Can seasonal allergies cause fatigue

Can Allergies Make You Tired?

Allergies happen when your immune system has a strong reaction to a substance that generally shouldn’t cause a reaction. These substances are called allergens.

Most of the time, allergens simply cause mildly uncomfortable symptoms such as:

  • coughing
  • itching
  • sneezing
  • skin irritation
  • runny nose

Luckily most people with allergies have only mild discomfort. But many also complain of feeling tired. Can allergies make you sleepy?

How do allergies cause fatigue?

Yes, allergies can make you feel tired. Most people with a stuffy nose and head caused by allergies will have some trouble sleeping. But allergic reactions can also release chemicals that cause you to feel tired. These chemicals help fight your allergies but also cause swelling of your nasal tissues that can make your symptoms worse. A lack of sleep and constant nasal congestion can give you a hazy, tired feeling.

Experts call this fatigue caused by allergies a “brain fog.” Brain fog can make it difficult to concentrate and carry out school, work, and daily activities.

How can you treat fatigue caused by allergies?

If you’re experiencing the effects of brain fog, there are some things you can do to feel less tired. First, you’ll need to stop the cycle of allergy symptoms and fatigue. You can try:

1. Find out your allergens

The first step in getting rid of your brain fog is finding out what’s causing your allergies. If you don’t know what you’re allergic to, you should visit a doctor who specializes in allergies. They’ll run tests to find out what’s causing your symptoms.

Common allergy tests include:

  • Skin tests. This involves pricking your skin with a needle to expose you to a small amount of an allergen. If you’re allergic, you’ll develop a raised bump in the spot of the allergen.
  • Blood tests. If you have allergies, your blood will contain certain cells that show you’re sensitive to certain allergens.
  • Physical exam. There are many physical signs of allergies, from skin irritation to nasal and breathing problems. These can help your doctor diagnose your allergies.

2. Limit your exposure to allergens

Once you know which allergens are causing your symptoms, you can reduce your exposure to them. For example, if you’re allergic to pollen, you can try to stay indoors on days when pollen counts are high.

You can check online with your local weather station to find your local pollen report. You should try to keep your windows closed if you have air-conditioning. If you do spend time outside, it’s important to bathe and change your clothing as soon as you come inside.

3. Take your medication

There are many kinds of allergy medications on the market. Some are targeted at specific allergies while others are more generalized and treat many kinds of allergies.

Your best bet if you want to avoid feeling tired is to take an antihistamine. These medications reduce swelling to temporarily reduce your allergy symptoms.

The only way to fully reduce your allergy symptoms is to cut out your exposure to allergens. Be aware that many antihistamines cause fatigue. So, if you’re trying to stay awake during the day, it’s best to take an antihistamine labeled as “nondrowsy” such as Claritin.

If you have trouble sleeping at night it might help to take an antihistamine that does cause drowsiness. These medications might ease your symptoms and also help you sleep. Benadryl is one antihistamine known to cause drowsiness.

Nasal sprays such as Flonase can also treat your allergy symptoms. These are available in both over-the-counter and prescription form. These sprays usually don’t cause drowsiness. But you should always check the label on your prescription to be sure.

4. Try allergy shots

Allergy shots are considered to be the strongest type of treatment for allergy symptoms. Allergy shots involve taking small injections of allergens under your skin. This helps you become less reactive to these allergens. This means less frequent and severe allergic reactions over time.

Allergy shots can be helpful in reducing fatigue because they provide fast and nondrowsy allergy relief. Talk to your doctor about what allergy shots might work best for you.

5. Try a neti pot

Some people with allergies can reduce their symptoms by using a neti pot. They fill this device with a saline solution that’s poured through one nostril. The solution can help clear your nasal passages and reduce swelling caused by allergies. This can reduce your fatigue.

The takeaway

Allergies cause sneezing, itchiness, runny nose, coughing, and other unpleasant symptoms. Allergies are annoying enough without fatigue thrown into the mix. And these annoying symptoms often make it hard to get any rest at night, leaving you tired all day. Allergy brain fog is unpleasant and can make it hard to function in school, work, and other daily activities.

The good news is there are many ways to get allergy relief and get rid of your brain fog. The first step in finding relief is getting tested for allergies so you know what’s causing your symptoms. Then you can work with your doctor to find a nondrowsy allergy treatment that’s right for you. Knowing your allergies can also help you determine which allergens to avoid.


