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the US, but is considered ¡°off-label¡± by the FDA (like many drugs), and
clinical trials for FDA registration in the US are ongoing. Further research is
needed to fine-tune issues of effective dosing, treatment schedules, and over-
all duration of treatment.
The protocol for SLIT is simple. After a medical history and exam, tests for
allergies are done, either by a blood test or skin testing. The SLIT drops are
then started in a highly diluted form and increased daily until a maintenance
dose is achieved. Drops are continued daily, at home, usually for three years.
Relief from symptoms is often achieved in the first few months, but it takes
2-3 years for the immune system to reset enough to allow long lasting relief.
If the results are not permanent, most of the time they will last 8-10 years
before more treatment is needed.
Our clinical experience with SLIT has been excellent with patients finding
allergy relief during the first few months. And given the safety profile we are
comfortable treating children down to age 3, which is just phenomenal given
that we are giving relief to these kids while preventing asthma from develop-
ing in many of them.
SLIT is safe, easy and inexpensive, and it works! We are working with Greer
(www.greerlabs.com) and Wellness Pharmacy (www.wellnesshealth.com) to
bring SLIT to Western Colorado, offering a complete SLIT treatment program
at a cost of $100 per month, which includes necessary office visits and the
allergy drops. We also offer quick and painless testing for allergies by using
the skin-prick or blood draw methods. Put an end to allergies once and for
all, call today to get started on the under the tongue allergy drops.
* * * * *
(Scott Rollins, MD, is Board Certified with the American Board of Family
Practice and the American Board of Anti-Aging and Regenerative Medicine.
He specializes in Bioidentical Hormone Replacement for men and women,
thyroid and adrenal disorders, fibromyalgia, weight loss and other complex
medical conditions. He is founder and medical director of the Integrative
Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser
Aesthetics (www.bellezzalaser.com). Call 970.245.6911 for an appointment
or more information.)
2013 July
Pg 6 - The Sunshine Express
Stop the Sniffling and Sneezing
Are you sick and tired of allergies? Fed up with the eye drops, antihista-
mines and inhalers? Frustrated with how much you are spending each
month trying to manage the symptoms of allergies? Help is here! Under the
tongue allergy drops is the easiest and most effective treatment for allergies
and it is available now.
Immunotherapy (IT) is recognized as the only curative treatment for aller-
gies. By exposing the immune system to slowly increasing concentrations of
an allergen it will eventually stabilize and regain control of the portion that
is hypersensitive to the allergen. The exact mechanisms of how IT works
are not fully understood, but they involve shifting a patient¡¯s immune re-
sponse to an allergen from a predominantly ¡°allergic¡± T-lymphocyte (TH2)
response to a ¡°non-allergic¡± T-lymphocyte (TH1) response.
IT started in the early 1900s and was based on the idea of the vaccine
against infectious agents. Along those lines, the first IT efforts started as
injections into the skin, were found to be very effective and thus remain
the standard method of delivery. Even in those early years there was also
interest in other routes of administration, such as oral, bronchial and nasal,
but these methods were never adopted due to cost, mixed success and side
effects.
Subcutaneous immunotherapy (SCIT) is the common technique here in the
US, which requires having to go the doctor¡¯s office for weekly injections,
a procedure that is expensive, time consuming and also dangerous. In
1986 The British Committee for the Safety of Medications reported several
deaths caused by SCIT, and raised serious concerns about the safety and
the risk/benefit ratio of SCIT. About the same time cheaper and more ef-
fective drugs, such as anti-histamines and inhaled steroids, were becoming
widely available. Amidst this backdrop, the interest in non-injected immu-
notherapy increased.
Sublingual immunotherapy (SLIT) involves taking ¡°allergy drops¡± under
the tongue where the allergens are absorbed in the oral mucosa. This was
first tested by randomized controlled trial (RCT) in 1986 and confirmed to
be safe and effective. In 1990 the first pediatric study appeared, and since
then over 60 double-blind RCTs have confirmed the safety and effectiveness
of SLIT.
In recent years several meta-analyses of these studies have appeared in
numerous allergy journals, concluding that SLIT is significantly efficacious
compared with placebo for rhinitis and asthma in children and adults. In
2003 the respected Cochrane review found that SLIT was safe and effective
for treating allergies and the updated 2010 review reinforces the conclusion
that SLIT is effective for allergic rhinitis and has been proven to be a safe
route of administration.
Just this month we have another favorable review from the journal of Im-
munology that concludes ¡°SLIT is confirmed to be a viable alternative to
SCIT in the treatment of allergies, with a very favorable safety profile¡±.
With concern to safety, all clinical trials have consistently agreed that SLIT
is safe with most side effects being local and mild. Irritation in the mouth is
by far the most common reaction, occurring in as much as 75% of SLIT us-
ers. Other side effects included mostly gastrointestinal symptoms, conges-
tion of the eyes or nose, or itching, and occur in 10-20% of users. In over
20 years of use only 6 cases of anaphylaxis have been reported with SLIT,
and some of these were using non-standardized allergen extracts. In the
SLIT comprehensive review, there were no deaths or anaphylaxis events
reported.
By comparison, according to the World Allergy Organization, it is estimat-
ed that 3.4 fatal and 22.8 near fatal reactions occur every year with SCIT.
Local reactions at the injection site, such as redness, swelling, and warmth,
are common, with about 10-20% of users experiencing large (>25mm) reac-
tions. Because of the risks most doctors are not routinely treating children
Health & Nurturing
Medicine
In Harmony
by Scott Rollins, M.D.
¡°Our clinical experience with SLIT has been excellent
with patients finding allergy relief during the first
few months¡±
- Dr. Scott Rollins, M.D.
¡°Don¡¯t you remember that love, like medicine, is only
the art of encouraging nature?¡±
- Pierre Choderlos de Laclos
under the age of 12
with SCIT. This is a
shame since IT has
been shown to lower
the risk of develop-
ing asthma.
SLIT is currently
commercialized
and widely used
throughout Europe,
Asia, Australia and
South America. In a
2006 report, from the
Journal of Allergy
and Clinical Im-
munology, the US
scientific commu-
nity finally acknowl-
edged the safety and
efficacy of SLIT. The
use of SLIT is per-
fectly legal here in