Our Food Allergy Institute Update: We’re Almost Done!

If you've been following along, you already know about our journey with the Food Allergy Institute. I'm so happy to share that we are almost done .... and the progress Z has made is honestly beyond what I let myself hope for when we started.

Z is almost 5 now, and cashews .... the nut that previously caused him to have an anaphylactic response .... are now something he eats freely. Like, a lot of cashews. Whenever he wants. I can't fully put into words what it feels like to watch that happen after everything we went through.

He has one more nut to pass testing on .... chestnut .... and then just a couple more appointments after that. The finish line is actually in sight.

To put this in perspective: tree nut allergies affect approximately 1.2 million children in the United States, and the traditional standard of care .... strict avoidance .... carries significant quality-of-life costs. A 2017 study in the Annals of Allergy, Asthma & Immunology found that children with food allergies have significantly higher rates of anxiety and social isolation than their peers. What FAI offers .... building true tolerance .... is transformative in a way that avoidance never could be.

What's Helped Us Stay on Track

A few things we've figured out along the way that have genuinely made this easier .... in case they help anyone else doing the program.

Daily pill organizers have been a game changer for us. We sort all of Z's nuts into them one night in advance, prepping about four weeks at a time. It sounds simple but when you're managing multiple nuts at different doses, having everything organized and ready to go takes so much mental load off the day.

We also use a daily calendar to cross off everything he's taken. Again .... simple, but it works. When you're in the thick of a busy week, you don't want to be wondering "did we do the hazelnuts today?"

The FAI Protocol: What We've Been Through

Phase	What Happens	Our Experience
Onboarding / skin testing	24-antigen panel, blood draws, intake exam	Long day; worth it for the baseline data
Launch visits (every 3 months)	Dose escalation; tolerance building begins	Initially anxious; becomes routine
Daily home dosing	Mix allergens into food; track doses	Requires organization but manageable
Food challenges	Supervised eating challenges at clinic	Nerve-wracking but empowering
Graduation / maintenance	Ongoing free eating of previously allergic foods	Almost there!

The Ongoing Hunt for the Right Mixing Agent

This is the part no one tells you about. You have to mix the nuts into something, and whatever you pick gets old fast. We've tried melted chocolate chips, ice cream, yogurt, pudding, cookie dough.... we just keep rotating. If you're in the program and struggling with this too .... you're not alone. Cookie dough has been a recent winner in our house, for what it's worth.

A Quick Note on Insurance

We switched to Blue Shield of California in 2026 and the appointments are now covered, which has been a relief. That said, the monthly fees and the SLIT fees for Z's outdoor allergies are still the same out-of-pocket cost. Just something to factor in if you're looking at the full picture of what this program costs.

We'll share a final update when we officially graduate from the program. Until then .... if you have questions about our experience, drop them in the comments. We're happy to share what we know.

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This post reflects my personal experience and is for informational purposes only. It is not medical advice. Please consult your own physician before making any health decisions.

Related Reading

How We Found the Food Allergy Institute

Our FAI Onboarding Visit

A Dad's Perspective on FAI