The Itch: Allergies, Asthma, Eczema & Immunology

#123: Supporting the Mental Health of Allergy Parents

Parenting a child with food allergies can feel overwhelming and isolating. We're joined by licensed therapist and food allergy mom Tamara Hubbard, MA, LCPC, to talk about her new book, May Contain Anxiety, and the often overlooked mental health challenges that food allergy parents face.

We explore how chronic stress, fear, and anxiety can affect parenting, relationships, and family dynamics. Plus, why supporting the mental health of allergy parents is crucial for the entire family’s well-being.

Tamara breaks down evidence-based tools from Acceptance and Commitment Therapy (ACT) to help parents manage food allergy anxiety, build confidence, and feel less alone on this lifelong journey.

What we cover in this episode about food allergy anxiety in parents:

• Tamara’s journey from substance abuse counselor to food allergy mental health advocate
• Why she wrote May Contain Anxiety and how it’s different from typical self-help books
• A breakdown of Acceptance and Commitment Therapy (ACT) and how it supports allergy parents
• The impact of food allergy anxiety on the whole family system, from parenting dynamics to sibling relationships
• Why this book is valuable for every stage of the allergy journey and helpful for allergists and extended family, too

May Contain Anxiety is available worldwide in English on September 30th, 2025.

Get 30% off by buying it at Hopkins Press and using the code: HMCA25

#122 - Mortality in adult patients with chronic spontaneous urticaria: A real-world cohort study

Do adults with chronic spontaneous urticaria (CSU) have a higher risk of death over time compared to people without hives?

We review the findings from “Mortality in adult patients with chronic spontaneous urticaria: A real-world cohort study,” published in April 2025, in The Journal of Allergy and Clinical Immunology. While CSU is often considered a non-life-threatening condition, this large study found something surprising: people with CSU had a significantly higher risk of death, especially from suicide.

Dr. G and Dr. Blaiss walk through key takeaways from a dataset of over 272,000 CSU patients and nearly 13 million matched controls. They explore what the results mean for mortality risk, clinical care, mental health screening, and the importance of proper, guideline-based treatment.

What we cover in our episode about CSU and mortality risk:

• What is CSU? Chronic hives are an unpredictable, itchy, and sometimes painful condition. It lasts for 6 weeks or longer and can continue for years.
• Mental health connection: CSU affects more than skin. Anxiety, depression, and suicidal thoughts are common and serious concerns.
• Study findings: CSU was associated with higher mortality at 3 months, 1 year, and 5 years. Suicide risk was over 3 times higher than in people without CSU.
• Demographics: Younger and White patients with CSU had the highest increase in risk.
• Treatment impact: Patients using guideline-recommended treatments like second-generation antihistamines or omalizumab had lower death rates.

INFOGRAPHIC

The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference.

 

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.

#121 - Avapritinib versus Placebo in Indolent Systemic Mastocytosis - PIONEER Trial

What happens when you target the root cause of indolent systemic mastocytosis?

In this episode of The Itch Review, we unpack key findings from the article “Avapritinib versus Placebo in Indolent Systemic Mastocytosis,” published on May 23, 2023, in NEJM Evidence.

Indolent Systemic Mastocytosis (ISM) is a rare chronic disease with life-altering symptoms. Until recently, treatment options were limited. We break down new data from Part 2 of the PIONEER study, which evaluated Avapritinib, a targeted therapy designed to inhibit the KIT D816V mutation that drives ISM.

Dr. Gupta and Dr. Blaiss explain how Avapritinib works, how the study was designed, and what outcomes were measured, including the Total Symptom Score (TSS). Most importantly, we explore what this treatment could mean for patients with moderate to severe ISM.

INFOGRAPHIC

What we cover in our episode about avapritinib versus placebo:

• Understanding ISM: How the KIT D816V mutation causes overproduction and overactivation of mast cells.
• Why current treatment falls short: The limitations of best supportive care and why many patients remain symptomatic despite multiple medications.
• How Avapritinib works: A tyrosine kinase inhibitor that targets the KIT mutation directly, aiming to reduce mast cell activation at its source.
• Inside the PIONEER trial: Study design, eligibility criteria, and how outcomes like Total Symptom Score (TSS) and serum tryptase were measured.
• What the data showed: Improvements in symptoms, lab markers, and quality of life and what this could mean for long-term ISM care.

The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference.

 

Made in partnership with The Allergy & Asthma Network.

Thanks to Blueprint Medicines 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.

#120 - Back to School with Food Allergies: Accommodations, Epinephrine & Preparing Your Child

Is it too early to start planning for school when summer has just begun? Not if your child has food allergies.

Dr. Nikki Chase, a board-certified allergist-immunologist, joins us to share what families need to know to prepare for a safe and successful school year. From school forms and emergency plans to when to self-carry epinephrine and how to teach self-advocacy, this episode is filled with practical, real-life guidance.

