What is allergy immunotherapy?

Allergy immunotherapy is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy.

Allergy immunotherapy treats the cause of your allergies, not just the symptoms. It builds tolerance by exposing your immune system to small amounts of what you’re allergic to on a regular basis. This can be done with weekly injections of “allergy shots,” the daily self-administration of “allergy drops” or “allergy toothpaste”, or by taking dry “allergy tablets”.

Over time, immunotherapy changes your immune system so that it is more “tolerant” of the allergens. As allergen tolerance grows, your allergies and their symptoms decrease, sometimes to the point that an allergy sufferer does not notice them anymore. Immunotherapy may also prevent conditions that often go along with allergies, like chronic sinusitis or asthma.

What are allergies?

Allergies are an overreaction of a person’s immune system to an allergen, an otherwise harmless protein that has no effect on a non-allergic person. Common sources of inhaled allergens are tree, grass and weed pollen, mold spores, dust mites, cockroaches, cats, dogs, birds, cows, horses, rabbits and rodents. The overreaction of the immune system that results from contact with one or more of these inhaled allergens may cause annoying symptoms like coughing, sneezing, itchy eyes, runny nose, and scratchy throat. A person will often have allergies to more than one allergen.

Mylan’s EpiPen Recall in the United States

Many of our patients have been prescribed epinephrine in case of a rare anaphylactic reaction to their allergy drops, so I wanted to pass along some information about a voluntary recall of Mylan’s popular brands of epinephrine: EpiPen 2-Pak® and EpiPen Jr 2-Pak®.
If you or someone you know were prescribed one of these medications, please click on the link below for more information about the lot numbers of the recalled products and for replacement information.   If your lot number matches one of the recalled products, you will need to contact Stericycle at 877-650-3494. If not, your EpiPen product is not affected by the recall and there is no further action necessary.
EpiPen Recall

Autism Spectrum Disorders and Food Allergies

In honor of the upcoming World Autism Awareness Day on April 2, I wanted to share some information regarding autism spectrum disorders (ASD) and food allergies.

 

General Information:

IgE-mediated allergic diseases (e.g., allergic rhinoconjunctivitis, atopic asthma and food allergy) are among the most common chronic conditions worldwide, and are continuing to rise each year.  In addition to easily recognized symptoms, such as a runny nose, itchy eyes, sneezing and coughing, allergic diseases can cause neuropsychiatric symptoms, such as irritability and hyperactivity, in otherwise healthy individuals. This is also likely to occur in children with autism spectrum disorders (ASD). Moreover, the discomfort and pain associated with allergic diseases could aggravate behavioral symptoms in ASD children. [1]  This may be due the child’s inability to communicate or fully understand or explain his or her discomfort.

 

Allergy Testing:

Autism spectrum disorder children are known to suffer from additional issues, with gastrointestinal (GI) and sleep disorders being the most common. It may be useful to test for food allergies to confirm or rule out allergies as a cause for GI issues.  Allergy testing can be done by skin testing or blood work.  Many times these tests indicate that children do, in fact, have true allergic responses to foods. Other times, the tests come back “negative” for food allergies.

 

Allergy Treatment:

If a patient tests positive for food allergies, they can be treated with sublingual immunotherapy (allergy drops), by avoiding the allergy-inducing foods altogether, or a combination of both.

 

For more information about World Autism Awareness Day, please go to: https://www.autismspeaks.org/.  Wear blue on April 2 to show your support of the Light It Up Blue national campaign.

 

[1] http://www.medscape.com/viewarticle/721702_1

Oral Allergy Syndrome

Have you ever eaten an apple and had an itchy mouth or throat?  Or perhaps you’ve eaten a big watermelon chunk, and you’re ears feel tingly inside.  (This is what happens to me with watermelon.  It’s very annoying to think you’re eating healthy, only to be plagued with itchy inner-ears.)  The reason for this is likely Oral Allergy Syndrome.  It is also called pollen-food allergy syndrome.  These symptoms; itching, tingling, and swelling of the mouth, lips, and throat and sometimes itchy ears; happen because your immune system can’t tell the difference between the proteins in these food and pollen.

Triggers for Oral Allergy Syndrome:

Although not everyone with a pollen allergy will experience oral allergy syndrome when eating the foods listed below, they are known to be associated with the allergens listed.  Basically, if you are allergic to ragweed, you may have a similar allergic reaction to watermelon, melon, oranges, tomatoes, potatoes, and peanuts.  If you eat these foods during the height of ragweed season, your reaction may be more severe.

Allergen Foods
Birch Pollen Apple, pear, cherry, nectarine, apricot, plum, kiwi, hazelnut, almond, celery, carrot, potato
Mugwort (Sage) Pollen Celery, carrot, spices, sunflower, honey
Grass Pollen Melon, watermelon, orange, tomato, potato, peanut
Ragweed Pollen Watermelon, melon, orange, tomato, potato, peanut
Sycamore (Plane tree) Pollen Hazelnut, peach, apple, melon, kiwi, peanuts, corn, chick pea, lettuce, green beans
Plantain (English) Pollen Melon, watermelon, tomato, orange, kiwi
Dust Mite Shrimp, snail


Treatment Options:

  • Avoid the trigger foods altogether
  • Cook the foods, as heat tends to break down the proteins
  • Sublingual immunotherapy drops for food or inhalant allergies

Why am I being treated for a cat allergy when I don’t have a cat?

