ALLERGY TESTING & TREATMENT
Frequently Asked Questions
WHAT IS ALLERGY TESTING?
Skin or blood testing is used for food, environmental or insect allergies. Skin testing is more sensitive and is usually preferred. Antihistamine medications need to be discontinued temporarily for accurate results. Allergy testing is generally very safe and not painful, though itching may occur if a patient is allergic.
Testing identifies allergic triggers and helps efforts to eliminate them. If the trigger is seasonal, patients can anticipate when to start or increase medications. Finally, knowing the exact environmental cause is needed to prepare allergy shots, which help patients with severe or persistent allergy or asthma symptoms.
WHAT ARE ALLERGY SHOTS & DROPS (IMMUNOTHERAPY)?
Allergy shots and drops prescribed by an board-certified specialist are both forms of immunotherapy. Immunotherapy is the closest thing to an allergy cure. Allergens (pollen, mold, dust mite or pet dander) are injected into the arm or dropped under the tongue at gradually increasing doses to desensitize the body to those triggers.
Both are proven to reduce nasal, eye, sinus and lung symptoms. Many shot patients reduce or even eliminate medications, saving money in the long run. Unlike medications, we treat the underlying cause and not just symptoms. If medications do not provide relief or you wish to take less, immunotherapy may be for you.
Allergy shots are also available for severe allergic reactions to insect stings. In this case the goal is to reduce the risk of anaphylactic reactions to these insects.
WHAT DO ALLERGY SHOTS INVOLVE?
Allergy shots involve a 3-6 month buildup phase where injections are given 1-3 times per week followed by a maintenance phase where they space to bi-weekly and eventually monthly. Results are typically expected at maintenance though some patients benefit sooner. Maintenance continues for 3-5 years total, after which most patients retain long-term immunity.
Generally, allergy shots are very safe. Because allergens are injected, there is always a small risk of reaction. Allergy shots should only be given in a doctor's office and you must wait 30 minutes after administration for your safety. Many patients can fit shots into a lunch break or after school.
Our office has plenty of seating, books, free Wi-Fi and most importantly trained staff to address your needs. Shots are given through the day and no appointment is needed. In the past, some doctors allowed allergy shots at home. These doses were either too low to work or carried an unacceptable risk of side effects. All national allergy organizations agree that shots should be given in a doctor's office.
AT WHAT AGE CAN SOMEONE START ALLERGY SHOTS?
Each case is reviewed on an individual basis, however the earliest we typically begin allergy shots for environmental triggers is around 4 years old where the patient is able to communicate appropriately. In cases of life-threatening reactions to insect stings, therapy may begin sooner if future exposure risk is high.
There is technically no upper age limit for immunotherapy, however certain conditions and medications may exclude a patient. Your physician will consider the entire medical history when determining each person's eligibility.
HOW MUCH DO ALLERGY SHOTS COST? IS IT COVERED BY INSURANCE?
Most insurance plans cover the preparation and administration of injections. Some plans cover all costs and in other cases a co-pay or deductible may apply. As the number of injections decreases with time, the associated costs decrease as well. As a service to our patients, our office verifies benefits to determine any out-of-pocket expenses before beginning therapy.
WHAT IF I DON'T LIKE NEEDLES?
For those worried about needles, allergy injections use much smaller needles than for many medications, about the size of an insulin syringe. Topical anesthetics are also provided to numb the skin and ETAA staff are pros at making the process as easy as possible. Children as young as 4 years of age have successfully gone through our treatment program. An alternative to injections is allergy drops (see below).
HOW DO ALLERGY DROPS COMPARE TO SHOTS?
Sublingual therapy (allergy drops) follow the same concept as allergy shots. Allergens found on testing are administered under the tongue daily to build a tolerance and reduce sinus, nasal, eye and lung symptoms.
The biggest advantage is that allergy drops carry much less risk of anaphylaxis and can be administered at home. For patients who desire long-term allergy relief but whose schedule or travel distance prevents weekly visits to the allergy clinic, or cannot tolerate repeated injections, allergy drops are a useful alternative.
ARE THERE DISADVANTAGES TO DROPS?
Due to differences in absorption, it is easier to “fit” more allergens (pollens, mold, dust mites, animal dander) into an injection than into drops, so patients with allergies to multiple triggers may be more suited for traditional allergy shots. Your doctor will discuss whether you can expect comparable results to shots in each specific case.
Although allergy drops have been widely used in Europe for decades, they are still not FDA approved in the United States. Therefore, it is not covered by most insurance plans and associated costs are the patient’s responsibility.
In some cases, allergy drops are still worthwhile financially, especially when counting savings from travel and injection fees. This is especially true if one has a high-deductible insurance plan requiring patients to cover the full cost of their therapy. Please note that the base cost to manufacture medical-quality allergy extracts is quite high, so if you see allergy drops sold for a low cost by non-allergist providers, over-the-counter at health stores or even online, keep in mind that you may not be receiving safe and regulated products or taking too low a dose to be effective long-term.
East Texas Allergy & Asthma is committed to price transparency and believes in discussion with individual patients to decide whether the advantages in terms of convenience and lack of needle pricks is worth the expense.