Board-certified otolaryngologist and Fellow of the American Academy of Otolaryngic Allergy
I start from the assumption that patients are smart people looking for answers to complicated questions.
Thirty-five years in, I still believe the same thing. Tell people the truth, including when the right answer is a pharmacy spray, a tablet, shots or another doctor, and they'll make good choices.
Page last updated
Dr. Menachof prescribed allergy shots for the first twelve years of his practice and was never dissatisfied with how well they worked. What concerned him was how few patients finished a full treatment course.
In 2003 he reviewed his own patients' records and found that fewer than one in five were completing the four-year course his practice recommended.
That same year he learned about sublingual immunotherapy from an experienced practice in Wisconsin and offered drops alongside shots for three years among his patients. In 2006 he made allergy drops his primary immunotherapy recommendation.
What I felt when I saw those numbers was embarrassment. I had been strongly recommending a four-year course to people, and in my practice, fewer than one in five were getting through it. Shots work if you finish them. That was never my complaint. But I couldn't point to anything else in my practice where I was making a strong recommendation that most of my patients wouldn't be able to carry out. That's what bothered me. Not that the treatment was failing, but that I was asking for something most people couldn't do, and I hadn't known it until I looked.
10 articles in 3 categories · newest
Browse by category
How Dr. Menachof reads the evidence, where he's changed his mind, and how you can too.
3 articles
How does a Quello allergy article go from a question in the exam room to a published piece? Dr. Menachof explains where AI helps with research, why he rewrites every article himself, and what he’s had to correct along the way.
Published Reviewed
After 35 years treating allergies, I’ve changed how I interpret tests, choose treatments and listen to patients. These are the lessons that changed my practice, and what they mean for your allergy care.
Published
Understanding the evidence behind allergy treatments starts with asking the right questions. Learn how to read research, interpret guidelines and recognise what the evidence can and can’t tell you.
Published Reviewed
What's behind your symptoms, from stuffy noses and sinus trouble to sleep and smell.
4 articles
Indoor allergies can be hard to identify. This article explains how to reduce common indoor allergens, including mold, dust mites, cockroaches, and pet dander, to help manage allergy symptoms year-round.
Published Reviewed
Treating a chronic stuffy nose involves addressing the underlying cause of nasal swelling. Treatment options include antihistamines, decongestants, nasal steroid sprays, and nasal irrigation. Read on to learn how each treatment can help.
Published Reviewed
Some allergies, including certain food allergies, can go away over time. Learn why allergy symptoms may improve, which allergies you can outgrow, and what to do next.
Published Reviewed
Sinus infections aren’t contagious, but the viruses that cause them can spread. This article explains how viruses, bacteria, allergies, and nasal polyps can contribute to sinus infections and when to take precautions.
Published Reviewed
Your options laid out, from the pharmacy shelf to immunotherapy, with the trade-offs.
3 articles
Do allergy drops actually work, and how long does it take to notice a difference? Dr. Menachof explains what the research says about symptom relief, how drops compare with allergy shots, and whether the benefits can last after you stop treatment.
Published
Allergies can make you feel tired for several reasons. This article explains how your immune response, poor sleep, and nasal congestion may contribute to allergy fatigue and shares tips to help you feel more energized.
Published Reviewed
Seasonal allergies can be uncomfortable and just downright annoying. Learn more about what affects our seasonal allergies and the best ways to treat them.
Published Reviewed
Every article on this page is written by Dr. Menachof. The reviewed date is the last time an article was checked against current evidence. How we write about evidence
Everything published here is written or reviewed by Dr. Menachof. Dr. Menachof writes these articles with the help of an AI system, and checks every claim against its source before it publishes. How these articles get made explains what that looks like. When we make a claim about a treatment, we tell you what kind of evidence sits behind it: a large randomized trial, a single small study, a professional guideline, or twenty years of watching patients in our own practice. Those are not the same thing, and we label them differently. Where the evidence is thin, we say so. Where we have made a judgment call inside a range the guidelines leave open, we say that too and explain how we got there. We would rather you trust the parts that are solid than believe all of it equally.
Dr. Menachof writes or reviews every article before it publishes, and reviews each one again at least every 12 months. A new guideline or a major study moves that review up. The reviewed date on each article shows the last time he checked it. Articles written by someone else carry the line "Medically reviewed by Michael R. Menachof, MD, board-certified otolaryngologist and Fellow of the American Academy of Otolaryngic Allergy".
If you spot an error, email info@goquello.com and we will look into it within 5 business days. When we correct an article, a note at the bottom says what changed and when.
Disclosure: I co-founded Quello, and Quello sells the treatment described here. I've written this to explain the evidence as I understand it, including where it's limited.
Michael R. Menachof, MD, is a board-certified otolaryngologist (ENT) and allergy physician based in Colorado. Dr. Menachof is the co-founder and Chief Medical Officer of Quello, a telemedicine allergy practice that treats patients at home with allergy drops. He has practiced otolaryngology and otolaryngic allergy since 1991, treating allergy with allergy shots for his first twelve years. Dr. Menachof began prescribing sublingual immunotherapy, allergy drops taken under the tongue, in 2003, and it has been his primary immunotherapy recommendation since 2006. Dr. Menachof's practice has treated more than 15,000 patients with allergy drops. He is certified by the American Board of Otolaryngology–Head and Neck Surgery and is a Fellow of the American Academy of Otolaryngic Allergy and of the American College of Surgeons. He received his medical degree from the University of California, San Francisco, completed his residency at the UCSF hospitals, and served as an associate clinical professor in the Department of Family Medicine at the University of Colorado School of Medicine from 1993 to 2024.
Before Quello, Dr. Menachof saw patients in person at Advanced ENT & Allergy Center in Greenwood Village, Colorado, the practice name of Advanced Ear, Nose & Throat, PC, which he cofounded in 2000. It was there, in 2003, that he reviewed his patients' records and began offering allergy drops alongside shots. Quello is that same practice, Advanced Ear, Nose & Throat, PC, now caring for patients at home.
Dr. Menachof is board-certified in otolaryngology–head and neck surgery by the American Board of Otolaryngology, a certification whose examined areas include allergy. He is also a Fellow of the American Academy of Otolaryngic Allergy, a credential open only to board-certified otolaryngologists and awarded after written and oral examinations in allergy and a peer interview.
The first step is knowing what you’re allergic to.
The first step is knowing what you’re allergic to.