When allergy shots are not an option

September 4, 2002

There are several reasons why a patient may not be placed on allergy shots.

The first line of defense against allergies is avoidance. The second option to be tried is usually medication. The third is allergy injections.

A physician once told me that if you give a patient shots without her trying avoidance or medication first, she will rely too heavily on the shots, and omit the other two important factors in controlling allergies.

A different physician said that since it usually takes all three approaches to get the allergies under control successfully, he prescribes all three initially.

As you can see, different physicians approach treatment differently. Both have convincing arguments for their rationale.

Another factor is asthma. Allergy injections play an important role in the treatment of asthma. But they also are dangerous when the ashtma is severe and not well controlled.

We don't give allergy injections when a person is wheezing or has uncontrolled asthma. The asthma must be managed at least to some extent by medications first, then shots can be considered. If your asthma is well-controlled by your inhaler, this may not apply in your case.

A third factor I see here is your mention of food allergies. Allergy shots are not recommended for food allergies. Shots for foods would be too dangerous. Eliminating foods known to cause allergic reactions, testing to determine other foods you are allergic to, and avoidance of those foods as well, is the most often recommended defense against food allergies.

Perhaps your physician has an entirely different reason for determining allergy injections are not right for you. He will base his assessment on your health history, current symptoms, physical examination, and test results, as well as your response to treatments he prescribes.

The best way to find out what your physician's reasons are is to simply ask him. Sometimes patients forget to ask these questions during their appointment, or feel the physician did not give them opportunity to ask all they wanted to know.

If that is your situation, I recommend you phone your physician's office and ask to speak with his nurse. She may have to phone you back, so be prepared to leave a number if necessary. She will get your chart and explain anything the physician has indicated there. If the answers are still unclear, she will likely talk with your physician herself to find the answers you need.

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