Understanding
Oral Immunotherapy
A comprehensive guide to Oral Immunotherapy, an innovative treatment for food allergies offered through Dr. Atul Shah's FATE™ Program at NY Food Allergy & Wellness. OIT helps desensitize patients to allergens like peanuts, eggs, milk, wheat, soy, sesame, and tree nuts, reducing the risk of severe reactions. Our experience and expertise can help you with uncommon foods like sunflower seeds, flaxseed, chickpeas, lentils, and many more. Tolerance enhancement to “Bite-proof” and free eating are real possibilities.
SUCCESS
STORIES
20+
30+
YEARS OF
EXPERIENCE
ALLERGENS
TREATED
Understanding
Oral Immunotherapy
A comprehensive guide to Oral Immunotherapy, an innovative treatment for food allergies offered through Dr. Atul Shah's FATE™ Program at NY Food Allergy & Wellness. OIT helps desensitize patients to allergens like peanuts, eggs, milk, and tree nuts, reducing the risk of severe reactions.
20+
30+
YEARS OF
EXPERIENCE
SUCCESS
STORIES
ALLERGENS
TREATED
What Is Oral Immunotherapy?
Oral Immunotherapy (OIT) is a desensitization treatment where patients consume gradually increasing amounts of an allergen under medical supervision to build tolerance. This process initially aims to raise the threshold for allergic reactions, providing protection against accidental exposures. When continued beyond these thresholds, free eating is a reality for most.
Definition and Mechanism: OIT works by exposing the immune system to small, controlled doses of the allergen, reprogramming it to reduce IgE production and reduce the risks of reactions. It's a way to manage food allergies more effectively than just avoidance. When immune cells are fully re-educated and do not make new IgE, free eating and long-term tolerance are possible.
Common Applications: Widely used for common allergies like peanut allergy, egg allergy, milk allergy, tree nut allergy, wheat allergy, soy allergy, and sesame allergy. Our experience and expertise allow us to help you with cashew allergy, walnut allergy, hazelnut allergy, almonds allergy, pecan allergy, pistachio allergy, sunflower seed allergy, flaxseed allergy, chick pea allergy, lentil allergy, fish allergy, shellfish allergy, and many more.
How Does Oral Immunotherapy Work?: Starting with tiny doses in a clinic, patients progress to daily home maintenance doses. Protocols for the peanut oral immunotherapy or egg oral immunotherapy protocol and for all other foods are tailored to individual needs. We design single or multiple food OIT protocols based on each patient’s individual needs.
Oral Immunotherapy vs Injections: NO. The OIT does not require injections. Unlike allergy shots for environmental allergies (subcutaneous immunotherapy), the food OIT is ingested orally, making it specific to food allergies rather than environmental ones. Patients can choose low dose longer duration treatment in the form of Food Sublingual Immunotherapy (SLIT) and they are given as drops to be held in the mouth. If the biologic medications are added or used along with OIT, they need to be given as injections.
Why Oral Immunotherapy
Awareness Matters
Raising awareness about Oral Immunotherapy is crucial as food allergies affect millions, with peanut allergy alone impacting about 1 in 50 children. OIT offers hope for "food freedom," allowing patients to eat previously avoided foods without fear of anaphylaxis. The science of food desensitization and our expereince in using this science allows us to help patients and families choose their goals. We want food allergy families to be aware of avaialble options for single and multi-food management options for common and uncommon foods. There is a lot we can do to help you even when others have seen limitaions or declined you of OIT or SLIT options.
Early intervention through OIT can prevent life-threatening reactions, improve quality of life, and reduce healthcare costs from emergency visits. Studies show OIT's effectiveness in children and adults, with ongoing research highlighting its role in treating one or many foods simultaneously. We recommend starting OIT as young as infants as younger start of OIT has shown better long-term outcomes.
At NY Food Allergy & Wellness, Dr. Atul Shah's FATE™ Program integrates OIT to provide personalized care, helping families navigate food allergies safely. Our mission is to provide you with the quality of life you deserve.
Common Triggers & Allergens
Treated with Oral Immunotherapy OIT
and Sublingulal Immunotherapy SLIT
OIT and SLIT targets a range of food allergens, with protocols adapted for specific allergies. Our internal trends show increasing use for multiple allergens and younger age groups.
Peanut Allergy: Oral immunotherapy for peanut allergy has documented high success in desensitization, sustained unresponsiveness and tolerance. Cross-contamination protection known as bite-proof to free eating is a reality for many. The FDA has also approved a product for Peanut OIT, supporting the science of desensitization.
Egg Allergy: Oral immunotherapy for egg allergy follows unique protocols for treatment of egg allergy in infants, children, and adults to reach protection and free eating with baked egg products and eggs by itself.
Milk (Dairy) Allergy: Oral immunotherapy for milk allergy helps with cow's milk allergy, a common trigger in infants, children and persisting for many adults.
Tree Nut and Cashew Allergy: Oral immunotherapy for all tree nut allergy, including cashew allergy, addresses the most common tree nut allergies.
