Allergy Shots/Immunotherapy
Original post by Wego Health Community Leader DanW:
When allergy medications don’t work, allergy shots (immunotherapy) may be able to provide long-term relief for allergies. Allergy shots are not considered effective against food allergies, but they can offer many people relief from hay fever (allergic rhinitis), asthma, and allergies to bee stings and some drugs.
Allergy shots work by desensitizing your immune system to certain allergens. Over a period of a few years, you get gradually increasing doses of the allergen that affects you (or an extract of that allergen). Over time, your body develops antibodies to the allergen and becomes desensitized to that allergen.
While I’ve never had allergy shots, I’ve experienced a similar effect from long term exposure to dogs. I gradually became “used to” the two particular dogs that I lived with and didn’t develop serious allergic reactions to them anymore. Unfortunately, my desensitization only worked for those two dogs (I was still allergic to other dogs), and once I no longer lived with them I became allergic to them again.
Just about all my friends have dogs, and my allergies can really take the fun out of getting together with friends, so I’ve been considering getting on an allergy shot regimen. I’ve heard, however, that they’re kind of a hassle, that they may not work especially well for someone with a well-established allergy, and that their effects aren’t always long-lasting.
Has anybody here tried allergy shots? What was your experience with them? Did you have any unpleasant side effects? Please share your knowledge here, and if you have questions, please share them, too.
Response from Ellen_CM:
We tried shots. They helped to a point, and then stopped and we almost got worse. In desperation we went a long way to a doc who treats (also) with sublingual drops. These did seem to help, and if bloodwork is any indication, they worked quite well. There were many other things we had to do tho, so our regime was more of a multi-modal approach.
During shots, we did have some fairly bad reactions when the doc was giving them, but antihistamines, Alka-Seltzer (balances the Ph in your body- surprising), possibly an inhaler or short dosepack of steroids, and backing down the amount we were using usually took care of it. Once we began doing the shots at home and I was allowed to determine dosage, I was more careful and we never had any of those issues. Slow and steady…
Response from Kori:
Ellen_WEGO_HealthPosted: 23 August 2007 03:29 PM
We tried shots. They helped to a point, and then stopped and we almost got worse. In desperation we went a long way to a doc who treats (also) with sublingual drops.
Ellen, what are sublingual drops and how are they used for allergies? I know subligual means under the tongue, but I’ve never heard of them for allergies.
Thanks!
Response from Ellen_CM:
Sublingual drops are basically the same as injections in theory, but the antigen is dropped and held under your tongue for a short time where it is very quickly absorbed (think Nitro for heart patients) instead of under the skin. They’re done several times during the day to get the same effect as the injections. Frequent testing is done to see if you’re at the correct dosage, and changes are made accordingly, just like for injections. It’s more difficult as the patient must be extremely compliant with using them or they don’t work and you’re wasting your time and money. Compliant patients seem to do really well on them tho it’s not for everybody and most docs using them will switch back over to injections if it looks like the treatment isn’t optimal. It’s very similar to a challenge test, but with a greatly diluted solution of the antigen.
Response from Ellen_CM:
Here is a Link to some good info about allergy drops vs injections. One of the clinics listed is the one that did so much to help us. We went there after my Uncle (who lives several hours from the clinic) had several people contact me to tell me of their personal experiences as well as those of family members. Until then, I had no idea that allergies could be treated any way but with injections. I met one man when he attended my wedding years before. The docs could no longer help him and gave up on him. He was so sick that he was unable to care for himself anymore and docs said he wouldn’t last much longer, and this is what saved his life.
We went to several allergists and never got sufficient treatment or knowledge in how to deal with allergies. The docs simply didn’t keep current on the best info out there to have other options to pull out of their pockets when we needed it. It was good treatment and good info, but it wasn’t enough for our situation. Many times we traveled hundreds of miles to the clinic (back in the days when there was just one) and I will never regret a single one of them. I’m not sure that my son would have survived his severe condition without their guidance and treatment. This was in the days before the internet, so much of the info is now thankfully available online.
