Risks and benefits of allergy immunotherapy injection

Overview

Allergy immunotherapy injections, often called allergy shots, are a treatment that helps your immune system become less sensitive to allergens (things you are allergic to, like pollen, dust mites, or pet dander). Over time, regular injections can reduce your allergy symptoms. This treatment works by exposing you to tiny amounts of the allergen, gradually building up your tolerance.

Allergy immunotherapy injections are a common treatment for people with moderate to severe allergies that do not respond well to other medications. They are used worldwide, especially for hay fever (allergic rhinitis), dust mite allergies, and bee sting allergies.

This treatment is typically offered to adults and children over age 5 who have severe allergy symptoms that affect their daily life, or who do not get enough relief from antihistamines or nasal sprays. It is also used for people with allergic asthma triggered by allergens.

Symptoms

Common symptoms

• Sneezing, runny or stuffy nose
• Itchy or watery eyes
• Itchy nose, throat, or roof of mouth
• Coughing, wheezing, or shortness of breath (if asthma is present)

Symptoms in children

• In children, allergy symptoms may also include frequent ear infections or sinus infections.
• Children may have trouble sleeping due to nasal congestion, leading to daytime tiredness.
• Allergies can affect school performance and concentration.

Symptoms in older adults

• Symptoms in older adults are similar but may be mistaken for other conditions like colds or sinusitis.
• Existing conditions like high blood pressure or heart disease can complicate treatment, so careful monitoring is important.

Causes

Main causes

• Allergies are caused by an overreaction of the immune system to normally harmless substances, such as pollen, dust mites, mold, pet dander, or insect stings.
• The exact reason why some people develop allergies and others do not is not fully understood, but genetics and environment play a role.

Risk factors

• Family history of allergies or asthma
• Personal history of eczema or food allergies
• Living in an environment with high pollen counts or indoor allergens like dust mites
• Having other allergic conditions, such as allergic rhinitis or asthma

When to see a doctor

See a doctor urgently if:

• If you have a severe allergic reaction to an allergy shot (see emergency symptoms above), call your local emergency number immediately.
• If you develop symptoms of anaphylaxis (trouble breathing, swelling, dizziness) within 30 minutes after a shot, seek emergency care.

Book a routine appointment if:

• If your allergy symptoms are interfering with your daily life, sleep, or work, talk to your doctor about whether allergy shots might help.
• Consider seeing an allergy specialist if over-the-counter medications are not controlling your symptoms.

Diagnosis

Your doctor will diagnose allergies by reviewing your symptoms, medical history, and performing tests to identify what you are allergic to.

Tests that may be done

• Skin prick test: small drops of allergen extracts are placed on your skin, then the skin is pricked to see if a reaction occurs.
• Blood test (specific IgE): measures the level of allergy antibodies in your blood.
• Your doctor may also ask you to keep a symptom diary to identify triggers.

What to expect at your appointment

If you are a candidate for allergy shots, your doctor will refer you to an allergy specialist. The specialist will review your test results and discuss the benefits and risks of immunotherapy. Treatment usually starts in a doctor's office, where you receive a small injection each week, with the dose slowly increased. You will need to stay for 30 minutes after each shot to monitor for any reactions.

Treatment

Allergy immunotherapy injections aim to change how your immune system reacts to allergens. The treatment involves regular injections of gradually increasing amounts of the allergen extract. Over time, this can reduce your symptoms. There are also other allergy treatments like antihistamines and nasal sprays, but shots are used when those are not enough or when you want long-term relief.

Self-care at home

• Keep a diary of your allergy symptoms and possible triggers.
• Use a saline nasal rinse to flush out allergens from your nose.
• Run an air purifier with a HEPA filter in your bedroom.
• Wash bedding in hot water weekly to reduce dust mites.

Medical treatments

Besides allergy shots, doctors may recommend antihistamine pills or sprays, decongestants, or nasal corticosteroid sprays (ask your pharmacist for options). For severe cases, sublingual immunotherapy (tablets or drops placed under the tongue, not an injection) may be an alternative. Always discuss the best options with your healthcare provider.

When is surgery considered?

Surgery is not a treatment for allergies themselves, but in rare cases, surgery may be considered for complications like chronic sinusitis or nasal polyps that do not improve with medication. Allergy shots may reduce the need for such surgery.

Living with this condition

Living with allergies can be challenging, but allergy shots can greatly improve your quality of life by reducing symptoms. You will need to visit your doctor regularly for injections, but many people find the time commitment worth it for the relief they gain.

Lifestyle tips

• Avoid known allergens as much as possible: close windows during high pollen seasons, use dust-mite-proof covers on pillows and mattresses, and keep pets out of the bedroom.
• Wear a mask when gardening or cleaning to reduce exposure.
• Plan activities around pollen counts or weather that affects symptoms.

Diet and exercise

A healthy diet rich in fruits, vegetables, and omega-3 fatty acids may help reduce inflammation. Exercise is safe and beneficial, but try to avoid exercising outdoors when pollen counts are high. Rinse off after being outside.

Mental health and emotional wellbeing

Living with chronic allergies can be stressful and may affect your mood or sleep. Allergy shots can help by improving symptoms, but it is normal to feel frustrated with the treatment schedule. If you feel anxious or down, talk to your doctor or a mental health professional. You are not alone.

Prevention

You cannot prevent allergies from developing, but allergy immunotherapy injections may reduce the risk of developing new allergies or worsen asthma. Early treatment can help prevent complications like sinus infections.

Vaccines

Allergy shots themselves are a form of immunotherapy often compared to vaccines. They work by training your immune system, but they do not prevent allergies in the way a vaccine prevents an infection. Make sure to stay up to date with routine vaccinations, such as flu shots, as recommended by your doctor.

Screening programmes

There is no routine screening test for allergies for the general population. Testing is recommended only if you have symptoms that suggest allergies.

Complications

If left untreated

• Untreated allergies can lead to chronic sinus infections, ear infections, and sleep problems.
• They can make asthma worse, leading to more frequent asthma attacks.
• Severe allergic reactions (anaphylaxis) to stings or certain allergens can be life-threatening.

Long-term outlook

The outlook for people with allergies is very good with proper treatment. Allergy immunotherapy injections can provide lasting relief even after the treatment ends. Many people experience significant improvement in their symptoms and quality of life. While mild side effects are common, serious risks are rare when the treatment is given correctly by a specialist.

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