They are drops of offending allergen, food or inhalant, placed under the tongue, creating allergen tolerance.

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, and can prevent development of future sensitivities. They do this by training the immune system to tolerate foods by a process called "down regulation". The immune system is taught to become more tolerant of food molecules in the allergy drop solution. This results in significant symptom reduction and less need for medications.

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. 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 received by children as young as 2 years of age. Long-term compliance is over 95%. As noted by the World Health Organization and the Cochrane Study Group out of London, sublingual immunotherapy (SLIT), or allergy drops, have been shown to be a safe and effective alternative to allergy shots, subcutaneous immunotherapy (SCIT).

Sublingual testing is done by simply placing a solution of suspected food under the tongue. If you are experiencing chronic symptoms that are indoors as well as outdoors, and do not vary much with the seasons, you will be tested with foods that are common in your particular diet.

1) Benefits: symptom reduction, limiting need for expensive medications and surgery, increasing quality of life. 2) Risks: adverse reactions, such as mouth itching and irritation, nasal blockage, headache, diarrhea, hives, and wheezing. 3) Alternatives: continued medical management and food avoidance.

You may want to keep a diet diary of what you eat and drink on a typical day, and note anything you seem to have frequently and to excess. Try to omit those foods to which you are addicted 4 days, and reintroduce. Note any symptoms. For example, chronic delayed allergy to dairy is common, so if you crave milk or cheese, try giving up all dairy products for 4 days, then re-introduce.

Milk, wheat, corn, egg, yeast and soy are the most common culprits. Common symptoms include: night time nasal blockage with dry mouth and snoring, persistent runny and itchy nose, deep ear itching, repeated sneezing, chronic throat clearing, vascular headache including migraine, wheezing with exercise, chronic cough, episodes of physical and mental fatigue, gastrointestinal problems including irritable bowel syndrome, skin itching and hives, episodes of ear ringing or buzzing with ear fullness and sometimes dizziness, intermittent joint pains, dark circles under the eyes, sinus and ear infections.

A list of suspected foods is obtained with a detailed history. Sublingual evaluation and treatment of chronic delayed food allergies is carried out. Upon initial symptom improvement, sublingual immunotherapy with custom made allergy drop solution is continued until symptoms have resolved.  The drops are then slowly tapered to one drop at bedtime.  If symptoms start to return, the drops are used more frequently, two or three times a day.   When symptoms of delayed food allergy have resolved for a year (allergen tolerance), the drops are discontinued.

When sublingual evaluation / treatment of delayed food allergies is not successful, or when only a few foods are suspected, the elimination / rotation diet may be helpful. 

The standard elimination diet can be done by removing the suspected food from the diet 4 days, followed by reintroducing the food on the 5th day, watching for symptoms to reappear. Typically, symptoms worsen initially, improve by the 4th day, and then worsen again within a day of reintroducing the food. Returning the food to the diet has been called a "food challenge", but the real challenge is trying to remove a favorite food from the diet when "that's in everything I eat!"

The rotation diet is another time-honored method of finding the food that is causing chronic symptoms, and preventing development of new food sensitivities. Eat the suspected food only every three or four days, and watch for symptoms to occur within the next 24 hours, often in the middle of the night.

Allergy drops are used three times a day. A drop is placed under the tongue first thing in the morning, at mid-afternoon, and at bedtime.

A past history of severe allergy reactions, unstable asthma or recurrent hives would increase 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.