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Chacko Allergy, 5555 Peachtree Dunwoody Road, Suite 135, Atlanta, GA (2026)

01/21/2026

There’s a lot of talk about using SLIT as a “bridge” to OIT in infants and toddlers — and here’s my honest take.

In real life, infants and toddlers cannot reliably hold allergen under the tongue. What often ends up happening?
They swallow it.

At that point, we’re essentially talking about low-dose OIT — and that’s okay. Both approaches can work. We’re often saying the same thing using different labels.

What matters most:
• Early treatment
• Age being on your side
• Not waiting until allergies worsen
• Avoiding missed windows of opportunity

I don’t spend time debating terminology. I focus on treating babies early and safely — because waiting and avoiding can change the trajectory in the wrong direction.

If you’ve been told to “just avoid”, please get another opinion.
And if I can help — or point you to trusted colleagues — I’m happy to.

Please share this with any parent who needs to hear it 🤍

📞: (678) 325-3788
💻: Schedule an appointment — https://bit.ly/4aW4Jf2
📍14 Convenient Locations: Alpharetta, Atlanta, Buford, Canton, Cu***ng, Druid Hills, Duluth, Johns Creek, Lawrenceville, Marietta, Midtown Atlanta, Peachtree Corners, Vinings, Woodstock

01/20/2026

“What can an adult or teen with severe nut allergies do if avoidance has been the approach their whole life?”

Short answer: you still have options.

For many of my high schoolers, college students, and adults, the goal isn’t to freely eat nuts. The goal is protection from accidental exposure — at restaurants, social events, travel, or shared foods.

That’s where low-dose oral immunotherapy comes in.

We can build to a small, steady maintenance dose — often within 6–8 weeks — and stop there. This provides a meaningful safety buffer without forcing anyone to “eat foods they don’t care to eat.”

In some cases, we use very low-dose, food-based options (like standardized nut protein snacks) that are:
• Easy to take
• Affordable
• Practical
• Designed for accidental exposure protection

Avoidance doesn’t have to be the end of the story — even after years.

If you’re a teen, college student, or adult with peanut or tree nut allergies and want peace of mind, there are real, effective options available.

If it’s not us, I’m always happy to connect you with trusted colleagues near you.

Please share this with someone who’s been told “it’s too late” 🤍

📞: (678) 325-3788
💻: Schedule an appointment — https://bit.ly/4aW4Jf2
📍14 Convenient Locations: Alpharetta, Atlanta, Buford, Canton, Cu***ng, Druid Hills, Duluth, Johns Creek, Lawrenceville, Marietta, Midtown Atlanta, Peachtree Corners, Vinings, Woodstock

01/19/2026

Cashew Journey with Dr. Chacko
I’m here with my buddy Ian — and today, he officially finished his treatment with me! 🙌 Mom and Grandma are cheering in the back because this has been a long journey.

We’ve been working through cashew, walnut, and today sesame. He just completed 1 gram of sesame, and he’s already been eating even more than that at home. When we started, his cashew was 9.5 — pretty high — and now he eats half a cashew like it’s nothing.

For families, especially in Indian households where cashews and sesame are in so many foods, weddings, and events, this changes everything. The biggest fear is always:
“What if my child gets exposed accidentally?”
Well, I prove it by showing you exactly how much they can now tolerate.

So thank you to Mom and Grandma for trusting me and sharing your story. ❤️

If your child has a cashew allergy, walnut allergy, or sesame allergy, reach out early. The earlier we start, the more we can reverse — and get these foods safely back into their diet.

Thanks everyone! 🙏✨

📞 (678) 325-3788
💻 Schedule an appointment — https://bit.ly/4aW4Jf2
📍 14 Convenient Locations: Alpharetta, Atlanta, Buford, Canton, Cu***ng, Druid Hills, Duluth, Johns Creek, Lawrenceville, Marietta, Midtown Atlanta, Peachtree Corners, Vinings, Woodstock

01/19/2026

Monday Walkthrough with Dr Chacko 👨🏽‍⚕️🥜✨

It’s a regular Monday here, so let’s dive in.

First up we have Eli, 9 months old, starting his peanut OIT journey. His IgE is high, but I believe by age 2–3 he’ll be eating peanut butter like any other kid. Starting early makes all the difference.

Next is Catherine — an adult peanut-allergic patient. Yes, we do treat adults too. She’s not trying to eat peanuts regularly, but she is protecting herself from accidental exposure. We’ll begin with peanut powder, and eventually transition her to one Mighty Me puff (about 50mg of protein). Accident protection matters, and long-term benefits are real.

Then we have a 13-year-old starting day one of reversing his peanut allergy — another peanut OIT start today. That’s three peanut cases just this morning.

Now meet Lily, working through sesame with numbers over 100. Sesame is trickier, so we’re using a sublingual approach and tracking her closely.