For those interested in research, there is an enormous list of published articles re: this therapy. From the SITE
(no direct link available- click “About our Treatment” then go to “Research..")
“Research Regarding Sublingual Immunotherapy
The current understanding of clinical efficacy, safety, mechanisms and indications for the use of sublingual-swallow immunotherapy (SLIT) in the treatment of allergies is embodied in the studies, papers and publications referenced in this document. Over 230 citations are contained in this bibliography, including over 80 peer-reviewed studies published since 1995.
Internationally, SLIT is used widely (50% in some European countries), with full regulatory and government backing. U.S. allergy leaders are writing in support of SLIT. (See section 1) The World Health Organization indicated its use in its 1998 position paper. In 2007, for the second time (originally in 2001), an international workgroup, including U.S. allergists, published the ARIA (Allergy Rhinitis and its Impact on Asthma) guidelines indicating SLIT as a viable treatment approach. The ARIA paper indicates that not only is there more modern research on SLIT compared to SCIT, but it is also of higher quality in terms of the WHO guidelines for research studies. A Cochrane Review, the most trusted independent, evidence based, meta-analysis organization in the world, released their analysis in 2003 and determined SLIT both safe and effective.”
It’s interesting to note that there are no anaphylactic type reactions to this therapy, yet these types of reactions are not uncommon with injection therapy. This therapy also can treat food and other allergies that are not currently treatable with injection therapy.
Some physicians who are not well-versed on the current research data do not consider sublingual allergy therapy a viable alternative to the old injections.
Obviously, this is not going to be for everyone, but it is an increasingly popular option. As I said earlier, most docs who use this type of therapy also use injections if their patients prefer or if the therapy is less than optimal for them, but that seem to be rarely the case.
For me, I’m a “proof in the pudding” girl, and if you don’t like it you can always switch back to ‘ol reliable’.
Response from Kori:
Thanks so much Ellen. One more question. Would an allergist do the drops, or would I need to see some other type of practitioner? I’m just trying to find out how to go about seeing someone in my area.
Response from Ellen_CM:
Kori D. - 12 September 2007 01:22 PM
Would an allergist do the drops, or would I need to see some other type of practitioner? I’m just trying to find out how to go about seeing someone in my area.
An Allergist specially trained in Sublingual Allergy Drops is who you will need to see. They will be able to tell you if you are a candidate for this kind of treatment.
Response from Adrienne:
Hi everyone
WEGO Health just published our Allergy Immunology page. Please make sure to rate and review and also post any comments here in addition to on the page. Thanks! We want to make this page as helpful and accurate as possible.
Allergy Immunology
Response from Felisha Griffin, MSPH:
Hi
A recent page on allergy shots has been added. It has some great information, including a link about sublingual drops.
http://allergy.wegohealth.com/allergy-shot.html
Response from Ellen_CM:
Hi Felisha,
It says the link was removed. Darn!
Response from Marie_Wego_Health:
Hi everyone. This is actually my first post on the forums. I think I’ve spoken with some of you on the phone this week, I’m the new Community Producer at WEGO.
I know this is an older thread, but I thought I’d throw in my 2 cents. I have your generic, run of the mill, seasonal allergies and have had them since elementary school. They were worst when I was a kid, and I missed a ton of school because I got sick every time the weather changed.
After a little while, my mom started to notice this, so she got me and my sister tested for allergies and the allergist recommended shots. I got two shots, once a week, for about 4 years. I have to say, it really did work for me. For those four years, and probably for two or three years after that, my pollen allergies just stopped being an issue.
Now of course, they’re back and I get sick pretty much whenever the weather changes or I travel. Maybe I should look into going back on them…
One other thing that was great about the shots was that they’re easy to do anywhere. My sister and I would travel a lot, especially during the summer breaks from school, and my mom would send us to a relative’s with serum in tow. The woman who lived across the street was a nurse, so she used to give us the shots when we were on vacation.
Anyway, that’s been my experience with shots. It seems like other responses suggest that perhaps more serious allergies don’t respond as well to this kind of treatment?
Response from drees:
Hi all - There’s a video on allergy shots on the nasal allergy page under treatments and Felicia’s posted a great page all about allergy shots.
