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June 25, 2019

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Weekend doctor: Allergy immunotherapy

By Amber Patterson, MD
ENT & Allergy Specialists of Northwest Ohio
If you or your child suffers from spring allergy symptoms, you may want to consider prevention tactics. Allergen avoidance and allergy medications are the first steps in managing allergies. If these are not completely providing symptom relief, or you prefer minimizing long-term medication use, consider allergy immunotherapy (IT).

This treatment, commonly referred to as “allergy shots,” involves receiving personalized injections of specific allergens over the course of three to five years. These injections are traditionally given under skin. The goal of allergy IT is to change the immune system so that the body tolerates the allergens and no longer interprets them as “foreign invaders.” Treatment schedules vary, but in general, injections are initially given one to two times per week, then spaced out to every four weeks for the remainder of the treatment course. The first injections are considered the “build-up” phase. During build-up, injection doses are very low and progressively increase with each visit until reaching a top dose. This top dose is known as a “maintenance” dose, the term used for the patient’s optimal treatment dose, which he or she will continue to receive with each future injection.

Most people begin noticing benefits within a year of the first injection, including decreased symptoms and needing fewer medications. Allergy IT can also prevent new allergies from forming and allergic rhinitis (nose symptoms from allergies) from progressing to asthma.

While most people tolerate the injections well, common risks of allergy IT include local reactions at the injection sites such as pain, swelling or bleeding. In rare cases, some individuals may experience severe allergic reactions such as swelling or difficult breathing. When these severe reactions do occur, it is typically within 30 minutes of receiving the injection and, if left untreated, could progress to a more life-threatening condition called anaphylaxis.

Because of risks associated with allergens injected under the skin, allergy shots should be administered in a medical setting with proper equipment to treat reactions. Patients should wait in the physician’s office 30 minutes after each injection to ensure accessibility to medical treatment if necessary.

Allergy sublingual immunotherapy (SLIT) tablets are a more recent FDA-approved method for administering allergy shots. SLIT tablets are available for individual treatment of grass, ragweed and dust mite. Allergy IT can be used for treating symptoms caused by environmental allergies such as pollen, pet hair/dander, dust mites and more. Additionally, this treatment can alleviate symptoms caused by allergic asthma, eczema or venom from flying insects or fire ants. Speak with your physician to help decide if allergy IT is right for you or your child.