 Airborne allergies, also called inhalant allergies, are typical seasonal allergies or “hay fever” that many suffer in the spring when grass and tree pollens are prevalent, and in the fall when weeds such as ragweed pollen is in the air, and in the middle of winter in Texas where mountain cedar is prevalent. Usual symptoms consist of nasal blockage, itchy runny nose, and eye itching. Seasonal asthma is less common. These seasonal allergies change with the direction of the wind, usually decrease when indoors and when traveling to another area. Some airborne allergy symptoms can be perennial, especially from animal dander such as cat, from house dust mites in bedding, and from mold, especially if there has been a water leak or high humidity levels in a house or a building such as at work or school.
The immune system makes an antibody called Immunoglobulin E (IgE) that attaches to the airborne allergens. This antibody can be detected with a high level of accuracy in a blood test. Skin testing is also a reliable test, especially with a technique called Serial Endpoint Titration (SET).
Medications such as nasal steroid sprays, antihistamines and oral steroids are often effective, at least temporarily.
| What are Allergy Drops? |
They are drops of offending allergen, food or inhalant, placed under the tongue, creating allergen tolerance.
Like allergy shots, the allergy drops use FDA approved antigen extracts to create a custom made solution for each patient. In the United States, many patients have received benefit from allergy drops. In parts of Europe, allergy drop therapy is used more often than shots. Much like a series of allergy shots, allergy drops are used to gradually build the immune system, for several years. |
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| How do they work? |
| Receptors under the tongue called dendritic cells detect molecules in the allergy drop solution and present them to immune system T cells. These T-regulatory cells induce and maintain tolerance to antigens, the molecules in the allergy drop, and can prevent development of future sensitivities. They do this by training the immune system to tolerate these molecules by a process called “down regulation”. Each time an allergy drop is placed under the tongue, the immune system is being taught to become more tolerant. This results in significant symptom reduction and less need for medications. |
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| Safe, Painless, Effective, Preventative, Low Cost, High Compliance |
Allergy drops are administered at home, saving time and travel expense. The out of pocket cost is low, especially considering less need for medications. Allergy drop therapy has been safely administered in the U.S. and in Europe, with no fatal reactions. A literature review by Southwestern Medical School in Dallas, revealed no severe life-threatening reactions in 15 consecutive years of allergy drop therapy worldwide. Self-limiting adverse reactions have been reported in less than 3 in 1000 doses. Allergy drops can prevent the development of asthma in children who are asthma-prone. Studies have shown that the development of asthma is many times less likely to develop in children that receive allergy drop therapy. This preventative effect lasts for years after completion of treatment with the drops. Because allergy drops are painless, they are ideal for use in children, and have been received by children as young as 2 years old. Long-term compliance is over 95%.
Allergy drops are not meant to replace allergy shot therapy, called subcutaneous immunotherapy (SCIT), which has been in use since the early 1900s. There are, however, several factors that make allergy drops a viable alternative to shots, as recommended by the World Health Organization and the Cochrane Study Group out of London. |
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| How is testing done? |
| Testing for inhalant allergies is done with superficial skin tests, using dilutions of common airborne allergens. An IgE blood test is alternative to skin testing. |
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| Benefits, Risks, Alternatives |
1) Benefits: symptom reduction, limiting need for expensive medications, increasing quality of life.
2) Risks: adverse reactions, such as mouth itching and irritation, nasal blockage, headache, nausea, hives, and wheezing.
3) Alternatives: continued medical management and avoidance. |
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| Treatment |
| Allergy drops are used three times a day. A single drop is placed under the tongue first thing in the morning, at mid-afternoon, and at bedtime. Inhalant allergies may take several months to improve. To be effective, treatment is usually started 4 months prior to the allergy season. Remember that avoidance is an important part of therapy. |
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| Prior to Your Visit |
| Avoid long-acting antihistamines, like Zyrtec and Allegra, two weeks prior to skin testing. Products like Singulair and nasal steroid sprays will not affect skin test results. The IgE blood test is not affected by medications. |
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| Who is not a candidate for Allergy Drop Therapy? |
A past history of severe allergy reactions, unstable asthma or recurrent hives increases the chance of a reaction to allergy drops.
You must notify the office if you have had emergency allergy treatment of any kind, especially for asthma. Severe, anaphylactic allergy is not treated with allergy drops.
A history of glycerin sensitivity may be a contraindication to use of the drops, however this problem usually improves gradually with continued use of the drops. |
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| Allertol is not used to prevent or treat immediate life-threatening allergy/anaphylaxis. |
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