For decades, allergen immunotherapy has brought relief to many environmental allergy sufferers. This treatment has successfully helped those who are affected by allergies triggered by allergens such as pollens, molds, dust, and dander. Our experts at Asthma Allergy Center in Tigard, OR are committed to providing the best cutting-edge treatments for our patients, including immunotherapy.
Is Immunotherapy Right for You? 5 Reasons to Consider Treatment
Overview: How the Immune System Functions
Your immune system is designed to keep your body in peak performance and defend against foreign intruders such as bacteria, viruses, and allergens (molecules or particles that trigger an allergic response). The true soldiers of the immune system are white blood cells, which stage an attack against anything not recognized by the body. For allergy sufferers, the immune response recognizes harmless particles as a threat and mounts a response.
Because this response can actually do significant damage (i.e. anaphylaxis), it is important to regulate the immune system so that it only responds to actual threats rather than insignificant environmental particles. For allergy patients, this involves something called desensitization – the process of repeatedly exposing the immune system to a particle (allergen) it originally recognized as harmful. Over time, the immune response will become conditioned to understand that this particle is not a threat and thus will not mount an attack.
Allergies and the Immune System
The immune system’s first line of defense is called innate immunity. Also known as natural immunity, innate immunity does not require previous exposure to a foreign particle to recognize it as a potential threat. The innate response is immediate, and it will mount an attack against any foreign substance invading the body. While this is helpful for invaders such as viruses, it is not so helpful in response to harmless allergens.
The immune system’s second line of defense is the adaptive (or acquired) response. As its name implies, this response takes some time to adapt to the new particle as foreign, and possibly harmful. Adaptive immunity is trained by the innate response to label the foreign particle as threatening. This response is not immediate as it is with innate immunity and requires repeated exposure to the foreign particle.
Why Allergen Immunotherapy Works
Allergy is a response activated by a concerted effort between the innate immune system and the adaptive immune system. Once the immediate response is triggered by the innate system, it catalyzes all future responses by the adaptive system. The adaptive system has been told to treat the particle as dangerous and therefore typically activates an allergic response within fifteen minutes of exposure.
Immunotherapy is the process of desensitizing the adaptive system’s response. It involves exposing the body to gradually increasing doses of the allergen creating the immune response. Treatment typically involves frequent allergy shots for environmental allergies or oral immunotherapy (OIT) for food allergies.
Desensitization Therapy for Environmental Allergies
Research has shown that receiving desensitization injections on a monthly basis for three or more years greatly reduces allergy symptoms or turns them off completely. Many patients find that they no longer need allergy medications to manage symptoms or need much less than they did prior to receiving the shots. Given new research, optimal dosages have increased and have made injection therapy much more effective than in the past.
Injections are not the only way to receive desensitization treatment. Oral medication is available in liquid and tablet form and must be taken sublingually (under the tongue) once a day. This provides the convenience of treating allergies at home rather than frequent visits to a medical office.
Desensitization Therapy for Food Allergies
Food allergies can also be treated with desensitization therapy. OIT for food allergies works the same way as other allergy desensitization processes – the body is exposed at first to a very small dose (micro-dose) of the allergen. The dose is increased gradually over time until a much higher dose is tolerated.
It is important to note that while allergy tests that prick the skin are a useful diagnostic tool, results may sometimes indicate that an allergy is not present, but there may still be an allergy or risk of reaction. In such cases, “food challenges” can be designed by your physician to determine the best way to resolve these issues.
When treatment first begins, injections are given more frequently (typically once a week) for the first several months. With each subsequent shot, the dosage is slightly increased. This is referred to as the build-up phase. After this, the frequency decreases. This is referred to as the maintenance phase and can last several years. However, this is the most beneficial phase, as the reduction of symptoms improves with time and consistency on a treatment plan.
What to Consider
1. Severity of Symptoms
If you have moderate to severe allergic responses to allergens, it may be time to consider allergy shots. Mild symptoms of environmental allergies may include sneezing, itching, runny nose, and watery eyes. Moderate to severe responses may include swelling, rash, and shortness of breath. These more severe symptoms may or may not occur before anaphylaxis, which is a serious condition that can cause swelling of the throat and airways, dizziness, low pulse, and collapse or shock.
Indoor allergens such as mold and dust, or seasonal allergies triggered by grass, weed, or tree pollens can be difficult to avoid. This can create a challenge in staying on top of managing symptoms. If you find that your symptoms are impairing the quality of your life, allergy injections are likely a viable option.
