Allergy Treatment and Management
For millions of Americans, allergies present an invisible battle constantly being waged. A fresh spring day may be heavenly for some but may cause a nightmare allergic reaction for others.
It may seem like these allergens are attacking you, but your allergic reaction is actually your body trying to protect you. Foreign substances are constantly bombarding your body. In response, your body has developed an immune system that produces antibodies to protect you. But sometimes immune systems overreact, producing in excess a certain antibody known as IgE, which causes allergic reactions.
Some common allergic reactions are:
- NOSE - Itching, congestion, sneezing, post-nasal drip
- EYES - Itching, redness, swelling, tearing
- EARS - Fluid in the middle ear, recurrent infections
- LUNGS - Shortness of breath, wheezing, chest tightness, coughing
- SKIN - Itching, welts, hives, blistery rash
- DIGESTIVE - Stomach cramps, vomiting, diarrhea
- OTHER - Headaches, fatigue, hyperactivity, depression
The first step in treating an allergy is to find out what is causing the reaction. There are a variety of ways to do this.
- Radioallergosorbent Testing (RAST) involves sending a sample of your blood to a lab to be tested for allergens. We don’t typically recommend this method as allergens may not show up in blood and can be missed.
- Conventional Intradermal Testing is one of the classic ways to test for allergens but also the most tedious. A very weak dose of potential allergens is introduced to the outermost layer of the skin to see if a reaction takes place. This method requires multiple shots to determine how reactive you are to each allergen.
- Modified Quantitative Testing (MQT) is a state-of-the-art method. It combines both intradermal testing and skin-prick testing. This allows the physician to precisely identify the degree of reactivity with fewer shots. This is our preferred testing method.
Once you’ve been tested by your physician, we’ll develop a treatment plan. At Washington Ear, Nose and Throat, we offer two types of highly effective treatment.
|Subcutaneous Immunotherapy (SCIT)
||Injections of allergen extract
||In your physician’s office
||Weekly, for a 30-minute appointment
||Covered by most insurance plans
||3-5 years, depending on severity of allergy
|Sublingual Immunotherapy (SLIT)
||Drops of allergen taken orally
||In your home
||Quarterly, to pick up the next vial of drops
||Not covered by insurance, out of- pocket expense for patient
||3-5 years, depending on severity of allergy
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How Do I Manage My Allergies?
- Avoid the allergen(s): While this may work in some situations, some substances such as pollen are hard to avoid.
- Treat the symptoms: Medication can provide you a measure of relief from your allergy symptoms, but it does nothing to address the root of the problem.
- Use immunotherapy: Alter the body’s reaction to the allergen(s). Building a resistance to the effect an allergen has on you is the only treatment method known to cure your allergies.
Those who suffer from one allergy may be more vulnerable to others, as allergens can stack up and spread your body’s defenses too thin. Our immunotherapy program provides patients with a testing and treatment plan that can improve overall health and well-being.
Your body is better able to handle other health issues and stressors.
- You may use fewer sick days at work.
- Living your life as you want to becomes easier.
Schedule an appointment to find out whether immunotherapy treatment may be a solution for you. Your health insurance may cover allergen testing and an injection treatment plan. An oral treatment plan (drops under your tongue) may be covered by your Health Spending Account (HSA).
Understanding Your Allergy Test
What Is an Allergic Reaction?
An allergic reaction occurs when your body reacts to a harmless substance as if it were a virus or bacteria. Whether the cause is pollen, mold, or animal dander, the result is the same: Your body creates an antibody known as immunoglobulin E (IgE), which binds to the invading allergen. Your immune system then launches its arsenal of biological weaponry against the threat, causing allergy symptoms that can range from moderate to severe.
In modified quantitative testing, we use natural, purified concentrates known as allergen extracts. Allergens are entirely sterile, organic, and are approved safe for clinical treatment. We test patients using a panel of approximately 40 geographically relevant allergens including:
- Pollens: trees, grasses, and weeds
- Dust and animal dander
- Molds and other environmental allergens
The term allergic load refers to the total amount of allergy within each individual. This “load” is determined by several factors, including the environment, season, and diet. When a person has too much allergen present, they will have increased symptoms.
Immunotherpy can lower the load so that symptoms can be controlled. The goal is to keep allergen exposure below the allergic threshold. To illustrate this point, imagine a cup. When exposure to allergens occurs, the cup begins to fill. If too much exposure occurs, the cup overflows, producing symptoms.
In addition, other factors such as stress, fatigue, poor nutrition, and illness will add to the overflow. If all the offending allergens were removed from the environment, then the symptoms would disappear. Since this is impossible, we try to remove as much of the allergen as possible.
