Laurie Menk Otto, ND, MPH

Naturopathic Medicine | Portland, Oregon

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Immunotherapy FAQs

What is sublingual immunotherapy?

Sublingual immunotherapy (SLIT) is a treatment for hay fever type allergies. Allergen extracts containing antigen are mixed with glycerin and delivered in drops under the tongue. The formulation is specific to your allergy test results and symptom picture. Over time, use of SLIT results in a decreased sensitivity to the allergen, decreased symptom severity, and decreased medication use when exposed to the allergens in the environment to which you are sensitive.

What is an antigen?

An antigen is the substance that causes your body to react and cause hay fever type reactions such as runny nose, sneezing, watery eyes, and nasal congestion.

How is it different from allergy shots?

SLIT works in a similar way to allergy shots, and use the same FDA-approved antigens, but the route of administration is drops under the tongue rather than shots.

What kind of allergies are treated with allergy drops?

At our clinic, allergy to tree, grass and weed pollens, animals, dust, and mold are treated using SLIT. Your exact prescription is determined based upon the results of your allergy test. Allergy to foods are also treated with SLIT but we do not offer that at this time. SLIT can treat allergy to multiple antigens at the same time.

Who should take allergy drops?

Some people may choose allergy drops over shots due to the convenience of in home administration, fewer doctor’s office visits, the increased safety profile, or if they don’t respond well to or tolerate shots well. Young children, people with asthma, highly sensitive people, and people with multiple allergies may choose to treat their allergies with SLIT rather than allergy shots. SLIT has not been shown to be more effective than shots, but does have distinct advantages for some people.

Are allergy drops safe? Are there studies that evaluate their effectiveness?

SLIT has been used in other countries for many years, and studies document their safety and effectiveness. The World Health Organization has endorsed SLIT as a viable alternative to allergy shots. The Cochrane Collaboration, which is the world’s most trusted international organization dedicated to reviewing health care treatment, concluded that allergy drop immunotherapy (SLIT) significantly reduced allergy symptoms and use of allergy medications.

What are the advantages of allergy drops?

SLIT is a viable allergy treatment for people of all ages.

Lower cost and fewer clinic visits when compared with allergy shots. Rather than having weekly appointments for allergy shots, people receiving SLIT have less frequent visits to the doctor’s office and therefore less copay.

Convenience. After the first dose, you can take allergy drops in your own home or wherever you are, which makes it easier to stay consistent with treatment.

Less medication. Research has shown that patients typically need less medication to control symptoms during and after using SLIT. This is less money out of pocket for medication.

Will medical insurance cover the costs?

At this time, most insurance companies cover the cost of diagnostic allergy testing and office visits. However, because allergy drops are an off-label use, they are not covered by insurance. Allergy drops do qualify for HSA or flex spending reimbursement.

How long will I need to take allergy drops?

Most often, SLIT will be prescribed for 2-5 years, after which point the need for it will be reassessed. Benefits are often felt within in the first few months, with some variance among individuals. For the greatest symptom control (no reaction to what causes your allergy symptoms) 2-5 years is generally recommended. Please be aware that SLIT is intended for long-term use, and if discontinued early, benefits may not be experienced.