The Allergist’s Role in Treating Chronic Cough – Part 3

The prior two segments I discussed the nasal and chest causes of chronic cough. As an allergist, I am always searching for underlying causes with an allergic basis- because there are so many triggers in the air that affect the respiratory system. But once I rule out that a chronic cough is not due to an allergy or infection, I start digging to see if the cause of the problem isn’t in the belly.

Yes, the stomach can cause a chronic cough. Many of you are familiar with the term,” reflux”, and you see enough ads on TV for heartburn medications. However, interestingly, the patients with chronic cough that have reflux many times have no heartburn symptoms, like burning in the stomach area or chest tightness. These patients may have a form of laryngeal reflux- meaning, the acid from the stomach flows back up the esophagus and irritates the larynx (your voice box area). Sometimes, the only symptom a patient may have is constant throat clearing- it is very annoying to them and others.

To literally, put the “fire out of the belly” involves a few steps. First, dietary changes are critical. Unfortunately, if you like the heavy tomato sauces with pasta dishes- look out- this is a key culprit for reflux. If you like having those few glasses of wine each night with dinner- beware, you will be coughing the rest of the night. There are other foods that may cause the reflux as well, and you find lists of foods on-line, but you should review this with your doctor or a nutritionist. Taking acid blocker medications may give you temporary relief, but its best to try natural ways to reverse this condition, because many new studies are showing that these acid blocker medications have side-effects if used long-term: softening of the bones (osteoporosis), increased risk of infection (because the stomach acid doesn’t kill the bacteria in foods) and depletion of other partially absorbed nutrients.

My other strong belief in reversing reflux is to use breathing exercises. Why breathing exercises? I learned from an excellent osteopath that the diaphragm (the muscle in our abdomen that separates the chest from the stomach) if tense and in spasm squeezes the junction where the stomach and esophagus meet, and this is an anatomical cause of the reflux- usually from stress, but totally reversible. I discuss examples of these breathing exercises in my book, Dr. Dean Mitchell’s Allergy andAsthma Solution (Marlowe 2006) which are very helpful.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

Food Allergy Advice for Pregnant Mothers


It would be nice for once if the advice doctors gave their patients made sense and didn’t seem to change all the time!

I admit as a food allergy specialist I am as guilty as my colleagues in being fooled by what seems obvious. In this case, nut food allergy is the canary in the coal mine. For years allergists with (what seemed like) logic on their side advised pregnant mothers with allergic histories to avoid nuts during pregnancy, while breast feeding and, of course, in their child’s early infancy. This with the hope of banishing the chance of peanut and nut allergy in their child.

In this week’sJAMA Pediatrics, researchers are reporting the opposite:

The more nuts women ate in pregnancy, the less likely their child was to be allergic to nuts.

There are studies showing that avoiding nuts in pregnancy actually increases the child’s risk of nut allergy. This is a complete turn around from the American Academy of Pediatrics position in 2000, where they recommended pregnant women avoid peanuts and tree nuts while pregnant, nursing and to avoid exposing their children to peanuts and nuts until age 3.


Is there any medical logic to this new recommendation?

Actually, there are some recent studies that help us to see that we were looking at this problem the wrong way.

Dr. Gideon Lack, a pediatrician in England, has shown interesting data comparing Jewish children with peanut allergy in London, New York and Israel. He found that Israel had significantly less peanut allergy than their comparable peers in New York and London.


Dr. Lack attributed the difference to the fact that Israeli mothers typically give their infants Bamba, a snack with a type of nut paste. The thinking is that by introducing the nuts and peanuts at an early age, immune tolerance in induced and makes the child less likely to develop the nut allergies later in childhood.

Interestingly, this concept is being seen in other types of allergies. For example, animal allergy studies are showing that if an infant is exposed to an animal, dog or cat, early in life, they are less likely to become allergic. After the age of 3, the child’s immune system is on course of either developing allergies or not.

