Modern Allergy Treatments and How They WorkMay 9, 2014
Depending on the patient, some allergy treatments work better than others. But is there a best way to treat allergies? Dr. Kevin Wilson, an ear, nose and throat specialist, talks about modern allergy treatments and how they work. He also discusses options patients have for a wide range of allergies and their treatments.
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Interviewer: When I was young, it was the scratch test and shots. That's about the only options I had for my allergies, and they didn't work. But I guess things have changed for allergy sufferers since then, quite a bit. We're with Dr. Kevin Wilson, ear, nose, and throat specialist at the University of Utah Hospital. Tell me about some of the newer treatments for allergies. Maybe we should start with I come in with allergies. What are you going to do?
Dr. Wilson: The first thing I'll do is ask what your symptoms are because, really, the treatments are often directed at specific symptoms, and different treatments work those different symptoms. As I talk to a patient about their options, I divide treatments into three categories. The first is avoidance, or we also call it environmental control. So if you know what you're allergic to, then you can take steps to decrease exposure to those allergens and therefore reduce your symptoms. The second category is pharmacal therapy or medications. There's a wide variety of medications from nasal sprays to eye drops to pills, and they all work differently and target different symptoms. I really like to understand what the symptoms are so I can target that medication to those symptoms. The third option is something called immunotherapy, which is what you were mentioning before: allergy shots. We also offer allergy drops, which are drops under the tongue. The idea here is that we give the patient the things that they're allergic to, and over time, their body becomes desensitized to those allergens so that they stop making the allergic response or at least significantly reduce it.
Interviewer: Is there a logic to this hierarchy?
Dr. Wilson: There is. It depends on the severity of the symptoms and how much the patient is willing to invest in this treatment. Some things are relatively simple. Taking a pill can be a relatively simple thing. There are some side effects to different medications. Avoidance can sometimes be a simple thing such as by maybe taking the cat out of the bedroom and not letting it sleep next to you on the pillow or trying to keep dust down in the home. But sometimes it can be more difficult if you're allergic to grass pollen. Then, really, your option is don't go outside for two months of the year. Most patients aren't going to go for that.
Interviewer: Sure. Yeah. Understood. Have treatments gotten better over the years?
Dr. Wilson: Well, certainly, the medications have improved. In the old days, and people who are treated 20 years ago may remember how horribly tired they became with antihistamine pills. There's a new class of antihistamines that have come out since then that are not sedating or are very minimally sedating so that you can take a pill and still function throughout the day and not be sleepy and falling asleep at the computer at work.
Interviewer: Are they more effective at treating the symptoms? When I was a child, as I said, I got the shots, and I never really felt a lot of relief from those.
Dr. Wilson: Yeah. It really just depends on, again, what the symptoms are, what you're allergic to. Most people do respond to the shots or the drops. The studies show about 80 to 90 percent of people do respond to them.
Interviewer: Wow. That's pretty good.
Dr. Wilson: So you were unfortunately in that small minority, it sounds like, if you didn't respond.
Interviewer: Lucky me.
Dr. Wilson: Yeah. So most people do respond. The downside to the immunotherapy is that it is a long-term treatment. So it's typically a three to five year treatment. Obviously, that's going to require a significant commitment on that part of the patient. If their symptoms are on the mild side, they may not be willing to do that. But it's certainly a good option for those for whom the medications don't work or who continue to have a lot of symptoms with medications.
Interviewer: Tell me a story about somebody who came in suffering from allergies and how your treatment changed their life.
Dr. Wilson: Maybe I should give my own experience. I am currently on immunotherapy shots.
Interviewer: So you're on that third stage?
Dr. Wilson: Yeah. Yeah. I've been treating my own allergies my whole life with different pills and sprays, and they work OK. But they have their downsides.
Interviewer: What are some of those downsides for you?
Dr. Wilson: Well, the pills always made me sleepy. So I could function, but I was always falling asleep, even with the newer generation of antihistamines. I just wanted something more definitive. I wanted to be able to go outside and not have to worry about it. I like to ride my bike to work. I didn't want to get to work with itchy eyes every day. So I put myself on the shots basically, and life is a lot better.
Dr. Wilson: I'm a lot happier. Yeah. And I've got a whole group of patients that are doing very well and they're real happy with the treatment they're on.
Interviewer: Do you know if insurance covers these types of treatments?
Dr. Wilson: In general, it does.
Interviewer: In general it does. So what would you want an allergy sufferer to know at the end of the day?
Dr. Wilson: If your symptoms are bothersome, there is help. There's help out there.
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