Frequently Asked Questions
Unlike most allergy drugs — which only treat symptoms — sublingual immunotherapy (allergy drops) addresses the underlying causes of allergies. Allergy drops use the same FDA-approved antigens as allergy shots, but deliver them in a liquid form under the tongue to highly specialized cells. Drops are given in gradually increasing doses until the patient develops a tolerance to the allergy-causing substance. Learn more about sublingual immunotherapy.
Insurance companies may cover the cost of the office visit and diagnostic testing, however, because allergy drops may be considered an off-label use, they may not be covered; please check with your employer or insurance carrier to be sure. Please verify with our business office, 608.782.2027, if your employer is self-insured and covers the drops or obtain a written authorization from your insurance company stating that allergy drops are a covered service and they intend to pay such claims, and what details they require on claims.
Allergy drops qualify for HSA or Flex Spending reimbursement. Most patients agree that the investment in allergy drops is well worth the lasting results and improvement in their quality of life, and the monthly costs are comparable to costs incurred from prescription and injection immunotherapy co-pays.
After your first appointment, your doctor will ask you to return in three to six months. At that visit, we may do more specific testing to see if treatment should be adjusted.
Phone consultations and virtual visits can be arranged for continuity of care between two visits for patients who live in Wisconsin, Illinois, Michigan, Minnesota, Iowa, North Dakota and South Dakota. For patients from other states, phone communication, but no active diagnostic or treatment decisions, will be provided at no cost to patient. Regular visits to the Clinic will still be necessary every six to twelve months.
After the second appointment, most patients return every six or twelve months so we can check your progress and make adjustments. You always have the ability to communicate with us through secure email if you have questions or concerns.
We provide tailored sublingual immunotherapy that is based on your specific allergens, and at your level of sensitivity — matching your allergic fingerprint. The La Crosse Method™ Protocol follows this philosophy. Treatment is matched to your testing, and gradually becomes stronger based on how you uniquely respond to treatment — it does not follow a cookie cutter formula that doesn’t take your individual response, lifestyle, and history into account. This precise approach helps ensure your treatment isn’t higher or lower than needed to respond. You can ask your provider if their approach follows this philosophy of treatment to be sure it is customized for you.
The benefit of sublingual immunotherapy is that a broad range of allergies, including those caused by dust mites, pollen, mold, animals, and foods can be treated. See Treating Allergy Conditions for more information.
We use sublingual immunotherapy (allergy drops) to train the body’s immune system to tolerate problem foods. This can greatly improve cases of:
- Eczema (atopic dermatitis) caused by common food allergy
- Hives (chronic urticaria) due to food allergy
- Asthma flares due to food allergy
- Anaphylaxis / systemic reactions to foods
- Recurrent ear infections in young children
We can begin treatment at any age, independent of IgE production levels or skin reactivity.
Consistent treatment is key to success. Patients who follow treatment as instructed, (taking drops three times every day and keeping regular follow-up appointments), typically reach tolerance that allows an oral challenge within three years. We routinely will not attempt oral challenges in children younger than six.
Although most allergy sufferers can benefit from allergy drops, they’re especially ideal for people who can’t tolerate or don’t respond to allergy shots, as well as people who are unable to commit to allergy shot therapy. These people include:
- Infants and children*
- Highly sensitive people
- Those with chronic conditions including sinusitis
- People with food and mold allergies
- People with multiple allergies including dust, pollen, animals
*Allergy drops have proven especially helpful for children with eczema and recurrent ear infections, which often have underlying allergic causes. Research shows that many children with untreated eczema and allergies often develop asthma and other chronic conditions later in life, so treating them early can have life-long benefits and may prevent development of other allergies.
Allergy drops have been used around the world for more than 100 years, and numerous studies validate both its safety and effectiveness. In fact, the World Health Organization has endorsed sublingual immunotherapy as a viable alternative to allergy shot therapy. The Cochrane Collaboration, the world’s most-trusted international organization dedicated to reviewing healthcare treatments, concluded that allergy drop immunotherapy significantly reduced allergy symptoms and medication use.
In 2013, the Agency for Healthcare Quality Research published a review that examined studies which used both sublingual and subcutaneous immunotherapy (allergy shot) treatments. Reviewers found sufficient evidence to support the effectiveness and safety of subcutaneous and sublingual immunotherapy for the treatment of allergic rhinitis (hay fever) and asthma.
In addition, La Crosse Method Protocol outcomes have been validated through the Validation Institute, an independent team of population health scientists and bio-statisticians who provide objective review to validate performance in healthcare.
See our bibliography for more information about research studies.