When you think about allergy symptoms, what probably comes to mind is sneezing, sniffling and itchy eyes. You might not think of sleeplessness or fatigue from allergies. And while everyone has a bad night’s sleep now and then, fatigue from disrupted sleep can sometimes point to more serious problems, like untreated or improperly treated allergies.


Find an allergist

When you are sniffling, sneezing and generally feeling poorly, you often don’t sleep well. But you might not make the connection between daytime allergy symptoms and a lack of sleep at night. And you might not realize that the combination can cause fatigue and other health issues. Also, an allergic reaction can release chemicals in your body that cause fatigue.

If you’re experiencing shortness of breath, wheezing, coughing, chest tightness and unusual fatigue, you might have exercise-induced bronchoconstriction (EIB). This condition affects about 10 percent of Americans. As many as 90 percent of people who have asthma also have EIB, but not everyone with EIB has allergy-related asthma. One way to get relief is by using an allergist-prescribed inhaler before you begin your workout routine. Breathing through your nose rather than your mouth during exercise can also help.

If you have allergies, you might use over-the-counter (OTC) medications to deal with symptoms. But this could cause more problems. OTC medications, such as decongestants and some antihistamines, can disrupt sleep. This can result in:

  • Trouble making decisions
  • Irritability
  • Greater risk of car accidents
  • Memory damage
  • Reduced hand-eye coordination
  • School and work injuries
  • Fatigue
  • Restricted activities

Seasonal Allergies and Joint Pain

Spring is here! With warmer days ahead, trees and flowers will begin to bud, which also means that the dreaded allergy season is right around the corner. Soon enough there will be runny noses, scratchy throats, watery eyes and, for some of you, joint pain. You read that right, seasonal allergies and joint pain! While not often associated with one another, the two actually are related and taking the time to understand the connection can help you prevent them.

What Are Allergies?

In the United States, allergies are typically heightened from March to early summer. Some common substances that cause allergies are pollen, dust, nuts, mold and bee venom. These substances are referred to as allergens, and to combat these your immune system produces antibodies that will help protect you from infections. Antibodies travel to your cells and cause them to release chemicals called histamines that help get rid of those allergens. Histamines cause inflammation so when you come in contact with allergens, you experience inflammation of your sinuses, skin, joints, and respiratory airways. This is why the most common allergy symptoms include the following:

  • Nasal congestion
  • Coughing
  • Sneezing
  • Runny Nose
  • Itchy throat
  • Itchy skin
  • Watery or itchy eyes
  • Joint, back and neck pain
  • Hives
  • Fatigue

Do Seasonal Allergies Really Cause Back, Neck and Joint Pain?

Absolutely! There are plenty of ways that seasonal allergies can cause back, neck and joint pain. The truth is that joint pain is unavoidable when allergies cause inflammation. During this time of the year, some people suffer from inflammation because your body is working hard to flush out the foreign allergens. As a result, this inflammation causes pain in your joints.

Fatigue can also explain why you feel joint pain during allergy season. Your body is working very hard to fight those allergens, as a result becomes exhausted, and this may cause your joint pain to feel worse.

Coughing, sneezing, and wheezing may also cause you to suffer from muscle, joint and neck pain.

Tips to Help Manage Your Seasonal Allergies to Avoid Joint Pain

  1. Monitor Pollen Counts. Try to stay indoors when pollen levels are highest (between 10AM and 4PM). You can check the daily pollen counts and forecasts online. The weather channel has a free personalized allergy tracker.
  2. Shower after being outdoors. This helps reduce the allergens that you bring into your home. Additionally, wash your hair before bed, to avoid getting allergens on your pillows and sheets.
  3. Don’t forget about your pets! Your pets can bring in pollen and mold on their fur, so bathing and grooming them can keep those allergen levels down. If your pets enjoy spending a lot of time outdoors, keep them out of your bedroom so you can keep allergens out of your bedding.
  4. Keep the windows in your home closed in order to keep allergens from drifting in from outside. Try running the air conditioner instead.
  5. Track your allergens. Keeping track of all of your activities and the time of day that your symptoms occur. This can help your doctor identify systems in order to help you manage your symptoms.
  6. Take allergy medicines. Antihistamines block your body’s response to allergies and typically work within an hour. Nasal spray is an option for more severe allergy symptoms. Your doctor may also recommend allergy shots if other medicines can’t relieve your symptoms.
  7. Stay ahead of the game! If you know you typically get allergies in the springtime, start taking your allergy medicine early on, before the season begins. This ensures that the medicine will be in your system by the time you need it.

