9 ms·

A lot of people take their allergies for granted, but real treatments for allergies are available and they work. I am on allergy shots and my severe cat allergi

A lot of people take their allergies for granted, but real treatments for allergies are available and they work. I am on allergy shots and my severe cat allergies are effectively cured, along with my lifelong hay fever. My son is doing sublingual immunotherapy for several food allergies including peanut and he is now able to eat several whole peanuts. Before he would react to milligrams; in a couple of years I expect him to be able to eat a PB&J. Luckily his eczema is gone now but if it wasn't we'd be trying Dupixent which is a wonder drug for a lot of people, and treating eczema in infancy is believed to stop the later development of other allergies and asthma as well. It hasn't been understood until recently (and still isn't known by many practitioners) that these allergy treatments are dramatically more effective and safer when started in the first months or years of life. It makes sense that treating allergies would be easier while the immune system is developing rather than afterward. I suspect that in twenty years it will be standard to start infants on sublingual immunotherapy for all the common allergens (literally putting a tiny, strictly controlled amount of the allergens under the tongue once a day, simple as that) as a prophylactic starting around four months of age, and that will essentially eliminate all of the common allergies in the population. We need more research to get there, but that's the trend I see. Another strong possibility is we'll finally discover the factors our immune systems are missing in modern life and reintroduce them, possibly in the form of probiotics, and stop most allergies from developing that way. Either way, I hope this is the last generation that suffers from high rates of allergies.

