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The Food Allergy Treatment Menu: Picking What's Right for YOUR Kid
Your kid has a food allergy. Your allergist says avoid it. But what if there are other options — and nobody told you about them? Three allergists debate OIT, SLIT, and Xolair.
April 1, 2026
7 min read
The Food Allergy Treatment Menu: Picking What's Right for YOUR Kid
Episode 37 of The Immune Edit with Dr. Doug Jones
If your child has a food allergy, you've probably asked the question: "What's the best treatment?" And if you've done any research, you've probably gotten a dozen different answers depending on who you asked.
In this episode of The Immune Edit, Dr. Doug Jones sits down with two fellow board-certified allergists — Dr. Tom Chacko (Atlanta, GA) and Dr. Farah Khan (Columbus, OH) — for an unfiltered, no-holds-barred conversation about the food allergy treatments available right now. They don't just explain the options. They debate them. And they disagree with each other. Out loud. On the record.
It's one of the most real conversations you'll hear three allergists have — and that's exactly why it matters.
Stop Asking "What's the Best Treatment?" — Start Asking This Instead
The biggest takeaway from this episode might be a mindset shift. Dr. Doug reframes the entire conversation early on: the question isn't "which treatment is the best?" It's "what's the right treatment for the right patient at the right time?"
That distinction changes everything. Because the answer depends on your child's age, which foods they're allergic to, how severe the allergy is, what your family's goals are, and even what stage of life your child is in.
As Dr. Doug puts it: "Are we sometimes guilty of matching patients to our preferred treatment instead of matching treatment to the patient?"
The Treatment Menu: What's Actually Available Right Now
The three doctors walk through the current options on the table for food allergy patients:
Oral Immunotherapy (OIT) — gradually introducing small, increasing amounts of the allergenic food under medical supervision. This has been the backbone of food allergy treatment for years. All three doctors agree that OIT is a slam dunk for infants and toddlers. A 14-month-old who reacted to peanut? Start OIT early, and there's an extraordinarily high chance of reversing the allergy by age four or five.
Sublingual Immunotherapy (SLIT) / Low-Dose OIT — placing small amounts of the allergen under the tongue, or dosing with very low amounts of the actual food. Dr. Tom Chacko makes the case (and Dr. Farah Khan agrees) that for practical purposes, SLIT and low-dose OIT are essentially the same thing. This is a great option for older kids — especially middle schoolers with peanut and tree nut allergies who don't necessarily want to change their diet. They just want protection from accidental exposures.
Omalizumab (Xolair) as Monotherapy — a biologic injection given once a month that's now FDA-approved for food allergy. This is where the conversation gets heated. Dr. Doug shares a real patient case: a college-age baseball player who did OIT faithfully for 12 years, stopped when life got too busy with professional sports, and now wants protection without a daily dosing commitment. Dr. Doug sees Xolair as a great fit for this patient's current stage of life. Dr. Tom pushes back — hard — arguing that low-dose OIT or SLIT would be simpler, cheaper, and just as effective.
The debate is fascinating because both doctors make valid points, and neither one is "wrong." That's kind of the whole point.
The Real-Life Case That Sparked the Biggest Debate
Dr. Doug's baseball player patient is the perfect illustration of why food allergy treatment isn't one-size-fits-all. This young man did everything right for over a decade. He was compliant, committed, and ate his daily dose of peanuts and almonds for 12 years.
But life changed. A professional baseball career with constant travel, a schedule that doesn't leave room for daily dosing routines, and the prospect of playing in a foreign country where food labels are in another language. He doesn't want to start over with OIT. He wants a safety net.
Dr. Tom's counterpoint? One puff of a low-dose product in the morning takes five seconds and costs almost nothing compared to $30,000 a year for Xolair. If the allergy is burdening him that much, why can't he remember to take that puff?
Dr. Farah jumps in with the reality check: "What if he's a chronic oversleeper and has to run to practice? He is telling you — I do not want to hassle with something daily."
This is where the conversation gets really good, because it exposes something all three doctors acknowledge: physicians have biases, and those biases can shape which treatments they recommend. The best care happens when the treatment matches the patient — not when the patient matches the doctor's preference.
When Your Kid's Allergist Doesn't Offer These Options
One of the most important points in this episode comes from Dr. Tom: most states don't have an allergist who offers OIT, SLIT, and biologic therapy for food allergies. For a lot of families, the treatment menu is limited by geography.
Dr. Doug and his nonprofit GAIN (Global Allergy Immune Network) run an annual conference to train allergists in these treatments. They're also expanding telehealth licensing across the United States to make consultations accessible to families who don't have a local provider offering advanced food allergy care.
If these treatments aren't available where you live, it doesn't mean they won't be. And in the meantime, virtual consultations with experienced allergists like Dr. Doug, Dr. Tom, and Dr. Farah can help you understand your options — even if treatment happens closer to home.
Anxiety vs. Trauma: The Piece Most People Miss
Dr. Farah's closing point deserves its own spotlight. She urges families dealing with food allergies to seek psychological support — especially if there's been a severe reaction in the past.
"If you have had a bad reaction and you are dealing with anxiety because of it or unpacked trauma, please find a psychologist or therapist or counselor that can help you unpack that stuff — because it becomes a part of the narrative that sometimes holds you back from potentially exploring the treatment option that could work best for you."
Dr. Doug adds an important nuance: anxiety and trauma are not the same thing, even though they often coexist in food allergy families. Trauma doesn't always look like obvious fear or avoidance. It can quietly shape how a family approaches every meal, every social event, every travel decision. Recognizing that distinction can be a game-changer in how families approach treatment.
The Bottom Line
There is no single "best" food allergy treatment. There's the right treatment for the right patient at the right time. And that answer can change as your child grows, as their immune system evolves, and as their life circumstances shift.
The most important thing you can do? Know your options. Talk to a doctor who will walk through all of them with you — OIT, SLIT, Xolair, avoidance — and help you and your family make the decision together.
Listen to Episode 37 of The Immune Edit:
Become a patient at GAIN: myimmunenetwork.com
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Learn more: drdougjones.com