What is ILIT?
Intralymphatic immunotherapy: allergy immunotherapy in which a small dose of allergen is injected directly into a lymph node, usually in the groin, under ultrasound guidance. A course is three injections, four weeks apart.
Questions and answers
Questions and answers
Plain answers about intralymphatic immunotherapy, the practices listed here and how the Society works. If yours is not here, write to info@ilitsociety.org.
About ILIT
What the treatment is and who it is for.
How is it different from allergy shots?
Shots place the allergen under the skin and rely on it reaching the lymph nodes on its own, which is why they take three to five years of regular visits. ILIT puts the allergen in the node directly, so far less allergen and far fewer visits are needed.
How is it different from allergy tablets or drops?
Sublingual tablets and drops are taken daily at home for several years and are approved for a handful of allergens. ILIT is three clinic visits over about eight weeks, and practitioners can prepare it for the allergens found on your test.
Which allergies can ILIT treat?
Published trials cover grass, birch and other tree pollens, ragweed, cat and dust mite. Many practitioners also treat other pollens, dog and moulds. Each listing shows the allergens that practice treats.
Does ILIT work for food allergies?
No. ILIT has been studied for airborne allergens that cause hay fever, allergic rhinitis and allergic asthma. It is not a treatment for food allergy.
Can it help allergic asthma?
Trials in people whose asthma is well controlled have reported fewer symptoms. Uncontrolled asthma rules ILIT out, so the allergist will check your asthma control first.
Who is a good candidate?
Someone whose symptoms are clearly caused by an allergen a skin or blood test confirms, who has not had enough relief from medicines, and who wants a course that fits into weeks rather than years. The allergist decides after a consultation.
Who should not have ILIT?
People with uncontrolled asthma, those taking beta blockers, pregnant women and people with certain heart conditions or immune disorders. Your allergist will go through the full list with you.
Can children have ILIT?
Some trials included teenagers, and some practices treat adolescents. Few data exist for younger children. Ask the practice whether it treats children and from what age.
Can I have ILIT if I am pregnant or planning to be?
Immunotherapy is not started during pregnancy. If you may become pregnant during the eight-week course, tell the allergist at the consultation.
The treatment
What happens at the visits and afterwards.
What happens before the first injection?
A consultation: your history, an examination and, unless you have recent results, allergy testing. The allergist confirms which allergens matter, checks that nothing rules ILIT out and explains the course.
What happens at an injection visit?
You lie down, the allergist finds a lymph node in the groin with ultrasound and places a very small volume of allergen into it with a fine needle. The injection itself takes a minute or two. You then stay for an observation period, usually thirty minutes, before going home.
Does it hurt?
Most people describe a brief pinch or pressure, similar to a blood draw. The node may feel tender for a day or two.
Why the groin?
The inguinal lymph nodes are large, close to the skin and easy to see on ultrasound, which makes the injection accurate and quick.
How many visits are there, and how far apart?
Three injections, four weeks apart, so a course spans about eight weeks. Add the consultation and any testing before it.
How long is each visit?
Around thirty to forty-five minutes including the observation period. The injection is a small part of that.
What are the side effects?
Mostly local: tenderness, mild swelling or a small bruise at the node, settling within days. Itching or mild hay-fever symptoms for a few hours are reported occasionally. Serious allergic reactions have been rare in the published series, which is why you are observed after each dose.
What should I avoid on the day?
Practices differ. Common advice is to skip strenuous exercise and alcohol for the rest of the day, keep taking your usual allergy medicines, and tell the practice beforehand about any new medication, illness or asthma flare.
What if I miss an injection?
Call the practice. A short delay is usually fine; a long gap may mean restarting the course. Do not try to make up a dose on your own schedule.
How soon will I notice a difference?
Many people notice less severe symptoms in the first pollen season after the course. Some notice a change within weeks; some need a second season to judge.
How long does the benefit last?
Published follow-up extends to three years in the larger trials, with symptom relief comparable to conventional shots over that period. Longer-term data are still being collected.
Can the course be repeated?
