What is an Allergist and Immunologist?
An allergist is a physician who specializes in the diagnosis
and treatment of asthma, allergies and certain immunological
diseases. The allergist is specially trained to identify the
factors that trigger asthma or allergies. Allergists help people
treat or prevent their allergy problems.
What Kind of training do Allergists and Immunologists have?
After earning a medical degree, the allergist completes a
three-year residency-training program in either internal medicine
or pediatrics. Next the allergist completes two or three more
years of study in the field of allergy and immunology. This
training deems the physicians eligible for certification by the
American Board of Allergy and Immunology (ABAI). Once they pass
the certification exam they are considered board certified inan
the field of Allergy and Immunology and become a diplomat of the
ABAI. You can be certain that your doctor has met these
requirements if he or she is certified by the American Board of
Allergy and Immunology.
You should see an allergist if:
- You have symptoms such as chronic sinus infections, nasal
congestion, post nasal drip or difficulty breathing.
- You experience hay fever or other allergy symptoms several
months out of the year.
- Antihistamines and over-the-counter medications do not
control your allergy symptoms or create unacceptable side
effects, such as drowsiness.
- Your asthma or allergies are interfering with your ability
to carry on day-to-day activities.
- Your asthma or allergies decrease the quality of your life
- You are experiencing warning signs of serious asthma such
- You sometimes have to struggle to catch your breath.
- You often wheeze or cough, especially at night or after
- You are frequently short of breath or feel tightness in
- You have previously been diagnosed with asthma, and you
have frequent asthma attacks even though you are taking asthma
- You needed to be seen in the emergency department or
admitted to the hospital for asthma and other allergic
- You have hives
- You have multiple drug allergies
- You have food allergies
- You have egg allergy that prevents you being able to be
How do allergists and immunologists work with other health
The role of the allergist and immunologist is typically to work
with other physicians, sometimes acting as a consultant to advise
other physicians about a specific diagnosis and treatment plan. In
other situations the allergist acts as a manager and keeps the
primary care physician updated on the care and treatment of the
Is specialty care more expensive?
You may be surprised to learn that specialized care may save
time and money and reduce the severity of disease. An allergist is
trained to spot clues in the medical history, physical examination
and allergy testing. The proper tests done early may save money in
the long run. Prompt diagnosis and specially tailored treatment
often save money by preventing complications of chronic allergy
Frequently Asked Questions (FAQ)
Q - What is an allergy?
One of the marvels of the human body is that it can defend
itself against harmful invaders such as viruses or bacteria. In
some people, the body reacts to harmless substances such as
dust, mold or pollen by producing an antibody called
immunoglobulin E (IgE). When patients with one of the allergic
diseases (such as rhinitis or asthma) are exposed to these
substances, the immune system then rallies its defenses,
launching a host of complex chemical weapons to attack and
destroy the supposed enemy. In the process, some unpleasant and,
in extreme cases, life-threatening symptoms may be experienced.
Q - What causes an allergic reaction?
Hundreds or even thousands of ordinary substances can trigger
allergic reactions. These are called "allergens." Among the most
common are plant pollens, molds, household dust (dust mites),
animal dander, industrial chemicals, foods, medicines and insect
An allergic reaction may occur anywhere in the body, but
usually appears in the skin, eyes, lining of the stomach, nose,
sinuses, throat and lungs -- places where special immune system
cells are stationed to fight off invaders that are inhaled,
swallowed or come in contact with the skin.
Q - What is the best method of testing for allergies?
The best first step in the diagnosis of allergies is a
thorough health history and physical examination. If you have
allergy symptoms that occur in association with exposure to
certain things, that is highly significant. Allergy diagnostic
tests, such as skin tests or blood tests, provide similar
information and merely confirm what your health history tells
the doctor. If your doctor were to rely exclusively on the
results of skin or blood tests (without history and physical
examination), you could be diagnosed as having an allergic
problem that you don't necessarily have.
Skin tests, in most situations, are preferable because (1)
the results are available immediately, (2) they are less
expensive and (3) they are more sensitive to subtle allergies.
A blood test is appropriate in certain situations,
particularly when you (1) cannot suspend antihistamine therapy
which can inhibit skin tests, (2) have widespread skin disease
making skin testing difficult, (3) are so sensitive to the
allergen that the test might be risky or (4) cannot be skin
tested for some other reason.
Q - What are allergy shots all about?
Allergy shots are an effective and safe treatment for people
who suffer from a variety of allergic diseases, including
allergic rhinitis (hay fever), allergic conjunctivitis, asthma
and insect stings. The treatment – also known as immunotherapy
or allergy immunization – works by introducing small amounts of
purified substances to which the person is allergic, in
gradually increasing amounts. The allergy shots improve the
patient’s natural resistance to the allergens and minimize or
eliminate the need for medications.
