Our Services
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Allergy Testing
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What is allergy testing?
Allergy testing is a diagnostic test used to identify substances that cause an immediate allergic reaction in the body. Skin prick testing is a common method used to identify allergic triggers and is used in our clinic for allergy testing.
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What does it test for?
Skin prick testing helps identify allergic (IgE) antibodies to environmental allergies including pollens, dust mites, pet dander. It can also help identify food allergies in patients with immediate symptoms to certain foods. To accomplish this, a small amount of allergen extract is placed on the skin, and then the skin is pricked with a small device to allow the allergen to enter the skin. If a person is allergic to the substance, a raised bump or hive will appear on the skin.
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How long does the test take?
The skin testing process including the interpretation of it will take about 15 minutes. You may experience some itching or mild discomfort during the test if there is a skin reaction, but this should subside quickly.
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What should I know prior to coming for a test?
Before coming for skin prick testing, it's important to avoid wearing tight-fitting clothing or clothing that covers the test site. You should also avoid applying creams or lotions to the test site, as these can interfere with the results.
Some medications can interfere with allergy skin prick testing but in general, antihistamines should be stopped at least 3 days before testing.
Allergy Immunotherapy
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What is allergy immunotherapy?
Allergy immunotherapy (AIT) is a long-term treatment that helps reduce the severity of your environmental allergies and may also be helpful in asthma and eczema. It involves receiving small amounts of the allergen to simulate your immune system which gradually reduce the severity of your allergy symptoms overtime.
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What are different types of allergy immunotherapy? (AIT)
AIT can be divided into subcutaneous immunotherapy (SCIT) or “allergy shots” and sublingual immunotherapy (SLIT) which is a tablet underneath your tongue.
Yearlong SCIT involves injecting the allergen extract(s) into the subcutaneous tissue of the arm and is done in a doctor's office. The treatment includes a buildup phase where the dosage is gradually increased until a maintenance dose is reached and the maintenance dose is injected regularly for 3-5 years. This can be done with both seasonal and yearly allergens.
Pre-seasonal SCIT involves injecting seasonal allergen extract(s) into the subcutaneous tissue of the arm a few months prior to the allergy season. These are generally weekly injections and are done in a doctor's office. It is recommended to also do these injections regularly for 3-5 years.
SLIT involves placing an allergen tablet under the tongue to be absorbed into the bloodstream. This method can be self-administered at home and does not require injections. The treatment typically lasts for 3-5 years and the first dose needs to be taken under supervision in a doctor’s office.
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What are side effects of allergy immunotherapy?
Side effects of SCIT:
Local reactions: This includes redness, swelling, and itching at the injection site. These reactions are usually mild and go away within the day. You may take an antihistamine to help reduce these symptoms.
Systemic reactions: This includes symptoms such as hives, itching, sneezing, and difficulty breathing. These reactions are less common, but can be serious. This is why you have to wait 30 minutes at the doctor’s office after your injections. If you experience any of these symptoms after receiving an allergy immunotherapy injection, please let your provider know immediately.
Side Effects of SLIT:
Local reaction: The most common side effect is itchiness in the mouth, tongue and throat. This usually resolves within minutes and the symptoms improve as you continue to take the tablets daily.
Systemic reactions: This is extremely rare and occurs much less than SCIT. However, if you develop symptoms of hives, sneezing and difficulty breathing after taking SLIT. You should seek medical attention immediately.
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Are there any precautions prior to starting allergy immunotherapy?
You should let your doctor know if you have any of the following conditions prior to or while on AIT.
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If you have a history of asthma and noticed worsening of your symptoms prior or during your visits for AIT
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If you have a history of heart disease and is taking a class of medication called a “beta blocker”
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If you are pregnant or intend to become pregnant
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If you are diagnosed with a new medical condition and started on any new medications
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If you notice problems with swallowing certain foods or having worsening reflux (if on SLIT)
Anaphylaxis
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What is anaphylaxis?
Anaphylaxis is a severe and potentially life-threatening allergic reaction. It can occur rapidly and requires immediate medical attention. Anaphylaxis happens when the immune system overreacts to an allergen, releasing chemicals that can cause a range of symptoms.
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What are symptoms of anaphylaxis?
Anaphylaxis can cause a wide range of symptoms that can affect multiple systems in the body, including:​
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Skin: hives, itching, swelling (especially around the face and throat)
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Respiratory: wheezing, shortness of breath, chest tightness, coughing, hoarseness
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Cardiovascular: rapid or weak pulse, low blood pressure, fainting, dizziness, confusion
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Gastrointestinal: nausea, vomiting, diarrhea, abdominal pain
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What should you do if you experience anaphylaxis?