Seems like there are some people aren’t good candidates for shots, like people with asthma or taking beta-blockers for heart conditions. And kids under five aren’t good candidates - probably because their immune system’s still developing.
The needle seems daunting to me - for all of you brave souls who’ve had the shots can you comment on that? Do you just get used to it?
Response from DanW:
Marie_WEGO_Health - 12 October 2007 12:21 PM
I have to say, it really did work for me. For those four years, and probably for two or three years after that, my pollen allergies just stopped being an issue. Now of course, they’re back and I get sick pretty much whenever the weather changes or I travel. Maybe I should look into going back on them…
Hi Marie. Thanks for joining us here in the Asthma and Allergy community! I think your experience mirrors many people’s—the allergy shots, if they work, do tend to provide lasting protection against allergies, at least for a while.
On WEGO’s allergy shots page, the article referenced as “Weighing the Costs" compares the cost of allergy shots to medications. Because of the potential long-term benefits of allergy shots, they can actually be cheaper than allergy drugs in the long run. Of course that depends on exactly how long the allergy shots protect you after you’ve stopped getting them. For some people, the protective effect lasts a lifetime, whereas for others, like yourself, the allergies come back sooner or later.
Marie_WEGO_Health - 12 October 2007 12:21 PM
Anyway, that’s been my experience with shots. It seems like other responses suggest that perhaps more serious allergies don’t respond as well to this kind of treatment?
I don’t have any first-hand experience with immunology therapy, but I think the allergy shots often do work for more serious allergies, though perhaps they are not as effective as for mild allergies. The other problem with very serious allergies is that allergy shots may cause anaphylaxis. This is rare, but from what I understand it’s happened often enough to make them inadvisable for some patients.
By the way, Ellen, the link you were asking about now appears to work. If not, the link I put in above goes to the same page.
Response from Marie_Wego_Health:
Dan, thanks for pointing out that link! I was thinking as I wrote up my message, “Sure, maybe I should go on shots again, but now that I’m paying for it myself...is that really affordable?” You make a good point about the potential long-term benefits.
As for Felisha’s comment about the shots & fear of needles, I was actually going to mention that as one of the benefits of getting allergy shots. I wasn’t wild about the whole needles thing, but I absolutely did get used to the shots, and I’m not afraid of them at all now. I think it helps that allergy shots are, on the whole, pretty small needles.
When allergy medications don’t work, allergy shots (immunotherapy) may be able to provide long-term relief for allergies. Allergy shots are not considered effective against food allergies, but they can offer many people relief from hay fever (allergic rhinitis), asthma, and allergies to bee stings and some drugs.
Allergy shots work by desensitizing your immune system to certain allergens. Over a period of a few years, you get gradually increasing doses of the allergen that affects you (or an extract of that allergen). Over time, your body develops antibodies to the allergen and becomes desensitized to that allergen.
While I’ve never had allergy shots, I’ve experienced a similar effect from long term exposure to dogs. I gradually became “used to” the two particular dogs that I lived with and didn’t develop serious allergic reactions to them anymore. Unfortunately, my desensitization only worked for those two dogs (I was still allergic to other dogs), and once I no longer lived with them I became allergic to them again.
Just about all my friends have dogs, and my allergies can really take the fun out of getting together with friends, so I’ve been considering getting on an allergy shot regimen. I’ve heard, however, that they’re kind of a hassle, that they may not work especially well for someone with a well-established allergy, and that their effects aren’t always long-lasting.
Has anybody here tried allergy shots? What was your experience with them? Did you have any unpleasant side effects? Please share your knowledge here, and if you have questions, please share them, too.
Response from Ellen_CM:
We tried shots. They helped to a point, and then stopped and we almost got worse. In desperation we went a long way to a doc who treats (also) with sublingual drops. These did seem to help, and if bloodwork is any indication, they worked quite well. There were many other things we had to do tho, so our regime was more of a multi-modal approach.
