Archive for December, 2013

Allergy Shots or Oral Tablets. Which Is Best?

When I was recently at an allergy conference in Baltimore, a major discussion session was the coming shift in immunotherapy for allergies with the introduction of oral or liquid allergy tablets, soon to be approved by the FDA.

And my patients have asked me, “Dr. Lubitz, what is the best way to treat my allergies?” I tell them there are many factors involved in which treatment is best.

In the New York area, grass pollens are predominant in the Hamptoms and Central Jersey and for a longer allergy season. In NYC, the grass season is shorter, but other pollen-related allergies dominate. And the first oral allergy tablet to be introduced is for grass pollens.

The sublingual or oral allergy treatment is of course the least risky. There are no known side effects to oral medication. However, even with allergy shots, the mortality risk is still extremely rare. The Mayo Clinic states that in a 10 year study of allergy shots, the fatality risk was 2/10th of 1%. But oral immunotherapy also has drawbacks.

Immunotherapy studies have shown that sublingual tablets are 10% less effective in treating allergies than shots. Also, at present, the oral tablets only treat one specific allergy. Most allergy sufferers have more than one allergy and so allergy shots can be tailored-made to treat the patient’s specific allergy or more than one allergy in a single dose.

It is estimated that 35% who take allergy shots complete the three year therapy required to protect them. By contrast studies suggest that there is a 10% drop off in compliance with patients who took oral allergy immunotherapy. One of the problems in America is that people don’t comply with their medication schedule at home whether it be blood pressure, diabetes or oral allergy medication.

So consult with your doctor to find which treatment is best.

For more on the diagnosis of allergies visit “Allergies” here

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The Holidays And Your Allergies

This time of year a lot of my patients tell me they are heading all around the country to visit family for the holidays. I tell them it’s important they take their allergy and asthma medication with them because the environment they may be traveling to may induce allergic or asthmatic reactions.

Interestingly, the American College of Allergy, Asthma and Immunology (ACAAI) reported in their annual Baltimore conference in November, said that number of people with asthma that are also allergic to cats has more than doubled over an 18 year old period. And as Dr. Leonard Bielory, MD, ACAAI fellow said “those with asthma are also 32 percent more likely to be allergic to cats than those without asthma.”

And the holidays can suddenly spur allergy symptoms in people with asthma and those that have never before had allergies. So if you’re visiting your aunt Mildred in Iowa and she has a cat, well you can have suddenly have itchy eyes, sneezing and a runny nose. Even for those who are not asthmatic, there is the Thanksgiving Effect, says the ACAAI “where college students return home to a pet they didn’t have symptoms to before and are now allergic.”

The ACAAI says that “60 to 85 percent of people with asthma have at least one allergy. However, the allergens in which most are allergic to has not been well researched.”

I tell my patients that allergies can strike people at any age, with symptoms disappearing and reappearing years later. It’s important they get treated for their symptoms right away, because some can be life threatening.

Travel safely this holiday season and don’t forget your medications!

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