If your joint pain persists outside of allergy season, it might be time to see an orthopedic surgeon. You can use our Find A Doctor tool to search for one in your area.


All About Seasonal Allergies & Joint Pain

Can Allergies Cause Joint Pain?

If you’re one of the 20 to 50 percent of Americans who has allergies, you know that they don’t always just affect you during the day—the congestion and other symptoms can make it tough for you to get quality sleep at night.

Why the connection? When you breathe in something that you’re allergic to, the allergen irritates your nasal passage, leading to congestion, sneezing, coughing, and a runny nose. It can be difficult to sleep with those kinds of symptoms, which is why people who have allergies tend to have worse sleep. The more severe your symptoms, the lower the quality of your shuteye is likely to be.

To help improve your sleep, you have to rid your home of whatever it is you’re allergic to. Here are four of the top culprits to look out for.

  • Dust mites: If you have dust in your home, then you likely have dust mites. And unfortunately, one of their favorite places to call home is your bed and pillows (dust mites feed off the dead skin cells that you shed while you sleep). Adding a simple dust mite cover to your mattress and pillows can work wonders, as can regularly washing your bedding in hot water.
  • Mold: Dampness can lead to mold, which is especially important to know if your bedroom has an attached bathroom. Avoid this by keeping the air moving in your bathroom—whether it’s by using the exhaust fan or opening a window.
  • Pet dander: Whether you have a cat or a dog, flakes of their dead skin—called pet dander—can be a common allergen. One of the best ways to avoid this is to keep your pet off furniture (especially your bed) and to vacuum regularly. A weekly bath and brushing for your furry friend can also reduce dander in the home.
  • Pollen: This allergen tends to peak seasonally in the spring and the fall. While you might need to take allergy medications to reduce symptoms, keep in mind that pseudoephedrine can keep you awake and antihistamines can make you drowsy during the day.

It’s great when the sun comes out, unless you’re allergic to pollen of course, and it also signals regular twenty-minute-straight sneezing sessions, red eyes and and an itchy throat. Hay fever, you demon.

But those aren’t the only symptoms of hay fever that can crop up. Have you ever noticed yourself feeling unnecessarily tired during times of high pollen count? If so, there’s a science-approved explanation behind it, and it’s got nothing to do with the drowse-inducing antihistamines you’ll have been scoffing.

Speaking to Live Science, allergist and immunologist at The Ohio State University Wexner Medical Center, Dr. Kara Wada, explained that seasonal allergies can notably reduce energy levels, leading to feelings of tiredness.

The expert described how the body expends substantial amounts of energy creating “the cells, proteins and all of the other substances” – collectively called inflammation – that emerge as part an allergic response. Effectively, inflammation tries to fight off the allergy, which results in the body being drained and subsequently emitting some of the same chemical signals as the ones released when you’re run down or unwell.

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Plus, if you’re unlucky enough for your reaction to pollen to continue throughout the night, this can interrupt sleep and significantly reduce the quality of rest you get.

Great. That’s another one to add to your list of reasons why having hay fever is shit.

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As the weather warms and pollen begins its dance across the sky, some people’s bodies hurl them into a storm of watery eyes, runny noses and sneezing fits.

But sometimes the spring and summer months also bring bouts of tiredness. Can people with allergies also blame this on seasonal allergens? The answer is yes; there are several ways that seasonal allergies can make us feel low on energy.

An allergy or allergic reaction is, by definition, a fight that the body puts up when it’s faced with a foreign invader, such as pollen, said Dr. Kara Wada, an allergist and immunologist at The Ohio State University Wexner Medical Center.

“The body expends a lot of energy in making all of the cells, proteins and all of the other substances” that build up during an allergic response, also known as inflammation, she said.

This energy expenditure wears out the body and “some of the same chemical signals … in addition to fighting off what it sees as an enemy, makes you feel unwell” and rundown, she said. This effect in seasonal allergies is like a watered-down version of the extreme tiredness that can overtake people who eat something they’re allergic to.

