Allergies? Silver Cross ENT Says Reach for the Allergy Drops Instead of Pills, Inhalers

Ah, spring, when a person’s thoughts turn to – the allergy relief shelf at the local pharmacy. 

While allergies this spring may seem to be worse – due to a relatively mild winter – Dr. Michael Gartlan, an Ear, Nose and Throat specialist on staff at Silver Cross Hospital in New Lenox, said it is very likely a person’s allergies are getting worse overall; not because of climate. 

“Without specific treatment addressing the root cause, a person’s inhalant allergies tend to progress, maybe so slowly they don’t notice,” said Dr. Gartlan, with ENT Surgical Consultants, located on the Silver Cross campus in Pavilion A. 

A person who has baseline symptoms of nasal congestion and drainage from their perennial or non-seasonal allergies – from dust mites, molds and animal dander to their own dogs and cats – will feel the additional acute allergic symptoms of itching, sneezing and drainage much more when trees, and then grasses, pollenate in the spring and early summer. 

Based on his experience with patients, Dr. Gartlan said various over-the-counter treatments result in only about a 30 percent improvement in symptoms, and because the allergies are likely progressing slowly over time, total symptom relief from medications diminishes over time. 

“That’s also because the over-the-counter allergy medicines are treating the symptoms, but not the underlying cause,” Dr. Gartlan said. “To do that, people need to come in to our office and have us test for what they are allergic to.” 

Allergy Testing and Treatment Options

Dr. Gartlan said their tests cover 40 different types of local inhalant allergens. Once they determine the specific cause or causes of these environmental allergies, and the degree to which the patient is allergic to them, they can mix an individualized immunotherapy treatment to address the allergies. 

“We use the same FDA-approved allergy extracts for individualized testing as we do for the allergy drop desensitization treatment,” he said. “It’s enough to stimulate the immune system to develop protective blocking antibodies, but below the threshold that would cause symptoms.” 

For many decades, he said, the gold standard for treatment was weekly shots at a doctor’s office. Patients would have to sit around afterward for a bit to make sure the dose didn’t elicit a major reaction. 

“But people are too busy to come in to a doctor’s office weekly now,” Dr. Gartlan said. “So, they may stop coming in after a while and just go back to over-the-counter medicines.” 

For the past 25 years, there has been another option that had great success, with only yearly doctor visits. 

What is SLIT?

Called Sublingual Immunotherapy, or SLIT, patients put drops under their tongues three times each day. The liquid is the same mixture as they would receive in a shot, Dr. Gartlan said, but at a lower, more frequent dose. 

Dosage of the SLIT is customized for each patient and depends on the severity of the allergy, he said. Those with more severe allergies get lower doses to administer so they can build up to the highest dosage they can tolerate. Then they can switch to a maintenance allergy drop dose for three additional years to burn memory into their immune system for long-term improvement. 

On average, patients report at least a 60 percent improvement or more once the maximal dose is achieved during their follow-up visits, Dr. Gartlan said. And that improvement continues after treatment concludes after the maintenance period. 

But much of it depends on the severity of the allergy and how early they began immunotherapy. 

“For a person who starts therapy at age 2, they could have a 90 percent improvement in their symptoms, because their immune system is much more malleable at that young age,” he said. 

Yes, age 2. 

“If the child has recurring sinusitis or ear infections, those could be worsened by allergies,” said Dr. Gartlan, whose practice includes pediatric ENT. “Parents also can tell if their older children have the same issues, or if they and their parents did. Often, patients have a genetic predisposition for inhalant allergies.” 

Insurance doesn’t cover the SLIT treatment vials, so some patients may flinch at the cost, roughly around $60 a month. But Dr. Gartlan said SLIT overall is much more cost-effective than a lifetime of allergy medications or allergy shots, since patients don’t have co-pays for weekly office visits. 

While you don’t need allergy tests to take over-the-counter allergy remedies, Dr. Gartlan said, “you also won’t find the underlying cause. And your allergies will only slowly continue to get worse. 

“We can find the cause, and SLIT can help silence them.” 

To request an appointment with Dr. Gartlan, visit silvercross.org or call (815) 717-8768.