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Should I get an allergy shot or allergy shots?

This may seem like a redundant question, but it is not.  That little “s” on the end is a distinguishing feature. There are significant differences in allergy shots that you should know when making healthcare decisions for yourself or your children in treating allergies.

Allergy shot: a single large dose of long-acting corticosteroid injected into the gluteal (buttock) region.  A common drug used for this is KenalogTM (Triamcinolone) at 40 mg.  This treatment has been used for decades and is indicated for “control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment.”  While this treatment can improve symptoms, be aware of the risks of steroids.  The risk of complications of steroids is directly related to the dose, person’s individual susceptibility, dosing schedule, route of administration (oral and injectable especially), and duration of treatment:

  • Local atrophy: if injection is not given deep enough, the tissue at injection site can dissolve leaving a hole the size of a golf ball
  • Avascular necrosis:  the femur (hip bone) is supplied by 1 artery and if the blood supply is cut off, the bone will die and a hip replacement may be necessary
  • Elevate blood pressure and lead to salt and water retention as well as loss of calcium and potassium
  • HPA axis: suppress hypothalamic-pituitary-adrenal (HPA) axis which means it impairs your body’s ability to respond to stressful situations by decreasing the natural cortisol made in the adrenal gland
  • Behavioral symptoms: mood swings, insomnia, psychosis, depression, euphoria, and personality changes
  • Appetite increase, weight gain and fat re-distribution (Buffalo hump and obesity around the mid-section)
  • Skin:  acne, striae (stretch marks)
  • Eyes: cataracts and glaucoma
  • Elevated blood sugar and diabetes
  • Pancreatitis (inflammation of pancreas), peptic ulcer disease (stomach ulcers)
  • Osteoporosis (fragile bones) /fractures especially higher risk in women after menopause
  • Growth slowing in children
  • Myopathy: muscle weakness and wasting
  • Recurrent infection from immune suppression: increased risk with chicken pox, reactivation of TB or any other virus, bacteria, fungus, protozoan, helminth (Strongyloides or threadworm)
  • Poor response to vaccines (potentially)
  • Poor wound healing

Allergy shots:  allergen immunotherapy is a series of small injections of the allergens that a patient has been found to be allergic to.  There is no steroid, antihistamine, anesthetic or other drug in this vaccine.  After a build-up phase, the maintenance phase of allergy injections continues for 3 to 5 years. Allergen immunotherapy can reduce the chance of developing asthma and of developing sensitivity to other allergens.  After the injections are completed, the effectiveness can last for years or decades.  The primary risk of allergy injections is an allergic reaction to the injection.  For this reason, allergy injections are given in the physician office and patient monitored for 30 minutes.

Now that you have the facts, you can help decide what is right for you.

PS. Dr. Zacharisen does not administer injectable steroids into the gluteal region.

This educational information does not take the place of your physician’s advice.

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