Dr. Meagan Shepherd: Welcome back to Allergy Actually, the place where three allergist moms and best friends get real about the immune system, seasonal, sniffles, and everything in between. It's a brand new year, which means fresh calendars, fresh intentions, and if we're honest, the same old allergies waiting for their big spring comeback. But not this year. Today we're talking about smart self-care for your immune system, the kind that actually changes your day-to-day life, and why starting immunotherapy now can set you up for your easiest allergy season yet. So this is a very fun topic and I think that we all decided that the new year really is that pivotal time that recurs, you know, every 12 months when we all think, okay, we're gonna do a little reset. Right? And a lot of the time the New Year's resolution comes up and it's something like, I wanna lose weight, I want to move more, something like that. And we get all jazzed up and some of us do end up sticking with that resolution throughout the year. And, you know, a lot of us like peter off after a little excitement at the beginning.

Prevention vs. Cure: Why It Matters for Allergies

Dr. Meagan Shepherd: So we wanted to talk to you today about your immune system and different disease processes and how you can keep these things in mind when you move forward and make your plan for the new year.

Dr. Kara Wada: Yeah, I, there's a saying that my mom, they love their sayings, but an ounce of prevention is worth a pound of cure. And really when we're thinking about allergies, we know that's the case. We know that's the case with, you know, our health in general. If we're able to, you know, put the work in day after day, with those small habit changes, they add up over time.

There also are some tools at our disposal as we're thinking about allergies, that goodness really can move the dial considerably pretty quickly. 

Why You Should Start Immunotherapy When You Feel Good

Dr. Kara Wada: And really, you know, as we're thinking about January, like having some measurable decrease in allergic inflammation, come March, April, May.

Dr. Amber Patterson: Yeah, that's a really good point. I had a patient the other day who said, "I feel good in the winter. I had been thinking about starting immunotherapy, but I'm gonna wait off and see how spring is." And I reminded her that spring is horrible for her every year for the last how many years we've known each other. And that actually it's more beneficial if you start immunotherapy, you know, if you have seasonal.

To start it during the time of year, you feel good because when you're doing immunotherapy, you're receiving what you're allergic to. So starting during that time where your immune system's a little more kind of neutral rather than flared up so much can be helpful. You can start any time of year, but it's like that's the time when you're not thinking you should start is actually when you should start.

Dr. Kara Wada: Yeah, if you're treating when you're already miserable, you're already kind of behind the eight ball. 

Dr. Meagan Shepherd: One of the nice things about different immunotherapy topics that we have discussed in different methods is there is at least one that is quicker acting than the others. And so it is very good for, if you are thinking, you know what? Right now it is, I don't know, January 1st we're gonna say, and I want to feel better by April, May, whenever, you know, trees are, you know, in full bloom and grass is hitting and all of those things. So interlymphatic immunotherapy that we've talked about before is something that is a great, great option for this. And just as a reminder, immunotherapy is where we slowly teach our bodies to learn to tolerate things that otherwise the body sees as an allergen and causes allergic inflammation.

So there is a way to do that rather quickly. So if one of you guys wanna talk about that.

Dr. Amber Patterson: Sure, yeah. With intralymphatic immunotherapy or the ILIT protocol that we've developed through the Auni ILIT Learning Network, there's a standardized protocol that we use to help patients retrain their immune system in just three office visits. So we do these allergy injections under ultrasound guidance. Inject the allergen directly into a superficial lymph node as opposed to with traditional shots where we do the injection under the skin of the arm. But by delivering that antigen directly to the lymph node, it's a more efficient process, and with one injection every four weeks, you can finish your treatment in eight weeks.

We tell people expect to feel better within a month of finishing that treatment, so within 12 weeks. But oftentimes patients report to us that they're feeling better sooner, better quality of life, life changing treatment for them.

Dr. Kara Wada: Yeah, and I, I think when we're thinking about, gosh, what are the ways that we really can harness the power of behavior change. 'Cause that's what we're talking about, you know, in regards to like making new habits, setting resolutions. We know from science that there are a few ways to do that. If you have fewer visits that you need to show up for, it's much easier for you to follow that through to completion. 

Beating the Odds: Micro-Habits for Treatment Adherence

Dr. Kara Wada: Like much easier. And when we think about traditional allergy shots, or even under the tongue drops, which you can do at home, gosh, the ability for folks to follow through on that over a three to five year process or timeframe is what, like half-ish? 

Dr. Amber Patterson: On average when you pull the different studies, and of course every practice could be different, but it's around like 50 to 60% of people that start traditional shots and SLIT will eventually quit before they complete a full course. And if you don't finish the full course, you don't get the long-term benefits that you set out to obtain.