During shots, we did have some fairly bad reactions when the doc was giving them, but antihistamines, Alka-Seltzer (balances the Ph in your body- surprising), possibly an inhaler or short dosepack of steroids, and backing down the amount we were using usually took care of it. Once we began doing the shots at home and I was allowed to determine dosage, I was more careful and we never had any of those issues. Slow and steady…
Response from Kori:
Ellen_WEGO_HealthPosted: 23 August 2007 03:29 PM
We tried shots. They helped to a point, and then stopped and we almost got worse. In desperation we went a long way to a doc who treats (also) with sublingual drops.
Ellen, what are sublingual drops and how are they used for allergies? I know subligual means under the tongue, but I’ve never heard of them for allergies.
Thanks!
Response from Ellen_CM:
Sublingual drops are basically the same as injections in theory, but the antigen is dropped and held under your tongue for a short time where it is very quickly absorbed (think Nitro for heart patients) instead of under the skin. They’re done several times during the day to get the same effect as the injections. Frequent testing is done to see if you’re at the correct dosage, and changes are made accordingly, just like for injections. It’s more difficult as the patient must be extremely compliant with using them or they don’t work and you’re wasting your time and money. Compliant patients seem to do really well on them tho it’s not for everybody and most docs using them will switch back over to injections if it looks like the treatment isn’t optimal. It’s very similar to a challenge test, but with a greatly diluted solution of the antigen.
Response from Ellen_CM:
Here is a Link to some good info about allergy drops vs injections. One of the clinics listed is the one that did so much to help us. We went there after my Uncle (who lives several hours from the clinic) had several people contact me to tell me of their personal experiences as well as those of family members. Until then, I had no idea that allergies could be treated any way but with injections. I met one man when he attended my wedding years before. The docs could no longer help him and gave up on him. He was so sick that he was unable to care for himself anymore and docs said he wouldn’t last much longer, and this is what saved his life.
We went to several allergists and never got sufficient treatment or knowledge in how to deal with allergies. The docs simply didn’t keep current on the best info out there to have other options to pull out of their pockets when we needed it. It was good treatment and good info, but it wasn’t enough for our situation. Many times we traveled hundreds of miles to the clinic (back in the days when there was just one) and I will never regret a single one of them. I’m not sure that my son would have survived his severe condition without their guidance and treatment. This was in the days before the internet, so much of the info is now thankfully available online.
For those interested in research, there is an enormous list of published articles re: this therapy. From the SITE
(no direct link available- click “About our Treatment” then go to “Research..")
“Research Regarding Sublingual Immunotherapy
The current understanding of clinical efficacy, safety, mechanisms and indications for the use of sublingual-swallow immunotherapy (SLIT) in the treatment of allergies is embodied in the studies, papers and publications referenced in this document. Over 230 citations are contained in this bibliography, including over 80 peer-reviewed studies published since 1995.
Internationally, SLIT is used widely (50% in some European countries), with full regulatory and government backing. U.S. allergy leaders are writing in support of SLIT. (See section 1) The World Health Organization indicated its use in its 1998 position paper. In 2007, for the second time (originally in 2001), an international workgroup, including U.S. allergists, published the ARIA (Allergy Rhinitis and its Impact on Asthma) guidelines indicating SLIT as a viable treatment approach. The ARIA paper indicates that not only is there more modern research on SLIT compared to SCIT, but it is also of higher quality in terms of the WHO guidelines for research studies. A Cochrane Review, the most trusted independent, evidence based, meta-analysis organization in the world, released their analysis in 2003 and determined SLIT both safe and effective.”
It’s interesting to note that there are no anaphylactic type reactions to this therapy, yet these types of reactions are not uncommon with injection therapy. This therapy also can treat food and other allergies that are not currently treatable with injection therapy.
Some physicians who are not well-versed on the current research data do not consider sublingual allergy therapy a viable alternative to the old injections.
Obviously, this is not going to be for everyone, but it is an increasingly popular option. As I said earlier, most docs who use this type of therapy also use injections if their patients prefer or if the therapy is less than optimal for them, but that seem to be rarely the case.
For me, I’m a “proof in the pudding” girl, and if you don’t like it you can always switch back to ‘ol reliable’.
