What is Immunotherapy?

What is Immunotherapy?

Think of immunotherapy as a "vaccination" against allergies. However, unlike a single shot you might get for tetanus or the flu, immunotherapy involves giving you steady, increasing amounts of the substances that cause your allergies. The whole idea of treating you with the very things that make you miserable may seem a bit odd, but in most cases, it works.

How Does It Work?

Receiving progressive immunizations with the substances that cause your allergies gradually makes you less sensitive to them. The injections cause a nonallergic or “good” antibody to build up. Then the allergic immune process subsides. In other words, allergy shots seem to reprogram the immune response to the things that cause your symptoms, so the next time you run into them, they give you less trouble.

What's Involved in Immunotherapy?

First, based on your history and skin test results, the substances that cause your symptoms will be determined. The results of these tests also help your doctor decide whether immunotherapy will likely help you.

Generally, allergy shots are given year round. At first, you will receive allergy shots at least once a week. Treatment starts with a tiny amount of the substances that bother you. Over six to twelve months, your dose will be gradually increased until it reaches a level of proven effectiveness. This dose is called the "maintenance dose."

The reason your doctor starts with a small amount is because you could develop a reaction to an allergy shot before your tolerance builds up. That's why immunotherapy is always given in a place equipped to handle a severe reaction quickly and you must remain in the waiting room for an observation period of 20 minutes.

In expert hands, immunotherapy will help most allergy sufferers significantly. Treatment will usually continue for several years. After the first nine to twelve months, you may need booster doses only once every two weeks. Eventually, the frequency will be tapered until you are requiring injections only on a monthly basis. In some cases, if your symptoms return over the years after allergy shots are stopped, it may make sense for you to start getting them again. Fortunately, most people don't need to continue getting their shots indefinitely and repeat desensitization can be accelerated.

When Will My Symptoms Get Better?

Most people begin to notice improvement after they have had allergy shots for six months or longer. Some notice benefit sooner. Be patient. It takes time to get results.

Be sure to follow the injection schedule. In addition, tell your doctor whether you think the shots are helping you and about any reactions. For example, some people develop a sore, swollen arm; wheezing; or an outbreak of hives after they return home from receiving an allergy shot. Reactions like these don't necessarily mean allergy shots should be stopped, but your doctor may need to make an adjustment in the amount of each shot. If you have asthma, you should NEVER receive your allergy shot when your peak flow values are less than 70% after bronchodilator and/or you are having an exacerbation of your asthma. If you use asthma medications daily, the peak flow should be measured before each allergy injection.

What Can I Expect From Immunotherapy?

When immunotherapy is successful, patients have fewer and less severe reactions to the substances that cause allergy and asthma. Allergy shots are not a cure, but they can significantly improve quality of life by reducing susceptibility to allergic inflammation.

Points to Remember about Immunotherapy:

  • You need to get your shots regularly for immunotherapy to work. Try not to miss! (Unless you are experiencing an exacerbation of your asthma.) Rarely, you could develop a severe reaction to an allergy shot. If this takes place outside your doctor's office, let him or her know immediately or seek immediate treatment.
  • Immunotherapy is not a quick fix. Most patients need to receive it for several years.
  • There are no guarantees. While immunotherapy works very well for the majority of people, it may not help some others.
  • Immunotherapy is not a cure. It is intended to make your allergies or asthma better by reducing allergic susceptibility. However, the allergy and asthma components of the immune system cannot be removed.
  • You should practice good avoidance measures. Windows should stay closed in the Spring and Fall. Pets to which you are allergic must stay out of the home or at least out of the bedroom. Prepare and maintain a sleeping environment free of house dust mite material.