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Allergen Immunotherapy

Purpose

Your individualized course of allergy shots (immunotherapy) is designed to decrease your allergic sensitivities. The vast majority of allergic patients (80-90%) will experience substantial reductions in their symptoms over time (months to years). Many also reduce or eliminate the need for other medications. Together with avoidance of offending allergens and medication allergy shots represent one of the recommended treatments for allergic rhinitis, allergic conjunctivitis, atopic dermatitis and asthma. Allergy shots are not useful for food/drug allergies or non-allergic conditions like infections.

Treatment Duration

The length of a treatment course varies on a case by case basis but in general a course requires 3 to 5 years of maintenance treatment for completion. Initially there is a build-up phase where the injections are given more frequently but as the High Dose, or maintenance dose, is reached the frequency of injections may be adjusted. The total duration of therapy can vary considerably from patient to patient. During your treatment you will be re-evaluated frequently by your physician. These visits will occur at least annually.

Schedule of Administration

Your series of injections begins at a low dose selected by your physician based on your skin test results and history. Over time the shots build gradually until you reach your High Dose. This High Dose is called the maintenance dose and you will stay on it for the duration of your treatment course unless it is changed by your physician. Maintenance therapy can be continued if you are pregnant BUT notify your OAAC physician when you become pregnant.

The build-up phase of the allergy shots can occur in different formats. Your physician will help you decide which is right for you. Most common is the weekly building schedule. Various accelerated schedules include: 2 or 3 time a week shots, clusters of several shots given on the same day and finally RUSH therapy where many injections are given on one day and then weekly shots follow until you are at your High Dose. RUSH therapy is associated with significantly more side effects (see below) and is not for every patient. However, it does bring you to the High Dose level in a month rather than slowly over many months. This is an advantage for some patients.

Safety

All allergy shots carry some risks for severe anaphylactic reactions. Therefore the injections need to be administered in a medical facility under medical supervision on a regular basis. Weekly or twice weekly shots from our clinic carry a risk of anaphylaxis of 0.015 to 0.02% of injections compared to nationally published risks of 0.1 to 0.3% of injections. RUSH therapy carries a nationally published risk of almost 40% of shots whereas our RUSH risk is closer to 10% of injections. This marked increase in risk however makes RUSH therapy unacceptable for many patients.

Recent News

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Winter Allergies: What Causes Them and How You Can Get Relief

From EverydayHealth.com

Yes, you can suffer symptoms of seasonal allergies in winter, too.

Most people don’t associate winter with allergies, but allergies persist into and through the cold months. Though it’s important to know that winter allergies do pose slightly different problems than they do during other seasons. (And knowing how to avoid them or minimize triggers can help keep you feeling your best all winter long.)

 

What Causes Allergies During the Winter

“You don’t have pollens in winter,” says Douglas H. Jones, MD, of the Rocky Mountain Allergy, Asthma, and Immunology Group in Layton, Utah. So outdoor winter allergies aren’t such a cause for concern. “But you still have the indoor [allergens].” And if you’re spending more time indoors during cold weather, you might notice an increase in allergy symptoms, such as sneezing, wheezing, and itchy, watery eyes. According to the American Academy of Allergy, Asthma, and Immunology, common indoor allergens (that might trigger symptoms in winter) include: (1)

  • Dander It’s the dander (dead skin flakes), not the hair of household pets such as cats and dogs, that can cause acute or chronic allergic reactions in people.
  • Dust Mites These microscopic bugs might be the most common cause of year-round indoor allergies, notes the Allergy and Asthma Foundation of America. (2) Dust mites thrive in bedding, carpeting, and the upholstered furniture inside your home.
  • Indoor Mold We all breathe in mold spores, but for those with an allergy, exposure can trigger sneezing, congestion, and itchiness. Mold and mildew favor damp areas, like basements and bathrooms.
  • Cockroach Droppings These persistent pests can live anywhere, and while they’re not a sign of an unhygienic or unsanitary household, it’s important to keep food well-contained and be vigilant about cleaning up crumbs. Fixing leaky faucets and pipes and sealing up cracks and crevices in your home can help keep cockroaches away.

