Allergy Services

Allergy Services

Allergies: Allergy Basics

What Are Allergies?

Allergies are an overreaction of the immune system. People who have allergies have a hyper-alert immune system that overreacts to a substance in the environment called an allergen. Exposure to what is normally a harmless substance, such as pollen, causes the immune system to react as if the substance is harmful.

What Happens During an Allergic Reaction?

When a person with a hyper-alert immune system is exposed to an allergen, a series of events takes place:

  1. The body starts to produce a specific type of antibody, called IgE, to fight the allergen.
  2. The antibodies attach to a form of blood cell called a mast cell. Mast cells are plentiful in the airways and in the GI tract where allergens tend to enter the body.
  3. The mast cells explode releasing a variety of chemicals including histamine, which causes most of the symptoms of anallergy, including itchiness or runny nose.

If the allergen is in the air, the allergic reaction will likely occur in the eyes, nose and lungs. If the allergen is ingested, the allergic reaction often occurs in the mouth, stomach and intestines. Sometimes enough chemicals are released from the mast cells to cause a reaction throughout the body, such as hives, decreased blood pressure, shock, or loss of consciousness.

What Are the Symptoms of Allergies?

Allergy symptoms can be categorized as mild, moderate, or severe (anaphylactic).

  • Mild reactions include those symptoms that affect a specific area of the body such as a rash, itchy, watery eyes, and some congestion. Mild reactions do not spread to other parts of the body.
  • Moderate reactions include symptoms that spread to other parts of the body. These may include itchiness or difficulty breathing.
  • A severe reaction, called anaphylaxis, is a rare, life-threatening emergency in which the response to the allergen is sudden and affects the whole body. It may begin with the sudden onset of itching of the eyes or face and progress within minutes to more serious symptoms, including abdominal pain, cramps, vomiting, and diarrhea well as a varying degrees of swellings that can make breathing and swallowing difficult.
  • Mental confusion or dizziness may also be symptoms, since anaphylaxis causes a quick drop in blood pressure.

*Allergy overview by Web MD.


Allergy Shot Counseling Information

  1. allergy doctor in mclean vaYou are starting Immunotherapy (Allergy Shots)
  2. Most patients will be given 2 shots
    1. Pollen in left arm
    2. Inhalants in right arm
  3. You will be required to wait 15 minutes after your shot to watch for reactions.
    If you cannot wait the full 15 minutes, we cannot give you your shot
  4. 2 types of reactions that may occur:
    1. Local-redness and swelling at the injection site
    2. General-itching, sneezing, wheezing/common allergy symptoms
  5. Serums are prepared from test results for your specific allergy combination.
  6. Shots are given once a week to start off. After reaching the specified goal in your treatment you will be able to begin a 2 or 3 week regiment.
    Be advised: No shot will be given to a feverish or very ill patient.
  7. The build up process takes place continually until the patient reaches the maximum strength and dose. Once this has occurred, patient will be on maintenance dose (same strength and same dose for duration of therapy.
  8. Therapy will take a minimum of 3 years:
    1. Why 3 years – we are slowly building up immunities to these allergens, this leaves the patient with less symptoms, and little to no medication will be needed.
    2. After 2 years – you may be retested to see your progress since therapy began. (No Antihistamines or Aspirin for 5 days prior)
  9. We will start with the weakest dose and strengths and work up.
    1. Strengths: T-2, T-1, T-0, T+1, T+2, T+3
    2. Doses: 0.05, .10, .20, .30, .40, .50
  10. Patients are required to follow up with their provider every 6 months for routine evaluation.
  11. Patients need to schedule shot appointments, we cannot work on a walk in schedule due to the need for your serums to be warm.
  12. We schedule our shots every 5 minutes for the nurse, it is very important to be on time. If for some reason you cannot make your scheduled time, please give us a call to see if you can still be seen.
  13. If you are more than 15 minutes late, you will have to reschedule.
  14. Clothing with easy access to the shot area should be worn.
  15. Some patients may notice a change in symptoms after a couple of months, but typically you won’t see changes until the next allergy season.
  16. It is common for some patients to feel fatigue following shots- this will go away, but may take a little while.
  17. No strenuous exercise for 3 hours following shots-it may induce asthma type symptoms.


