Low Dose Immunotherapy (LDI)

Low Dose Immunotherapy (LDI) is a treatment for increasing immune “tolerance” of an overactive immune system. Allergy and autoimmunity represent an alteration or overactivation of appropriate immune tolerance. LDI retrains the immune system for specific antigens, thereby decreasing overactive immune response and decreasing symptoms.

This type of immunotherapy was discovered in Great Britain in the 1970s and called “Enzyme Potentiated Desensitization” (EPD). The technique utilized very small concentrations of antigens along with an enzyme, beta glucuronidase, which helps educate the T cells involved in the immune response. This treatment was brought to the US, but in the early 1990s the FDA stopped the importation of EPD. At this point, Dr. Shrader reproduced the mixtures of EPD and called them LDA. LDA originally used antigens causing certain allergies and the technique was later expanded by Dr. Vincent to treat various autoimmune conditions using a variety of different antigens, called LDI.

LDI for Autoimmune Diseases
Autoimmune diseases and conditions that involve an overactive immune system (like allergies) can be treated with LDI. It is now understood that many autoimmune diseases are “triggered” by an initial infection. Sometimes, when the immune system recognizes the infection and mounts an attack, through an antibody-mediated immune response, there is a cross reactivity with the body’s own tissue. This process is called “molecular mimicry.” A good example of this is Rheumatic Fever, where damage to the heart can occur after the Streptococcus infection is treated. Often there can be more than one trigger for a disease process.

The key is recognizing the difference between an “infection” and an “immune reaction.” Infections involve an organism in a place where it doesn’t belong and antimicrobial therapy is curative, such as pneumonia, cellulitis, endocarditis, etc. An “immune reaction” is an inflammatory response to an organism that is either a normal organism in the human body, or is not improved with antimicrobial therapy. Chronic Lyme disease is another example of an “immune-mediated” process rather than an “infection.” Many people without Lyme Disease symptoms harbor the bacteria that causes Lyme Disease. Symptoms often do not resolve with antibiotic treatment in Chronic Lyme Disease. Symptoms often return after treatment with antibiotics.

What conditions respond well to LDI?

• Food allergies/sensitivities, environmental allergens, chemical sensitivities, mold sensitivity
• Eczema, acne, rashes
• Chronic Fatigue
• Crohn’s disease, Ulcerative Colitis, IBS
• Yeast sensitivity
• Endometriosis
• Chronic Lyme Disease
• Rheumatoid Arthritis, Ankylosing Spondylitis, generalized joint pain
• Fibromyalgia
• Herpes outbreaks
• Chronic Sinusitis

What is the procedure for LDI?
Patients will first undergo a history and physical to determine if LDI or LDA are appropriate therapeutic techniques. Often lab work will be done prior to LDI or LDA therapy to help guide therapy. LDA and LDI doses are given by administering a small drop (less than 1 ml) of the enzyme and antigen mixture under the tongue. Doses are typically repeated every 7–8 weeks, but “booster” doses can be given as soon as 1–2 weeks, based on response to the first dose. The key to LDI is finding the right concentration that the immune system responds to. Concentrations range from 4c up to 20c, or more, if needed. “1c” refers to a 100:1 dilution, and each successive number is another 100:1 dilution.

Because there can be multiple different antigens that trigger the patients’ symptoms, multiple antigens may need to be given before symptoms fully improve. Once we find the antigen or antigens that alleviate symptoms, the antigens can be combined and given together.

What can I expect after LDI treatment?
There are three things that can happen after a dose.

1. If the dose is too weak, there will be no change in symptoms. We can then proceed with the next stronger concentration in 1–2 weeks.
2. If the dose is too strong, there will be a flare in symptoms. Flares usually occur in the first 72 hours and usually last a day or two, but can last up to several weeks. A flare is not necessarily a bad thing, because we know we have chosen the right antigen. If we get a flare, we must wait 7–8 weeks for the immune system to “reset.”
3. If the dose is almost strong enough, there will be a temporary improvement in symptoms, but not lasting the full goal of 7 weeks or more. If this is the case, we know we are close to the right strength, but need to give a slightly stronger dose. We can then give a “booster” dose in 2 weeks.

Once the correct dose is found, doses are given every 7–8 weeks, sometimes with “booster” doses, as needed. Often, patients see longer and longer improvements in symptoms and can space doses out longer than 7–8 weeks, and sometimes are able to stop completely.

For more information, click below to download the LDI Patient Handbook pdf: