Heard of the hay fever injection? You may have heard good or bad things about it, but it's time to remove the sting and look at the real pros and cons.
Hay fever is a common phenomenon. Every year, 10-15% of us will be afflicted by symptoms of pollen allergy. Whether you're sneezing, suffering from a runny nose or experiencing more severe exhaustion and sickness, you're not alone.
Hay fever works just the same as any other allergic response: the immune system responds to a foreign substance entering the body and attempts to remove it. In the case of hay fever, this foreign body is pollen, which is harmless to your health. Hay fever is simply your immune system over-reacting.
Some plants release pollen as early as January, and can continue as late as September. That's several months of potential discomfort. There's currently no known cure for hay fever, although symptoms can be lessened through the use of a variety of treatments.
Treatments are available on prescription and over the counter. Around 10% of hay fever sufferers find their symptoms do not respond to readily available treatments such as anti-histamine tablets. Anti-histamines are not without side effects and they do not prove effective in every case. As an alternative, sufferers may consider the use of steroids.
Steroids are some of the most powerful anti-inflammatory medications available. They help supress the body's immune response and are used to treat a variety of conditions in which the body's immune system gets out of control. These include asthma, rheumatoid arthritis and hay fever.
Steroid treatments are available in tablet form, or in the form of an injection known as the Kenalog injection. The injection effectively contains the same medication as steroid tablets, but the route of administration is different. When the steroids are injected instead of ingested they are deposited directly into the muscle. There, they leak into the bloodstream in a low dose over the course of around three weeks. Hay fever sufferers generally only require one injection to reduce symptoms for the entire hay fever season. Compared to taking tablets every day, that's very convenient.
The Kenalog injection contains 40mg of the steroid Triamcinolone. Each injection is roughly equal to the steroid dose from taking a 5mg tablet of Prednisolone every day for around three weeks. One of the benefits of the injection is that it does not have to go through the liver or the digestive system, so you can administer a slightly lower dose than the tablet form.
Kenalog injections have helped many people to control hay fever symptoms. That's not insignificant. For severe sufferers, life can be seriously disrupted by hay fever. Untreated, hay fever has been shown to reduce exam results by between 5-10%. Patients report feeling unwell or exhausted for several months at a time.
The general public have been given a lot of information about steroids in recent years, not all of it positive. To be clear, many of the more severe side effects of steroids come from the use of very high doses over a long period of time. The hay fever injection contains a relatively low dose and carries a much lower risk of adverse side effects.
That's not to say that steroid medication is risk-free. It is possible to experience side effects from the Kenalog injection or steroid tablets. These could include swelling, breathing difficulties, itchy skin or skin rashes and abdominal pain, amongst others. Before anyone agrees to a steroid treatment, they should be made explicitly aware of the potential side effects, but it's also good to remember that they are relatively rare.
At the London Doctor's Clinic we offer both the Kenalog injection and steroid tablets to our patients. We make it our priority to talk to each patient about the pros and cons of each treatment route. If opting for the injection, every patient is given an extensive written consent form outlining the risks and benefits. Our Doctors will also talk them through each different treatment option to find the one that's best for their needs. We never encourage patients to opt for one treatment over another and we make it a priority to be transparent about the pros and cons. Our goal is to help them make an informed choice.
So why has the hay fever injection got a bad rep?
The main difference between the injection and the tablet form is that once you've had the injection, there's nothing that anyone can do to stop the steroids leaking into your blood stream. If you do suffer any side effects, these may last for up to three weeks. If you're taking tablets, stopping the treatment will usually cause the symptoms to cease within twenty-four hours. In a nutshell - the injection is faster and more convenient than the tablets, but if you're unlucky enough to suffer side effects, you'll be stuck with them for longer.
The NHS have now ceased offering the Kenalog injection as a treatment for hay-fever. It's easy to see why. In a system where you're aiming to minimise the time patients spend with Doctors, tablets are a safe, effective treatment. At a private clinic where you have time to talk people through their options, I can't see any reason why you wouldn't allow patients to weigh up the pros and cons for themselves.
Many private patients choose the injection thanks to its convenience. From my perspective, that's a perfectly reasonable choice. Our goal is to make people feel better. We believe that given the correct information, patients are capable of making the right choice for their own health.