Will immunotherapy control my allergy symptoms?

Immunotherapy, or allergy shots, retrains the immune system to make you less sensitive to specific allergens. Allergy shots are usually given by injection once every 2 weeks to twice a week for several months. During this time, the dose is gradually increased. Once a maintenance dose is reached, injections are given less often. There are also "cluster" and "rush" schedules that can shorten the time to improvement and less frequent injections. These may involve pre-treatment with an antihistamine or corticosteroid to lessen the chance of systemic reactions.

Besides reducing symptoms, allergy shots can prevent new allergies and reduce the risk of asthma. This therapy is most effective for children and young adults.

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Immunotherapy targets a specific allergen and works to change the process that causes symptoms in the first place rather than treating the symptoms themselves. It can be very effective, providing long-term relief for years after treatment has stopped, and it may also prevent the development of new allergies. Here's how it's done:

By gradually and repeatedly exposing a person to an allergen through injections (subcutaneous) or drops placed under the tongue (sublingual), the body's immune system begins to tolerate the substance and, over time, reduces its extreme response. (Note: Sublingual therapy is used extensively outside of the United States but has not yet been approved by the Food and Drug Administration [FDA] for use in America.)

Typically, immunotherapy shots are given once or twice a week by a specialist in allergen immunotherapy until an effective dose is achieved; then, the shots are given less frequently. It may take up to a year for symptoms to improve, and treatment generally continues for 3-5 years.

Immunotherapy is recommended for people who have moderate to severe allergy symptoms, have had a specific immunoglobulin E (IgE) antibody identified in their blood, and have not experienced sufficient relief from medications or cannot tolerate medications. Unfortunately, while immunotherapy works well for some people, it may not work at all for others.

Side effects include swelling or hardening at the injection site, itchy mouth (with sublingual therapy), difficulty breathing, and, in rare cases, anaphylactic shock.

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Immunotherapy, often called "allergy shots," aims to desensitize the patient to the triggering allergen by gradually increasing exposure over a period of time. Allergists recommend this treatment only for allergic rhinitis and conjunctivitis, allergic asthma and insect venom allergies. Immunotherapy doesn't work for food allergies. Indeed, the primary treatment for food allergies is not to eat the food that triggers the reaction.

Immunotherapy can help control symptoms of environmental allergies, but they cannot help prevent food allergies. At this time the only treatment for a food allergy is to avoid the food(s) that trigger the immune response. There are many therapies currently being tested in hopes of desensitizing a food in the body; however none are widely supported yet due to lack of evidence. Working with a dietitian can ensure that your allergen-free diet provides the nutrients you or your child need for your best health. www.EatRight.org

Allergy shots or immunotherapy are very effective for treating pollen and other airborne environmental allergies that play a role in hay fever and asthma. This type of therapy is almost curative of severe insect sting allergy. However, past studies attempting to use allergy immunotherapy shots for foods had too many side effects. The current treatment for food allergies is avoiding the food and being ready to treat with medications in the event of a severe allergic reaction. However, the good news about food allergy is that many future therapies are under study.

An allergy shot, or immunotherapy, is a vaccine that causes a state of tolerance and reduces allergy symptoms until they dissipate and go away. Allergy injections are appropriate for anyone who is consistently suffering from seasonal allergies, allergic asthma, pet allergies or indoor allergies.

Watch allergist Clifford Bassett, MD, discuss the long-term health benefits of immunotherapy.

Allergy shots (immunotherapy) are injections that contain small amounts of an antigen (a substance you are allergic to). They stimulate your immune system to create antibodies to block your allergic response. Basically, what this means is that your body will block the allergic reaction you have to the substance.

Allergen immunotherapy, fast or slow, always involves injecting substances to which the patient is known to be allergic. Therefore, unwanted or even dangerous reactions are always possible. These range from itchy, localized swelling to systemic and even fatal anaphylaxis.

With immunotherapy, as it is with all allergy-related medical care, a good history is the key to good treatment. The doctor's deductions should be supplemented by skin tests, which are both more accurate and less expensive than radioallergosorbent RAST tests.

Effective allergen-specific immunotherapy should also meet a number of criteria:

First, the allergic condition must be proven as responsive to allergy shots. The conditions currently recognized as falling into this category are allergic rhinitis, allergic conjunctivitis, asthma, hypersensitivity to fire ants and other hymenoptera, and drug allergy.

Second, the allergenic substances in the injectable vaccine should be specific to the allergy being treated and uncontaminated by extraneous allergens. That's not to say that several allergens can't be mixed into fewer shots by an allergist who knows what to consider in making combinations, because of course each child wants as few injections as possible. The allergist must consider the season, the dose of each allergen, and the compatibility of each allergen in the mixture.

Third, because shots increase in potency as immunity is built up, the allergens must also be strong enough at each level of treatment to provoke a maximal immune response.

Finally, the patient has to be dedicated. He or she has to stick to the whole course of treatment and not stop when he thinks he is all better.