Frustrated with the limitations of traditional immunotherapy, a few doctors (most of them known as a clinical ecologists) are trying to revive a system of allergy testing and immunotherapy developed several years ago and collectively known as serial dilution titration and neutralization therapy. This variation of standard immunotherapy still involves lots of time in a doctor’s office, considerable expense and allergy shots.

In some ways, however, it may make up for a few of the shortcomings of traditional immunotherapy. Serial dilution testing, as we discussed in Allergy Tests: What They Can and Cannot Tell, is done on the skin (although a few doctors use drops of the test extracts which can be placed under the tongue in people who are not fond of needles).

Doctors test for several common allergens, plus any others to which the individual seems to be particularly sensitive. In that respect, the test is similar to standard test. However, the individual is not necessarily tested with one absolute amount of each test extract, but possibly with a series of up to 15 or 20 increasing dilutions, one every ten minutes or so.

The size of any wheal and the nature of symptoms are noted. Doctors experienced with serial testing use the dose which does not produce symptoms – the ”endpoint” – as a guideline for choosing the optimal dose for this therapy. Again, the dose that is too small to produce a reaction yet large enough to prevent reactions is considered optimal.

Doctors feel that, in this way, they can get a better picture as an individual. What’s more, they claim that the treatment dose can usually turns out to be much smaller than that treatment dose can be used to neutralize, or turn off, a reaction. The therapeutic dose immunotherapy, and takes only one or two testing sessions to achieve.

That compares to a period of about six months of such experimentation to reach maintenance doses in standard therapy. Once the correct treatment dose is arrived at, doctors using neutralization claim that some people gain immediate relief.

One big difference between the two therapies is that some doctors using neutralization send patients home with premixed doses of extract to help them tolerate foods and inhalants to which they are allergic. That’s rare with standard therapy except for carrying emergency vials of adrenaline to be used in case of a severe bee sting reaction or other serious symptoms.

Another major difference is that neutralization is used to treat sensitivities to auto exhaust, tobacco smoke, formaldehyde and other hard to avoid chemicals, although shots for those no not work nearly as well as shots for conventional allergens.

”People always ask us for shots against air pollution,” says Constantine J. Falliers, M.D., a traditional allergist and editor of the Journal of Asthma. ”Well, we have no such thing.” Many doctors using neutralization feel that, unlike conventional therapy, it can be successfully used to treat food allergy, holding out hope to the many people who are allergic to wheat, yeast or other ubiquitous dietary items.

Both standard immunotherapy and neutralization seem to work in approximately eight out of ten people on whom the particular method is used, and both are relatively safe – they're used without reservation on the young, the old, the pregnant – and even in people who are suffering a cold or the flu.

For the individual who’s endured years of standard immunotherapy without relief of symptoms, neutralization certainly holds promise (to locate a doctor in your area who uses this technique, you can write to the Society for Clinical Ecology, c/o Del Stigler, M.D., Secretary, 2005 Franklin Street, Suite 490, Denver, CO 80205).

Is This Really What You Want?

What you get right down to it, though, needles usually hurt. Doctors’ office can be boring. Visits are time consuming. So no one relishes the prospect of going for allergy shots of either kind: both methods cost a great deal in terms of anxiety, discomfort, time and money.

In terms of both effectiveness and comfort, the self help, ”take charge” approach to personal allergy control can minimize the need for either standard immunotherapy or neutralization. Don't hesitate to enlist your doctor’s help in finding out exactly what you’re allergic to.

After that, you owe it to yourself to methodically manipulate your diet and environment – to make your world as allergy safe as possible. That approach – with or without allergy shots – will no doubt require a considerable investment of thought and effort at first, possibly followed by a series of smaller maintenance measures. But in terms of total, pain free relief, you can only come out ahead.