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March 2010: Sublingual (Under the Tongue) Immunotherapy

25 Feb 2010

Dr. Janaki Emani is an Ear, Nose and Throat specialist/Otolaryngologist at Lakefront Medical Associates, located at Weiss Memorial Hospital. She has a special interest in allergy, nasal/sinus, otology, and head and neck surgery.

Dr. Janaki Emani
ENT/Otolaryngologist
Lakefront Medical Associates
Weiss Memorial Hospital
(773) 564-5355

Many people suffer with allergies because of the inconvenience of taking the day off to go to a physician’s office or because of a fear of needles. For these people there is another option, available at Weiss Memorial Hospital. Instead of regular allergy shots and needles, this self-administered alternative comes in the form of droplets, which are put under the tongue three times daily.

Allergy shots versus allergy drops
The biggest difference between droplets and shots is that patients who use the droplets don’t need a physician to administer them. The patient dispenses the droplets, without having to make a trip to the physician’s office, making it a convenient alternative.

During the summer of 2009, I became the first physician in Chicago to offer sublingual (under the tongue) immunotherapy. The droplets are formulated to each patient’s specific needs. For example, if patients have a pollen allergy, the droplets contain a pollen extract. Though purified and filtered, the substance itself is being placed under the tongue.

Allergies occur when cells misinterpret certain elements such as pollen, grass or animal fur as harmful, and signal the immune system to attack. However, curative therapies such as shots and droplets applied regularly and over long periods of time can teach the body not to respond to allergens.

Because the patient receives the allergens multiple times a day, the doses are smaller than with once-weekly shots, lessening the risk of a severe reaction such as anaphylactic shock.

The history of sublingual immunotherapy
The practice originated in Wisconsin 40 years ago. Europeans use it too—in the form of a dissolvable tablet that patients place under the tongue to combat grass allergies. Still, some insurance companies do not recognize the droplets as an insurable form of treatment, but the cost ends up being the same as for shots because patients don’t make weekly office co-pays.

The idea behind this form of treatment dates back to ancient medicinal practices common among Native Americans and the Chinese, who would chew on substances to which they had a systemic reaction. Some Native Americans, for example, hunted in areas heavy with poison ivy and would place small amounts of the plant in their mouths at night. Over time, their reactions to it decreased.

For more information
If you would like more information about sublingual immunotherapy, or would like an appointment, please call Dr. Emani’s office at (773) 564-5355.