And lastly, a 1-year-old with low peanut numbers beginning a gradual “bamba challenge” — slowly introducing peanut puffs into the diet to build tolerance safely.

Just a regular Monday here:
High volume, families traveling from near and far, and lives changing every day.

If your child has a food allergy — peanut, sesame, cashew, anything — reach out early. And if it’s not with me, I’ll always point you to someone who can help. There are options. 💛

Thanks everyone!

📞 (678) 325-3788
💻 Schedule an appointment — https://bit.ly/4aW4Jf2
📍 14 Convenient Locations: Alpharetta, Atlanta, Buford, Canton, Cu***ng, Druid Hills, Duluth, Johns Creek, Lawrenceville, Marietta, Midtown Atlanta, Peachtree Corners, Vinings, Woodstock

01/17/2026

From 10 ➡️ 0 🥜🙌
This baby started with a peanut IgE of 10 — high for an infant. Instead of avoiding, we began peanut oral immunotherapy (OIT) early, and now she’s eating peanut butter with no issues! 💪

Her new test? Totally negative.
If we had done nothing, those numbers would’ve likely gone up. But early action stopped the train before it gained speed. 🚂

So if your baby has a food allergy, don’t wait — early intervention matters.

📞: (678) 325-3788
💻: Schedule an appointment — https://bit.ly/4aW4Jf2
📍14 Convenient Locations: Alpharetta, Atlanta, Buford, Canton, Cu***ng, Druid Hills, Duluth, Johns Creek, Lawrenceville, Marietta, Midtown Atlanta, Peachtree Corners, Vinings, Woodstock

01/16/2026

Real Progress. Real Families. 💪
At Chacko Allergy, we don’t just talk about food allergy treatment — we show you the results. Here are a few of today’s stories:

🥚 Grant’s Journey — 2 years ago, he failed a baked egg challenge with hives + vomiting. Today? He’s eating muffins without a problem thanks to egg oral immunotherapy.
🥜 Archie’s Progress — Practicing peanut introduction while still being a kid (yes, toys included 😅).
🥛 Noah’s Update — Traveling 2+ hours from Chattanooga to tackle milk allergy. After failing a milk challenge, he’s now slowly tolerating milk step by step.
🌰 Max’s Path — With his mom (a pediatric nurse practitioner), starting peanut treatment with Bamba — the goal: peanut butter soon!

These are the wins that keep us going. Not every case is easy, but every step forward matters. 🙌

📞: (678) 325-3788
💻: Schedule an appointment — https://bit.ly/4aW4Jf2
📍14 Convenient Locations: Alpharetta, Atlanta, Buford, Canton, Cu***ng, Druid Hills, Duluth, Johns Creek, Lawrenceville, Marietta, Midtown Atlanta, Peachtree Corners, Vinings, Woodstock

01/15/2026

SLIT vs OIT: What’s Actually Happening? 🤔💡
In this clip, Dr. Chacko and Dr. Alice Hoyt break down what SLIT really looks like in real-life families — especially young kids and teens — and how it compares to low-dose OIT.

SLIT basics, micro-dosing, and practical teen plans (5–10 mg range). Real life matters.

Here’s what they explain:
🔸 What SLIT is: tiny amounts of allergen placed under the tongue — but young toddlers often swallow it immediately. Practically speaking, many end up ingesting ~5 mg of protein.
🔸 Why it still works: research and real-world results show that low, slow, steady exposure can help build protection over time.
🔸 How dosing differs from OIT:
• SLIT = tiny micro-doses (5–10 mg), empty mouth, no food right before/after
• OIT = higher doses, best taken with food during a “happy tummy” time
🔸 Measured alternatives: tools like precisely measured puffs can help deliver consistent micro-doses — but always under guidance from your allergist.

Every patient is different. Every plan is customized. And sometimes simplicity + consistency beats complexity.

📞 (678) 325-3788
💻 Schedule an appointment → https://bit.ly/4aW4Jf2
📍14 Locations: Alpharetta, Atlanta, Buford, Canton, Cu***ng, Druid Hills, Duluth, Johns Creek, Lawrenceville, Marietta, Midtown Atlanta, Peachtree Corners, Vinings, Woodstock

01/14/2026

When families see numbers like IgE greater than 100, they often assume there’s nothing we can do. But this case is a great reminder that we still have tools — even for patients with EoE-like symptoms.

By slowing down her dosing and making small, intentional adjustments, we built a level of tolerance that now protects her from accidental peanut exposures without triggering symptoms. It takes patience, monitoring, and teamwork, but the payoff is huge: less fear, fewer restrictions, and more confidence in daily life.

There’s always a path to explore when we take the time to understand each patient’s needs.

📞: (678) 325-3788
💻: Schedule an appointment — https://bit.ly/4aW4Jf2
📍14 Convenient Locations: Alpharetta, Atlanta, Buford, Canton, Cu***ng, Druid Hills, Duluth, Johns Creek, Lawrenceville, Marietta, Midtown Atlanta, Peachtree Corners, Vinings, Woodstock

01/13/2026

Milk Progress Update with Dr Chacko 🥛✨
Doctor Chacko here with my friend Ava and her mom — and today was a huge milestone for her milk allergy journey.

