Can immunotherapy improve my seasonal allergies and asthma?

Question

Hello doctor,

Every spring and fall, my allergies become completely overwhelming, with nonstop sneezing, a runny nose, itchy eyes, and a scratchy throat. Antihistamines provide some relief, but I still feel miserable for weeks at a time. I have also tried nasal sprays, though their effectiveness is inconsistent. I am beginning to consider whether allergy shots or immunotherapy might be worthwhile. Are these common treatments for seasonal allergies, and how long does it typically take to see results? Additionally, I have mild asthma, and it seems that my allergies sometimes trigger wheezing as well. What is the best long-term approach to manage these symptoms?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

It sounds like you are experiencing moderate to severe seasonal allergic rhinitis, possibly accompanied by allergic asthma triggers. Allergy immunotherapy, either allergy shots or tablets, could be a beneficial next step. Your symptoms, including sneezing, runny or blocked nose, itchy eyes, and throat irritation, are classic signs of seasonal allergies likely caused by pollen. The worsening of symptoms in spring and fall suggests triggers such as tree or grass pollens in spring, and ragweed or mold in fall. Since your asthma flares up alongside allergy symptoms, more aggressive allergy management is warranted. You have already tried first-line treatments like antihistamines, intranasal steroids, antihistamine eye drops, and leukotriene receptor antagonists, but if these are not consistently effective, immunotherapy is a strong option to consider.

Allergy shots (subcutaneous immunotherapy) are effective for allergens such as pollen, dust mites, mold, and pet dander. This treatment involves weekly injections during a build-up phase lasting three to six months, followed by monthly maintenance injections for three to five years. It can reduce or eliminate the need for medications and may prevent progression to more severe asthma, although it requires regular clinic visits. Alternatively, sublingual immunotherapy (daily tablets or drops taken under the tongue) offers a less invasive option that can be administered at home after the initial dose in a clinic. While slightly less potent than shots, it is effective for specific allergens like grass, ragweed, and dust mites.

Because allergies and asthma often occur together, if your allergies trigger wheezing or shortness of breath, a controller inhaler such as a low-dose inhaled corticosteroid (for example, Budesonide) might be necessary during allergy seasons. Treating allergies aggressively can help reduce asthma flare-ups. A long-term plan includes confirming your allergen triggers with skin or blood testing, starting daily nasal steroids two to three weeks before allergy season, and considering adding Montelukast if asthma worsens with allergies. If symptoms persist, an immunotherapy consultation is advised. Use a rescue inhaler (for example, Albuterol) as needed for asthma symptoms.

Immunotherapy usually begins to show improvement within three to six months, but full benefits typically take one to two years to develop. The effects can last for years even after stopping treatment.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.