What happens at an ILIT consultation

Most people arrive at an ILIT consultation with one question: can I have it? The allergist arrives with a different one: should you? The hour in between is where the two meet.

Before you go

Take your usual allergy medication unless the practice tells you otherwise, and write down what you react to and when. Skin testing needs antihistamines stopped for several days, so a practice that plans to test on the day will tell you in advance. If you have had testing before, the results save time; a photo of the report is enough.

Bring a list of everything you take, including over-the-counter and herbal products. Beta blockers in particular matter, and not everyone thinks of eye drops as medication.

What the allergist checks

The history comes first: what triggers symptoms, which months are worst, what has and has not helped. Then an examination, and then, if nothing on file settles it, testing: skin prick on the forearm, or a blood test for specific IgE. ILIT treats the allergens you are sensitised to, so the test decides what goes in the vial.

The question is never just whether ILIT works. It is whether it is the right tool for this person, this season, this set of allergens.

Summit Shah, MD, Premier Allergy & Asthma

Who is ruled out

• Uncontrolled or severe asthma
• Pregnancy, or planning one during the course
• Beta blockers and some other medications
• Certain cardiac conditions

What a course involves

Three injections, four weeks apart, into a lymph node in the groin under ultrasound guidance. Each visit is around 45 minutes including observation. Most practices quote the whole course as one price.

Not approved by the FDA. ILIT is given off-label in the United States, using extracts licensed for other routes. The allergist should explain what that means for you before you decide.

Questions worth asking

• How many ILIT courses has this practice given, and since when?
• Which allergens will be in my vial, and why those?
• What happens if I react during observation?
• What does the price cover, and what would be extra?
• When would I expect to notice a difference?

You do not have to decide in the room. A good consultation ends with a plan you understand, whether that is ILIT, conventional shots, tablets, or nothing yet.