What are Allergies?
Your body’s immune system helps keep you healthy by producing disease-fighting antibodies. These antibodies can destroy harmful foreign substances such as viruses and bacteria that cause disease. But if you have an allergy, certain types of antibodies get over stimulated and your body reacts when it comes into contact with a normally harmless substance. The air we breathe. The food we eat. The things we touch. They can all trigger an allergic reaction.
The culprit is an over-reacting antibody called immunoglobulin E or IgE. Generally found in miniscule amounts in the body IgE is much more prevalent in people with allergies. The IgE antibody is the key that allows normally harmless pollen to attach to our nasal linings causing histamine and other mediators to be released resulting in allergy symptoms.
When we think of allergy we usually think of upper respiratory irritations such as sniffling, sneezing, an itchy runny nose and itchy watery eyes. However, allergies can have a more serious impact. Allergies can affect the skin (atopic dermatitis), the gastrointestinal tract and the lungs. When allergies affect our lungs in the same way they affect our nasal passages this is called allergic asthma. Allergic asthma can be potentially life threatening. If you or a loved one suspect allergies are affecting your life, talk with one of our allergists. They can determine the best diagnostic approach and treatment therapy.
Some diseases that affect the upper respiratory system are not allergy-related. The only way to be sure is to get tested. Even if it turn out that you don’t have an allergy, your doctor will have a valuable piece of evidence to help diagnose your condition accurately.
What is Asthma?
Asthma occurs when the airway linings become swollen and inflamed and cause muscle spasms that constrict airflow to the lungs. An asthma attack is characterized by labored or restricted breathing, a tight feeling in the chest, coughing and wheezing. The condition may develop quickly and may vary in severity from mild discomfort to life-threatening attacks in which breathing stops completely.
Asthma is a condition, which is always present, but symptoms may be dormant until triggered by an allergen, infection, or cold weather. Other conditions, which may trigger an asthma attack, are aspirin, physical exertion, environmental irritants, and sometimes food additives or preservatives.
For the majority of people, allergens cause no problems, however they can trigger an allergic reaction in susceptible individuals. Allergens are a major source of breathing problems and other physical symptoms in children and adults. Some of the most common allergens are plant pollen, dander from pets, house dust mites, molds, and some foods. When an allergic individual comes into contact with one of these allergens, a series of events cause the body to release chemicals called mediators, which can trigger an asthma attack. Most people can relate to the stuffy runny nose common with allergies or even the common cold. Just picture the same process occurring in the lower airways of the lung. This is the same as an asthma attack.
Smoke, perfume, paint, gasoline fumes, cold air, and industrial chemicals are some examples of environmental irritants that can cause asthma trouble. These irritants probably trigger asthma symptoms by stimulating irritant receptors in the respiratory tract. In turn, these receptors cause the muscles surrounding the airway to constrict, resulting in an asthma attack. It is important to differentiate between allergic and irritant triggers to asthma, as treatment modalities can differ.
A leading cause of an acute asthma attack is a viral respiratory infection. Bacterial infections, with the exception of sinusitis, tend to triggers asthma attacks less often.
Aspirin products can trigger asthma attacks in certain individuals. A significant decrease in lung function is noticed in five percent of people with asthma after taking aspirin. Other over the counter pain relievers can cause similar symptoms in some individuals. People with asthma should avoid these products.
People with asthma should be able to participate in almost any activity if under the proper care. Exercise and sports that involve prolonged periods of running are more like to provoke an asthma attack than a non-aerobic one. One of the best-tolerated sports for asthmatics is swimming. Many professional athletes have asthma and can perform at peak levels if their asthma is controlled.
What is the difference between asthma and allergies? Allergies are one of the factors that can trigger an asthma attack. Asthma is inflammation and obstruction of airflow in the bronchial tubes. Not everyone with asthma has allergies and there are many people with allergies whom do not have asthma.
Is asthma life threatening? Yes, it can be, however if properly treated and controlled chances are few. Deaths occur more frequently in adults than children. The single factor leading to severe or fatal asthma attacks seems to be a delay in administering appropriate drug therapy. Having an action in place, working with your allergist, recognizing the triggers and early warning signals of an attack or using a peak flow meter to detect the degree of bronchial obstruction can all contribute to a decrease in the frequency and severity of attacks.
