Allergy Shots vs Drops vs Tablets for Environmental Allergies
Allergy Immunotherapy is the only type of allergy treatment that changes the immune system to become less allergic to an allergen. This can be considered more of a problem solver by “desensitizing” the immune system to the allergen as opposed to medications that only treat the symptoms.
Allergy shots have been given successfully by allergists over the past 100 years and have significantly improved over time with advances in allergy serum and protocols. It has proven to be successful for the treatment of Allergic Rhinitis and Conjunctivitis (nasal and eye allergies), Allergy Induced Asthma, Insect Allergy and Atopic Dermatitis (Eczema).
Allergy immunotherapy induces tolerance to the immune system by giving low doses of the allergens initially then building up on these doses over time. This process desensitizes the allergens to the immune system and decreases the allergic symptoms when exposed to those allergens via the environment.
Allergy immunotherapy is for patients that prefer to decrease or avoid chronic allergy or asthma medications. Also for patients that have not been controlled with a variety of medications, allergy immunotherapy is typically much more effective.
TYPES OF IMMUNOTHERAPY: Shots vs Drops vs Tablets
Allergy Shots (also called SubCutaneous ImmunoTherapy or SCIT) has been shown to be the most effective way of allergy desensitization for the best symptoms relief.1 This requires allergy injections in a medical office. This therapy has been well studied and has long been approved by the FDA which allows for insurance coverage. When done by Board Certified Allergists this therapy has been shown to be very effective in symptom reduction. Allergy shots have also been shown to have sustained benefit (long term desensitization) in most patients for many years beyond treatment period.
Allergy Drops (also called SubLingual ImmunoTherapy or SLIT) are administered under the tongue and has been shown to be effective for certain allergens. Studies show a wide range of results and moderate symptom reduction is possible in appropriate candidates. This has not yet been approved by the FDA but based on studies has been shown to be safe with rare chance of serious side effects. This can be done seasonally for symptom improvement but has not been adequately proven to have long term benefits after treatment.
Allergy Tablets: In 2014 the FDA approved sublingual (under the tongue) dissolvable tablets containing grass pollens and ragweed pollen separately. These tablets are used seasonally to reduce symptoms from grasses or ragweed and do not have the long term benefits compared to allergy shots. This is like Allergy Drops but does not include other potential allergens contributing to symptoms. Studies have shown 20-30% reduction in symptoms on average over placebo
What is right for me?
There are many options to manage patients with environmental allergies. Our Allergists will determine what is best in your individual case. Our physicians, board certified in Allergy and Immunology, utilize extensive training, years of clinical experience, and a wealth of knowledge to direct the most effective interventions for your immediate and long term care.
1 Medical Literature Reference: Harold S. Nelson, MD; Subcutaneous Immunotherapy Verses Sublingual Immunotherapy: Which is More Effective? Journal of Allergy and Clinical Immunotherapy, April 2014
The answer is not as easy as some would think. There are many factors that affect our health. To support a healthy immune system one consideration is what you are fueling your body with day to day. This is more complicated than picking regular or premium unleaded gasoline for your car.
Swapping a diet high in processed foods full of preservatives/sugars and artificial sweeteners for a whole food based diet is one of the best ways to provide your body with the right kind of fuel. The old saying, “You are what you eat” is proving to be the root of good health. Many patients will inquire about taking supplements to boost their immune system. It is true that we can obtain the nutrients we need from the vast assortment of vegetables, fruits, fiber rich whole and cracked grains, beans and legumes, fish/seafood and other protein sources, healthy fats, fresh herbs, spices and teas. Indulging *sparingly*on 1-2 glasses of red wine per day or dark chocolate also show in studies added health benefits. How many of us are consuming enough of these powerhouse nutrient rich foods every day?
Based on the current research there are several vitamins and supplements that support a healthy immune system. For example, if you are deficient in Vitamin D (have a Vitamin D 25, hydroxyurea blood level drawn by our medical professionals) taking a supplement can bring the level back into normal range. Residing in the southwest doesn’t protect you from Vitamin D deficiency. It is true that our bodies convert Vitamin D2 to Vitamin D3 with sun exposure, but due to skin cancer risk we should limit our direct sun exposure to 20-30 minutes per day. Wearing a daily SPF 30 zinc oxide based sunscreen is recommended, but this also reduces our Vitamin D absorption. Vitamin D acts as an important part of the immune system and promotes the uptake of calcium in our intestine to support dense strong bones. Vitamin D deficiency has been associated with more frequent infections and linked to increasing risk of cancers, cardiovascular disease, multiple sclerosis, rheumatoid arthritis, and Type 1 diabetes mellitus.
We can’t talk about supporting a healthy immune system without mentioning the digestive tract where about 90% of your immune system stems from. Lately, this is one area in medicine that is getting a lot of press. Maintaining healthy gut bacteria with a healthy diet and a daily probiotic can certainly put you on the path to wellness. An important tip for purchasing supplements is finding a professional grade brand that is third party verified for purity and quality. A probiotic with multiple strains totaling 25 billion CFUs (colony forming units) is typically adequate for adults and children. Consider scheduling an appointment here at AAAI with Nicole Englert PA-C for our Alliance Care to further guide you on quality supplement and healthy living recommendations.
So we are back to where we started…we are what we eat! Who knew bacteria can be your friend…healthy probiotic bacteria that is. Don’t forget to get adequate sleep, typically 7-8 hours a night. Healthy stress management practices such as exercise, yoga, meditation, journaling, reading and even tackling a new hobby or bringing back an old one that brings you joy are all great ways to start feeling well again.
Our Arizona weather is warming up, so everyone wants to open up the doors and windows to take a breath of fresh air. If you suffer from allergies, asthma or eczema, this act will likely increase those Spring sniffles, wheezing and itchy rashes. Who says we don’t have four seasons in Arizona? Well if depends on what kind of seasons you are referring to. Here is Arizona we have four allergy seasons, because our temperatures don’t get below freezing enough to make most of the plants and weeds go dormant. So how do we enjoy our beautiful Spring here in the desert without feeling miserable? Implement these tips and you are likely to enjoy our warm weather with a clearer head, lungs and skin.
1) Keep your windows and doors shut at least during the peak pollen count times of day: late morning, early afternoon and on winndy days. You can sign up on the American Academy of Allergy, Asthma and Immunology’s website or smart phone apps to receive notifications about airborne allergens in your area.
2) Consider using 3M filtrate filters in your home to trap about 30% more allergens and a small room air purifier with a HEPA air filter, especially in the bedroom.
3) Vacuum frequently, preferably with a model that uses a HEPA filter.
4) Keep animals out of the bedroom, even if you’re not allergic to pets. They bring pollens into your room and onto you bed. Bathe your pet once weekly to keep pet dander to a minimum.
5) Wash all bedding once a week in hot water and consider using an allergen-proof pillow case/mattress cover.
6) Regularly launder window coverings, such as curtains and dust or wipe to clean blinds.
7) Change clothes and shower before bed to remove pollen from hair and skin.
Reducing exposure to pollens is the key to managing allergies, but the fact is we can’t live in a bubble. Your allergists here at AAAI will assist you in optimally controlling your symptoms. Schedule an appointment with one of our providers to further discuss preventative and treatment recommendations.