If you’ve made it through this series—from spring allergy basics to telling allergies apart from infections, managing allergy-triggered asthma, and preventing sinus infections—one theme keeps coming up: treating allergy symptoms as they happen is only half the battle.
Antihistamines, nasal sprays, and decongestants help you get through a bad day. But they don’t change the underlying problem. Every spring, every exposure to dust mites, every encounter with pet dander—your immune system keeps overreacting the same way it always has.
What if you could actually change how your body responds to allergens? That’s exactly what allergen immunotherapy does—and it starts with knowing precisely what you’re allergic to.
At AG Care, we offer comprehensive allergy testing and treatment at all five of our Brooklyn and Queens locations. In this final installment of our Allergies & Respiratory Health Series, we’ll walk you through what allergy testing involves, what your results mean, and how immunotherapy can provide the long-term relief that over-the-counter medications never will.
Why Guessing at Your Allergies Isn’t Enough
Most people with allergies have a general idea of what bothers them. “I’m allergic to pollen.” “Cats make me sneeze.” “I think it’s dust.” But general impressions are a poor foundation for treatment—especially when you’re dealing with symptoms that are severe, persistent, or worsening over time.
Here’s why precision matters:
You may be reacting to triggers you haven’t considered. Many patients who blame tree pollen discover they’re actually sensitized to dust mites, mold, or cockroach allergens—indoor triggers that affect them year-round. Others learn they react to multiple pollen types with overlapping seasons, which explains why their “spring allergies” seem to last all the way through fall.
Treatment strategies differ by allergen. Avoiding oak pollen requires different actions than avoiding dust mites. A nasal corticosteroid might be the right first-line treatment for seasonal pollen allergy, while someone with perennial dust mite sensitivity might benefit more from environmental controls plus immunotherapy.
Immunotherapy requires specific allergen identification. If you’re a candidate for allergy shots or sublingual therapy, your treatment formulation is built around your exact allergen profile. You can’t do immunotherapy without testing first.
Untreated allergies get worse. There’s a well-documented phenomenon called the “allergic march”—the progression from mild allergic rhinitis to more severe conditions like allergic asthma, chronic sinusitis, and even food allergies. Early identification and treatment can slow or halt this progression.
How Allergy Testing Works at AG Care
AG Care offers a comprehensive 72-panel allergy test at all five Brooklyn and Queens locations. Here’s what to expect:
The Skin Prick Test
The skin prick test (also called a puncture or scratch test) is the most common and reliable method for identifying IgE-mediated allergies—the type responsible for sneezing, itchy eyes, hives, and respiratory symptoms.
During the test, a small amount of purified allergen extract is applied to your skin (usually the forearm or back) using a tiny lancet that barely breaks the surface. It’s not a needle injection—most patients describe it as a light scratch. Multiple allergens are tested at the same time.
What we test for:
- Tree pollens — oak, birch, maple, elm, and other species common in Brooklyn and Queens
- Grass pollens — Timothy grass, Bermuda grass, and other regional varieties
- Weed pollens — ragweed (the dominant fall allergen in NYC), plantain, lamb’s quarters
- Dust mites — Dermatophagoides pteronyssinus and farinae (the two most common species)
- Mold spores — Alternaria, Aspergillus, Cladosporium, Penicillium
- Animal dander — cat, dog, and other common pets
- Cockroach allergens — a significant trigger in urban apartments throughout Brooklyn and Queens
- Other environmental allergens — feathers, latex, and additional regional triggers
Results in about 15 minutes. If you’re allergic to a substance, a small raised bump (wheal) surrounded by redness (flare) will appear at that test site. The size of the reaction helps your provider gauge the severity of your sensitivity.
Before Your Test
To ensure accurate results, you’ll need to stop taking antihistamines for a specific period before your appointment:
| Medication | Stop Before Testing | Examples |
|---|---|---|
| First-generation antihistamines | 48–72 hours | Benadryl (diphenhydramine) |
| Second-generation antihistamines | 3–7 days | Zyrtec (cetirizine), Claritin (loratadine), Allegra (fexofenadine) |
| Tricyclic antidepressants | 7–14 days (consult your doctor) | Amitriptyline, doxepin |
| Nasal corticosteroid sprays | No need to stop | Flonase, Nasacort — these don’t affect skin test results |
When you schedule your allergy testing appointment at AG Care, we’ll provide specific instructions based on your current medications.
Blood Tests (Specific IgE)
In some cases—such as when patients can’t stop antihistamines, have severe skin conditions like eczema, or when skin testing isn’t practical—we may recommend a specific IgE blood test. This measures allergen-specific antibodies circulating in your blood. Results typically take a few days but provide the same actionable information.
Understanding Your Results: What Happens Next
Allergy testing isn’t just about confirming what you already suspect. It’s a diagnostic tool that shapes your entire treatment strategy. After testing, your AG Care provider will review your results and build a personalized plan that may include:
1. Targeted avoidance strategies. Knowing your exact triggers allows for precise environmental modifications. For example, if you test positive for dust mites but negative for pet dander, you can focus your efforts on mattress encasements, humidity control, and regular hot-water laundering rather than worrying about your dog.
