Allergy Drops Erase 30 Years of Suffering for MD

Dr. Leiken, who has suffered from allergies for over 30 years, stands in front of an Olive tree in his backyard. Since he’s been taking allergy drops, the Olive tree no longer triggers his symptoms.

In the past, AllerVision’s blog has featured Dr. Dean Mitchell sharing his wisdom from many years of running an allergy practice. In this and future posts, we’ll be looking at allergies from the patients’ and other providers’ points of view.  

I am a physician who has been suffering from allergies for over 30 years. Five years ago, I started to give AllerVision’s allergy drops a try and have had excellent results.

Before I started using the drops, I had severe hay fever symptoms sporadically throughout the year but much more intensely between November and May. I often had sinus infections and my nose was stopped up a good deal of that time. Often I would sneeze many times in a row. Over the past 25-30 years, I tried various methods to deal with my allergies. I received shots from an allergist; it seemed to help for a time but after a couple of years I received less and less benefit. That treatment was costly and time consuming. In later years, I tried acupuncture. That also helped for a time and then lost its effectiveness. 

I suffered without any sort of treatment for quite a while until I began taking the drops. Within about three months I noticed a remarkable change in my hay fever symptoms. The most obvious improvement was that I was able to go into my backyard where there is an olive tree that never failed to cause an allergic reaction. I was even able to sit under the tree with no symptoms! Over these five past years that I’ve been taking the drops, there has been just one occasion where I experienced severe allergic symptoms; a nasal cortisone inhaler solved the problem in that situation. 

Unlike the other treatments, I have not found any noticeable diminishing effect of the AllerVision drops.They have been a major help to me over these years. I also appreciate the fact that I don’t have to go to an allergist each week for shots and I don’t have to wait in his office for a half hour to see if I develop an anaphylactic reaction. And I don’t have to make a weekly co-payment.

In short, as a long-time allergy sufferer, I can very highly recommend AllerVision drops.

Dr. Stanley Leiken, MD

(Disclosure: Dr. Leiken is the father of AllerVision co-founder Jennifer Robb and an investor in the company. His comments above, and his investment, are based on his success with the treatment.) 

The Important Difference Between Clinical Allergy and Allergy Sensitization

A doctor’s review of patients’ medical history is as important as skin test results in diagnosing clinical allergies.

I’m sure you have patients come into your office and say: “I was once tested by an allergist and told I was allergic to everything green!” I’m  always dismayed when I hear that patients were given results in this manner. Almost no one is allergic to “everything green.” Patients may be sensitized to multiple allergens but most likely they’re not allergic to them all. Making the distinction between clinical allergy and allergy sensitization requires the doctor to study each patient’s health history in conjunction with allergy test results.

Let’s demonstrate with a food allergy example… A patient visited my office and told me that he attended a party and ate a piece of cake. Within 15 minutes, he developed hives (urticarial) all over his body. He wasn’t sure what was in the cake but was worried about what he should avoid in the future. I tested him and the results showed a positive for tree nuts — walnuts, cashews and pistachios. The skin tests also showed positive for milk and eggs, but he told me that he eats eggs and drinks milk all the time without a problem. We found out that the cake contained walnuts, so I diagnosed him with walnut and tree nut allergy. I explained that his positive allergy tests to egg and milk demonstrated that he has allergic sensitization to the raw pure proteins in those foods, but, with no clinical complaints, he can still continue to eat them.

Here is another example of a potentially confusing situation that you may encounter using the AllerVision skin testing panels: you test a patient and find she is allergic to several tree pollens, grass pollens and ragweed pollen. The patient’s history says she only has symptoms in the spring — from March until June. She has no symptoms in the fall. My assessment would be that she has clinical allergy to the spring pollens, trees and grasses, and allergic sensitization to ragweed. This distinction becomes important not just in educating the patient, but in determining the patient’s course of immunotherapy. In this case, you might decide to treat the patient for the trees and grasses but leave the weeds out of the equation.

The allergy world is buzzing with research on diagnostic techniques to delineate clinical allergies more clearly. One company is working on a blood test that involves Resolve Component Testing. That measures a protein called Ara h2 — highly specific for peanut allergy. Preliminary studies indicate 95% accuracy. In the meantime, don’t forget the importance of clinical history in conducting the “detective work” required to distinguish clinical allergy from allergy sensitization. And remember that, as always, the AllerVision clinical team is available to work with you and discuss your cases any time you have questions.

Dr. Dean Mitchell

The Late Summer Breezes Send Ragweed Pollen Flying

Ragweed spreads widespread misery in late Summer.

We’re approaching summer’s finish line and we all want to soak up as much sun and fun as possible before the weather turns chilly. Unfortunately, in addition to marking the end of summer, August hails the beginning of the ragweed pollen season. Ragweed allergy, classically known as Hay Fever, is recognized by allergy suffers far and wide as the “summer cold” that lasts through Labor Day — and sometimes beyond.

I have vivid memories of my father suffering from Hay Fever. I was 10 years old and hopeful that my dad would play catch with me when he got home from work. But one look at his red nose and watery eyes and I knew I’d have to wait for another day… or another season. My father would head straight to his bedroom where he would turn on the air-conditioner and close the door. When my dad stayed outside for an extended period, he had to “pop” Spantial, an ornate combination of sedating antihistamine and decongestant. That helped the symptoms but he struggled to stay awake with the old-fashioned antihistamine, and fought agitation from the decongestant. We’ve come a long way since my childhood in the 70s.

