The Itch: Allergies, Asthma, Eczema & Immunology

#157 - Dating, Kissing, and Intimacy with Food Allergies

Mia Silverman, food allergy advocate, joins us to talk about the real emotional and practical side of dating with food allergies. From what the research says about kissing risks to setting boundaries to why your allergies might actually be the best filter you have.

What we cover in this episode about dating with food allergies

• When to tell someone about your food allergies. Mia shares why she brings up her allergies early and how she works it into her dating app profile without making it a big deal.
• Fear of rejection. Mia opens up about being ghosted and bullied, and how she learned to reframe rejection as a filter rather than a failure.
• The risks of kissing with food allergies. Dr. Gupta breaks down what the research actually says about allergens in saliva and what your partner can do to reduce the risk.
• Intimacy beyond kissing. From latex-free condoms to body fluids, Dr. Gupta covers what food allergy patients need to know about being safely intimate with a partner.
• Date ideas and setting boundaries. Mia shares practical tips for early dates, setting food-allergy rules, and keeping the conversation open without making it feel overwhelming.

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Made in partnership with The Allergy & Asthma Network.

Thanks to Genentech and Kaléo for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

#156: Is Your Asthma Worse Than It Should Be? Signs of Uncontrolled Asthma

If you have asthma, there is a good chance you have learned to live around it. You sleep with your inhaler on the nightstand. You skip the walk because you know it will leave you breathless. This is called uncontrolled asthma, and it is more common than you think. But here is the thing: none of that is normal, and none of it is something you have to accept.

Dr. Juanita Mora, allergist and immunologist, joins Kortney and Dr. Gupta to help patients figure out whether their asthma is actually being managed the way it should be, and what to do if it is not.

What we cover in this episode about asthma symptoms and control

• What well-managed asthma actually looks like. Dr. Mora explains what life should feel like when your asthma is properly treated, and why so many patients have accepted a version of their life that is smaller than it needs to be.
• Why frequent flare-ups are a warning sign. Why underlying airway swelling is dangerous and why catching it early matters.
• The Rules of 2. Five questions covering daytime symptoms, nighttime waking, rescue inhaler use, inhaler refills, and steroid use that can help you figure out if your asthma needs more attention.
• When to ask for a referral. If you are answering yes to any of these questions and your treatment plan is not changing, it may be time to push for a referral to an allergist or pulmonologist who has more tools to help.
• First steps you can take with ControlYourAsthma.org. Dr. Mora walks through the campaign website, available in English and Spanish, including videos, the Rules of 2 quiz, and access to a free asthma coach.

More resources

• ControlYourAsthma.org
• ControlarTuAsma.org
• Free Asthma Coach Program

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Made in partnership with The Allergy & Asthma Network.

Thanks to Sanofi-Regeneron for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

 

#155 - Did I Cause My Child's Food Allergy?

When a child is diagnosed with a food allergy, one of the first things many parents wonder is, "Did I do something wrong?" and "Did I cause my child's food allergy?" You question if it was something you ate or didn't eat during pregnancy, whether you breastfed long enough, or if you introduced foods too late. The guilt is real, and it is incredibly common.

Kortney and Dr. Payel Gupta sit down with Dr. Joanne Moreau, a board-certified allergist and immunologist, to unpack exactly how food allergies develop, and why no parent should carry the weight of blame.

What we cover in this episode about food allergy development and parent guilt

• How food allergies develop. The immune system, genetics, and environment all play a role, and science is still uncovering why.
• Food allergy genetics and family history. A parent with asthma, eczema, or hay fever raises a child's risk, even without a food allergy themselves.
• Pregnancy diet, breastfeeding, and food allergy. No conclusive evidence links what a mother eats during pregnancy, or whether she breastfeeds, to whether a child develops food allergies.
• Eczema and food allergy. Cracked or inflamed skin lets food proteins in before the gut can build tolerance, which can trigger sensitization.
• Early allergen introduction. Introducing allergenic foods between 4 and 6 months of age, and keeping them in the diet consistently, is one of the best tools we have.

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Made in partnership with The Allergy & Asthma Network.