silisili 3y ago
I'm not sure that would always help. I'm allergic to grasses and dogs, for example, despite growing up in a house with dogs and tons of grass outside. I still love both, so just deal with it. Perhaps just exposure to more deadly things, like nuts and shellfish?
- danielheath 3y ago
  Anecdotal: Cat allergy shots helped my symptoms in a way that living with cats for years never did.
  - silisili 3y ago
    Never tried dogs. I did grass allergy shots for about 6 months as an adult. All that ever gave me was an itchy arm. My nose -still- becomes a spigot every time I have to cut grass...
    - i_am_jl 3y ago
      6 months? Were you told to expect results that quickly? I don't think I saw meaningful results from my subcutaneous allergy shots for 1-2 years.
      - silisili 3y ago
        To be honest, no. I stopped due to out of pocket costs and not seeing any result in that time period.
    - danbolt 3y ago
      I’m the same way. I tried the shots for a year but they made my eczema a lot worse. I wish they were a panacea.
    - modeless 3y ago
      6 months may not have been long enough for them to work. And allergy shot protocols are not standardized. Your allergist may not have used a large enough dose or the right updosing schedule. I've had shots at three different allergists (I stopped the first two treatments for personal reasons unrelated to the treatment), and this third one seems to give larger doses (which unfortunately makes the shots more painful), and is also the most effective one by far.
    - Modified3019 3y ago
      It took about a year before there was any noticeable effect for me. It was only at the 3 year mark when I could tell specifically how much better certain things were. It it definitely not a quick fix, you need to commit to the long haul. Edit Yeah, doing out of pocket definitely makes it harder to keep up with. Fortunately my insurance covers most of the cost of my shots.
- modeless 3y ago
  Everything you're allergic to is something you were exposed to at least once; your immune system has to see it and learn to recognize it before you can react to it. Some types of exposure are good and some are bad. Good types include oral exposure and continuous exposure (as in sublingual immunotherapy). Bad types include skin exposure (especially with eczema) and intermittent exposure with long periods of zero exposure (e.g. seasonal pollens including grass). Timing is also important especially relative to other immune triggers like actual sickness or vaccines or allergens that you already react to. This is all poorly characterized in general and a lot more study is needed, but we definitely know of ways to expose you to allergens that are much less likely to cause allergies and in fact are likely to reduce or cure them.
  - ttymck 3y ago
    > Everything you're allergic to is something you were exposed to at least once; your immune system has to see it and learn to recognize it before you can react to it. Is this true? From a biochemistry perspective, it doesn't seem like it's necessarily true. Allergies could be genetic, in which case a genetic mutation results in the phenotype where an immune system mis-identifies allergens as harmful.
    - modeless 3y ago
      In biology anything is possible. I'd never rule out something like that. But for all common allergens I'm aware of it is true, you cannot be allergic until after your first exposure. That said, some things are "cross reactive" due to similar proteins, meaning that e.g. you could be allergic to goat's milk even though you've only been exposed to cow's milk. And some of these relationships are less obvious, like cashew and mango or banana and latex.
      - pfannkuchen 3y ago
        How do you detect that someone is allergic without exposing them? Or does the test not count? My tautology hackles are raised.
- spondylosaurus 3y ago
  There are broad-spectrum allergy shots that work by essentially turning off the part of your immune system that triggers allergies (IgE antibodies) while leaving the rest of your immune system (IgG, IgM, etc.) intact. I've been on one called Xolair for almost four years now and it's worked wonders for my copious environmental allergies... dust bunnies hardly make me sniffle now!
- projektfu 3y ago
  An allergist I saw had four dogs walking around the clinic all the time. I asked him if that was a problem and he said in his experience, people aren't allergic to dogs, i.e. dander, but rather to the allergens that rest in the fur. Wiping the dogs frequently allows his patients to enjoy the company of the dogs. They were all short haired single-coated dogs. The saliva, on the other hand, definitely can cause me to break out when a dog's teeth scrape my arm. But if I work with a cat and touch my eye, I get conjunctivitis right away. Anyhow, the immunotherapy can really work, and definitely made my allergies better, even though it didn't ban them completely. For example, I used to be unable to share a room with a rabbit without an N95. Now I can visit rabbit households without a problem. My children will definitely be getting early allergy testing and immunotherapy if needed.
- naasking 3y ago
  > I'm allergic to grasses and dogs, for example, despite growing up in a house with dogs and tons of grass outside. I believe ramping up exposure dose is an important part of the protocol. You don't immediately jump to the highest dose for many drugs. Exposure to large amounts of allergens regularly just trains your immune system to continue responding as if it's being attacked. The point is to introduce doses that don't trigger a strong reaction so the system learns to ignore it, and then ramp up from there.
Obscurity4340 3y ago
Whats the regimen? Is it chronic/life-long or is there are point where you're effectively immunized to the allergens in question? Do you ask your dr for a referral and to whom are you directed for evaluation?
- modeless 3y ago
  Different allergies behave differently and some are easier to treat than others. My allergy shots are a 3 year course of monthly shots. Afterward I will supposedly have lifelong protection but we will see. For food allergies personally I suspect that after 5+ years of exposure without reactions you're probably protected for life, especially if you start treatment as an infant or toddler, but there aren't any long term studies to determine whether that's true. Current guidelines for food allergies are to maintain daily allergen exposure indefinitely to maintain tolerance.
  - Obscurity4340 3y ago
    Would this be effective potentially for chronic rhinitis/runny nose? I would be all over that if so
    - modeless 3y ago
      Absolutely yes.
      - Obscurity4340 3y ago
        How do you bring this up with your doctor so I know where to ask for or be directed towards? Like what did you have to ask for to initiate all this?
        modeless 3y ago
        You need to see an allergist. You can get a referral or call one directly for an appointment.
nextos 3y ago
> [...] discover the factors our immune systems are missing in modern life and reintroduce them Sadly, many commensal bacteria that co-evolved with us have gone extinct due to a variety of modern interventions [1]. Re-engineering the gut microbiome is an incredibly challenging problem but essential to re-establish immune tolerance, which is governed by microbes [2]. [1] https://www.cell.com/current-biology/pdf/S0960-9822(15)00614-4.pdf https://www.cell.com/current-biology/pdf/S0960-9822(15)00614... [2] https://www.nature.com/articles/s41586-023-06431-8 https://www.nature.com/articles/s41586-023-06431-8
- Sparkyte 3y ago
  Everything changes. That is the problem, we might not see it but disease and even nature itself is in costant flux. It isn't because we are killing it off which is the misunderstanding. If the landscape for bacteria and viruses change we should assume we are just as susceptible to things. We humans like to think our lives as unchanging, immovable, irreplacable and staticly shaped."The 90s lives on!", it is a perfect example that we paint this illusion because it is hard to accept that from this point on everday second, minute, hours... so on will change and alter us. That alteration is irreversible even if we can change or shape the outcome. People are just uncomfortable with this idea.
  - adroniser 3y ago
    that's like, really deep, man.
    - Sparkyte 3y ago
      It is insane to think that not a single atom you were born with exists with you as an adult. Really brings up the Ship of Theseus vibes. Kind of leading, since it is hard to say exactly. Some guessitimates are 2%. But really that isn't a lot of what once was you.
