Photo of a metal bucket overflowing with waterWhat is the water bucket theory of allergies? Let’s say you are allergic to house dust mites, trees, and cats. Now imagine that with every exposure to an allergen, your bucket fills with some water. When your bucket overflows with water, you have allergy symptoms.

You protect yourself from house dust mites as best you can, but you are likely still exposed to them on some level. So let’s say that, at baseline, your bucket is about 1/2-filled.

Now let’s imagine that its springtime and trees are blooming. When you go outside to take your dog for a walk, you’re exposed to tree pollen. Your bucket becomes 3/4-filled. Now imagine your daughter rescues a cat that then becomes the newest member of your family. Your bucket is now filled to the top and splashing over.

Everything you do to reduce your allergy exposure or reactivity can help prevent the water in your bucket from overflowing. If avoiding your allergen isn’t possible or adequate to control your symptoms, then your doctor may recommend medications or allergy immunotherapy (AIT).

Allergy Medications

Allergy medications are widely available over-the-counter, however they don’t fix the root of the problem. Antihistamines are the most common allergy medication. They block the effects of histamine, a chemical released during an allergic reaction.

Inhaled corticosteroid nasal sprays, another commonly used medicine, targets inflammation in the nose. These medications also have no lasting benefit to your immune system.

Allergy Immunotherapy

The best way to keep the water level in your bucket low? Adapt your immune system so that you are no longer sensitive to substances to which you are allergic, starting with your major allergy first. This addresses the root of the problem and is the goal of AIT.

AIT is a natural treatment for allergies. It involves giving doses of the allergen that, over time, allows you to develop tolerance.

It is available as FDA-approved sublingual allergy tablets or allergy shots.

For allergy tablets, patients take the first dose in the doctor’s office. Then they can take the tablets at home. Allergy tablets are available for house dust mite, grass, and ragweed allergies. FDA established the dosage for tablets through double-blind, randomized, controlled studies. This ensures an accurate and effective dose every time.

Using the bucket theory scenario above, this self-administered and convenient form of AIT would remove half of the water from the bucket by treating the house dust mite allergy. The water level would decrease so that even the new family cat isn’t as problematic as it otherwise would be.

Allergy shots are the mainstay of allergy immunotherapy. Doctors can combine several allergens into the treatment mix.  The dose for each allergen component in the allergy shot mix varies by physician.

Patients take the shot in the doctor’s office weekly for the first 6-12 months and then bi-weekly to once a month for 3-5 years.

Everything you can do to lower the incoming water into your allergy bucket will benefit your allergy health. Take charge now and ask your doctor about options to treat your allergies.


This article was supported by a medical education grant from ALK.

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