Will immunotherapy help reduce my allergy symptoms?

Question

Hello doctor,

I have been experiencing severe and constant nasal congestion, frequent sneezing fits that last 15 to 20 sneezes in a row, a clear runny nose, and intensely itchy eyes, nose, and throat for most of the year, particularly during the spring and fall allergy seasons. My symptoms are so severe and debilitating that I can not sleep at night due to complete nasal blockage. I am constantly tired and foggy during the day, and I have significant difficulty concentrating at work because of drowsiness from antihistamines and general malaise.

I wake up every morning with a thick postnasal drip, a sore, scratchy throat from mouth breathing all night, dark circles under my eyes from poor sleep quality, and swollen eyelids. I have tried multiple over-the-counter antihistamines, including Cetirizine, Loratadine, and Fexofenadine, as well as nasal corticosteroid sprays and oral decongestants. Still, they either do not provide adequate relief or cause intolerable side effects such as severe drowsiness, dry mouth, or nosebleeds.

My symptoms are triggered by tree pollen, grass pollen, ragweed, dust mites, pet dander, and mold, making it nearly impossible to avoid triggers in daily life. Could I benefit from formal allergy testing to identify specific allergens, and would allergen immunotherapy (allergy shots) help reduce my symptoms?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

You have already identified likely triggers, but formal testing confirms exactly which allergens the immune system reacts to and how strongly.

Two main types of testing:

Skin prick testing: Small drops of allergen extracts are applied to the skin, and reactions appear within 15 to 20 minutes. Quick, accurate, and inexpensive.
Serum-specific immunoglobulin E (IgE) blood testing: This is useful if there are skin conditions, if stopping antihistamines is not possible, or if certain medications are being taken. It helps pinpoint exact allergens (specific pollen types, dust mites, molds, etc.).

Formal allergy testing helps guide avoidance strategies and determine eligibility for allergen immunotherapy (AIT). Allergen immunotherapy (allergy shots or drops). Since the symptoms are severe, persistent, and poorly controlled with medication, immunotherapy is a very reasonable next step. Small, gradually increasing doses of allergens are given (via injection or sublingual drops or tablets) to retrain the immune system to tolerate them over time.

Consult an ENT (ear, nose, and throat) surgeon for further evaluation and management.

I would suggest the following measures:

Cetirizine tablet 10 milligrams, one tablet in the morning and at night for two weeks.
Beclomethasone Dipropionate and Levosalbutamol Inhaler 135/35 micrograms, two puffs in the morning and at night.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.