Should I see an allergist? An allergist is a physician who specializes in the diagnosis and treatment of allergies and asthma. Our physicians have passed a qualifying examination and are specially trained to identify the factors that trigger allergies or asthma and help the patient prevent or treat the condition.
If you suspect you have either allergies or asthma, our allergists will help you learn more about your condition and treat your symptoms. You should make an appointment to see one of our allergists if:
There is no cure for asthma, but there are many treatments available. More is learned about asthma every year and newer more effective drugs are being developed. Therefore, most people with asthma live a perfectly normal life.
If you have asthma, please take this test.
If you answered yes to any of the above questions, then your asthma is not likely to be under good control. You should be under the care of a doctor. If you are already under the care of a doctor, you should discuss the results with him or her so that your treatment regimen can be optimized.
What is anaphylaxis?
Anaphylaxis is a severe allergic reaction and is a medical emergency. It requires immediate medical attention. It can result in difficulty breathing, loss of consciousness, and possibly death if not immediately treated.
Anaphylaxis occurs in some people when they are exposed to a substance in which they are allergic called an allergen.
Anaphylaxis is caused the same way other allergies are. The bodies defense against countless substances, the immune system, overreacts to a substance generally considered harmless. To those with severe allergies, however, such substances can be dangerous.
A specific antibody called Immunoglobulin E or IgE is present in people who have allergies. When allergens first enter the body of a person predisposed to allergies, a series of reactions occur, and allergen-specific IgE antibodies are produced. They travel and attach themselves to the surface of cells called mast cells, where they wait for their particular allergen.
The next time that person comes into contact with the allergens he or she is sensitive to, the IgE captures them and initiates the release of chemical “mediators” from the mast cells. If anaphylaxis occurs, the reaction is severe and requires immediate medical treatment.
Signs and Symptoms
Various organ systems are affected by a “systemic reaction” also known as Anaphylaxis. Some systems affected are the skin, upper and lower respiratory tracts, cardiovascular system, eyes, uterus, and bladder. Some symptoms can include nausea, vomiting, abdominal cramps, hives, swelling of the tissues in the lips or joints, diarrhea, itchy skin, severe anxiety, headache, sneezing, coughing, shortness of breath, and wheezing. Some of the most dangerous symptoms include low blood pressure, difficulty breathing, shock, and loss of consciousness.
If you or someone you know has experienced an anaphylaxis reaction it is very important that you make an appointment and speak with one of our allergists. They will obtain a detailed medical and allergic history and with your help choose the best diagnostic and treatment options.
Most people when asked believe they have allergies to some foods. Some believe they have multiple food allergies. They will describe their reactions in a wide spectrum of symptoms. These include abdominal and gastrointestinal symptoms, rash or hives, headache or flushing. Most of the time when people believe they are allergic to a great number of foods, it turns out that their symptoms or rashes are unrelated to true food allergies. If someone is having frequent random “reactions'”, they might assume it was the last thing they ate. It is a logical line of thinking, especially if the reactions appear allergic in nature. However, patients that present with chronic hives, many believe are caused by foods, the true cause is not discovered 85-95% of the time. Even after extensive food allergy testing.
There is no medically proven way to treat true food allergies, except avoidance. When true food allergies are discovered, usually the person has just a few and avoidance is possible. Many people have food intolerance to one or more foods. These cause less serious non-allergic reactions to things such as foods, food additives or other ingredients. Sometimes “food allergy” turns out to be gastrointestinal conditions such as Irritable Bowel Syndrome or esophageal reflux disease.
The truth is medical science doesn’t have a very good understanding of food allergy in general. We understand IgE mediated allergy very well (i.e. Immediate hives or wheezing after peanut ingestion), and understand that eczema may be worsened by foods. There are also well-described allergic syndromes such as milk induced colitis in children. However, there are probably other-induced allergic syndromes that have not been scientifically worked out.
If you suspect you have food allergies, it is very important to be tested for true IgE mediated food allergy reactions. It is the only way to know for sure. True IgE mediated food allergies can be dangerous and proper diagnosis is needed to determine what foods to strictly avoid. Unfortunately there are no allergy shots to desensitize to food allergies, they must simply be avoided. If you do not have true food allergies our allergists can give very good advice regarding elimination diets and possible referral to a GI specialist. Call our office to schedule an appointment.
What is Latex?