Response from Kori:
Thanks so much Ellen. One more question. Would an allergist do the drops, or would I need to see some other type of practitioner? I’m just trying to find out how to go about seeing someone in my area.
Response from Ellen_CM:
Kori D. - 12 September 2007 01:22 PM
Would an allergist do the drops, or would I need to see some other type of practitioner? I’m just trying to find out how to go about seeing someone in my area.
An Allergist specially trained in Sublingual Allergy Drops is who you will need to see. They will be able to tell you if you are a candidate for this kind of treatment.
Response from Adrienne:
Hi everyone
WEGO Health just published our Allergy Immunology page. Please make sure to rate and review and also post any comments here in addition to on the page. Thanks! We want to make this page as helpful and accurate as possible.
Allergy Immunology
Response from Felisha Griffin, MSPH:
Hi
A recent page on allergy shots has been added. It has some great information, including a link about sublingual drops.
http://allergy.wegohealth.com/allergy-shot.html
Response from Ellen_CM:
Hi Felisha,
It says the link was removed. Darn!
Response from Marie_Wego_Health:
Hi everyone. This is actually my first post on the forums. I think I’ve spoken with some of you on the phone this week, I’m the new Community Producer at WEGO.
I know this is an older thread, but I thought I’d throw in my 2 cents. I have your generic, run of the mill, seasonal allergies and have had them since elementary school. They were worst when I was a kid, and I missed a ton of school because I got sick every time the weather changed.
After a little while, my mom started to notice this, so she got me and my sister tested for allergies and the allergist recommended shots. I got two shots, once a week, for about 4 years. I have to say, it really did work for me. For those four years, and probably for two or three years after that, my pollen allergies just stopped being an issue.
Now of course, they’re back and I get sick pretty much whenever the weather changes or I travel. Maybe I should look into going back on them…
One other thing that was great about the shots was that they’re easy to do anywhere. My sister and I would travel a lot, especially during the summer breaks from school, and my mom would send us to a relative’s with serum in tow. The woman who lived across the street was a nurse, so she used to give us the shots when we were on vacation.
Anyway, that’s been my experience with shots. It seems like other responses suggest that perhaps more serious allergies don’t respond as well to this kind of treatment?
Response from drees:
Hi all - There’s a video on allergy shots on the nasal allergy page under treatments and Felicia’s posted a great page all about allergy shots.
Seems like there are some people aren’t good candidates for shots, like people with asthma or taking beta-blockers for heart conditions. And kids under five aren’t good candidates - probably because their immune system’s still developing.
The needle seems daunting to me - for all of you brave souls who’ve had the shots can you comment on that? Do you just get used to it?
Response from DanW:
Marie_WEGO_Health - 12 October 2007 12:21 PM
I have to say, it really did work for me. For those four years, and probably for two or three years after that, my pollen allergies just stopped being an issue. Now of course, they’re back and I get sick pretty much whenever the weather changes or I travel. Maybe I should look into going back on them…
Hi Marie. Thanks for joining us here in the Asthma and Allergy community! I think your experience mirrors many people’s—the allergy shots, if they work, do tend to provide lasting protection against allergies, at least for a while.
On WEGO’s allergy shots page, the article referenced as “Weighing the Costs" compares the cost of allergy shots to medications. Because of the potential long-term benefits of allergy shots, they can actually be cheaper than allergy drugs in the long run. Of course that depends on exactly how long the allergy shots protect you after you’ve stopped getting them. For some people, the protective effect lasts a lifetime, whereas for others, like yourself, the allergies come back sooner or later.
Marie_WEGO_Health - 12 October 2007 12:21 PM
Anyway, that’s been my experience with shots. It seems like other responses suggest that perhaps more serious allergies don’t respond as well to this kind of treatment?
I don’t have any first-hand experience with immunology therapy, but I think the allergy shots often do work for more serious allergies, though perhaps they are not as effective as for mild allergies. The other problem with very serious allergies is that allergy shots may cause anaphylaxis. This is rare, but from what I understand it’s happened often enough to make them inadvisable for some patients.
By the way, Ellen, the link you were asking about now appears to work. If not, the link I put in above goes to the same page.