Allergies can also indirectly cause you to feel tired by robbing you of sleep. “It’s not uncommon to hear that people have poorer quality sleep from their allergies,” Wada told Live Science, especially “if their nose is so stuffed up they have to breathe from their mouth or post-nasal drip wakes them up in the middle of the night.”

Why exactly do allergies make sleeping challenging? In essence, the body fights what it deems as foreign substances in the body by sending its little molecular army to the site of the invasion, causing inflammation there. Inflammation or swelling of the lymphatic tissue behind the nose, called the adenoids, could lead to a person breathing with their mouth open, which, in turn, can disrupt sleep, said Dr. Gloria Riefkohl, a pediatrician at Nicklaus Children’s Hospital in Miami.

This disruption happens because when the adenoids get larger, they can cause obstruction in nasal passageways, which can reduce the amount of oxygen we need to breathe comfortably, said Dr. Priyanka Seshadri, a pediatric resident also at Nicklaus Children’s Hospital.

“Seasonal allergies can definitely also affect concentration,” she said. “Kids could be misdiagnosed with ADHD or a learning disability when sometimes it is just really bad allergies.”

“Especially if you’re not getting good quality sleep, we know that that can result in not as clear thinking, not as much focus,” Wada said. “That’s not going to lead to being your best self .”

Finally, people can become drowsy while trying to cure their allergies. The most common allergy-fighting medications are called antihistamines (histamines are a chemical the body releases during allergic reactions). But a common side effect of some of these medications, such as diphenhydramine (brand name Benadryl), is drowsiness, Riefkohl said.

  • Booze Snooze: Why Does Alcohol Make You Sleepy, Then Alert?
  • Why Are Pollen Allergies So Common?
  • Why Do People Get Sick When the Seasons Change?

Originally published on Live Science.


Far too many people deal with constant fatigue today. Unfortunately, individuals don’t always know what causes their symptoms. Fatigue often manifests itself during the day after a restless night of sleep. It’s a vicious cycle that never seems to end. These days, a number of health conditions can cause fatigue, but few people seem to consider allergies as the culprit. Fighting allergy fatigue requires a comprehensive approach.

Allergies Affect People Day and Night

Chances are high that individuals with allergies know they have them. They’ll spend their days sneezing, coughing, and feeling congested. Typically, people realize how allergies affect themselves during the day. Not all sufferers recognize that allergies can worsen the quality of their sleep. The immune system targets allergens, and this frequent immune response disrupts the body in various ways.

How To Tackle This Situation

To fight allergy fatigue, individuals need to remove allergens wherever possible. Dust, pollen, and even pet hair can cause symptoms like breathing issues at night. A bed should be covered throughout the day by a mattress encasement and pillow covers. Likewise, a person should vacuum their home’s floors often and keep windows closed. An air purifier that removes allergens can make sense for certain households.

Allergy sufferers can take steps to protect their own body, too. For instance, allergy medications can be purchased over the counter at drug stores. Antihistamines and decongestants are popular options to fight back against allergy symptoms. Individuals can take a nightly bath or shower before bed. In doing so, they wash away allergens and particles on their skin and hair.

Fewer Allergens Means Less Fatigue and Better Sleep

After taking these steps, individuals can expect their constant fatigue to lessen. Symptoms could improve in leaps and bounds for some sufferers. Fewer allergens in the home and bedroom will lead to higher quality sleep. From there, a person can expect to feel more rejuvenated in the morning and have more energy during the day. Those that suffer from severe allergies can still reduce their fatigue and other symptoms in noticeable ways!

Molds, mites and pollens: Common causes of allergic fatigue

Take the quizzes below to determine the likely cause of your allergic fatigue: molds, mites, dust, pollens.

Have your home examined by a house doctor and cleaned of all possible sources of mold and dust contamination. Buy products that kill mites. Get rid of wall-to-wall carpeting and any old, dusty shelves of books, magazines or old mildewy wallpaper.

Get tested for sensitivity to molds. Using the provocation neutralization technique, help combat your mold allergies with extremely dilute injections or drops of the molds to which you are sensitive.

Take lots of vitamin C, especially after allergy testing, to help neutralize an allergic reaction caused by histamine release in the body.

Could allergies be causing your fatigue?