Latex is a milky fluid produced by rubber trees. Using different methods, latex can be processed into a variety of products, such as gloves and balloons. During manufacturing, chemicals are added to increase the speed of curing (vulcanization) and to protect the rubber from oxygen in the air. Products made completely of, or from blends of natural rubber latex and other compounds, are very common, ranging from rubber bands to car tires. Allergic reactions have primarily been caused by dipped latex products, especially gloves, balloons and condoms. Products made from crepe rubber, such as soles of shoes, are less likely to cause reactions. Most latex paints are not a problem since they do not contain natural latex. A few specialized waterproofing paints, however, do contain natural rubber latex.
What types of Allergic Reactions can occur?
There are two typed of allergic reactions to latex. The first is contact dermatitis, a poison ivy-like rash, which appears 12-36 hours after contact with latex. This is most common on the hands of people who wear rubber gloves, but may occur on other parts of the body following contact with latex. The prevalence of this form of latex allergy does not seem to be increasing. Contact dermatitis is usually the result of sensitization to chemicals added during rubber processing. While very irritating, this form of allergy is not life threatening.
Immediate or IgE antibody-mediated allergic reactions are potentially the most serious form of allergic reaction to latex. Like other common forms of allergy, these reactions occur in people who have previously become sensitized. With re-exposure, symptoms such as itching, redness, swelling, sneezing, and wheezing may occur. Rarely, anaphylaxis or life threatening symptoms, such as severe trouble breathing and loss of blood pressure are caused by latex exposure.
The severity of the immediate reaction depends upon the person’s degree of sensitivity and the amount of latex allergen getting into the body. The greatest danger of severe reactions occurs when latex comes into contact with moist areas of the body such as the lips because, more of the allergen can be rapidly absorbed by the body.
Latex can also become airborne and cause respiratory symptoms. Latex allergen adheres to the cornstarch powder used on gloves. As gloves are used, the starch particles and latex allergen become airborne, where they can be inhaled or come into contact with the nose or eyes and cause symptoms. High concentrations have been measured in intensive care units and operating rooms, for example. The use of non-powered gloves reduces the risk of these reactions.
The capacity of latex products, especially gloves, to cause allergic reactions varies enormously, partly by brand and partly by production lot.
It is estimated that at least one percent of the population in the United States has latex allergies. However, certain groups of individuals are at high risk for developing immediate allergic reactions from latex. Individuals with spina bifida ( a congenital problem with the development of the spinal column) and those with congenital urinary tract problems seem to have a risk of nearly 50 percent, presumably from frequent exposure. The most severe reactions reported have occurred in health care settings, where 10 to 17 percent of health care workers have latex allergies. Others who may be at increased risk are those who have had many medical or surgical procedures, resulting in exposure to latex gloves. Even in normal adults, the risk of sensitization to latex may be as high as six percent.
Cross Reactions Between Latex and Foods
Latex-sensitive patients may also be allergic to some foods, especially bananas, avocados, kiwi fruit, and European chestnuts. This is because these foods contain some of the same allergens as those in latex.
If you suspect you have a latex allergy, talk with our Asthma & Allergy of Idaho physicians. They may recommend latex allergy testing. It is the only way to know for sure. Several testing options are available. Skin testing, RAST or patch testing. Our physicians will pick the test most suited for you.
Insect stings are very common to Americans. For most people this means pain and discomfort usually for a few hours, and redness, swelling, and itching at the site of the sting.
Some people however, are unfortunate and develop allergy to insect stings. Their immune system overreacts to the venom injected by a stinging insect. After the first sting the person’s body produces an allergic substance called Immunoglobulin E or IgE antibody, which reacts with the insect venom. The first reaction is not usually severe, however, with each subsequent sting symptoms can worsen. Worsening reactions at the localized sting site may be an indication that you are developing an allergy, which can become more severe.
A small number of people have severe venom allergies and stings may be life threatening. Severe reactions to stings can involve many body organs and may develop rapidly. Symptoms of severe reaction can include itching, hives over large areas of the body, swelling in the throat or of the tongue, difficulty breathing, dizziness, stomach cramps, nausea or diarrhea. Extremely severe cases can result in a rapid fall in blood pressure, which may result in shock and loss of consciousness. This is a medical emergency and may be fatal.
If you have had large localized reactions or symptoms of severe reactions to stinging insects make an appointment to speak with one of our allergists. Venom allergy testing is usually indicated. After testing many questions will be answered and specific emergency treatment options are made available.
