Sublingual therapy is approached in exactly the same way, the neutralizing dose being determined by a series of injections. But the mixture of extracts for home use is supplied as drops, one of which is placed under the tongue. There is rapid absorption into the bloodstream from this area, and it bypasses the liver, so the extract is not broken down rapidly. The effect of drops is not as long-lasting as that of a subcutaneous injection – the treatment has to be repeated every few hours. However, they are useful for inhalant allergies, or reactions to substances that are “only encountered occasionally, because the drops can be used only when needed. Sublingual therapy has been successfully used to treat patients with allergic reactions to house-dust mite and pollen. It is also claimed to be effective for patients sensitive to synthetic chemicals, where industrial alcohol is used instead of an extract. The question of using mixtures of extracts for neutralization is a difficult one. The trials of this technique have all involved solutions containing single food extracts. Yet some practitioners use up to 70 food extracts in a mixture. Whether the method still works under these conditions is uncertain.

There is also concern over the possible dangers of this technique to patients with violent allergic reactions. It is theoretically possible for such a person to suffer anaphylactic shock when injected intradermally with their allergen, and this could be fatal. However, this technique has now been widely used for many years, and no fatal (or even near-fatal) reactions have occurred. Nevertheless, anyone who has experienced immediate and violent allergic reactions to food (or other allergens) should be carefully assessed before such treatment begins.

Finally, it is claimed that the provocation-neutralization method can be used as a diagnostic test, to determine which foods are the culprits and avoid the need for an elimination diet. These claims are rejected by the majority of doctors because they feel the test is too unreliable. Detailed trials show that there are often positive reactions to extracts of foods that do not provoke symptoms when eaten (false positives). Occasionally foods that cause symptoms will not produce a positive wheal (false negatives).


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