What Are Allergy Drops and How Do They Treat Allergies?

Scott Webb (Host): Let's be honest, nobody really likes needles. And when it comes to treating allergies, we now have the option of taking allergy drops instead of shots or using over-the-counter anti-histamines. I know, it's amazing. And joining me today to discuss the many benefits to allergy drops is Dr. Haley Overstreet.

She specializes in allergy medicine at Aspire Allergy and Sinus. This is A-Choo the podcast for people with allergies and sinus issues from Aspire Allergy and Sinus. I'm Scott Webb. So, Doctor, thanks so much for your time today. We're talking about allergy drops today and maybe why folks should choose them over some of the other options like shots and anti-histamines.

So as we get rolling here, what are allergy drops?

Haley Overstreet, MD (Guest): Allergy drops are basically the same thing as allergy shots. It's just administered in a different way. So, instead of doing a sub Q injection, it is just three drops sublingual or under the tongue.

Host: Yeah. And let's maybe go into this a little bit more, cause I'm sure folks are maybe just hearing about it for the first time and maybe want to try something like this out, especially if they have allergies, of course. So, how did they work exactly?

Dr. Overstreet: So, basically it is a administration of the allergens that they are allergic to. And we're just introducing it to the immune system in a way starting low and gradually increasing over time. So that we're desensitizing the immune system to these allergens so that your body no longer has, a reaction or symptoms.

Host: Yeah. So, it's like a slow introduction to the allergens, which sounds really interesting. And maybe this should be obvious to me, but how exactly do people take allergy drops?

Dr. Overstreet: As I was mentioning earlier, it's three drops under the tongue every day. In a perfect world, it's one drop three times a day, but that's not always feasible. And that's okay. Because oftentimes it works doing it twice a day or even one time a day. If you don't have the time to split them up. But it's just three drops under the tongue.

You let him sit for at least 20 seconds before you swallow and then 20 minutes before eating or drinking. And so I just tell my patients figure out what works for your schedule, what works for your routine and work it into that. Our drops do not have to be refrigerated as well. And so they can sit out at room temperature and you just put it either by your toothbrush or on your nightstand somewhere where you're going to see it so that you remember it. And you can incorporate it into your routine.

Host: Yeah. This sounds really easy, like almost too easy. And I'm sure it's great for kids and probably just busy people, right?

Dr. Overstreet: It is extremely helpful for our children who, you know, do not like to take injections. That was definitely a big deterrent. And then as you mentioned for our patients who are busy, especially our adolescents who have, you know, sports and other things to get to and school, it's hard for them to take time out.

And so it's really a great option for really anyone because it's something where you don't have to deal with needles. You can travel with them. They meet the fluid restrictions for airlines. And so, it's a convenient option for pretty much any of our patients. And then we also have flavors to the drops as well, so that they don't taste bad either.

We started that for our kids and the adults have jumped on board and they love to add strawberry grape, apple, raspberry, whatever their favorite flavor is, to their drops. And we also have an app too that makes it even easier. An app called Perx where you can download this app and it sends you reminders. So, it even helps you a little bit and reminds you to take your drops whenever you'd like it to remind you. And there's even little incentives along the way that can help keep you on track. So.

Host: It's all really amazing. I'm just shaking my head saying, you know, I almost wish my daughter had allergies. It would be so easy if she did. Cause you know, she plays multiple sports and so on. So, really amazing and not surprising at all as an adult myself who likes things with flavor, not at all surprising to hear that adults are like, well, hey, maybe just drop a little strawberry in there for me. It's really cool. So how long

Dr. Overstreet: It makes it a little bit more fun. Yeah.

Host: It really does. Yeah and the app as well. How long does it take for them to kick in if you will, how long does it take before they start to work?

Dr. Overstreet: So, on average in my practice, I tend to see patients having symptom improvement within three to six months. Now everyone's a little different. We typically say, you know, up to nine to 12 months, because at that point we're getting kind of to our what we call a maintenance phase of the drops where they're at higher concentrations. But on average, about six months, most of our patients are seeing improvement of their symptoms.

