Although avoidance is always the primary recommendation, more treatment is usually advised. Medications frequently are used to decrease allergy symptoms and return patients to full health. Recent advances in medications for allergies, asthma and other allergic diseases have been phenomenal. Improvements in drugs have eliminated most of the side effects associated with them just a few years ago. Your specialist at Houston Allergy and Asthma Clinic will be able to suggest the latest safe, and most effective, medications for treating your allergic illness. Medications are generally divided up into two categories–those to prevent your symptoms, and those to treat your symptoms. It is reasonable to infer that prevention medications must be used regularly to be most effective. Prescription medications can be very expensive; however, we will work with you and your insurance company to find the most effective therapeutic alternatives covered by your plan.
Several types of medications are available — both over-the-counter (OTC) and prescription — to help reduce annoying allergy symptoms like runny nose and congestion. These include antihistamines, decongestants and corticosteroids among others.
Although increasingly popular, OTC allergy and asthma medications are not free from side effects or interactions. Decongestants are a prime example of this. Most OTC decongestants contain pseudoephedrine or phenylephrine, potent decongestants that can also be very stimulating. This can lead to increased blood pressure, a dangerous situation if you high blood pressure. Even patients with normal or borderline blood pressure can experience hypertension while taking decongestants. They can also cause insomnia.
The fast acting decongestant nasal sprays, like Afrin and Neo-Synephrine, also have risks. Long term use of these sprays can result in your nasal lining becoming addicted to them. This leads to rebound swelling of the nasal lining which leads to worse congestion than you were treating in the first place and an increasing need to use the medication. These nose sprays are useful, but should not be used more than 3-5 days without medical supervision.
Herbal remedies can have their own risks. Echinacea is a popular herbal supplement readily available in forms ranging from teas to lozenges. Its most common use is as a treatment for colds and an immune booster. While it is generally regarded as safe, allergy sufferers beware. Echinacea is related to ragweed, the bane of the allergy sufferers existence in the fall. If you are allergic to ragweed, you may actually get allergy symptoms from Echinacea. Some patients who are allergic to grasses, a spring allergen, also get symptoms from Echinacea.
Immunotherapy (Allergy Shots or Drops)
Although medications may reduce or prevent symptoms, only a regimen of allergy shots or drops can actually alter or fix a patient's allergic response. Allergy shots have been used by the medical profession since 1911. This time-tested therapy decreases a patient's sensitivity by introducing increasingly larger doses of the substances to which the patient is allergic. The treatment is a method for increasing the allergic patient's natural resistance to the things that are triggering the allergic reactions.
Think of it this way: The allergic response is an overreaction to a harmless substance. When the allergic patient comes across something to which they are sensitive, the allergic cascade begins, often leading to misery. The non-allergic person will breathe in the same thing and have no adverse response. The goal of allergy shots is to gain this tolerance to harmless substances which are mistaken for dangerous invaders.
The immunization procedure begins with injections of small amounts of purified "extracts" of the substances that are causing allergic reactions. For example, the animal dander, dust mites, or pollen. Each of these has proteins which can be used to induce tolerance when properly administered. The immunization injections are approved for this purpose by the U.S. Food and Drug Administration (FDA) and, over the years, have been improved considerably.
Allergy shots or drops stimulate the immune system to fight allergies safely, effectively and naturally. Beginning with small doses and increasing gradually on a twice weekly or weekly basis, the therapy continues until a maintenance level is achieved. Then the maintenance dose is injected on a less frequent basis.
Immunity does not occur immediately, but patients can begin to feel better quickly. In many patients, treatment can be discontinued after 3 or 5 years and the immunity is maintained for several additional years. For others, treatment may be needed for longer periods of time.
With the immune system restored to good health, fewer or no medications may be required. Work or school days are no longer missed. The burden of allergies is lifted, and allergies are no longer an issue in daily life.
Candidates for immunotherapy include patients of all ages. Pregnant patients may continue treatment started prior to pregnancy.
Until recently, allergy shots (immunotherapy) had been used as a last resort after medications and environmental control efforts had been unsuccessful. Recent studies suggest that immunotherapy should begin sooner rather that later. As opposed to antihistamines, which treat symptoms, or inhaled steroids, which prevent symptoms, allergy shots are designed to actually eliminate the underlying allergy. The Practice Parameters for Allergen Immunotherapy quote studies stating that receiving allergy shots for one or two items actually prevents the formation of allergies to other allergens. The Practice Parameters also point out that for children with allergies limited to the nose and sinuses, allergy shots reduce the chances that the allergy will progress to asthma, decrease the frequency of sinus and bronchial infections, and enable patients to get better sooner and stay better longer.
