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November 17
Myth or Fact: Can Local Honey Cure Allergies?
November 13
Myth or Fact: Do Hypoallergenic Dogs Exist?

Is there such a thing as a dog that won't cause allergic symptoms? ​Allergy Partners gives the real scoop.

November 09
Toys for Tots

Allergy Partners of Fredericksburg will be participating in Toys for Tots this year.  We will be accepting new unwrapped toys, in both locations until Friday, December 11, 2015.  





October 30
Breaking News: Sublingual Immunotherapy

What is Sublingual Immunotherapy (SLIT)?

There has been a lot of press recently as well as television and print advertisements touting the availability of sublingual immunotherapy (SLIT).  Unlike traditional allergy shots (called Subcutaneous Immunotherapy or SCIT), SLIT is taken as either drops or tablets under the tongue.
Does it Work?
A recent meta-analysis (a study that statistically analyzes multiple other studies to identify trends and confirm positive effects) of SLIT for seasonal allergies show that it may offer only small benefit. Danilo Di Bona and colleagues looked at 13 studies enrolling over 4000 patients and in 7 of 13 studies the group taking the immunotherapy reported improved symptoms with decreased use of medications.  In six of the thirteen studies there was no more improvement than in the placebo (no medication) group.  The conclusion was that while some patients will benefit, many may not, and it is not possible to identify those that will respond prior to initiating therapy.
What Are the Side Effects?
Over half of the patients in the treatment group reported either oral or GI/stomach side effects. Seven patients had allergic reactions requiring epinephrine.
In the not so recent past, immunotherapy or “allergy shots” was a fairly narrow topic for discussion.  Those patients with nasal allergy and allergic asthma who were not well controlled on medications were offered subcutaneous immunotherapy (SCIT) as a better alternative to medication and a potentially disease modifying intervention.  The injection therapy works directly on the patient’s response to allergens which results in short term symptom control, reduced medication requirement, and a durable long term improvement.   The downside was a significant commitment to receiving injections in a medical setting on a regular basis.
Fast forward to the past few years.  Sublingual immunotherapy (SLIT) utilizes allergen as drops or dissolving tablet under the tongue.  This approach has been common in Europe for a number of years for patients symptomatic from a single allergen. It is also available off label in the United States for single or multiple allergens using conventional allergen extracts. Tablets for grass and ragweed have become available by prescription. These require at least pre-seasonal therapy beginning three months prior to the pollen season and may be more effective if continued all year.  The major advantage of SLIT is that the allergens can be self-administered at home with the availability of epinephrine as the risk of serious systemic reactions is low. 
Traditional subcutaneous immunotherapy allows the inclusion of multiple allergens in a single injection, and in the large majority of studies, has been shown to be more or equally efficacious when compared to the sublingual program.  Since many of our patients are allergic to multiple environmental allergens, this may be their best choice.

Fortunately, Allergy Partners physicians are able to offer sublingual and injection therapy and select the type of immunotherapy that best serves your individual needs.

For more information, visit:


October 29
Auvi-Q Recall

Please refer to the Auvi-Q website for the latest information on the Auvi-Q Recall.  Please contact our office if you or your child need a new prescription sent to the pharmacy.

October 16
Our very own Allergy Myth Busters!

Inspired by one of our favorite television shows, Allergy Myth Busters looks at a number of popularly held beliefs about allergy. But are these myths just urban legends or are they true?

The Myth:
IgG RAST testing is an effective means to identify food allergies.
What does science say?
It is estimated that 15 million people in the United States have food allergies. This includes up to 1 in 13 children. Therefore, appropriate evaluation and treatment of these allergies are essential. Various methods have been described to test for food allergies since the 1970s. These include skin prick testing to possible offending foods, ImmunoCAP IgE blood testing, and IgG RAST blood testing.
So is the myth busted or true?
Detection of IgG antibodies has been discredited as a reliable diagnostic tool since the 1980s. Unlike IgE antibodies, which are responsible for allergies, IgG antibodies can be found in allergic and non-allergic people regardless of whether they are healthy or sick. IgG antibodies are the normal antibodies made by the body to fight off infections. Increase in levels of IgG antibodies present in the circulating blood is thought to be a normal response to the ingestion of food. In fact, IgG antibodies have actually been found to go up during successful research studies on food immunotherapy. Also, allergy testing to foods using IgG RAST testing has been shown to lack clinical relevance. These tests are not validated and lack sufficient quality control.
These unproven tests may lead to false diagnoses, increased anxiety, and a useless strict avoidance diet. If a food allergy is suspected, evaluation, diagnosis, and treatment should be performed by a board certified allergist. The evaluation should include a thorough medical history and a physical exam. The allergist may perform tests including skin prick tests and ImmunoCAP IgE blood tests to help identify a food allergy. Both methods are highly sensitive and useful to help exclude a diagnosis of food allergy. An oral food challenge or even a trial elimination diet may be necessary. These tests have all been proven to be effective diagnostic methods which the board certified allergist may use in conjunction with the information from the clinical history and physical to provide a diagnosis of a food allergy.

