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Immunotherapy

Allergy Immunotherapy

What is immunotherapy? What are allergy shots? How does immunotherapy work?

You may be trying to find answers to these questions, and you have come to the right place!

Allergy immunotherapy is a treatment in which a patient is injected with small amounts of an allergen on a regular basis.  The doses are slowly increased over time, causing the patient’s immune system to become less and less sensitive to the allergen.  This type of therapy is also called "allergy shots."

 

When people have allergies, their blood contains high levels of Immunoglobulin E (abbreviated IgE), an allergic antibody.  IgE is activated by an allergen (ragweed, cat, dust mites, etc), and then binds itself to “mast” cells that will then release histamine.  Histamine is the chemical directly responsible for your allergy symptoms - sneezing, swelling, allergy cough, congestion, etc.

 

How Long Does Immunotherapy Take?

Immunotherapy is a long-term commitment of up to five years (or more) of treatment.  The results are slow and gradual, but some patients do notice an improvement in allergy symptoms within six months of starting this allergy treatment.

 

After two years of immunotherapy, your NY allergy doctor can assess how successful the treatment has been.  If you have been able to reach high doses of allergen, you should have noticed an improvement in your allergy symptoms by this point.

 

After four or five years, most patients can discontinue treatment and will experience reduced allergy symptoms (or no symptoms at all) for a significant period of time.  However, it is likely that symptoms will slowly return over the next several years.  If or when you start to experience significant allergy symptoms again, you may consider continuing immunotherapy treatment.

Who Should Consider Immunotherapy?

Immunotherapy is recommended for patients with significant allergy symptoms that last at least six weeks out of each year.  It is also considered for patients with asthma, frequent sinusitis, or allergies to insect stings.  Because of the time required and the risk associated with immunotherapy, it is not recommended for patients with mild allergies.  It is also not approved in the US for people who have food allergies.

Reactions to Immunotherapy

During your course of treatment with allergy shots, you may experience adverse reactions.  These reactions fall into two classes:

Local reactions are those that occur at the injection site (usually the backs of the arms). You may experience redness, swelling, itching, or an irritating lump. An antihistamine (like Benadryl) and/or an ice pack can be useful in reducing any swelling or discomfort.  This type of reaction can occur during the recommended 30-minute waiting period at the allergy doctor’s office, or sometime over the next 24 hours. It is helpful if a patient can describe the location and size of any local reactions, so that the NY doctor can properly adjust your next dose.  Depending on the severity of the reaction, your NYC specialist may hold your dose the same or reduce your dose.

 

Systemic reactions (also called anaphylactic reactions) are much more troublesome than local reactions because they can be life-threatening.  A systemic reaction usually begins with itchiness or a tingling/tickle in the throat.  It can evolve to include difficulty breathing, hives, chest tightness, dizziness, swelling of the lips or throat, or a general sense of warmth in the body.  This type of reaction usually occurs right after the injection (within ten minutes) but can be slightly delayed (up to an hour).   If you may be experiencing a systemic reaction, you should return immediately to your NY allergist’s office or go straight to the emergency room.

Drugs to Avoid if you are on Immunotherapy

Beta-Blockers are a class of drugs that are used to treat heart problems. However, Beta-Blockers should not be taken by patients who are undergoing immunotherapy. Beta-Blockers can make you resistant to epinephrine, the most critical drug used to treat systemic reactions. Also, there is some evidence that patients who are taking Beta-Blockers are more likely to experience reactions from immunotherapy.

If an ear, nose, and throat doctor or any other NYC dr has prescribed Beta-Blockers to you, it is very important to let him/her know that you are on immunotherapy and were informed that you should not take Beta-Blockers.

 

Summary

If you are interested in immunotherapy, call us at 212-686-4448 to schedule an appointment. NYASC has access to the latest testing and treatment, and we offer convenient allergy & asthma clinics throughout NYC: Murray Hill, Midtown, Upper West Side, Chelsea, and Queens.  We see pediatric and adult patients from all around the New York City area, including Queens, the Bronx, Brooklyn, Manhattan, and Staten Island. And our specialists can also help you find relief for your asthma, nasal and sinus symptoms, ENT (ear, nose, and throat) conditions, respiratory allergies, & skin problems. 212-686-4448.

Immunotherapy (Allergy Shots) and Pregnancy

Allergy shots are usually not started for a woman during pregnancy, though there is no medical reason not to do so. The beginning of immunotherapy has the most allergic reactions to the shots (see reactions to shots). If a woman has been receiving immunotherapy and becomes pregnant, she may safely continue the shots during the pregnancy. Immunotherapy has been used for over 75 years and does not harm the baby.

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