The longer I practice medicine at Mitchell Medical Group the greater respect and awe I have for studying societies that have figured out the answers to medical problems we encounter. In many cases, we don’t need a magic pill, what we need is a lifestyle that promotes awareness and healthy living.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

Anaphylaxis (Allergic Shock): What Anyone With a Food Allergy Needs to Know

The medical name forallergic shock isanaphylaxis (ana-filaxis) and it can be a deadly form of allergic reaction.Anaphylaxis used to be most commonly associated with bee stings but today,food allergies are a much more common cause of this serious reaction.

One of my patients came to me with a story that is all too common: she was having a salad, with multiple toppings, and suddenly experienced severe diarrhea. Most of us would associate diarrhea with a stomach or intestinal upset from spoiled food but many patients and doctors don’t realize that diarrhea or vomiting can be the initial sign of a severe food allergy reaction. My patient also described further alarming symptoms: a hot, flush feeling running through her body and blurry vision. These are also classic signs of anaphylaxis, as histamine and other chemicals begin to flood the body. She was stumbling in the street until a taxi cab picked her up and brought her to the door step of the hospital.

Because she came by taxi, emergency staff didn’t recognize the seriousness of her condition. She was observed for several hours until the allergic reaction finally subsided on its own. In many cases, patients with severe allergic reactions are given an injection of Benadryl, which is unfortunately not the appropriate first line treatment for anaphylaxis.

The patient had had this kind of reaction before, but a previous visit to an allergist hadn’t yielded any results. Currently, I am running tests to figure out if she is allergic to nuts, legumes, or any vegetables that could have been in her salad. The key thing I have emphasized to her is that this could occur again, and that she needs to have anEpiPen to self-treat if she is not near medical help. An EpiPen looks like a big pen, but it contains epinephrine (adrenalin) in an injectable form, which can reverse a severe allergic reaction within minutes. A patient that uses an EpiPen should dial 911 for medical attention and be properly evaluated. The great news is that studies have shown that early, appropriate use saves lives!

This holiday season there will be lots of parties and delicious tantalizing treats – if you have a food allergy, especially a severe one, please be sure to have an EpiPen and know how to properly use it. The Boy Scout motto, “Be prepared” can save your life.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

Dr. Oz and Dr. Dean Agree: Sublingual Allergy Drops Can Help Allergy Patients!


I watched with excitement last Tuesday asDr. Oz presented his show:

The Worst Allergy Season Ever!

I was curious if he was just going to make his viewers aware that pollen allergies can be severe this year, or whether he was going to introduce a new remedy. I watched with amazement as he asked theallergist on the show, “what about all this talk onAllergyDrops?” My colleague, Dr. Bassett, mentioned that he was aware that allergy drops are now being used to help children and adults with all types of airborne allergies. I was so excited to see this happen on national television. Finally, Allergy Drops are getting the attention they deserve!

Our practice has been using Allergy Drops for 15 years! I wrote the book:Dr. Dean Mitchell’s Allergy andAsthmaSolution (Marlowe 2006) which discusses my serendipity in discovering a physician who introduced me to this new treatment, and how it radically changed our way of practicing medicine. The premise of the treatment is that by building up the body’s natural immune system to counteract the allergies, you can develop life-long immunity and be free of medications. Our practice has treated thousands of patients over this 15 year period, and the majority of patients has achieved significant relief.

One of my favorite stories that aired onFox News several years ago was about a young boy Mark who suffered with terrible spring allergies and asthma (you can see it onYouTube). He loved playing baseball, but during the Little League season his sneezing and wheezing were so bad he had to come out of the game. We treated Mark with allergy drops to tree and grass pollen and he did a complete turnaround.Dr. Steve Salvatore was shown having a catch with Mark in Central Park during the height of the spring pollen season. Mark didn’t miss a throw!

