Immunity
Because botulinum toxin is a biological product, it is possible for the body to create antibodies and develop immunity to the effects of the toxin. Measures are in place to guard against immunity:- The “recipes” for botulinum toxins have been refined to reduce the chances of the body forming antibodies
- Physicians use the smallest dose needed to get a positive result
- Injections are typically not repeated more often than every 3-4 months
- Physicians generally use one serotype at a time rather than alternate or mix type A and type B
An important distinction must be made between individuals who have become immune to the toxin and individuals who have not had an optimal treatment: Someone who has become immune to botulinum toxin does not react at all to the product. This is very different from someone who gets some results from the injections but not the results they were hoping for or expecting. If a person is getting any results at all then there is hope that the way the botulinum toxin is administered can be manipulated to get a good result.
If you are receiving botulinum toxin injections and getting some result but not the result you expected or unacceptable side effects, ask your physician about the specific symptoms that concern you. Treatment with botulinum toxin may require a trial period to establish the appropriate dose, injection sites, and targeted symptoms but it is a very adaptable treatment that can create a dramatic benefit. A physician may test a patient for immunity by injecting a tiny amount of botulinum toxin into the brow muscle and observing the effect.
In some cases, a patient who has previously been successfully treated with botulinum toxin begins to experience a loss in benefit. Several factors could be responsible for this change. The nature and pattern of muscle contractions may change over time, thus necessitating an adjustment in the site of injection and dosage. If deep muscles become involved, it may be difficult to access those muscles. If you notice a change in how your symptoms respond to botulinum toxin, discuss these changes with your doctor.
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