Oral Immunotherapy or OIT, is the process of desensitizing the body to an allergen through introduction of the allergen gradually over time. This treatment is not super common as under a hundred allergists in the United States do this practice in clinics. The process can take as little as six months up to over two years, depending on the patient. Choosing to do OIT is a big time commitment among the mental and physical commitment. Each OIT patient starts with an around five hour appointment at the allergy office. During this appointment the patient starts with 1 mL of peanut solution A, this dose is equivalent to 250,000th of one peanut. Throughout the long appointment the patient will then get a higher quantity of peanut solution A every half-hour, under medical supervision. Then the patient is ready to really start the process. There are a few rules the patient must follow to make the process successful and safe. The dose has to be taken before noon everyday and also has to be taken between 21 and 26 hours of the last. Meaning the time taken the dose the previous day, plus or minus three hours. Additionally, the patient can not exercise or do anything physically exerting or sleep until two hours after they have the dose.

 Every week the patient then has to go back to the allergy clinic for an up-dose appointment where each week the amount of the peanut solution is increased, or the concentration of the solution is increased. There are 5 concentrations you have to move through before getting to a solid peanut, each one is labeled by a letter, peanut A, B, C, D, and E. Typically patients are on each peanut solution for a month, depending on if they have a reaction or not. Reactions can range from itchy throat and skin to anaphylactic shock, so that is why each up-dose is done in the clinic, just to make sure each person completing it is safe. Once the patient takes the dose they stay in the office for an hour if there is no reaction they then are able to take that dose everyday at home until their next weekly, up-dose appointment. Once the patient completes all the solutions they move up to two peanut m&m’s. Once they are on solid peanuts the process seems to go faster. The patient will continue moving up amounts of peanut m&m’s, or switch forms if they choose, till their final appointment where they have to eat 40 peanut m&ms, or 30 dry roasted peanuts. If the patient ates all of the final dose they have then graduated the OIT program and will move on to a maintenance dose, that will only be the minimum of peanuts or peanut products they can consume. There have only been 342 people to complete this program in Iowa.