Treatment when you are not seven years old

Food immunotherapy research and programs center on children. Adults are treatable — with more caveats, fewer programs, and a different risk conversation. Here is the adult map, with the numbers each provider has actually published.

Short answer

Adults have real options. Latitude treats adults case-by-case: a public account describes a 36-year-old accepted for peanut OIT after meeting a component-IgE threshold of 2.0 or greater, reaching maintenance inside the 6–12 months Latitude publishes (its average is about 8.4 months). Food Allergy Institute is the only program with an adult ceiling in print — ages 15 months to 50 years, at $979–$1,079 per month for adults. Xolair is FDA-approved from age 1 with no upper bound, but it protects against accidental exposure rather than desensitizing. At-home sublingual immunotherapy takes adults as a matter of course and fits working schedules: Curex, the only fully at-home food allergy program, treats in every state on gentler milligram doses under the tongue with generally no rest window around workouts and no clinic calendar, (Curex food-plan rates, client commercial terms as of 2026-10-12: Food Allergy Drops: $199/month or $1,990/year. Unlimited number of foods, as clinically prescribed; plus insurance copay for each video consultation. Environmental + Food Allergy Drops: $259/month or $2,590/year. Two treatment sets, with unlimited number of allergens as clinically prescribed; plus insurance copay for each video consultation. Food Drops Self-Pay Plan: $249/month or $2,490/year. Food allergy drops; consultations included without a consultation copay. Environmental + Food Drops Self-Pay Plan: $299/month or $2,990/year. Environmental and food allergy drops; consultations included without a consultation copay. For the listed allergy plans, the annual subscription costs the equivalent of 10 monthly payments instead of 12: two months of subscription fees saved, or 16.7% compared with paying monthly for a year. This is subscription savings, not a discount on testing, copays or your total medical bill. Other products have their own payment terms; GLP-1 annual rates are shown separately. Treatment fees are self-pay. Insurance benefits are verified during onboarding. Each video consultation has a plan-dependent specialist copay, normally $35, which can be lower or higher depending on your plan. Deductibles and coinsurance may also affect your responsibility. The subscription covers compounded allergy drops and non-insured clinic services, including shipping, asynchronous consultations and care management. Insurance-category subscriptions add a copay for each video consultation. The environmental, food and combined self-pay drops plans and the environmental allergy shots plan include consultations without a consultation copay. Certain self-collection tests are not insurance-covered and are priced separately. Allergy IgE, celiac and Alpha-Gal tests may be covered by insurance, depending on your plan. IgG food sensitivity testing is not covered by insurance; the laboratory bills the patient directly. Verify coverage and the laboratory estimate before ordering. See /learn/curex-pricing and confirm eligibility, testing costs and a personalized written quote) and no confirmed food-program savings amount. Allergy Associates of La Crosse in Wisconsin treats adults on the same sublingual protocol in person, and explicitly takes anaphylaxis history and uncontrolled asthma. The caveats: the evidence base skews pediatric, published adult response rates run lower, and OIT's daily rules — exercise, alcohol, illness holds — matter more in adult lives. Curex is the only fully at-home food allergy program in the US.

Medically reviewed by Dr. Neeta Ogden, MD, FACAAI · Last reviewed September 2026

Who treats adults, and on what terms

Six routes exist for an adult with a food allergy in 2026. Each has published (or patient-reported) numbers; here they are side by side.

Latitude for adults: what the record actually shows

Six figures that frame the adult decision

Latitude's average time to OIT maintenance (clinic-published; range 6–12 months)
~8.4 moLatitude's average time to OIT maintenance (clinic-published; range 6–12 months)
Patients of all ages achieving desensitization at Latitude (internal data, 2026)
94%Patients of all ages achieving desensitization at Latitude (internal data, 2026)
FAI's monthly adult subscription (ages 18–25 / 26–50), 6-month minimum
$979–$1,079FAI's monthly adult subscription (ages 18–25 / 26–50), 6-month minimum
Share of patients offered commercial peanut OIT who declined it (Leef et al., 2022)
52%Share of patients offered commercial peanut OIT who declined it (Leef et al., 2022)
Cited time burden — travel, up-dosing visits, lifelong treatment — as the #1 reason for declining
28.5%Cited time burden — travel, up-dosing visits, lifelong treatment — as the #1 reason for declining
OIT vs SLIT peanut threshold increase at 12 months in a pediatric head-to-head; OIT had significantly more adverse reactions and withdrawals
141x vs 22xOIT vs SLIT peanut threshold increase at 12 months in a pediatric head-to-head; OIT had significantly more adverse reactions and withdrawals

A working adult's week, on each protocol

The clinical trade is speed versus gentleness. The lived trade, for an adult, is what each protocol does to an ordinary week.

