Alternative approaches to immunotherapy of allergy.

Alternative therapies for allergic diseases may be prescribed by physicians or provided by other practitioners or selected by patients without resorting to consultation with a health advisor. The most popular alternative therapies include dietary manipulation and exaggerated avoidance of allergens. Established medical therapies include herbs (Western and Asian), homeopathy and acupuncture; many publications suggest they are of value in allergic disease management. However, most studies lack sufficient power, do not have adequate controls, fail to duplicate standard clinical practices, or utilize a heterogeneous group of subjects. Careful analysis suggest that popular alternative therapies might offer a minimal benefit over placebos, but further studies are required for more rigorous evaluation of outcomes. Numerous esoteric or non-specific methods of treating allergic diseases are also available which may be promoted by enthusiastic practitioners or supported by satisfied patients. The majority of such therapies will never be scientifically evaluated, and the results of such modalities will be difficult to separate out from those of true placebo treatments. It is evident that while the "prose" of scientifically established therapies is appealing to a declining number of patients, the "poetry" of complementary therapies resonates with an increasing majority of the public who believe in the magic of alternative medicine.