Oral Immunotherapy

Anxiety is the Biggest Road Block on Our OIT Journey

Isaiah’s first week of OIT was the most exciting nightmare ever.

He wanted to be so brave.

Many parents and physicians have no idea that the biggest obstacle between the child and oral immunotherapy (OIT) is fear.

Imagine you have been told your ENTIRE life, that if you eat even a teeny bit of peanut it can kill you. It is drilled into your head, by your extremely well-meaning parents and doctors that you may NEVER leave your house without your epi-pens, you must ask all questions about ingredients, read all labels, and inform every restaurant employee who even looks your way of your food allergies and the doom they may cause.

And even still. When in doubt you always abstain.


Now your mother, the woman you trust the most in the world. And your doctor, who you trust because you have been trained to, are both telling you to eat the one thing you are CERTAIN will kill you.


Now what?

oit anxiety oral immunotherapy

Can you just turn off the anxiety machine? There is no magic brain wipe. Rationality does not come into play with something that is so intangible.

The fear of the peanut was intangible, the liquid containing peanut is tangible.

When forced to choose between what you can’t see – the idea – and what you can – the peanut- the idea, the fear, the thing you can’t flush down the toilet or hide on your plate, wins.

Fear wins.

And so our conversations often went like this:

“And soon I won’t be allergic to peanuts, right?”


“And this is such a small amount it won’t kill me, right?”


“How much is it again?”

“2.05 micrograms”

“And how big is that?”

“It’s so small you can’t see it”

“But, like, on your fingernail, show me.”

“Sweetie, it’s like a speck. You can’t see it.”

“Okay, so it can’t kill me.”

“Right, it can’t kill you.”

“But it can make me sick?”


“Yes or no mommy, can it make me sick?”

“Well, maybe you could have a little tummy ache.”

“But only a tummy ache? No spots?” (spots are his word for hives)

“No honey, no spots for such a small amount.”

“So nothing then, basically nothing, right?”

“Right sweetie, it’s just a teeny tiny bit.”

Feeling quite confident that this line of questioning has been exhausted, I abandon it and prepare his dose.

As I get ready to hand it to him he screams, “WAIT!”

“Yes sweetie.”

“So, you’re sure then.”

“Yes, I’m sure.”

“I’m going to be alright?”

“You are going to be totally alright.”

“Because I did this same dose yesterday, right? So if I was okay yesterday, I’ll be okay today?”



anxiety OIT Oral ImmunotherapyFor the first two weeks of oral immunotherapy his anxiety was winning. He had stomach aches everyday. My anxiety was thinking about going for a ride with his anxiety off to never-never land where no one is ever afraid of peanuts and we could swim in lagoons forever.

But I had to be strong for him. I had to be brave so he could be brave. I had to resist the urge to pummel him with questions when he had a complaint about his stomach, or cleared his throat, or looked at me funny.

When he visited the toilet more than twice a day, I bit my tongue. I couldn’t remember, did he always go to the bathroom that much? Or was he only doing it now, after starting the OIT?

I mentioned my concerns to our Doctor and he agreed that it could be anxiety, however, since stomach upset is the most common complaint, the most recent protocol suggested adding Prilosec and Zantac daily to combat any possible issues.

The point was, that once stomach problems occurred, it was harder to back them down. The key was stopping them before they started.

He was now recommending to all the patients in OIT to take Prilosec and Zantac. Whether the response was psycho-somatic or real, the complaints died off. And the only anxiety we experienced were on up dose days.

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