Matthew A. Rank, MD, an allergy expert with the Mayo Clinic in Phoenix, Arizona, says that although specific data is hard to pin down, roughly 5 to 20 percent of Americans suffer from some form of winter allergy.

What You Can Do to Prevent Winter Allergies

A big problem with winter allergies is that cold-weather lifestyles can turn a simple allergic reaction into something worse, says Dr. Jones.

“People are turning up their heaters, which makes the indoor air even drier,” he says, “and that leads to dry noses, which increases the incidence of nosebleeds and skin cracking” — which in turn boosts infection risk when someone’s nasal passages are already inflamed from allergies. Jones recommends using nasal saline rinses to lower the risk of contracting a secondary viral infection.

It may not be possible to get rid of winter allergies entirely, but you can reduce exposure to allergens, at least in your own surroundings. Jones, Dr. Rank, and other allergy experts offer these tips for minimizing indoor allergen exposure in winter:

  • Use a humidifier to reduce dryness in the air, but don’t turn your home into a rain forest: Dust mites thrive in humidity over 60 percent and temperatures of 60 to 85 degrees Fahrenheit. Mold also grows faster in high humidity. Rank recommends a maximum humidity of 50 percent.
  • Avoid wall-to-wall carpeting, which provides a favorable environment for dust mites. Use area rugs instead.
  • Clean, dust, and vacuum regularly, using a vacuum with a high-efficiency particulate air (HEPA) filter.
  • Wash sheets weekly in hot water — at least 130 degrees Fahrenheit — to kill dust mites, and use hypoallergenic cases for mattresses and pillows to keep dust mites trapped.
  • To minimize dander, bathe pets once a week — though not more often, as more frequent bathing can dry out a pet’s coat and skin — and keep animals out of the bedroom of anyone in the house who has allergies.

If you’ve done all you can to allergy-proof your home but you still have symptoms, it might not be your fault, Jones adds. Public areas, such as workplaces, can have the same allergy-inducing conditions as your home: dry air, dust, and dust mites. In addition, pet owners often get dander on their clothes and unwittingly transport it into public places. The level of cat dander in public places is high enough to trigger allergy, Jones says.

Winter Allergies Versus a Cold

During the winter, it can be difficult to distinguish an allergy from a cold. Both share symptoms, such as sneezing, runny nose, and congestion. But colds are viral infections, while an allergy is your body’s immune system response to an irritant or trigger.

According to the National Institutes of Health (NIH), colds don’t usually last more than a couple of weeks, while allergies will continue as long as the allergen is present. (3) And symptoms like itchy, watery eyes are typically a sign of an allergy, not a cold or the flu, while aches and fever are not associated with allergies. A cough sometimes comes with allergies but is more commonly a sign of a cold, and when it’s more severe, the flu.

 

Treatment Options for Winter Allergy Symptoms

To treat allergy symptoms, Jones cautions against older over-the-counter (OTC) medicines, which, he says, can do more harm than good.

“Some of these drugs have too many side effects,” he notes, “and people don’t really understand how to match their symptoms to the product. They just know they feel bad and want to feel better.”

For example, some OTC allergy drugs contain decongestants, like pseudoephedrine, which can raise a user’s heart rate. The active ingredient in the antihistamine Benadryl — diphenhydramine — causes some tissues to dry out and promotes urinary retention, Jones says. “So people with prostate problems, who may have trouble urinating, find that that condition worsens when they take diphenhydramine.”

Jones says that better options are decongestants that contain loratadine (such as Claritin) and cetirizine (like Zyrtec), two drugs that moved from prescription to OTC status in recent years. Prescription steroid nasal sprays (some of which are also now available over-the-counter) tend to be more effective than antihistamine tablets, adds Rank, though individual responses vary and the two types of drugs are often used in combination.

Talk to your doctor and your pharmacist before taking any over-the-counter medication, to discuss whether it’s appropriate for your symptoms and potential side effects.

The American Academy of Allergy, Asthma, and Immunology notes that if you have a pet allergy, you might consider immunotherapy ­— allergy shots or tablets — that can potentially desensitize you to the allergen and provide lasting relief. (4)

The post Winter Allergies: What Causes Them and How You Can Get Relief appeared first on Oklahoma Allergy and Asthma Clinic.

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