Other Allergens: Includes oral immunotherapy for wheat allergy, sesame allergy, walnut allergy, hazelnut allergy, almond allergy, pecan allergy, pistachio allergy, sunflower seed allergy, flaxseed allergy, chick pea allergy, lentil allergy, fish allergy, shellfish allergy, and many more. Call us to verify the updated food list for OIT.
Diagnosis, Management & Eligibility
for Oral Immunotherapy
Determining eligibility for OIT involves thorough evaluation to ensure safety and success. We use FATE Program Steps to maximize success.
Initial Consultation and Allergy Assessment: The journey begins with an initial consultation. During this meeting, Dr. Atul Shah & NY Food Allergy & Wellness team, will conduct a thorough assessment of the patient's medical history, dietary habits, and symptoms. This step is crucial for forming a preliminary understanding of the potential allergens and the severity of the various food allergy symptoms.
IgE Tests & BAT: We use allergen Skin Tests, sIgE and component blood tests, IgG4 tests, Basophil Activation Tests (BAT) based on patient history to confirm true food allergy from false positive tests.
Oral Food Challenge (OFC): Oral Food Challenges are considered the gold standard for diagnosing food allergies. During an OFC, the patient consumes small amounts of the suspected allergen under strict medical supervision to observe any reactions. This method provides definitive results and is conducted with the utmost care and safety. Patients may not need OFC before starting OIT if history and prior tests are enough to make an accurate diagnosis.
Food SLIT and Food OIT: Some patients may need food SLIT as an alternative or before OIT. Some may need biologics and can be used along with OIT.
Age Considerations: Oral immunotherapy starts at as young as infants. The OIT done through our FATE Program has been effective for all age groups, including children, adolescents, and adults. More and more young children and adults are seeking Oral Immunotherapy under our FATE Program.
Precautions and Exclusions: Patients with uncontrolled asthma, EoE, or certain other medical conditions require better control of these conditions before we start OIT. We focus on managing these conditions in the early stage and modify our protocols to increase success in these patients.
Management & Treatment with Oral Immunotherapy
Managing OIT requires a structured approach through phases, with Dr. Atul Shah's expertise ensuring optimal outcomes.
Protocol and Phases: Oral immunotherapy protocol includes up-dosing in clinic visits and maintenance at home. How long does oral immunotherapy take? Typically 6-12 months to reach maintenance, with ongoing daily doses.
At-Home Management: Oral immunotherapy at home involves careful dosing, monitoring for side effects, and avoiding triggers like exercise post-dose.
Combination Therapies: Options like oral mucosal immunotherapy (OMIT), sublingual immunotherapy, or omalizumab enhance effectiveness.
Our FATE™ Program: Led by Dr. Atul Shah, the 5-phase FATE™ Program at NY Food Allergy & Wellness offers customized OIT for desensitization. With 15,000+ success stories, it covers oral immunotherapy for food allergies, including peanut, egg, milk, and nut allergies.
Link to more on FATE™: Food Allergy Treatments
Oral Immunotherapy Success Rate and Effectiveness
Does oral immunotherapy work? Yes, OIT has been shown to be effective for desensitization in peanut, egg, and milk allergies. Oral immunotherapy for peanut allergy is particularly effective, with studies indicating protection from accidental exposures in many cases.
Research Insights: Studies like "oral immunotherapy in food allergy where are we now" and "early oral immunotherapy in peanut allergic preschool children is safe and highly effective" support its efficacy.
Pros and Cons: Pros include reduced anaphylaxis risk and improved quality of life; cons involve commitment and potential side effects.
Real-World Examples: Oral immunotherapy review and reddit discussions (e.g., peanut oral immunotherapy reddit) highlight patient experiences.
Oral Immunotherapy Side Effects and Risks
While effective, OIT has risks that require monitoring.
Common Side Effects: Oral itching, abdominal pain, vomiting, hives, wheezing, and oral immunotherapy anaphylaxis.
Serious Concerns: Oral immunotherapy and EoE (eosinophilic esophagitis), eczema flares, or oral immunotherapy for allergies side effects like peanut oral immunotherapy side effects.
Mitigation: Supervised protocols minimize risks; oral immunotherapy pros and cons should be discussed with providers.
Dr. Atul Shah:
Pioneering Food Allergy
Treatments in Manhattan.
Dr. Atul Shah, MD, FACAAI, FAAAAI, is the founder of NY Food Allergy & Wellness and a renowned allergist with over 20 years of experience. With more than 15,000 success stories across children, teens, and adults, Dr. Shah’s expertise knows no age limits. He holds dual fellowships and has been honored with prestigious awards, including America’s Top Physician. Dr. Shah is a leader in allergy care, offering personalized, life-changing treatments for all ages.
Dr. Atul Shah, MD, FACAAI, FAAAAI, is the founder of NY Food Allergy & Wellness & a renowned allergist with over 20 years of experience. With more than 15,000 success stories across children, teens, & adults, Dr. Shah’s expertise knows no age limits. He holds dual fellowships & has been honored with prestigious awards, including America’s Top Physician. Dr. Shah is a leader in allergy care, offering personalized, life-changing treatments.
