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Why allergy shots don’t work

Claritin, Zyrtec, Xyzal, Allegra, Nasonex, Flonase, Singulair. All treat allergy symptoms, but none actually makes you less allergic. You stop the medicine, and it soon stops working.

Allergy shots are unique in that if taken at the right dose for at least three years, they can continue to provide beneficial immunologic effects after you stop taking them. Frequently, though, people say allergy shots don’t work. Why is that? Most likely, it’s an inadequate dose. To a point, the higher the dose, the better the protection it gives you.

Ask your allergist, “How many micrograms of Der p 1 does my maintenance dose for dust mites contain?” Higher doses are associated with increased side effects, but most reactions are mild – itchy arms, local swelling. Taking antihistamines before getting the shot or applying ice to the site of the shot usually works. Rarely, high effective doses of allergy shots can cause serious reactions – wheezing, throat tightness, hives all over, even anaphylaxis. That’s why we monitor each patient with a digital timer after each shot, and then send patients out with their own EpiPen or Auvi-Q to use if they have a late reaction.

Why else don’t allergy shots work? It’s important to split up some components into separate vials. For example, mold extract can digest grass extract. If you are allergic to several things, but your allergy serum is all in just one vial, it is possible that some of its contents are being degraded. There is enormous variability in how allergy shots are formulated, and how they are dosed.

Many allergists continue to follow recommendations made 30 or 40 years ago. At The Allergy Clinic, we base our recipes on guidelines published in 2011. Maybe that is why we hear “these shots have changed my life” more often than “these allergy shots don’t work.”

Need quick relief? Look into our RUSH procedure. Don’t like needles? Allergy drops that go under the tongue may be a good choice. Though drops are not FDA approved (and therefore not covered by insurance), they are safe, effective and legal. The cost of $192/month is a lot of money, but consider the time you save not having to go to the doctor’s office to get shots, and that you can take them with you when you travel. Bootleg allergists may offer drops for less money, but you have no certainty that their recipes have any input from physicians certified by the American Board of Allergy & Immunology.

No one nose allergies like we do.™

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.

Author
David B. Engler, MD, FACAAI, FAAAAI Dr. Engler is a board-certified allergist and immunologist who hails from Houston, Texas. He was recently voted Best Allergist/Immunologist in Houston by H Texas Magazine, an honor based on peer and reader voting, as well as a Super Doctor by Texas Monthly Magazine.

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