If breathing in the beauty of spring trees and sprouting green induces sneezing, coughing, postnasal drip and itchy eyes, nose and throat, it’s quite likely you suffer from pollen allergies. Opting for over-the-counter allergy medications can keep those aggravating hay fever symptoms at bay but according to Daniel Todd, MD, FACS, Midwest Ear, Nose & Throat, long- term relief for hay fever and other allergic diseases can be acquired through immunotherapy. The question is – would you prefer allergy shots, drops or tablets? “Immunotherapy can reverse the allergic immune response by exposing people, over time, to small amounts of the pollen to which they are allergic, essentially desensitizing the immune system to the allergen,” Dr. Todd explains. “Subcutaneous immunotherapy is the ‘gold standard’ in desensitization. It is an excellent option for allergy patients but allergy shots are often not utilized due to inconvenience and discomfort. Treatment does require weekly allergy shots for several months, followed by monthly ones for several years. Sublingual immunotherapy (allergy drops) are taken under the tongue and like allergy shots, require a time period for treatment.” Immunotherapy receives accolades as treatment for allergic diseases, but the method of delivery continues to be a topic of discussion. Subcutaneous immunotherapy reigns as the traditional immunotherapy delivery method approved by the FDA, thus paid by insurance. Although the allergy serum is the same for shots and drops, and drops are custom-made doses for each individual’s allergy profile, the wait for oral immunotherapy approval continues. The delay affects insurance payment but fortunately, not availability. “We have been helping people with allergy drops since 2004.” Despite pending FDA approval for oral immunotherapy in the United States, immunotherapy continues to rise as a promising star in the treatment of allergic diseases. Joining the delivery methods of immunotherapy shots and drops is breaking news about the release of a tablet form of immunotherapy for allergy sufferers. “Stallergenes and ALK-Abello are the European companies that are currently entering the allergy tablet oral immunotherapy business,” Dr. Todd says. “Both companies sell allergy drops in Europe, much like we offer at our clinic. ALK-Abello has a grass-pollen pill named Grazax that is just timothy grass. Stallergenes has a grass mix pill, as well as a dust mite pill, and is working on a ragweed pill, a cedar pill and a birch tree pill. The pill is just a more convenient, marketable form of drops.” The politics amidst subcutaneous versus oral immunotherapy suggests a point to ponder. “It is interesting that we can take the same allergy serum and inject it into your subcutaneous tissue and receive payment from insurance companies,” Dr. Todd says. “But, if we put the same serum under your tongue – we do not get paid because the delivery is not FDA approved. They are different mechanisms of delivery, but the immunotherapy seems to work either way.” “Hopefully the approval of oral immunotherapy will expand its utility,” Dr. Todd adds. “It is safe with few reactions, no life threatening reports versus reports from allergy shots. Oral delivery offers convenience (as it can be taken at home), is less expensive and is much more appealing for children. Sublingual delivery seems to have similar long lasting effects (reversing or “curing” some allergic diseases), similar to shots.” Page 2 of 2Whether shots, drops or tablets, the possibility of preventing allergic disease, rather than controlling symptoms with medications, is an optimistic dose of encouragement for allergy sufferers of all ages.