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Writer's pictureDr. Alice Hoyt

The Risks of SLIT and OIT in Food Allergy – What You Need to Know

Okay, let's get to it. What are the risks of OIT and SLIT for kiddos with food allergies?

In this podcast episode, I had the pleasure of speaking with board-certified allergist and pediatrician, Dr. Sakina Bajawala. Our discussion centered on strategies to enhance safety during food immunotherapies and ways to conquer food allergy fears. We talk about about the benefits and risks of OIT and SLIT.

Food allergies can pose a significant burden on affected families, with anaphylaxis being a major concern.

The rate of anaphylaxis during a course of immunotherapy and the risk associated with each exposure were addressed in detail. Contrary to what many might think, the rate of anaphylaxis as a function of the number of exposures is relatively low during oral immunotherapy. This is largely due to the efforts made by allergists to optimize baseline health prior to initiating treatment.


Optimizing baseline health is a crucial part of managing food allergies.

I love the way Dr. Bajawala likens the body's ability to handle allergic inflammation to a bucket that fills up with various triggers such as uncontrolled eczema, poorly controlled asthma, and active environmental allergies. By getting these conditions under control, we create more room in the “bucket,” reducing the likelihood of it overflowing and causing an allergic reaction.


During the episode, we also explored the distinct safety measures for oral immunotherapy, sublingual immunotherapy, and food desensitization.

These therapies differ in their approaches and safety protocols, but both aim to retrain the immune system to tolerate allergens. The benefits and risks of OIT and SLIT are always critical considerations. Oral immunotherapy can provide protection to higher doses of allergen, but OIT requires a more extended dosing safety-window to prevent reactions during dosing. Sublingual immunotherapy can reduce the risk of systemic or anaphylactic reactions to smaller doses of allergen but has a significantly less time-intensive dosing safety-window. 


One interesting point we discussed was the potential of sublingual immunotherapy to create significant levels of protection even at low doses. With the emergence of new research and data, we can expect more advancements in the treatment of food allergies in the coming years.


Lastly, we discussed the importance of having a food allergy informed counselor in the process of managing food allergies.

A counselor who understands the intricacies of food allergies can provide valuable support to both the patient and their families, aiding in the journey to regain control over food allergies. This is important, especially when thinking about the risks of OIT and SLIT.


Do the risks of OIT and SLIT outweigh the benefits?

This podcast episode in which I discussed the risks of OIT and SLIT with my colleague Dr. Sakina Bajawala shed light on the importance of understanding food allergies and their management. What is right for your family? And do the risks of OIT and SLIT outweigh the benefits? Talk with an OIT- and SLIT-informed allergist. With expert guidance, families battling food allergies can find hope and reassurance, allowing them to regain control over their lives. This means less stress and more joy!




Or listen to the episode wherever you hear podcasts!

Get your food allergy questions answered!

We hope you enjoy the podcast “The Risks of OIT and SLIT in Food Allergy – What You Need to Know.” Do you have any questions about the risks of OIT and SLIT? Or about food allergies in general? Sign up for our newsletter where you can submit your questions and stay up-to-date on all things food allergy and YOUR kiddo!

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A note from Dr. Hoyt

I have talked about a non-profit…

Pam and I volunteer with the non-profit The Teal Schoolhouse. Its primary program is Code Ana. Code Ana equips schools for medical emergencies like anaphylaxis.

Code Ana’s Online Epinephrine Training Program helps support that goal. Through this program, you will educate yourself while you support this important mission!

A medical emergency response plan is important for everyone at any school. Code Ana's program Med-E Ready is a comprehensive approach to school-focused medical preparedness. This program guides schools through the process of creating a medical emergency response plan. A response team is also developed! This is one of the most important components of a school's food allergy policy!

Does your kiddo’s school have Code Ana?

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Remember, Dr. Hoyt is an allergist, but she isn't your allergist, so talk with your allergist about what you've just learned!

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