Allergy Testing

  1. allergy doctor in McLeanDue to the limited space in our allergy testing room, we ask that you come by yourself unless you have medical or translation needs that require you to have someone accompany you.
  2. Please wear short sleeves.
  3. No Antihistamines or Aspirin for 5 days preceding the test.
  4. If you have any questions, please call the office.

Drugs that Interfere with Allergy Testing

The Most Common Allergy Medications to avoid
Allegra D
Clarinex/Clarinex D
Claritin D
Zyrtec D

MAO Inhibitors. Must be off for 5 days prior to testing and then be off permanently. Cannot be given adrenaline or it will provoke hypertensive crisis.

Eutonyl (Pargyline)
Eutron (Pargyline & Methyclothiazine)
Flroxone (Furzaolidone)
Matulane (Procarbazine)
Nardil (Phenelzine)
Parnate (Tranyleypromine)

Antihistamine/Decongestant Preparations. Should be off. Omit for 7 days prior to testing.

Advil Cold/Sinus
Allegra, Allegra D
Astelin Nasal Spray
Claritin, Claritin D
Dramamine Isoclor
Excedrin PM
Optivar Eye Drops
Tylenol PM
Robistussin CF
Tavist I, Tavist D
Tylenol Cold/Sinus

Please refrain from taking all cold medications, nose drops and sprays, cough medications, cough drops and other antihistamines in any form.

H2 Antagonists – Anti-Nausea Medications. Should be off for 5 days prior to testing.

Tagamet (Cimetidine)
Zantac (Ranitidine)
Zatiden (Ketotifen)
(or any like medication)

Beta Blockers – Should be off for 5 days prior to testing and then permanently for immunotherapy treatment.

Betapace (Sotalol) Blocarden (Timolol Maleate)
Brevibloc (Esmolol HCL)
Cartrol (Carteolol HCL)
Corgard (Nadolol)
Corzide (Nadolol & HCTZ)
Inderal (Propraolol)
Inderid (Propranolol & HCTZ)
Kerlone (Betaxolol HCL)
Levatol (Penbutolol Sulfate)
Lopressor (Metoprolol Tartrate)
Normodyne (Labetolol HCL)
Normozide (Labetolol & HCTZ)
Sectral (Acebutolol HCL)
Tenoretic (Atenolol & Chlorthalidone)
Tenormin (Atenolol)
Timolide (Timolol & HCTZ)
Toprol XL (Metaprolol Succinate)
Trandate (Labetolol HCL)
Visken (Pindolol)
Zebeta (Bisoprolol
Ziac (Bisoprolol & HCTZ)

Trycyclic Antidepressants – Must be off 3-6 weeks prior to skin testing and then may continue for immunotherapy.

The patient must be weaned by the prescribing doctor and substitute with another drug if desired. Patient must do this under doctor’s supervision or severe depression could result.

Adapin (Doxepin HCL)
Apo-Trimip (Trimipramine Maleate)
Asendin (Amoxapine)
Aventyl (Nortriptyline HCL)
Elavil (Amitriptyline)
Endep (Amitriptyline)
Emitrip (Amitriptyline)
Endlil (Amitriptyline)
Etrafon (Combination Drug)
Impril (Imipramine HCL)
Levate (Amitriptyline)
Limbitrol (Combination Drug)
Meravil (Amitriptyline)
Pamelor (Nortriptyline HCL)
Rolavil (Amitriptyline)
Sinequan (Doxepin HCL)
Surmontil (Trimipramine Maleate)
Trofanil PM (Impramine HCL & Pamoate)
Trazodone (Desyrel
Triadapin (Doxepin HCL)
Trialic (Combination Drug)
Tripramine (Imipramine HCL)
Triptil (Protriotyline HCL)
Vivactil (Pritroptyline HCL)

Anti-Inflammatory Drugs – Must be off 5 days prior to skin testing and then may continue for immunotherapy.

Ibuprofen medications

Allergy Testing Form

Download the Allergy Information and Testing Form Download in pdf