FAQs for families

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Latitude Difference

How is Latitude different from my current allergist?

At Latitude, our clinics are 100% focused on food allergy. Our board-certified allergists are all specially trained and deeply experienced in food allergy treatment and care. And our clinics provide quick access to important testing and treatment options, including oral food challenges. 

  • We are affiliated with UCSF Benioff Children’s Physicians, a world-class network.
  • Food Challenge Availability — our clinical model enables us to offer quicker access to food challenges, often within less than two weeks of an initial testing appointment. 
  • We offer treatment with oral immunotherapy (OIT) for single and multiple foods, for children as young as 12 months old and adults.
  • Our treatment program is built on evidence-based protocols and important elements to ensure safety and compliance, including our mobile App, that allows for real-time clinical monitoring of at-home dosing. 
  • Our team of Patient Care Coordinators (PCC) provide their personal experience with food allergies and OIT and are here to support you.

How do I know if Latitude is right for me or my child?

You may have many questions as you navigate your choices for food allergy care. With your very first call to Latitude, our team is here to help you determine if our practice is the right fit for you. We are here for you when:  

  • You suspect that you (or your child) have a food allergy, and you’re seeking an accurate diagnosis and want to understand your treatment options.  
  • You or your child has been diagnosed with food allergies.
  • Your baby has eczema and you need to determine if a food allergy exists.
  • Your baby is at higher risk of developing a food allergy, and you are seeking early food introduction in the interest of prevention.

Where are your clinics located?

We have multiple clinics in the San Francisco Bay Area and a clinic on the Upper East Side in New York City. As we grow, we welcome families from outside of the area and will personalize their care plan to accommodate the logistics of travel.

Please call us at (888) 528-1592 or contact us to make an appointment.

Do you accept insurance?

Yes. We accept in-network PPO insurance with a wide variety of insurance carriers including Aetna, Anthem Blue Cross, Blue Shield, CIGNA, Health Net, and UnitedHealthcare. We also accept certain HMO plans. Our insurance page  includes the information that you may need to verify if our providers are in network with your specific plan. Please call (888) 528-1592 if you have specific insurance questions. 

Food Allergy Questions

What is Food Allergy?

Food allergy is an immune system reaction that occurs soon after eating a certain food. Even a tiny amount of the reaction-causing food can trigger signs and symptoms such as digestive problems, hives or swollen airways. This happens because the immune system overreacts to the proteins in that food. While a person can be allergic to any food, the nine most common allergens are cow’s milk, egg, peanuts, wheat, soy, fish, shellfish, sesame, and tree nuts.

What are the signs and symptoms of a food allergic reaction?

Anaphylaxis is a serious, life-threatening allergic reaction and can present with wheezing, chest tightness or trouble breathing, loss of consciousness, or feeling faint.

If two of the following symptoms occur, consider anaphylaxis and inject epinephrine, and seek emergency care:

  • Hives — Rash, or red, itchy skin
  • Stuffy or itchy nose, sneezing, or itchy and teary eyes
  • Vomiting, stomach cramps or diarrhea
  • Angioedema or swelling
  • Hoarseness, throat tightness or a lump in the throat

FARE has an excellent list of words children may use to describe a food allergy reaction that can be found here.

Are food sensitivities or intolerances the same condition as a food allergy?

While most food sensitivity or food intolerance symptoms in adults range from mild to moderate, food allergy symptoms can be severe — and in some cases, life-threatening. Symptoms of a sensitivity and an allergy can be similar, and it’s important to know the difference between an allergy and a sensitivity. A board-certified allergist can determine if testing for food allergy would be helpful to rule out the potential of a life-threatening issue. And a registered dietitian can guide a patient through an elimination diet safely and effectively to best diagnose and manage a food sensitivity. 

When should I introduce peanut and other allergenic foods into my child’s diet?

Many parents have heard that early introduction of allergenic foods (within the first year of life) helps to prevent food allergy later in life. There are several studies suggesting that early introduction of peanut and egg improves a child’s chance of not having allergies to those foods later in life. In particular, early introduction of egg and peanut is recommended for infants at risk of developing food allergy (at-risk criteria include moderate-severe eczema requiring prescription creams/ointments, as well as existing food allergy). Many allergists have extrapolated from these data, and recommend introducing all types of allergenic foods, such as tree nuts, sesame, wheat, cows milk, and seafood during the first year of life. Note that this recommendation is not yet supported by clinical trials, and may not have as protective of an effect as early introduction of egg and peanut. Early introduction of these foods does not prevent all food allergies, and it is still possible to develop food allergies despite efforts to include them in the diet early in life.

Are there other resources to learn more about food allergies and how to manage them?

We realize how important it is for patients and their families to understand food allergies and treatment options, and to learn about current research and relevant information. Latitude provides tools for the food allergy community including:

  • Latitude Online Community — this private Facebook group is available for Latitude patients and other food allergy community members and advocates. Participants are encouraged to ask questions and find support in this safe space.  
  • Latitude Email Newsletter — join our email list for food allergy news, community events and Latitude updates. 

