American Board of Allergy and Immunology
Undergraduate
B.S. in Biology and B.A. in Anthropology
Southern Methodist University, Dallas, Texas
Medical School
M.D., Saba University School of Medicine, Netherlands-Antilles
Residency
Pediatrics and Chief Residency, Louisiana State University School of Medicine Shreveport, Louisiana
Fellowship
Allergy and Immunology, Louisiana State University School of Medicine Shreveport, Louisiana
Staff Privileges
Medical City Denton and Texas Health Presbyterian Hospital Denton
Other Credentials
Member of the Denton County Medical Society
Member of the Texas Medical Association
Member of the American Academy of Allergy, Asthma and Immunology
Member of the American College of Allergy, Asthma and Immunology
For patients that suffer from allergies, typical treatments include a combination of oral, nasal and ocular antihistamines and/or corticosteroids. These medications will temporarily treat the symptoms of allergies, but only allergen immunotherapy will treat the underlying cause of the allergies. It works by administering small increasing doses of allergen extracts during a build-up phase, followed by a certain tolerated dose in the maintenance phase for a minimum of 3 years. Over time, this procedure is designed to trick your immune system by ‘desensitizing” or immunizing” you to the allergens you are allergic to, allowing for greater symptom relief and a decreased need for medications. Potentially, eliminating your allergies. For the allergic patient, it can greatly improve their quality of life.
Traditionally, allergen immunotherapy has been given in the form of allergy shots where patients receive weekly injections during their buildup phase followed by monthly injections during their maintenance phase for a minimum of 3 years. Since this form of immunotherapy carries the risk of potential serious allergic reactions, all injections are given in the office setting with supervision.
Sublingual immunotherapy or SLIT allergy drops is an alternative method in which small doses of allergen extract (liquid form) are administered sublingually (under the tongue), held there for a period of time and then swallowed. During the build-up phase, drops are administered daily in an increasing fashion. Once in the maintenance phase, a certain number of drops will be taken daily for a minimum of 3 years. The risk of serious allergic reactions is very low and thus can be self-administered by patients or caregivers at home.
Does it work?
Just as with allergy shots, SLIT allergy drops are designed to “immunize” you to the allergens you are allergic to. Allergy drops have been used for more than 100 years. Over the last 30-40 years, many scientific studies have shown SLIT allergy drops to be effective in reducing allergy symptoms over time. In 2009, the World Allergy Organization (WAO) published a paper endorsing SLIT allergy drops as a safe and effective alternative treatment to allergy shots.
Is it safe?
As mentioned above, the risk for serious allergic reactions is very low making this a safe alternative to allergy shots. Anaphylaxis to allergy drops has not been reported. Based on research data, mild side effects include localized oral itching, redness, and/or swelling that can be minimized with medication and/or adjustment of dosing as directed by your allergist.
Can children take it?
SLIT allergy drops are safe and effective for both children and adults. Depending on the patient, it can be started as early as age 3 or 4.
Advantages of SLIT allergy drops vs traditional allergy shots
Safer – decreased rates of mild, moderate and severe allergic reactions
Comfortable – no needles, less pain
Convenient – it can be self-administered at home
SLIT allergy drops and the FDA
The liquid extracts used for allergy testing are the same extracts used in allergy shots and the same extracts are also used in allergy drops. These extracts are very safe and FDA approved. The allergy injection method has been approved for many years; however, the method of placing these extracts sublingually or under the tongue is not FDA approved at this time. The use of SLIT allergy drops is still considered safe by the FDA but is considered to be an “off-label” treatment. Because of this, most insurance plans do not cover the cost of SLIT allergy drops.
What’s the next step?
If you or your child suffers from allergy symptoms, the first step is to find out what you or your child is allergic to by completing allergy skin testing. Based on the initial visit and allergy testing results, SLIT allergy drops may be a long-term treatment option to help reduce symptoms, reduce the need for allergy medication, and improve overall quality of life.
Our physicians at North Texas Allergy & Asthma Center are board-certified allergists with extensive experience in both pediatric and adult immunotherapy. Call our office for an appointment so we start the evaluation process, answer any questions you may have, and help make you feel better!
SHIKHA MANE, MD
Board Certified Allergist
