Treating Allergies With Allergy Shots
Hi, I hope everyone is having a good spring. Last time I wrote about being tested for allergies. This time I will discuss a common question that I receive-treating allergies with allergy shots.
Allergy shots are typically given to patients whose allergies are not controlled by prescription medications for allergies. We usually like to try prescription medication first as allergy shots can be dangerous and require a lot of work for patients. In order to receive allergy shots, you must first see your allergist who will determine to what you are allergic (see last blog for methods). Allergy shots are basically injecting into your arm small doses of to what you are allergic. When starting allergy shots, we start by injecting the smallest dose and then the goal is to give larger doses with each shot until you get to a "maintenance" dose. The idea is that your body will become tolerant to the allergen and can be exposed to larger amounts without having symptoms. The allergy shots will contain mixtures of proteins to the items which your allergist found that you were allergic, therefore we need to start with small doses because you may have a reaction to the injection. After receiving your allergy shot, we ask that you wait in the office for at least 15-30 minutes to make sure that you do not have a reaction to the injection. Typical reactions may include itching, redness or swelling at the site where the injection was, or in some cases, people may experience a more generalized reaction with difficulty breathing, hives over the body and swelling of the throat. These reactions to the allergy shot can be treated by giving antihistamines, steroids, inhalers and adrenaline. You may also need to receive replacement fluids via the vein if your blood pressure drops. However, the more severe reactions do not occur frequently, but may occur when you have a cold or there is a high pollen count outside. Therefore if you are receiving allergy shots, you should let your doctor know if you have been recently sick.
Allergy shots are usually given once per week when you start. Each week, the dose of the shot is increased, provided that you don’t have a reaction with the last shot. If you have a small reaction, the allergist may give you the same dose, or slightly less. If you have a large reaction, the dose will be made even smaller. When you reach the largest dose, the maintenance dose, you can start receiving shots every 3-4 weeks, which makes it a lot easier. It usually takes about 4-5 months to reach this point where you can come every 3-4 weeks.
Not everyone responds (e.g., their allergy symptoms get better) to allergy shots and it is difficult to predict who will respond. We usually say that if you have not had any improvement in your allergies after 1 year of receiving shots, that you will not respond and we stop the shots. Allergy shots are usually continued 3-5 years if you respond well to them and then they are stopped. It is believed that the shots may change your immune system so that you become tolerant to the allergen. Again, if you have further questions about receiving allergy shots, please ask your allergist, or you can write to me.
Paula Busse is an allergist-immunologist in New York, New York and is affiliated with Mount Sinai Hospital. She wrote for HealthCentral as a health professional for Allergy and Skin Care.