We discuss how to make the most of your summer doctor visits, why early planning matters, and how newer epinephrine options, like the nasal spray, may help reduce fear and delay in use. You’ll also hear Dr. Chase’s advice on helping kids build confidence and take ownership of their allergy care.

What we cover in our episode about preparing for school with food allergies:

•  504 plans explained: What they are, how to request one, and why they matter for legal protection and clear school accommodations.
• Anaphylaxis Action Plans: What’s included, how they differ from 504 plans, and why they take the guesswork out of emergencies.
• Epinephrine device options: From auto-injectors to nasal spray, what’s available and how to choose the best fit for your child.
• What to work on this summer to build allergy confidence: The rules, responsibilities, and privileges kids should practice to stay safe and feel more in control.
• Self-advocacy & communication tips: How to help your child speak up, navigate cafeteria dynamics, and respond to food allergy bullying.

More resources about back-to-school with food allergies

• Planning for School with Food Allergies
• School Plans for Students with Food Allergies
• Managing Allergies in Schools: A Guide for Staff
• Epinephrine for Anaphylaxis: What Treatments are Available?
• Food Allergy Treatment & Management

 

Produced in partnership with The Allergy & Asthma Network. Thanks to ARS Pharma for sponsoring this 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.

#119 - Processing Emotions After Anaphylaxis: Navigating Guilt, Family Reactions, and Moving Forward

Have you ever wondered what happens after an anaphylactic reaction?

How do you process everything that went down, from ingesting the allergen to using epinephrine? In this candid conversation, Kortney sits down with Tamara Hubbard, a licensed clinical professional counselor, to unpack the emotional aftermath of a severe allergic reaction.

Kortney shares her own recent experience of self-administering epinephrine for the first time after over 30 years of living with food allergies. Together, they explore how guilt, self-doubt, and family dynamics can shape recovery and how to move forward without letting fear or shame take over.

What we cover in this episode about processing an anaphylactic reaction:

• The moment Kortney realized she needed to self-inject epinephrine and why it felt empowering.
• Why it’s common to second-guess yourself during an allergic reaction.
• The unique guilt and blame that can surface after a reaction, even when you did everything right.
• How to handle well-meaning but unhelpful comments from family and friends.
• Tips for processing the event without letting it define your future.

About Our Guest

Tamara Hubbard, MA, LCPC is a licensed clinical professional counselor and the founder of the Food Allergy Counselor Directory & Website. She specializes in helping individuals and families navigate the emotional and mental health challenges that come with managing food allergies. Tamara is passionate about empowering people to build confidence and resilience while living safely with food allergies.

Learn more about Tamara’s work at FoodAllergyCounselor.com.

#118 - Do Indolent Systemic Mastocytosis Patients & Providers Agree on Symptom Control?

Do patients and their healthcare teams view the impact of indolent systemic mastocytosis on quality of life in the same way?

In this episode of The Itch Review, we unpack key findings from a May 4, 2025, descriptive study from The Journal of the Advanced Practitioner in Oncology, “Patient and Advanced Practitioner Perspectives on Symptom Burden and Symptom Management in Indolent Systemic Mastocytosis.”

Is there a disconnect between what patients feel and what providers think when it comes to indolent systemic mastocytosis (ISM)? A new study suggests yes, revealing a mismatch between how patients and advanced practitioners (APs) perceive disease control and what that means for care. This episode dives into whether research like this could help bridge the gap between patient experience and clinical perspective.

What we cover in our episode about the indolent systemic mastocytosis:

• Understanding ISM: What makes indolent systemic mastocytosis a unique multisystem condition?
• Symptom burden explained: Frequency, severity, duration, distress, and functional interference.
• Patient vs practitioner views: Understanding the most impactful symptoms differs from patient to AP. 
• Practical tools: The Indolent Systemic Mastocytosis-Symptom Assessment Form (ISM-SAF) is a validated instrument that can be used to determine symptoms and severity.
• Barriers and solutions: Why tracking symptoms is hard and how clinics can improve coordination.
• AP-focused Toolkit: Resources to help nurse practitioners, PAs, and pharmacists provide patient-centered ISM care.

GET THE INFOGRAPHIC HERE

***

The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores the latest allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference.

***

This podcast is made in partnership with The Allergy & Asthma Network.

Thanks to Blueprint Medicines 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.

#117 - BATURA Trial: Does a Combo Inhaler Help Mild Asthma?

There have been countless advances in controller therapies for asthma, but our go-to rescue inhaler, a quick-relief bronchodilator, hasn’t changed in decades.

In this episode of The Itch Review, we spotlight “As-Needed Albuterol–Budesonide in Mild Asthma” published in The New England Journal of Medicine, May 19, 2025. This article looks at the BATURA trial, which tested whether adding budesonide to albuterol rescue inhalers cuts exacerbations in adults whose mild asthma remains uncontrolled on occasional albuterol/short-acting beta agonist (SABA) therapy.

Could this combo inhaler really cut severe asthma attacks in people with mild disease?

