But a promising area of research, oral immunotherapy (OIT), may be about to change that.
What Is Oral Immunotherapy?
Oral immunotherapy involves giving someone a tiny, controlled doses of an allergen (like peanuts, tree nuts, or milk) in gradually increasing amounts over time.
The goal is to train the immune system to become less reactive or even tolerant to the substance. It's not a cure, but it could reduce the risk of severe reactions from accidental exposure.
How OIT Trials Work
Participants in OIT trials usually start with a minute dose of the allergen, often a fraction of a milligram, and increase their intake slowly over several months under medical supervision. These trials are carefully monitored and often conducted in hospital settings due to the risk of reactions.
Recent UK-based and international trials, including studies at institutions like Addenbrooke’s Hospital in Cambridge and Imperial College London, have shown that up to 70–80% of participants can build up some level of desensitisation. That means they may not react, or may only have a mild reaction, if they accidentally eat a small amount of the allergen.
Who Might Benefit?
Children with peanut, hazelnut, or other tree nut allergies
People allergic to milk or eggs
Families hoping to reduce daily anxiety around food
Those at high risk of accidental exposure
However, OIT is not suitable for everyone, especially those with a history of severe or uncontrolled asthma or anaphylaxis. It’s important that any decision to begin this type of therapy be made with an allergy specialist.
Are There Risks?
Yes, OIT can cause allergic reactions, especially during the build-up phase. Some people experience gastrointestinal upset, mouth itching, or more serious reactions. That’s why trials are so vital—to determine who benefits most and how to keep them safe.
The Future of Allergy Care?
While OIT is still not widely available on the NHS, several trials are ongoing and commercial treatments (like Palforzia, a peanut allergy treatment approved in the UK) are emerging. With further research, personalised immunotherapy plans could become a mainstream part of allergy care.
Oral immunotherapy isn’t a magic bullet, but it may be a significant step forward in empowering people with food allergies to live more confidently. If you or your child are living with a nut or other food allergy, talk to your GP or allergy specialist about whether an OIT trial might be an option for you.