Allergenuity Health has chosen to provide comprehensive sublingual immunotherapy (SLIT) because it is the safest and most versatile type of disease-preventing and immune-modifying treatment currently available. Allergy shots (SCIT) and Oral Immunotherapy (OIT) also have benefits, but each has a limited scope and more risk to the patient without enough added benefit to outweigh the risks for most patients, in our opinion. Ideally, each patient would have access to each option and the best fit for your individual conditions and goals would be determined. Below is a more detailed comparison of SLIT, SCIT, and OIT so that you can think about which option may be best for you.

Sublingual immunotherapy (SLIT) has an abundance of study data and clinical evidence in support of its ability to train an immune system towards tolerance of both environmental and food allergens. Different than the other forms of immunotherapy, SLIT directly engages special immune cells in the mouth (oral Langerhans cells) that have demonstrated a preference for tolerance promotion. A reduction in medication use is generally seen over time on treatment, along with symptom relief, allergic disease improvement, and sometimes additional areas of health improvement due to the broader effects of general immune tolerance promotion. SLIT uses the FDA antigens approved for testing or injection but does not involve injections nor the pain and risks associated with that. It does not require weekly or monthly interruptions to your school or work schedule for doctor’s appointments as most of the treatment doses are taken at home. SLIT can be flexibly used to treat either one or multiple allergens at a time. It does not typically require an inconvenient rest period after each dose, and may or may not require decreasing your dose during an illness. It has a very low side effect risk profile, and anaphylaxis related to dosing is not a common concern. It can be safely used in patients with severe asthma and severe eczema with great results, though management by a physician with appropriate expertise is recommended. It is easy to do. Furthermore, SLIT drops can be used safely in pregnancy and in any age including infants and young children, which offers an incredible opportunity for allergic disease prevention. Treatment length greatly varies, but studies have shown that investing 4+ years on SLIT can not only improve your health and quality of life during treatment but can often lead to persistent results for years after treatment is stopped.

Allergy shot treatment (SCIT) has a century of evidence showing the benefits of immune modification by controlled allergen signaling. It is extremely effective at reducing the risk of anaphylaxis in those with severe venom allergy. This form of immunotherapy also uses FDA approved antigens. It typically requires weekly to monthly doctor’s appointments for injection administration and a 30 minute wait period for your safety. A reduction in medication use is generally seen over time on treatment. Injection immunotherapy is limited to only environmental allergen treatment after having proven very unsafe for food allergen treatment. There is a significant side effect risk profile including severe asthma exacerbations and anaphylaxis. It is contra-indicated in several severe allergic conditions and for patients on certain medications. It is not used in young children. In many offices, carrying 2 epinephrine auto-injectors with you for your shot appointments is required for your protection after you leave the office. Treatment length greatly varies but the average is 3-5 years on environmental allergy shots, often with persistent results for years after the treatment is stopped. Venom shots are typically carried out lifelong to maintain strong protection from potential anaphylaxis.

Oral Immunotherapy (OIT) is a newer option available in some clinics for the treatment of some food allergens. It has recently been the subject of several studies and significant research funding in the US. It is currently not FDA approved. It is typically limited to only one allergen at a time. It generally requires a long initial dose-escalation appointment and then weekly or every-2-week doctors appointments for further dose escalations. There is a significant side effect risk profile with in-office and home dosing including anaphylaxis. Having 2 epinephrine auto-injectors with you is highly advisable. A 1-2 hour activity rest period is usually required after each daily dose. Decreasing your dose is advisable during illnesses to prevent reactions. It is not used in young children. Protocols are generally set up to attempt to escalate dosages quickly to the point of tolerating a substantial amount of the allergen at a food challenge within 1-2 years, provided the dose escalations are tolerated. If the food challenge is passed, for continued protection, patients are generally advised to continue to eat a substantial amount of their allergen daily or on a regular basis, which for some is feasible and for others presents a big challenge.