Thanks to Genentech and Kaléo for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

 

#154 - What Providers Need to Know About Uncontrolled Asthma

If you treat patients with asthma, this episode is for you. Not just allergists, but GPs, pediatricians, family medicine doctors, urgent care providers, and anyone who sees a patient with asthma in their practice.

Dr. Cherie Zachary, current president of the American College of Allergy, Asthma and Immunology, joins Kortney and Dr. Payel Gupta to talk about why uncontrolled asthma remains a serious and largely preventable problem, and what providers can do differently starting with their next patient visit.

What we cover in this episode about uncontrolled asthma

• The data behind the problem. ER visits, hospitalizations, and asthma deaths have not improved in years, and Dr. Zachary explains why that should concern every provider who treats asthma patients.
• An ER visit is a treatment failure. Dr. Zachary makes the case that any asthma patient who ends up in urgent care or the emergency room should trigger an immediate reassessment of their treatment plan, not just a course of steroids and a send-home.
• Five questions every provider should be asking. The episode walks through a standardized set of control questions designed to help providers catch uncontrolled asthma before it becomes a crisis, covering steroid use, ER visits, rescue inhaler use, nighttime waking, and daily activity limitations.
• Why patients normalize their symptoms. Providers hear what controlled asthma should actually look like, and why patients often don't volunteer the information needed to catch a problem.
• Who is most at risk. Dr. Zachary shares which patient populations are most likely to have uncontrolled asthma and least likely to be identified, and what providers can do to close that gap.

More resources about uncontrolled asthma

• ControlYourAsthma.org 

• Free AAN Asthma Coach Program

• Find an allergist

• Understanding Oral Corticosteroid Overuse in Asthma

Made in partnership with The Allergy & Asthma Network.

Thanks to Sanofi-Regeneron for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

#153 - Food Allergy Bullying: How to Talk to Your Child and Their School

Food allergy bullying is more common than most parents realize, and most kids never bring it up on their own. Research shows it affects up to 1 in 3 children with food allergies, and the signs can be easy to miss: a lunchbox that keeps coming home full, a sudden reluctance to go to school, or quietly backing off from safe food habits to avoid standing out.

In this episode, psychologist Dr. Amanda Whitehouse joins Kortney and Dr. Payel Gupta to talk about what food allergy bullying actually looks like, how to start a conversation with your child without shutting them down, and when and how to bring the school into it.

What we cover in this episode about food allergy bullying

• What food allergy bullying looks like. From verbal teasing and social exclusion to threats involving allergens, and how it differs from everyday teasing.
• Signs your child may be being bullied. Behavioral shifts to watch for include school avoidance, changes in eating habits, and withdrawal from activities they used to love.
• How to start the conversation. Why open-ended questions and connection before action are key to getting your child to open up.
• When and how to involve the school. How to approach teachers and administrators, know your child's rights, and document what's happening.
• Building resilience after bullying. How involving your child in the solution, rather than swooping in to fix it, helps them feel empowered rather than powerless.

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Made in partnership with The Allergy & Asthma Network.

Thanks to Genentech and Kaléo for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

#152 - How to Advocate for Better Healthcare

Kortney and Dr. Payel Gupta sit down with Nissa Shaffi, MS, Director of Advocacy at the Allergy & Asthma Network, to talk about what patient advocacy really means, how the healthcare system works as a whole, and how everyday people with allergies, asthma, and related conditions can learn to use their voice to push for real change.

What we cover in this episode is patient advocacy for allergy and asthma

• Anyone can be an advocate. Advocacy is not just for politicians or lawyers. It is for anyone who sees a problem and wants to do something about it, from patients, caregivers, doctors, and everyday people alike.
• Forms of advocacy, from social media to Capitol Hill. You do not have to fly to Washington to make a difference. Advocacy starts with education, storytelling, and showing up in whatever way you can.
• How the healthcare system actually works. No single insurance company, hospital, or drug maker is to blame for everything. Understanding the whole system is what makes advocacy effective.
• Why your story can change a law. Personal experience is one of the most powerful tools in advocacy. Real patient stories have driven landmark legislation and saved lives.
• PALI, the Patient Advocacy Leadership Initiative. A free monthly program from the Allergy & Asthma Network that teaches patients the language, tools, and knowledge they need to advocate confidently at any level.