Ask yourself the following questions. If you answer yes to most of them, you may be suffering from dust allergies:

  1. Do you feel worse indoors?
  2. Do you feel better outside?
  3. Do you feel worse when sweeping or cleaning?
  4. Do you feel worse each year when the furnace is turned on?
  5. Does your fatigue recur each year with the return of cold weather–when windows are closed?
  6. Do you feel worse within 30 minutes of going to bed–as dust particles settle or dust mites on the bed begin to bother you? Or do you feel worse on awakening?
  7. Are you worse in a closed-up, air-conditioned home?

If you answer yes to most of the following questions, you may be suffering from mold allergies:

  1. Are your symptoms worse outdoors between 5 p.m. and 9 p.m., in cool evening air?
  2. Do you feel worse in damp places–woods, basement, attics, or certain rooms in the house? Do you feel worse on rainy, gray, humid days?
  3. Do you feel worse raking leaves or mowing grass?
  4. Do you feel distinctly better after the first late-autumn frost?
  5. Do you feel better in an air-conditioned room?
  6. Do you feel better when you are away from home or traveling (especially at the seashore, the desert or high mountain elevations)?
  7. Do your symptoms continue beyond the ragweed season (late August)?
  8. Are you most improved when temperature is below freezing?

If you answer yes to the majority of the following questions, you probably suffer from pollen allergy:

  1. Do you suffer from itching eyes and runny nose?
  2. Are you worse outside in the mornings?
  3. Are you worse on clear and windy days?
  4. Are you improved on rainy days?
  5. Are your symptoms better inside in an air-conditioned office or home?
  6. Do you feel much worse when you go from an air-conditioned room to the outdoors during summer months?
  7. Are you improved after the first light frost?


Allergic rhinitis occurs when allergens in the air are breathed by a patient that is allergic to them, irritating and inflaming the nasal passages. Allergens may include dust mites, pollen, molds, or pet dander. In people who are allergic to them, these particles trigger the release of a chemical in the body that causes nasal congestion, sneezing, watery eyes, and runny nose. These symptoms can lead to poor sleep, which can result in significant daytime sleepiness and fatigue.

Allergic rhinitis (allergies) may occur year-round or seasonally. When it occurs seasonally it is usually caused by airborne particles from trees, grass, ragweed, or outdoor mold. Causes of year-round allergic rhinitis include indoor substances such as pet dander, indoor mold, cockroach and dust mites in bedding, mattresses, and carpeting.

Sleep problems are common in people with allergic rhinitis. One study found that sleep is dramatically impaired by allergic symptoms and that the degree of impairment is related to the severity of those symptoms. In addition, sleep problems are linked with fatigue and daytime sleepiness as well as decreased productivity at work or school, impaired learning and memory, depression, and a reduced quality of life.

Obstructive sleep apnea (OSA), a sleep disorder in which breathing is briefly and repeatedly interrupted during sleep, is linked with allergic rhinitis. OSA occurs when the muscles of the throat relax and fail to hold the airway open during sleep. People with OSA may suffer from severe daytime sleepiness and a range of chronic health problems such as heart disease, stroke, and sexual dysfunction. Nasal congestion, which causes the upper airway to narrow, increases the risk of both snoring and OSA among allergic rhinitis patients. The good news is that reducing nasal inflammation may reduce symptoms of snoring and OSA as well as daytime fatigue and sleepiness, according to at least one study. This is particularly important for those OSA patients who have trouble with continuous positive airway pressure(CPAP) devices because of nasal congestion.

In addition, research suggests that allergic rhinitis is a risk factor for snoring and OSA among children. Snoring and other sleep problems are linked with poor performance in school, lower IQ, and even brain damage, according to recent research. Parents are urged to pay close attention to sleep symptoms in children with allergic rhinitis and discuss their children’s sleep with their pediatricians.

With such a high rate of sleep disorders and other health problems among allergic rhinitis patients, getting adequate sleep on a regular basis is essential to maintaining physical and mental health as well as performance, safety, and overall well-being.

According to NSF’s 2006 Sleep in America poll, 15% of American adolescents take medications for allergies.

Additional Info:

  • Coping
  • Symptoms
  • Treatment

Reviewed by David G. Davila, MD (December 2009).

Allergy Shots (Allergen Immunotherapy)

What Is It?

Published: December, 2018

Allergy shots are a treatment that can help to prevent or minimize allergic reactions. They are personalized to each patient—the shots are only useful when specific allergy triggers have been identified. Allergy shots are received on a schedule, over a period of several years.