4 Reasons We Practice Allergy Drops:

  • EASY: The beautiful thing about Allergy Drops is that, unlike allergy injections, there is NO Shot!
  • CONVENIENT: The other big factor is that you do the drops at home, or wherever you are travelling. There is no need to go to the doctor’s office.
  • SAFE: Another key factor is safety. Allergy drops have been reported in medical literature to be much safer than shots.
  • EFFECTIVE: And finally, they work….enough said.

The key to this treatment is to get on a regimen before your symptoms are severe.Using Allergy Drops is like working out with weights: you have to put some time in to see results.

I didn’t get invited toThe Dr. Oz Show yet, but if he does give me a call next year I’m going to insist the title of the show be:The Best Allergy Season Ever…on Allergy Drops!

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

Cat or Dog Allergies Don’t Have to End Badly… Allergy Drops Can Help!

kids-and-dog-on-carpetThis past week theAmerican Academy of Allergy,Asthmaand Immunology had their annual meeting in Boston. The Academy estimates that 40 to 50 million Americans suffer from asthma or allergic diseases. Asthma rates alone have more than tripled in 25 years, now affecting 22 million people. A recent article USA Today article titled, “Allergies triggered by‘things we love’ are rising,” suggests that pets may be having an increased effect on our allergies. It is estimated that 90% of homes have significant levels of dog and cat hair – even in those homes that don’t have a pet! How can that be? Pet dander is easily transferred from pet owner’s clothing to other places they visit. Studies done in Scandinavia and here in the USA have shown that school children without pets still had a measurable amount of pet dander in their home, transferred to them at school from classmates with pets at home.

Allergists that see patients with allergies and asthma caused by their family pet typically recommend removing the pet from the home – this is sensible, but sometimes emotionally very difficult. Dr. Dana Wallace, the president of theAmerican Academy of Allergy, Asthma and Immunology admits that, “in 30 years of practice, I can count on one hand the number who have willingly given up a pet.” I can confirm her experience, but I disagree with Dr. Wallace, who says that allergy shots are the only alternative. I typically see patients that either have a cat or dog that one of the family members is allergic to, or I see patients that are in a relationship with someone that has a pet that is causing tension. For these patients, I feel comfortable offering them the choice ofsublingual allergy immunotherapy, more commonly known asAllergy drops. In my book,Dr. Dean Mitchell’s Allergy and Asthma Solution, I describe how children and adults can reverse their allergies by using allergy drops safely at home. A study published in the journalAllergy in 2007 by Alvarez-Cuesta showed how sublingual immunotherapy to cat dander extract reduced nose, eye, and asthma symptoms.

A man in his 30’s once came to see me because his fiancée had 3 cats and every time he went to her apartment he started wheezing and needed to use an inhaler to control his symptoms. His fiancée was also a patient of mine and I knew that it would be difficult for her to give up the three cats she had had for some many years. He tested positive for cat allergens, I treated him with allergy drops, and his symptoms abated. The couple got married and now, even with his increased his exposure to cats, his symptoms are minimal and getting better with time. He did the full course of the allergy drops treatment for 3 years and he was able to stop using any medications to control his allergies. Several years went by after he had finished his treatment and, by chance, I ran into him outside my office one day. We exchanged pleasantries and I asked him how he was doing. He responded, “Good and bad.” The bad news was that he and his wife had divorced, but the good news was that he got to keep the cats… “That’s the good news?” I asked. He responded, “Yes, now that I’m no longer allergic to them I didn’t want to lose them…”

I can’t always guarantee results, but I have had a lot of nice outcomes like the one I described above!

Cat and dog allergies don’t have to end badly… Allergy drops can help!

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

Over-the-Counter Allergy Medications: The Complete Guide

The majority of allergy medications are now available without a prescription. This is obviously a good thing if you are an allergy sufferer, as you do not have to see your doctor to get a prescription for a simple treatment.


However, you should be careful. Over-the-counter allergy medications can be tricky if you don’t know all of the benefits or risks of using them.

