IgE level spike – why?

Hi all – you may have read my woes about Xolair seemingly not working well for me.  Before I started Xolair I had blood work and my IgE was 151.  My recent blood work is IgE 525. Perplexing to say the least.  My eosinophils were 0.  So other biologics wouldn't qualify.  I heard the info through my pulmo's nurse so I couldn't get opinions.  I see the pulmo in 2 weeks.  Opinions?  I don't get it.  I must be an allergic fool.


Comments 5

  • Shea

    Interesting… Well… I did xolair for a year and it didnt lower my IgE or eosinophils, so I stopped. But I had both high and have an immune/ allergic condition called churg-strauss syndrome that is often marked by both those being high. 

    I have heard IgE can be to allergy, another immune condition, or the body fighting infrction from parasite or other things that it considers "not-self". 

    I cant remember if you said before, but.. Do you have allergies/ have you been tested with skin-prick recently or in tbe past? 

    What time of year was your bloodwork before xolair?

    Spring pollen season is starting here in Florida pretty hard so– depending on where you live, it could be that you are reacting to pollens . I am not sure when eosinophils becone involved in the allergic process or if they are only sometimes involved… But allergists are good to have on top of pulmos sometimes too, so thats an idea..

  • Richard

    hi Shea – Thanks for responding.  My pulmo is giving me Xolair because I have allergic asthma.  The last time I had allergy testing was 50 years ago.  My mother said i lit up like a Christmas tree.  What I'm confused by is why would my IgE spike so high if Xolair is meant to lower IgE levels?

  • Shea

    My guess would be that the xolair just isnt really working, and that the rise is due to a rise in allergens in your environment (like pollens which are crazy around here this time of year). 

    I know Xolair can cause an allergic reaction because I remember I had to always have my epipen with me and be monitored BP after I got it, but it is anti-IgE so I cant imagine it would be making IgE higher– but I dont know– the Dr will know more on that. And if you stop getting it and it goes back down, then thatd be convincing that it is causing some weird reaction in you. 

    If you do go get allergy tested again (you might have to wait until your not on xolair), you would know better what to avoid. Like for pollen, I never have the windows open during the spring and I change clothes and shower after being outside for long, and have and HEPA in my room. If its animal dander (our main trigger) youll know to avoid places where animals regularly reside or frequent. If its molds, you can try to avoid humidity and get someone to do any raking for you or wear an mask and keep skin and eyes covered when doing yard work. If its dust mites mostly, then you can work on getting encasements for mattress and pillows and weekly washing bedding in hot water. Im not sure if you do all that stuff already– it took me time to do all that bc my son and I both have bad allergies to all of the above– but it has helped me keep my eosinophils and IgE lower practicing avoidance, and the skin prick tests just helped it sink in to me and really motivated me to make changes and feel more in control of the diseasejust .

  • LK

    When I was on Xolair my allergist said I would have to be off of it for 6 months before I could get allergy tested.  Seems that it would alter the test results for that long.

  • Melanie Carver

    Total IgE levels do not remain static in the body.  They fluctuate due to exposure to allergens (seasonal variations), hormones,  aging,  atopic dermatitis flares,  etc. When it is tested,  it is just a snapshot of the total IgE that day. It could change a week later due to changes in environment. 

    Tracking symptoms may be a better indication of tracking the progress of the treatment.  This is because a spike in IgE doesn't always correlate to a spike in symptoms (or vice versa).

    As far as ranges, having a total IgE in the hundreds is typical for people with allergic diseases.  

    Since it has been a while since you've had allergy testing, it might be a good time to discuss with your pulmonologist about seeing an allergist. There may be complementary treatments that may help improve your symptoms (e.g. nasal sprays, allergy medicines, allergy immunotherapy shots or pills).

    Do you have a list of questions prepared for your appointment?

    Best wishes,  Richard!