Is sublingual immunotherapy as effective as injections? i'm targeting fatigue that allergies cause. living in austin/tx it's almost year-round.

Depends: Currently only 2 sublingual preparations that are approved by FDA for allergen immunotherapy (grass and ragweed). If you have limited sensitivities two one or both of these then sublingual therapy could be an option. Allergy shots are better if you have both seasonal/year round allergies. Avoid non-standardized sublingual drops with multiple allergens included, not enough surface area on tongue.

Overall shots better: When comparing sublingual vs subcutaneous immunotherapy, the latter turns out to be more effective overall. The fact that sublingual IT often causes oral itching and requires daily dosing leads to a very high drop-out rate. In addition, the allergens available for sublingual are quite limited- Dust mite may soon be approved but molds are likely many years away.