This is where I come in:

The complete guide to the best over-the-counter allergy medication forspring allergy relief explains everything that an allergy sufferer needs to know when choosing an OTC allergy medicine for theirallergy symptoms orallergy relief.

Let’s get started.

Oral Over-the-Counter Antihistamines


Benadryl (which has the generic namediphenhydramine) is a common oral over-the-counter antihistamine. It has been around the longest and is the most widely used, but it shouldn’t be:

Benadryl may be beneficial for an acute allergic reaction to a food, but as a chronic medication it has too many drawbacks.

Benadryl is a short-acting antihistamine, so it’s protection is limited to a few hours. The other well-known adverse reaction is that it crosses into the brain and makes users tired. Pharmaceutical companies have taken advantage of this drawback by adding diphenhydramine to pain medications, like Tylenol PM or Advil PM, in their nighttime formulas.

A Better Alternative to Benadryl

A much better choice of oral antihistamines are the newer products:Claritin (loratidine ),Allegra (fenofexadine) andZyrtec (cetirizine).

These antihistamines act for a much longer period of time, varying from 24 hours to 3 days with just one pill and tend to be much less sedating than the older antihistamines, with few drug interactions or side-effects.

Advantages of Oral Over-the-Counter Antihistamines

There are advantages to taking an oral antihistamine forallergic symptoms such as sneezing, runny nose and eye itching.

These medications can block each one of these reactions and are easy to administer. There is no difficult technique involved in taking these types of antihistamines, which include eye drops or nose sprays.

Therefore, you would probably think these antihistamines are theperfect allergy medication.

However, in reality they are good, but not great! Let’s learn more.

Topical Medications

For the tougher allergy symptoms, such as severe nasal congestion, red eyes and throat itching, topical medications trump the oral antihistamines:

By administering the topical solution to the nose and/or eye, the tissue gets an immediate and deeper absorption of medicine to block the allergic reaction.

Afrin Nasal Spray


My patients continually talk about their confusion when choosing over-the-counter nasal sprays. Many are aware of Afrin but are afraid to use it.

They have heard it is addictive – and they are right!

Afrin is not a good medication to use to treat nasal allergies on a long-term basis. It does not block allergic inflammation and you can get a rebound effect where, after you stop using it, you become even more congested, hence the addictive quality.

Cortisone Nasal Sprays

Additionally, many patients are aware that nasal sprays can contain cortisone and have concerns around whether it is dangerous. Cortisone nasal sprays, such asFlonase (fluticasone) orNasacort are steroid sprays that are available over-the-counter. They can work wonderfully in relieving symptoms within an hour and last for a full day.

These nasal sprays tend to be very safe, since they mainly work locally in the nasal tissue without significant absorption by the rest of the body. This avoids concern of a drug-drug interaction, which can happen with an oral antihistamine. However, like with all nasal sprays I tell my patients that technique is critical, so it is important that you are using them in the right way.

The Importance of Technique

When using nasal sprays, it is essential that you have the right technique. You should aim the spray to the side of the nose, not to the middle! If you aim to the middle of your nose you can irritate your nasal septum or, in the worst case scenario, perforate or make a hole in the septum. If you have been using a cortisone nasal spray for over a month, I would advise checking with your doctor to see if have been using the right technique.

Over-the-Counter Allergy Eye Drops


Ophthalmic eye drops are an excellent way to relieve severe eye itching and redness. There are many different OTC allergy eye drops, and of course some are good and some are bad.

The Bad: Visine Allergy Eye Drops

Visine‘s over-the-counter allergy eye drops are a bad choice for allergy sufferers with itchy or swollen eyes. The decongestant in theVisine may “Get the Red Out” as they advertise in the commercials, but likeAfrin, it can be addicting and cause more long-term problems.

The only antihistamine eye drops available are older version type antihistamines and I do not recommend them!

