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FAQs for EPD
1/ What conditions can be treated with EPD?
Any condition where foods, inhalants or chemicals produce symptoms may respond to EPD treatment. Both antibody and cell mediated type reactions, and atopic conditions may benefit from EPD.
Conditions where we may use EPD include: Hay fever, house dust mite allergy, rhinitis, allergic conjunctivitis, asthma, eczema, Urticaria, IBS, Crohn’s disease, Ulcerative colitis, migraine, rheumatoid arthritis, SLE and chronic fatigue syndrome. If you wish to discuss whether EPD or a Balanced Medicine approach could help you, please contact us.
2/ How effective is EPD?
An American audit of 10,372 patients receiving EPD treatment found that 20% of patients reported excellent improvement, 30% very good, 26% good, 14% fair, 8% no change and 2% of patients felt they were worse after receiving EPD. The results varied in different conditions. Shrader et al’s 2001 White Paper for the United States Senators and Representatives on Enzyme potentiated Desensitisation includes the results of this audit and can be viewed at www.epd.org.uk/useful-links.html
The evidence suggests that EPD is the most effective form of immunotherapy. Dr McEwen who developed EPD in the1960s has written a paper summarising the EPD scientific evidence and trials.
3/ How soon will I notice the benefits?
Because the EPD effect relies on new lymphocyte suppressor cells maturing, the response to treatment is usually seen at or after 24 days. The onset of improvement may be abrupt, i.e. unwell/symptoms one day, well/no symptoms the next. Not all patients respond to the first injection, depending on the individual, the condition being treated and the attention which has been given to the treatment preparation. A response is often seen first time for hay fever for example, but patients with complex multiple allergies may find that it takes a number of injections before they respond to the treatment. An improvement which begins after three to eight doses is termed a ‘late response’.
4/ How many treatments will I need to have?
This depends on the individual, the problem and the response to treatment. In simple hay fever, it is usual to give an injection in November and 6 weeks pre-season, followed by a single annual booster each Spring for about 4 years. After this, most people find that their response is permanent. For house dust mites, an injection is given in September and a second dose in November, and again an annual booster for 2 to 3 years is all that is required. For asthma, eczema, and many other conditions, a second dose is given 8 weeks after the first, and then 3 monthly for usually about a year. When patients find that their symptoms have not recurred after 3 months, the interval is extended to 4, 6 and then 12 months. Many patients know when their EPD is due! Treatment is usually stopped after 6 years.
5/ Is EPD suitable for children?
Yes. EPD can safely be given to children.We give EPD to children over the age of five. Children younger than five years are usually treated with allergen avoidance advice.
6/ I am pregnant. Can I still have EPD?
Although there is no evidence to suggest that EPD causes a problem in pregnancy, as a precaution we do not treat pregnant women or those actively trying to conceive.
7/ Can I have EPD on my first appointment at the Centre?
No. We need to see you first to make sure that EPD is suitable for you. Preparation for EPD begins before the injection, so time needs to be allowed for this
8/ What do I have to do to prepare for my treatment?
Many foods, inhalants, chemicals and drugs can interfere with EPD. The website contains a down loadable information sheet which patients need to follow. In addition, depending on the individual, there may be additional preparation and treatments needed prior to EPD. If you need to have a course of antifungal, antibiotic, antihistamine or steroid treatment prior to EPD, we will provide you with a private prescription or ask you GP to prescribe it for you. If you have a private prescription, you will pay for the cost of the drug at the chemist of your choice.
9/ What if I have a cold or viral infection on the treatment day?
A viral illness can block the EPD response, so you should not have EPD in the first week of an infection. If you have booked your EPD and then get a cold/flu, please contact us as soon as you are aware of your symptoms. If you let us know, we can rearrange your appointment within 2 weeks of the original one. Missed appointments without informing us are charged in full, but because of the EPD being affected by colds that you can’t always predict, you can rearrange your appointment any time leading up to the appointment time for EPD only. Other appointments are subject to our usual cancellation policy.
10/ Is EPD a licensed treatment?
EPD is not produced on a standard drug licence, so is not listed in the British National Formulary. It is technically an ‘unlicensed drug’. It is produced in a small UK laboratory under a ‘specials licence’ from the Home Office. This type of licence is for small volume productions, as a normal drug licence is exceedingly expensive and only appropriate for drug companies producing large quantities of a treatment.
11/ Can I have this treatment on the NHS?
As far as we are aware, this treatment is not offered on the NHS.
12/ Can I have EPD at home?
Unfortunately it is not possible for us to give EPD in your own home. We have to have access to a lot of equipment, and it is not practical to transport this. The EPD is drawn up in a laminar flow (clean air) cabinet, and the injection has to be given within 5 minutes once it has been mixed. The EPD is kept in a temperature controlled drug fridge until it is drawn up.
13/ When do I need to pay for the treatment?
For the initial consultation, you will need to settle your bill in the clinic after your appointment. For actual EPD appointments, we ask that you pay at the time of booking. This is because we have to order your EPD dose 2 weeks prior to the treatment date.
14/ Does it hurt?
The EPD injection does sting, a bit like an insect bite, but this usually settles within a few minutes. It is not possible to use local anaesthetics with EPD.
15/ How big is the needle?
We use a tiny insulin needle and syringe. The needle itself is so small it isn’t really uncomfortable; it is the EPD itself that causes the stinging.
16/ Where will the injection be given?
The injection is given into the superficial layer of skin, usually on the forearm.
17/ Who will give the injection?
A Doctor or Nurse Practitioner
18/ Could I have a reaction to the EPD injection?
The fluid in the EPD injection raises a tiny bleb. Some patients find that they develop a wheal, up to 5cm in length. This is not usually itchy and resolves without treatment. All patients have to wait in the clinic for 30 minutes after their injection. If you do develop a wheal however, we ask that you wait until the wheal stops developing (usually within the 30 minutes anyway). Very occasionally a late phase swelling may follow the wheal 3-6 hours after the injection. This is harmless and is gone within 5 days. It is associated with a good response to treatment.
Infection at the EPD injection site is very rare, but does require a suitable antibiotic. It usually develops later than the late phase swelling. However, we encourage our patients to report any reactions if they do occur, so that we can advise.
Patients may sometimes find that their allergy symptoms are much better, or even worse in the few days immediately following treatment. Anything that happens at this stage is not permanent, and bears no relation to the true EPD response which occurs at about 24 days. Asthma may get temporarily worse 4 to 72 hours after treatment and asthma inhalers may also block EPD. Therefore, we usually start asthmatic patients on a short course of steroids just before and after treatment, and we consider their asthma treatment very carefully.
19/ What happens if I have an allergic reaction to the treatment?
You will have to wait in the clinic for 30 minutes after the injection. A wheal or swelling does not usually require any treatment, unless excessive. The only possible reported case of anaphylaxis to EPD occurred in someone working for many years on the Beta glucuronidase enzyme in a lab, so they were allergic to the enzyme itself. The enzyme used is obtained from the Canadian abalone mollusc, so it is highly unlikely that the general population would have become allergic to it. However, our clinic is equipped to deal with an anaphylactic reaction as well as more minor allergic responses. There is always a doctor and a nurse practitioner on site when EPD is given.
20/ What can I do if I have a needle phobia?
Firstly, please do tell us and discuss it with us. If you faint just after EPD, the response will not be affected, but if you faint after 1 hour, the vasopressin produced during a faint may block the EPD.
EPD uses a tiny needle. Your Balanced Medicine treatment plan may offer practical ways to help you deal with your phobia and the stress surrounding it.