The price allergy sufferers pay for our mild climate is a never-ending sneezy season, especially those sensitive to grass pollen or dust mites. Until a few years ago, the only treatment for severe allergies was a five-year course of shots (twice a month for the first year, then monthly). And for safety reasons, patients undergoing that course must wait in the allergist's office for 20 minutes after each shot in case they experience an allergic reaction to the shot itself.
Now, sniffly, sneezy, watery-eyed allergy sufferers have another option. Enter sublingual immunotherapy (SLIT), a new FDA-approved treatment whereby patients allow tablets to dissolve under their tongues. The tablets must be taken for five years as well, but there’s no need for biweekly trips to the doctor’s office.
The difference between these tablets and over-the-counter pills like Claritin or Zyrtec is this: The data so far suggests that after the treatment, it’s possible that you’ll be immune to the allergen.
“You’re gradually nudging the immune system into a nonallergic state to those things,” says Ronald Simon, MD, Scripps Clinic allergist and immunologist. “To accomplish that, you have to do it on a regular basis for a very long time.”
Dr. Simon points out that patients should steer clear of the non-FDA-approved sublingual treatments offered by some doctors. The FDA has approved only the dissolving tablets, and the liquids some practitioners give patients aren’t proven. “Those have never been shown to be effective,” he says.
Whether you choose the traditional shots or the new dissolving tablets, get tested first. Allergy tests can be done via blood or skin. Though the methods are comparable, skin tests are somewhat more sensitive and generally done by specialists who may be able to offer a more complete picture of all the risks and benefits.
“It’s best for patients to have the most comprehensive understanding about all their options,” Dr. Simon says. “It really is an individual decision.”
There are numerous types of grasses that cause allergies; a blood or skin test is required to determine exactly which one is affecting you. One important thing to note: Unlike subcutaneous shots, sublingual tablets cannot immunize you against two specific types of grass, Bermuda and Johnson.
It is unlikely, though, that a person would be allergic to only Bermuda or Johnson grass and not to other types. So in most cases, sublingual tablets would probably still be beneficial — and would spare you the weekly trips to the doctor’s office.
“No one should have to suffer from allergies these days,” Dr. Simon says. “Thanks to SLIT and other emerging new therapies, more people than ever before have treatment options that are effective and convenient.”