October 01
​Benefits of Immunotherapy (Allergy Shots)

Allergic rhinitis, better known as hay fever, is one of the most common chronic illnesses and is estimated to affect 20% or more individuals at some point in time. An allergy can be considered an exaggerated immune response where the body is trying so hard to keep the allergens out that undesirable symptoms such as sneezing, rhinitis, congestion, and wheezing occur.   Allergic triggers include seasonal pollens and year-round allergens such as house dust mites, mold, and animal dander.


Many allergy sufferers also suffer from asthma. Upwards of 70% of all asthmatics have underlying allergies. In children, the numbers are even more staggering as 80-90% of asthmatic children are allergic. Conversely, allergic children have a 40-60% risk of asthma.  Allergies also can negatively impact quality of life with malaise, fatigue, loss of sleep, and loss of school and work days.  The resulting expenses for treatment and lost wages are very substantial, ranking high on the list with medical expenditures.


Fortunately, many allergy and asthma patients respond well to symptomatic treatment and avoidance.  Education about allergen avoidance and control and the ongoing use of an effective medication can lead to excellent results for many. 


For those patients for whom conservative treatment proves inadequate because of severity, chronicity, and complications, an evaluation by a board certified allergist is in order.  An allergist will use a thorough history and exam to establish the best available options for treatment.  When indicated, allergy skin tests identify specific sensitivities to seasonal and perennial allergens.  Such testing provides the most cost effective answers, which can then be correlated with that particular patients’ history and physical findings. 


In a patient with such severe chronic respiratory allergy, subcutaneous immunotherapy (SCIT) or “allergy shots” may offer the best opportunity to modify, in a sustained fashion, the underlying problems.  SCIT helps up to 80% of pollen allergic and 60-65% of environmentally allergic patients.  By a variety of mechanisms, SCIT teaches the body to “block” or decrease the exaggerated immune response. 


In the office, this process takes place by formulating an allergen vaccine targeted against a person’s allergy triggers. Initial doses are very small and administered in increasing doses. As the dose is increased, the immune response begins to change. After a build- up period, immunotherapy is continued at a targeted optimized dose every 2-4 weeks for a 3-5 year course.


Allergy shots have been shown to result in less symptoms, severity, and complications of both asthma and allergies over time. Additionally, successful SCIT leads to less need for medication and less need for medical attention. 


Current medications for allergies and asthma are very effective in treating the symptoms and preventing asthma flares. However, they do not alter the underlying cause of asthma. When the medicines are stopped, allergy and asthma symptoms recur. 


This is one of the key differences between immunotherapy and other treatments. By fundamentally changing the immune process to underlying allergies and asthma, immunotherapy can change the disease process. After 3-5 years of immunotherapy, many patients are able to stop allergy shots and their symptoms remain controlled without more medication.


In young children, allergy shots may also prevent the development of new allergies and asthma. One study by DeRoches, et al showed that children on SCIT were much less likely to develop new allergies after 3 years. The Prevention of Asthma by Immunotherapy (PAT) study also showed that immunotherapy can prevent the development of asthma in allergic, at-risk children. Children receiving immunotherapy were 48% and 60% less likely to have developed asthma at 3 and 5 years respectively than the children who did not receive SCIT.


By its nature, immunotherapy carries with it the risk of allergic reactions. While most reactions are localized with some swelling, itching and pain, more severe allergic reactions can occur. Immunotherapy, therefore, should always be administered in a doctor’s office and patients should be monitored for 30 minutes after all injections. Fortunately, these reactions are rare and Allergy Partners strives to ensure the safety of all patients.


Learn more about immunotherapy by contacting your trusted Allergy Partners Allergist.​

October 01
In the News

In the News:

Study shows second severe reactions can occur hours to days after an initial allergic reaction and occurs in up to 15% of children.


We all know how scary an allergic reaction can be, especially if it occurs in a child.


New research in children shows it is even more important to be prepared to treat the initial reaction aggressively and to be prepared to treat what is known as a secondary or delayed reaction. Delayed reactions occur when the initial reaction is treated and the symptoms resolve but then return hours to days later.


A recent study looked at records of children who were seen in emergency departments for anaphylaxis (significant allergic reactions) to find out how often a second reaction occurs.


In about 75 percent of the delayed reactions, the second reaction occurred within 6 hours of the initial allergic reaction but could occur up to days later. The children more likely to have a delayed reaction usually had more severe initial reactions requiring more than one dose of epinephrine. At least half of the delayed reactions were serious enough to require another dose of epinephrine.


The take home messages: Be prepared with at least 2 doses of epinephrine if you are your child are at risk for a serious allergic reaction. Remember to use the epinephrine early.  Do not wait for life threatening symptoms to occur to use epinephrine as an allergic reaction can be fatal. Don’t be afraid to give the second dose of epinephrine if symptoms are not improving or progress on the way to the emergency department. If you are not admitted to the hospital for your allergic reaction, be prepared for a secondary reaction by having more epinephrine available.​

September 11
Allergy Myth Busters: Local Honey

Inspired by one of our favorite television shows, Allergy Myth Busters looks at a number of popularly held beliefs about allergy. But are these myths just urban legends or are they true?