      - tuukkah 3y ago
        Hmm, two percent of the atoms you were born with, or two percent of the atoms you consist of as an adult? (If former, it really is little, if latter, it's mostly because of the bulk added by normal growth.)
makeitdouble 3y ago
> A lot of people take their allergies for granted This bit get me perplexed. Severe allergies usually means pills and an Anapen prescription from a specialist that needs to be renewed at least every few years due to the experiation of the pen. If between two visits there was new ways to deal with a specific allergy I'd expect the doctor to guide their patients (at least ask if they're willing to give it a shot). Are there people out there followed by a specialist for years, subject to a deadly condition that affect their daily food choice, that never got asked if they'd want to get rid of their allergy as a cure was available ? That feels unethitical, borderline criminal to me.
- modeless 3y ago
  The risk of death from food allergies is often exaggerated. Fatal anaphylaxis is actually extremely rare. Even in people with severe allergies. Meanwhile the treatments are not 100% guaranteed to work, and they do have significant risks of their own, plus costs both monetary and non. So it's completely reasonable even for people with severe allergies to choose to not be treated. But I agree that more people should be made aware of the options.
  - makeitdouble 3y ago
    > Fatal anaphylaxis is actually extremely rare. Even in people with severe allergies. If your only metrics is dead people, perhaps. If we look at people ending up in ER in a severe state, there would be a lot more (anecdotally that's how many of us have discovered allergies, from asking other parents dealing with it) > Meanwhile the treatments are not 100% guaranteed to work, and they do have significant risks of their own, plus costs both monetary and non. Thanks, I assume there's significant research behind them, so I'd see how a doctor could want to wait a bit more advancement before mentionning it to their patients.
- the_gipsy 3y ago
  Some common allergies, hay fever or animals, are simply put up with by most people. If they are not dangerous. They make your life difficult, but it's not like you're in pain. I was miserable every spring from the hay fever. Ironically when you're supposed to crawl out and enjoy nature after winter, I preferred to stay confined. From the dustmites, I had irregular sleep because I would have a clogged nose in bed or severe sneezing.
WA 3y ago
> A lot of people take their allergies for granted, but real treatments for allergies are available and they work. Source please. I talked to several doctors about treating hay fever (grass pollen allergy) and the consensus was that desensitization doesn't work that often. Success rate is 20-50% or something like that and there's the risk that the body develops other allergies for some reason. Apparently, my hay fever symptoms are rather strong. Medication doesn't really work. Best is avoidance: staying inside, vacation in countries with less grass pollen, and wearing FFP2 masks outside (helps a lot!). Stuff you don't breathe in doesn't need to be fought by the immune system.
- the-dude 3y ago
  When I resumed going outside a lot again ( early in the season too ) my hayfever practically disappeared. The first year I still had severe symptoms early in the year which I decided I had to endure.
- modeless 3y ago
  I'm not aware of any increase in risk of developing other allergies from the treatment. It is true that success is not guaranteed, however I believe the success rate is higher than that. Here's a study finding 76% effectiveness in dust mite allergies in adults. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705479/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705479/ And as I mentioned, I expect much higher effectiveness in children. That said, the treatment does have risks and costs. It's certainly reasonable to decide against trying it. If your allergies cause asthma, Xolair and Dupixent are other options you can try. Combining Xolair or Dupixent with desensitization treatment is an exciting current area of research.
  - d__a__n___g 3y ago
    [flagged]
  - hdjjhhvvhga 3y ago
    > Xolair Unfortunately Omalizumab has some inherent risks and it's probably not something you'd consider first.
olau 3y ago
Oral treatment is really low tech as long as you're not dying from it. For instance, for grass, the pollen is easily available, you can just chew seed stalks and spit them out. I've gone from being pretty miserable 5 years ago to not feeling much in the pollen season.
- modeless 3y ago
  Yeah, it's possible to DIY in some cases since, as you say, the treatment is low tech, literally just having the allergens in your mouth. But I highly recommend using an allergist, especially if your allergies are severe, where the possibility of anaphylaxis is there. There are other possible rare side effects as well, such as eosinophilic esophagitis. Following a protocol where the amount is strictly controlled and possible side effects are monitored is important for safety.
  - seabass-labrax 3y ago
    Plus, if your doctor is very clued-up, they might even know of a scientific study to refer you to where your experiences can better the academic literature about your allergy. Sometimes, you even get paid for participating in such experiments.
    - modeless 3y ago
      True, though you risk being told after years of diligent treatment that you were in the placebo group.
- Ozzie_osman 3y ago
  The first problem with this would be if you have a severe reaction because you gave yourself too large a dose or happened to be particularly sensitive that day (having an illness or other immune reaction going on). The other thing I'd question is the efficacy. The standard treatments gradually increase dose to "train" the immune system. Presumably you won't have as fine-grained an ability to adjust the dose you're exposing yourself to, and so you might over or under expose.
juanani 3y ago
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supazek 3y ago
Every time I talk to someone that’s on a stack of meds or has gone through multiple journeys using modern medicine they always seem to be the most unhealthy people. It seems like a chicken or egg problem, and maybe it’s just confirmation bias but i much prefer natural remedies. These people seem to be constantly fighting side effects. Too many unknowns when it comes to highly concentrated exotic chemical solutions.
- modeless 3y ago
  Natural remedies like... taking small doses of the thing you're allergic to in order to desensitize yourself? Because that's what the immunotherapy I'm talking about is. Not "exotic chemical solutions".
  - namaria 3y ago
    It's always the people who decry medicines, i.e. highly pure, intensely tested dosages of chemicals, as "exotic chemicals" while in the same breath advancing "natural medicines", i.e. wildly variable dosages of hundreds of random molecules. Some people seem to think "chemical" is something artificial and bad while "natural" is somehow a rainbow of goodness and not the result of insanely complicated biochemistry.
- namaria 3y ago
  Concluding medicine = bad because it's always the sickest people who are on the most meds is basically a caricature of bad logic. I refuse to believe this isn't satire.
seabass-labrax 3y ago
> ...treating eczema in infancy is believed to stop the later development of other allergies and asthma as well. This is a fascinating topic, and one which I think deserves a lot more attention, as it cross disciplines like 'dermatological', 'nutritional' and 'respiratory' medicine; it is related to many parts of the body and so could potentially explain not yet fully understood aspects of our biology. In a limited fashion though, I think I know what caused my eczema, and what to remove to effectively cure it: stress! My eczema was nowhere near as bad as some people's, but for a while during childhood I saw the doctor about it; I used dermatological pastes daily for weeks and rubbed it off multiple time a day times with cotton wool. However, eventually I gave up as it seemed to make no difference. Since then, it has become apparent to me that it is almost directly correlated with mental stress, which ironically (but perhaps luckily!) means I'm not really bothered by it any longer. I understand that 'relax' probably isn't going to work on its own if you have eczema badly, but it's interesting that what seems like purely mental stress about entirely non-physical things has such a strong effect on our physiology.
hdhd 3y ago
