Sublingual Immunotherapy May Be Safer Than Allergy Shots

Dr. Paula J. Busse Health Pro
  • Although allergy pills such as anti-histamines treat the usual symptoms of allergies such as a runny nose, itchy eyes and sneezing, they do not "cure" the disease.


    In another blog, I wrote about allergy shots (allergen immunotherapy). Allergy shots work for some, but not all patients, to change their immune systems so that they may not need to take anti-allergy pills, or to perhaps take less of them.


    The theory behind giving allergy shots is to give patients smaller and then eventually larger doses of the allergen (or the protein in the allergen that actually causes the reaction). Patients receive one shot each week, for up to six months.

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    However, there is a form of giving allergen immunotherapy by mouth, called sublingual immunotherapy (SLIT). SLIT has been used in Europe, but is not currently approved by the FDA for use in the United States. There are clinical trials underway though, so it's possible that in the near future, SLIT will become available in the United States.


    SLIT is given to patients by placing under the tongue a small amount of the item to which they are allergic. Patients will then usually swallow it. It is important to note, that we do not give patients foods to which they are allergic as this may result in death (There are some trials which are studying this).


    While allergy shots are usually given once per week, and eventually once per month, giving the allergen by mouth can either be done once per day or once per week. It may take a longer time to get the patient to the maintenance dose (the full amount of the allergen) when giving it by mouth.


    It may seem like taking the allergen to which you are allergic by mouth may be more dangerous than by taking it through a shot, but actually, one of the advantages of taking it by mouth is that it may be less dangerous. It may be safer because the immune cells in your mouth may be different from those found where the shots are given. These cells may "see" the proteins differently and react to them differently.


    Some patients may complain of tingling in the mouth or some lip swelling. Fortunately these are usually not dangerous and do not lead to closure of the airways, but in some patients they may.

    Therefore, in general, allergy shots are probably more risky than taking the treatment by mouth.

    The drawback, however, is that it will probably take longer for you to feel relief of your allergy symptoms when taking the therapy by mouth. Another advantage of taking the allergy treatment by mouth is that it could be done at home, you may not need to visit the allergist every time.


    We are just beginning to understand how giving an allergen by mouth may help improve allergy symptoms. However, it is important that you DO NOT try to make your own mixtures to place under your tongue (this is especially true with food allergies, where exposure to allergens could lead to life-threatening anaphylaxis) The therapy, which, again, is NOT approved for use in the United States, whould only be done under the supervision of a doctor.

Published On: March 31, 2008