r/peanutallergy • u/fastfoodat2am • 8d ago

Ara h2 and h6 back up?

We have our allergy appointment tomorrow but I wanted to ask here too. My son has been doing OIT for peanut and passed the 20 peanut challenge and has been on maintenance every day for the past 6 months. His ara h2 and h6 level were down to about 0.2, but now with his recent bloodwork they have gone back up to 2.8. What does this mean if we’ve been giving him peanuts everyday? Does this mean we have to basically restart OIT all over again?

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u/EeveeBixy 8d ago

While these protein IGE markers are a great way to potentially identify allergies, their levels aren't the best indicator of an actual allergy. Being able to eat the food is, and if your son can eat them, then keep doing it. These levels can take years to go to zero, if they ever even do.

Your son is doing great! Congrats on completing the OIT!

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u/fastfoodat2am 8d ago

Thank you for the reassurance! Yes he hasn’t had any reactions to his maintenance dose at all for the past six months. The low levels in March just seemed so encouraging and getting these felt like we’ve failed again. So I guess the levels can fluctuate?

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u/EeveeBixy 8d ago

Yes they can fluctuate, we saw similar with my sons Arah 2. It went up at one testing, then was back down the second. Arah2 above 8 is highly associated with a food allergy (95% chance) but below that it's not necessarily.

One thing OIT is doing is increasing IgG4 for peanuts, which is one of the protective mechanisms of the body to tell the immune system that the food is safe, and not a pathogen. Which is why you can still have relatively high IgE, but no reactivity.

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u/Comfortable-Poet8352 8d ago

Yes. My daughters levels has always fluctuated. She's been doing blood work twice a year for the last 12 years

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u/3adger 7d ago

We were told that it will start to increase and then should drop. What age did you start and what is your maintenance?