St. Louis Allergy Immunotherapy
There are three basic approaches to treatment of allergic diseases (such as allergic rhinitis, hay fever, sinus problems, and asthma). These approaches are: (1) avoidance of the offending allergens,(2) allergy and asthma medications,and(3) allergy immunotherapy, also known as allergy shots. The main advantage of allergy immunotherapy is that it is the only way that we have at present to actually decrease the severity of your allergic problems. Medications and environmental controls only work as long as you continue to take the medication or continue to avoid the allergen. Allergy immunotherapy can actually make you less allergic. In addition, after a course of immunotherapy, most patients will experience a prolonged remission of their allergies after stopping allergy shots. This is not to say that the allergies are completely gone (cured), but that they are less than they were prior to the immunotherapy program. The main disadvantage of allergy immunotherapy is the effort involved in the immunotherapy program. This program is outlined below.
The Allergy Immunotherapy Program
Your immunotherapy is based on the results of your allergy skin testing and your evaluation by your allergist. Allergy injections consist of extracts of the actual allergens discovered on your skin testing, for instance pollens, molds, dust allergens, and animal dander. There is therefore risk of allergic reactions to allergy shots, necessitating a number of precautions. First, your allergy shots will initially be very dilute, and will slowly build up in volume and concentration. Second, allergy shots must be given in a medically supervised setting, which generally means a physician’s office(preferably your allergist’s office), where serious reactions can be appropriately and immediately treated. Third, you must always wait 20 to 30 minutes in the office after each allergy injection, since serious reactions, which can be very serious, usually occur in this time period.
Initially, in the “build-up” period, injections will be given one or two times per week. This build-up period usually continues for about six to nine months. Injections can then be “spread out,” usually at first to every other week, then every three weeks, then sometimes monthly. This build up period can be shortened significantly with rapid desensitization, also known as rush immunotherapy. Usually the patient will begin to notice benefit from injections at about the end of the third vial, sometimes a little earlier and sometimes later. About 80 to 90% of patients who undertake an allergy immunotherapy program will experience benefit.
Allergy immunotherapy is a long-term undertaking, usually 3 to 5 years. If a patient took shots for, say, 6 months and stopped, he would tend to lose any benefit of the program over the ensuing months. On the other hand, most patients who undertake the full program (3 to 5 years) will enjoy a long-term remission (years) after stopping allergy shots.
Allergy immunotherapy may safely be continued in pregnancy. Let us know, however, if you are pregnant, because this may affect your immunotherapy dose or schedule.
St. Louis Immunotherapy Available at Allergy and Asthma Consultants, P.C.
Robert F. Onder, M.D.
711 Old Ballas Rd.
St. Louis, MO 63141
St. Peters, MO 63376