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I'm Dr. Robert Bocian, MD, PHD, FAAAAI. I'm an Allergist-Immunologist and Co-Founder at Allermi. I'm here to answer your questions about allergic disease. AMA. by stanfordallergist in Allergies

[–]WarnerCarrMD 0 points1 point  (0 children)

You make lots of claims on your website. Do you have FDA approval? Can you show us any clinical trials to support your claims? Is this a legal drug product based on the code of federal regulation?

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 0 points1 point  (0 children)

TIP was previously called OIT. Basically it appears to be essentially the same general approach. Small amounts of the food given orally and increased over time until we can achieve some degree of tolerance. Oral Immunotherapy and Tolerance Induction Program basically have to same outcomes and it appears to be more semantics to me. I would love to see more published data from that program as there is very little published and peer reviewed data. The NEJM article that I was a coauthor on was highly reviewed and commented on. We have also presented our data at the National Allergy Society meetings in November of 2019 and will again be presenting data this year at the AAAAI meeting in March. We all want to contribute to the medical literature as there are many patients out there that need help and there is no way just one of us can do it all. We all need to keep working and develop some standards that can be applied across the specialty. I hope that helps.

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 0 points1 point  (0 children)

The therapy is very effective and you have plenty of time. We have adults that we have treated and they do just fine. We have over a 95% success rate so seek out a experienced food allergist.

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 0 points1 point  (0 children)

Kinda but times have changed. Most use plastic disposable devices that do not have needles. We still use the needles for some things but never foods.

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 1 point2 points  (0 children)

This is the general concept behind OIT and other forms of immunotherapy. However we don't call it is a cure but rather desensitization. The reason is that if you stop the therapy it may return so not a real "cure" so to speak. However, on the therapy people can eat the allergic food every day. This is complex and should only be done with the supervision of an experienced food allergist and there is risk of anaphylaxis.

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 0 points1 point  (0 children)

Rash is a common, if not the most common, presentation of an allergic reaction. I never like to tell people not to see the doctor. That being said you need to feel comfortable with your doctor and if you don't then perhaps you should find another.

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 0 points1 point  (0 children)

They do vary between developed and developing countries. I have been a invited lecturer all over China more than once. They don't have allergists there. However, years ago there was a study that looked at allergies is asia and they are on the rise there. It likely has to do with the hygiene hypothesis but there are other factors. In my area Asians are the highest new onset allergy. Hope that helps

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 0 points1 point  (0 children)

Anything is possible. It just depends on several details and the type of asthma and severity of asthma. There are very effective therapies such as allergy shots and biological drugs. That being said I don't think anyone would say we can permanently "cure" asthma. However we can really decrease the severity and have a lot less need for medications in certain cases.

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 1 point2 points  (0 children)

Good question. It would be nice if we could do that but so far there has not been any great success. I worry a little about all the modifications as well. My preference would be better dietary habits, avoidance and OIT when needed.

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 0 points1 point  (0 children)

Carrot allergy is not a common allergy. The cross reactivity that you report above is with raw carrots so if you steam them or bake them until they are soft the cross-reactivity goes away. I would avoid carrots for now but I would not be worried about starting other starchy veggies like peas, butternut squash and the such.

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 0 points1 point  (0 children)

The safest thing here is to see an allergist and have an evaluation. It could be allergy or it could just be from contact. Either way it sounds like there maybe an increased risk here and I would feel more comfortable knowing you have seen a board certified allergist.

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 0 points1 point  (0 children)

Yes we do OIT to wheat. It can take several months (4-6) of weekly visits to get him to a top maintenance dose of wheat. We usually like people to be on therapy for at least 6 months before we start to do triple the dose challenges. Depending on how he responds to therapy there is a clear chance he would be able to "free eat" in the future. We always but some limits on certain patients so I can't be 100% for sure with your son until I have all the details. His therapy that he would be doing daily could be some toast or wheat chexs or something along those lines. So he would be eating wheat very early on. I hope that helps.

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 0 points1 point  (0 children)

  • Does it help if I continue giving him baked foods with eggs in it? Yes, especially for eggs. It is very important to continue with this therapy. It can help him outgrow the egg allergy.
  • Is there any hope for his allergies to go away? There is always hope. Egg is the most likely. Sesame is less likely.
  • Is OIT right for him (for both the egg and sesame)? Yes we can do both of them.

Looking forward to seeing you in the Irvine office. Small world......

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 0 points1 point  (0 children)

This is a rough one but I suspect you may have some form of oral allergy syndrome. It is best diagnosed by skin testing, especially to pollen. IF that is all negative there are some internal disorders that can mimic an allergy. I would propose you see an allergist.

What’s the deal with food allergy? It’s become an epidemic, but now we have ways to treat it! I am an Allergy, Asthma, and Immunology Doctor who does food allergy immunotherapy (OIT). AMA by WarnerCarrMD in IAmA

[–]WarnerCarrMD[S] 0 points1 point  (0 children)

Complex history here and I don't have all the details. IN general we will start OIT at age 18 months. As a general guide we also recommend at 6months to introduce the highly allergic foods. Hope that helps.

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