HomeAnswersAllergy SpecialistallergenIs it necessary to continue allergy shots up to maintenance dose even after their side effects?

Will I get relapse if I discontinue the allergic shots maintenance dose?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At August 5, 2022
Reviewed AtDecember 19, 2023

Patient's Query

Hi doctor,

Last year I tried allergy shots for six months and quit due to developing stomach pain. I did not reach the maintenance dose. I recently restarted shots and reached eight months this time. I had stomach pain the whole time, but my allergist assured me it was safe to continue. I made it two months into the maintenance dose (seven maintenance injections). Suddenly my allergies decreased a lot, and I developed very dry sinuses. Due to all these issues, I quit shots for good last month, but my sinuses remain very dry. I have two questions:

1) Given how long I did shots, will I likely relapse and get a runny nose again, or will the decrease in allergies I am having be permanent? If I am likely to relapse, how long would it take?

2) Was it safe to get allergy shots for six months and then eight months despite them giving me constant stomach pain? Once I stopped, my stomach pain resolved. My allergist had told me to continue despite the pain every time I brought it up. But ultimately, it did not feel right to continue.

Hello,

Welcome to icliniq.com.

Can you please let us know what symptoms you were facing? For how long did you have those? What shots are you taking, as in the protein extracts of which allergen? Were you explained about sublingual immunotherapy? Most likely, you will have a relapse. But it may not be immediate. With the above details, I will be able to provide more insights.

Thank you.

Patient's Query

Hello doctor,

Thank you for the response.

The main symptom I am having is very dry sinuses. It started about four to six weeks after starting my maintenance dose. I stopped having a runny nose and had fewer reactions from allergens, but my sinuses became very dry. I also had sharp stomach pain while doing allergy shots. My allergist thought it was not related to the shots, but my stomach felt much better after stopping shots, so I think there may have been some relation. I can find the information about the shots and extracts of which allergens. Should I send the medical records I have about them? I can request those. I asked about sublingual immunotherapy but was told it was not available at my allergy clinic, unfortunately.

Hi,

Welcome back to icliniq.com.

I would need the names of allergen extracts (allergens) to which you were given immunotherapy. Yes, please send the medical records. I understood what symptoms you faced with the immunotherapy - dry sinuses and stomach pain, possibly a side effect of subcutaneous immunotherapy. But did the stomach pain have any relation with the time of taking the injections? Was the pain on and off or constantly present? Was it getting relieved with antacids? Regarding dry sinuses, did you try nasal rinsing and douching to keep them moist? Steam? Along with the shots, did you use any nasal sprays? If so, which one? I want more details on the symptoms of the allergy for which you started the shots. Which allergy test was done, and what was the report. You were sensitive to which substances? I practice sublingual immunotherapy and have excellent results in my patients. Moreover, the side effects are practically nil, and everyone completes the full course.

Thank you.

Patient's Query

Hi,

Thank you doctor for the reply,

I have attached records of allergen extracts and my allergy test results. I have also attached additional notes about the shots (schedule, duration, etc.). Please let me know if you need additional records or information. I usually feel acidity in my stomach within a few minutes of taking a shot. The pain would be relieved by taking Omeprazole 40 to 80 mg or Pepcid 20 to 40 mg daily. I have tried nasal rinsing and steam for my dry sinuses, but my problem persists. I have had some benefits from using oils or vaseline, but not too much.

My main questions are:

  1. Are my allergies likely to relapse? If so, how long will it take to relapse? Will my allergies eventually have the same intensity as before?
  2. Can the shots or dosages I was given cause dry sinuses?

Hello,

Welcome back to icliniq.com.

From the attached images (attachments removed to protect the patient's identity), it appears that you have reached the maintenance dose of 0.5 mL of 1:1 dilution and took five such injections. Ideally, we must keep giving you the maintenance dose for a few years. Your allergies may relapse in a few years. Moreover, the benefits you have achieved now will not be the actual benefits you will attain after the completion of the course. You will find more improvement after the full course. Over time the allergies may attain the same intensity as before. However, there is a good chance that you will have some form of immunity even after this towards those allergens. If you manage to avoid those allergens and practice various precautions, this may be enough to lead a symptom-free life.

Patient's Query

Thank you doctor for the reply,

I can send you my CT scan results also. I had sinus surgery two years ago. I see that even though I stopped allergy shots after five maintenance injections over eight months, is it still likely to take years for my allergies to return? They are not likely to return in a few months or one year at a similar intensity.

Hello,

Welcome back to icliniq.com.

Regarding the return of the symptoms, we cannot be very sure. The course is not complete. In some patients, the course is for three years. Some may even need periodic boosters every few years.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Shyam Kalyan. N
Dr. Shyam Kalyan. N

Otolaryngology (E.N.T)

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