Services

SLIT (Sublingual Immunotherapy) – Allergy Drops

Sublingual immunotherapy is offered at our San Mateo (Bay Area) Allergy Office.

Sublingual Immunotherapy: Allergy Shots Without the Needles?

Allergic conditions account for many sick, nonproductive days for millions of adults and children. While many adults are able to “deal” with their allergies, children in particular are very vulnerable to their symptoms. Often, their allergic conditions are misdiagnosed as colds or other respiratory tract infections. Because allergies usually present in childhood, it is important that the underlying condition is identified and appropriately treated. By getting the allergy under better control, you or your child can halt the progression of the allergy, lessen the risk of developing secondary complications such as asthma and sinusitis, and most importantly, feel better.

In recent years, sublingual immunotherapy/allergy drops (SLT) has gained popularity in the treatment of allergies. This treatment is widely utilized in Europe and the World Health Organization has endorsed sublingual immunotherapy as a viable alternative to injection immunotherapy or allergy shots. Many of our patients, both adults and children, have noticed a significant improvement in their allergy symptoms with this treatment. There have been numerous medical studies on SLT and this treatment is now a “headliner” at the major allergy conferences. In the upcoming years, allergy drops are sure to become a standard in the treatment of many allergic conditions, including hayfever, asthma, eczema and even food allergies.
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What is sublingual immunotherapy or allergy drops?

Immunotherapy, as opposed to allergy medication, “treats” the underlying allergies and builds immunity, rather than just blocking the symptoms. In SLT, the vaccine is administered orally, under the tongue, rather than by injection. During the “build-up” phase, the doses are gradually increased but once “maintenance” dose is reached, you or your child will typically take the same dose for the duration of the treatment. The same allergy extract that is FDA approved for allergy shots is used in SLT. A major advantage of allergy drops is that it is administered in the convenience of your home, instead of at the doctor’s office.

How effective are allergy drops?

Although allergy shots are still considered the “gold standard” for allergy treatment in the United States, allergy drops are considered first line treatment in a number of European countries. They are very effective in relieving allergy and asthma symptoms, making them worth considering as an alternative to allergy injections for many patients, particularly children. As with allergy injections, numerous medical studies have proven that allergy drops can help prevent the onset of asthma in children with allergic rhinitis (hayfever). There have also been many studies showing that allergy drops have resulted in a significant reduction in the need for allergy and asthma medications.

Are the allergy drops safe?

The incidence of significant adverse reactions to allergy drops is very low and the most common reaction reported is mild itching or tingling of the mouth or tongue. It is extremely rare to have a serious systemic reaction to allergy drops, even rarer than with allergy shots. With dosing adjustments, treatment usually proceeds as scheduled, without further incident. As noted above, the extracts used in SLT are the same FDA approved, standardized, extracts used in injection immunotherapy. However, because the FDA has not yet approved these allergy extracts for sublingual administration, they are classified as “off-label”. Off-label use of an FDA approved product is extremely common in the United States, and is often utilized by physicians. The classic example is the off-label use of aspirin to help prevent heart attacks, which occurred for years when the FDA had not yet approved this use, even though it was widely known that aspirin treatment was safe and effective.
Other examples include the use of seizure medications which were proven and widely used off-label to prevent migraine headaches and chemotherapy agents, approved by the FDA to treat one form of cancer, which were then proven to be very effective and commonly used to treat other forms of cancer. There is frequently a very long lag time between when a medical treatment is proven to be effective and when the FDA approves it to treat a specific medical condition.

How do I start this treatment for me or my child?

The first step is to identify the underlying allergy and from there, we will formulate your vaccine based on the results of your allergy testing and medical evaluation. The allergy drops are individualized to treat your allergies and will contain the allergens to which you are allergic. Although many insurance companies do not cover allergy drops, there are several companies that do and we will do our best to assist you regarding your questions and concerns.

Sublingual Immunotherapy Treatment Is Similar To Injection Therapy

  • Click here to learn more about making an appointment or call now (650) 343-4597
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Lifestyle Changes

First and foremost let me start by saying that these people did one hell of a job figuring out my sinus problems. When I first arrived there, I explained what was going on with me having excessive inflammation in the sinus…after they tested me, I found out that I was being exposed to dust mites which gave me a strong reaction. I followed the doctors guides lines in terms of cleaning my room and ever since, my sinus inflammation went away for good and now I have a healthy sinus. Thank you for everything.

- Johnathon T
Dr. Engler is great and his staff, both medical and administrative, are wonderful. Dr. Engler is competent, caring, and listens better than any doctor I’ve ever had, constantly and patiently asking if I have any more questions. The staff is great. The nurses are very friendly and helpful. The desk staff is the same. I have been going here over a year and have always received caring and competent treatment. I highly recommend them.
- Tom B
Hands down the best place to go for Allergies and Asthma. The staff is incredibly kind and caring and so professional and helpful. I’ve been going here for over 30 years and they have gone out of their way countless times to make sure that I was well-cared-for. The nurses are excellent and always make sure to ask how my family is doing not to mention that they give the most painless allergy shots around. They remember little details about me and always make sure to give me a lollipop for my son, even when he’s not with me. Brooke is a great diagnostician and listener and each time I have an appointment with her, I always leave feeling better. The same is true for Dr. Engler.

My 10 year old son also has allergies and asthma and the staff makes sure that he feels well taken care of and comfortable, despite his having Autism and ADHD. He actually looks forward to going there with me, whether it be for my allergy shots or even when he needed allergy skin testing. When you’re a patient at the Allergy and Asthma clinic, you are treated as if you are the only patient they have, even when the waiting room is full. Dr. Engler has hired truly excellent staff, from the front desk people to the nurses and medical assistants. If you have allergies and/or asthma and you live on the Peninsula or even in the city, I highly recommend that you visit the Allergy and Asthma Clinic. They are truly amazing and will make you feel so much better.

-Sandi S.
I had an amazing experience at this clinic. Dr. Engler and the staff were all extremely welcoming, warm, and thorough in their various lanes of work from the front desk to billing to the assistants to Dr. Engler himself.
One thing I wish I knew before coming in was that the food test covers 80 allergens, and the environmental test covers 80 allergens meaning if you want to do both you need to come two separate days. This is kind of a hassle but definitely worth it since you’ll be tested for 160 allergens whereas most clinics only test 80 total.
Through the tests I figured out what I was allergic to and was advised to use an over the counter medication which has drastically helped and eliminated the symptoms I was experiencing. Dr. Engler also covered all the things I needed to do to reduce my symptoms via my lifestyle which was super helpful with my symptom reduction as well. I’d highly recommend this clinic! Insurance covered the tests and visits. (I have anthem blue cross)
-Christina L
I’ve been a patient at The Allergy and Asthma Clinic for over 12 years, and I can’t speak highly enough of the care I’ve received. Growing up with severe pollen allergies, I’ve been on and off allergy shots for years, and this clinic has truly been a lifesaver for me.
From the moment you walk in, you’re treated like family. The staff is incredibly kind, caring, and genuinely invested in your well-being. I have never had a negative experience with anyone here; everyone is consistently friendly and supportive.
Dr. Engler is exceptional! He has a remarkable ability to quickly and effectively address any situation. His expertise and compassionate approach have made a significant difference in managing my allergies.
If you’re struggling with allergies or asthma, this is the place to go. I wholeheartedly recommend The Allergy and Asthma Clinic to anyone seeking top-notch care.
-Trevor C