What It’s Used For

Common allergic symptoms are sneezing, runny nose, itchy eyes or asthma attacks. Allergy symptoms are caused by your body’s reaction to a substance (allergen) that is inhaled, touched or eaten. Allergens cause no symptoms in a non-allergic person, but in an allergic person who is sensitized to that antigen, an immune reaction against the allergen causes symptoms.

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Allergy Shots (Immunotherapy) FAQ

1. What are allergy shots?

With allergy shots, specific amounts of natural allergen extracts are injected under the skin of the arm which causes the body to produce antibodies that block allergic symptoms over time. Allergy shots help your body build its natural resistance to the effects of tree, grass, and weed pollen, dust mites, mold spores, animal dander, and insect venom. Allergy shots are also known as “allergen immunotherapy.” It is also the only treatment currently available that strengthens the immune system to provide lasting relief and prevent new allergies and asthma.

2. Who should get allergy shots?

You may benefit from allergy shots if you:

  • Have symptoms not controlled with allergy medications
  • Have side effects from allergy medicines
  • Want to decrease medication use
  • Have allergy triggers that you cannot avoid (e.g., pollen, dust, pets)
  • Have severe reactions to stinging insects, including bees and fire ants
  • Want to spend more time outdoors
  • Want a better long-term solution to your allergy problem

Allergy shots are also effective in the treatment of allergic asthma. Over time, they can help your breathing and decrease the need for asthma medicines. Allergy shots also benefit some patients with eczema or atopic dermatitis, when the condition is associated with other allergies.

3. Why should I get allergy shots at Allergy and Asthma Care of Blakeney?

Allergy and Asthma Care of Blakeney is an independent solo allergy practice founded by Dr. Steven McEldowney, who is a board certified allergist. His goal is to provide the best practices in allergy and asthma care, including allergy shots. As a small office, we personalize care and spend more time with our patients. We completely individualize testing and treatment recommendations. For allergy shots, we use the highest quality allergy extracts in recommended doses proven to be clinically effective. Our build-up schedule is shorter so that most patients improve and achieve monthly dosing faster. We also schedule allergy shot visits to minimize wait times and maximize efficiency. We have a high level of clinical success and are constantly striving to improve all aspects of treatment.

4. How much do allergy shots cost?

Most insurance plans cover both the cost of vaccine preparation and administration of shots. Some insurance plans may cover 100% of costs, however some insurance plans may require a co-pay or deductible. This will be dependent on your individual insurance plan. Allergy shots in our office do not involve a specific office visit level co-pay, but there is a smaller charge for administration of the allergy shot. I would recommend contacting your individual insurance plan to determine your benefits. As a service to our patients, we will contact the insurance company on behalf of the patient to determine any potential out-of-pocket expenses before committing to treatment.

5. How effective are allergy shots?

Allergy shots are over 90% effective when given properly. It has been proven in clinical studies to decrease allergy symptoms, medication use, prevent new allergies and asthma in children, and promote lasting-relief of allergy symptoms even after treatment is stopped. Research shows allergy shots are cost-effective and reduce overall health care expenses, including costs from prescription medicine use, office visits, hospitalizations, and missed work/school.

6. Are allergy shots effective for children?

Allergy shots are especially effective in children, because treatment has been proven to help prevent the development of new allergies and asthma. As many as 25% of allergic children may develop asthma as they get older if untreated. This observation is sometimes referred to as the “atopic march.” Allergy shots are normally given to children 5 years or older, but may occasionally be given earlier.

7. Can allergies go away on their own?

While it is certainly possible that allergies may improve, most people will continue to have symptoms that remain the same or worsen over time. Individuals with seasonal allergies may often develop year round symptoms, and individuals with year round allergies may also develop seasonal flare-ups.

8. Where can I get allergy shots?

Allergy shots are normally provided by a board certified allergist, such as Dr. McEldowney. Allergy shots must be given under the supervision of a physician in a facility equipped and trained to identify and treat adverse reactions to allergy injections. For this reason, allergy injections are not administered at home.

