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Monday 9am - 5pm Tuesday 9am - 5pm Wednesday 9am - 5pm Thursday 9am - 5pm Friday 9am - 5pm Saturday 9am - 5pm Sunday 9am - 5pm

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

03/15/2026

Look what I got for you — a peanut Jellycat.”

People pay good money for these little plushies… but when you come to our office, we give you the real peanuts.

And honestly? That’s the goal. Helping patients go from avoiding peanuts to actually eating them safely through immunotherapy.

Also… plot twist — it’s not even a real Jellycat, just a little Bobo fake one. 😅

But the message is real: we’re here to help.

📞: (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

03/13/2026

Wednesday Part 1️⃣

Y’all always ask what a “regular” day looks like… so here it is 👇🏽 real cases, real progress, real clinic flow.

Jack is 2 years old. Already completed peanut immunotherapy and now we’re working on walnut. Peanut? Done. Now we up-dose and keep building protection. That’s the beauty of starting early.

Next up is Sam — 10 years old, peanut IgE of 8. And I get this question all the time: “Is it too late?” No. Especially with numbers like that. There’s strong data showing even elementary school kids can reverse peanut allergy. I’ll say it again — I expect him to be eating peanut butter and jelly by high school. The data backs it.

Then we’ve got William, 4 years old. His numbers aren’t very high, so we’re introducing peanut slowly using modified Bamba as a vehicle. Gradual exposure, closely monitored, building tolerance safely over time.

And his sister Ava? Very allergic — completely different game plan.

➡️ That’s where Part 2 comes in. Different siblings. Different goals. Different strategies.

Go watch Wednesday Part 2 to see how we approach high numbers, low-dose protection, and food challenges like hazelnut.

Questions about your child’s allergy numbers or timing? Let’s talk.

📞: (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

03/12/2026

Back in 2008, allergists were still asking a big question: does early exposure to allergenic foods actually help?

At the time, avoidance was common and the research was still developing. By 2014, Dr. Chacko and his team were already leaning into what the science was beginning to show, becoming one of the first practices in Georgia to offer oral immunotherapy (OIT).

Today, OIT is no longer fringe and is increasingly recognized as part of modern allergy care. Years of research, experience, and thousands of patient cases later, we’re still learning, refining, and helping families move forward with more options.

📍12 Convenient Locations: Alpharetta, Atlanta, Buford, Canton, Cu***ng, Druid Hills, Duluth, Johns Creek, Lawrenceville, Midtown Atlanta, Marietta, Woodstock.

03/11/2026

If your baby reacts at 8 months old, don’t wait a year.

In infants and toddlers, timing is everything.

If a baby reacts to peanut, milk, or egg at 6–9 months — the old model was: avoid and recheck in a year.

But here’s what we’re learning:

If you repeat labs in 4–6 months and watch the trend, you can intervene before IgE levels climb higher.

Because once numbers climb high, they’re harder to reverse.

Early introduction. Early reassessment. Early intervention.

That infant window is powerful.

And if we standardized that approach nationwide, food allergy would look very different 10 years from now.”

Follow both and and drop us a comment if you or your little one is experiencing allergies.

03/10/2026

🥚 From “Do Nothing” to Birthday Cake Freedom 🧁
We did a Baked Egg Challenge.

This sweet family was referred by a friend after being told by multiple allergists to simply avoid egg and “wait it out.” No plan. No options. Just fear and restriction.

When they came to see Dr Chacko, the conversation shifted from limitation to possibility.

Her egg white IgE in January 2025 was around 20
That’s considered high.

Less than a year later?
She’s eating baked egg muffins. Brownies. Proof-of-concept birthday cake freedom. 🎂

Today wasn’t just about a muffin.
It was about:
✔️ No more panic over accidental exposures
✔️ Feeling included at parties
✔️ Confidence instead of constant anxiety

Mom shared how daunting it feels to not have real answers about your child’s allergy. And how smooth this process has been. That confidence shift? That’s everything.

They even met another mom driving 2–3 hours from Athens for egg therapy. Families are traveling because options exist — even if not every practice offers them.

We likely treat more egg and milk OIT patients than anyone in the Southeast — hundreds of families choosing proactive care over “just avoid it.”

If you’ve been told avoidance is your only option… it might be time for another conversation.

Possibility is out there. 💛

📞: (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

immunotherapy

03/09/2026

Using your nasal spray correctly matters more than most people realize 👃

In this clip, Dr. Chacko shows exactly how to spray — and where people go wrong:
• Aim outward toward the eye/sinus, not straight up the middle (can cause nosebleeds)
• Use it daily — not “as needed”

For spring allergies, timing is everything. Starting before symptoms peak is what actually makes these sprays effective. If you’re seeing this now, you’re right on time — or a little late 😉🌸

If congestion, sneezing, or sinus pressure keep coming back every year, it’s worth getting evaluated so you’re not guessing anymore.

📞 (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

03/08/2026

Today was a big day with the Williams family — first time trying eggs.

Mom shared that bloodwork showed a mild egg sensitization, so the big question was:
Is this a true clinical allergy… or something we can safely introduce?

That’s exactly why supervised food challenges matter.

One spoonful turned into several pretty quickly. That’s always a good sign. Even the French toast got approval.

Labs give us data.
But real-world exposure under supervision gives us answers.

The goal isn’t just “passing.”
The goal is confidence. Inclusion. Less fear at birthday parties and family breakfasts.

If your child has been labeled allergic based on numbers alone, it may be time for a conversation.

You don’t know what’s possible until you explore it safely.

📞: (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

03/06/2026

🥜 Let’s Talk About the Stanford Peanut Patch Study.

Why am I pushing back?

From what’s being proposed, infants with peanut allergy may be randomized to either a placebo or the peanut patch to see if it works.

