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Updated: Oct 17, 2022

What Causes Allergies?

An allergy is an unusual response of the body to an environmental agent. This can manifest itself in many ways including the presence of itchy & watery eyes, itchy throat, coughing, asthma, sneezing, lethargy, and more. While most individuals may not be allergic to a particular item, some individuals are genetically predisposed to allergies to certain agents or become allergic as time goes by. The development of allergies depends on genetics, environmental interactions, degree of exposure to the particular allergen and duration of exposure, and yet unknown factors. One thing is for sure, even mild to moderate allergic reactions can disrupt the quality of your daily life.

Treatment for Allergies

The good news is that there are treatment options available that can help reduce the effects of allergens by building up your body's immune system. The three most common treatment options that we offer here at Texas, Sinus, Allergy, Snoring & Sleep Institute are Immunotherapy, Allergy Drops, and Nasal Sprays.

Immunotherapy (Allergy Shots)

Immunotherapy is designed to increase your resistance to the allergens that cause your symptoms. Unlike in Europe where monovalent or single antigen immunotherapy is practiced, in the US generally, we generally practice polyvalent immunotherapy or shots that contain multiple allergens. Allergy shots are also called subcutaneous immunotherapy or SCIT. They are injected just under the skin in the forearm and you are monitored for about 20 minutes thereafter for a reaction. That means we give shots containing multiple allergens under the skin to increase your immunity to allergens you are allergic to. In general, injection with one or two shots once or twice a week is initiated and over months it is decreased to once a week to once every other week and then monthly when maintenance dosing is achieved. The duration of therapy is about 2-3 years.

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.


"I'd had debilitating allergies to cats & dust mites for over 25 years. Between allergy medication, inhalers, air filters, and constant deep cleaning, I was able to function at home. But all it took was was to be around someone with cats or visit a friend's home, and my throat would start feeling scratchy, I'd start sneezing and wheezing and I was done.

I ended up having an absolutely horrible & scary allergic reaction to something I ate and I needed help right away. I made my first appointment with Dr. Khetarpal and was immediately blown away by his bedside manner and knowledge. Dr. K first took care of the issue at hand and successfully treated the allergic reaction. He then suggested I come in for allergy testing. I went back to the clinic 2 weeks later and was so impressed with the entire staff. They were thoughtful, thorough, and kind. The tests revealed that I was allergic to just about everything. It made sense! Dr. K suggested a treatment plan and I chose to come in weekly for allergy shots. This is long-term care, but it's worth it. I'm not kidding when I say that the results were nothing short of miraculous. 2 weeks after I began my shots, I traveled to visit my mom who had a cat and I only had to reach for my inhaler twice during the entire weekend. I was finally able to breathe and function. It's been almost 2 months and I haven't had to take my allergy medicine every day. I have less wheezing and scratchiness in my throat. I feel like my entire life has improved. I am so thankful for Dr. K and his entire staff for their help. This truly feels like a second shot at life."

- S. Lozada

Allergy Drops

Allergy drops or sublingual immunotherapy, also called SLIT, is 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 more widely adopted in the US now. 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. Allergy shots are not FDA approved yet, and therefore are not covered by insurance.

Advantages of Allergy Shots

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 going back to the original dose of treatment. It is a very convenient form of therapy.

While 2-3 years may seem like a long time, it is the safest and most effective way to help your body build an immunity to environmental and food allergens.

Nasal Sprays

Nasal steroids are very effective in improving nasal symptoms of allergic rhinitis. Non-sedating antihistamines (such as Claritin, Allegra, Zyrtec) are also effective but less so. Antihistamine nasal sprays may also reduce symptoms.


Do you suffer from allergies? Ask Dr. Khetarpal about allergy testing and treatment options. Same day and next day appointments available!

Dr. Khetarpal accepts most major insurance plans and is accepting new patients in The Woodlands and in The Heights. Make an appointment with Houston's #1 ENT


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