Allergic Hives (Urticaria)
Likely the most distressing problem Allergy/Immunologists and Dermatologists see in their patients, is hives or urticaria. In most people hives are self-limited, only lasting a few weeks. In these self-limited cases, a theory is that the hives might be caused by a virus.
The definition of urticaria or hives is that it is a rash with the following characteristics: they are red to pink in color, their shape varies from small bumps to blotchy or streaky areas, they are very itchy, and they appear and disappear, they do so without a trace. Hives can sometimes be accompanied by swelling of areas of the body, such as the lips, tongue, and hands – a condition called angioedema. The information below pertains to both hives and angioedema.
Hives can occur as an allergic reaction to a variety of things (foods, insect stings, and medications – especially aspirin or motrin-type drugs). In this case, the patients usually figure out the association by themselves, and never bother coming to a specialist’s office. When hives are caused by an allergic reaction to a substance, they usually break out within one hour of the exposure. The hives usually occur each time the person is exposed to a particular substance.
Most often, however, we see people that have chronic urticaria or hives, defined as hives lasting longer than 6 weeks. This is a much more vexing problem for both the patient and the doctor. Patients like this come in miserable and worried with this problem, often having seen multiple specialists. Neither the patient nor the doctor can determine the cause of the hives. Patients will often say, “it has got to be something causing these hives.” The truth is hard to accept for some patients.
In the overwhelming majority of cases it is not “something” causing the chronic hives, it is “nothing.” That is, in about 95% of chronic hives cases, the hives are “idiopathic” (a medical term that means there is no discernible cause). Because of the 5% of cases with a cause, it is worthwhile to see a physician to determine if any underlying disease is present (e.g. thyroid problems, liver problems, skin disease, sinusitis) or if there is an allergic cause (i.e. a reaction to a drug, insect, food, etc.). This can be accomplished with a good history and physical, as well as a few blood and urine tests.
In about half of patients with chronic idiopathic hives, the explanation is that body’s immune system is, in a sense, overactive. The urticaria represents an “autoimmune” phenomenon – the immune system (which is charged with fighting off infection) is attacking the normal tissue of the body and causing inflammation. Even though, we know certain hive sufferers have an autoimmune problem causing their rash, there is not presently a specific treatment for them besides the usual medication for urticaria. In the other half of patients whose chronic hives are not autoimmune in nature, medical science has no idea what is causing their misery.
So, in the great majority of patients with chronic hives, there is really no exposure (drug, food, insect, chemical) to blame for the urticaria. The patient must understand and accept this for their ideal management. Basically, all that needs to be done is treat the hives. The main treatment of hives is antihistamines, and they will work if they are used properly. Common reasons for lack of effectiveness of antihistamines are 1) the particular antihistamine used is not strong enough 2) the antihistamine is not used in a high enough dose 3) the antihistamines are not continued for a long enough period.
Most allergists prefer to try the new non-sedating antihistamines first. If that doesn’t eliminate the hives, some doctors will either increase the dose, or add another sedating type of antihistamine at night. It is important that high doses are tried before adding unproven medications to the regimen. If that doesn’t work, some doctors may try a short course of cortisone/steroid-type pills to clear the hives completely. Then the patient can maintain the effect with the much safer antihistamines, since steroids have significant side effects if used long term. One important issue for patients taking strong antihistamines at high doses is sedation. Fortunately, most patients will become less affected by sedation after they have taken the drug regularly for a while.
There are other medications that may be added to the antihistamines, but these are non-standard therapies. That is, there is not a lot of good scientific information supporting their use. However, if the hives are not responding to high doses of antihistamines, most allergist will consider trying them.
The important thing is that the patient is given enough medication (antihistamines, perhaps in conjunction with other drugs) to suppress the hives. What ever amount and type medication works, experts say that patients with chronic hives should remain on that particular regimen, taking the drugs every day, whether or not they have the hives on any given day. The idea is that you are preventing the hives from breaking out. Some doctors suggest that medications should be continued for long periods- perhaps even a month after the hives have disappeared. Again, the exception to this are, the cortisone-steroid-type medications, which should only be used for short periods initially to quiet down the urticaria.
There is some good news for patients with hives. The statistics are that more than 50% of cases of hives will be spontaneously resolved in about 6 months. More and more patients resolve with time, so that by a few years, most patients are cured.