Here’s my issue:

In 2026, the standard of care for infants with peanut allergy is evolving toward early oral immunotherapy and structured food introduction — not placebo. We already have strong real-world experience showing that carefully dosed peanut protein by mouth can work very well in this age group.

So if you’re going to study a patch, compare it to oral immunotherapy in infants. That’s a meaningful question.

But placebo vs. patch? That feels outdated.

And here’s my bigger concern:

If the patch gets approved, there will likely be a massive marketing push. Multi-million-dollar campaigns. Key opinion leaders. Messaging that this is “the solution.”

We’ve seen that play out before with Palforzia — strong branding around something that, at its core, was still peanut protein therapy.

Money doesn’t mean something is bad.
But money absolutely shapes the narrative.

Do I think there may be a very small subset of toddlers who might benefit from a patch? Possibly.

Do I see most of my infant peanut patients needing it if approved? No.

In my practice, we can usually accomplish protection through carefully structured oral introduction — without a device, without a patch, and without the added cost layer.

My job isn’t to hype or to tear down.
It’s to talk to you like family and help you think critically.

If you’re considering enrolling in a patch study or just confused about your options, I’m happy to walk through the pros, cons, and what I’d realistically recommend.

Marketing is loud.
Data matters more.

📞: (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

03/05/2026

🥛 Severe Milk Allergy + EoE History — Can We Still Do OIT?

I get this question all the time:
“Can we even consider OIT with numbers that high?”
“What about EoE?”

So here’s a real teaching case I reviewed during Sunday charting.

5-year-old.
History of Eosinophilic esophagitis (on medication).
Severe milk allergy.

Pre-OIT milk IgE= 89.
That’s very elevated.

Instead of defaulting to avoidance, we carefully microdosed and slowly built tolerance through structured milk OIT.

Today?
He’s tolerating 65 mL of milk daily — nearly a cup in baked form — without issue.

Next step: introducing visible milk this weekend.

And yes — we’re monitoring closely for EoE symptoms. When you treat high-volume, complicated milk cases, you learn how to watch patterns, adjust dosing, and down-dose if needed.

Most allergists are not comfortable treating:
• High IgE milk (like 89)
• Milk + EoE history
• Complex desensitization cases

That’s okay.

We see a large volume of complicated milk and egg patients — among the highest in the Southeast — so these scenarios are routine for us.

This wasn’t a “perfect case.”
This was a real child.
High numbers.
Complicating history.
Thoughtful plan.
Measured progress.

Options exist — even when things look severe on paper.

If you’ve been told milk is off the table forever, it may be worth a conversation.

We’re happy to review cases and let you know what’s realistic.

📞: (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

03/04/2026

“Why weren’t we taught oral immunotherapy in fellowship?”

In fellowship, many of us were taught that OIT was research-only. Dangerous. Not standard. Don’t touch it.

But here’s what happened in real life.

Patients were grateful. Outcomes were improving. Data started supporting it. And slowly, practice patterns began to change.

The problem isn’t that doctors are wrong. It’s that culture in medicine changes slowly.

Some programs now teach OIT. Some still don’t. Some allergists have experience. Some don’t.

But here’s the key: even if you don’t offer OIT, you should at least discuss it and refer appropriately.

Avoidance alone is no longer the only option.

Medicine evolves — and our responsibility is to evolve with it.

Follow both and and drop us a comment if you or your little one is experiencing allergies.

03/03/2026

🥛🥚 The Volume Tells the Story.

I genuinely didn’t realize just how many severe milk and egg allergy families we were serving… until we started tracking.

Since November — in just three months — 80 new patients with severe milk and egg allergies.

Families are traveling 6–7 hours.
We have patients coming from Florida.
Even referrals connected to Vanderbilt University.

Why?

Because many allergists and even academic centers aren’t offering milk and egg OIT. Not because they’re wrong — but because they’re not comfortable with it.

And comfort comes from volume.

We see a high volume of milk and egg cases. That experience has allowed us to become very precise with microdosing — carefully introducing tiny, controlled amounts and building up safely.

That’s how you get results.

We’re also comfortable with:
• Microdosing protocols
• Slow build strategies
• Down-dosing when needed (though we rarely have to)

When you treat enough patients, you develop pattern recognition and confidence that only repetition can build.

If milk or egg allergy has been limiting your child’s life — and you’ve been told avoidance is the only option — we’re happy to offer a second opinion.

Milk.
Egg.
Or any type of oral immunotherapy.

We’re here.

📞: (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

03/03/2026

🌰 High Numbers. Real Protection. Practical Goals.

I want to share this case so families understand what options actually exist.

This is a 10-year-old I saw in March with very elevated labs:
• Pistachio: 48
• Walnut: 36
• Cashew: 32
• Peanut: Positive

Those are high numbers. The kind that make most people feel stuck.

But here’s the key — this family didn’t care about freely eating nuts.
They just wanted protection from accidental exposures.

That’s an important distinction.

So we built a slow, structured oral immunotherapy plan — peanut and tree nut coverage — gradually increasing tolerance in a controlled way.

Eventually, we transitioned him to daily maintenance using MightyMe Puffs — the same multi-nut puffs often used for early introduction in babies.

He now takes four puffs daily (about 10–20 mg of mixed nut protein).

Goal achieved:
✔️ Protection against accidental exposure
✔️ Reduced anxiety
✔️ Freedom to live life without constant fear

Not every family wants “food freedom.”
Some just want safety.

And even with high IgE numbers, protective desensitization is very possible.

If you’ve been told the numbers are “too high” to do anything — that’s not always true. There are different approaches depending on your goals.

If this sounds like your situation, we’re happy to talk through options or point you toward someone experienced in this space.

Sometimes the win isn’t eating the nut.
It’s not being afraid of 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

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