclift 2y ago
    Seems like a problem when avoidance goes even a bit wrong though. :(
    • deleted 2y ago
      [deleted]
  • zoky 2y ago
    I mean, avoidance is more effective than vaccination in preventing you from getting the flu, but that’s not the point of getting vaccinated.
    • dminor 2y ago
      How does one practically avoid flu exposure?
      • zoky 2y ago
        The same way you avoid exposure to anything. Stay home, don’t go near sick people, etc. The point is that in the event that you are somehow exposed, it’s better to be vaccinated than not. I wouldn’t tell you to not trust the advice of your doctor. But I would tell you that there is an always argument both ways for something like this. A different doctor may feel differently, and sometimes doctors change their minds when given a bit of pushback. It might be worth asking about the possibility of oral immunotherapy in addition to avoidance, rather than as a substitute for it.
  • munchbunny 2y ago
    So there’s one factor that doesn’t get discussed much: adherence to a fairly draconian treatment regimen for “forever”. Our allergist screened us for whether they thought that as parents we had the resolve and diligence to figure out a way to get a baby/toddler to eat a full teaspoon of peanut and cashew every single day. And as any parent can tell you getting them to eat a specific thing every single day is non-trivial. Oral immunotherapy seems to be very effective but sticking with it is nontrivially hard.
• halfcat 2y ago
  If you are willing to say, what was your son’s peanut allergy level? One of our sons is 6/6 on peanuts and they were very hesitant to try oral immunotherapy, more or less saying they weren’t willing to given the risk of anaphylaxis.
  • eskibars 2y ago
    I don't remember for sure, but I'm pretty sure it was 1 below the max level. I seem to recall it was on a scale of 5 with our test, but it might have been on a scale of 6
• shmichael 2y ago
  In Israel this is done naturally by feeding children Bamba, a puffed peanut snack, at a very early age. Research shows significantly decreased levels of peanut allergy. https://www.npr.org/sections/thesalt/2015/02/23/388450621/feeding-babies-foods-with-peanuts-appears-to-prevent-allergies https://www.npr.org/sections/thesalt/2015/02/23/388450621/fe...
  • eskibars 2y ago
    Yeah, we hadn't heard of this when our son was born, but the allergist mentioned it. When our daughter was born, we gave her something like this at his recommendation. The ones we got were some puffs that have a whole pile of allergens in tiny doses. Causation vs correlation and all that, and a small sample size, but our daughter doesn't have any issues with any allergies.
    • compumetrika 2y ago
      The economist Emily Oster wrote an excellent series of books about pregnancy anf early kid years, where she dives into details about various studies, whether they are causal, etc. It's one of the best practiacl explainations of reading research I've encountered targeted at non-academics, really well done. She has a chapter on peanut exposure allergies and i think inrecall that these early-exposure results are in fact from causal research vs just correlational research (basically there are at least two types of papers out thwre -- correlational and causal. As you might guess causal is harder to get for many reasons). Great books; she may also have published some chapters on her substack (substack came after the book I think). I realize as I write this that you are probably saying that for your own experience you can't disentangle correlational from causation, to which I would say -- correct!
      • MobileVet 2y ago
        Emily Oster is a national treasure that is still flying under the radar for most people. As above, she presents excellent science in an approachable manner for non-science minded folks. She also has enough of the technical details for this with the knowledge to be confident she has done a strong analysis. If you are a parent and haven’t checked her stuff out, please do. (Zero affiliation or connection)
• munchbunny 2y ago
  We did this for our son (peanuts and cashews) and it was also life changing. He’s on a daily maintenance dose for life, but we no longer fear the possibility of either allergen being near him in public places or cross contamination in food. He still has to carry his epipen, but now the prognosis for “oops he ate something with peanut in it” is no reaction at all until he’s several peanuts in. He’s not cured and can still eat his way to anaphylaxis with a bag of peanuts, but he can take a few bites out of a PB&J sandwich and nothing will happen. One detail in particular makes a huge difference: oral immunotherapy seems to be significantly more effective in babies (starting before age 2) with significantly better outcomes. Adults and young children have a much higher incidence of side effects (most common one is a constantly upset stomach) that makes avoidance potentially still better for overall quality of life, but our allergist told us that among their <2 year old cohorts they’ve seen zero out of [upper two digits] experience any of those side effects at all. We started our son when he was 1 year old. In our case the kid started eating peanuts basically as soon as they started eating solid foods, so the allergy happened despite early exposure. Actually we caught the allergy early enough to start OIT early because of early exposure.
