Sublingual Immunotherapy (SLIT)

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Sublingual Immunotherapy (SLIT) is a process in which an allergic patient can become desensitized to pollens and other inhalant allergens like molds and pets, and foods that trigger allergic rhinitis (nasal congestion), allergic conjunctivitis (itchy, teary eyes), asthma, eczema and other allergic conditions. Small doses of the actual allergic substance are placed under the tongue daily, and the dose is gradually increased each week until a “maintenance” dosage is achieved. A protective antibody, Immunoglobulin G, is gradually formed to block the allergic reaction. Improvement induced by SLIT is gradual. Many patients notice an improvement within the first 3 months. Progress is evaluated every 3 to 6 months.

How Long Should Someone Receive Immunotherapy?

A two year period is adequate to assess the treatment. Once maintenance full dose therapy has been achieved, one should notice a significant improvement in symptoms. At year 3 or 4 a trial discontinuing vaccine therapy can be considered. After SLIT is stopped, symptoms may return at a rate of 20% the first year, 30% the second, and up to 40% after three or more years. With food allergies the relapse rate is variable due to their nature. (Milk and egg food allergies are usually outgrown, nut are rarely outgrown.)

Who Might Consider SLIT?

SLIT is recommended for patients with significant allergies, including seasonal allergies (hay fever), or chronic allergies (mite, pet, or mold). When these allergies result in 1) bothersome symptoms, 2) frequent upper respiratory infections (sinusitis), 4) eczema, 5) sinus headaches, 6) food allergies, 7) asthma, 8) require an “excess” of medications such as daily medication for control then SLIT is usually helpful.

How is Allergy Diagnosed?

Allergy skin tests are used to confirm there indeed are allergies and to define exactly which allergens are involved. For over 75 years allergy skin testing has been the best method of identifying allergens.

Immunotherapy and Pregnancy

SLIT is usually not started for a woman during pregnancy, only because of the malpractice climate, though there is no medical reason not to do so. If a woman has been receiving SLIT and becomes pregnant, she may safely continue SLIT during the pregnancy. SLIT has been used for 35 years and does not harm the baby.

Reactions to SLIT

Unlike with allergy shots, there is virtually no risk of a severe life threatening allergic reaction. Reactions are infrequent. The most common reaction is localized mouth and/or tongue itching. If this happens you may be advised to adjust your dose and/or take an antihistamine (allergy pill) daily.

A publication of the American College of Allergy, Asthma and Immunology, the March-April 2005 issue, concluded that SLIT is a safer treatment than conventional allergy shots that significantly reduces symptoms and medication requirements.

Allergy Seasons
Trees	Spring	Mites	Year round but worse Spring, Fall
Grasses	June thru Aug	Dog and cat	Year round but worse Spring, Fall, Winter
Ragweed	Mid-Aug thru Oct	Mold spores	worse Spring, Summer, Fall

SLIT is a self-pay service that is not covered by most health insurance companies. Generally you will start with three 7.5cc SLIT dropper bottles at $30.00 each, a one (1) month supply. Later, one or more 15cc dropper bottles at $60.00 each, a two (2) month supply. There is a one time $25.00 instruction / demonstration fee when you pick up your first dropper bottles, payment for all is to be rendered at time of service. If for any reason, once your SLIT has been ordered you do not wish to follow through with your treatment, you will be billed for the cost of the dropper bottles.