Sublingual IT didn't work for us much. We are now on OIT and it's night and day. Real milk from day 1, up to 8ml/day now. Agree with the overall sentiment. But bear in mind the US is more advanced than many countries, these treatments may not be available. Even in the US, OIT is done in research setting and not covered by insurance.
arcticbull 3y ago
> Another strong possibility is we'll finally discover the factors our immune systems are missing in modern life and reintroduce them, possibly in the form of probiotics, and stop most allergies from developing that way. People who grow up with cats or dogs are a lot less likely to have allergies. They just drag everything in an expose you, I assume. [1] [1] https://time.com/6266337/pets-food-allergies-children/ https://time.com/6266337/pets-food-allergies-children/
cogman10 3y ago
Are you permanently getting shots? If so, what's the frequency? I'm a hay fever sufferer and it be nice if I want miserable for 2 months a year.
IG_Semmelweiss 3y ago
>>>>>>>>>>> (literally putting a tiny, strictly controlled amount of the allergens under the tongue once a day, simple as that) as a prophylactic The english name for this practice is "Hormesis". A form of hormesis famous in antiquity was Mithridatism, the practice whereby Mithridates VI of Pontus supposedly made himself immune to a variety of toxins by regular exposure to small doses[1] (Kings had to be paranoid about poisons) https://en.wikipedia.org/wiki/Hormesis#History https://en.wikipedia.org/wiki/Hormesis#History
- p3rls 3y ago
  It should be noted this will render you unable to commit suicide via peanut butter in an emergency
- js2 3y ago
  Boy, you teed this right up, didn't you? "Alright, where is the poison? The battle of wits has begun. It ends when you decide and we both drink, and find out who is right, and who is dead." https://www.youtube.com/watch?v=rMz7JBRbmNo https://www.youtube.com/watch?v=rMz7JBRbmNo
VoodooJuJu 3y ago
I'm glad we can depend on the modern medical-industrial complex to provide us with lifelong treatments that rescue us from the problems caused by....modernity. Going forward, let's take the via negativa. Rather than add more dependencies, which come with complexity and misaligned incentives, let's see what we can remove.
- api 3y ago
  https://pbs.twimg.com/media/DA64y1dXoAAnHzW.png https://pbs.twimg.com/media/DA64y1dXoAAnHzW.png Modernity has unambiguously created a net increase in health. The key here is net increase, which can happen even if some of what modernity brought was negative. Over time we gradually figure out what the negatives are and either remove or correct them.
  - VoodooJuJu 3y ago
    These life expectancy stats are deceptive because they factor in infant mortality. In the days of yore, if one survived to the age of five, one's life expectancy wasn't much lower than it is today [1]. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2625386/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2625386/
c4mpute 3y ago
I was diagnosed with hayfever as a boy and had immunotherapy for it. It was useless. I also had frequent exposure before my diagnosis (without symptoms), which seems typical according to my doctor, because allergies tend to develop /after exposure/. This, as my anecdotal evidence, and every medical text about it, contradicts your ideas. Please consult a doctor before doing anything you suggested to your children or yourself, because your suggestions are /dangerous/.
- explorigin 3y ago
  Sublingual immunotherapy is a customized treatment administered by medical doctors. What do you mean by dangerous? (I'm not affiliated with https://www.wyndly.com/ https://www.wyndly.com/, but that could be a good place to start for those unfamiliar.)
  - c4mpute 3y ago
    Dangerous as in: exposure can cause allergies that haven't been there before. Medical treatment with allergens can also cause allergies and therefore shouldn't been done willy-nilly in a prophylactic manner. Also, suggestions like those usually bring out the quackery in people, with things like "Oh, hayfever? Let's cure it by doing summer holidays on the farm!" and "Oh, peanut allergy? I have a sandwich for you, kid!".
    - explorigin 3y ago
      Clearly you have never seen proper immunotherapy (which has been in practice for decades). All patients are prescribed an epi-pen prior to starting treatment. It used to be that all doses were monitored for anaphylactic reactions but that is now clinic-dependent.
- modeless 3y ago
  I'm not suggesting that anyone should do anything without the advice of a doctor. Yes, deliberately exposing yourself to things you are allergic to is dangerous and an allergist's guidance is very important for safety. I'm sorry immunotherapy didn't work for you but your anecdotal evidence doesn't invalidate all the published research. Yes, allergies always develop after exposure. But not all exposure is created equal! Some types of exposure tend to cause allergies while other types tend to protect against allergies. Immunotherapy is the right type of exposure, under the guidance of an allergist.
granshaw 3y ago
It’s astounding that we have an understanding of far away phenomena like black holes and supernovas, but have such a poor understanding of so many aspects of the systems in the human body still
- modeless 3y ago
  Modern medicine is really primitive compared to the sophistication of biology. I think it will take superhuman AI to fully understand and control biological phenomena.
- tmn 3y ago
  We have models for those things. That doesn’t mean we understand the true phenomena in all it’s nuance.
Ozzie_osman 3y ago
They are a hell of a commitment though, at least the shot-based ones. Once a week you have to go to a clinic, get the shot, wait 30 minutes to ensure no reaction. If you miss doses, you fall behind and have to repeat things. I got about 70% of the way through my treatment then had to travel for two months, after which the thought of starting back up again was daunting and I just gave up.
- pid-1 3y ago
  I brought the vaccine and stored in my refrigerator. The clinic's nurse showed me how to use it by myself. Not sure if that's possible everywhere / for every treatment. After ten weeks taking shots every Sunday, my allergies got significantly better. I used to be that guy with a perpetually stuffy, running nose, now I can't even remember the last time that happened. 10/10 would do again.
  - Obscurity4340 3y ago
    Do you still take it regularly or are you essentially "immunized" now? Sounds amazing anyway. Whats the shot called?
    - Ozzie_osman 3y ago
      https://www.mayoclinic.org/tests-procedures/allergy-shots/about/pac-20392876 https://www.mayoclinic.org/tests-procedures/allergy-shots/ab...
    - pid-1 3y ago
      > Do you still take it regularly My understanding is that after 10 weeks, I was supposed to get a monthly shot for 2-3 years. I ended up never doing the second part, though. > are you essentially "immunized" now? No, I'm not. I was told by doctors the effects of this sort of treatment last for "several years". > Sounds amazing anyway. Whats the shot called? I still have the shot, it does not have any specific brand, just the lab name in the box. That's the lab's wepage: http://www.llac.com.br/ http://www.llac.com.br/. The shot itself has the dosage, my name, the doctor's name, the expiration date and "ALÉRGENOS INALÁVEIS 1:10.000" written on it.
tarboreus 3y ago
When I was a child, my (many) siblings and cousins played in rat-infested hay bales. None of us have allergies. Coincidence? Seriously, though, I do think that sterile environments have something to do with it.
- modeless 3y ago
  That's a leading hypothesis. Research has specifically shown that children who spend time in barns with hay and farm animals are significantly protected from allergies. Even before birth! It does take a large amount of exposure, though. Something like a couple hours once a month is probably not protective and might even cause sensitization.
  - tarboreus 3y ago
    Yeah, we practically lived there.
JumpinJack_Cash 3y ago
> > Another strong possibility is we'll finally discover the factors our immune systems are missing in modern life AKA Close calls with death, we should reintroduce them, but we won’t out of fear
amluto 3y ago
> treating eczema in infancy is believed to stop the later development of other allergies and asthma as well. Out of curiosity, do you have a reference for this?
- modeless 3y ago
  Pretty easy to find by Googling. Here's one: https://www.jaci-inpractice.org/article/S2213-2198(19)31018-9/fulltext https://www.jaci-inpractice.org/article/S2213-2198(19)31018-...