The Best Eye Allergy Drops: Prescription

There are many good prescription antihistamine eye drops such asPatanol,Pataday, Elestat andOptivar. Be sure to check with your doctor to see which one would be best for you. Also, check with your insurance coverage. Many of these eye drops can be very expensive so make sure you are covered.

Why Do You Need An Allergist?

At this point you may be wondering: “Who needs an allergist when all of these over-the-counter allergy medications are available?” I thought about this question long and hard, and surprisingly there are still many allergy sufferers who need the help of acertified allergist or immunologist.

One important service I provide to my patients is allergy desensitization or immunotherapy.I have treated thousands of patients effectively with sublingual allergy drops to environmental allergens, like tree and grass pollen, cats and dogs and dust and mold.

Sublingual allergy immunotherapy, is a natural way to get lasting protection against airborne allergens. The only key factor is that a patient has to build up high levels several monthsbefore the beginning of their allergy season.

The snow is finally melting here in NYC, so we are all braced to go out an enjoy the warmth and green of spring. If allergies slow you down, consider these medications available at your local pharmacy. If they paralyze your golf game or jogging, consider sublingual allergy drops – beating allergies has never been easier!

You can read more about how I usesublingual allergy drops to treat my patients in my book:Dr. Dean Mitchell’s Allergy and Asthma Solution.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

Peanut Allergy Prevention: Is Conventional Thinking by Doctors All Wrong?

Allergies are on the rise – especially peanut allergies


I just read a great article inThe New Yorker magazine by one of my favorite science writers,Dr. Jerome Groopman. The February 7th issue, is titled:The Peanut Puzzle. The article discusses what has baffled Food Allergy researchers for the past twenty years: Why are food allergies, particularly peanut allergies, on the rise when more and more mothers aware of this problem are taking specific precautions to try and decrease the risk that their child will have a food allergy? For years, mothers were told to breast feed their child, and avoid peanuts during pregnancy and breast feeding. None of this now seems to make a difference. And in fact, in the future theopposite advice might be given. Why?

The first theory – Play with dirt

There are a few interesting and plausible theories now circulating that may explain this conundrum: First,The Hygiene Hypothesis, which I discuss in my book,Dr. Dean Mitchell’sAllergy andAsthmaSolution (Marlowe 2006). The hypothesis makes the case that with advances in medical practice, such as vaccinations and increased use of antibiotics in the first year or two of an infant’s life, that we are re-directing the immune system away from the infection fighting mode and resetting it to battle against allergies. Their data shows that children growing up on farms, surrounded by dirt and animal manure, seemed to have less allergies. It was part of the “play with dirt” theory of exposing children to certain endotoxins that may actually strengthen the immune system.

The second theory – The sunshine vitamin

The 2nd and newer theory revolves around the “Sunshine Vitamin”, Vitamin D. Researchers are finding that geographical areas – typically in the U.S. below Atlanta on the east coast and out west in Arizona and Southern California that allergies are less prevalent. Studies have shown that Epinephrine, the injectable medication for a severe allergy attack, (anaphylaxis) is more commonly written in these areas of the country. Vitamin D is also being found to help decrease allergic dermatitis, specifically atopic dermatitis (eczema) because it blocks certain proteins in the skin that cause the inflammation. I am now routinely recommending Vitamin D to my patients with eczema.

The third theory – Give babies peanuts

The 3rd and final new theory is fascinating because it goes against everything we think is logical. An infant at risk forfood allergies, specifically peanut allergy, should be given peanuts early in life. Dr. Gideon Lack, a pediatric allergist at St. Mary’s Hospital in London, has published letters in British medical journals drawing attention to the disparity between peanut allergy in the U.K. and U.S.A vs. Israel. He found that the risk in the U.K. among Jewish children was 11X higher than the Jewish children in Israel – this was astonishing. I know families in my New York practice that have children with peanut allergy and have cousins in Israel without any food allergies. One interesting, but not proven theory, is that Israeli infants are givenBamba, a peanut concoction early in life, which may cause the immune system to build an early tolerance from the exposure.

