Al­lergy shots are ef­fec­tive for most

Daily Freeman (Kingston, NY) - - YOUR DAILY BREAK - An­thony Ko­maroff Ask Dr. K

I’m plagued by sea­sonal al­ler­gies. Should I con­sider im­munother­apy?

Many peo­ple know all too well the mis­ery of al­ler­gies — the sneez­ing, runny nose, post­nasal drip, wa­tery eyes and itchy throat. They try to fight back with al­lergy med­i­ca­tions. But im­munother­apy, also known as al­lergy shots, may be a bet­ter op­tion.

I spoke to my col­league Dr. Paul Hester­berg, an in­struc­tor in medicine in the al­lergy and clin­i­cal im­munol­ogy unit at Har­vard-af­fil­i­ated Mas­sachusetts Gen­eral Hos­pi­tal. He noted that peo­ple of­ten re­sist al­lergy shots be­cause they fear in­jec­tions and turn to them only as a last re­sort. But the shots can be an ef­fec­tive way to con­trol symp­toms that in­ter­fere with daily life. They can also help re­duce de­pen­dence on al­lergy drugs.

Al­lergy shots will not elim­i­nate your al­lergy. They change your im­mune re­sponse to bet­ter tol­er­ate it. Med­i­ca­tion treats symp­toms; al­lergy shots help pre­vent the symp­toms from oc­cur­ring in the first place.

The shots are given with a small nee­dle, just un­der the skin — not deep into the mus­cle. Some­times there is tem­po­rary ten­der­ness and red­ness at the spot where the shot has been given. On very rare oc­ca­sions, there is a se­ri­ous re­ac­tion called ana­phy­laxis that can cause a drop in blood pres­sure and breath­ing prob­lems.

A re­cent study of adults aged 65 to 75 found al­lergy shots re­duced symp­toms by 55 per­cent after three years of ther­apy. The study also showed that the amount of med­i­ca­tion this group needed to re­lieve symp­toms dropped by 64 per­cent.

Shots are avail­able for cer­tain pol­lens, dust mites, mold, cat and dog hair and in­sect stings. There is no proof they work for food or drug al­ler­gies.

Shots are done in two phases: buildup and main­te­nance. The buildup phase in­volves re­ceiv­ing in­creas­ing amounts of the al­ler­gen — the sub­stance that causes the allergic re­ac­tion — once or twice a week. This phase lasts three to six months.

The main­te­nance phase be­gins after reach­ing the full dosage. Dur­ing this pe­riod, pa­tients are in­jected on a monthly ba­sis for up to three to five years.

As with any kind of treat­ment, al­lergy shots may not work for ev­ery­one, and they are not rec­om­mended for peo­ple with cer­tain risk fac­tors. These in­clude some types of heart dis­ease and se­vere, poorly con­trolled asthma.

If you are un­easy about in­jec­tions, im­munother­apy op­tions that can be taken by mouth are avail­able for cer­tain al­ler­gies. They also are less likely to cause side ef­fects than al­lergy shots and can be taken at home after your first dose in the doc­tor’s of­fice. Oral im­munother­apy is fairly new, and it is still not clear which ther­apy — in­jected or oral — is bet­ter.

The main ques­tion most of my pa­tients ask when con­sid­er­ing al­lergy im­munother­apy is how much time it will take. As you can see from my de­scrip­tion of what’s in­volved, it does in­volve many vis­its to the doc­tor’s of­fice. Only you can trade off the amount of time it is go­ing to take against the im­por­tance of re­duc­ing your al­lergy symp­toms.

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