Vancouver may have had its last snowfall of the season this past week but even a layer of snow sufficient for a day or two of sledding couldn’t quite cover all the new shoots of green popping up around us.  The buds are forming on many trees, and BC’s lengthy allergy season is going to start soon.

While spring and summer are eagerly awaited by most people after the dark and rainy autumn and winter months of the wet west coast, the transition to blooms can harbor doom for allergy sufferers whose immune systems overreact to various pollen in the environment.

An Ounce of Prevention

Prevention is one of the six pillars of naturopathic medicine, and an ounce of it is worth a pound of cure according to the old adage.  Since we can’t reasonably prevent pollen from erupting from plants every year we can turn our attention to re-training the immune system to ease up on its response to environmental allergens instead.

Immunotherapy is a treatment in which very low levels of antigens (compounds that trigger an allergic reaction) are introduced into the body.  Such small doses stay below the radar of the immune system so that an allergic response isn’t initiated. The constant exposure to antigens acts as a kind of “white noise” where the immune system gets used to having the allergens around and eventually learns that such antigens are not worth the overblown reaction of allergy.  After a few years of treatment it is possible to achieve desensitization where those antigens no longer cause an allergic response!

Sublingual Immunotherapy (aka.  SLIT)

There are two main forms of immunotherapy available to allergy sufferers:  allergy shots, in which antigens are injected into the body (Sub-Cutaneous Immunotherapy or SCIT), and sublingual immunotherapy/SLIT in which antigens are introduced to the immune system under the tongue on a daily basis.  

Allergy shots have been in use longer and have strong evidence for efficacy.  However, they are less convenient as they require a weekly medical appointment, and carry a greater risk of side effects1.  SLIT is a newer therapy that also demonstrates efficacy with lower risk of systemic side effects, and greater convenience to the patient as it is done at home and doesn’t require a needle (a bonus for some needle-phobic adults as well as children!)2.  Side effects of SLIT tend to be more localized, such as an itchy mouth when starting treatment or increasing the dose.  More studies are needed to compare the two head-to-head but both forms of immunotherapy are supported by the World Allergy Organization3.

Many insurance companies cover the cost of SLIT either partially or entirely.  During the course of treatment of 3-5 years progressively less allergy medication is required to treat allergy symptoms.

SLIT is a wonderful consideration for people with mixed feelings about the impending change in the seasons.  With allergy symptoms under control enjoyment of the warmth and beauty of spring and summer is within reach for allergy sufferers!

References:

  1. Nelson HS. Subcutaneous immunotherapy versus sublingual immunotherapy: which is more effective? J Allergy Clin Immunol Pract. 2014 Mar-Apr;2(2):144-9; quiz 150-1. doi: 10.1016/j.jaip.2013.11.018. PMID: 24607040.
  1. Saporta D. Efficacy of sublingual immunotherapy versus subcutaneous injection immunotherapy in allergic patients. J Environ Public Health. 2012;2012:492405. doi:10.1155/2012/492405

Canonica GW, Cox L, Pawankar R, et al. Sublingual immunotherapy: World Allergy Organization position paper 2013 update. World Allergy Organ J. 2014;7(1):6. Published 2014 Mar 28. doi:10.1186/1939-4551-7-6