Ava tolerated 20 mL of milk with us. That’s not a tiny “test sip”… that’s a significant dose that can soon translate into real foods like pizza, baked goods, and eventually ice cream. 🍕🍦

Before we began, her milk IgE was around 45, and now she’s taking this dose without Xolair. (We’re not anti-Xolair — just thoughtful about when it’s actually needed.)

Mom, who’s a PICU nurse, found us online after feeling stuck with the standard “test every six months” approach and no real progress. She wanted a Whole Foods–based plan and a path that actually moved forward — and now we’re here.

At this pace, I expect Ava to be enjoying milk in everyday foods within the next 2–3 months.

Thank you both for letting us share your story. Families need to know that options exist.

If your child has milk, egg, peanut, or sesame allergies and you’re wondering what’s possible, reach out — we’re happy to help or connect you with someone closer to you.

Thanks everyone! 🙏✨

📞 (678) 325-3788
💻 Schedule an appointment — https://bit.ly/4aW4Jf2
📍 14 Convenient Locations: Alpharetta, Atlanta, Buford, Canton, Cu***ng, Druid Hills, Duluth, Johns Creek, Lawrenceville, Marietta, Midtown Atlanta, Peachtree Corners, Vinings, Woodstock

01/12/2026

Busy Day of Multi–Tree Nut Therapy 🌰🥜
Here’s what a regular day looks like at Chacko Allergy 👇
✨ Addison (Age 4) — Starting multi tree nut OIT with MightyMe puffs. She’s had walnut reactions in the past, but today she’s safely introducing multiple nuts for the first time!

👦👩 Two Siblings — A 4th grader + a high schooler both beginning multi tree nut therapy. Cashew numbers are especially high, so we’re moving carefully — but both are on track toward tolerance.

🍫 Another Patient — After peanut OIT, today was the first time ever trying Reese’s Peanut Butter Cups + PB&J. A big milestone!

⚖️ Overall, today was a moderate clinic day: 3 patients starting multi tree nut OIT + 1 peanut milestone. Some days it’s 6–7, but each one matters. 💙

📞: (678) 325-3788
💻: Schedule an appointment — https://bit.ly/4aW4Jf2
📍14 Convenient Locations: Alpharetta, Atlanta, Buford, Canton, Cu***ng, Druid Hills, Duluth, Johns Creek, Lawrenceville, Marietta, Midtown Atlanta, Peachtree Corners, Vinings, Woodstock

01/11/2026

Candid Conversation With a Family 🥚✨
If you're new here, these are real, everyday chats with parents in clinic — no script, no actors, just honest conversations about food allergies.

Today I was talking with a mom about her child’s egg allergy, and I told her what I tell almost every family:

Egg is one of the hardest foods for a kid to avoid.
It’s at every birthday party, every school celebration, every cake, cookie, and muffin 🎂🧁
Avoiding it completely is nearly impossible.

Her child’s egg IgE was very high, the kind of number that scares most parents — and honestly, when I was a young allergist, it would’ve scared me too.

But now, after 10+ years of doing this:
👉 I see 5–10 patients a week with IgE levels over 100
👉 I’ve treated hundreds of these cases
👉 And I feel very confident guiding families through it

Can I guarantee success? No.
But I told mom plainly: “I’d bet money that your child will do fine.”

These are the candid conversations I have every day.
Experience matters. Treatment options matter. And kids deserve the chance to live normally — not in fear of every birthday cake.

If you’ve been told “just avoid it,” there may still be hope.

📞 (678) 325-3788
💻 Schedule an appointment — https://bit.ly/4aW4Jf2
📍 14 Convenient Locations: Alpharetta, Atlanta, Buford, Canton, Cu***ng, Druid Hills, Duluth, Johns Creek, Lawrenceville, Marietta, Midtown Atlanta, Peachtree Corners, Vinings, Woodstock

01/10/2026

From Vomiting to Victory: Overcoming Egg Allergy 🥚💪
When this patient first came to us in 2023, their egg IgE levels were over 100 — and an attempt at introducing egg led to vomiting and anxiety. 😣

But we adjusted the protocol, slowed things down, and kept working with them. Now, two years later, they’re eating baked egg—and their numbers dropped to 25! 🙌Every case is different, but this shows what’s possible when we personalize OIT and stay patient. 🌟

📞: (678) 325-3788
💻: Schedule an appointment — https://bit.ly/4aW4Jf2
📍14 Convenient Locations: Alpharetta, Atlanta, Buford, Cu***ng, Druid Hills, Duluth, Johns Creek, Lawrenceville, Marietta, Midtown Atlanta, Peachtree Corners, Vinings, Woodstock

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