More resources

• PALI (Patient Advocacy Leadership Initiative): 
• Allergy & Asthma Day on Capitol Hill (AADCH)
• AAN Advocacy Center, take action today! 

Bills Allergy & Asthma Network is prioritizing this year:

• Safe Step Act
• EPIPEN Act
• HELP Copays Act 
• One School One Nurse Act
• See all the bills on the Network’s Advocacy page

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Made in partnership with The Allergy & Asthma Network.

#151 - What Allergists Think About Antihistamines

If you have ever taken an antihistamine labeled "non-drowsy" and still ended up foggy and tired, you are not imagining it. Allergists have a lot to say about that label and about the foggy feeling that comes with allergy season in general.

In part two of our live recordings from the AAAAI conference in Philadelphia, Kortney and Dr. Payel Gupta talk to allergists from across the US about what they actually think about antihistamines.

What we cover in this episode about antihistamines:

• Non-drowsy does not mean the same thing for every antihistamine. Zyrtec, Claritin, and Allegra are all labeled non-drowsy, but some are more likely to make you sleepy than others.
• Why allergists have moved away from Benadryl. First-generation antihistamines cross into the brain more easily, causing drowsiness and a range of other side effects that are far less common with newer antihistamines.
• The foggy feeling might not be your medication. Congestion from untreated allergies disrupts your sleep, and poor sleep creates its own fog. Sometimes it is the disease, not the drug.
• Timing your antihistamine makes a real difference. Taking it before you head out gives it the best chance to work. And if it makes you drowsy, switching to a nighttime dose is a simple fix.
• Not all second-generation antihistamines are approved for pilots. Fexofenadine has the lowest penetration into the brain of any antihistamine tested, which is why the FAA cleared it as the only option pilots can take while flying.

Second-generation antihistamines (non-sedating or minimally sedating)

• Cetirizine — Zyrtec

• Loratadine — Claritin, Alavert

• Fexofenadine — Allegra

• Levocetirizine — Xyzal

• Desloratadine — Clarinex (prescription only)

First-generation antihistamines (sedating)

• Diphenhydramine — Benadryl, ZzzQuil, Unisom

• Chlorpheniramine — Chlor-Trimeton

• Brompheniramine — Dimetapp

• Dimenhydrinate — Dramamine

• Hydroxyzine — Atarax, Vistaril (prescription only)

Thank you to our allergists

A huge thank you to every allergist who stopped what they were doing at the AAAAI conference to talk to us. We could not make this episode without you.

• Dr. Mansi Kotwal, Instagram
• Dr. Lauren Davidson, Instagram
• Dr. Joel Brooks, LinkedIn
• Dr. Pratibha Vakharia, allergyv.com
• Dr. Rathika Gupta
• Dr. David Wertheim

Thanks to Opella for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

 

# 150 - What Allergists Really Think About Your Allergy Nasal Spray

Ep. 150: What Allergists Really Think About Your Allergy Nasal Spray

If you have ever grabbed a nasal spray off the pharmacy shelf, used it for a few days, and given up because nothing seemed to be happening, you are not alone. And according to the allergists we spoke to at the AAAAI conference in Philadelphia, that is not uncommon.

In this episode, Kortney and Dr. Payel Gupta share real conversations with allergists from across the US about what they actually think about allergy nasal sprays.

What we cover in this episode about allergy nasal sprays

• Why allergists love nasal steroid sprays. They work at the source of the problem by calming swelling inside the nose before your symptoms have a chance to take hold, and you can pick them up at the grocery store without a prescription.
• You may not feel the nasal spray work right away. Nasal steroid sprays need about two weeks of consistent daily use before you feel a difference. The medication is working, you just cannot feel it yet. Do not give up early.
• When to start before allergy season. Starting your spray a couple of weeks before your season hits means you go in with as little swelling inside your nose as possible, giving the medication the best chance to work.
• Why so many patients stop using their spray. Incorrect technique causes irritation and nosebleeds, and means the medication is not landing where it needs to.
• Not all nasal sprays smell or feel the same. If the smell or taste of your spray puts you off, there are options without it, and that is worth a conversation with your allergist or pharmacist.

