Services for Your Child and You
Food allergy management goes beyond skin testing.
For years, patients and families have depended on Dr. Hoyt to hear their stories. So much of food allergy is nuance, and every history is different. During your consultation at the Hoyt Institute of Food Allergy, you will sit and talk with the Institute Team about your story.
Focusing on families with children with food allergy, Dr. Hoyt will base your child's evaluation on your child's unique story. That evaluation may include recommendations for skin prick testing, blood testing, and ingestion challenge(s).
It all starts with your child's story being heard.
Skin Prick Testing
What it determines: are allergy antibodies present in the skin?
Skin prick testing is a staple in the evaluation of food allergy. This service is performed in the Institute only after a thorough consultation with Dr. Hoyt. Skin testing recommendations are based on the patient's unique presentation.
Skin prick testing is performed on the arm or back using allergen solutions and tiny lancets. Skin prick testing exposes immune cells in the top layer of skin to a potential allergen. If those immune cells have allergic antibody on them, the cells will secrete chemicals locally at the prick site and cause a red, raised, itchy bump.
A positive skin test indicates allergic antibody is present and, thus, the patient is sensitized.
A positive skin test suggests the patient is at risk of allergy but does not confirm the patient is allergic.
What it determines: are allergy antibodies present in the blood?
Blood testing for food allergy is an important part of the evaluation of food allergy. This service is performed in the Institute only after a thorough consultation with Dr. Hoyt. Like skin testing, blood testing recommendations are based on the patient's unique presentation.
Blood testing is performed by taking a small blood sample and sending it to the lab. In the lab, the blood is run through an ImmunoCAP machine, and allergy antibodies, called Immunoglobulin E (IgE), are detected if present.
As with skin prick testing:
A positive blood test indicates allergic antibody is present and, thus, the patient is considered "sensitized."
A positive blood test suggests the patient is at risk of allergy but does not confirm the patient is allergic.
This is the gold standard for whether food allergy is present.
An ingestion challenge is a procedure performed by an allergist in the allergist's office. During the procedure, the family brings in the food to which the child is potentially allergic. Under the supervision and patient-specific protocol determined by the allergist, the child ingests increasing amounts of the food. The goal "dose" is an age-appropriate serving size of the food.
Prior to the appointment, the child's family is counseled on the potential risks and benefits of the ingestion challenge procedure.
If the ingestion challenge procedure does not trigger allergy symptoms, the challenge is considered negative, and the allergist likely will recommend incorporating the food into the diet.
If the ingestion challenge procedure triggers allergy symptoms, the procedure is considered positive, and that food is confirmed an allergen. The allergist may then recommend avoidance or an immunotherapy program.
Oral Immunotherapy (OIT)
Treating the allergy with the allergen
The days of "avoid the food and come back as needed" are gone. Food allergy families now have options for treatment. While avoidance of the allergen is always an option and sometimes the best option for a family, the Institute offers oral immunotherapy.
Oral immunotherapy, known as “OIT," is a way to teach the immune system to tolerate a food. For over a decade, private practices have been utilizing OIT protocols to help patients with food allergies. In addition, academic institutions have pioneered FDA-approved therapy, and they play a major role in providing a better understanding OIT, such as how the treatment works and the safety of this treatment.
OIT is based on the principles of classic pollen immunotherapy, such as “allergy shots.” Of note, allergy shots have been used for over a century to teach the immune system to tolerate environmental allergens, such as pollens.
OIT may be indicated in a patient with a confirmed IgE-mediated food allergy. The therapy is provided under close supervision of a trained allergist and involves ingesting tiny amounts of the allergen. Initial doses and increased doses are administered in the allergist's office then continued daily at home.
OIT typically requires months to reach a maintenance dose of the allergen then years to induce tolerance to the food.
Learn more about our OIT Program here.
Avoidance is always an option.
If a child has an IgE-mediated food allergy, it is important that the child avoid that food to prevent anaphylaxis, a severe allergic reaction.
Although therapies like oral immunotherapy are becoming more and more prevalent, those therapies are not always the best fit for a patient with food allergy. In those cases, avoidance is the best management plan.
But avoiding an allergen is not necessarily simple, and rarely is it fun. At the Institute, you will receive support in and education on how to avoid the allergen, how to make safe (and tasty!) food substitutions, and how to talk with your loved ones, schools, and other groups about your child's food avoidance plan.
Anxious thoughts are normal, but they don't have to wreak havoc on your or your family's lives.
Do you know who performs most of your kiddo's food allergy management? It isn't your child's allergist. It's you. Although the medical care your child receives at the Institute is cutting-edge and personalized to your child, it is you that is making those day-to-day, sometimes minute-by-minute decisions on how to manage your child's food allergy. That management can weigh on you, especially when you do what all loving parents do: think about worst-case scenarios. The non-stop management of food allergy can trigger anxious thoughts, so we provide access to food allergy-focused support for all our families with food allergy regardless of the child's treatment plan.