Yes. Some practices offer a booster or a repeat course if symptoms return after a few years. Your allergist will advise based on how you responded.
Can ILIT be combined with other treatments?
You keep using your usual antihistamines, nasal sprays or inhalers during the course. Some allergists combine ILIT with tablets or shots for other allergens; that is a decision for the consultation.
Evidence and approval
What the research shows and what “off-label” means.
Is ILIT proven to work?
Randomised controlled trials since 2008 have found that three intralymphatic injections reduce symptoms and medication use for grass, tree pollen, cat and dust-mite allergy, with results comparable to three years of conventional shots. Most trials were small, and a few, using different doses or intervals, found no benefit.
Where was it developed?
At the University of Zurich, where the first trial in grass-pollen allergy was published in 2008. Research groups in Scandinavia, Korea and the United States have since run their own trials.
Is ILIT approved by the FDA?
No allergen extract is approved for intralymphatic use. In the United States ILIT is given off-label, using extracts that are licensed for allergy shots.
What does “off-label” mean?
A licensed product is being used in a way its label does not describe. That is legal and common in medicine, and the physician takes responsibility for the decision. It also means the treatment is not standardised: doses and protocols vary between practitioners.
Why is it not more widely offered?
It needs ultrasound skill, time per patient and willingness to work off-label, and the large long-term trials that drive guidelines are still to come. Most practices listed here adopted it after training with colleagues who already offer it.
Is there ten-year data like there is for shots?
Not yet. The longest published follow-up is around three years, with smaller reports beyond that. That is one of the trade-offs to discuss at the consultation.
Cost and insurance
Who pays, and what to ask.
How much does ILIT cost?
Each practice sets its own price. Because the treatment is off-label and the course is short, most practices charge a package price for the three injections rather than billing per visit. Ask for the total before you start.
Does insurance cover it?
Usually not, because no extract is approved for intralymphatic use. Some practices can bill the consultation, testing and observation through insurance and charge the injections separately. Check with both the practice and your insurer.
Can I use an HSA or FSA?
Usually yes, as ILIT is a medical treatment prescribed by a physician. Confirm with your plan administrator and keep the itemised receipt.
What is included in the price?
Ask whether the quote covers the consultation, allergy testing, the allergen preparation, the three injections and the observation periods, and what a repeat course would cost later.
Finding a practitioner
How the search works.
How do I find a practitioner near me?
Enter a zip code or city on the home page, or use “my location”. Results are ordered by distance from that point, with the closest first, and every listing is shown on the map.
What does the 50-mile ring mean?
Practices within 50 miles of the place you searched are listed first as your local options. Practices beyond that are listed separately under “Further away”.
Nobody is listed near me. What now?
The results still show the three closest practices and how far they are. Patients often travel for ILIT, because a whole course is three visits; a practice a few hours away can be practical. You can also ask your own allergist whether they offer it or know a colleague who does.
Can I filter by allergen?
Yes. Use the allergen menu on the search, or the filter chips on the results page, to show only practices that treat the allergen you care about.
What does the “Consultations available” badge mean?
That practice takes consultation requests through this site, at the practice or over video, so you can ask about ILIT before deciding. Practices without the badge are reached through their own website or phone number.
Why do some practitioners appear more than once?
Each listing is one practitioner at one office. A practitioner who offers ILIT at two offices has two listings, so the distance and map pin are right for each.
Are the practitioners ranked?
No. Results are ordered by distance only. We accept no payment for placement, and ratings do not change the order.
What do the badges on a listing mean?
They show facts the practice has supplied and we have checked where we can: board certification, how long the practice has offered ILIT, whether it uses ultrasound guidance, and the allergens treated.
How current is the information?
Practices update their own details and we check in with them periodically. Confirm hours, insurance and prices with the practice before you visit.
A practice I know offers ILIT but is not listed. Why?
Either it has not applied yet or its application is still being checked. Please tell the practice about us, or send us its name and we will invite it.
Consultations and appointments
What happens when you contact a practice through the site.
Can I book an appointment on this site?