2. Optimized medication regimens. Your results help your provider recommend the most effective medications for your specific allergy profile—and eliminate ones you don’t need.
3. Immunotherapy evaluation. If your allergies are moderate to severe, poorly controlled with medications, or causing downstream problems like asthma or recurrent sinus infections, immunotherapy may be recommended.
Beyond Antihistamines: The Treatment Ladder
Most people start with over-the-counter options and assume that’s all that’s available. In reality, allergy treatment exists on a spectrum—and the further you go, the more lasting the relief.
| Treatment Level | What It Does | Duration of Benefit | Best For |
|---|---|---|---|
| Oral antihistamines | Blocks histamine to reduce sneezing, itching, runny nose | While taking the medication only | Mild, intermittent symptoms |
| Nasal corticosteroid sprays | Reduces inflammation in nasal passages | While using daily; best with consistent use | Moderate persistent nasal symptoms |
| Combination therapy | Antihistamine + nasal spray + eye drops as needed | While taking medications | Moderate-to-severe multi-symptom allergies |
| Allergen immunotherapy | Retrains your immune system to tolerate allergens | Years of sustained relief after completing treatment | Severe or persistent allergies; allergy-driven asthma or sinusitis |
The first three levels manage symptoms. Immunotherapy is the only treatment that addresses the root cause.
How Allergen Immunotherapy Works
Allergen immunotherapy has been used for over a century—first described in 1911—and remains the only treatment proven to modify the underlying immune response that causes allergic disease. Instead of blocking symptoms after they start, immunotherapy gradually retrains your immune system to stop overreacting to harmless substances.
The process works through a principle called immune tolerance: by exposing your body to slowly increasing doses of the allergens you’re sensitive to, your immune system learns to tolerate them rather than mount an inflammatory response.
Over time, immunotherapy produces measurable changes: reduced IgE antibody production (the antibodies that trigger allergic reactions), increased protective IgG antibodies, and upregulation of regulatory T cells that keep allergic inflammation in check.
Subcutaneous Immunotherapy (SCIT) — Allergy Shots
This is the traditional form of immunotherapy and the one most widely used in the United States. Here’s how it works:
Build-up phase (3–6 months): You receive injections 1–2 times per week, with gradually increasing allergen doses. Each injection is given in the allergist’s office, and you’re monitored for 30 minutes afterward.
Maintenance phase (3–5 years): Once you reach your target dose, injections are spaced to every 2–4 weeks. Most patients begin noticing significant improvement during the first year of maintenance.
What the research shows: Clinical trials and real-world studies consistently demonstrate that patients who complete a full 3–5 year course of immunotherapy experience sustained symptom relief for years after stopping treatment. According to research presented at the American Academy of Allergy, Asthma & Immunology (AAAAI), immunotherapy can also reduce the risk of developing new allergies and may help prevent allergic rhinitis from progressing to asthma.
Sublingual Immunotherapy (SLIT) — Under-the-Tongue Tablets
SLIT is a newer, FDA-approved alternative that’s gaining momentum. Instead of injections, you dissolve a tablet containing allergen extract under your tongue daily. The first dose is given under medical supervision, but after that, you take it at home.
Currently available SLIT tablets in the U.S. include:
- Grass pollen tablets (Grastek) — for Timothy and related grass allergies
- Ragweed pollen tablets (Ragwitek) — for ragweed allergic rhinitis
- Dust mite tablets (Odactra) — for house dust mite allergies
- Tree pollen tablets — for birch-family and related tree allergies
Advantages of SLIT: No needles, administered at home, and a favorable safety profile with fewer systemic reactions than shots. Studies show that three years of consistent SLIT treatment can provide sustained symptom improvement for at least two additional years after discontinuation.
Considerations: SLIT tablets are allergen-specific (one tablet per allergen type), so patients with multiple allergies may need multiple tablets or may be better served by SCIT, which can combine multiple allergens in a single injection.
SCIT vs. SLIT: Which Is Right for You?
| Factor | SCIT (Allergy Shots) | SLIT (Tablets) |
|---|---|---|
| Administration | In-clinic injections | Daily at home (after first supervised dose) |
| Frequency | Weekly → monthly | Daily |
| Multiple allergens | Can combine multiple allergens in one shot | One allergen per tablet; may need multiple tablets |
| Treatment duration | 3–5 years | 3+ years |
| Common side effects | Local redness/swelling at injection site | Itching/tingling in mouth; throat irritation |
| Risk of systemic reaction | Small but present (administered in clinic for safety) | Very low |
| Best for | Multiple allergen sensitivities; patients who prefer less frequent dosing | Patients who prefer home treatment; single or limited allergen sensitivities |
Your AG Care allergist will discuss which option makes the most sense based on your test results, lifestyle, and allergy severity.