silisili 3y ago

I'm not sure that would always help. I'm allergic to grasses and dogs, for example, despite growing up in a house with dogs and tons of grass outside. I still love both, so just deal with it. Perhaps just exposure to more deadly things, like nuts and shellfish?

danielheath 3y ago
Anecdotal: Cat allergy shots helped my symptoms in a way that living with cats for years never did.
- silisili 3y ago
  Never tried dogs. I did grass allergy shots for about 6 months as an adult. All that ever gave me was an itchy arm. My nose -still- becomes a spigot every time I have to cut grass...
  - i_am_jl 3y ago
    6 months? Were you told to expect results that quickly? I don't think I saw meaningful results from my subcutaneous allergy shots for 1-2 years.
    - silisili 3y ago
      To be honest, no. I stopped due to out of pocket costs and not seeing any result in that time period.
  - danbolt 3y ago
    I’m the same way. I tried the shots for a year but they made my eczema a lot worse. I wish they were a panacea.
  - modeless 3y ago
    6 months may not have been long enough for them to work. And allergy shot protocols are not standardized. Your allergist may not have used a large enough dose or the right updosing schedule. I've had shots at three different allergists (I stopped the first two treatments for personal reasons unrelated to the treatment), and this third one seems to give larger doses (which unfortunately makes the shots more painful), and is also the most effective one by far.
  - Modified3019 3y ago
    It took about a year before there was any noticeable effect for me. It was only at the 3 year mark when I could tell specifically how much better certain things were. It it definitely not a quick fix, you need to commit to the long haul. Edit Yeah, doing out of pocket definitely makes it harder to keep up with. Fortunately my insurance covers most of the cost of my shots.
modeless 3y ago
Everything you're allergic to is something you were exposed to at least once; your immune system has to see it and learn to recognize it before you can react to it. Some types of exposure are good and some are bad. Good types include oral exposure and continuous exposure (as in sublingual immunotherapy). Bad types include skin exposure (especially with eczema) and intermittent exposure with long periods of zero exposure (e.g. seasonal pollens including grass). Timing is also important especially relative to other immune triggers like actual sickness or vaccines or allergens that you already react to. This is all poorly characterized in general and a lot more study is needed, but we definitely know of ways to expose you to allergens that are much less likely to cause allergies and in fact are likely to reduce or cure them.
- ttymck 3y ago
  > Everything you're allergic to is something you were exposed to at least once; your immune system has to see it and learn to recognize it before you can react to it. Is this true? From a biochemistry perspective, it doesn't seem like it's necessarily true. Allergies could be genetic, in which case a genetic mutation results in the phenotype where an immune system mis-identifies allergens as harmful.
  - modeless 3y ago
    In biology anything is possible. I'd never rule out something like that. But for all common allergens I'm aware of it is true, you cannot be allergic until after your first exposure. That said, some things are "cross reactive" due to similar proteins, meaning that e.g. you could be allergic to goat's milk even though you've only been exposed to cow's milk. And some of these relationships are less obvious, like cashew and mango or banana and latex.
    - pfannkuchen 3y ago
      How do you detect that someone is allergic without exposing them? Or does the test not count? My tautology hackles are raised.
spondylosaurus 3y ago
There are broad-spectrum allergy shots that work by essentially turning off the part of your immune system that triggers allergies (IgE antibodies) while leaving the rest of your immune system (IgG, IgM, etc.) intact. I've been on one called Xolair for almost four years now and it's worked wonders for my copious environmental allergies... dust bunnies hardly make me sniffle now!
projektfu 3y ago
An allergist I saw had four dogs walking around the clinic all the time. I asked him if that was a problem and he said in his experience, people aren't allergic to dogs, i.e. dander, but rather to the allergens that rest in the fur. Wiping the dogs frequently allows his patients to enjoy the company of the dogs. They were all short haired single-coated dogs. The saliva, on the other hand, definitely can cause me to break out when a dog's teeth scrape my arm. But if I work with a cat and touch my eye, I get conjunctivitis right away. Anyhow, the immunotherapy can really work, and definitely made my allergies better, even though it didn't ban them completely. For example, I used to be unable to share a room with a rabbit without an N95. Now I can visit rabbit households without a problem. My children will definitely be getting early allergy testing and immunotherapy if needed.
naasking 3y ago
> I'm allergic to grasses and dogs, for example, despite growing up in a house with dogs and tons of grass outside. I believe ramping up exposure dose is an important part of the protocol. You don't immediately jump to the highest dose for many drugs. Exposure to large amounts of allergens regularly just trains your immune system to continue responding as if it's being attacked. The point is to introduce doses that don't trigger a strong reaction so the system learns to ignore it, and then ramp up from there.