• Yawrehto 2y ago
  Me too. My younger sibling, as a child, had (and still has) allergies (at the time, peanuts, tree nuts, eggs, sesame & sunflower). About a year, maybe 2, after starting to eat small amounts, they could do sesame, stovetop (!!) eggs, and nut butter. The problems went from 'allergic reaction' to 'won't eat the eggs and nuts'. (I think at one point the solution was pancakes with nut butters and sprinkles. Kid still had a hard time eating it.) I don't know why it's taken so long for this to gain broader acceptance.
• marcod 2y ago
  Sorry for being nosy, but did you do oral immunotherapy with or without professional support?
  • eskibars 2y ago
    With. First they did a blood test (instead of a scratch test) to identify possible allergy levels. Then the allergist had us come into the office to take e.g. a few micrograms of peanut powder and watch him for reactions. Then we maintained the dose at home every day for the next couple weeks, taking zyrtec with it to avoid hives, etc. Then we'd go back in, try doubling the dose as a challenge. If he had a bad reaction, we stayed on the same dose another few weeks, and if not, it became the new standard level. Rinse and repeat for about a year until we got to 2 peanuts, 1 cashew, and 1/4 tsp of tahini, which we maintained now for the past ~1.5y. We're due for another blood test and challenge here soon, as the allergist suggested there's a small chance that the immunotherapy could result in the allergies essentially receding
    • nathancahill 2y ago
      Our son is allergic to nearly everything (peanuts, nuts, dairy, eggs, sesame, wheat) and we haven't found an allergist willing to work with us. Do you know if there's an age factor for immunotherapy effectiveness? He's 2 1/2 yo.
      • munchbunny 2y ago
        Age is a known factor for oral immunotherapy’s risk and effectiveness, and the commonly cited fuzzy threshold is starting before 2 years of age. The data isn’t that strong, but “start very young” basically has practitioners’ consensus. You have to shop around for allergists willing to do it. Our first allergist told us they weren’t comfortable doing it but it was becoming an increasingly popular option and referred us to several allergists who did it. We’ve also spoken to allergists who were bearish on it. It’s because there’s very little published data.
      • nostrademons 2y ago
• Obscurity4340 2y ago
  Is this effective and available for milder chronic hayfever and runny,partially blocked nose, generally speaking?
  • RamblingCTO 2y ago
    Yes it is: https://www.aok.de/pk/magazin/koerper-psyche/haut-und-allergie/desensibilisierung-endlich-allergiefrei/ https://www.aok.de/pk/magazin/koerper-psyche/haut-und-allerg... I heard that you can choose between pills every day for a prolonged period OR three injections over a year. Not sure how accurate this is, but every "allergologe" provides this in Germany.
  • ad700x 2y ago
    I visited my local allergist for this (in the USA). Basically the treatments available to me were either shots or eyedrops. The shots required visiting the office almost daily, then weekly, then less frequently. The eyedrops can be self administered. I was told both treatment options are not permanent and need to be basically done in perpetuity. The cost was a couple thousand dollars per year (basically no insurance coverage). Seems like the treatment options are evolving pretty rapidly and these options aren't available everywhere. Or this is what I was told.
    • jorvi 2y ago
      > I was told both treatment options are not permanent and need to be basically done in perpetuity You were told wrong. Shots have a ramp-up period and then a five year maintenance period where you get one shot a month. Afterwards, you've effectively been cured.
      • morsch 2y ago
        A friend just started the shots and there was no ramp up, he's getting the shots every four to six weeks from the start. When I looked into it ten years ago, you had to come in weekly for a long time, which discouraged me from doing it.
  • deleted 2y ago