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Allergies

Why should I consider allergy shots, again?

06/24/2008

Question:

From the late 1980`s until 2002, I took 2-3 allergy shots weekly for multiple allergies. I have just used Flonase and sometimes Allegra (more recently Singulair) and Advair 100/50. Recently I was re-tested for allergies due to the frequency of sinus infections and was surprised to discover nothing changed in the 12-14 years of taking shots. The medications control day to day symmptoms, but I will still get 4 or so sinus infections in a year and once a year have near bronchitis situation (usually mid-winter). The ENT wants me to do shots or sublingual therapy. I am very reluctant because if 14 years didn`t work, I don`t think restarting shots will. (I`m 59 years old). Both therapies are expensive and time consuming. I rarely have a headache from allergies and just try to avoid situations that I know will make me have more symptoms. Is there a compelling reason that I should start something that I would need to do for years when it`s already not worked in the past?

Answer:

While I can't speak specifically to your situation, I would suggest asking a few questions. First, it sounds like the medication is controlling symptoms. If the medication is controlling symptoms, is there a need to change therapy? Second, what would the dose of the new shots be? If the dose will be the same as previously used, there may be little added benefit. If, however, there is going to be an increased dose, then there may be benefit. Third, why shots or sublingual? There are studies for sublingual therapy in the US, but as of right now, no approved sublingual products or doses.

I would further discuss the situation with your doctor and consider another opinion if you are not in agreement with your doctor. Immunotherapy is a commitment of 3-5 years and should only be done for the right reasons and when all people agree it is the right thing to do.

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Response by:

David  Hauswirth, MD David Hauswirth, MD
Clinical Assistant Professor
Pulmonary, Allergy, Crtitical Care & Sleep
Pediatrics
College of Medicine
The Ohio State University