Thank you to our allergists

A huge thank you to every allergist who stopped what they were doing at the AAAAI conference to talk to us. We could not make this episode without you.

• Dr. Jessica Hui, Instagram | LinkedIn
• Dr. Jamie Rutland, Instagram | Instagram: The Health Exchange Podcast
• Dr. Juan Carlos Murillo, Instagram | LinkedIn
• Dr. Tobi Olayiwola 
• Dr. Jake Rosenblum, LinkedIn
• Dr. David Wertheim
• Dr. Sonali Majmudar, Instagram | LinkedIn

Thanks to Opella for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

 

#149 - What is Chronic Rhinosinusitis without Nasal Polyps

Chronic sinusitis without nasal polyps is the most common form of chronic sinusitis. Even so, most patients spend years without a clear explanation, cycling through antibiotics that do not address what is actually going on.

In this episode, Kortney and Dr. Payel Gupta are joined by Dr. Michael Blaiss and Dr. Anju Peters, an allergist and immunologist at Northwestern University who co-authored the 2025 Adult Sinusitis Clinical Practice Guideline. Together, they break down what chronic sinusitis without nasal polyps (CRSsNP) actually is, what the real quality-of-life impact looks like, and how a proper diagnosis is confirmed.

What we cover in this episode about chronic rhinosinusitis without nasal polyps

• Not an infection. Chronic sinusitis without nasal polyps is driven by inflammation lasting 12 weeks or more, not by bacteria or a virus, which is why antibiotics often do not help.
• The hidden quality of life burden. Beyond congestion and sinus pressure, patients commonly experience fatigue, poor sleep, anxiety, depression, and social isolation.
• Why so many patients go years without a correct diagnosis. Symptoms overlap significantly with conditions like allergic rhinitis or migraines. Many patients adapt to feeling unwell rather than seeking answers.
• How doctors confirm the diagnosis. A diagnosis requires objective evidence of inflammation, as seen on nasal endoscopy or a CT scan of the sinuses, not symptoms alone.
• The connection between sinusitis and asthma. The nose, sinuses, and lungs share one connected airway, and about 60% of people with this condition also have asthma, with each capable of making the other worse.

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Made in partnership with The Allergy & Asthma Network.

Thanks to Insmed for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

#148 - How Do You Know Your Chronic Hives Are Under Control?

Chronic hives that come and go without warning are exhausting physically and emotionally. But here is something many patients don't realize: feeling "okay" is not the same as being well controlled.

Kortney and Dr. Gupta are joined by Dr. Tom Chacko, a board-certified allergist and immunologist based in Atlanta, to discuss what good hives control actually looks like and what to do when you are not there yet. From "just living with" your condition to managing a bad flare, tracking your symptoms, and preparing for your follow-up appointment, this episode gives you the tools to stop just coping and start getting better care.

What we cover in our episode about what chronic hives control looks like:

• Chronic spontaneous urticaria. The plain-language definition of CSU, including why hives appear without a clear trigger and what angioedema is.
• The trap of normalizing symptoms. Why patients adjust their lives around hives without realizing it, and how to spot the signs that your condition is not actually controlled.
• How to track your hives. Why symptom tracking helps with diagnosis and better care, and how to use tools like the UAS7 score.
• What to bring to your follow-up appointment. The concrete information your doctor needs to work with you to find the best treatment plan. This includes information about sleep, daily activity, and medication side effects.
• How to ask for more help. What to say when antihistamines are not enough, and what newer treatment options exist for CSU patients today.

More resources about chronic hives

• UAS-7 Urticaria Activity Score worksheet

• Allergy & Asthma Network chronic urticaria resources

• More episodes about hives

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Made in partnership with The Allergy & Asthma Network.

Thanks to Novartis for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.