ALLERGY IMMUNOTHERAPY
DON'T LET SEASONAL ALLERGIES HOLD YOU BACK.
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IMMUNOTHERAPY
Immunotherapy is designed to increase your body's natural resistance to the allergens that cause your symptoms. Unlike in Europe, where monovalent, or single-antigen, immunotherapy is practiced, in the US, we generally practice polyvalent immunotherapy that contains multiple allergens. There are two main types of immunotherapy. The first is allergy shots, called subcutaneous immunotherapy (SCIT). They are injected just under the skin in the forearm, and you are monitored for about 20 minutes thereafter for a reaction. Some providers give shots containing multiple allergens under the skin to increase your immunity to allergens you are allergic to. In general, injection with 1 or 2 shots once or twice a week is initiated, and over months it is decreased to once every other week, then monthly once maintenance dosing is achieved. The second is allergy drops, called sublingual immunotherapy (SLIT). These do not require patients to come into the office; they can be self-administered.
DURATION OF IMMUNOTHERAPY
Allergy Immunotherapy requires a time commitment, but the result is worth the wait! Building up your immunity to allergens and allergies must be done slowly over 3-5 years to avoid triggering an adverse allergic reaction during treatment. Some patients choose to receive treatment for an even longer period of time because of the effectiveness and relief they experience. The duration of treatment will affect how long the immune system continues to block the allergens for which it was treated.
BEGINNING IMMUNOTHERAPY
At Texas Sinus, Allergy, Snoring & Sleep Institute, Dr. Umang Khetarpal focuses on sublingual immunotherapy (SLIT) or drops
Drops
Allergy drops, or sublingual immunotherapy (SLIT), are a relatively new form of immunotherapy in the US. While it has been practiced in Europe and South America for over 30 years, it is now more widely adopted in the US. Drops containing allergens that you are allergic to are mixed in a bottle and placed under the tongue. This is a daily treatment, and the duration is 2-3 years as well. There are minimal side effects to date, with the most common one being a bad taste.
There are many advantages to taking allergy drops. There are minimal side effects and you do not have to come to the office weekly. Travel is possible while on drops, and missing a few days of treatment does not require returning to the original dose. It is a very convenient form of therapy.
As of now, allergy drops are not covered by insurance carriers because they are not FDA-approved. However, we believe it is only a matter of time before that happens.
There are other treatment options, including sinus surgery, that can help reduce sinus congestion from allergies. It is important to discuss treatment options with an allergy specialist and ENT, such as Dr. Khetarpal, to receive the best recommendation for treatment.
RISKS OF IMMUNOTHERAPY
Either during allergy testing or during shots, an anaphylaxis reaction can occur. Tongue or voice box swelling may occur during this, resulting in breathing difficulty. Typically, an EpiPen shot and steroids with Benadryl may be given right away. If you are on immunotherapy, always carry an EpiPen shot with you for use in an emergency.
MANAGING AND TREATING YOUR ALLERGIES - TIPS FROM DR. KHETARPAL
*Wash all bedding, including mattress pads, in hot water or bleach every 10 days.
* Clean your home. Dust mites are, by most studies, the most common allergen to cause
allergic reactions. Regular vacuuming with a HEPA filter, washing items in hot water, and using
mite-proof casings will reduce these allergens.
* Using HEPA filters in the bedroom, study, or TV room will help reduce pollen and particles
levels.
* Dust mite matter and pet dander hide in fabric, such as curtains, furniture upholstery, carpets,
and bedding. Keeping these clean is important.
* Remove carpeting in your home if possible
* Avoid smoking
* Basements, bathrooms, kitchens, and rooms with reduced ventilation must be well ventilated
to prevent or reduce mold growth.
* Bathe pets once a week to reduce pet dander, and, if possible, keep your pet out of the
bedroom. Wash your hands after petting animals.
* Because chalk can irritate children with allergies, advise the children not to sit too close to the
chalkboard
* Limit the number of indoor plants; mold thrives in potting soil.
* For individuals with food allergies, always read the ingredients before ingesting a new or
packaged food. When dining out, ask restaurants for a list of ingredients or for a meal prepared
without the offending food or additive.
* Nasal steroids (such as flonase or fluticasone, Nasonex, available OTC) are very effective in
improving the nasal symptoms of allergic rhinitis. Non-sedating antihistamines (such as Claritin,
Allegra and Zyrtec (all available OTC) are also effective but less so. Antihistamine nasal sprays
such as azelastine or astepro (available OTC) also reduce symptoms.
* Immunotherapy, such as sublingual immunotherapy (also called allergy drops), or
Subcutaneous immunotherapy (also called allergy shots) is very effective in reducing an
individual's allergic reactions over the long term.
* Allergy drops or sublingual immunotherapy is our preferred option, given the flexibility in using
it, more rapid escalation towards maintenance dosage, can be taken with you during travels, no
requirement for weekly office visits, and much less risk of anaphylaxis. Because allergy drops
are not FDA-approved, they are not paid for by insurance carriers. However, drops are very
safe, and increasing research and our own data on them show they are highly effective in most
patients.