Why One-on-One Care at NYFA
Outshines Larger Institutions
NY Food Allergy & Wellness, the best food allergy institution, offers a private practice experience that sets us apart. Our clients from the Upper East Side, Scarsdale, and Roslyn benefit from:
Discretion and Privacy: A quiet, upscale environment ensures your care remains confidential.
Tailored Treatment Plans: Every step of the FATE™ Program is customized to your unique needs.
Direct Access to Expertise: Work closely with Dr. Shah, benefiting from over 20 years of experience and 15,000 success stories.
Onsite Testing: Needed skin tests and blood tests are arranged onsite while you are in the office. We’re the only CLIA-certified and DOH-approved Basophil Activation Test (BAT) lab in New York State, offering cutting-edge diagnostics to get an accurate diagnosis unavailable elsewhere.
Food Oral Challenges, SLIT, OIT in Exclusive and Private Setting: Everything needed is done safely in a child and adult friendly environment in an exclusive private setting.
Oral Immunotherapy FAQ
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Oral immunotherapy (OIT) has demonstrated effectiveness in desensitizing patients to food allergens like peanuts, eggs, milk, and tree nuts, with research showing positive outcomes in inducing a desensitized state. Factors such as treatment duration and patient age can influence results, with ongoing studies supporting its role in providing protection against accidental exposures. At NY Food Allergy & Wellness, Dr. Atul Shah's FATE™ Program has helped over 15,000 patients achieve successful desensitization, tailoring protocols to maximize effectiveness while minimizing risks. For personalized advice, schedule a consultation with Dr. Atul Shah at NY Food Allergy & Wellness.
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Oral immunotherapy (OIT) is a treatment for food allergies where an allergic individual is fed gradually increasing amounts of the allergen to increase the threshold that triggers a reaction. It involves starting with very small doses under medical supervision and progressing to maintenance doses, aiming for desensitization rather than a cure. This approach reprograms the immune system to tolerate the allergen better, reducing the severity of accidental exposures. At NY Food Allergy & Wellness, our FATE™ Program uses evidence-based OIT protocols customized for patients, offering a path to greater food freedom. We do a deep dive into medical history in phase 1, which helps us with our approach moving forward, using methods such as the Basophil Activation Test (the only certified lab in NYS), and we may opt for an Oral Food Challenge—all of which can then determine the next phase, OIT or SLIT, based on patient's preference. Finally, this leads to bite-proof to free eating desensitization. For personalized advice, schedule a consultation with Dr. Atul Shah at NY Food Allergy & Wellness.
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Yes, immunotherapy can be taken orally through oral immunotherapy (OIT), which is specifically designed for food allergies by ingesting increasing doses of the allergen. This differs from traditional allergy shots but is effective for desensitizing to foods like peanuts or eggs. Another oral form is sublingual immunotherapy (SLIT) for food allergies, where drops or tablets are placed under the tongue. At NY Food Allergy & Wellness, we specialize in oral methods like OIT via the FATE™ Program to help patients manage food allergies safely. We do a deep dive into medical history in phase 1, which helps us with our approach moving forward, using methods such as the Basophil Activation Test (the only certified lab in NYS), and we may opt for an Oral Food Challenge—all of which can then determine the next phase, OIT or SLIT, based on patient's preference. Finally, this leads to bite-proof to free eating desensitization. For personalized advice, schedule a consultation with Dr. Atul Shah at NY Food Allergy & Wellness.
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The duration of oral immunotherapy is case by case, depending on individual factors such as the specific food allergen, patient's response, and any adjustments needed during treatment. Typically, the process involves an initial up-dosing phase followed by maintenance, but timelines vary to ensure safety and effectiveness. At NY Food Allergy & Wellness, the FATE™ Program structures OIT for efficient progress—we do a deep dive into medical history in phase 1, which helps us with our approach moving forward, using methods such as the Basophil Activation Test (the only certified lab in NYS), and we may opt for an Oral Food Challenge—all of which can then determine the next phase, OIT or SLIT, based on patient's preference. Finally, this leads to bite-proof to free eating desensitization. For personalized advice, schedule a consultation with Dr. Atul Shah at NY Food Allergy & Wellness.

The Gold Standard in Food Allergy Diagnosis:
The FATE™ Program at NY Food Allergy & Wellness
Start Your Journey to Food Allergy Freedom Today
Ready to take control of your food allergies? Connect with Dr. Atul Shah to begin your journey. Schedule a telehealth consultation or in-person visit with NY Food Allergy & Wellness to explore the FATE™ Program and start building tolerance to your allergens. With at-home testing, personalized plans, and expert guidance, food allergy desensitization has never been more accessible.
Don’t let food allergies hold you back. Take the first step toward a life without fear—contact us today!

Dr. Atul Shah’s FATE™ Program has helped over 15,000 patients, offering a proprietary, one-on-one approach that stands apart from larger institutions. As New York’s only certified BAT allergy lab, our DOH-approved, CLIA-certified facility provides unique insights that others don’t, allowing for more precise desensitization for children, teens, and adults—even into their 50s. This private practice model ensures personalized care, helping patients regain confidence in their lives, careers, & overall well-being.
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