2. Symptoms Are Not Alleviated by Medication
Medications are good for managing allergies in the short-term, but if they don’t control your symptoms then alternative methods should be considered. If you consistently rely on medication to feel okay, then allergy shots may be a better way to manage your symptoms. In addition, if you notice that your medications no longer work like they used to, or if they have stopped working altogether, you are a good candidate for allergy shots.
However, before you decide that your medication is not working, be sure to check with your doctor that the correct medication is being used for your particular symptoms. For example, antihistamines might work for someone suffering from runny nose and watery eyes but could exacerbate problems for someone whose biggest complaint is dryness in these areas.
3. Medication Interactions
Some people have concerns about how their allergy medications will interact with medications they take for other health issues. It is important to have this conversation with your doctor. If you are experiencing challenges from interactions between medications, or if the side effects of allergy medicines are impairing your ability to maintain daily activities, then you may want to consider allergen desensitization therapy.
Some patients also prefer not to be on long-term medications. In this case, the only way to really avoid symptoms is to work with a doctor to determine if allergen desensitization is the best choice or if your allergies can be managed through a thorough understanding of how to avoid the allergens that trigger your allergic response.
4. Duration of Illness
If you have been a lifelong allergy sufferer, desensitization therapy could not only improve your symptoms now but also well into the future. The goal of allergen desensitization is to improve the way the body responds to harmless substances, which reduces adverse symptoms and improves future immune response. Those who have suffered for a length of time with little improvement despite medication should consider this treatment.
Another reason many people opt for desensitization therapy is the rising cost of medicines. Considering the amount of over-the-counter or prescription medications needed to control symptoms, a person suffering from allergies for many years will have spent a considerable amount of money on temporary relief.
5. Prevention of Asthma
Allergic asthma develops when the airways narrow and inflame due to a response to an allergen. Asthma affects the bronchioles of the lungs, and as they swell during an allergic attack, breathing can become difficult. Shortness of breath and wheezing all hallmark symptoms of this condition, which can make even normal daily activities challenging.
Since allergies and asthma are often linked, allergen desensitization can prevent asthma from developing and reduce symptoms if asthma already exists. While not everyone who has allergies will develop asthma, an ounce of prevention is worth a pound of cure.
Prevention of Allergic Reactions
Even during treatment, it may be helpful to learn the best ways to avoid and prevent allergic reactions. Some key ways to avoid environmental allergens are to limit outdoor activity as much as possible. If you do need to work outside, a pollen mask can help reduce exposure. Pollen counts are highest in the mornings and late evenings, so keep doors and windows closed as much as possible during these times.
Changing clothing quickly when coming indoors from doing outside chores will help limit exposure from allergens being brought into your home. Frequent vacuuming and use of a HEPA air filter can significantly improve conditions indoors for allergy sufferers. In addition, using air conditioning to circulate air and keep it cool will also be beneficial.
The best way to reduce the risk of food allergies is simply to avoid the food. However, this is easier said than done as it can be difficult to determine if common allergens such as milk, wheat, nuts, and seafood are ingredients in the foods we eat. Therefore, the number one way to limit exposure is to become an avid reader of food labels.
No matter how diligent you are, cross-contamination between foods does happen. You should always be prepared to fight an allergy attack by keeping an epinephrine-injecting device nearby at all times. Wearing medical-alert jewelry can also help those around you identify what is wrong should you become sick or anaphylactic.
Benefits of Allergen Immunotherapy
While medications are helpful in controlling allergy symptoms, they only work for as long as you take them. One of the biggest benefits of allergy shots or OIT is that some people find lasting remission from their symptoms. And even though some people relapse after discontinuing treatment, the maintenance phase of treatment (usually 3-5 years) keeps most symptoms and discomfort in check. In fact, most people feel relief after only three months.
In addition to minimizing the duration of illness, allergen desensitization limits the amount of medical treatment a patient needs over time. It also reduces the risk of complications from medications or the development of other related conditions, such as asthma.
End the Discomfort
If you are ready to take the next step in managing your allergy symptoms, call the Asthma Allergy Center in Tigard, OR for a consultation. We proudly serve Oregon with locations in Beaverton, McMinnville, Newberg, and Tigard. Our expert medical professionals are ready to help you get control of your symptoms and rediscover your quality of life.