RUSH immunotherapy, or RUSH I.T. as it is also known, is a technique that accelerates the administration of allergen injections, shortening the time frame required to obtain relief from allergies.
Conventional immunotherapy consists of weekly or twice weekly allergen injections, administered over a period of six to eight months in increasing doses that gradually desensitize a person. During RUSH I.T., in a carefully monitored clinic environment with a three-day regimen of premedication, the patient receives six to eight months of dosage in one day and is able to move to maintenance dosage much more quickly, which actually imparts the beneficial immune effect.
A History of Success
Since 1996 The Allergy Clinic, our sister clinic, one of the leading allergy practices in the Southwest, has administered RUSH I.T. safely to more than 3,000 patients. While the procedure is associated with incidences of systemic reactions, most reactions are mild and easily treated.
A Day of RUSH I.T.
Before RUSH I.T. is administered, a patient will undergo allergy skin tests to determine allergic triggers. Only after the allergist has determined allergic triggers and his/her overall health is RUSH I.T. recommended.
For three days prior to a RUSH I.T. treatment, the patient follows a prescribed regimen of medications, including corticosteroids and antihistamines, which reduce the incidence of serious reactions.
On the day RUSH I.T. is administered, the patient arrives in the morning, and throughout the day, under close supervision by a physician, nurse practitioner, physician assistant and nurses, receives increasing doses of allergen injections over the course of six to eight hours. When the series of injections are completed, the patient is allowed to return home after one or two hours of in-the-clinic observation.
Over the next four to eight weeks, the frequency of the allergen injections is tapered off until the patient needs an allergen injection only about once every three or four weeks.
The Advantages of RUSH I.T.
For many individuals, RUSH I.T. is an excellent alternative to the longer, conventional method of administering allergy therapy because it:
- Offers quicker relief;Eliminates the need for weekly or twice-weekly allergy shots;
- Requires fewer shots;
- Allows patients to reach maintenance dosage months sooner than conventional immunotherapy;
- Accommodates schedules, especially for individuals who travel frequently;
- Hastens desensitization for patients who wish to avoid allergy medications during pregnancy; and
- Permits individuals who live distances from an allergy clinic to receive allergy shots on a less frequent basis, therefore significantly reducing the number of visits and commuting time.
Leading Treatment Facility
When it comes to innovation in allergy treatment, the highest level of patient care and a top-notch staff of board-certified allergists and professional nurses, Houston Allergy and Asthma Clinic is one of the leading facilities in the United States. At HAAC, patients are assured of a complete allergy evaluation by nationally recognized experts who listen and prescribe the most effective method of relief.
For more information about RUSH I.T. or to make an appointment, call 713.522.9911.
Sublingual Immunotherapy (Allergy Drops)
Sublingual immunotherapy, aka SLIT, is a method for treating allergies where drops of an allergen solution are placed under the tongue. SLIT can be as effective as traditional allergy shots, but without the needles. Popular in Europe for 30 years, SLIT is catching on in the US and is now available at Houston Allergy and Asthma Clinic.
After allergy skin testing, Houston Allergy and Asthma Clinic creates custom drops for your specific allergy triggers. These drops are composed of the same FDA-approved allergen extracts that we use to make allergy shots. At home, on a daily basis, patients place a prescribed number of drops under their tongue. After two minutes, the drops are swallowed. Treatment involves a short build-up phase where drops increase in number and strength, followed by a maintenance phase that lasts for three to five years.
Advantages of SLIT are that it is safe enough to take at home, saving lots of travel time, gasoline, and clinic visits; the lack of needles make SLIT much easier for young children (and many adults) to tolerate; and SLIT is great for people who travel frequently.
Disadvantages of SLIT are limited to the fact that insurances companies consider it an "experimental treatment thus, they won't pay for it. Still, the cost is significantly less compared to a lifetime of allergy medications and numerous office co-pays, not to mention how much better you'll feel. We cannot perform Rush with SLIT, so the time to relief is longer with drops than with shots. Even though SLIT is not FDA approved, it is Safe, Effective, and Legal.
Are all allergy drops equal? No! Don't confuse SLIT as practiced at Houston Allergy and Asthma Clinic with the low potency drops given by some "bootleg allergists"? and ENTs. While low-dose SLIT has been used for years, its value has never been shown to be higher than placebo. In other words, a sugar pill has an equal chance to provide the results you get from the bootleggers.
Interested in SLIT? Call 713.522.9911.