Dr. Shrader’s LDA: A Dramatically Effective Immunotherapy for Allergy

            LDA (short for “low dose allergens”, or ultra low dose enzyme activated immunotherapy) is a method of immunotherapy enhanced by a minute dose of the enzyme, beta glucuronidase (dose is 10^-13).  The beta glucuronidase activates extremely miniscule doses of various allergens (10^-6 to 10^-17) and stimulates the production of T-suppressor cells.  These cells actively "switch off" helper cells that are erroneously causing patients to be ill by misidentifying normal substances in the body to be allergens.  T-cells may live for long periods of time in the bloodstream, so LDA needs to be administered only every 2 months at first, and then less often as time passes, generally with one to three tiny (1/20 c.c.) intradermal (in the first layer of skin) injections on the inner aspect of the forearm [see references]

            LDA is used to treat all types of allergy, sensitivity and intolerance to inhalants (pollens, dust, mites, danders, etc.), foods and chemicals.  It is used to treat such conditions as seasonal and perennial hay fever, asthma, all types of food allergy and many other problems.

Development of LDA       

            Since over 2000 patients relied on EPD for their ability to function normally at the time the FDA stopped usage in the USA, they were left with no other options but to receive EPD outside the USA, or to try to import EPD into the USA themselves.  In an effort to continue to treat patients who required EPD but were unable to import it or afford to go outside the USA for treatment, Dr. Shrader began to develop a suitable substitute in the summer of 2001.  This was done using the procedures already published by several authors (included in the EPD reference section).  Dr. Shrader tested various formulations with patient volunteers in his office until April of 2002, when he evolved a formula that appeared to function the same as EPD did, and to work similarly well.

            LDA uses the same active components as EPD does (beta glucuronidase and others), but Dr. Shrader added many more pollens, foods and other allergens.  LDA is compounded by a compounding pharmacy in the USA.  The FDA has been told by the Supreme Court that it cannot regulate compounding pharmacies the same as it regulates “manufactured” (retail) drugs, so compounding pharmacies are allowed to compound specific “compounds” that physicians prescribe, the same as they have done since the very beginning of medicine in this country.

            The use of LDA is limited by necessity in the USA because it is available only by prescription for specific physicians’ patients, and is not available as a retail product.  The compounding pharmacy also may not advertise LDA to the public, so it is unlikely you will hear much about it.  Other physicians are allowed to use compounded products formulated by themselves or products formulated by other physicians, so many other physicians in the USA (most of whom have used EPD in the past) have chosen to use LDA in their offices.

Bacterial Components of LDA are no longer generally available.

            EPD contains bacterial antigens in all of the “basic” formulations.  Dr. McEwen included these bacteria for various reasons, not the least of which was to treat chronic infections such as bronchitis.  The FDA clearly frowns on bacterial vaccines in this country, no matter where they come from, and has removed all bacterial antigens (such as MRV, staph lysate and others) from pharmacy shelves, whether compounding or not.  Since the other allergens and components in LDA are from pharmaceutical suppliers accepted by the FDA, Dr. Shrader did not want to include bacterial antigens in LDA.  Please note: neither EPD nor LDA are approved by the Food and Drug Administration.

            The absence of the bacteria from the general mixtures of LDA appears to make no difference – with the exception of the treatment of facial rashes secondary to lupus, where "plain" LDA has appeared to fail for at least one patient.  Otherwise, the fact that bacteria were not included in LDA does not seem to be critical, and since the FDA does not approve any bacteria used by a compounding pharmacy, there was really no choice.  Certain bacterial components (PKB and Bacteroides) are still used to treat rheumatoid arthritis, ankylosing spondylitis, reactive arthritis and a few other conditions, but they are available only at Dr. Shrader's office.

If you have been treated with EPD and plan to switch to LDA

            As mentioned, LDA contains most of the same components EPD originally did, but Dr. Shrader also added more allergens.  Now that LDA has been employed since 2002 in this country, we have found certain idiosyncrasies.

            Patients who switch to LDA from EPD may find they “relapse” for the first 2-3 LDA treatments.  This is the rule rather than the exception, and the physicians using LDA have found that these patients return to their previous status by the time they receive three LDA treatments.  After that time, patients who were receiving EPD treatments infrequently will get to a similar schedule on LDA, though they must generally receive LDA every 2-3 months again at first.  Patients who took awhile to do well on EPD will take approximately the same time to do well again on LDA.           

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Last modified: April 08, 2006