Allergy Shots: Are They Worth It 5 Things You Need To Know
If you suffer from allergies, youre familiar with the constant congestion, sneezing, itching, watery eyes, and other hay fever symptoms that always spring up as springtime rolls around. Or maybe your symptoms plague you all year long because of ever-present pets, mold, and dust.
Perhaps youve tried oral decongestants, nasal sprays, and eye drops all with no long-term success. If thats the case for you, youre not alone. Allergies are the 6th most common cause of chronic illnesses in the US.
Fortunately, one of the most effective treatments is one of the simplest: an allergy shot. Weve asked Dr. Daniel Reichmuth, one of our expert immunologists, to share insight into the question, Are allergy shots worth it?
How Much Will My Allergy Medication Cost
Once youve found an allergy medication that fits your needs, youll ultimately want a good price for it. All of the medications listed in this article have brand-name and generic forms. Most are also available over-the-counter. Their cost will largely depend on whether you buy them over the counter or with a prescription. And as it turns out, visiting your provider and getting a prescription for a generic version can be well worth it.
Lets take Claritin as an example. Claritin costs about $33 retail. If you get a prescription for the generic form, loratadine, you might pay about $10 cash instead for the same amount. Thats over 50% savings. Now, if you use a GoodRx coupon with your prescription, that same amount of loratadine can cost as little as $4, saving you 87% off the brand-name, over-the-counter price.
Prolotherapy Brings Oxygen To The Joint To Help Provide Healing Cells Energy And A Clean Safe Work Environment
In a 2017 stem cell study Dr. Ming Pei of West Virginia University publishing in the medical journal Biomaterials suggests that while adult stem cells are a promising cell source for cartilage regeneration, they have a hard time in a harsh joint environment when hypoxia and inflammation have created a toxic soup for the stem cells to work in. As noted above healing cells, like your native stem cells, like a clean, safe work environment. Chronic inflammation slowly and steadily brings about a low oxygen environment in joints because the body feels that diseased tissue will die in a low oxygen environment. Oxygen deprivation is designed to be a short-term drastic measure to healing a wound. But chronic inflammation means a slow strangulation of the joint
Sometimes we forget the cells of the body obtain their energy via aerobic metabolism. The primary substrates or substances that are needed for aerobic metabolism are oxygen and glucose. The body breathes to get oxygen and we eat to break down the food into sugar. Even if a person just eats protein, ultimately the body finds a way to break down the protein into individual amino acids and eventually into glucose. Without glucose, the cells and the body cannot live.
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Cooling Your Face With Some Eye Stones
Sometimes allergy relief looks like self-care. If your eyes are puffy from intolerable itchiness, maybe youd benefit from a pair of eye stones, which you first refrigerate and then place gently on your eyes.
If anything, the cooling sensation will feel good and, maybe even better, the stones will force you to rest in one place and just relax after a frustrating day of allergies.
Comparisons With Other Allergy Medications
Researchers are often studying, comparing, and improving antihistamines. Other popular brands on the market today are Allegra and Benadryl.
- Allegra contains the active ingredient fexofenadine. Allegra is non-sedating, so it should not make a person feel drowsy. Allegra is also a second-generation antihistamine.
- Benadryl contains the active ingredient diphenhydramine. This acts faster than the other three and aims to treat minor skin reactions, not seasonal allergies. Benadryl is a first-generation antihistamine, which makes it sedating, so people tend to feel drowsy after taking it.
When a person comes into contact with an allergen, their immune system reacts and produces a chemical called histamine.
Histamine causes many allergy symptoms, including inflammation of the skin or sinuses, pain, redness, and wheezing.
Immune responses also encourage extra mucus to develop, which helps to clear allergens from the nose and throat.
Allergy medications block histamine responses. This dulls the bodys response to minor or harmless allergens, such as pollen, dust, and pet dander.
Claritin and Zyrtec are effective and safe for most people with minor allergies. However, as with all medications, there may be some side effects.
Loratadinepresent in Claritinmay not be safe for people with severe liver conditions. The liver has to break down loratadine. The kidneys break down cetirizinefound in Zyrtecand the body excretes it in the urine, largely unchanged.