Host: Yeah. And so how long is the treatment plan? And also maybe like, what's the efficacy, if you will, you know, so how long are folks on these things and how well do they work?

Dr. Overstreet: So, the treatment plan it's recommended to be done for about three to five years. Again, every patient is different and we meet with them at least once a year to assess their progress and decide if we need to make any adjustments to their prescription so that every year is as productive as possible.

But on average, the recommendation is for three to five years of treatment so that when they come off of those drops, symptoms don't come back. They get those long-term results. As far as efficacy for the drops, it's very similar to the injections. We now have a lot of studies that are showing at the one-year mark, if someone's doing injections versus drops, the efficacy is still 87, pushing 90%, which is really great either way. We don't have any head-to-head studies right now on injections versus drops. And every patient is different. But, on average, the efficacy is really great for the drops. So, there's really no reason not to try it at this point, if you're busy or have other, cost-prohibitive, whatever the case may be for the injections.

Host: Yeah, I think you're so right. And as you say, this versus shots or having to go to the store and buy antihistamines and things, and I'm sure they will get to comparing things, head to head in terms of efficacy. But even as you say, at 87 to 90%, pretty amazing. And, so many positives here, so many reasons, to give this a shot or, well, we don't want to say shots right. To, to give this drop, if you will, maybe. It's all. Yeah, it's all good stuff. And I guess maybe in the final analysis here, Doctor give us your best reasons, your best takeaways, why people should choose the drops over shots over the over-the-counter anti-histamines if you will.

Dr. Overstreet: Well, I'll start with the anti-histamines or the decongestants, those over the counter medications. Those are all good medications. They do help. However, number one, there is still a cost, you know, that is associated with that. And it's treating the symptom, not the root cause. And it's always best to go back and to treat what's causing these symptoms versus continually putting a band aid on them. So, we do use anti-histamines and nasal sprays and nasal rinses and all of those things, in addition to, especially while we're getting started on immunotherapy treatment.

Host: Yeah. And then maybe let's just go over one last time. When we talk about drops versus shots, I think you've discussed the many benefits to at least giving drops the opportunity, today but let's just go back over that. Why would you recommend the drops over shots?

Dr. Overstreet: I think it's something where you just have to assess what works for your lifestyle. And then also sometimes what works for your budget because injections are not covered by all insurances or at least the out-of-pocket costs can still be pretty cost-prohibitive. Whereas the allergy drops, even without insurance, it ranges between $40 to $60 a month, which is doable.

The other thing is, your schedule, your lifestyle. If you are someone who enjoys traveling, then the injections are not for you. That drops would be, you know, definitely something that you would be able to be more compliant with. If you are a person who is working in an office or in a position where it's difficult for you to take time out during the day to come and have an injection in the office and then be observed for 30 minutes. So it usually takes about an hour out of your day, between travel time and having the injection administered and monitored; then definitely drops are much easier. You know, put those under your tongue and you can go about doing whatever you're doing, even while you're waiting to swallow or waiting that 20 minutes to eat or drink.

So it, it just fits into a busy lifestyle a lot easier. And then if you're someone who's active who enjoys exercising, or like we were talking about with our younger patients who are in sports and activities, there's no period of time that they have to be off of that exercise or off of those activities.

Whereas we do recommend at least two hours of no vigorous exercise after the injections. So, it just works for those patients who are busy, who do not have time to come into the office or who have a needle phobia, which we all know is something that no one likes. This is a great option for any of those patients.

Host: It really is. This has been so educational today to learn about allergy drops and all of the many benefits. It's rare that you go through, you know, when I host these, where there isn't some sort of downside, but I really can't find one here. And really amazing to learn about this. So Doctor, thanks so much for your time and you stay well.

Dr. Overstreet: Thank you for having me.

Host: For more information, go to aspireallergy.com and you can find more episodes and information at aspireallergy.com/podcast. This has been A-Choo!, the podcast for people with allergies and sinus issues from Aspire Allergy and Sinus. I'm Scott Webb. Stay well.

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