Obscurity4340 3y ago

Whats the regimen? Is it chronic/life-long or is there are point where you're effectively immunized to the allergens in question? Do you ask your dr for a referral and to whom are you directed for evaluation?

modeless 3y ago
Different allergies behave differently and some are easier to treat than others. My allergy shots are a 3 year course of monthly shots. Afterward I will supposedly have lifelong protection but we will see. For food allergies personally I suspect that after 5+ years of exposure without reactions you're probably protected for life, especially if you start treatment as an infant or toddler, but there aren't any long term studies to determine whether that's true. Current guidelines for food allergies are to maintain daily allergen exposure indefinitely to maintain tolerance.
- Obscurity4340 3y ago
  Would this be effective potentially for chronic rhinitis/runny nose? I would be all over that if so
  - modeless 3y ago
    Absolutely yes.
    - Obscurity4340 3y ago
      How do you bring this up with your doctor so I know where to ask for or be directed towards? Like what did you have to ask for to initiate all this?
      - modeless 3y ago
        You need to see an allergist. You can get a referral or call one directly for an appointment.

nextos 3y ago

> [...] discover the factors our immune systems are missing in modern life and reintroduce them Sadly, many commensal bacteria that co-evolved with us have gone extinct due to a variety of modern interventions [1]. Re-engineering the gut microbiome is an incredibly challenging problem but essential to re-establish immune tolerance, which is governed by microbes [2]. [1] https://www.cell.com/current-biology/pdf/S0960-9822(15)00614-4.pdf https://www.cell.com/current-biology/pdf/S0960-9822(15)00614... [2] https://www.nature.com/articles/s41586-023-06431-8 https://www.nature.com/articles/s41586-023-06431-8

Sparkyte 3y ago
Everything changes. That is the problem, we might not see it but disease and even nature itself is in costant flux. It isn't because we are killing it off which is the misunderstanding. If the landscape for bacteria and viruses change we should assume we are just as susceptible to things. We humans like to think our lives as unchanging, immovable, irreplacable and staticly shaped."The 90s lives on!", it is a perfect example that we paint this illusion because it is hard to accept that from this point on everday second, minute, hours... so on will change and alter us. That alteration is irreversible even if we can change or shape the outcome. People are just uncomfortable with this idea.
- adroniser 3y ago
  that's like, really deep, man.
  - Sparkyte 3y ago
    It is insane to think that not a single atom you were born with exists with you as an adult. Really brings up the Ship of Theseus vibes. Kind of leading, since it is hard to say exactly. Some guessitimates are 2%. But really that isn't a lot of what once was you.
    - tuukkah 3y ago
      Hmm, two percent of the atoms you were born with, or two percent of the atoms you consist of as an adult? (If former, it really is little, if latter, it's mostly because of the bulk added by normal growth.)

makeitdouble 3y ago

> A lot of people take their allergies for granted This bit get me perplexed. Severe allergies usually means pills and an Anapen prescription from a specialist that needs to be renewed at least every few years due to the experiation of the pen. If between two visits there was new ways to deal with a specific allergy I'd expect the doctor to guide their patients (at least ask if they're willing to give it a shot). Are there people out there followed by a specialist for years, subject to a deadly condition that affect their daily food choice, that never got asked if they'd want to get rid of their allergy as a cure was available ? That feels unethitical, borderline criminal to me.

modeless 3y ago
The risk of death from food allergies is often exaggerated. Fatal anaphylaxis is actually extremely rare. Even in people with severe allergies. Meanwhile the treatments are not 100% guaranteed to work, and they do have significant risks of their own, plus costs both monetary and non. So it's completely reasonable even for people with severe allergies to choose to not be treated. But I agree that more people should be made aware of the options.
- makeitdouble 3y ago
  > Fatal anaphylaxis is actually extremely rare. Even in people with severe allergies. If your only metrics is dead people, perhaps. If we look at people ending up in ER in a severe state, there would be a lot more (anecdotally that's how many of us have discovered allergies, from asking other parents dealing with it) > Meanwhile the treatments are not 100% guaranteed to work, and they do have significant risks of their own, plus costs both monetary and non. Thanks, I assume there's significant research behind them, so I'd see how a doctor could want to wait a bit more advancement before mentionning it to their patients.
the_gipsy 3y ago
Some common allergies, hay fever or animals, are simply put up with by most people. If they are not dangerous. They make your life difficult, but it's not like you're in pain. I was miserable every spring from the hay fever. Ironically when you're supposed to crawl out and enjoy nature after winter, I preferred to stay confined. From the dustmites, I had irregular sleep because I would have a clogged nose in bed or severe sneezing.

WA 3y ago

> A lot of people take their allergies for granted, but real treatments for allergies are available and they work. Source please. I talked to several doctors about treating hay fever (grass pollen allergy) and the consensus was that desensitization doesn't work that often. Success rate is 20-50% or something like that and there's the risk that the body develops other allergies for some reason. Apparently, my hay fever symptoms are rather strong. Medication doesn't really work. Best is avoidance: staying inside, vacation in countries with less grass pollen, and wearing FFP2 masks outside (helps a lot!). Stuff you don't breathe in doesn't need to be fought by the immune system.

the-dude 3y ago
When I resumed going outside a lot again ( early in the season too ) my hayfever practically disappeared. The first year I still had severe symptoms early in the year which I decided I had to endure.
modeless 3y ago
I'm not aware of any increase in risk of developing other allergies from the treatment. It is true that success is not guaranteed, however I believe the success rate is higher than that. Here's a study finding 76% effectiveness in dust mite allergies in adults. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705479/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705479/ And as I mentioned, I expect much higher effectiveness in children. That said, the treatment does have risks and costs. It's certainly reasonable to decide against trying it. If your allergies cause asthma, Xolair and Dupixent are other options you can try. Combining Xolair or Dupixent with desensitization treatment is an exciting current area of research.
- d__a__n___g 3y ago
  [flagged]
- hdjjhhvvhga 3y ago
  > Xolair Unfortunately Omalizumab has some inherent risks and it's probably not something you'd consider first.

