Introducing an Enhanced Way to Treat Allergy in Extremely Sensitive Individuals.
March 17, 2013 1 Comment
At a minimum, 8 million Americans suffer with significant allergies. This costs each one of them annually about $2000 in OTC and prescriptive copayments (if they have insurance) and results in far more expensive complications like sinus infections, asthma, poor sleep, lost school or work attendance, and even up to 15 points on standardized IQ testing. That’s a lot to give up for overreacting to dust mites, pollens or the family pet.
Picture of one of my patients after simple prick testing for 58 antigens and 2 controls.
As you can see, several of these are remarkably severe reactions.
Antihistamines can causes drowsiness, increased risk of infections, and increase the risks of seizures. Nasal steroids also increase the risk of infection and can cause adrenal suppression with the loss of bone strength.
With all of these potential risks, it makes sense to try preventing the allergic reactions.
One of the ways we block the body’s allergy response is to create immunity to the allergy with chronic exposure via either injections or sublingual antigens (the medical term for the thing causing the allergy). This process is called immunotherapy and its various forms (primarily shots and drops under the tongue) have been subjected to rigorous scientific evaluations and numerous publications.
Despite these well published and accepted desensitization techniques, I have faced extraordinary challenges in treating children with allergies when they are combined with autism, PANDAS, PANS or ADHD type of issues. Repeatedly I have observed remarkable behavioral reactions to even low dose sublingual (under the tongue) therapy. Children with these disorders often respond to allergy desensitization with increased self-stimulatory behaviors, worsened inattention, and increased hyperactivity, so obviously this defeats the purpose.
The problem is the doses required in standard protocols expose these very sensitive children to far too much provocation with resultant adverse clinical responses.
Below is the accepted protocol for sublingual immunotherapy, rapidly escalating the dose of antigen to the maintenance dose of 15-25 micrograms of antigen per dose. The dose for shots is less but equally harmful to this population.
Despite the level of scientific evidence favoring drops under the tongue (SLIT) your insurance company will claim this is unproven and experimental. They are stuck in past and are actually financially incentivizing doctors to expose your child to the severe reaction potential of shots (known as SCIT). Allergy shots have a known risk of death and severe asthmatic reactions. This prompted the many governments is Europe to move away from paying for SCIT in favor of the far safer SLIT. We in the US are unfortunately stuck with our anachronistic insurance system. However, the out of pocket costs for SLIT are less than the costs of OTC allergy medications and with much better long term results.
From the same article:
But even standard SLIT protocols present the very reactive child (or adult) with far too much antigen in the early phases of the protocol.
So about a month ago I called Susan Harris, a pharmacist at Greer Laboratories (a leading pharmacy producing allergy therapies). I explained my observations about excessive reactions in my special needs population to all of the standard protocols. After some productive discussions, we developed what I call the Harris-Bradstreet SLIT allergy desensitization protocol.
This protocol involves 5 steps from very dilute exposures leading eventually to the traditional maintenance levels as published above. There are 5 levels until maintenance; with each level lasting 5 weeks, and within each level there are 5 step-ups. So it takes 25 weeks to reach maintenance levels.
The cost of the Harris-Bradstreet protocol will very based on the number antigens required, but most families find it very affordable and worth the difference based on the reduced side-effects. If you are interested in this safe alternative for special needs cases please contact my office at 470-253-7445.