Most patients do not report side effects, but some may report minor mouth itching or stomach upset—especially when beginning treatment or as prescription strength increases. Most reactions resolve themselves on their own, or with antihistamines. Report symptoms lasting more than an hour to your doctor. Rarely, patients have reported hives with rash, swelling or itching on one or more parts of the body. Angioedema, or swelling of the ears, tongue, lips, throat, hands, feet or intestines, has not been reported with the La Crosse Method Protocol, but requires immediate medical attention if it occurs. Anaphylactic shock has not been reported using this protocol, but has rarely occurred with other protocols. Patients with this history should have epinephrine available when taking drops.
In addition to being able to treat patients of all ages safely and effectively, there are other advantages to allergy drops.
- Therapy treats the cause, not just temporary symptoms. The goal of allergy drops is to help you build long-term tolerance to your allergens so ongoing treatment and medication is no longer needed.
- Lower cost, fewer clinic visits. Compared to shots, allergy drops cost less and require fewer clinic visits. Most patients receiving allergy drops need only a few clinic visits the first year, and then once every 6-12 months until visits are no longer needed.
- More convenient. You can take allergy drops at home, school, or wherever you are, making it much easier to stay with your treatment.
- Less medication. Our patients report, and research confirms, that they typically need less medication to control symptoms after beginning allergy drops.
- Enjoy healthier days. The end benefit of taking drops consistently? Feeling better. Patients typically report fewer clinic visits, hospitalizations, and less lost time from work and school.
First, it’s important to understand that the antigens used in allergy drops are the same FDA-approved, physician-prescribed antigens used in allergy shots. They’re also prepared the same way as allergy shots. The difference is the route of administration — a dispenser that delivers the antigen under the tongue versus a syringe injecting antigen into tissue. The FDA does not approve treatments, they approve products, so it’s highly unlikely that the FDA will ever “approve” multi-antigen immunotherapy.
Antigens are labeled by the FDA for single use through injections and some for sublingual immunotherapy. A number of FDA-approved biologics are considered off label use when delivered via sublingual immunotherapy, which is both legal and highly common. Most physicians prescribe drugs in an off-label manner today, for example, the use of blood pressure medications for migraines, montelukast for COPD, or arthritis drugs to treat shingles. Multiple antigen therapies for both injection and sublingual use are also an off-label use of FDA-approved biologics.
Allergy drops are widely accepted as an effective treatment throughout the world. That acceptance is growing in the United States as the treatment becomes more widely available and providers are better educated about its benefits.
We prepare a custom solution for each patient according to the type and severity of his or her allergy.
Drops contain custom concentrates of the allergen(s), called antigens, the patient is found to be allergic to upon testing.
The antigens are put into a glycerin solution for stability. We do not add preservatives or other drugs/additives to the allergy drops.
Most patients take allergy drops each day for three to five years, but it varies according to the severity of their allergies, seasonality, and how well they follow treatment.
Many patients’ symptoms improve within a few weeks to months, but need to keep using the drops through the full course of therapy to get long-term benefit.
Patients with severe food or mold allergies may need to continue treatment long term to gain benefit.
A benefit of immunotherapy — whether allergy shots or allergy drops — is that it can alter the course of allergic disease by treating the root cause, not just the symptoms. Once tolerance is built, it can be permanent for many patients. Key studies have been conducted to explore the long-lasting effect of allergy drops, including a 10-year study on children with asthma that demonstrated drops maintained effectiveness long after treatment stopped.
But even the best treatments won’t work if you don’t stay with them. Like allergy shot treatment, it’s important to stay with allergy drop treatment until your doctor has determined it can be discontinued to give you the best chance of long-term effectiveness.
Once a patient turns 18, they become their own guarantor, which requires a separate account and a separate statement. If you want to discuss your child’s treatment with us after they turn 18, they must complete a Medical Information Release Form granting us permission. Questions? Contact our business office at (800) 950-9740.
Please submit school forms in May or early June and allow at least two weeks turnaround time. Forms not submitted by the end of July may be assessed a processing fee due to high volume of requests and provider availability.
We are happy to support families by completing paperwork to make heading back to school safe and to enable you to communicate with those caring for your children during the school year. We want to make sure we can manage this process more effectively for families and our providers, and appreciate your help in making that happen.
Our providers have years of unique experience diagnosing and managing mast cell activation syndromes. Following the original evaluation, we will usually initiate immunotherapy to address underlying allergies. At the same time, we will introduce mast cell stabilizers and other immune-system modifiers. In select cases, such as Ehlers-Danlos Syndrome, Fibromyalgia, Irritable Bowel Syndrome etc., chronic pain management may be necessary.
When anxiety symptoms are present, we will introduce appropriate medical management.
Due to the complex nature of these disorders, referrals to specialists are sometimes needed.
Our providers do specific testing based on your history and exam, but if you have results, please bring them.
Yes, it’s important to rule out other diagnoses first.
We draw blood daily and use various tools and techniques to make patients as comfortable as possible for the short time it takes. Please let us know about any concerns before your visit.