One of the most important hallmarks of the La Crosse Method™ Protocol is the custom, patient-tailored approach to treating allergy. Each sublingual immunotherapy (SLIT) prescription is created based on specific test results, exam and patient history. No two patients are the same, and neither are the allergy drops following this protocol.
Because of this personalized approach and frequent retesting, it’s a suitable treatment option for most allergic patients, even those who have been told “no” from other treatment measures. Allergy shots have traditionally been used to treat the cause of allergy in the United States, but certain populations are firmly restricted from receiving this treatment.
Dr. Mary Morris, Allergychoices’ Medical Advisor, partner at Allergy Associates of La Crosse and a lead author of the La Crosse Method Protocol helps explain three populations that are excluded from allergy shot treatment that could likely benefit from SLIT, also known as allergy drops.
Those who are “too allergic”
Many individuals who test highly to their allergens may be turned away from other allergy treatment options because they are “too allergic.” Because allergy drops following the La Crosse Method Protocol are tailored to match each individual’s unique allergies and level of sensitivity, allergy at most any level can be treated safely.
Dr. Morris explains that repeat allergy testing makes allergy drops a safer option for those who are highly allergic, “We recommend retesting often to see if the patient is improving. With allergy shots, it’s typically a set escalation with no testing in between increases.”
“With injections, typically you won’t know if the dose is too much until a reaction occurs, and then they may decrease the dose,” Dr. Morris says. Allergy treatment following the La Crosse Method is flexible. If tests show that the patient needs to slow down escalation, it can be done simply, without the added risk for severe reaction.
Children under 6 years old
If Dr. Morris could broadcast a message to everyone, she says she would use the opportunity to explain that while allergy shots are typically not permitted for children under 6 years old, allergy drops are a safe option.
Why are children not allowed to have allergy shots?
“I don’t think children have higher rates of reactions with shots. The worry is that if they may have a reaction and it isn’t recognized,” Dr. Morris explains. “The criteria in America states that the child has to be old enough to tell you that they’re developing symptoms. They have to be old enough to recognize their throat is feeling tight, or that they are having problems breathing.”
SLIT is safe for children because it’s highly personalized and testing is done often to determine progression of tolerance. Additionally, administration under the tongue is safer because the specialized dendritic cells default to allergic tolerance. The area under the tongue has the highest concentration of allergen presenting cells found anywhere in the body. By lowering the allergic threshold in children, they are less likely to develop additional allergic conditions as they grow. This is called the allergic march, which studies have shown is slowed, and perhaps even halted, when allergy is treated early.
“We’re missing such a golden opportunity in those precious years if not doing immunotherapy, that by the age of six, we’ve missed the opportunity for prevention of asthma, we’ve missed our opportunity for decreasing risk of new allergy development, we’ve perhaps unnecessarily restricted a diet for four or five years,” Dr. Morris says. “That is the number one place in which I think, you have no other option for immunotherapy, why would you not do sublingual immunotherapy in that patient population?”
One bonus of allergy drops that children notice is the ability to treat their allergies without painful injections. Since allergy drops can be taken from wherever you are, they fit into the busy schedule of just about every child.
Patients with uncontrolled asthma
One of the firmest restrictions for allergy shot therapy is uncontrolled asthma, due to what can be a fatal combination with severe allergic reactions. Dr. Morris explains, “The practice parameters are very clear for injection immunotherapy that those who have unstable asthma aren’t candidates for injection immunotherapy. Of the deaths that have happened due to injection immunotherapy, the biggest risk factor was unstable asthma.”
Due to the possibility of life threatening reactions due to the combination of asthma and allergy, shots are typically not an option. Even those with mild to moderate asthma have to be monitored. “A lot of practices now make patients do a pulmonary function test every time they come to get shots to make sure they’re not impaired, which has actually been a good thing because the number of deaths dropped because of that guideline,” Dr. Morris explains.
SLIT is an option for those with asthma and over time, many with allergy-related asthma see a decrease in asthma symptoms, too.
Treating allergies with allergy drops can be a safe, effective, and affordable option. If your health conditions count you out for other allergy treatment measures, consider asking your provider if allergy drops following the La Crosse Method might be an option.
By Taylor Pasell, Allergychoices