Skin testing for allergies can be done during an initial consultation, and results are available within 20 minutes for most tests. Skin testing involves using a small plastic applicator with allergen applied to the tip, which scratches the very top layer of skin on the back or inner forearm. This does not cause bleeding but allows the allergen to enter the skin. Positive skin tests result in areas of itching and redness that are interpreted by the doctor. Following review by the doctor, the area is washed and treated to minimize itching and discomfort.
In addition to skin testing we sometimes order blood work, obtained in an offsite lab, to detect allergens. Results are typically available within a few days.
Penicillin testing can be done at your initial consultation. Testing is done via both scratch and intradermal methods. Scratch testing involves using a small plastic applicator with allergen applied to the tip, which scratches the very top layer of skin. This does not cause bleeding but allows the allergen to enter the skin. Intradermal testing involves a very small needle to deposit allergen into the top layers of the skin. If these skin tests do not show evidence of a penicillin allergy a patient may then undergo an oral challenge to penicillin. During the oral challenge a patient drinks small amounts of Amoxicillin until they have ingested one full dose, followed by a period of time during which the patient is observed closely for the development of any symptoms.
Lung function testing, or spirometry, is a breathing test performed in the office that evaluates for conditions such as asthma, COPD or vocal cord dysfunction. It is a non-invasive form of testing.
Oral immunotherapy (OIT) is the process of teaching your immune system to no longer react to a food allergen, also known as desensitization. Through OIT we are able to provide a treatment option for our food allergy patients that allows them to safely eat the foods they have previously avoided. We are excited about our new website OIT of Western Michigan and encourage you to visit it if you would like to learn more about treating food allergies.
Allergy Shots (subcutaneous immunotherapy or SCIT)
Otherwise known as allergy shots, Allergen Immunotherapy (AI) is a series of allergen injections designed to make the patient’s immune system more accepting of allergens in the environment. This results in reducing symptoms, reducing or eliminating the need for medication, and a decrease in time lost due to illnesses caused by allergies.
Allergy Drops (Sublingual immunotherapy or SLIT)
Sublingual Immunotherapy (SLIT or "Allergy Drops") is the name given to allergy vaccines that are administered orally. The extract, rather than being administered by an injection (i.e., Allergen Immunotherapy), is administered as oral allergy drops that are placed under the tongue ("sublingual"), held there for a short period of time, and then swallowed. Sublingual Immunotherapy is a unique form of immunotherapy that combines safety and convenience with excellent benefit. Popular in Europe for many years, SLIT is now being introduced into the United States and is gaining in popularity.
Allergy Tablets (Inhalent Oral Immunotherapy)
There are currently four FDA approved oral immunotherapy allergy tablets. Two are specifically for the treatment of grass pollen allergy, and one is for ragweed allergy, and one for house dust mite allergy. The two grass pollen allergy tablets are Oralair, which has five kinds of northern grass pollen, and Grastek, which has timothy grass pollen. The short ragweed allergy tablet is called Ragwitek. The house dust mite tablet is called Odactra.
Patch testing involves applying allergen-containing patches to the back that are taped in place and left for 48 hours. The patches are then removed prior to examination by the doctor. Test results are interpreted by the doctor and reviewed with the patient in detail.
An oral food challenge can be done to diagnose or rule out a food allergy. These are typically pursued if a patient has previously tested negative or very low positive on skin and blood testing. An oral challenge is performed in the office to ensure a safe and controlled environment for the patient.
An oral medication challenge can be done to diagnose or rule out a medication allergy, although only certain classes of medication can be evaluated via this method. Medication oral challenges are performed in the office to ensure a safe and controlled environment for the patient.
A. No, our patients are able to maintain their desensitization by eating prescribed amounts of the whole food. For example, a patient who has undergone peanut OIT will be eating grocery store peanuts at home to maintain their desensitization.
A. Side effects with OIT are usually mild and may consist of mouth itching, throat itching, mild rash (hives) and abdominal discomfort. Severe reactions, while rare, are possible, including anaphylaxis. Patients undergoing OIT must continue to carry their epinephrine auto-injector at all times. Some patients may develop a condition called eosinophilic esophagitis or EoE. EoE occurs when the lining of the esophagus becomes sensitive to allergenic foods. Symptoms may include nausea, heartburn, vomiting, abdominal cramping and/or pain. These symptoms typically resolve with dose adjustments or discontinuation of OIT. It is important to note that we adjust each patient's OIT schedule as needed based on the development of any symptoms.
Biologic medications are offered for a variety of allergic conditions. We stay up-to-date with new indications for this type of injectable treatment, and offer in-office, infusion center and at-home dosing options as indicated by individual patient needs.