If you experience symptoms of anaphylaxis, it is important to seek immediate medical attention. Call 911 or your local emergency medical services (EMS) right away. If you have been prescribed an epinephrine auto-injector (such as an EpiPen), use it right away as directed. After using the auto-injector, seek medical attention even if symptoms improve
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What can cause anaphylaxis?
Anaphylaxis can be caused by a wide range of allergens, including foods, medications, insect stings, latex and may even be related to exercise.
Food Oral Immunotherapy
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What is food oral immunotherapy (OIT)?
Food oral immunotherapy (OIT) is an experimental treatment that involves gradually increasing doses of a food allergen to a person who has a confirmed allergy to said food. We currently only offer OIT to children under 8 years of age.
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What is the goal of food OIT?
At this current time, food OIT is not a cure. It helps increase a person's tolerance to a specific food allergen, so as to reduce the chance of an reaction when they accidentally ingest a food they are allergic to. The ultimate goal is to improve a person's quality of life and reduce the risk of accidental exposure to the allergen.
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What is the cost and duration of therapy?
The initial consultation is free of charge for patients with OHIP. However, should you decide to under go OIT, it is not OHIP covered. The general duration of food oral immunotherapy varies depending on the individual and the food but ranges between 6 - 12 months and will require biweekly or monthly visits with us to ensure safe dose escalation and adjustment.
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What are some of the common side effects of OIT?
OIT is generally safe when performed under the supervision of a qualified allergist. However, there is always a risk of an allergic reaction, which is why it is important to undergo treatment in a medical setting.
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Common side effects of OIT can include gastrointestinal symptoms such as stomach pain, nausea, vomiting. However, there is always a risk of severe symptoms including hives, respiratory symptoms such as coughing or wheezing which could be consistent with anaphylaxis.
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Urticaria and Angioedema
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What is urticaria and angioedema?
Urticaria and angioedema are skin conditions that can occur together or separately. Urticaria is characterized by raised, itchy, and red welts (hives) that can appear anywhere on the body. Angioedema is a swelling of the deeper layers of the skin and can cause swelling around the eyes, lips, tongue, and rarely the throat.
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What can cause urticaria and angioedema?
Urticaria and angioedema can be caused by a wide range of factors, including:
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Foods (generally these reactions would be immediate)
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Medications (especially NSAIDs)
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Infections
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Physical triggers (such as cold, heat, pressure, and exercise)
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Stress or emotional factors
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What is the treatment of urticaria and angioedema?
The treatment of urticaria and angioedema involves identifying and avoiding triggers, if possible, and treating symptoms with medications. Antihistamines are the first-line treatment for mild to moderate symptoms, and specialized medications may be required.
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What is the natural course of urticaria and angioedema?
Most patients with urticaria and angioedema will notice decreasing frequency within the year. Some patients may notice intermittent flare ups when exposed to certain triggers.
Venom Hypersensitivity
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What are venomous stings?
Venomous stings are caused by the bites or stings of certain insects, such as yellow jackets, honeybees, wasps, hornets and fire ants. These insects inject venom into the skin, which can cause an allergic reaction in some people.​​
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What are reactions to a venomous sting?
There are three types of reactions to venomous stings:
Local Reactions: This is the most common type of reaction and causes swelling, redness, and pain at the site of the sting. Local reactions are usually mild and go away on their own within a few hours.
Systemic Reactions to the Skin: This type of reaction can cause symptoms throughout the body, such as hives, itching, swelling but does not have issues with breathing or feeling lightheaded.
Anaphylaxis: This is a severe, life-threatening allergic reaction that can occur in some people. Symptoms of anaphylaxis include swelling of the face, tongue or throat, difficulty breathing, and low blood pressure. If you experience any of these symptoms after a venomous sting, seek emergency medical attention immediately.
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What are some ways to avoid being stung?
To avoid venomous stings, it's important to take the following precautions:
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Wear protective clothing: If you're going to be in an area with a lot of insects, wear long pants and sleeves, closed-toe shoes, and a hat.
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Avoid brightly colored clothing: Brightly colored clothing can attract insects, so it's best to wear neutral colors.
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Avoid sweet-smelling perfumes and lotions: These can attract insects.
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Be cautious around nests: If you see a nest or swarm of insects, move away slowly and avoid swatting or provoking them.
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What are some treatment options to a venomous sting?
There are several treatment options for venomous stings, including:
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Antihistamines: These medications can help relieve symptoms such as itching, hives, and swelling and should only be reserved for local reactions or reactions that only affect the skin.
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Epinephrine auto-injectors: This should be provided by your doctor if you are diagnosed with an allergy to a venomous insect. This should be used when you experience systemic reactions including hives, swelling, difficulty breathing and feeling light headed.
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Immunotherapy: This is a long-term treatment that involves receiving regular injections of the venomous allergen to which you are allergic to. This slowly modified your immune system and reduces the severity of your allergy symptoms to the venomous stings overtime.