 

We were sitting around the conference table the other day at our staff meeting, chatting about allergies, when a great topic came up.  Cat allergy.  Now, I don’t claim to be an expert in allergies.  I don’t have any of the fancy letters after my name, like my colleagues: DO, RPh, RN.  I don’t need to worry about educating prescribers or patients on the ins and out of allergy.  So, I ended up learning something by listening to this conversation that I thought was worth passing along.

 

We have had patients ask why they are being treated for their cat allergy even though they don’t own any cats.  Here’s what I learned: cat dander can stick to things.  It can stick to the clothes of a cat owner, and be transferred to the clothes or furniture of a cat-allergic person.  It can stick to the backpack of a child and be brought to school to be shared with cat-allergic classmates.  I think you’re getting the picture.

 

According to the American College of Allergy, Asthma & Immunology (ACAAI), “in a home that previously had cats, it may take up to 20 to 30 weeks before the cat allergen concentration is reduced to the levels found in animal-free homes.”  Other researchers have said that cat dander could last in a home for several years after a cat has been removed.

 

In summary, non-cat-owner patients who are allergic to cats are often treated for their cat allergy due to the potential ‘exposure’ to cat dander.  You never know when you might be exposed to cat dander…you may want to stay away from my house for the next 20 weeks-several years!

Food Allergy Awareness

I read a great blog post a few days ago, written by a guest blogger for FARE (Food Allergy Research & Education).  The blog post was written to encourage others to participate in Fare’s Food Allergy Heroes Walk.  The take-home message for me was simple- Create Awareness.

My first profession was that of an elementary school teacher.  I was young and single, with no children of my own.  My ‘awareness’ of food allergies was very limited.  I knew of food allergies, I’d heard of people being allergic to peanuts, but had no real understanding what that meant for a child with food allergies or a parent with a food-allergic child.  Due to my inexperience, I didn’t have any understanding that being in contact with a peanut, or peanut butter, or a child who just ate a peanut butter sandwich for lunch could produce such disastrous outcomes- anaphylaxis, emergency rooms, feeling like nobody understands.  I didn’t ‘get it’ when parents and organizations had wars with the airline industry about banning peanuts as snacks.  I just thought, “Well, don’t eat the peanuts then.”  I didn’t understand that there are people so allergic to peanuts that by simply breathing in the cabin air on an airplane could make them sick, or that by touching a seat-back someone touched who had recently eaten peanuts and then wiping their eyes, nose, or mouth could have a severe allergic reaction.  I also was not aware that there were treatments for food allergies, such as allergy drops/sublingual immunotherapy.

Many years have gone by since I was a teacher, and I’m now a mother of three children, who thankfully do not have food allergies.  However, I have become more ‘aware’.  Aware of the needs of individuals with food allergies, aware of the needs of individuals as a whole- the need for sympathy and understanding from others, no matter what their ‘cause’ may be.

If you’re looking for a FARE walk, please follow the link to find a location near you.

http://fare.foodallergy.org/site/PageServer?pagename=heroes_walk_active_events

Spring Allergy Season is Right Around the Corner!

 

Spring allergy season is fast approaching, and for some parts of the country, it started in February.  Hard to imagine, with snow on the ground everywhere I look!  However, I know my allergies will catch up with me soon enough.

If you have spring allergies, then trees are likely the culprit.  You can get your local allergy outlook at sites like https://www.pollen.com/. You can view pollen counts, your current allergy season, and view a national allergy map.

Those of you who started sublingual immunotherapy prior to the spring allergy season should be less symptomatic than those of us  who either waited too long to start therapy or haven’t been to our provider to get allergy tested/treatment.

It’s not too late to begin a sublingual immunotherapy program to treat the underlying cause of your allergies. Check with us to see if there’s a provider in your area that treats allergies with our allergy drops.

Recent study in the Journal of the American Medical Association (JAMA) recommends at least 3 years allergy immunotherapy

Allergy Drops-safe and effective

A February, 2017 allergy immunotherapy research study published in JAMA recommends that patients continue their subcutaneous (allergy shots) or sublingual (allergy drops) allergy treatment for at least 3 years for long term effectiveness.

Sources: Shortened dose of immunotherapy ineffective in allergic rhinitis,  All-American Allergy Alternatives, LLC

18 Things To Know About Food Allergy Reactions E-Book

Allergic Living is the leading magazine for those with food allergies, celiac disease, gluten sensitivity or environmental allergies. It features in-depth articles, news and safe recipes.

Source: 18 Things To Know About Food Allergy Reactions E-Book | Allergic Living