Question:
I have been on and off allergy shots 3 times now, over the
last 6 years.
I am allergic to dust and dog dander (and have plenty of
both in my house-although I do all the typical avoidence things).
I was on shots for 2 years, seemed to do fine, got off them.
Started having problems and got back on shots for another
2 years and did fine up till about 3 months before I quit. Seemed
I was getting sick all the time (sinus, asthma, cough, etc.) so I quit
the shots.
TMALSS, I have been off shots for about 4 months and decided
to give them "one more try" and retested and started this week.
Funny thing is, I immediately started feeling bad. Whistling nose, low
grade cough, chest tightness, trouble breathing, and wheezing
slightly.
Could this be my imagination. I guess I could be getting "triggered"
by a number of things and just misinterpreting it since starting the
shots are the only thing I can "visibly" relate to.
Since allergy shots are of such a low dose, is it *at all* feasible
that the fact that they are injecting you with your particular
allergen *cause* you to have symptoms?
Answer:
The theory behind shots is that they cause low-dose tolerance, and,
eventually, habituation. However, if the dose in the shot is too high
for your tolerance [and adding more allergens to your system, which is
already exposed, this may very well be the case], they can cause the
problem they are supposed to prevent. So, no, it isn't your imagination;
and, yes, you need to discuss it with your allergist. Allergy shots contain the allergens that can trigger your asthma.
A high dose can cause an anaphylactic reaction; that's why they tell
you to wait in the office after the shots. If you get anaphylaxis
(shock and low breathing response), they will inject you with epinephrine. It happened to me once; but 90 minutes after I left office. I drove back
and my Peak Flow had dropped to 20% (<100 L/min) Got 1 shot each of fast
acting and long acting epi. After this episode, my shots strength was cut
in half; also I was required to do a Peak Flow test before shots. If I
wasn't at least 90% PB, no shot that day.
NEVER GET SHOTS IF YOUR PEAK FLOW IS DOWN.
But even normal shots can cause some asthma symptoms for 24 hr after shots;
I was told not to exercise vigorously before or for 24 hr after shots.
I had shots for 5 yr for dust mites, grass pollen, etc. Not sure how
much good it did.
Go to:http://www.ncbi.nlm.nih.gov/PubMed/
And look it up. Allergy shots seem to work for some people but not for others. There have
been scientific trials for safety and effectivness (otherwise they
wouldn't be allowed in the US).
You could be reacting to the phenol used as a preservative or to the glycerine.
A small group of doctors exist who can help you with phenol-free allergy shots.
Try writing to Pan American Allergy Society
FAX: (210) 997-8625
for a doctor in your area.
My asthma symptoms have improved since I took shots, I just don't know
how much to attribute to the shots since I also changed meds (now use
Serevent instead of regular dose of Ventolin, plus low dose TheoDur and
Double Strength Vanceril 4-5 pf/day [was 16 pf/day Azmacort]) Also
learned how to better manage the asthma using a Peak Flow Meter and
Action Plan. I have a combination of allergic and nonallergic adult
onset asthma, so shots can only help the allergic component.
I think that if shots don't help after a couple of years its not worth
continuing. I was never retested during the 5 yr, so have no scientic
way of knowing if they reduced allergies. Dr. Plaut, in his book on
Children with Asthma, says he only recommends shots to 10% of his
asthma patients.
I had shots once/month for 5 yr. I think cost of the shots was around
$25/month (1 shot in each arm, 1 was standard mix, other special mix)
HMO pickup cost of shots, I paid for serum, which was fairly cheap.
If I missed a monthly shot, they reduced dose of next shot, then had
to work my way back up. Shots are a hassle.
Allergy shots seem to work better for those with hayfever than those
with asthma (I do have mild hayfever, seasonal symptoms seem to have
reduced but perenial symptoms seem to have increased)
I want to try one of the new antileuketrienne drugs. Possibly Accolate,
although if Singulair is about to be released that would be preferable
since its a once/day pill (Accolate is twice/day on empty stomach)
Its supposed to help upper and lower allergic symptoms; is very
useful to those with the 'Triad' asthma (with aspirin sensitivity)
Here's a link from Mayo Clinic on allergy shots:
http://www.mayohealth.org/mayo/9606/htm/9606up_2.htm