Response from Marie_Wego_Health:
Dan, thanks for pointing out that link! I was thinking as I wrote up my message, “Sure, maybe I should go on shots again, but now that I’m paying for it myself...is that really affordable?” You make a good point about the potential long-term benefits.
As for Felisha’s comment about the shots & fear of needles, I was actually going to mention that as one of the benefits of getting allergy shots. I wasn’t wild about the whole needles thing, but I absolutely did get used to the shots, and I’m not afraid of them at all now. I think it helps that allergy shots are, on the whole, pretty small needles.
Replies to This Discussion
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Permalink Reply by nat3 on -
I see this is an old thread but maybe someone can advise me. I started allergy shots this week and was very ill for over a day. I previously have had CFS but not as sick with that anymore, I still have a very touchy immune system.
I can't deal with being that sick on a weekly basis and of course will run this by my doctor. And I seriously considered taking part of a vicodan just to deal with the EXTREME pain, facial and systemic along with other symptoms, but I don't want to feel that horrible hung over feeling from that either!
My allergy problem is fairly disabling. I can't really do "normal" things without becoming very sick. I need some resolution to this but.....any advise on this? Thanks. (I tested + to about 13 of environmental/mold and 13 pollens.)
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Permalink Reply by Janeen on -
nat3,
I'm sorry you are feeling so poorly! I don't have much experience with allergy shot as I've not had them myself. Most people I know tolerate them very well. Having said that though, my Mother In Law ended up having a terrible reaction to allergy shots and had to go to the ER. My best advice to you would be to contact your doctor. Even though it's the weekend, most doctors have an answering service that can reach them in an emergency or a doctor on-call that can answer questions. I would call and explain to them how you feel. If it's caused by the shots then I'm not sure that the Vicodin would help anyway. The doctor could better prescribe something that would take away the adverse reaction to the shots. I think my MIL's doctor tried increasing her dose of Clartin before her trip to the ER.
I hope you are feeling better soon. I'm sorry I don't have better advice for you, but I think a call to your physician would be your best bet.
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Permalink Reply by nat3 on
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Hi Janeen,
Thanks for your input. I'm not sure if you could classify mine as a reaction or more like it just making me very sick. I have had many years of illness and finally narrowed down the last legs of getting well to this overwhelming allergy problem.
Most doctors have a very difficult time understanding chronic illness, they want to put it into a box that they can prescribe something for. I've been working on healing my body and immune system for years. It's a lot of work and dedication!
The shots just made me feel physically sick and caused me to have extreme pain too. I didn't have anaphylactic type reaction...so that's why I considered taking something to numb the symptoms. I'm a nurse and a medical researcher so I understand a little of my options, but like I said it's frustrating because my way is really to heal through lifestyle measures and doctors don't seem to get that....but at the same time facing that extreme once a week is a frightening prospect. What you think?
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Permalink Reply by Janeen on
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If the shots made you that ill, I would think about discontinuing them. I'm not sure that kind of misery is worth the outcome or possible outcome (some people I know say the shots gave them their life back, others found little or no effect).
Have you or can you see a physician that deals with more alternative medical treatment? We have 2 clinics by me that I know of that work at healing the whole person not just the issue at hand and they do so by alternative treatments. I know several people that have been greatly helped by such a clinic, and most found help there when all traditional medicine seemed to fail. Unfortunately because it's considered "alternative", it's not covered by insurance. But for your life style it may be something worth looking into.
No matter what you decide, I hope you are feeling better now. I'm sorry the shots seemed to make things worse.
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Permalink Reply by nat3 on
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Thanks for your reply....I was on interferon for a year and this is EXACTLY like it. I've told myself many times that I won't go through anything like that again. I will talk to the allergist, but I agree with you, I think another approach is more likely to work without causing me this degree of over the top suffering. I did end up taking some codeine on Saturday because it was so agonizing. I hate drugs so that wasn't a normal thing for me to do. My allergist is only in 1 day a week so I have to wait till Thurs. to see what she says. Maybe I'll feel better by then...haha...a little sarcasm there...thanks a bunch.
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