Do I really need Allergy Shots?

There are 3 basic methods used to improve allergy symptoms. These include avoidance, medication(s), and allergy shots. If the first two work well for you, the answer may be 'NO'. Most people have tried the first two extensively before they ever visit an allergy specialist, and if you are started on shots, avoidance and medication will still be part of your treatment program.

Avoidance

The simplest method to follow is to avoid what is bothering you. Under ideal circumstances this would be the perfect remedy but is not necessarily practical. If your allergy problem is a family pet, the ideal situation would be to remove the pet from the home. To some patients this is like removing a family member from the home and an absolute impossibility. An alternative that some patients will follow is removal of the pet from their room and cleaning the room thoroughly. Recent studies with cats have shown that washing your cat once a week can significantly decrease the amount of cat allergen in your home. This will usually take around six months to have an effect. It must be understood that anything less than complete avoidance of the animal to which you are allergic represents a less effective compromise.

Avoiding dust and dust mites can be very difficult, but dust reduction and decreasing dust mite exposure will be very helpful. The same is true for pollens and molds. Keeping windows closed and cleaning up damp areas in the home are fairly effective means of minimizing the aggravation these cause. We have included some literature for you to read more extensively on how to practice good avoidance measures at home.

Medications

Many drugs are available to help relive allergy symptoms, both over-the-counter and by prescription. These are necessary and helpful when used correctly, but do nothing to change your susceptibility to allergy attacks. If allergy symptoms are mild or infrequent, medications may be enough to at least partially treat your symptoms. If your allergies are becoming worse each year, affecting your quality of life, and medications are not helping you or you have unwanted side effects, allergy shots should be considered. Below we will summarize the types of medications available and their uses. You need to be aware that immunotherapy (allergy shots) requires both long-term commitment and patience. As you wait for the benefits to start, it is important for you to use both medications and avoidance to effectively control your symptoms.

1. Antihistamines - These drugs block the effects of histamine after it is released from your body as a result of an allergic reaction. They reduce itching and help dry secretions from your nose. They act quickly and can be used as needed for your symptoms. The majority of the older antihistamines cause drowsiness, but some of the new ones are non-sedating and are better tolerated by most patients. It is best to avoid this medication at the beginning of a sinus infection for about 4-5 days because it may prevent your sinuses from draining properly, making it more difficult to treat your infection. Men with prostate problems need to be aware that they may have trouble urinating while on these medications.
2. Decongestants - Often combined with antihistamines because of their stimulating rather than sedating effects, the decongestants tend to offset the drowsiness caused by the antihistamine. Decongestants work by narrowing the blood vessels to the nasal tissue to reduce the swelling and congestion. These medications may make your blood pressure go up and generally should be avoided in patients with hypertension (high blood pressure).
3. Nasal Steroids and Cromoly (Nasalcrom) - These medications are applied directly to your nose in liquid form using a squirt bottle or spray. They are able to decrease the inflammation that is causing the swelling and mucous drainage but they may take 5-7 days to start having an effect. These medications work best if they are used on a regular basis and not reserved for times when you are having difficulty with your allergies. The most important side effect of nasal steroids is irritation of the nose, especially the nasal septum (bone). Make sure the doctor or nurse has reviewed with you how to properly apply this medication.
4. Oral or Injectible Steroids - In certain situations of severe allergic symptoms, you may need to take these medications for a limited period of time. These medications are capable of 'short-circuiting' your allergic response. These medications work well, but are not without potentially severe or dangerous side effects and should only be used under certain situations when other medications have failed. Steroids by NO means should be used as your seasonal allergy shot to relive your symptoms. Some important side effects you need to be aware of are: weight gain, increased appetite, water retention, upset stomach (always take with meals), sleeplessness, and (very rarely) weakening of the bones.