Hopefully, over the next few years we physicians will better understand the causes of peanut and other food allergies. In the meantime, our best options are careful avoidance through education, being prepared with an EpiPen and awaiting new desensitization treatments.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

Are you Using your Asthma Inhaler Correctly? You and Venus Williams May Want a Review

The weather in New York and much of the country has been frigid. We are hitting new records for snow and cold temperatures. I see this affecting the health of my allergic andasthma patients. For starters, my patients with asthma are requiring increased use of theirasthma inhalers because of the cold weather. This is understandable because very cold weather can cause the bronchioles (the lung tubes) to spasm and a patient with asthma may experience chest tightness, wheezing or coughing. It is imperative that asthmatic patients take precautions before going outside in this weather.

1)use a scarf to cover your mouth when outside: breathing in cold air through your mouth can immediately trigger an asthma attack; your nose is supposed to be doing the breathing , because it warms and humidifies the air before it gets to your lungs.

2) if you are going to be walking outside many blocks or for an extended timeuse your inhalerat least an hour before you go outside to open the airways and give you extra protection.

3) Make sure youknow how to use your inhaler (s) correctly.

My nurse, Mildred, is an avid sports fan. She was watching the Australian Tennis Open on TV, and she happen to see Venus Williams struggling to breathe. She saw Venus use an asthma inhaler on the change-over to help her breathing. However, Mildred, who has worked with me for many years and knows how to use an asthma inhaler correctly, quickly told me: she was shocked thatVenus Williams appeared to be using her asthma inhaler incorrectly! Venus is not alone. I frequently see patients that have asthma, who before coming to my office were never shown the correct way to use an inhaler. In my book,Dr. Dean Mitchell’s Allergy and Asthma Solution (Marlowe 2006), a chapter called,”The Asthma Action Plan“, discusses and illustrates the correct way to use an asthma inhaler.

“The Asthma Action Plan” shows you the proper technique and strongly encourages anyone using a rescue inhaler, like Ventolin or ProAir, to usea spacer device. A spacer device is essentially a holding chamber so that the aerosolized medicated particles can be inhaled deeply into the small air tubules where the spasm is taking place. There are studies that show a spacer device is as good as or even better than the nebulizer machine many asthma patients rely on. I also discuss in this chapter the common mistakes patients make when using their inhalers. One important tip:Wait a few minutes if possible between puffs of your inhaler. Many patients rush to get it done. By waiting a few minutes (2-3) between puffs, you are allowing the larger bronchioles to more fully open, and then the 2nd puff can go deeper to open the small bronchi where the blockage is occurring.

In the meantime, Stay Warm! Spring is only a month away.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

Scott Walker’s Dog Allergy and Presidential Race


The headline on the front page ofThe New York Times on April 1st, 2015 read:Governor, Allergic to Dogs, May Run Against Political History. Believe it or not, this was not an April Fool’s joke!

The article was about Governor Scott Walker, a Republican from Wisconsin, who is running for the presidency in 2016 and appears to have already lost one major constituency – dogs.

Politics and Dog Allergies

I do not think the Dog PAC has ever thrown its weight for either Democrats or Republicans. However, I’m sure in this dog-eat-dog world, not having at least the dog owners in your corner could cost you some votes.

The article doesn’t go into detail about how severe Governor Walker’s dog allergies are, but I assume they must be strong, as he won’t even hold a dog in a photo opportunity.

Apparently he is also not alone: Governor Chris Christie’s children are allergic to dogs too. Although his children are not running for office, if Chris gets elected as our next president we can expect no White House pooch in this administration either.

I Can Help!

I want to extend my help to these two potential presidential candidates. Although I am apolitical (I’m not a fan of either party) I am a doctor who treats patients with severe allergies to dogs (and cats), and I get excellent results!

