Louisville allergists offer alternative to allergy shots


by Alex Schuman


Posted on May 12, 2014 at 11:56 PM

Updated Tuesday, May 13 at 5:45 AM

LOUISVILLE, Ky. (WHAS11) – "I was that kid who had the tissue stuffed up their sleeve," Jasmine Herren said.

Herren’s old allergy test would show severe reactions to grass, trees and ragweed. 

“Sometimes I would take time off from school,” she said.  “But sometimes I would come home from school and put cold compresses on my eyes.  My eyes were just that itchy."

Herren is just one of the thousands in the Ohio River Valley who suffer each spring and fall.  But, Herren does not suffer much anymore.

"I'm outside right now.  Three years ago I would not be able to be able to outside right now and having this conversation,” she said.  “I would be holding a tissue to my face."

She can now actually enjoy her yard thanks to a method rarely used in the United States.

"I would say the vast majority of people do not know about drops,” Dr. Brian Hawkins of Community Ear Nose Throat & Allergy said.

One of Hawkins’ partners at the ENT clinic wanted to start offering something called allergy drops back in 2006.

"I was quite skeptical," Hawkins said.

The idea is very similar to an allergy shot.  When a doctor gives you a shot they are injecting a mixture of what your body allergic to, they then give you more and more of the allergen as you come back with the aim of building up your immunity.

This same principal is used for drops, but instead of injecting the allergen you take a drop or two under your tongue.  The area below the tongue is considered extra absorbent.

"It kind of itches the first time,” Herren said.  “Under my tongue was getting very, very itchy."

You still get a regular allergy test.  The doctor then mixes the antigens to fit that specific person and give you the vile to take home. 

The treatment period usually takes several years.  Herren is in her third.

“It’s something I can do at home by myself – on my schedule,” Herren said.

“Over the past eight years I’ve seen it work,” Dr. Hawkins said.  “I’m pretty convinced it’s a good method for immunotherapy.”

Allergists do offer the drops but traditionally rely on methods more studies support.

 “They may not have the same degree of efficacy that tried and true subcutaneous shots have," Doug Lots, an allergist for Family Allergy and Asthma said.

The drops are also not FDA approved, but the antigen or liquid used to make drops, are the same FDA approved antigens used in shots.  Doctors still can give them patients as an  "off-label." treatment. 

"The lack of FDA approval doesn't mean that they're not safe,” Lotz said.  “The FDA approval if anything translates into an inability for things to be covered by insurance."

Without insurance patients have to pay out of pocket, which can cost hundreds of dollars. 

"The discussion usually turns from a pleasant surprise to disappointment," Hawkins said.

According to a 2013 review from Johns Hopkins, the allergy drops are safe and do not have any life-threatening incidents, but the review also shows they only found, "moderate," improvements for allergy drop users. The review noted more studies must be done.

“I think the jury is still out to some degree,” Lotz said.

Hawkins offers patients both drops and shots.  He said he believes if you add up the co-pays, cost in time, and gas, the drops end up being not much more expensive.

"There are always going to be risks with anything new,” Herren said. “The FDA wants to make sure they've charted every possibility first before they go through.  My allergies were severe enough that I wanted to try anything that was possible."