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Allergy Shots as Immunotherapy

There are a half-dozen popular treatments for allergy symptoms. Benadryl (diphenhydramine), Claritin (loratadine) and others are well known antihistamines. Decongestant sprays, such as Nasonex, are readily available by prescription. But these treat only symptoms. Allergy immunotherapy attempts to get to the root of the problem - the overactive immune system - and to offer a long-term cure by changing it permanently. In essence, it's a form of vaccination.

Allergy immunotherapy generally comes in the form of shots taken weekly. The syringe contains a carefully calibrated dose of allergen, such as an extract of ragweed pollen or cat dander, sometimes genetically modified. The goal is to gradually desensitize the immune system. Since an allergic reaction is an overreaction to a substance seen as a foreign invader, the idea is to 'teach' the immune system to better distinguish friend from foe.

The treatment is not experimental. It has been in clinical use for several years. But it does carry some possible downsides.

Shots are much more expensive than over-the-counter pills and creams. Since they're administered by a trained professional allergist they are also frequently more costly than prescription medications taken at home.

They also require making those visits to the doctor, regularly and for a long time. A few weeks to a few months is usually required to calibrate the correct type and amount of allergen given in the shots. Once established, the treatments may go on for three to five years or more. The length varies with each patient, but the goal is more or less to permanently alter the patient's immune system reaction to certain substances. That takes time.

Allergy shots are also not useful in certain classes of allergy, particularly food allergies. While the treatment might potentially work, the risk of anaphylaxis is considered too high. The shots inject the patient with a substance that produces the allergic reaction. Therefore, there is too great a chance that a food allergy sufferer can have a life-threatening reaction.

On the upside, there is ample clinical evidence from numerous careful studies that support a belief in the efficacy of the treatment. In short, it works. Not for everyone, naturally. But about three-quarters of those receiving long-term treatment do eventually rid themselves entirely of the allergy. For many, even the substantial reduction in symptoms makes the effort and expense worthwhile.

It is effective in treating those allergic to animal dander, dust mite waste and pollen grains. It's highly useful for those who can't take or don't find relief from standard medications. It has been successful at permanently relieving hay fever and may prevent the onset of asthma in children. It has been shown to reduce the odds of an allergic reaction to bee and wasp stings.

For those who suffer severe symptoms, or who simply want to avoid taking pills for the rest of their lives, that is very good news.