No. Every practice runs its own schedule and records, so booking happens with the practice. What the site offers is a way to ask for a consultation or an appointment; the practice then contacts you.
What is the difference between a consultation and an appointment?
A consultation is the first conversation, in person or over video, to find out whether ILIT is right for you and what it would cost. An appointment is for the treatment itself, for people who have decided to go ahead after a consultation.
What happens after I send a request?
The request goes straight to the practice’s inbox, with your email address as the reply address, and you receive a copy. The practice contacts you to confirm a time. Nothing is booked until it does.
How quickly will the practice reply?
Most practices answer within a few working days. If you have not heard back in a week, call the number on the listing, or write to us and we will nudge them.
Can I have the consultation over video?
Where the listing shows a video option, yes. The injections themselves always happen at the practice.
What should I bring to the consultation?
Any previous allergy test results, a list of your medicines, notes on when and where your symptoms are worst, and your questions about cost and timing.
I need help now. Is this the right place?
No. If you are having a severe allergic reaction or any emergency, call 911. This site is for planning treatment, not for urgent care.
About ILIT Society
Who we are and how the directory is run.
What is ILIT Society?
An independent directory of allergists who offer intralymphatic immunotherapy, with plain-language information about the treatment. It exists so that patients can find the practitioners who do this, and so that practitioners can find each other.
Who runs it?
It was founded by a board-certified allergist who offers ILIT and is run by the Society with help from listed practitioners, who write and review the Journal articles. The footer names the organisation.
Is it a medical practice?
No. The Society does not see patients, give medical advice or take part in your treatment. It connects you with practices and explains the treatment in general terms.
Do practices pay to be listed?
No. Listings are free, and we accept no payment for placement, position or badges.
Does a listing mean the Society endorses the practice?
No. A listing means the practice has told us it offers ILIT under a board-certified allergist and that we have checked the certification. It is not an assessment of quality or outcomes.
How do you check practices?
We verify the supervising allergist’s board certification against the certifying board’s public records and confirm the practice’s details with the practice. We do not inspect practices or audit their results.
Who writes the Journal?
Listed allergists and the Society’s editors. Each article shows its author, the allergist who reviewed it and the review date, and cites its sources.
Can I rate or review a practice?
You can rate one. On a practitioner’s page choose Rate and give one to five stars; it is anonymous and needs no account. Written reviews are not offered, and ratings never change the order of search results.
How do I contact the Society?
Email info@ilitsociety.org. We answer questions about listings, articles and the site; we cannot advise on your own treatment.
I found a mistake in a listing or article.
Please tell us at info@ilitsociety.org with a link to the page. We correct listings with the practice and articles with the reviewing allergist.
For practitioners
Getting listed and keeping a listing current.
Who can be listed?
Practices that offer ILIT under the supervision of an allergist who is board-certified in allergy and immunology and licensed in the state of the office listed. The full criteria are on the listing criteria page.
How do I apply?
Fill in the application form. It asks for the practitioner, the practice, each office where ILIT is offered, the allergens treated, a headshot and a contact email. You can add several offices to one application.
What does it cost?
Nothing. Listings are free, and there is no paid tier.
How long does approval take?
We aim to answer within two weeks. We check the board certification and may email you to confirm details. You receive an email when the listing is live.
What information is published?
The practitioner’s name, credentials and photo, the practice name, each office address and phone number, the website, the allergens treated and the other details on the form. Your contact email for requests is never published.
Can I list more than one practitioner from my practice?
Yes. Each practitioner who delivers ILIT is listed separately, at each office where they offer it. Apply once per practitioner.
How do I update or remove my listing?
Email info@ilitsociety.org from the contact address on your listing and we will make the change, usually within a few days. Removal is immediate on request.
How do consultation requests reach me?
By email, to the address you gave on the application, with the patient’s email as the reply address. You can switch requests off or change the address at any time by writing to us.
Can I use the ILIT Society badge on my website?
Yes, while your listing is live. The badges page has the images and the code; link the badge to your listing or to the site.
Where can I learn the technique?
Write to us and we will pass your question to listed practitioners who teach the technique, and watch the Journal for courses and papers.