No one really knows what causes one person to have allergies when another one doesn’t, or why one substance triggers an allergic reaction in an individual when another doesn’t. Allergic reactions can range from mild irritations to anaphylaxis (a severe reaction that’s a life-threatening emergency). But for the sufferer, allergies are always unpleasant and unwelcome.
Fortunately, it is not necessary to live with chronic allergies forever, because there’s a cure: immunotherapy. Immunotherapy actually retrains the body to no longer be allergic to chronic allergy triggers. Not everyone who has allergies needs immunotherapy, but for those who do, it can be a game changer.
Taking Over the Counter Antihistamines
Nearly 1 in 3 U.S. adults and more than 1 in 4 U.S. children, have some type of allergy. For a large percentage of them, allergies are a mild or occasional inconvenience.
Over-the-counter antihistamines can minimize the symptoms when a person is experiencing seasonal allergies. Utilizing this ‘medical management’ approach may be sufficient for an individual who gets allergies in the spring for a couple of weeks when pollen counts are highest.
For folks who are mildly allergic to pet dander, taking antihistamines daily may suppress symptoms enough to live comfortably with a cat, dog, or other type of pet.
Medical management does a good job of keeping the symptoms at bay. If there’s ever a point when the symptoms just become too much, then immunotherapy is a great next step.
Immunotherapy for Chronic Allergies
Immunotherapy treatment can actually cure a person’s chronic environmental allergies. It’s different than taking antihistamines to manage seasonal symptoms. Immunotherapy is a process of retraining the body to no longer be allergic to environmental allergens.
Immunotherapy actually gets to the source of the issue, desensitizing and raising a patient’s tolerances so that when they’re exposed to an allergy trigger, they’re not getting the symptoms that they used to.
You should consider having immunotherapy when:
- allergies consistently interfere with your quality of life
- your allergic reactions are increasingly severe, or
- you don’t want to take antihistamines every day for eternity
Just like gradually adding chili powder to food over time can train the taste buds to tolerate spicy food, immunotherapy slowly and carefully trains the immune system to tolerate allergenic substances.
Diagnosing the Allergy
WWMG’s ENT clinic offers immunotherapy to treat patients with chronic environmental allergies. The first step is accurately identifying the substances that cause an allergic reaction.
Allergy testing involves skin pricks on the patient’s back and intradermal (just below the skin) on the arms. Our team does both tests to determine which substances a patient is allergic to and how severely. It helps them decide where to start with the allergy treatment plan.
Treatment is customized to the individua. Patients with a severe response to skin testing will begin immunotherapy with more diluted allergens in their dose to avoid an allergic reaction to the treatment.
A blood test is a diagnostic option when allergies are so severe the patient can’t stop taking antihistamines long enough for a skin test, or when a patient’s other prescription medications put them at risk of a negative reaction from a skin test.
Immunotherapy Treatment Options
There are three forms of immunotherapy treatment: tablets, shots, or drops.
Most allergies will be treated with a customized formula that is either administered through shots or sublingual drops (under the tongue). Tablets are available only for specific allergies.
Tablets
If a patient is diagnosed as allergic to only one substance, and that substance is either grass pollen, dust mites, or ragweed, they can receive a prescription for immunotherapy tablets.
The tablets are taken as a daily pill just like antihistamines. The antigen (allergen) content in prescription immunotherapy tablets is gradually increased until the patient’s body no longer reacts when exposed to the target substance in their environment.
Shots
The most common immunotherapy treatment is allergy shots. Shots may be recommended for patients with allergies to trees, grasses, weeds, mold, house dust, animal dander, and insect stings.
Allergy shots must be given at a clinic, and are usually covered by most health insurance plans (check with your insurance provider to verify coverage).
A custom treatment formula is developed for each patient based on their diagnosed allergies. The formula is tested on the patient through an initial injection, and if they tolerate it, they can begin the full course of treatment.
Patients receive shots weekly for a full year, and then monthly for the next four years. In most cases, patients begin to see an improvement in their symptoms after six months, but it can take up to a year for substantial relief from some allergy symptoms.
Patients may experience some swelling at the injection site for a couple of days after each shot. In the event of a more severe reaction, the allergist will reduce the exposure levels to the allergen and adjust the treatment plan accordingly.
Even in small doses, the allergy provider is giving the patient things they’re allergic to, so there is the chance of anaphylaxis. Although the chances of having an extreme reaction are rare, every patient who undergoes immunotherapy is prescribed an EpiPen as a precaution.
Drops
Drops may be used to treat the same allergens as immunotherapy shots. Immunotherapy drops relieve allergies faster than shots, and are less likely to cause a severe reaction.
Patients who opt for immunotherapy drops receive their first dose at a health clinic. Drops are placed under the patient’s tongue for 2 minutes, then swallowed.
After the initial dose, patients can administer the drops themselves at home, ideally at the same time each day.
A patient can reach maintenance phase much faster than with shots, so they should feel relief much sooner by using drops. Patients’ symptoms are usually relieved within three to six months, and they generally complete the treatment after about three years.
Immunotherapy drops have a higher safety profile. There’s a much lower chance of having adverse reactions because they’re absorbed under the tongue instead of injected into the bloodstream. Usually, the worst reaction is itchiness around the tongue and mouth, or a stuffy nose.
The drops are the way of the future for allergies. Allergists in America and Europe have been doing this form of treatment for years.
Until sublingual allergy drops complete the FDA approval process, healthcare providers cannot bill insurance for them. Patients choose to pay out of pocket for immunotherapy drops because the ease and effectiveness are substantial benefits of this form of treatment.
Shots vs Drops
Once an allergy is diagnosed, if tablets are not recommended, the choice of immunotherapy shots or drops belongs to the patient.
In general, the most effective treatment option is the one that will fit the patient’s schedule. Both the shots and drops will treat allergies extremely well over time.
As mentioned above, shots are usually covered by insurance, and drops are paid for out of pocket by the patient. Many patients find the total out of pocket costs to be about the same for shots or drops, partly because the length of immunotherapy treatment is longer if you’re getting shots.
Whether you opt for shots or drops, at the start of treatment you can keep taking over-the-counter allergy medications to control symptoms until the immunotherapy starts to work. The further you get along on the immunotherapy shots, your provider can advise on tapering down your antihistamine dose.
At the end of the three-to-five-year treatment program, you will be tested for allergies again. If there is a 90% decrease in the reaction, your allergist will stop the therapy for a three-month trial period to see if allergy symptoms return. 95% of the time patients discover their allergies are completely gone, and can discontinue treatment. Sometimes it’s a little bit longer, depending on the patient.
When to Seek Help for Allergies
If chronic allergies are affecting your quality of life, or if your seasonal allergies are severe, the team at WWMG’s Ear, Nose & Throat clinic can help. Request an appointment today with our Allergy specialist. They’ll diagnose the root cause of your allergies and recommend an immunotherapy treatment plan to help you find relief.