The  Myth:
The use of local grown honey  can help relieve symptoms of allergic rhino-conjunctivitis and associated atopic (allergic) conditions including asthma.
What does the science say:
A literature search returns very few articles specifically addressing and using locally grown honey. A study published in the Annals of Allergy, Asthma and Immunology in February 2002 negates the benefits of local grown honey. The study followed a cohort of 64 people randomly assigned to one of three groups, with the first receiving locally collected, unpasteurized, unfiltered honey, the second nationally collected, filtered, and pasteurized honey, and the third, corn syrup with synthetic honey flavoring. They were asked to consume one tablespoonful of honey or substitute daily and to follow their usual standard care for the management of their symptoms. Neither honey group experienced symptom relief when compared to the placebo group.
To the contrary, a study in the International Archives of Allergy and Immunology in May 2011 appeared to show a benefit. In this study, Forty-four patients with physician-diagnosed birch pollen allergy consumed either no honey, regular honey or honey to which birch pollen was added (birch pollen honey or BPH) in incremental amounts from November 2008 to March 2009. At the conclusion, patients in the first 2 groups experienced no improvement of symptoms but the BPH group experienced a statistically significant improvement in symptoms scores.
So is the myth busted or true:
Essentially both articles are supporting the same conclusion i.e. locally grown honey is not beneficial for allergies. How so? Obviously in the first article there was no benefit obtained in the group consuming locally grown honey but the same result was actually shown in the second study. If the honey was not doctored with additional birch pollen, symptom improvement DID NOT occur.
Despite this, the second article is often cited as being beneficial in lay publications and websites promoting organic or naturalistic methods for treating allergies. They appear to ignore the fact that birch pollen HAD TO BE ADDED. The first article is cited often as being outdated or old and therefore given no credence, which is foolish. Otherwise most of what's available is purely anecdotal with little factual evidence supporting the claim. Surprisingly, some websites purport the benefit but contradict their own anecdotal evidence.
Remember that bees are in the business of collecting a flower's nectar, not pollen to produce honey. Therefore very little pollen is deposited in honey. Also, the pollen they handle is produced by flowers that require cross pollination by insects unlike the majority of allergy triggering tree, grass and weed plants that do not require insects to carry pollen for fertilization. They produce huge amounts of pollen and depend on the wind for distribution/pollination. They don't need the bees. Yes some of the allergen inducing pollen grains end up in the honey but they are in insignificant quantity.
Final thought :
Remember if you are experiencing difficulty with allergy, your local Allergy Partners specialist is available to administer immunotherapy which utilizes a natural pollen extract to alleviate symptoms. It is the only modality proven to statistically reduce the progression of atopy and potentially reverse the allergic IgE mediated mechanism preventing asthma and the progression of allergy. Also, the consumption of locally grown honey is fine, but should not be given to infants under 12 months of age. Diabetics will likely have difficulty with blood glucose control and if a person is allergic to bee venom they may be at an increased risk of developing anaphylaxis to locally grown honey.

September 11
Of Pharaohs and Bee Stings

Was the death of a pharaoh the first report of an insect sting reaction? 

In 1989, an article in Hospital Practice by Ovary  stated that the death of Pharaoh Menes after a wasp sting in 2600 BC was the first reported account of an anaphylactic reaction to insect stings.  According to Krombach, this was based on hieroglyphs found on his sarcophagus and tomb. Dynasties that came after Menes believed him to be the first Pharaoh and he is credited with many things, including the introduction of papyrus and writing.  But Krombach and his fellow authors argue that he was likely a mythical figure who may not have even lived.  Oh well -- so much for exotic origins.  No matter when the first reaction was, it is likely that insect sting allergy started a very long time ago.

A review article in the June 2015 Journal of Allergy and Clinical Immunology In Practice spoke about the state of the art in treating stinging insect allergy. Reactions to stinging insects account for 10% of all cases of anaphylaxis presenting to emergency rooms and there are about 40 deaths per year in the US due to these reactions. The estimate is that 0.4% to 0.8% of children and 2% to 3.5% of the general adult population experience systemic reactions to insect stings at some point in their lives.
The Players
The Hymenoptera are the most studied stinging insects, with purified, commercial venoms for testing and treatment in the United States. Hymenoptera include the Apidae (honeybee) and Vespidae (aerial yellow jacket or New World hornets) which include Vespinae (yellow jackets and aerial yellow jackets) and Polistinae (wasps). There are also a number of types of stinging ants. The most common in the US and best studied is the Imported Fire Ant (IFA), Solenopsis  invicta. Since inadvertent importation through Mobile, Alabama during 1930-1940, this fire ant has spread throughout the Southeast of the US as far north as Maryland and even into the arid southwest.

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 About this blog


Welcome to our blog site! Stay tuned to get the latest news. We will share tips and techniques for living with and managing your Allergies & Asthma. We look forward to sharing useful resources with our patients!