9. Are allergy shots safe?

Yes. The most common type of reaction is a local reaction. These vary from a dime-sized itchy spot to a large lemon-sized area of swelling. These often do not require specific treatment and improve as allergy shots are continued. The risk of a serious allergic reaction is rare, but may include serious life-threatening anaphylaxis. Most of the time, a shot of epinephrine will relieve symptoms. Serious allergic reactions normally occur within 30 minutes. As a result, patients are required to remain in the office 30 minutes after their shots are given for observation. Less frequently, patients may have a delayed reaction outside of 30 minutes. We also require and train patients to use an auto-injectable epinephrine pen to carry to and from their shot appointments to cover this rare situation.

10. Why do allergy shots need to be repeated?

Allergy shots work like vaccines. The body develops stronger immunity and decreased symptoms as the allergy vaccine dose is increased and repeated over time. The body’s reaction to allergens is switched from allergy to “tolerance”, which means the body develops the normal state of ignoring allergens in the environment.

11. What is the process of allergy shots?

There are two major phases, including build up and maintenance. During the build up phase, the strength of the allergy vaccines is gradually increased by a fixed schedule to reach a target dose referred to as the maintenance dose. Shot are normally given 1 to 2 times per week initially. This duration is normally 3 to 6 months depending on how often shots are received. The maintenance phase is started after the target therapeutic dose is achieved. In our office, most patients are quickly converted to monthly shots.

12. How long will it take to feel better on allergy shots?

Some patients will notice an early improvement of symptoms within several weeks during the build up phase, but it may take as long as 6 to 12 months on the maintenance dose to see a significant improvement. The effectiveness of immunotherapy is related to the strength of allergy vaccines and the length of treatment.

13. How long do I have to take shots?

The standard duration of treatment is 3-5 years to receive maximum benefit. Most patients can be stopped at that time. Most people have lasting remission of allergy symptoms, but others may relapse after stopping allergy shots. The duration of therapy can vary from person to person and some individuals may need to stay on allergy shots longer than the usual duration.

14. What happens if I don’t get better on shots?

As stated previously, allergy shots are over 90% effective in reducing allergy symptoms. Most patients will improve clinically and decrease the need to take medication, however, not everybody will be able to stop taking all allergy medications. The effectiveness of immunotherapy should be evident after 1 year on maintenance dosing. If a patient has not seen improvement after this time, the individual’s specific treatment should be reviewed to discuss possible reasons why the treatment failed and explore other treatment options.

15. What are the reasons that allergy shots don’t work?

There are multiple reasons that allergy shots may not be as effective as they should. First, it is important to identify and treat all clinically relevant allergens the patient is exposed to. Second, it is necessary to use allergy vaccines in levels high enough to improve symptoms. Clinical studies provide us with specific dosing recommendations to be effective. Third, allergy vaccines have very specific mixing recommendations. If incompatible allergens are treated in the same vial, they can decrease the effective strength of the vaccine. Not following recommended guidelines for dosing and mixing will decrease the effect of treatment. Finally, allergy shots must be given long enough at therapeutic doses to be effective. As mentioned previously, it may take as long as 1 year on maintenance therapy to notice significant improvement in symptoms and medication use.

16. How are specific allergens selected for allergy vaccines?

Allergy shots should be completely individualized based on clinical history, allergen exposure, and allergy test results. A unique treatment mixture is then created for every individual. Allergy vaccines should be prescribed by a board certified allergist with specific training in formulating allergy vaccines.

17. What is a board certified allergist?

An allergist should be certified by the American Board of Allergy and Immunology which is the only allergy subspecialty board recognized by the American Board of Medical Specialties. This ensures that your physician has had at least 2-3 years of subspecialty fellowship training in an ACGME-accredited training program and has passed the board exam in Allergy and Immunology. Dr. McEldowney is board certified by both the American Board of Allergy & Immunology and the American Board of Internal Medicine.

18. How do I check if an allergist is certified by the American Board of Allergy and Immunology?

You may verify that a doctor is board certified at or call toll-free 1-866-ASK-ABMS (275-2267). A short registration and log-on may be required for the website. You should verify specific certification from the American Board of Allergy & Immunology. Note, physicians may be board certified in other specialties (for example, pediatrics and internal medicine) and be considered “board certified”; however, this does not assure proper subspecialty certification specifically for Allergy and Immunology.

19. Can allergy shots treat food allergy?

Allergy shots may help some individuals with pollen-food syndrome, a condition where raw fruits, vegetables and some nuts cause itching of the mouth and tongue. These individuals often have severe pollen sensitivity and food-related symptoms may improve with treatment of underlying pollen allergy. However, it is not generally indicated specifically for food allergy and the best option for people with food allergies is to strictly avoid foods that cause symptoms.

