Allergies Diagnosis and Treatment
At the Allergy Center of Potomac Ear, Nose and Throat, we provide comprehensive diagnosis and treatment of environmental allergies. We perform skin testing for 28 of the most common allergens of the Washington DC metro area. We offer immunotherapy for the treatment of allergies.
Allergy Center hours
Monday – Thursday 9:00 AM – 6:00 PM (Last shot given at 5:45 PM)
Friday 9:00 AM – 5:00 PM (Last shot given at 4:45 PM)
Conditions We Treat
What is Immunotherapy?
Immunotherapy is a program of regular exposures of increasing amounts of extracts of allergens (organic substances which use allergies) to which you are sensitive. When sufficient relief of your allergy symptoms cannot be achieved with environmental controls and medications, immunotherapy can reduce your sensitivities. It is effective for pollens, dust, mold spores, fungi, and some animal danders.
Immunotherapy can be accomplished in 3 ways: shots, sublingual drops, and more recently tablets (only for certain grasses).
Allergy shots (Subcutaneous Immunotherapy or SCIT) have been used for decades for allergy sufferers and are covered by most insurance providers. Weekly shots are given and you are observed for 15 minutes in the office for any severe allergic responses. Although extremely rare, there is a small risk of anaphylaxis after giving an allergy shot.
Sublingual drops (Sublingual Immunotherapy or SLIT) allows one to self administer the allergens underneath their tongue. However, most insurance providers do not cover this because it has not been FDA approved. You are observed in the office for the first two doses to ensure there is no severe reaction. Subsequently, you will be allowed to self administer the drops at home. It is safe and has less risk for anaphylaxis than allergy shots. It is much more widely used in Europe and has proven safe in European trials.
In April 2014, the FDA approved Grastek ®, Oralair ®, and Ragwitek ® tablets for sublingual immunotherapy. These are tablets that you can take at home. These are useful if you have specific allergies as listed below and you ONLY want to treat those specific allergies:
- Grastek® is used to treat allergies to Timothy grass
- Ragiwitek® is used to treat allergies to Ragweed
- Oralair® is used to treat allergies Sweet Vernal, Orchard, Perennial Rye, Timothy and Kentucky Blue Grass
For more information on immunotherapy see our Frequently Asked Questions section.
The Common allergens that we test include:
- Ash White
- Box elder
- Bermuda Grass
- Johnson Grass
- Timothy Grass
- Lambs Quarter
- House Dust Mix
- American Dust mite
- (Dermatophagoides farina)
- European Dust mite (Dermatophagoides pteronyssinus)
- Feather (chicken, duck, and geese)
What is Immunotherapy?
Your allergy symptoms are caused by your body producing excessive amounts of allergy antibody when you breathe allergens. Immunotherapy helps your immune system build protective antibodies to the various allergens for which you are being treated. These protective antibodies reduce the allergic reactions and can suppress your system’s tendency to produce excessive allergy antibodies.
Allergy immunotherapy can be done in two ways. Either through injections or throat a regimen of sublingual drops
Injections are administered weekly until you have achieved your maximum symptom-relieving dose. This takes several months depending on your degree of sensitivity.
The blood tests and skin tests indicate a safe starting dose. Each patient is different and the strength of the maintenance dose and frequency of injections is tailored to the individual.
The maximum symptom-relieving dose is then repeated weekly until your symptoms have been controlled through at least two consecutive seasons. After that time, an attempt is made to gradually taper your injections. Most patients undergo immunotherapy an average of 3-5 years.
Generally, as the strength of your treatment dose is increased, you will experience relief of your symptoms after the injection. This relief gradually wears off during the week and your symptoms may return. Eventually, the majority of your symptoms will be controlled from week to week.
Interruptions in your progress can occur if you have an infection, are under stress, or have other medical problems that are not controlled and can produce allergic-like symptoms. Excessive exposure to pollens, dust, molds irritants, tobacco smoke or smog in your environment may cause an increase in your symptoms. It may be necessary to adjust your allergy dose and take allergy medication.
Occasionally, you may have a local reaction at the injection site consisting of redness and swelling. It is usually of little importance. When a local reaction is greater than 2 inches or persists for more than 48 hours, it is an indication to adjust your next treatment dose.
You may experience a slight increase in your allergy symptoms the first day after the injection. This may be controlled with allergy medication if necessary and also indicates a need to adjust your treatment dose. It is important to notify us of any local reactions or increased symptoms.
Rarely, patients can have severe life threatening systemic anaphylactic reactions. This is why all our patients are prescribed an epinephrine pen. All patients must bring their epinephrine pen with them to all allergy shot appointments in case this rare emergency happens. Our office is equipped with medications and equipment needed to manage the reaction.
Allergy injections can be safely administered during pregnancy.
When your allergy symptoms have been controlled through two consecutive seasons, it is then appropriate to taper off allergy injections. If your symptoms have responded to immunotherapy, your inhalant allergy symptoms will remain controlled as the interval between injections is lengthened. The method for tapering allergy injections is adjusted to fit the individual patients.
If you are not improving, you will be reevaluated. Other inhalant allergies or perhaps, food sensitivities may be contributing to your symptoms. Additionally other factors can contribute allergic-like symptoms: irritants such as smog, smoke and chemicals, other medical conditions and medications, stress and infection.
Our Head Audiologist
Emily Pastore, Au.D., CCC-A
Dr. Pastore has moved along the east coast with her U.S. Coast Guard husband Mathew from Maine, to South Carolina, back up to Cape Cod, MA before making Woodbridge, VA their home in order to be near family. Dr. Pastore enjoys working in all aspects of clinical audiology from testing hearing, to special diagnostic testing for dizziness and balance, to finding the right hearing aid options for each patient.
Dr. Pastore spends her time outside the clinic with her young daughter and son taking walks along the local trails as well as watching her daughter in gymnastics and her son learn to play the drums.