Low dose antigen therapy (LDA) is my preference for any patient with multiple allergies.  Sublingual immunotherapy (SLIT) works well if you can identify a narrow range of triggers (18 per bottle) accurately, and not miss any. If triggers are numerous, SLIT gets expensive with multiple bottles, but LDA covers the entire spectrum (hundreds of antigens included at 10 to the minus 13 concentration). Patients with foods, molds, pollens, chemicals, universal reactors (sensitive to everything), people with autoimmunity (documented cures in the literature for inflammatory bowel disease, Hashimoto’s, psoriasis, tics, etc - I try it for everyone with autoimmunity).  SLIT does not treat universal reactors or chemical sensitivity, and does not have peer-reviewed data on autoimmunity. 

 

The active principle of LDA is simple:  instead of suppressing immunity or blocking other antibodies, beta-glucuronidase (an enzyme) causes antigen presenting cells to turn on T regulatory cells which brings those reactions back into balance without suppressing the rest of the immune system.  Balances, does not suppress immunity.

 

The mechanism of action is completely different from US-style “blocking antibody” shots (which are not allowed to be done in doctors’ offices in the UK due to danger and lack of efficacy). 

 

LDA generally requires one shot (intradermal, like a TB test) every two months (observing all the precautions in the pink book) the first year, once every three or so months the second, depending on response. Most are finished at 2 years. 80-90% success across the board, no deaths or serious complications in 40 years.   May require a “top up” shot every year or two for a while.  You need to do LDA for a year to be sure whether it will or will not work.

 

It is necessary to give a tapering dose of prednisone for people with skin or other anaphylactoid reactions.  (25-20-15 day of shot – 10 – 5 - 0)

 

Documentation of allergy either with testing or with unequivocal history is required.

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There is a rare adult (and maybe 5% of kids with autism, who generally get their LDA as a sublingual drop) who will have worse allergies with the first shot.  This is generally not repeated and they do well subsequently. 

 

Treatments are given every 8-10 weeks; shots cannot be given at shorter intervals as it doesn’t work.  Nothing horrible happens if you have a shot sooner, you just lose the shot and have to wait.  More information on this treatment can be found here.