Sick and tired of allergies? Fed up with the eye drops, antihistamines and inhalers? Frustrated with how much you are spending each month trying to manage the symptoms of allergies? Help is here! Under the tongue allergy drops is the easiest and most effective treatment for allergies and it is available now.
Immunotherapy (IT) is recognized as the only curative treatment for allergies. By exposing the immune system to slowly increasing concentrations of an allergen it will eventually stabilize and regain control of the portion that is hypersensitive to the allergen. The exact mechanisms of how IT works are not fully understood, but they involve shifting a patient's immune response to an allergen from a predominantly "allergic" T-lymphocyte (TH2) response to a "non-allergic" T-lymphocyte (TH1) response.
IT started in the early 1900s and was based on the idea of the vaccine against infectious agents. Along those lines, the first IT efforts started as injections into the skin, were found to be very effective and thus remain the standard method of delivery. Even in those early years there was also interest in other routes of administration, such as oral, bronchial and nasal, but these methods were never adopted due to cost, mixed success and side effects.
Subcutaneous immunotherapy (SCIT) is the common technique here in the US, which requires having to go the doctor’s office for weekly injections – a procedure that is expensive, time consuming and also dangerous. In 1986 The British Committee for the Safety of Medications reported several deaths caused by SCIT, and raised serious concerns about the safety and the risk/benefit ratio of SCIT. About the same time cheaper and more effective drugs, such as anti-histamines and inhaled steroids, were becoming widely available. Amidst this backdrop, the interest in non-injected immunotherapy increased.
Sublingual immunotherapy (SLIT) involves taking “allergy drops” under the tongue where the allergens are absorbed in the oral mucosa. This was first tested by randomized controlled trial (RCT) in 1986 and confirmed to be safe and effective. In 1990 the first pediatric study appeared, and since then over 60 double-blind RCTs have confirmed the safety and effectiveness of SLIT.
In 1993 the European Academy of Allergy and Clinical Immunology (EAACI) stated in its position paper that SLIT was “a promising route” for immunotherapy. In 1998 the World Health Organization stated that SLIT “may be considered as a viable alternative to the injection route in adults.” The same year EAACI put forth a position paper stating “the use of SLIT in clinical practice is justified because of the ascertained efficacy and the favorable safety profile.” In recent years several meta-analyses of these studies have appeared in numerous allergy journals, concluding that SLIT is significantly efficacious compared with placebo for rhinitis and asthma in children and adults.
With concern to safety, all clinical trials have consistently agreed that SLIT is safe with most side effects being local and mild. Irritation in the mouth is by far the most common reaction, occurring in as much as 75% of SLIT users. Other side effects included mostly gastrointestinal symptoms, congestion of the eyes or nose, or itching, and occur in 10-20% of users. In over 20 years of use only 6 cases of anaphylaxis have been reported with SLIT, and some of these were using non-standardized allergen extracts. In the SLIT comprehensive review, there were no deaths or anaphylaxis events reported.
By comparison, according to the World Allergy Organization, it is estimated that 3.4 fatal and 22.8 near fatal reactions occur every year with SCIT. Local reactions at the injection site, such as redness, swelling, and warmth, are common, with about 10-20% of users experiencing large (>25mm) reactions. Because of the risks most doctors are not routinely treating children under the age of 12 with SCIT. This is a shame since IT has been shown to lower the risk of developing asthma.
SLIT is currently commercialized and widely used throughout Europe, Asia, Australia and South America. In a 2006 report, from the Journal of Allergy and Clinical Immunology, the US scientific community finally acknowledged the safety and efficacy of SLIT. The use of SLIT is perfectly legal here in the US, but is considered “off-label” by the FDA (like many drugs), and clinical trials for FDA registration in the US are ongoing. Further research is needed to fine-tune issues of effective dosing, treatment schedules, and overall duration of treatment.
In 2003 the respected Cochrane review found that SLIT was safe and effective for treating allergies and the updated 2010 review reinforces the conclusion that SLIT is effective for allergic rhinitis and has been proven to be a safe route of administration.
The protocol for SLIT is simple. After a medical history and exam, tests for allergies are done, either by a blood test or skin testing. The SLIT drops are then started in a highly diluted form and increased daily until a maintenance dose is achieved. Drops are continued daily, at home, usually for three years. Relief from symptoms is often achieved in the first few months, but is takes 2-3 years for the immune system to reset enough to allow long lasting relief. If the results are not permanent, most of the time they will last 8-10 years before more treatment is needed.
Our clinical experience with SLIT the last few years has been dynamite with patients finding allergy relief during the first few months. And given the safety profile we are comfortable treating children down to age 3 which is just phenomenal given that we are giving relief to these kids while preventing asthma from developing in many of them.
SLIT is a safer, easier and less expensive option than SCIT. We are working with Greer Labs and Wellness Pharmacy to bring SLIT to Western Colorado, offering a complete SLIT treatment program at a cost of $100 per month, which includes necessary office visits and the allergy drops. We also offer quick and painless testing for allergies by using the skin-prick or blood draw methods. Put an end to allergies once and for all – call today to get started on the under the tongue allergy drops.