The Allergist

Episodes

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  The smoke detector problem 27.10.2026 28m

  “Allergy tests are evidence toward a verdict, but they are not the verdict themself.” Dr. Nicole Chase There’s no shortage of tests allergists use. Skin prick tests, component testing, serum-specific IgE. These are all go-to tools for allergists. But are we asking too much from them and are we changing the test meaning with some of our interventions? Dr. Nicole Chase thinks so. Dr. Chase is associate professor of medicine at the University of Minnesota and a partner at St. Paul Allergy ...
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  ENCORE: The many faces of milk problems 13.10.2026 29m

  “There is nothing magical that happens in your gut that says, ‘oh, now you’re ready for cow’s milk.’ — Dr. Farah Khan Milk has a special talent for creating chaos in clinic. One day it’s mucousy stools and a terrifying diaper photo, the next it’s hives after yogurt, delayed vomiting with lethargy, or a family that’s been dairy-free for years with no improvement in eczema. On this episode, Dr. Mariam Hanna is joined by pediatric allergist and clinical immunologist Dr. Farah Khan to walk throug...
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  Stopping strictures before they start 29.09.2026 28m

  "This is an allergic disease, and allergists need to help take care of this person." Dr. Seema Aceves Found yourself scratching your head about how to approach EoE in young patients? Who will go on to develop chronic disease, facing stricture and food impaction from remodelling? Our current approach can feel like it is stuck in the Stone Age. But not to worry, Dr. Seema Aceves will rocket us to the cutting edge of EoE diagnostics and treatment. Dr. Seema Aceves is Professor of Pediatrics and ...
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  Breaking down the epithelial barrier hypothesis 15.09.2026 27m

  There’s a question that’s been circulating widely these days. It’s in the clinic, it’s in the news, and it’s on patients' minds. Why do allergies appear to be increasing? Enter the epithelial barrier hypothesis. This is a developing theory that sees a connection between the ‘atopic march’ and the breakdown of the epithelial barrier. On today’s episode we speak with Professor Cezmi Akdis. Professor Akdis is a director of the Swiss Institute of Allergy and Asthma Research in Davos and professor...
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  Drop the SABA-only reliever. It’s not worth the risk 01.09.2026 43m

  "I don't think any asthmatic in this world should have a SABA, ever." —Dr. Paul O'Byrne Is it asthm...
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  ENCORE—Epinephrine Essentials: Balancing Confidence, Safety, and Misconceptions 18.08.2026 29m

  “If that medicine is associated with fear of an injection, then we are giving the impression that a diagnosis of food allergy is worse than a life sentence.” — Dr. Paul Turner When it comes to managing anaphylaxis, epinephrine is the gold standard. But even with its life-saving potential, misconceptions abound, and newer delivery methods like nasal and sublingual formulations are raising questions for allergists and patients alike. In this episode, Dr. Mariam Hanna sits down with Dr. Pa...
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  Milk and egg: different ladders, different outcomes 04.08.2026 23m

  "Food, milk and egg ladders look the same, but they're not the same." — Dr. Juan Trujillo Ladders are close to standard in some clinics now. The evidence that they change the course of anything is still thin. So families are climbing, clinicians are advising, and nobody has settled the question underneath: is a ladder modifying the disease, or is it keeping everyone busy while a child outgrows it on schedule? On this episode, Dr. Mariam Hanna puts that to someone who has lived with the questi...
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  Managing the child-to-adult transition 21.07.2026 28m

  "...these are chronic conditions that are not going to magically go away when a patient turns 18 or 21." — Dr. William Anderson Adolescence and early adulthood tend to be a rough stretch for patients with allergic disease. Asthma that used to be well controlled can start to drift. Teenagers take more chances with foods they are meant to avoid, and they show up for fewer of their appointments. Meanwhile the daily management is sliding off the parent and onto a patient who often is not ready to...
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  New Epinephrine Options. Fewer Fears? 07.07.2026 28m

  “If you are willing to use it and use it quickly, that's what I want you to have.” — Dr. Jay Lieberman Epinephrine is everywhere in allergy practice. Prescribed, refilled, demonstrated, repeated. And still, it carries a strange kind of fear. Patients hesitate. Clinicians sometimes hesitate too. Is it dangerous? Is it a last resort? How bad does the reaction have to be before it counts? On this episode, Dr. Mariam Hanna is joined by Dr. Jay Lieberman, professor of pediatrics at the University ...
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  CVID? No. SAD? Maybe. 23.06.2026 27m

  “You can have a patient that has normal immunoglobulins and abnormal responses to protein antigens as well. Historically, I’ve seen these patients. They do happen. They are out there.” — Dr. Benjamin Prince Specific antibody deficiency (SAD) has never been a clean diagnosis. Some patients carry normal immunoglobulins and still land in clinic with recurrent infections and poor vaccine responses. The newer pneumococcal vaccines have scrambled the old testing pathways. This episode covers which ...
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  When It’s Not Asthma, Think Larynx 09.06.2026 25m

