The Allergist

“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 thi...

“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. Th...

“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...

“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 be...

“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 epi...

“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?....

“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 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, p...

"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 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...

"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 diagn...

“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. Mari...

“It’s not about knowing each one. It’s about knowing the patterns, the warning signs, the general pathways, and knowing when to ask a friend when you’re a little bit lost.” —Dr. Tamar  Rubin On this episode of The Allergist , Dr. Mariam Hanna turns the focus to how allergists LEARN to recognize when common presentations may signal a deeper immune problem — and how that diagnostic instinct is built...

Keeping up with the allergy literature can feel like a second job layered onto an already full clinic day. Between evolving guidelines, expanding biologic options, and long-held assumptions quietly being challenged, it’s hard to know which papers are worth slowing down for. This episode takes a deliberately selective approach. Dr. David Khan — chair of the American College of Allergy, Asthma, and...

== Happy holidays to our audience around the world!  As a gift, and a break for The Allergist team, we are replaying our most popular episode from 2025. We hope you enjoy it as much this time around. See you in the New Year! == “We have to keep in mind that urticaria has to be treated until it's completely gone. So, absolute control of the disease.” — Dr. Hermenio Lima Chronic spontaneous urt...

“We should stop being scared of food, and we really should just let babies eat.”                                                                                                           — Dr. Carina Venter Dr. Mariam Hanna sits down with Dr. Carina Venter, a leading dietitian and researcher in food allergy prevention and management. They get into the everyday realities of feeding infants and chil...

“It's kind of like we opened a Pandora's box and trying to close it up again is going to be very hard.” —Dr. Zachary Rubin Dr. Zachary Rubin joins Dr. Mariam Hanna for a candid look at the “difficult and misinformed” patient — the growing phenotype every allergist now manages weekly. A double board-certified pediatrician and allergist-immunologist with a massive social media footprint, D...

“People know that asthma sucks. They don’t know that sinus disease sucks. It really impacts people's quality of life. It impacts their function. It needs to be taken very seriously.” — Dr. Andrew Thamboo Chronic sinusitis doesn’t just clog the nose—it can drag down quality of life, complicate asthma, and leave patients caught between specialists. Dr. Mariam Hanna talks with Dr. Andrew Thamboo...

“The immune system generally likes to be a well-balanced machine. It’s kind of like Goldilocks — too much is no good, too little is no good, and it’s finding that balance.”  Dr. Vy Kim Tregs have been called therapists, peacekeepers, and now—thanks to this year’s Nobel Prize—front-page immunology. Dr. Vy Kim joins Dr. Mariam Hanna to unpack why these cells might hold the key to everything from tol...

“Don't just rely on the textbook definition of when the pollen seasons are. You need to have reliable data to know when the pollen seasons are starting, when they're ending, and when they're peaking.”  Dawn Jurgens Allergy season may be winding down, but for allergists, the work never really stops. This is the moment between ragweed and winter — a brief respite before the cycle begi...

“Vaccine counseling is really a team sport. — Dr. Anne Pham-Huy Vaccines can stir anxiety for patients and confusion for clinicians, especially when biologics enter the mix. Dr. Mariam Hanna is joined by Dr. Anne Pham-Huy, clinical immunologist at CHEO, member of the Special Immunization Clinic Network, NACI member, and chair of Immunize Canada. Together, they break down the science of vaccine res...

“Atopic dermatitis is not just about what you see on the skin. It's about what the patient's experiencing.” Dr. Melinda Gooderham Eczema care has become a world of creams, cleansers, oils, and myths — but what actually works? Dr. Mariam Hanna is joined by Dr. Melinda Gooderham, assistant professor at Queen’s University and consultant physician at the Peterborough Regional Health Centre....

“You will think it is mastocytosis much more often than you'll actually diagnose mastocytosis.” — Dr. Matthieu Picard Mastocytosis is rare, complex, and often confused with other mast cell disorders. To help clinicians cut through the confusion, Dr. Mariam Hanna welcomes Dr. Mathieu Picard, allergist and clinical immunologist, who has built a dedicated practice caring for patients with mast c...

“At least 60% don't respond to anything or who have been to somebody else before and they've come to me and they've tried everything and failed” — Dr. Imran Satia Dr. Imran Satia, Respirologist and Associate Professor at McMaster University and Canada Research Chair in Chronic Cough, joins Dr. Mariam Hanna to walk clinicians through a practical, evidence-based approach to diagnosing...

“Putting yourself out there online as a doctor is not easy. But staying silent while misinformation spreads—that felt worse.” —Dr. Amiirah Aujnarain Dr. Amiirah Aujnarain has built a community of 80,000 followers by blending evidence-based allergy education with a candid, human presence online. On this episode of The Allergist , she joins Dr. Mariam Hanna to examine how social media is shaping all...