Sahil updosed to 2 whole peanuts today. Dr Mack congratulated him on coming this far in the OIT journey and asked Sahil how much further he would like to go. Sahil said he would like to reach the end of Dr Mack’s protocol which is 4 peanuts a day. This would allow Sahil to eat food without having to worry about cross contamination with peanuts.
Dr Mack also reviewed Sahil’s bloodwork from December 2015 which showed his IgE antibody levels to individual tree nuts range from 0.77 to 4.84. His peanut IgE was >100.
Normal IgE levels should be <0.35 but these tests have a high rate of false positives especially in atopic individuals. An elevated allergen specific IgE result means the person likely has an allergy, however the number does not predict the potential severity of a reaction. An oral food challenge is needed to confirm an allergy diagnosis. But Sahil never had an oral food challenge to any tree nuts as our previous allergist advised us to avoid them just based on bloodwork and skin prick results.
Dr Mack says he will order bloodwork again after Sahil has completed peanut OIT and is in the maintenance period. He will then challenge Sahil to individual tree nuts. We are also hoping his soy allergy will diminish due to the peanut OIT since soy and peanut are both in the legume family.
Jaya was sick for most of September so she was not able to updose again. She will continue at 1 mL of milk daily. She asked me today: “When will I be able to eat stuff my friends eat like yogurt, cheese sticks and pizza?”. I don’t know but I told her hopefully by September 2018.
Sahil and Jaya. They are in this journey together.