How do you manage high-threshold food allergies beyond strict avoidance?

Thanks for the question Dr. @Dr. First Last.

The field is moving beyond a strict avoidance-only option, and this is an evolving area in managing patients who have food allergies but react at higher thresholds.

For patients with evidence of a higher reaction threshold, I still start from a foundation o...

I would recommend starting with OIT. You do not necessarily have to begin at the very lowest possible dose, but it is important to start at least 10–20 fold below the patient’s established threshold. This allows you to build some degree of desensitization before approaching—and eventually exceeding—...