Treating Mold Allergies

5-6 year sago I underwent allergy shots (immunotherapy) for just about every allergen out there. Upon retesting last week my allergies to most seasonal pollens were gone as was my dog allergy, but the indoor allergies remain... with dust mite reaction somewhat reduced. The mold allergy has stayed the same & that is suspected to be the allergen causing my present symptoms. I would consider allergy shots again but my allergist says he does not include mold in his allergy shots b/c of injection site reactions (itchy) and asthma reactions. I could have sworn it was included in my shots last time but he says if it was, it was very small amounts *shrugs*

Antihistamines don't work well for me. They tend to dry out my sinuses too much (I recently found out that I have large turbinates which may or may not be surgically reduced). Apparently, since my symptoms are not hayfever (like watery eyes, sneezing) antihistamines aren't exactly the first choice anyway. I tend to have postnasal drip, some sinus pressure & drip into my chest & asthma. I'm so sick of being on a bunch of medications: cortisteroids, bronchial dilators, antihistamines, etc. most of which don't really work. I used to use the netti pot but lately it makes my sinuses fell more full & like water is trapped. I know about environmental controls & I have them all.

Any opinion on allergy shots for mold allergies or other treatments?

[David Tinkelman, M.D.]

Not all experts believe desensitization to molds is effective but all agree that environmental control must be part of any strategy, as you have suggested.  The abstract that follows my comment suggests that desensitization to molds is safe and might even be effective.  Note also that, in this study, persons with rhinoconjunctivitis, albeit seasonal, showed improvement.

One need not have watery eyes and sneezing to have allergic rhinitis.  .In addition, H1-antihistamines have been shown to attenuate the symptoms associated with early- and late-phase allergic reactions. Cumulative clinical evidence indicates that H1-antihistamines may have a beneficial effect on asthma symptoms and improve quality of life.

You might want to consider requesting a 2nd opinion from another allergist, or inquire at the nearest Academic (Medical School associated) Medical Center, if the Allergy Division is conducting any clinical research studies on new/unique drug therapy for the treatment of perennial allergic rhinitis, in persons like yourself, seemingly refractory to conventional therapy.

Good luck

Here is the abstract:

Authors Full Name Kuna, Piotr. Kaczmarek, Jadwiga. Kupczyk, Maciej.

Institution Department of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.

Title Efficacy and safety of immunotherapy for allergies to Alternaria alternata in children.


Source Journal of Allergy & Clinical Immunology. 127(2):502-508.e1-6, 2011 Feb.

Abstract BACKGROUND: The safety and efficacy of specific immunotherapy for mold allergy are not known in children and adolescents.

OBJECTIVE: We evaluated the efficacy and safety of specific immunotherapy with a standardized allergen extract in a randomized, double-blind, placebo-controlled, 3-year prospective study of patients who were allergic to only Alternaria alternata.

METHODS: Fifty children and adolescents (25 girls; 5-18 years of age) with A alternata-induced seasonal allergic rhinoconjunctivitis and/or bronchial asthma were randomly assigned to groups given treatment (Novo-Helisen Depot, A alternata 100%) or placebo. The primary end point was the combined symptom medication score. Secondary end points included safety, quality of life, and sensitivity to allergen-specific nasal challenge.

RESULTS: Forty-five children completed the 3-year study. Although there was no significant change in year 1, the combined symptom medication score decreased in years 2 and 3 of the study (by 38.7% and 63.5%, respectively; P < .001 for each). The reduction in symptoms was associated with a significant improvement in quality of life (P < .05) and decrease in sensitivity after allergen-specific nasal challenge. Side effects were observed in 7 patients; the most common (edema at the site of injection) occurred after 11 injections.

CONCLUSIONS: Allergen-specific immunotherapy with standardized A alternata extract reduces symptoms of asthma and rhinoconjunctivitis in children and adolescents without serious side effects. Copyright Copyright 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Publication Type Journal Article. Randomized Controlled Trial.

Date Created 20110201

Year of Publication 2011