In summary, the great majority of cases of chronic hives (urticaria) have no cause. If you suffer with hives or chronic urticaria make and appointment to see one of our allergists. Your physician will get a good history and physical exam along with a few blood and urine tests (and possibly some allergy tests). If no cause is found, you must work closely with the physician to find a medication regimen that suppresses the hives until they resolve on their own.
Allergies and Children
Diaper rash, stomachache, rashes, ear infections – they are common problems in childhood. As a parent, you want to relieve the suffering caused by these conditions as quickly as possible. Though many children show signs of these diseases once or twice, they seem to outgrow them. Others, however, suffer again and again with the same or progressively worse symptoms. If your child repeatedly is developing disease symptoms such as stomachache, headache, skin rash, congestion, itchy eyes, runny nose and wheezing, allergy may be a contributing factor.
Babies generally are free of the kinds of symptoms we associate with allergy. However, research has shown that allergies start early in life and can be detected before allergy symptoms appear. What’s more, these studies indicate that children actually grow into their allergies and allergic sensitivities change as exposure in the environment changes. Allergic diseases are inherited. A family history of allergies and/or asthma is a strong indicator that a child may have or be developing allergies. Children can develop allergies at any age, the most common is ages 6-12 years. By this time the child has had multiple exposures in his/her environment (seasonal allergies, animals, and molds) to become sensitized to allergens. It makes good sense to find out as early as possible if your child is allergic and just what he/she is allergic to. Make an appointment to speak to one of our allergists. They will determine the best medical approach and an appropriate time-table for allergy testing.
Laboratory testing for allergy can provide valuable information to help determine if your child is allergic and how best to manage the condition. When you know for sure, you can work with our physicians to determine a course of treatment that will help your child feel better as quickly as possible. Without testing, allergy and allergic diseases can worsen, and this can have a profound effect on your child’s physical and emotional quality of life.
What is allergy testing?
A particular substance causes allergy reactions. Any substance that can trigger an allergic reaction is called an allergen. To find out what particular substance is causing your problem, your physician may suggest you undergo allergy evaluation by testing your skin or your blood.
Allergy skin testing is considered the “Gold Standard” for identifying specific allergens. A tiny amount of allergen is scratched across or lightly pricked into the surface of the skin on your back. If you have an allergy the allergen that you are allergic to will cause a reaction to begin in your body. People with allergies have an antibody called Immunoglobulin E or IgE in their body. This antibody activates special cells called mast cells. These cells release mediators such as histamine, which is the chemical that causes redness and swelling. During testing this redness occurs only where allergens to which you are sensitive have been applied.
Along with scratch tests, intradermal tests are sometimes needed. This is more sensitive and identifies lower level allergies. A tiny amount of allergen is injected under your skin, usually on the forearms. This test might be done if your reaction to the scratch test cannot be clearly determined.
A RAST test is a simple blood test. RAST stands for radioallergosorbent test. The results are usually available within 2 weeks. To do this test a patient does not have to stop taking any medications. This is a test that is easy for children as it only involves a blood draw.
After speaking to one of our allergists they will determine if allergy testing is indicated and with your help in the decision process choose the most appropriate allergy testing procedure.
Immunotherapy (Allergy shots)
Immunotherapy is one of the major breakthroughs in modern allergy treatment. It is call by different names, including desensitization, hypo-sensitization, and just plain “allergy shots”.
In the immunotherapy process, a series of injections is given of gradually increasing doses of allergen extracts. Only the specific substances to which a patient tested allergic to are included in the extract mix. These include, most commonly, weed, grass, and tree pollens; dust mites; and mold spores. Each shot given has a bit higher dose than the preceding, until a “maintenance” level is reached. This higher maintenance dose is continued for a period of time – generally one to three additional years – as allergy symptoms continue to abate.
Partial to complete relief is experienced in about two-thirds of patients. The relief can last for a period of years after the allergy shots are ceased. In many cases the relief is very long term, especially in children.
A patient who embarks on this therapy should make the commitment to see it through. It is time consuming, and certainly not without cost. Starting immunotherapy, then stopping, then restarting again can be an expensive waste of time.
Before you wave immunotherapy off as being too expensive or time consuming do the math. Think about how much you spend in the course of a year on antihistamines, decongestants, analgesics and the like to obtain relief. Then considered time missed from work or school due to allergy symptoms (or how much leisure time has been wasted).
