Is there a way to get to the full dose of allergy shots quicker?
Yes.  As stated above, the typical build up for allergy shots takes 3-6 months and it can take 2-3 months before you
begin to notice significant improvement in symptoms.

Another way to build up allergy shots is to "rush" it.  With a "rush" build up, the equivalent of the first 10-15 doses are
given in 4-8 hours, instead of  7-15 weeks.  This means that you should reach the maintenance dose of allergy shots
in nearly half the time it would normally take, and people often start to notice an improvement in symptoms within
about a month.  This is a procedure that is not offered by most allergists, but which I do on a frequent basis at the
Greensburg office.  Please contact our office if you would like more information on rush immunotherapy.


What are the benefits of allergy shots?
Allergy shots are effective in improving symptoms caused by pollens, molds, animals, dust mites, and cockroaches.    
IF proper doses are used (some non allergy trained physicians often use doses which are too low to be effective),
allergy shots are usually successful in up to 90% of patients with seasonal allergies and in 70%-80% of individuals
with year long allergies.  Symptoms do not improve overnight as it takes time to build up the dose and for the immune
system to change to a less allergic state.  Symptoms gradually improve as the dose of the shots increases.   Full results
are usually achieved within about 1 year of starting injections.   Because allergy shots interact with the immune system,
many people continue to have benefits many years after they have completed their treatment.  

  • Allergy shots decrease the chance of new allergies.    Studies demonstrated that the chance of developing new
    allergies to pollens and other environmental allergens decrease by about 50%.
  • Allergy shots reduce the risk of developing allergic asthma in individuals with environmental allergies by about
    50-70%
  • In allergic asthma, allergy shots result in a significant reduction in symptoms and medication use.   In many, the
    asthma can completely go away.    For example, a study published in 1968, which looked at children with
    asthma, demonstrated that 70% of the children who received allergy shots for 4 years no longer had asthma.   
    In the placebo group, only 20% of the kids became free of asthma during the study.

There are not many studies on eczema and allergy shots, but the data that is available demonstrates that allergy shots
can be effective in improving eczema—but only if it is associated with environmental allergies, not food allergies.

Currently, allergy shots are not recommended for the treatment of hives, angioedema,
food allergies, or eczema (if
associated with food allergies).   


Who can receive allergy shots?
Generally, children age 5 and above, and adults can receive allergy shots.    
Allergy shots are a good treatment option if you have one of the following:
  • Severe allergy symptoms which significantly affect quality of life, even while taking allergy medications
  • Significant side affects from allergy medications
  • Have a desire to avoid using medications for the long term
  • Frequent ear or sinus infections which are felt to be from environmental allergies
  • Allergic asthma

Allergy shots are generally not suitable for individuals with heart problems, taking beta-blocker drugs, or who have
poorly controlled asthma.   Individuals considering allergy shots should discuss their particular case with a board
certified allergist.  

What are the side effects of allergy shots?
Generally, shots are very safe.   Some reactions are possible since they contain particles that your body is allergic
to.    The most common reaction is what is called a local reaction.  A local reaction is an area of redness and swelling
which occurs at the injection site.   It may happen almost immediately after an injection, or develop an hour or two
later.  A local reaction can be bothersome as it may be itchy, but it is not dangerous.  A local reaction usually goes
away on its own within a few hours.

Much less frequently, individuals can develop allergic reactions with allergy shots.   Studies show that overall, about
2% of individuals may experience an allergic reaction.     The majority of the time, these reactions are mild, with
symptoms such as watery or itchy eyes, sneezing, itchy nose or ears, post nasal drip, or hives.   Very rarely, reactions
can be very severe, with symptoms such as breathing difficulties, swelling in the throat, low blood pressure, or passing
out.  Some deaths have been reported from allergy shots.  Most allergic reactions develop within 30 minutes of an
injection, therefore individuals are required to wait in the doctor's office for 30 minutes after each injection so that the
physican can  treat any reaction that might occur.


Sources
Nelson HS. Allergen Immunotherapy: Where is it Now?  J Allergy Clin Immunol 2007;119:769-77.
Allergen Immunotherapy practice in the United States: guidelines, measures, and outcomes. Ann Allergy Asthma
Immunol. 2011;107:289-300.
Johnstone DE, Dutton A. The value of hyposensitization therapy for bronchial asthma in children - a 14-year study.
Pediatrics 1968; 42:793-802.
Blazowski et al. Anaphylactic shock because of sublingual immunotherapy overdose during third year of maintenance
dose  Allergy 2008;63:374.
Cochard et al.  Sublingual immunotherapy is not always safe alternative to subcutaneous immunotherapy.  J Allergy
Clin Immunol 2009;124:378-379.
Anthony Frew Sublingual immunotherapy NEJM 2008;358:2259-2264
AllergyExpert.US
Allergy Shots

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Typically, each allergy shot prescriptions is made up of 4-5
vials.   The treatment starts with a very weak concentration
of
allergens (the one on the left, with the green top).   Over
a 3-6 months period, the dose is gradually increased by
using progressively higher doses from the more
concentrated vials - this is called the buildup phase.    
During this phase, shots are typically received once or twice
a week.  Once the full dose is reached (from the vial on the
right, with the red colored liquid), the treatment enters the
maintenance phase. In the maintenance phase, patients
typically receive shots every 2-4 weeks.    It is
recommended to continue shots for a total of 3-5 years in
order to obtain the best long term benefits.
What are allergy shots?
The allergy shot, also called allergy injection or subcutaneous immunotherapy (SCIT), is a form of treatment aimed at
treating allergies.    While allergy medications can be very effective in improving allergy symptoms, they just cover up
the symptoms, so the allergy shot was devised as a way to treat allergies by targeting the actual cause of allergies –
the immune system (which is why allergy shots are also called “immunotherapy”).

Allergy shots are not new – they were first tried almost 100 years ago, in 1911 when 2 London doctors (Leonard
Noon and John Freeman) used a watery extract of boiled pollen to treat an allergic individual.   Since then, allergy
shots have been studied extensively and improved.  

Allergy shots involve a series of injections given at regular intervals over a 3-5 year period.    Initially, the shots
contain minute amounts of allergens, but over time the dose is gradually increased.  As the treatment progresses, the
body’s immune system becomes less sensitive to allergens, and symptoms gradually improve.    
  
"Long-term follow-up on
immunotherapy studies
demonstrates that allergy shots for
3 years...shows persistent
long-term effects on clinical
symptoms after termination of
treatment and long-term,
preventive effects on later
development of asthma in children
with seasonal rhinoconjunctivitis. It
is so far the only treatment for
allergic diseases that has been
shown to be able to prevent
worsening of disease and
development of asthma. In this
light, allergy shots should be
recognized not only as first-line
therapeutic treatment for allergic
rhinoconjunctivitis, but also as
secondary preventive treatment for
respiratory allergic diseases"

Lars Jacobsen; Erkka Valovirta  How
Strong is the Evidence That
Immunotherapy in Children Prevents
the Progression of Allergy and
Asthma?
Curr Opin Allergy Clin Immunol.  
2007;7(6):556-560
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