olau 3y ago

Oral treatment is really low tech as long as you're not dying from it. For instance, for grass, the pollen is easily available, you can just chew seed stalks and spit them out. I've gone from being pretty miserable 5 years ago to not feeling much in the pollen season.

modeless 3y ago
Yeah, it's possible to DIY in some cases since, as you say, the treatment is low tech, literally just having the allergens in your mouth. But I highly recommend using an allergist, especially if your allergies are severe, where the possibility of anaphylaxis is there. There are other possible rare side effects as well, such as eosinophilic esophagitis. Following a protocol where the amount is strictly controlled and possible side effects are monitored is important for safety.
- seabass-labrax 3y ago
  Plus, if your doctor is very clued-up, they might even know of a scientific study to refer you to where your experiences can better the academic literature about your allergy. Sometimes, you even get paid for participating in such experiments.
  - modeless 3y ago
    True, though you risk being told after years of diligent treatment that you were in the placebo group.
Ozzie_osman 3y ago
The first problem with this would be if you have a severe reaction because you gave yourself too large a dose or happened to be particularly sensitive that day (having an illness or other immune reaction going on). The other thing I'd question is the efficacy. The standard treatments gradually increase dose to "train" the immune system. Presumably you won't have as fine-grained an ability to adjust the dose you're exposing yourself to, and so you might over or under expose.

juanani 3y ago

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supazek 3y ago

Every time I talk to someone that’s on a stack of meds or has gone through multiple journeys using modern medicine they always seem to be the most unhealthy people. It seems like a chicken or egg problem, and maybe it’s just confirmation bias but i much prefer natural remedies. These people seem to be constantly fighting side effects. Too many unknowns when it comes to highly concentrated exotic chemical solutions.

modeless 3y ago
Natural remedies like... taking small doses of the thing you're allergic to in order to desensitize yourself? Because that's what the immunotherapy I'm talking about is. Not "exotic chemical solutions".
- namaria 3y ago
  It's always the people who decry medicines, i.e. highly pure, intensely tested dosages of chemicals, as "exotic chemicals" while in the same breath advancing "natural medicines", i.e. wildly variable dosages of hundreds of random molecules. Some people seem to think "chemical" is something artificial and bad while "natural" is somehow a rainbow of goodness and not the result of insanely complicated biochemistry.
namaria 3y ago
Concluding medicine = bad because it's always the sickest people who are on the most meds is basically a caricature of bad logic. I refuse to believe this isn't satire.

seabass-labrax 3y ago

> ...treating eczema in infancy is believed to stop the later development of other allergies and asthma as well. This is a fascinating topic, and one which I think deserves a lot more attention, as it cross disciplines like 'dermatological', 'nutritional' and 'respiratory' medicine; it is related to many parts of the body and so could potentially explain not yet fully understood aspects of our biology. In a limited fashion though, I think I know what caused my eczema, and what to remove to effectively cure it: stress! My eczema was nowhere near as bad as some people's, but for a while during childhood I saw the doctor about it; I used dermatological pastes daily for weeks and rubbed it off multiple time a day times with cotton wool. However, eventually I gave up as it seemed to make no difference. Since then, it has become apparent to me that it is almost directly correlated with mental stress, which ironically (but perhaps luckily!) means I'm not really bothered by it any longer. I understand that 'relax' probably isn't going to work on its own if you have eczema badly, but it's interesting that what seems like purely mental stress about entirely non-physical things has such a strong effect on our physiology.

hdhd 3y ago

Sublingual IT didn't work for us much. We are now on OIT and it's night and day. Real milk from day 1, up to 8ml/day now. Agree with the overall sentiment. But bear in mind the US is more advanced than many countries, these treatments may not be available. Even in the US, OIT is done in research setting and not covered by insurance.

arcticbull 3y ago

> Another strong possibility is we'll finally discover the factors our immune systems are missing in modern life and reintroduce them, possibly in the form of probiotics, and stop most allergies from developing that way. People who grow up with cats or dogs are a lot less likely to have allergies. They just drag everything in an expose you, I assume. [1] [1] https://time.com/6266337/pets-food-allergies-children/ https://time.com/6266337/pets-food-allergies-children/

cogman10 3y ago

Are you permanently getting shots? If so, what's the frequency? I'm a hay fever sufferer and it be nice if I want miserable for 2 months a year.

IG_Semmelweiss 3y ago

>>>>>>>>>>> (literally putting a tiny, strictly controlled amount of the allergens under the tongue once a day, simple as that) as a prophylactic The english name for this practice is "Hormesis". A form of hormesis famous in antiquity was Mithridatism, the practice whereby Mithridates VI of Pontus supposedly made himself immune to a variety of toxins by regular exposure to small doses[1] (Kings had to be paranoid about poisons) https://en.wikipedia.org/wiki/Hormesis#History https://en.wikipedia.org/wiki/Hormesis#History

p3rls 3y ago
It should be noted this will render you unable to commit suicide via peanut butter in an emergency
js2 3y ago
Boy, you teed this right up, didn't you? "Alright, where is the poison? The battle of wits has begun. It ends when you decide and we both drink, and find out who is right, and who is dead." https://www.youtube.com/watch?v=rMz7JBRbmNo https://www.youtube.com/watch?v=rMz7JBRbmNo

VoodooJuJu 3y ago

I'm glad we can depend on the modern medical-industrial complex to provide us with lifelong treatments that rescue us from the problems caused by....modernity. Going forward, let's take the via negativa. Rather than add more dependencies, which come with complexity and misaligned incentives, let's see what we can remove.

