Severe allergies are a serious challenge but few people like getting allergy shots. Now, a new medication might be a simple alternative.
Ten-year-old Nicholas Cunningham loves baseball but severe allergies put a crimp in his game.
“It was hard because I couldn't do much with my friends 'cause all the pollen in the air,” he says.
Nicholas is allergic to the pollen in grass and trees, along with mold, dogs and cats.
His mother, Carol Cunningham, says, "In the springtime, he would be having bad allergy attacks, and then in the fall, he’d also have bad allergy attacks, which would develop into asthma.”
Allergy shots offer relief but require frequent doctor visits. Then, after the injection, patients have to wait 20-minutes to make sure they don't have a life-threatening reaction.
Dr. Robert Anolik's Vireo Allergy Centers are the first to offer oral allergy therapy in the form of drops put under the tongue.
Dr. Anolik says, "You kind of fool the immune system by exposing it to gradually increasing amounts of the allergen, to the substance that you’re allergic to.”
The drops work the same as allergy shots but don't trigger the reaction.
Dr. Anolik says, "It’s changed in the lining of your mouth and seems to go into the regional lymph nodes where it’s presented to the immune system and doesn’t get absorbed for an hour and a half or two hours.”
So far, daily drops have kept Nicholas on the playing field.
Carol says, "He’s still on preventive medications, but he’s weathered the allergy season this spring phenomenally.”
The allergy drops cost $100 a month and are not yet covered by insurance. For more information, visit vireo-online.com or call 877-MYDROPS.
Fast Facts:Approximately 40 million Americans have allergic rhinitis, or respiratory allergies.
The most common causes of allergic rhinitis are tree pollen, grass pollen, weed pollen, mold spores and dust mites.
Allergy shots are successful in treating 90 percent of people with seasonal allergy symptoms and 70 to 80 percent of those with year-round symptoms.
Another option that may soon become available is oral allergy drops. Instead of getting an injection, a few drops of the allergy extract are held under the tongue for two minutes, then swallowed.
An allergy is an inappropriate over-reaction of the body’s immune system to a normally harmless substance (called an allergen). Respiratory allergies are caused by inhaling an allergen. They are also referred to as allergic rhinitis, or “hay fever.”
The American College of Allergy, Asthma and Immunology estimates about 40 million Americans have allergic rhinitis. The most common offenders are tree pollen, grass pollen, weed pollen (especially ragweed, which affects 75 percent of those with hay fever), mold spores and dust mites.
Exposure to an allergen can produce a number of symptoms, like sneezing, coughing, itching or watery eyes, runny or clogged nose and postnasal drip. Some patients develop dark circles under the eyes (nicknamed “allergic shiners”). In susceptible people, exposure to an allergen can trigger an asthma attack, leading to coughing, wheezing and shortness of breath.
Dealing with Allergies
The best way to deal with allergies is to avoid the allergen. However, in most cases, that’s impossible. But there are ways to at least reduce exposure. Stay indoors when pollen levels are highest (usually in the morning or on very windy days). Use air conditioners on warm days to prevent pollens from entering through the window (don’t forget to clean the filter!) When working outdoors, wear a face mask with a filter designed to keep out pollen. Replace wall-to-wall carpeting with washable throw rugs. Most people don’t want to give up pets. But at least keep the animals out of the bedroom to reduce allergen exposure at night.
When symptoms occur, there are a number of different options to choose from. Allergy medications are available over-the-counter and by prescription. Eye drops can reduce itching and tearing. Nose sprays reduce inflammation causing nasal congestion.
Another option for people with allergies is allergy shots (immunotherapy). Doctors give a very small amount of the substance that causes the allergy through an injection under the skin. Gradually, the dose of the allergy shot is increased. The shots increase production of a protective antibody, enabling the body to develop a tolerance to the allergen, reducing allergy symptoms. The American Academy of Allergy, Asthma and Immunology reports allergy shots are successful in 90 percent of people with seasonal allergic rhinitis (i.e., symptoms regularly occur at a certain time of the year) and in 70 to 80 percent of those with perennial (year-round) allergic rhinitis.
Oral Immunotherapy for Allergies
Although allergy shots are very effective, some people dislike having to get regular injections. They are also inconvenient because the shots must be given in a doctor’s office. That’s because some people develop a severe reaction after an allergy shot and may require immediate medical intervention.
Allergy patients may soon have another option. It’s called sublingual immunotherapy (SLIT, or allergy drops). Robert Anolik, M.D., Allergist with Vireo Allergy Center, says the oral drops are made from the same extracts used to produce allergy shots. The concentrations are adjusted, just as with shots, starting with a very low dose and gradually increasing it. Once each day, patients place six drops under the tongue, hold them there for two minutes and then swallow. The drops are safer than injections because they don’t appear to cause severe reactions. Thus, the drops can be used by the patient at home. With drops being more convenient and less painful, patients are more likely to comply with therapy.
Anolik says oral immunotherapy has been used in Europe and South America for about 30 years, but is still a relatively new technique here in the U.S. He recommends patients start treatments about three to six months before expected onset of symptoms because it takes time for the body to develop a response to the therapy. Estimated cost of the sublingual immunotherapy is about $100/month.
Currently, the extracts used to produce the oral allergy drops are only approved for injections. However, clinical trials are now underway to confirm the safety and effectiveness of the drops for oral administration. Once the drops are FDA approved, Anolik is hopeful insurance companies will cover the cost.
Web ResourcesAmerican Academy of Allergy, Asthma and Immunology Web site
For general information on allergies:
American College of Allergy, Asthma and Immunology Web site
Asthma and Allergy Foundation of America Web site
National Institute of Allergy and Infectious Diseases Web site