Cytopoint Allergy Shot Vs Immunotherapy For Dogs
Immunotherapy should not be confused with cytopoint allergy shots, which are intended for short-term relief rather than as a permanent solution.
This is an anti-itch injection given at the veterinary practice that lasts four to eight weeks, Dr. Harbour said. This is a monoclonal antibody that targets the itch mediator and prevents the signal of itch from going to the brain.
So instead of training the immune system to reduce reactions for good like with immunotherapy cytopoint basically just tricks your dogs brain by making her think shes not itchy.
Allergy Shots And Immunotherapies
Allergy shots are sometimes prescribed to allergy sufferers who have adverse reactions to medications that are ingested, as well as for people who want to be more aggressive with their treatment plans. With this option, doctors inject small amounts of actual extract from the allergen in the hopes of making the patient more tolerant to the allergen over time. The process may take years, but can be especially effective for those allergic to dust or cat dander, and for preventing the development of asthma in children.
A Direct Correlation Between Increased Steroid Concentration And Increased Chondrocyte Apoptosis
It becomes perplexing then, that these medications continue to be routinely injected into peoples joints therapeutically for pain. While corticosteroid and analgesic injections have the potential to temporarily relieve pain by shutting down the bodys inflammatory mechanisms, these medications are toxic to cartilage cells. Results of bovine cartilage studies from the University of Pittsburgh School of Medicine revealed the following:
A direct correlation between increased steroid concentration and increased chondrocyte apoptosis as well as increased chondrocyte toxicity with increasing time of exposure to methylprednisolone. The addition of lidocaine to methylprednisolone significantly increased the rate of chondrocyte cell death.
In the American Journal of Sports Medicine, university medical researchers in Japan demonstrated a case history in which a patient received high-dose cortisone treatments for a case of Bells Palsy, the same patient was also a volunteer subject in a study to test a stem cell-based Tissue Engineered Construct for cartilage and bone defect. Stem cells were harvested from the patient to build a scaffold patch.
- At three weeks after the cortisone treatment, the patients stem cells could not help generate the construct needed for the cartilage/bone patch.
- At seven weeks after steroid therapy the stem cells could, the stem cells had successfully withstood a direct attack from the cortisone, but it did take 7 weeks to recover.
Advantages Of Allergy Drops
There are a number of advantages of allergy drops or sublingual immunotherapy such as:
- you can combine several different allergens in the drop format to allow for treatment of multiple allergies at a time
- drops can be custom made to start at low doses and gradually build up to higher doses this is VERY important because many allergic patients are highly sensitive to the allergen and this technique avoids side-effects
- there is no risk to an adverse reaction such as anaphylaxis like there is with allergy shots
- the drops taste pretty good
- you can take the drops from the treatment of your home
- less doctor visits
Dr. Mitchell has treated patients with sublingual allergy drops for over 20 years with amazing results!
These allergy drops are not currently covered by insurance companies but we try to make them an affordable price. Currently, they cost slightly more than you would pay in copays for a weekly allergy shot.
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What Is Immunotherapy Is It The Same As Allergy Shots
Immunotherapy refers to treatment and management plans that train the immune system to act differently than it normally would. For example, treating your immune system not to react to allergens.
There are multiple types of immunotherapy used for allergies. Subcutaneous immunotherapy refers to immunotherapy that is done under the skin, via a shot. Subcutaneous immunotherapy, then, is another term for allergy shots. SCIT is a long-term treatment designed to reduce the severity of symptoms for allergy sufferers. For some, their allergies may even stop completely. This type of immunotherapy is considered the gold standard for allergy treatment.
What Does The Allergist Do
Before starting immunotherapy, the allergist will take a complete medical history.
- Be sure to tell him or her about every medication you take, prescription and nonprescription, even those you take only occasionally.
- Report any vitamins, dietary supplements, herbal products, and other alternative therapies you take.
- Also report every allergy you know of.