api 3y ago
https://pbs.twimg.com/media/DA64y1dXoAAnHzW.png https://pbs.twimg.com/media/DA64y1dXoAAnHzW.png Modernity has unambiguously created a net increase in health. The key here is net increase, which can happen even if some of what modernity brought was negative. Over time we gradually figure out what the negatives are and either remove or correct them.
- VoodooJuJu 3y ago
  These life expectancy stats are deceptive because they factor in infant mortality. In the days of yore, if one survived to the age of five, one's life expectancy wasn't much lower than it is today [1]. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2625386/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2625386/

c4mpute 3y ago

I was diagnosed with hayfever as a boy and had immunotherapy for it. It was useless. I also had frequent exposure before my diagnosis (without symptoms), which seems typical according to my doctor, because allergies tend to develop /after exposure/. This, as my anecdotal evidence, and every medical text about it, contradicts your ideas. Please consult a doctor before doing anything you suggested to your children or yourself, because your suggestions are /dangerous/.

explorigin 3y ago
Sublingual immunotherapy is a customized treatment administered by medical doctors. What do you mean by dangerous? (I'm not affiliated with https://www.wyndly.com/ https://www.wyndly.com/, but that could be a good place to start for those unfamiliar.)
- c4mpute 3y ago
  Dangerous as in: exposure can cause allergies that haven't been there before. Medical treatment with allergens can also cause allergies and therefore shouldn't been done willy-nilly in a prophylactic manner. Also, suggestions like those usually bring out the quackery in people, with things like "Oh, hayfever? Let's cure it by doing summer holidays on the farm!" and "Oh, peanut allergy? I have a sandwich for you, kid!".
  - explorigin 3y ago
    Clearly you have never seen proper immunotherapy (which has been in practice for decades). All patients are prescribed an epi-pen prior to starting treatment. It used to be that all doses were monitored for anaphylactic reactions but that is now clinic-dependent.
modeless 3y ago
I'm not suggesting that anyone should do anything without the advice of a doctor. Yes, deliberately exposing yourself to things you are allergic to is dangerous and an allergist's guidance is very important for safety. I'm sorry immunotherapy didn't work for you but your anecdotal evidence doesn't invalidate all the published research. Yes, allergies always develop after exposure. But not all exposure is created equal! Some types of exposure tend to cause allergies while other types tend to protect against allergies. Immunotherapy is the right type of exposure, under the guidance of an allergist.

granshaw 3y ago

It’s astounding that we have an understanding of far away phenomena like black holes and supernovas, but have such a poor understanding of so many aspects of the systems in the human body still

modeless 3y ago
Modern medicine is really primitive compared to the sophistication of biology. I think it will take superhuman AI to fully understand and control biological phenomena.
tmn 3y ago
We have models for those things. That doesn’t mean we understand the true phenomena in all it’s nuance.

Ozzie_osman 3y ago

They are a hell of a commitment though, at least the shot-based ones. Once a week you have to go to a clinic, get the shot, wait 30 minutes to ensure no reaction. If you miss doses, you fall behind and have to repeat things. I got about 70% of the way through my treatment then had to travel for two months, after which the thought of starting back up again was daunting and I just gave up.

pid-1 3y ago
I brought the vaccine and stored in my refrigerator. The clinic's nurse showed me how to use it by myself. Not sure if that's possible everywhere / for every treatment. After ten weeks taking shots every Sunday, my allergies got significantly better. I used to be that guy with a perpetually stuffy, running nose, now I can't even remember the last time that happened. 10/10 would do again.
- Obscurity4340 3y ago
  Do you still take it regularly or are you essentially "immunized" now? Sounds amazing anyway. Whats the shot called?
  - Ozzie_osman 3y ago
    https://www.mayoclinic.org/tests-procedures/allergy-shots/about/pac-20392876 https://www.mayoclinic.org/tests-procedures/allergy-shots/ab...
  - pid-1 3y ago
    > Do you still take it regularly My understanding is that after 10 weeks, I was supposed to get a monthly shot for 2-3 years. I ended up never doing the second part, though. > are you essentially "immunized" now? No, I'm not. I was told by doctors the effects of this sort of treatment last for "several years". > Sounds amazing anyway. Whats the shot called? I still have the shot, it does not have any specific brand, just the lab name in the box. That's the lab's wepage: http://www.llac.com.br/ http://www.llac.com.br/. The shot itself has the dosage, my name, the doctor's name, the expiration date and "ALÉRGENOS INALÁVEIS 1:10.000" written on it.

tarboreus 3y ago

When I was a child, my (many) siblings and cousins played in rat-infested hay bales. None of us have allergies. Coincidence? Seriously, though, I do think that sterile environments have something to do with it.

modeless 3y ago
That's a leading hypothesis. Research has specifically shown that children who spend time in barns with hay and farm animals are significantly protected from allergies. Even before birth! It does take a large amount of exposure, though. Something like a couple hours once a month is probably not protective and might even cause sensitization.
- tarboreus 3y ago
  Yeah, we practically lived there.

JumpinJack_Cash 3y ago

> > Another strong possibility is we'll finally discover the factors our immune systems are missing in modern life AKA Close calls with death, we should reintroduce them, but we won’t out of fear

amluto 3y ago

> treating eczema in infancy is believed to stop the later development of other allergies and asthma as well. Out of curiosity, do you have a reference for this?

modeless 3y ago
Pretty easy to find by Googling. Here's one: https://www.jaci-inpractice.org/article/S2213-2198(19)31018-9/fulltext https://www.jaci-inpractice.org/article/S2213-2198(19)31018-...