Are Food Allergy Drops the Best Treatment Option?

For families living with food allergies, everyday moments like dining out or packing a lunch can bring worry over accidental exposure. Dr. Mireku understands that worry from personal experience as well. Prior to being “the allergist” she was the parent at the emergency department seeing her loved one react – and that experience is why Safe2Bite | Texas Food Allergy Center exists. Sublingual immunotherapy for food allergies (SLIT) offers a different way to manage an allergy. Also called food allergy drops, this method trains the body to tolerate small amounts of an allergen placed under the tongue.

So are food allergy drops the best treatment option? For some kids, yes. But for others, there could be another choice that’s better. The answer to this depends on factors including treatment goals, allergic sensitivity, family logistics and underlying medical conditions. Despite all of these factors, food allergy drops are safe and well-tolerated by infants, children, teens and adults.

At Safe2Bite, Dr. Mireku considers each patient’s allergy history, test results, age, routine, cultural diet preferences and family needs before recommending SLIT, OIT or another food immunotherapy treatment plan. Here are some important facts about food allergy drops, and why many North Texas families choose them over other options.

5 Reasons Food Allergy Drops May Be the Right Treatment

Anyone who has struggled with the daily demands of allergen avoidance may find that food allergy drops provide a more manageable treatment option. Allergists increasingly offer the drops as a lower-risk alternative to other immunotherapy treatments.

1. Simple At-Home Dosing

Food allergy drops appeal to many patients because dosing is simple and can be done at home. To use this treatment, the patient or parent administers drops containing small amounts of the allergen protein under the tongue. This slowly retrains the immune system’s response over several months. Occasional in-office visits confirm the treatment is on-track. Annual food challenges are also conducted to confirm progress and protection from the allergic food.

2. Easier for Young Children

With allergy drops there are no needles and no pills. Since food allergy drops deliver the dose as a small amount of liquid, many children find this method to be easy and stress-free, particularly when they may have anxiety about eating an allergen. SLIT relies on consistency over a period of years, making a simple routine easier for children to stick with.

3. More Convenient for School and Travel

Food allergy drops come in a compact bottle that’s easy to transport during travel. This makes it convenient for school days, vacations and other times when families are away from home. While this type of food allergy treatment can improve daily life in many ways, if doses are frequently missed it will not be as effective. The obvious convenience of SLIT is one reason many allergists recommend it.

4. Less Disruption to Daily Routines

This small step is very easy to incorporate into a morning routine. With food allergy drops, a parent measures out the dose with the dropper and administers the solution under the child’s tongue. The child should hold it there for about 2 minutes before swallowing. After that, the rest of the routine continues as usual.

5. A Lower Allergen Dose

Food allergy drops typically use a lower dose than alternative treatments like oral immunotherapy. While this can increase the overall treatment duration, the lower dose limits the amount of allergen entering the child’s system. A lower dose generally means a lower risk of reaction, making SLIT a good option for patients at risk of severe reactions.

When Food Allergy Drops Are Not the Best Fit

1. The child that wants to eat without limits.

If a 12-year-old wants to be able to eat a dessert at a restaurant or eat larger amounts of an allergen, the faster and more effective option is oral immunotherapy. SLIT reduces reaction risk but does not allow unrestricted eating.

2. Families that are unwilling to commit to daily dosing.

SLIT has a decreased risk of anaphylaxis but requires consistent dosing over months to years to build tolerance. Dosing sporadically can be problematic because it can increase the risk of an allergic reaction.

3. Patients with uncontrolled asthma, eosinophilic esophagitis, or cardiovascular disease.

These conditions should be controlled prior to administering any food allergy treatment. Ignoring existing health problems increases the likelihood of an allergic reaction and minimizes the efficacy of the treatment.

4. Families that have not yet had accurate diagnostic testing.

It often happens that a significant number of the patients referred to us for treatment are actually not allergic to one or more foods on their list. Component testing and, if necessary, an oral food challenge test must precede any form of treatment. Treating an allergy that has not been accurately diagnosed is a costly mistake, and may expose a child to unnecessary risk.

How Effective Are Food Allergy Drops?

Clinical trials on food allergy drops have shown measurable improvements in tolerance. In a 36-month study conducted on 50 peanut-allergic children between ages 1 and 4, 60% of the children under peanut SLIT achieved desensitization compared to none in the placebo group.

After a 3-month period with no intervention, 48% of the children under Peanut SLIT met the study definition of remission, compared with none in the placebo group. The best desensitization and remission outcomes were seen in children who started the treatment at a younger age (1 to 2 years old), implying that earlier intervention produces better results.

Overall, for the right patient, SLIT is a very manageable treatment that can offer long-term relief from many of the common food allergies.

Food Allergy Drops vs. Oral Immunotherapy

For most families the biggest question is not whether the food allergy should be treated, but which kind of treatment will suit their needs. SLIT and OIT both aim to increase tolerance to food allergens, but they do it differently.

In the case of SLIT, a small dose of food allergen extract is introduced under the tongue. For OIT, a certain quantity of food allergen is taken orally, and the dose is increased gradually under the supervision of an allergist.

Since SLIT involves lower doses, this method may be preferred by those who search for a milder treatment option with a lower dose burden and a strong safety profile. In general, because OIT employs larger quantities of the allergen, it can potentially produce better desensitization effects than SLIT does in a shorter period of time. OIT is preferred when the priority is a more intensive approach, and the family can commit to more frequent clinic visits.

The answer to which approach is the best for each family is based on factors such as allergy severity, medical history, lifestyle and long-term treatment goals. Because Safe2Bite offers both treatment options, families receive a personalized plan after a thorough consultation, followed by testing and a discussion with our board-certified allergist.

For additional side-by-side analysis, read our article on Is OIT or SLIT Right for Your Child’s Food Allergies?

Discuss Food Allergy Drops With a North Texas Allergist

Safe2Bite provides food allergy testing and treatment for families in North Texas. Visit one of our locations in Frisco, McKinney or Southlake for support with food allergy drops and other innovative allergy treatments. Call (469) 916-5504 or request an appointment online.