  “If the asthma is under good control but they are still having these episodes, then I do think that maybe they have a PVFMD component to their breathing issue.” Dr. R. Jun Lin Patients come into clinic short of breath. It hits during exercise, it looks dramatic, and they may even describe noisy breathing or the feeling that they “can’t get air in.” So we do what clinicians do: we think asthma. We try inhalers. But sometimes, no matter how many puffers are thrown at the problem, nothing change...
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  When AI meets the allergy clinic 26.05.2026 27m

  “AI might feel like magic at times, but mostly it's just powerful technology, and with any technology, it's a tool.” —Merlijn van Breugel AI is no longer a future-tense possibility for allergists. It is already shaping diagnosis, prediction, documentation, patient communication, and the way clinicians think through complex decisions. But if AI can process more than we can, what still belongs to the clinician? On this episode of The Allergist, Dr. Mariam Hanna is joined by Merlijn van Breugel,...
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  The Expanding Toolbox for Food Allergy 12.05.2026 28m

  “It’s a fun time to be a food allergist”—Dr. David Fleischer Food allergy treatment is no longer just about avoidance, epinephrine, and hoping for the best. With high-dose OIT, low-dose OIT, SLIT, EPIT, Xolair, and other biologics entering the conversation, allergists now face a more practical question: what are we trying to achieve, and what approach best fits this patient and family? On this episode, Dr. Mariam Hanna is joined by Dr. David Fleischer, section head of allergy and immunology a...
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  Evidence-Based or Autopilot? A review of systematic reviews 28.04.2026 26m

  “We need more than just random care. We need randomized care.” — Dr. Derek Chu For years, the allergy world has been drowning in a sea of data—risk factors, prevention strategies, and enough diagnostic tools to fill a warehouse. But how do you translate 340 different risk factors into a cohesive plan when an anxious parent is sitting in your clinic demanding a skin test for their four-month-old?. On this episode, Dr. Mariam Hanna is joined by "systematic review genius" Dr. Derek Chu to unpack...
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  Microbiome in IEI, Much More Than Probiotics 14.04.2026 26m

  “We came up with the idea of testing a ketogenic diet… which in mice, it’s basically a lot of Crisco… giving a keto diet to mice with CGD… led to a decreased susceptibility to colitis.” —Dr. Emilia Liana Falcone The microbiome isn’t something sitting on the sidelines. It’s part of the immune system, interacting with the barrier, shaping responses, and, in IEI, reflecting the underlying defect. On this episode, Dr. Mariam Hanna is joined by Dr. Emilia Liana Falcone, physician-scientist and dir...
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  Small Risks Big Rewards with SCIT 31.03.2026 28m

  “This is a safe and very effective therapy, which is probably underutilized within our own community.” —Dr. Susan Wasserman Subcutaneous immunotherapy (SCIT) sits in that uncomfortable space between routine and risk. It’s one of the few interventions in allergy that can actually modify disease. But it also carries a small, very real risk of severe reactions. On this episode, Dr. Susan Wasserman, professor at McMaster University and a national leader in immunotherapy, walks through what safety...
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  Rewriting the Immune Code 17.03.2026 28m

  "So the future is one IV infusion, likely no chemotherapy, and that'll cure our IEIs." — Dr. Nicola Wright For children born with inborn errors of immunity, bone marrow transplant has long been the closest thing medicine had to a cure. It works — but it comes with chemotherapy, graft-versus-host disease, and a donor search that doesn't always end well. Gene therapy is changing that calculus. Dr. Mariam Hanna speaks with Dr. Nicola Wright, a pediatric hematologist and clinical immunologist at ...
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  Consent is a Conversation 03.03.2026 24m

  "That wholesome conversation that you take a minute or two to go through really creates a physician-patient relationship, expands that communication. Probably will not only improve patient outcomes, but reduce medical-legal risk for physicians in the consent process." — Dr. Lisa Thurgur A signed form isn't consent. It's paperwork. On this episode, Dr. Mariam Hanna is joined by Dr. Lisa Thurgur — emergency physician, award-winning educator, and a physician advisor with the Canadian Medical P...
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  Infant anaphylaxis: What it looks like when they can't tell you 17.02.2026 28m

  "I have come across allergists in different countries who often don't even prescribe epinephrine for very young children that have only had a history of mild reactions." — Dr. Katherine Anagnostou An inconsolable cry. A baby who's just not acting right. Tongue thrusting. Lip licking. Scratching at their own tongue. These aren't the symptoms that make it into standard diagnostic criteria — but they might be the clearest signal a non-verbal child can give. On this episode, Dr. Mariam Hanna is j...
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  The many faces of milk problems 03.02.2026 29m

  “There is nothing magical that happens in your gut that says, ‘oh, now you’re ready for cow’s milk.’ — Dr. Farah Khan Milk has a special talent for creating chaos in clinic. One day it’s mucousy stools and a terrifying diaper photo, the next it’s hives after yogurt, delayed vomiting with lethargy, or a family that’s been dairy-free for years with no improvement in eczema. On this episode, Dr. Mariam Hanna is joined by pediatric allergist and clinical immunologist Dr. Farah Khan to walk throug...