Today, state-of the-art symptom control treatment is available to provide relief for ragweed allergy sufferers but a well-planned approach to treatment is necessary. That means starting a program several weeks before ragweed season peaks. For appropriate candidates, I recommend Nasalcrom spray twice daily starting in early August. This allows time to build up the necessary protection. Nasalcrom is composed of cromolyn sodium, a mast cell inhibitor, and it is extremely safe with virtually no side effects. However, early prophylactic use is the key to success since it takes several weeks to reach effective levels. This is in contrast to steroid nasal sprays which work immediately but, if used for long periods, can have adverse effects.

The new exciting breakthrough in treating Hay Fever is sublingual immunotherapy. The FDA has recently approved Ragwitek, the  pharmaceutical-grade sublingual tablet to treat ragweed allergy. The medical studies have shown the efficacy of this product and validated the benefit of sublingual immunotherapy. My concern is that this product is only available as a high dose tablet without the build-up recommended for desensitizing patients to allergens. 50% of patients had adverse reactions to Ragwitek — such as sublingual irritation from the tablet, itchy throat, sneezing and nasal congestion. Also, Ragwitek is approved only for adults 18 years and older. Since the tablet treats only ragweed allergy, it’s usefulness does not extend to patients with allergy to other weeds or to allergens in the other antigen categories.

Based on my clinical experience, I believe that a better option is the use of sublingual immunotherapy drops, also known as allergy drops. These liquid drops are made from the same allergen extracts used for injections. They can be used to treat multiple allergens at the same time, so they are not limited to ragweed, they are easy to use at home, and they actually taste good. The AllerVision program promotes the safe buildup of allergen doses to achieve tolerance to the allergen for safe, successful treatment. The AllerVision program uses FDA-approved allergens in an off-label method, which is a common practice in medicine.

I’m sure many of your patients have their final summer vacation days planned. Make sure that your ragweed sensitive patients are protected so they can create summer memories that DON’T revolve around allergic disease!

Dr. Dean Mitchell

The Allergy Clock is Ticking: Spring Ahead, Don’t Fall Behind in Treatment

Spring usually brings beautiful weather — and lots of allergies.

It’s been a brutal winter throughout most of the country. Once we get even a few consecutive days with weather in the 60’s and sunshine, everyone will rush outside for extra-long lunch breaks. My New York City office is right around the corner from Central Park, which is flooded with fresh-air-seekers of all ages as soon as spring emerges. For individuals who suffer with allergies, excitement for Spring is tempered with the weary anticipation of inevitable symptoms. However, with the right strategy and treatment all of your patients can be enjoying the blossoming of flowers and the sweet smell of Spring.

The first step in helping your Spring allergy patients is identifying them! The best strategy is identifying them before the pollen starts to skyrocket. How can you do this? Run a report of your billing codes for April, May, and June, filtering for the diagnosis of sinusitis, asthma, otitis, dermatitis, bronchitis, conjunctivitis, and, yes, allergic rhinitis. This list will provide you with a valuable group of patients who notoriously wait until their allergy symptoms are severe to seek treatment from your office. Remember, most allergy medications are over-the-counter and patients are taught by their pharmacies and big pharma marketing to take treatment into their own hands. The problem is, most of these medications are not nearly effective enough to provide true relief when the pollen counts are high and patients’ symptoms are at their worst. My recommendation is that you contact these patients – as you would your flu patients before the season – and inspire them to come and get evaluated for a pre-treatment program before it’s too late.

The typical early Spring pollen culprits are the trees. The initial pollen in March comes from the Maple and Elm trees, soon followed in April by Birch and Oak. (The AllerVision Facebook page has featured a full-scale “Field Guide” of allergenic trees. Check it out at facebook.com/allervisionllc.) If your patients suffer with Spring allergies, they need to know these pollens can start early in the season if the weather warms up. The AllerVision screening and skin testing program will help uncover the connection between pollens symptoms, and encourage your patients to prepare.  The worst parts of this allergy season are typically the beginning of Spring and the time between Mother’s Day and Memorial Day. Why does it worsen in the later period? This is usually double-whammy time: tree pollens still float around as grass pollen starts its surge. Again, using the allergy skin test, the gold standard, enables you to set out a plan for your patient to beat the perceived enemy at it’s own game.

Once you identify your tree and grass pollen patients, it’s time to take action; get them started on Nasalcrom immediately. It’s an effective, safe, cromolyn sodium nasal spray designed to stabilize mast cells. The caveat is that it works best if started a few weeks before the pollen counts are high. The other great option, that is now over-the-counter but it is rarely recommended by doctors, is Nasacort.

Of course, there is only ONE disease-modifying treatment for allergic disease: immunotherapy. Your allergy sufferers deserve the option of definitive resolution. And they especially love the fact that immunotherapy, unlike the other options, is not a drug. Your patients will appreciate the natural option that fixes the problem with almost no side effects — who wouldn’t?! Allergy drops or shots are the solution to Spring and your patients’ ticket to the great outdoors!

The clock is ticking: Find those patients before they find your office in a miserable state yet again!

– Dr. Dean Mitchell