Allergies and Allergy Shots

What is Allergy?


Allergy is a condition, often inherited, in which the immune system of the affected person reacts to something that is either eaten, touched, or inhaled that doesn’t affect most other people. The patient’s immune system overreacts to this substance as if it were an “enemy invader” (like a virus). This reaction leads to symptoms that often adversely affect the patient’s work, play, rest, and overall quality of life.


Allergens cause Allergies


Any substance that triggers an allergic reaction is called an allergen. Allergens “invade” the body by being inhaled, swallowed or injected, or they may be absorbed through the skin. Common allergens include pollen, dust, and mold.


How common are Allergies?


Allergies are among the nation’s most common and costly health problems. They affect as many as one in four people. More than 50 million Americans have allergic rhinitis. The yearly sales of antihistamines, decongestants, nasal cromolyn and nasal corticosteroids now exceed $5 billion.


What happens during an Allergic Reaction?


The immune system reacts to an allergen that has entered the body as if it were an “enemy invader” (like a virus). It produces special antibodies capable of recognizing this same allergen when it enters the body at another time. When the allergen again enters the body, the immune system rapidly recognizes it, causing a series of reactions. These reactions often involve cellular destruction, blood vessel dilation, and production of many inflammatory chemicals including histamine. Histamine produces some of the more common allergy symptoms such as sneezing, scratchy throat, hives, and shortness of breath.


What are the Symptoms of Ear, Nose, and Throat Allergies?


People often think of allergy as only “hay fever,” with sneezing, runny nose, nasal stuffiness and itchy, watery eyes. However, allergies can also cause symptoms such as chronic “sinus” problems, excess nasal and throat drainage (post nasal drip), head congestion, frequent “colds,” hoarse voice, eczema (skin allergies), recurring ear infections, hearing loss, dizziness, chronic cough and asthma. Even stomach and intestinal problems as well as excessive fatigue can be symptoms of allergy.


Symptoms of ear, nose, and throat allergies may include:


  • Repeated sneezing
  • Nasal itching and rubbing
  • Difficulty breathing through the nose
  • Runny nose
  • Dark circles under the eyes
  • Crease across bridge of nose
  • Frequent throat clearing
  • Mouth breathing
  • Diminished/ lost sense of smell/taste
  • Recurrent, unexplained nosebleeds
  • Recurrent ear infections
  • Recurrent sinus infections
  • Fluctuating hearing loss
  • Cold-like symptoms more than 10 days
  • Symptoms recur same time each year
  • Chronic fatigue
  • Symptoms can range from minor to severe.



The greater the frequency and/or amount of exposure, the greater the chance that the susceptible person will develop an allergic problem that will require treatment.



Can Allergy Change with Time?


Yes. It is common for symptoms to change over time. For example, a baby may develop colic, ear infections, or have eczema but as the baby grows older, he/she may develop different symptoms such as hay fever, asthma, or recurrent sinusitis.


Research has also shown that a small percentage of allergic people will outgrow their allergies with time.



Allergy Treatment 


Treatment for allergies may include avoidance (which is often impractical) and medical treatment with antihistamines, leukotriene blockers, nasal steroids, nasal antihistamines, and other medications. If avoidance and medical treatment are unsuccessful, allergy tests and allergy shots may be recommended.



Allergy Testing


Skin prick testing is often performed to diagnose allergy. A small amount of the allergy particle (allergen) is applied to the skin. A small bump will result in an allergic patient.


Another skin test, called an intradermal test, involves injecting a small amount of allergen into the arm or back. It is a very accurate test and is sometimes used if the skin prick test is negative.


Blood testing is also accurate and can be used to definitively diagnose allergy. Although the results are not immediately available like skin tests, blood tests only require one sample of blood, and is often used in children.




Allergy shots (immunotherapy) are given to patients who have evidence of positive reactions on skin or blood tests. The dose of the allergy shots are based on the results of the tests. Injections are usually given once a week and may be continued for 3 to 5 years to obtain best results. Over time, allergy shots actually make the patient’s immune system less allergic.


Sublingual immunotherapy (SLIT) involves applying the allergen under the tongue and then swallowing it. Recent research has shown it to be beneficial in controlling allergy symptoms. The obvious advantage is the patient does not receive an injection. Unfortunately, at this time, insurance companies do not cover sublingual drops. (It is becoming more popular with patients with high deductibles).



The doctors at Head & Neck Surgical Associates are board certified in Otolaryngology (Ears – Nose – Throat) and Head & Neck Surgery. Physicians at HNSA have passed additional written and oral exams to become board certified in allergy treatment also by the American Association of Otolaryngic Allergy.






What is Food Allergy?


Allergies can also develop from the overreaction of your immune system to foods. This will lead to the unwanted symptoms associated with allergic inflammation.


However, not all adverse reactions after eating food are due to allergy. They can be from simple over eating. Also, food that has spoiled can easily be contaminated with bacteria that can result in food poisoning; foods that contain chemicals such as caffeine, tyramine (red wine), and histamine (strawberries) can also cause non-allergic reactions.


An allergic reaction to a food, on the other hand, involves the immune system, and occurs when the immune system distinguishes the foods’ surface architecture as being different from normal body tissues. It then triggers a sequence of allergy inflammation events leading to unwanted symptoms.


Different types of Food Allergies and Food Allergy Symptoms


Immediate-Type Food Allergies


Immediate-type food reactions, sometimes called fixed food reactions, are not very common. Even so, they attract the most attention because they cause rapid and sometimes very dramatic reactions. Breaking out in hives and itching or serious swelling of the tongue and throat soon after eating shellfish, peanuts, or garlic, are typical examples of immediate food reactions. The best treatment for this type of food allergy is complete elimination of the offending food from the diet.


Delayed-Type Food Allergies


Delayed-type food reactions, sometimes called cyclic or hidden food allergies, are the most common food allergy. However, unlike immediate food reactions, the connection between the causative food and the symptoms is more difficult to pinpoint—thus the term “hidden” food allergies. This is because the typical symptoms from a delayed food allergy are slow to develop because repeated exposures to the food over a long time are required. Also, the symptoms are not so dramatic; they are usually slow to develop, chronic, and lingering. Headaches, runny nose, ear pressure, cough, and eczema are some examples of these symptoms.


Delayed food allergies occasionally contribute to symptom production in persons with longstanding ear, nose, and throat complaints, such as ear or sinus infections, chronic voice or throat problems, eczema, hives, migraine, and asthma. These symptoms may also occur in people who do not have allergies, thus making it important to obtain a precise diagnosis.


To further complicate things, the types of food that cause delayed allergies are commonly included in just about everyone’s diet—milk, wheat, corn egg, soy to name a few.


Food allergies are often difficult to diagnose because unlike testing for inhaled allergens, food allergy testing is not as accurate. However, food allergy testing is often helpful to diagnose illness, but the results must be carefully reviewed by your doctor.




Associated Treatments