20. Do you offer sublingual immunotherapy (allergy drops)?

Sublingual immunotherapy is the practice of placing drops of allergy extracts under the tongue instead of by injections. Sublingual immunotherapy is not FDA approved and is not covered by insurance companies. As such, these allergy drops are usually paid out-of-pocket to providers using it off-label. Although it has been used more extensively in Europe than the United States, there are important differences in extracts and patient characteristics that need to be determined. Clinical studies are underway and it may be an important treatment option in the future. At this time, we do not offer this form of treatment (allergy drops). Update: Recently, the FDA has approved three commercially available tablets specifically for grass and ragweed allergy. For individuals who these are the most important allergens, this may be a helpful form of immunotherapy treatment without shots.

Allergy Shots – What You Need to Know

Allergy Shots

Allergen immunotherapy injections or “allergy shots” are a treatment for patients with allergic runny or stuffy nose, allergic asthma or life threatening reactions to insect stings. Allergy shots are for people who have serious allergy symptoms that are not helped by changes to their environment and/or medicines. Some studies have shown that allergy shots may stop asthma from developing in children with nasal allergies.

How They Work

Allergy shots may “turn down” your reactions to the things that you are allergic to. The shots do not cure your allergies, but you will have fewer symptoms and need to use less medicine.

It is important to stay on schedule with your allergy shots. If several weeks have passed since your last shot please call and speak to an allergy nurse, 203-432-8797. We may need to change your dose before your next shot.

How long to I have to keep getting my allergy shots?

There are two phases to allergy shot therapy: a build-up phase and a maintenance phase.

  • Build-up phase: In this phase you will start with a low dose injection and build to a higher dose of allergens over time. For typical immunotherapy this phase lasts from 6 to 10 months, depending on how often you get your shots and how well you tolerate them. The build-up phase for venom therapy generally lasts for 10 weeks.
  • Maintenance phase: When you reach your “effective therapeutic dose” you will begin the maintenance phase. During this phase you receive your allergy shots less often, usually every 3 to 4 weeks. The maintenance phase typically lasts 3-5 years (or longer if advised by your allergist).

Reactions to allergy shots

Reactions to allergy shots are common. Most reactions are local (redness and swelling where you got the shot). Rarely, reactions can affect your entire body. This is referred to as a systemic reaction, and it can be dangerous. For this reason you must stay in our office for 30 minutes following every shot appointment. Additionally, you should not exercise for 2 hours after your shots.

If you are having asthma symptoms when you are scheduled for an allergy shot it is important to tell your nurse. Allergy shots can worsen asthma symptoms.

Local reactions

Local reactions are the most common. They can vary from a dime-sized itchy spot to a large lemon-sized swelling. You may need to take an antihistamine (like Benadryl), and apply ice to reduce your reaction. If you have a local reaction tell your allergy nurse at your next visit. If a local reaction lasts longer than 24 hours or happens often your allergist may change your allergy shot schedule.

Systemic reactions

Systemic reactions include:

  • stuffy or runny nose
  • sneezing
  • cough
  • itchy or red eyes and ears
  • itching or tightness of the throat
  • hives
  • flushing
  • lightheadedness
  • chest tightness
  • wheezing,
  • and rarely, life-threatening reactions (including difficulty breathing and/or a dangerous drop in blood pressure ).

Most systemic reactions are mild and improve with treatment, but these reactions may become life threatening. If you experience a systemic reaction in the office tell a nurse right away. The nurse may give you an injection of epinephrine (EpiPen®) or another medication to quickly relieve the symptoms. You may need to be transported to the Yale New Haven Hospital Emergency Department for further treatment and observation.

We will prescribe an epinephrine auto-injector (aka EpiPen®) for you to have with you on your allergy shot days. If you have a systemic reaction after you leave the office, you may need to use your EpiPen® and go to Yale Health Acute Care or a local emergency room for further treatment.

Changes in your health

If at any time during the course of your immunotherapy you develop a new medical condition, you become pregnant, or you start a new medication, please tell the nurse. In particular, high blood pressure or heart medications and certain antidepressants cannot be taken with allergy shots. You should not get your allergy shot if you are have a fever, rash, asthma symptoms, or increased allergy symptoms.

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