We also encourage you to follow us and join our conversation about all aspects of food allergies on Facebook and Instagram.

Additional recommended resources include: 

Oral Immunotherapy

What is OIT?

Oral Immunotherapy (OIT) — a process that regularly exposes the patient to increasing amounts of the foods they are allergic to, with the goal of desensitizing the body and protecting against anaphylaxis secondary to accidental exposures.

Is OIT a cure?

OIT is not a cure for food allergies. It is a desensitization. In order to maintain desensitization, a patient needs to continue to eat the foods they have been desensitized to on a regular basis.

Research shows that OIT is approximately 85% effective when supervised by an expert care team who specialize in food allergy treatment. At Latitude our success rate is in line with this. While there are a small number of clinical reasons a patient may need to stop therapy, the remaining 15% of patients primarily pause treatment due to the time commitment or other lifestyle demands.

When is the best time to start OIT?

Children who are treated at very young ages often have very successful outcomes  — potentially benefiting from a more flexible immune system and avoiding much of the emotional impact of food allergies. Younger patients tend to have less anxiety and less taste aversion associated with their doses, which often helps the process go smoothly. At Latitude, we will begin treatment as young as 12 months old. Some patients over 4 years old may benefit from short-term use of Xolair (an injectable biologic in investigation for food allergy) in an off-label use to support the OIT process. We also can provide Palforzia, an FDA-approved pharmaceutical product for treating peanut allergy only in patients aged 4-17 years old.

How long does the OIT process take?

Patients generally come into the clinic for an “updose” visit every two weeks during several months of active treatment. These appointments may be spread out over a longer period based on the patient’s clinical and practical needs.

It generally takes between 6-12 months of active treatment before a patient reaches maintenance. During maintenance, daily dosing is continued at the same level for the long-term. 

Can I have an allergic reaction while being treated with OIT?

It is possible to have an allergic reaction while going through OIT. The goal is to have you progress through your treatment at a very slow and safe pace to reduce the risk of reaction.

Do you treat multiple allergens simultaneously with OIT?

How do I know if I am a good candidate for OIT?

While there are some underlying medical conditions that may preclude treatment, most patients can be treated with oral immunotherapy. We provide OIT for adults and patients as young as 12 months old. Before embarking on OIT, our specialized providers will discuss the benefits and risks with you, and address the following: 

  • Clarifying diagnosis to verify the current list of allergies
  • Reaction history
  • Emotional readiness of the patient and family
  • Ability to incorporate therapy into your lifestyle
  • Expectations and measures of success

I had a bad allergic reaction in the past, is it safe for me to do OIT?

Yes, you can safely be treated with OIT even if you have had severe allergic reactions in the past. Safety is our number one priority, and our entire team is trained to handle adverse reactions.

If I have hay fever, asthma, eczema or other allergic conditions, in addition to food allergy, can I be treated with OIT?

Yes, while focused on food allergy, our clinicians take extra steps with each visit to our office to ensure that asthma and other allergic conditions are well-controlled. We encourage direct communication between our clinicians and your other doctors to ensure these other conditions are monitored.

What is Xolair, and do you offer Xolair in conjunction with OIT?

Xolair (omalizumab) is an anti IgE medication that works by inhibiting the allergic reaction process. It is FDA approved for use in children over age 6 with asthma and in children over age 12 with chronic urticaria (hives). At Latitude, we offer Xolair in conjunction with OIT to increase safety for some patients over age 4. While this injectable biologic has been granted Breakthrough Therapy Designation for the prevention of severe allergic reactions to food allergy by the FDA, it is still an “off label” usage and may not be covered by insurance. If our allergist prescribes this medication for you, we can work with you and your insurance plan to help understand the out-of-pocket costs before proceeding.

If OIT does not seem like a good fit for me, what are my treatment options?

Our clinicians will carefully review your food allergy care options with you to determine the best personalized plan for you and your family. Other options may include evaluating other forms of food allergy immunotherapy including SLIT, working with a Registered Dietitian on related nutrition issues, or a referral to another specialist to address underlying medical conditions such as a gastroenterologist or a general allergist.  

Is OIT covered by insurance?

Most of the services we provide are covered by insurance. For example, our initial diagnostic visits and follow up office visits are typically covered. If we determine that oral immunotherapy is the right treatment plan for you, office visit costs will be covered by your insurance, but there is a one-time program fee — only applicable to oral immunotherapy patients — that is considered a non-covered service and therefore not billable to insurance. Payment plans are available for the program fee and it is often FSA- or HSA-eligible. If you are considering treatment, please call us for more details.

How can I learn more about your clinic and treatment options?

We welcome your questions at (888) 528-1592, [email protected], or via our contact form.

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