- If you are a woman, it is essential that you tell your allergist if you are pregnant or have any plans to become pregnant in the foreseeable future. In this case, allergy shots might be better suited for another time. Based on your particular situation, the allergist will tell you your options for treatment of your allergies during pregnancy. In certain situations, allergy shots can be continued during pregnancy, if it is determined that the potential benefits outweigh the risk of an unlikely, but potentially severe, reaction to one of the shots.
- At first you will get the shots often, once or twice a week.
- After about 6-12 months, you will start maintenance therapy, which means a shot about every month or so.
- Most people continue to take maintenance therapy for 3-5 years.
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What Formulations Of Antihistamine Injections Are Available
- Prescription antihistamine injections are available in injection form.
- Diphenhydramine, promethazine, and dimenhydrinate are administered intramuscularly and intravenously.
- Hydroxyzine hydrochloride is administered only intramuscularly.
- Antihistamine injections are not recommended for administration via subcutaneous route.
Is Slit For You
You might consider the under-the-tongue approach if you have frequent, bothersome dust mite, grass, or ragweed allergy symptoms that don’t respond sufficiently to allergy medications such as steroid nasal sprays, and you dont want to use traditional immunotherapy.
But what’s a better choice, tablets or shots? Some early research suggests that SLIT may be “somewhat less effective” than allergy shots, according to UpToDate, which provides evidence-based treatment information to healthcare providers. Experts say that clinical trials comparing traditional immunotherapy with sublingual are needed to determine which is more helpful.
In addition, notes Dykewicz, “patients who are allergic to multiple allergens would be better candidates for SCIT, which can be used to treat multiple allergens. Administration of several different types of SLIT tablets together has not been well-studied.”
And while the risk of a serious allergic reaction with SLIT is far lower than it is with allergy shots , the sublingual approach isn’t for everyone, he adds.
For example, you shouldn’t use it if you have conditions such as severe, unstable, or uncontrolled asthma eosinophilic esophagitis , an immune disorder that can make swallowing food difficult or a history of a severe reaction to immunotherapy. If you’re considering the therapy, be sure your doctor has your full medical history.
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Cortisone Can Make Bone On Bone Worse By Thinning Out The Meniscus But One Injection Appears Okay
One of the reasons that you are considering a knee replacement or are thinking about getting a cortisone injection is because you have been told you have a bone on bone knee. So the idea that cortisone may make this worse by thinning out your meniscus is concerning doctors.
In August of 2020 in the journal Scientific Reports doctors expressed concerns about damaging the meniscus tissue with cortisone injections. It should be noted that this researchs main findings were that it was okay to get one cortisone injection. For many people, one injection would be considered safe. Here are the learning points of that research:
- Although intra-articular corticosteroid injections are commonly used for the treatment of knee osteoarthritis, there is controversy regarding possible side-effects on the knee joint structure.
- In this study, the effects of intra-articular corticosteroid injections on worsening the knee structure and creating greater pain were examined.
- Findings: No significant effect of the intra-articular corticosteroid injections were found on the rate of cartilage loss nor on any other knee structural changes or patient-reported pain scores. In conclusion, a single intra-articular corticosteroid injection for the treatment of osteoarthritis-related knee pain was shown to be safe with no negative impact on structural changes, but there was a transient meniscal thickness reduction, a phenomenon for which the clinical relevance is at present unknown.
Immunotherapy Injections Versus Sublingual Immunotherapy
Immunotherapy has been given by injection for more than 100 years and many studies prove that it is effective. A number of studies published in the last five years have shown that very high dose sublingual immunotherapy , where allergen extracts are retained under the tongue for a few minutes, then swallowed, can also be effective. SLIT has a longer history of use in Europe than in Australia and New Zealand, where it is used more commonly than injected immunotherapy.
The allergen extracts currently available in Australia and New Zealand for oral and injected therapy are very potent, and are NOT the extremely weak and ineffective extracts used by some medical practitioners ten or more years ago.
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As With Most Medications Allergy Tablets Have Possible Side Effects
Many of these side effects will be localized in the mouth area since thats where youre putting the allergen, Dr. Hong says. You could experience things like itching and swelling of your lips, for example.