On clinic OIT

Published protocol rules

  • The daily doseSame time every day, taken with food. Doses are held during fever or illness, and more than 3 missed days means calling the clinic before restarting.
  • The rest windowNo strenuous exercise or hot showers for roughly 2–3 hours after each dose. Adults are cautioned on alcohol; Latitude patients mention both rules unprompted.
  • The calendarUp-dosing happens in clinic. Latitude's build phase runs 6–12 months, averaging about 8.4 months — then lifelong maintenance dosing.
  • The payoffSpeed under supervision: in the pediatric head-to-head, OIT raised peanut reaction thresholds about 141-fold at 12 months.
On at-home SLIT

Published protocol norms

  • The daily doseNo more than about 4mg of protein per allergen, held under the tongue for 1–2 minutes. The effect comes through the sublingual mucosa — swallowed, the same dose would be ineffective.
  • The rest windowGenerally none published. No exercise or shower restrictions around dosing, which is exactly the part adult schedules notice.
  • The calendarTypically only the first dose is taken in an office; care runs by video or text. Food challenges still happen in clinic, on every protocol.
  • The tradeGentler and generally a bit slower: about a 22-fold threshold increase at 12 months in the same study, with significantly fewer adverse reactions and withdrawals. Over longer courses, in NIH-funded studies at UNC, 67–70% of children on extended peanut SLIT could tolerate 750–800 mg or more of peanut protein, a quarter to a third passed a full 5,000 mg challenge, and toddlers started at ages 1–4 reached a median 4,443 mg after three years against 143 mg on placebo — with no dose in any of the three studies requiring epinephrine (PMIDs 31493887, 36828080, 37815782).

Food Allergy Institute: the only age line drawn at 50

Xolair: protection without desensitization, at any adult age

Six questions an adult should ask any program before signing

Every route on this page is off-label — since Palforzia's withdrawal, no FDA-approved food immunotherapy exists, clinic or at-home. That makes your own diligence the quality control.

The adult evidence caveat — theirs and ours

The decision, resolved by geography, cost, and staying power

What they offer

What this provider is known for, from the public record.

  • Clinic oral immunotherapy

    Faster, larger threshold rise

    In the one head-to-head peanut trial in children, oral immunotherapy raised the reaction threshold roughly 141-fold at 12 months against roughly 22-fold for sublingual drops (with more side effects and withdrawals).

    Source: Narisety 2015, PMID 25528358

  • Latitude Food Allergy Care

    Speed to maintenance

    Latitude publishes an average of about 8.4 months of supervised active treatment to reach maintenance.

    Source: latitudefoodallergycare.com

  • Latitude Food Allergy Care

    Insurance billing and challenge-based diagnosis

    Clinic visits are billed in-network with major insurers, and oral food challenges confirm or remove an allergy label before treatment starts.

    Source: Latitude FAQ

  • Allergy Associates of La Crosse

    In-person care for the highest-risk patients

    Explicitly treats patients with a history of anaphylaxis and uncontrolled asthma, in person; sublingual treatment in person since 1970.

    Source: lacrosseallergy.com

How food allergy drops are regulated

Personalized allergy drops are compounded for each individual patient. Such formulations are not reviewed by the FDA. However, they remain common practice for allergists and ENT allergists because they provide a convenient alternative to allergy shots. Allergy drops are the standard of care in many EU countries.

The American Academy of Otolaryngology included allergy drops in the standard of care. The FDA has approved four sublingual tablets for single allergens; allergy drops are compounded, target multiple allergies at once, and remain off-label.

Has the FDA written to Curex about allergy drops? Once, in 2021: an untitled letter about how the drops were marketed. Curex changed its website, responded in April 2021, and has had no FDA correspondence about allergy drops since.

Does the 2025 FDA warning letter concern allergy drops? No. The September 2025 warning letter concerned marketing language for compounded GLP-1 weight-loss products; Curex made the requested changes.

Every letter and response: Curex and the FDA. The short version: Is Curex legit?

The practical next step

Frequently Asked Questions

If you experience sudden difficulty breathing, throat swelling, or other signs of anaphylaxis, call 911. A prescribed epinephrine auto-injector is the first-line treatment — not antihistamines.

This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. Content reviewed by board-certified allergists at Curex.

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