LOW DOSE ALLERGEN IMMUNOTHERAPY (LDA)

HOW DOES LOW DOSE ALLERGY TREATMENT (LDA) WORK? 

Low Dose Allergen (LDA) immunotherapy uses a low dose allergen injection enhanced by a minute dose of the enzyme, beta- glucuronidase.  This injection stimulates the production of T-suppressor cells.  These cells “switch off” helper cells that are causing patients to be ill my misidentifying normal substances in the body to be allergens.  T-cells may live for long periods in the bloodstream, so LDA needs to be administered only every 2 months at first and then less often as time passes.  The injections are given with very tiny intradermal needles on the inner aspect of the forearm.

HOW DOES LOW DOSE ALLERGY TREATMENT (LDA) COMPARE TO TRADITIONAL IMMUNOTHERAPY? 

It is difficult to treat single seasonal allergies with the traditional allergy shots/immunotherapy. The reason is that you must receive the traditional injection treatments year round, and require several months of uninterrupted therapy to be effective. The traditional, progressive immunotherapy treatments start with a low dose, and the patient gets a larger dose, as tolerated, until he or she reaches a maintenance level.  If you interrupt treatment for more than a couple of months, the patient must start the progression over. Unfortunately, some patients can never get relief with traditional immunotherapy.


The concentration of LDA injection dosages does not change throughout the treatment.  Each treatment is generally more effective than the last, regardless of the period between injections. Therefore, LDA treatments make it possible to achieve allergy relief with seasonal injections since the traditional buildup period isn’t necessary.  LDA is an effective treatment for patients with seasonal or perennial (year-round) allergies. Typically, after 15 LDA treatments, many patients find they can discontinue therapy because they’re free of symptoms.


A primary advantage of LDA is the rapid onset and the wide spectrum of coverage. LDA contains all of the major allergens found in the United States and Canada so patients can travel allergy-free. Since traditional immunotherapy is generally limited to a few allergens in one particular region, traditional therapy may not provide protection if you’re exposed to allergens outside your treatment region.


Traditional immunotherapy is limited to inhalant allergies only — pollens, mites, dander, molds, dust, and dust mites. In addition to LDA inhalant treatments, LDA can also treat chemical sensitivity and food allergies.

IS ALLERGY TESTING REQUIRED? 

Allergy testing helps to establish what known allergens to avoid but isn’t a requirement to determine the LDA injection formula.  The LDA serum contains more than 300 allergens that are effective for allergens found in Canada and the entire United States.

ARE THERE ANY ADVERSE EFFECTS OF LDA? IS LDA SAFE FOR CHILDREN? 

LDA uses a natural pathway of immune modulation at a strength less than that which occurs in nature.   An initial study of over 10,000 patients done in the US from 1993-2001 found no significant adverse reactions to LDA.   In a United States study, repeated ear infections in children responded to LDA better than any other condition (we find that ear infections are most often caused by a reaction to foods).  Many double-blinded studies have proven the effectiveness and safety of the LDA treatment.


In most cases, patients will experience a localized swelling at the LDA site.  There may also be some itching and redness.  Rarely, there is swelling of the lower arm following the treatment which is a temporary reaction.

For some patients, there can be a temporary flare of symptoms following their LDA treatment, especially after the first one to three treatments.  This is a good sign that the therapy will work well as you progress in treatments. Your doctor will help you manage any unmasking symptoms.


Allergy is a lifetime disease and frequently starts out in early childhood as eczema and food allergies.  It then develops into inhalant allergies and may progress to asthma.  LDA is a safe treatment, even for young children, to stop this progression.


WHAT ARE THE DISADVANTAGES OF LDA? 

LDA will not work for patients who cannot avoid taking certain medications that interfere with LDA during the three-day period after the LDA injection.   LDA may not be suitable for patients who can’t avoid a high chemical or high-antigen environment during the critical three days.

WHAT ARE THE REQUIREMENTS OF LDA? 

Before treatment commences a visit it is required with one of our doctors.  During treatment and for 48 hours or more afterward, patients need to follow a hypoallergenic diet.  Certain medications are not compatible with LDA and patients must avoid them for three weeks following treatment.  Certain supplements are recommended on all days except the ‘three critical days’ (day before, day of and day after treatment).  Talk to your doctor about these medications and supplements, ‘sometimes patients may substitute other medications that do not interfere with LDA.  All patients are required to read the — Low Dose Allergen Therapy – LDA Patient Instruction Booklet

I ONLY HAVE ALLERGY SYMPTOMS IN THE SPRING. WILL LDA WORK FOR ME? 

Yes, since you can get LDA shots intermittently after your first treatment cycle, LDA should work well for you. Many patients once they are symptom free from their first treatment cycle only need one treatment per year (or no treatment), just before their allergy season.

HOW SOON WILL I FEEL RELIEF? HOW LONG DOES THE TREATMENT LAST? 

That varies with your age and health.  It isn’t unusual for younger patients to get some relief from their allergy symptoms within 24 hours of getting an LDA injection. However, the primary effect of the treatment occurs about three weeks after the LDA injection.  Most patients report relief from their allergy complaints by the time they’ve had three treatments.


Each LDA treatment usually works a little better and longer than the previous treatment.  In general, LDA will get most inhalant allergies under good control after 3 injections, food allergies can take a year, and severe autoimmune disorders may take two years.  We space LDA treatments two months apart initially.   After six treatments, most patients can go four to five months between treatments.  We have some patients who have had multiple treatments find their treatments now can last close to a year.  In general, the effect’s duration gets longer with each treatment.

I HAVE SEVERE ASTHMA, CAN LDA HELP? 

Yes, LDA works very well for asthma patients.  In some cases, LDA permanently resolves asthma.  Treating the asthma patient with LDA does pose some challenges because most of the long-acting asthma medications aren’t compatible with LDA. In those cases, we may be able to change the medication regime temporarily for LDA to work.  After several treatments with LDA, the patient may no longer need many of the asthma medications.

DOES INSURANCE COVER LDA TREANTMENTS? 

No, there’s no special CPT billing code for LDA, so insurance doesn’t cover LDA at this time.  However, if you have naturopathic coverage than f/u visits with our doctors will be covered.

DOES LDA WORK FOR AUTOIMMUNE DISEASES? 

Yes, LDA is very effective in treating some autoimmune disorders.  Talk to your doctor about your individual needs.