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The Doctor is in! Ask a Flight Surgeon!

Hello all, searched the entire forum as well as reddit but couldn't find the very specific answer I am looking for. For context; I currently have a peanut/tree nut allergy (mild anaphylaxis, only react when consumed) but can eat peanut oil, pesto, etc. I was NPQ by NRC/N33 last year in May for "Allergy to peanuts, with anaphylaxis - Unfavorable" as well as "Allergy to other foods". Never had a problem/reaction in my 20 years of life but did react during a skin prick test as well as an initial Oral Food Challenge 4 years ago.

I am starting Oral Immunotherapy this week for both peanuts and tree nuts. My civilian allergist is super supportive but unfamiliar with military accession standards. She needs a specific "Target Maintenance Dose" to aim for to ensure the final clinical notes satisfy a waiver board. My recruiter reached out to a source at N33, but the response was vague: "It’s not a numbers thing—they need to show that they can ingest and be in the vicinity of peanuts without any anaphylactic reaction."

While "vicinity" is clear (I can smell & touch no problem), "ingest" is pretty broad. To my civilian allergist "ingesting" could mean 300mg (one bite) or 8,000mg (a handful).

The Question - For those with experience in the waiver process or Flight Docs familiar with NAMI/N33 standards: Is there a specific protein gram amount or "number of peanuts/tree nuts" that the board expects to see passed in a final Oral Food Challenge? Thank you!
 
Hello all, searched the entire forum as well as reddit but couldn't find the very specific answer I am looking for. For context; I currently have a peanut/tree nut allergy (mild anaphylaxis, only react when consumed) but can eat peanut oil, pesto, etc. I was NPQ by NRC/N33 last year in May for "Allergy to peanuts, with anaphylaxis - Unfavorable" as well as "Allergy to other foods". Never had a problem/reaction in my 20 years of life but did react during a skin prick test as well as an initial Oral Food Challenge 4 years ago.

I am starting Oral Immunotherapy this week for both peanuts and tree nuts. My civilian allergist is super supportive but unfamiliar with military accession standards. She needs a specific "Target Maintenance Dose" to aim for to ensure the final clinical notes satisfy a waiver board. My recruiter reached out to a source at N33, but the response was vague: "It’s not a numbers thing—they need to show that they can ingest and be in the vicinity of peanuts without any anaphylactic reaction."

While "vicinity" is clear (I can smell & touch no problem), "ingest" is pretty broad. To my civilian allergist "ingesting" could mean 300mg (one bite) or 8,000mg (a handful).

The Question - For those with experience in the waiver process or Flight Docs familiar with NAMI/N33 standards: Is there a specific protein gram amount or "number of peanuts/tree nuts" that the board expects to see passed in a final Oral Food Challenge? Thank you!

I don't think this is a number anyone can answer for you. In the end, whether you ingest a little or a lot and it shows a reaction, you are still DQ. By the way, in the MANMED it calls out no allergy immunotherapy within a year for aviation.
 
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