You might be wondering why youd take something that could give you allergy symptoms when what you want is, well, to rid yourself of allergy symptoms. But these side effects typically fade within a few days to a week, the AAAAI says. After that point, the tablets should continue to battle your allergy without causing you too much grief.
If you do experience allergy symptoms while taking sublingual immunotherapy , its OK to use symptom-relieving medications like nasal sprays, antihistamine tablets, and eye drops.
Immunotherapy sort of works in the background, but whatever a person needs to take in order to feel comfortable…is perfectly fine, Dr. Reisacher says.
More severe reactions to allergy tablets, like anaphylaxis, are rare yet possible. Doctors account for this in a few ways. The first dose needs to be done in a monitored setting, just in case you have an allergic reaction, Dr. Hong explains. The recommendation is typically to have a patient stick around under medical supervision for 30 minutes after taking their first allergy tablet, according to the AAAAI. Its also recommended that doctors prescribe an epinephrine autoinjector alongside the tablets, which you could use to keep your airways open if you were having a severe allergic reaction.
They’re Not Just For Seasonal Allergies
Allergy shots can be effective for people with hay fever and other seasonal allergies, but they can also work for year-round indoor allergieslike mold, dust mites, and animal danderand allergies to insect bites or stings.
“In the case of stinging insects, the shots can be close to curative,” says Dr. Dziadzio. “That’s the one time I really push people to get the shots no matter what, because it’s such a dangerous allergy.” Allergy shots may also be a good choice for people who don’t like taking medications or can’t avoid the thing they’re allergic tolike a pet or the great outdoors.
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Corticosteroid Damaged Knee Cartilage And Provided No Significant Pain Relief After Two Years
In 2017, doctors from Tufts Medical Center in Boston asked, What are the effects of intra-articular injection of 40 mg of triamcinolone acetonide every 3 months on the progression of cartilage loss and knee pain in patients with osteoarthritis?
Writing in the Journal of the American Medical Association, they published their answer:
Among patients with symptomatic knee osteoarthritis, 2 years of intra-articular triamcinolone, compared with intra-articular saline, resulted in significantly greater cartilage volume loss and no significant difference in knee pain. These findings do not support this treatment for patients with symptomatic knee osteoarthritis.
- Corticosteroid damaged knee cartilage and provided no significant pain relief after two years.
In other words, cortisone can either work or make the problem worse.
In February of 2020 a review study with the title Medical Reversals in Family Practice: A Review, published in the journal Current Therapeutic Research, Clinical and Experimental offered these points:
The Appeal Of Intratympanic Injection
The investigators hope that the study will shine the light of science on intratympanic steroid injections, which are growing in popularity, Dr. Rauch said. The logic of treating by injecting directly into the ear has some appeal, but it is simplistic to think that if some is good, more is better, he said. Prior research has shown intratympanic steroid injections get approximately the same results as oral treatment.
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How Can Allergy Tablets Help
If you’re the right candidate for it, can be helpful for sure, Sandra Hong, M.D., a physician in the Department of Allergy and Clinical Immunology at the Cleveland Clinic, tells SELF.
In addition to having certain allergies and being in the right age range, you may be a candidate for allergy tablets if youve tried a lot of short-term allergy treatments but are still experiencing symptoms at a level you find hard to bear, according to the American Academy of Family Physicians or if you spend so much on short-term allergy relievers that you think it may be more cost-effective to seek treatment that lasts for a longer time.
You can start taking daily allergy tablets for dust mites at any time of year, but grass and ragweed allergy tablets need to be taken daily starting three to four months ahead of the allergy season for the best possible results.
The hope would be that by the time that season starts, significantly better, Dr. Hong says. You would then continue to take the tablets until your system built up immunity.
Unfortunately allergy tablets dont work immediately. Taking allergy tablets as recommended can ideally provide long-lasting relief after around three to five years, according to the American College of Allergy, Asthma, and Immunology . As with shots, allergy tablets wont necessarily cure your allergies. But they can help reduce some peoples symptoms and need for as much medication.