Q - Do allergy shots have side effects?
Like all medical treatments, allergy shots (immunotherapy)
can have side effects. Your doctor will discuss this with you in
Q - Why is it that frequent exposure to an allergen can
increase sensitivity and cause allergic reaction, yet repeated
exposure to an allergen in allergy shots helps build ups immunity?
Regularly scheduled, repeated exposure to small amounts of an
allergen can lead to immunity, whereas infrequent and erratic
exposure does not confer immunity but increases the likelihood
of producing allergen sensitization.
Irregular exposure to allergens can lead to the production of
antibodies (called IgE-mediated antibodies). The presence of
these antibodies, when exposed to an allergen can lead to an
In allergy shots or immunotherapy, the allergen exposure is
closely regulated and given on a scheduled basis. Small amounts
of allergens are given over a period of time to build up to
maintenance doses. This leads to the production of blocking
antibodies (called IgG antibodies) and a decrease in the level
of allergic or IgE-mediated antibodies.
Q - What is asthma?
Asthma is a chronic, inflammatory lung disease characterized
by recurrent breathing problems. People with asthma have acute
episodes when the air passages in their lungs get narrower, and
breathing becomes more difficult.
The problem is an oversensitivity of the airways, which
overreact to certain "triggers" and become inflamed and clogged.
Q - What causes asthma?
The cause of the lung abnormality that is asthma is not yet
known. For 90% of children and 65% of adults who develop asthma
it is due to or associated with allergies. Through research,
scientists have established that the disease is a special type
of inflammation of the airway that leads to contraction of
airway muscle, mucus production and swelling in the airways. The
airways become overly responsive to environmental allergens and
irritants. The result is wheezing, shortness of breath, chest
tightness and coughing.
Q - Can asthma be cured?
As yet there is no cure for asthma, but asthma can be
controlled with proper treatment. People with asthma can use
medicine prescribed by their physician to prevent or relieve
their symptoms, and they can learn ways to manage episodes. They
also can learn to identify and avoid the things that trigger an
episode. By educating themselves about medications and other
asthma management strategies, most people with asthma can gain
control of the disease and live an active life.
Q - Is asthma a psychological or emotional disease?
No. Although episodes of asthma can sometimes be brought on
by strong emotions, it is important to know that asthma is not
the result of emotional factors such as a troubled parent-child
relationship. Years ago, people more commonly believed that
asthma was "all in one's head" and therefore not a real illness.
Physicians and other medical scientists today know that this is
Q - How is asthma diagnosed?
Asthma is sometimes hard to diagnose because it can resemble
other respiratory problems such as emphysema, bronchitis and
lower respiratory infections. For that reason, asthma is under
diagnosed – that is, many people with the disease do not know
they have it and therefore are never treated. Sometimes the only
symptom is a chronic cough, especially at night. Or, coughing or
wheezing may occur only with exercise. Some people mistakenly
think they are having recurrent bronchitis, since respiratory
infections usually settle in the chest in a person with asthma.
To diagnose asthma and distinguish it from other lung
disorders, physicians rely on a combination of medical history,
a thorough physical examination, and certain laboratory tests.
These tests can include spirometry (using an instrument that
measure the air taken into and out of the lungs, chest X-rays
and blood and allergy tests).
Q - What does an asthma attack feel like and what happens
during an attack?
An asthma episode feels somewhat like taking deep breaths of
very cold air on a winter day. Breathing becomes harder and may
hurt, and there may be coughing. Breathing may make a wheezing
or whistling sound.
These problems occur because the airways of the lungs are
getting narrower. The muscles that surround the airways tighten,
the inner lining of the airways swells and pushes inward, and
the membranes that line the airways secrete extra mucus, which
can form plugs that further block the air passages. The rush of
air through the narrowed airways produces the wheezing sounds
that are typical of asthma.
Q - Are there asthma patient support groups?
There are several asthma support groups. One national
organization is the Allergy and Asthma Network Mothers of
Asthmatics. Another is the Asthma and Allergy Foundation of
America. There also is a Food Allergy and Anaphylaxis Network.
Here are some links to visit:
Q- What are the main national allergy associations in the
They are The Academy of Allergy, Asthma and Immunology (AAAAI)
and The American College of Allergy, Asthma and Immunology (ACAAI).
Q- What are some of the anti-asthma medications?
Advair, Alvesco, Asmanex, Flovent, Pulmicort, Qvar, Singulair,
Symbicort, Dulera, Xolair, ProAir, Proventil, Ventolin and