Your doctor will work with you to create a treatment plan to reduce your allergic load and control your symptoms.
What to Expect From Modified Quantitative Testing
Modified quantitative testing is a two-step process that allows us to determine which elements in the environment are causing your symptoms.
Skin Prick Testing
A special applicator is used to deliver a small amount of antigen on the surface of the skin. This test acts as a screening process that takes 20 minutes to determine the safest strength of antigen to test with an intradermal injection.
Intradermals involve placing a small amount of antigen just beneath the surface of the skin. After 10 minutes the severity of your reaction will allow you doctor to determine an effective treatment plan with a high degree of accuracy. Any swelling should vanish within 24–48 hours. As soon as testing is complete, you can resume taking antihistamines or any other medication you were instructed to avoid prior to the modified quantitative testing process.
Please be sure to report any delayed reactions to your allergy team.
Using your test results, your allergy specialist will work with you to create a treatment plan appropriate for your unique allergies. Once it’s determined which substances set off your immune system, your treatment team will administer preparations of minute amounts of things you are allergic to. Both methods are effective, but many insurance plans will only cover allergenic extract shots.
- No appointment is necessary to receive your allergen extract shots.
- Take your Epipen® to our clinic during scheduled injection hours.
- A member of our team will be happy to administer your dose.
- For safety, expect to wait 30 minutes after your injection to monitor for adverse side effects.
It is crucial that you maintain a strict injection schedule during the initial build-up phase. With each injection, your specialist is gradually exposing your body to increasingly large doses of allergens. Once you can tolerate the maximum dose, treatment will enter the maintenance phase, in which injections will be less frequent.
Treatment plans are tailored to unique individuals, but typically patients in the build-up phase can expect injections every five to nine days, while those in the maintenance phase receive injections once every four to six weeks.
If you miss shots during your buildup phase, you may not be able to advance to the next strongest dose and thus prolong the build-up phase.
What Is Immunotherapy?
By exposing your body to small doses of things you are allergic to, your immune system will gradually develop a resistance to their harmful effects. Unlike other treatment options, immunotherapy targets the cause of the underlying condition rather than treating the symptoms, thus reducing the effects of your allergies and improving your overall health.
This is the only disease-altering course of action.
Think of your immune system as a team of bodyguards dedicated to guarding your health. They do a great job repelling common riffraff like germs and bacteria, but sometimes a harmless substance sets off a false alarm and convinces them to go on the attack, which results in itching, inflammation, and a host of other symptoms. This is an allergic reaction.
Immunotherapy trains the body to reduce these false alarms. By exposing your immune system to increasingly stronger doses of things that you are allergic to, your team of tiny bodyguards will gradually learn the difference between flower pollen and an actual health hazard.
According to research, the effects of immunotherapy can last 5–10 years or longer after treatment, allowing you to enjoy daily activities outdoors or to enjoy the company of pets without watery eyes or a scratchy throat affecting your quality of life.
What to Expect From Treatment
Each patient and treatment plan is unique, but many patients report an improvement in allergy symptoms in as little as three to six months. As your immune system develops a tolerance for allergens, you will no longer experience the uncomfortable side effects of allergy symptoms.
Best of all, studies have determined that immunotherapy may strengthen the immune system. Studies show that immunotherapy may prevent the onset of other allergies, the development of asthma, and other poor health conditions following treatment. You may experience side effects from either treatment including itching, redness, and swelling at the injection site, but these are generally minor, and serious reactions are rare.
Drops vs. Shots
Both drops and shots have been proven effective and safe. The big difference between the two is time commitment. Whether you choose shots or drops, your allergy specialist will be closely monitoring your condition. If you can free up time in your schedule to visit the clinic each week, you may decide that injections are right for you.
Additionally, most insurance companies cover the cost associated with injections. Consult your allergy specialist for a comprehensive explanation of your options. Drops could appeal to patients who can’t commit to frequent clinic visits. Instead of shots, you’ll receive a vial of specially formulated drops to be taken orally three times per day. Periodically, your doctor will retest you with a limited number of antigens to ensure treatment is as safe and effective as possible.
If you’re visiting the clinic for your first treatment, you should expect to stay for 30 minutes after receiving your vial in order to monitor for an allergic reaction.
Tips for Success
BE PERSISTENT - Immunotherapy works best when patients adhere to a treatment schedule.
BE COMMITTED - If the treatment process seems daunting, just remind yourself that immunotherapy offers long-lasting, life-changing results.
BE PATIENT - Your body is unique and will react to treatment on its own schedule.
BE INVOLVED - Notify your physician of any reactions.