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New York, NY 10022

Sublingual Immunotherapy (SLIT)

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Sublingual Immunotherapy

Sublingual Immunotherapy (SLIT) is a homeopathic way to treat allergies, and it is one that you do yourself, at home. Small doses of allergens (the substances that cause allergies) are placed under your tongue every day. The dose is gradually increased each week until you reach a “maintenance” dose. This dose is continued for one to three years. A protective antibody, Immunoglobulin G, is gradually formed to block the allergic reaction. Improvement from allergic symptoms is gradual, but many patients notice a difference within the first 3 months. Progress is evaluated every 6 to 12 months.

How Long Should You Receive SLIT?

Your starting dose depends on the severity of your symptoms and allergy testing results. The more severe your symptoms the more dilute the starting dose, and the longer it takes to get to maintenance dose.  Once maintenance dose is reached, you should notice a significant improvement in symptoms. After 3 to 4 years, SLIT may be discontinued, but symptoms may return at a rate of 20% after the first year, 30% after the second, and up to 40% after three or more years.

Who Might Consider SLIT?

SLIT is recommended for patients with significant allergies, including seasonal allergies (pollen, trees, grass, ragweed), or year round allergies (dust mites, dogs cats, or mold). They can be considered for anyone who is a candidate for allergy shots, especially if they travel or their schedule cannot accommodate weekly office visits. In our practice, we do not use SLIT for food allergies.

How are Allergens Determined?

Allergy skin tests (scratch test) or blood testing (RAST) are used to identify allergens and define the severity of the allergic reaction to determine a safe starting dose.

Immunotherapy and Pregnancy

Beginning SLIT is not recommended during pregnancy.  However, if a woman becomes pregnant while on SLIT, she may safely continue it during the pregnancy. SLIT has been used for over 35 years and will not harm the baby.

Reactions to SLIT

Unlike allergy shots, SLIT has no risk of anaphylaxis or any other severe, life threatening reaction. Infrequently, SLIT can result in mild symptoms, such as localized mouth and/or tongue itching. If this happens, you may be advised to adjust your dose and/or take an antihistamine to alleviate symptoms.

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Linda D. Dahl, MD