What Causes Dog Allergies?

As you would expect, dog allergies are caused by dog dander or hair. The larger and hairier the dog, the more allergen is in the air and this will trigger an allergic reaction to the person at risk.

Why is Anyone Allergic to these Wonderful Domesticated Animals?

Well, the answer to that may lie in evolution: there was a time when our wonderful canine pets existed more in the form of wild wolves.

Being allergic to these animals and having these symptoms may have alerted early man to their dangers and protected them.

Now, with the wolves’ population fleeting, we have an abundance of adorable hounds in every home whose only threat is making us sneeze, wheeze or itch if you are allergic to them.

A Great Solution


Fortunately, in my allergy practice I have found one of the best dog allergy treatments: sublingual allergy drops!

Sublingual allergy drops are a desensitization (also called immunotherapy) where small doses of actual dog dander are given to patients in the drops initially, and then built up over time to high doses.

Eventually, the high dose levels of drops create immune tolerance or protection, so that a person with dog allergies can actually be in the presence of a dog without significant symptoms.

I have treated hundreds of patients with dog allergies and have enabled them to not only visit friends and families with pets, but to actuallyown dogs themselves!

A Quick Message to Governor Walker

Governor Walker: I’m ready to serve my country if you get elected as our 45th president – and eliminate your dog allergy. If you don’t end up in the White House, you can still come see me in New York City.

* I write about the desensitization (or immunotherapy) process in my book,Dr. Dean Mitchell’s Allergy andAsthmaSolution (De Capo, 2006).

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

Are My Allergy Drops Working?

running-though-flowersI have been treating patients suffering from environmental allergies and allergicasthma with sublingual allergy drops for over 15 years. The track record of success has been quite high.

I have seen patients who couldn’t be in the same room with a cat or dog who are now able to live with one in their home!

I have seen athletic patients who hated running in the spring because their allergies made them so miserable overcome these allergies with the drops.

My most remarkable patient to date is a young woman who wouldn’t even try to go outside on the high pollen count days in the spring, and she sent me photos of her completing the New York City Triathlon one year after allergy drop therapy.

I have my clinical experience helping patients reverse their symptoms. Still, I frequently get the question:

Am I getting better?

Until recently, I had to answer, “No.” This is because no test will tell you if the drops are working, we just have to see how you feel.

Times they are a changin’, as the song goes.


In a recent issue ofThe Journal of Allergy and Clinical Immunology, new ways to assess how a patient is responding to sublingual allergy drops is explored. Researchers discuss using blood tests to follow how an allergic patient’s immune system changes with proper dosing of allergy drops.

In my practice at Mitchell Medical Group, I usually draw a blood sample to analyze the specific allergy antibody, called specific IgE (E stands for epsilon, but I tell patients it is the “evil” antibody) to various allergens.

For example, if you came in with a history of being allergic to spring pollens and animal dander, I would run the blood test for these allergens and the report might come back showing high levels of IgE to specific trees, grasses and even cat and dog dander. I then instruct my staff to prepare a specific mixture of allergens into the allergy drops that will target the immune system to build of tolerance to the allergen so it doesn’t cause symptoms. I explain to the patients the effects of allergy drops takes time–at least a few months–to start to see a rise in the protective antibodies. These protective antibodies are called IgG4 (the G stands for gamma but I call it the “good” antibody). The typical profile that I look for in patients responding to treatment is a decrease in the specific IgE to the allergen (cat, dog, pollen, mold, dust) and a rise in the IgG4. I usually wait until the end of the first year of treatment to check these levels. It also gives the patient time to see if the drops are working as well.

At Mitchell Medical Group, we have been at the forefront of advancing allergy treatment with sublingual allergy drops and I’m excited that the new advances in blood testing are helping confirm what the past 15 years have taught me as well:

Sublingual allergy drops are a great natural way to protect yourself from allergies!

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island