Who Should Consider Immunotherapy?
Immunotherapy isn’t for everyone with mild seasonal sniffles. But it’s worth discussing with your provider if:
- Over-the-counter medications don’t adequately control your symptoms
- You need multiple medications to get through allergy season
- Your allergies last for multiple seasons or occur year-round
- Allergies are triggering or worsening asthma
- You experience recurrent sinus infections driven by allergic inflammation
- Side effects from allergy medications (drowsiness, dry mouth, rebound congestion) are affecting your quality of life
- You want a long-term solution rather than lifelong symptom management
Children are also excellent candidates. Research shows that starting immunotherapy early may prevent the “allergic march”—the progression from rhinitis to asthma and additional sensitivities. AG Care’s pediatric providers can evaluate whether your child would benefit.
Long-Term Allergy Management: Building a Year-Round Plan
Whether or not you pursue immunotherapy, effective allergy management isn’t something you do only when symptoms flare. It’s a year-round strategy.
Pre-season preparation (4–6 weeks before your worst season):
- Start nasal corticosteroid sprays before pollen counts rise
- Schedule allergy testing if you haven’t been tested recently
- Review your immunotherapy schedule if you’re already in treatment
- Stock up on saline rinse supplies
During peak season:
- Monitor local pollen forecasts at Pollen.com or the National Allergy Bureau
- Keep windows closed on high-pollen days
- Shower and change clothes after outdoor activities
- Use HEPA air purifiers in bedrooms
- Take medications consistently—don’t wait for symptoms to become severe
Off-season maintenance:
- Address indoor allergens (dust mites, mold, pet dander) with environmental controls
- Continue immunotherapy shots or tablets as prescribed
- Schedule a follow-up with your AG Care primary care provider to assess how your allergy plan is working
- Use the WeHealth app for virtual follow-ups and prescription refills
Frequently Asked Questions About Allergy Testing & Immunotherapy
Does allergy testing hurt?
The skin prick test feels like a light scratch—not a needle injection. Most patients, including children, tolerate it well. Slight itching at positive reaction sites is normal and resolves within an hour.
How much does allergy testing cost at AG Care?
AG Care accepts most major insurance plans, and allergy testing is typically covered. For uninsured patients, we offer affordable self-pay options. Call 877.471.9091 for specific pricing.
Can children get allergy tested?
Yes. Skin prick testing can be performed on children as young as 6 months, though it’s most commonly done in children age 2 and older. Our pediatric team is experienced in working with young patients.
How long does immunotherapy take to work?
Most patients notice improvement within the first 6–12 months. Full benefit typically develops over 2–3 years. The recommended course is 3–5 years for lasting results.
Will I need allergy medications during immunotherapy?
Usually yes, at first. But most patients gradually reduce their medication needs as immunotherapy takes effect. Many patients significantly reduce or eliminate their daily allergy medication within 1–2 years.
Is immunotherapy covered by insurance?
Most insurance plans cover allergen immunotherapy, as it’s a well-established, evidence-based treatment. Our billing team at AG Care can verify your coverage before you start.
Can I get allergy testing and start treatment the same day?
Allergy testing can often be completed during a single walk-in visit, with results available in about 15 minutes. If immunotherapy is recommended, your provider will discuss next steps and schedule your treatment initiation.
Get Tested. Get Answers. Get Relief.
You don’t have to resign yourself to popping antihistamines every spring for the rest of your life. Allergy testing gives you the answers you need, and immunotherapy gives you a path to lasting relief—the kind where your immune system actually stops overreacting instead of you constantly managing the fallout.
Schedule allergy testing at any of our Brooklyn and Queens locations. Walk-ins are welcome, or check in online to save time.
Bushwick · 1295 Broadway, Brooklyn, NY 11221 · (929) 205-5533
Brownsville · 454 Ralph Ave, Brooklyn, NY 11233 · (929) 510-5765
Flatbush Junction · 693 Flatbush Ave, Brooklyn, NY 11225 · (929) 556-5502
Canarsie · 8984 Flatlands Ave, Brooklyn, NY 11236 · (929) 355-5513
Jamaica, Queens · 172-20 Jamaica Ave, Jamaica, NY 11432 · (929) 367-5545
Questions? Call 877.471.9091 or email [email protected].
This article is part of our Allergies & Respiratory Health Series for Brooklyn and Queens residents:
Part 1: Spring Allergies in Brooklyn & Queens: Symptoms, Treatment & Testing
Part 2: Allergies vs. Cold vs. Flu vs. COVID: How to Tell the Difference
Part 3: Asthma & Allergies: When Pollen Triggers Breathing Problems
Part 4: Sinus Health: Preventing and Treating Sinus Infections
Part 5: Allergy Testing & Long-Term Relief: Beyond Antihistamines (You’re reading it)
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment recommendations. If you are experiencing a medical emergency, call 911.