Certainly, immunotherapy is not the answer for every patient. Some find relief from occasional symptoms through a treatment program of avoidance measures and prescription medications. But many others sing the praises of allergy shots, when, after taking the injections for a period of time, the desensitization begins to kick in and the allergic response is reduced or eliminated. After allergy testing our allergists will discuss the risks and benefits of immunotherapy if it is in deed indicated.
Which is better for me: allergy shots or allergy drops?
Reducing people’s sensitivity to certain allergens (e.g. pollens, animals, molds, venoms) has been possible for nearly 100 years in this country. Over the years, we have improved and refined the methods used. The “gold standard” method for the past 50 years has been subcutaneous (just under the skin) injections of purified allergens, also known as subcutaneous immunotherapy (SCIT). An alternative to injection therapy is now available. This method involves placing allergen liquids or dissolvable tablets under the tongue where the allergens are absorbed into the body through the oral mucous membranes. This method is referred to as sublingual immunotherapy (SLIT). SLIT offers two conveniences compared to SCIT that make this an exciting alternative to injection therapy: no needles and at-home therapy! This information sheet will explain more about each method to help you understand which method would be best for you.
How Do These Therapies Reduce Your Allergies?
Both methods reduce your allergy symptoms by altering your immune system’s reaction to naturally occurring allergens. Over time, with continued use, you can live comfortably with animals or pollens that now cause you allergic eye, nose or lung symptoms. Fewer symptoms mean fewer medicines and a much better quality of life! Medications used in allergy therapy (antihistamines, nasal steroids, eye drops, etc.) are like a Band-aid? on a toddler’s cut finger; when the Band-aid? hides the cut from the child’s eyes, he feels better. If the Band-aid? falls off later that day, the cut becomes visible again and the child panics. Another Band-aid? keeps things calm until the cut eventually heals. Allergy medications do not “cure” allergies; they simply reduce the symptom severity. Allergy immunotherapy, whether SCIT or SLIT, can actually “heal the cut” reducing medication needs in the future, sometimes to zero!
How Are These Therapies Administered to You?
Both methods rely upon frequent exposure to your allergens although the frequency and starting doses vary between the two methods. Both methods carry a slight risk of allergic reaction. The risk with SCIT is higher than with SLIT and requires in-clinic delivery with a 20 to 30-minute wait with each injection. We start SLIT in our clinic but quickly move to at-home use because of the reduced severe allergic reaction risk. The two methods are compared side-by-side on the reverse side of this paper.
|Starting Dose||Usually 1/10,000th the “maintenance” dose||1/10th the “maintenance” dose|
|Dose frequency||1-2 times a week for first 3-6 months, once a week for next 6 months and ultimately once every 2-4 weeks (Average patient) Accelerated build-up schedules are available.||Once daily, always!|
|Treatment Location||Clinic||Home after first 3 doses in clinic|
|Duration of Treatment||3-5 years recommended||Same as SCIT|
|Symptom Reduction Possible||Up to 100% relief (without medicines!)||40-60% relief (Higher in some cases)|
|Time to Initial Symptom Improvement||4-9 months (average)||2-6 months (average)|
|Number of Treated Allergens Possible||Up to 30+ (pollens, molds, mites, animals, venoms)||1-3 (cat, dog, mold, select pollens)|
|Adverse Reactions: Most common to least common||Injection site swelling and itch. Hives, eye/nose allergy symptoms, breathing difficulty, full anaphylaxis are rare but possible.||Oral itch and slight oral swelling. Nausea, vomiting, hives and breathing difficulty are very rare.|
|Insurance Coverage||Yes, plan-dependent||Not yet|
|Eligible Patient Age Range||4-5 years and up||2-3 years and up|
Which Method Is Best for You?
Subcutaneous therapy offers the greatest benefit potential to the largest percentage of our allergy patients. Use this if you have multiple pollen, mold and/or animal allergies or if you are insect venom allergic. At the moment, SCIT is the only option for venom-allergic patients. Use this method also if you are looking for “maximum” benefit.
If you are very afraid of needles, have only a few major allergens (dog, cat, grass or sagebrush pollens) or have a personal life schedule that prevents in-clinic treatment, SLIT may be the best choice for you! Children allergic to the family cat or dog can reverse their allergy symptoms using SLIT and avoid a “shot”! A hunter allergic to sagebrush pollen can finally find relief in the Fall hunting season with the convenience of in-home therapy!
Please talk about this choice with your allergist.