So that's a really good point. It's also a cost thing if you're going to invest in a medical treatment for yourself. Either way, you know there's some kind of investment. Really think long and hard, which 1:00 AM I going to be able to commit the time to? Is it three visits to the office? Is it weekly visits over three to five years, weekly and monthly? Is it something I have to do every single day, but at home? Like everybody knows themselves and what their history of pattern changes.

Dr. Kara Wada: I think, you know, there's some micro habits we can do too. So the other way that we can really affect change is just making these small little swaps or minor behavior changes that add up over time. And so, you know, one of those things is a 10 minute reset at the end of the day. You know, cleaning up your space, your office space at the end of the day, I say that and I'm looking at my office space and it needs a reset right now. You know, if you have a humidifier, cleaning it out, if you, you know, using it, but cleaning it out, making sure maybe you pick up one that's easier to clean, or that uses tap water so you're not having to worry about. You know, what are some ways that you can make some of these changes but reduce the friction in doing it? And maybe incorporating some of these things into non-negotiables. So for me, my morning meds, I always get them out and take them when I'm making my coffee because my coffee, coffee is a non-negotiable. And in the evening I take my evening meds when I'm brushing my teeth 'cause that's a non-negotiable. 

Planning Your Allergy Year: Expectations and Medication Breaks

Dr. Meagan Shepherd: One of the things that I'm big on is having, I'm a big goal setter and I like to think, I think in a linear time fashion, and I try to do this with my patients too. So for instance, when I'm seeing them in January, we talk about, or you know, the first few months of the year we talk about what our plan for the year is.

And this is even people who I've seen for ages who may or may not have wanted some type of immunotherapy, but just basically with every patient, I like to talk about what our plan is. People get worried, I think, whenever we start a medication and they think that it's something they have to be on every single day for the rest of their life, and in some cases it may be, but what I always tell them about allergies in particular, they're dynamic, they change. It's based on how your body is doing with other diseases. It's total inflammatory state, different seasons, different exposures. There's so many things that affect that so I tell them, okay, so for the first part of the year, I think that we're going to do this with a goal of hopefully being able to wing down on our asthma medications through, you know, these months.

And so when I see you again, hopefully at that time you will have been able to decrease your inhaler. And we come up with the plan for the decrease by this time. And so you get this medication break hopefully through this season, and then we will restart it, you know, at this point, and I just like to give them an idea about how we expect their disease to continue, or you know, how, how it will be with each season, and to come up with a management plan to let them know that it's not something that is always going to be exactly the same. And so I think that's important to set people up with those expectations and the knowledge that, you know what, it's not gonna be like this every day. I know it sucks right now. I have to do my inhaler two puffs twice a day every single day during the fall and winter. But you know what? As soon as it, you know, hits May, I'm good and I can stop everything. You know, not everyone can do that, but there are some patients that can, and so I like to go through all of those so that they have appropriate expectations and an idea of what to expect.

Letting Go of Limiting Beliefs: Visualizing a Better Allergy Season

Dr. Amber Patterson: Those are great things to bring up with patients to have them thinking about too. 

Dr. Kara Wada: I was gonna say, one of the things that I've been trying to play around with too is helping people let go of some of the limiting beliefs that they come into those visits with, that they've lived, you know, in recent years with a really significant burden of symptoms with their allergies or asthma.

Like, you know, it's really easy to fall into this frame of mind that's a little bit like Eeyore. "Oh, it's just gonna be bad, like it's inevitable." But really help them see what 2026 allergy season could look like and start to imagine that, that, you know, what that could be. Because really, you know, when we think about the professional athletes and every, like, how do you think that they're hitting all those free throws? It's not just practicing the reps with their muscles, it's also opening your mind up to the idea that the future could look different.

Dr. Meagan Shepherd: That's really an excellent point. So, this has been a great discussion. I'm actually really excited to think about talking about with some of these things with my patients and then also thinking about for myself. These are very good ideas, so thanks for hanging out with us. If you are ready for a calmer, clearer, more energy friendly allergy season in 2026, now's the moment to start the habits that support your immune system and to consider immunotherapy before spring hits. If that's something that you're a candidate for, please reach out to your allergist and talk about it now. Don't wait until you're hot in the middle of allergy season.

So if this episode help you think differently about your health, please hit follow. Share it with other people who are allergy warriors in your life. Leave us a quick rating. It helps more people find real practical answers just like this. We'll see you next week. Your Immune Confident Year starts now. 

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