What we cover in our episode about the BATURA trial:

• Understanding asthma: In asthma, your airways both tighten up and get swollen. Treating both the tightness and the swelling right when you feel symptoms could stop a full-blown attack.
• All-online trial: BATURA used telehealth to enroll 2,516 people with mild asthma from across the U.S. and ran the study until it saw a preset number of 172 serious attacks.
• Big takeaways: The combo inhaler cut serious attacks by almost half, halved yearly flare-ups, and slashed steroid use by 63%. All without people needing to use their medication more often.
• Why it ended early: An independent safety board reviewed the data mid-trial and concluded that the combo inhaler was so clearly better that it would’ve been unfair to continue giving anyone the old treatment.
• What’s next: We still need studies on teens and children to ensure that these same benefits hold true for younger patients.

GET THE INFOGRAPHIC PDF HERE

***

The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores the latest allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference.

***

This podcast is made in partnership with The Allergy & Asthma Network.

Thanks to AstraZeneca 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.

#116 - Why Fexofenadine Is Considered a Truly Non-Sedating Antihistamine

Have you ever wondered whether fexofenadine (Allegra®) really doesn’t make you drowsy?

In this episode of The Itch Review, we dissect a July 2024 systematic review from Current Medical Research & Opinion, “Why fexofenadine is considered a truly non-sedating antihistamine with no brain penetration.” 

This rigorous systematic review pools over 60 human studies from PET brain-scan trials and Proportional Impairment Ratio (PIR) tests to driving-simulator research and real-world quality-of-life surveys. It looks to answer one question: Does fexofendine ever sneak past the blood–brain barrier and slow you down like first-generation allergy meds?

This episode looks at the evolution of H1 antihistamines from first-generation drugs like diphenhydramine to today’s second-generation options (cetirizine, loratadine, and fexofenadine) to show how each interacts with the blood–brain barrier (BBB) and why that matters for sedation.

We highlight the review’s key studies:

• PET Imaging: Measuring H1-receptor occupancy. Fexofenadine registers <1%, even at high doses
• PIR Analyses: Proportional Impairment Ratio tests show virtually zero cognitive or motor impairment when taking fexofenadine
• Driving & Aviator Trials: Side-by-side comparisons with diphenhydramine, alcohol, and fexofenadine

Finally, we dive into real-world outcomes on reaction times, work-and-school performance, pediatric safety, and even NASA’s approval for pilot use.

GET THE INFOGRAPHIC TO FOLLOW ALONG

***

The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores the latest allergy and immunology studies through 30-minute conversations that are accessible for everyone. This podcast aims to support busy clinicians, patients, and caregivers in staying updated on current research. Each episode provides valuable insights from key journal articles and includes a convenient one-page infographic in the show notes for easy reference.

***

This podcast is made in partnership with The Allergy & Asthma Network.

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.

#115 - Managing Food Allergies in College-Aged Students (Ages 18-21)

Stepping into young adulthood also means stepping up as the primary manager of your food allergies.

For teens and young adults with food allergies, early adulthood is an exciting but challenging shift. It’s the first time you’re the primary communicator, managing everything from dining halls to doctor’s appointments on your own. Add in new living spaces, new friends, and a growing social life, and there’s a lot to navigate.

Dr. Theresa Bingemann joins Kortney and Dr. Payel Gupta to unpack how food allergy management changes as you step into early adulthood. We cover self-advocacy skills, emergency preparedness, how to create allergy-friendly spaces in shared housing, and tips for navigating social life safely. Plus, we dive into practical advice for managing stress, staying emotionally healthy, and finding your footing in this new phase of life.

What we cover in our episode about managing food allergies in young adults:

• Self-advocacy matters. Learn how to speak up about your allergies with confidence.
• Planning ahead for emergencies. Practicing with an epinephrine device is not just for kids! Plus, knowing the available campus resources is key to feeling secure in your food allergy management.
• Creating a safe living space. Tips for setting up allergy-friendly dorm rooms and kitchens with roommates.
• Navigating social life. How to handle parties, dating, and dining out while staying safe.
• Managing emotional well-being. Support strategies for handling anxiety, stress, and the transition to independence.

Episode 6 in our “Food Allergies: Ages & Stages” series 

Across six episodes, we explore how food allergies show up and shift through different phases of life, from introducing solids in infancy to navigating school and adapting in adulthood. We’re here with evidence-based info, expert insights, and lived experience to guide you through it all.

• Episode 110: Early Allergen Introduction
• Episode 111: Food Allergy Basics for Newly Diagnosed Families
• Episode 112: Managing Food Allergies in Babies and Toddlers
• Episode 113: Managing Food Allergies in School-Age Children
• Episode 114: Managing Food Allergies in Teens

AAAAI Ages & Stages PDFs

• Food Allergy Stages: Young Adults (18–21 years)

Thanks to Genentech and Aquestive for sponsoring this 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.

#114 - Managing Food Allergies in Teenagers (Ages 12–18)

Independence, risk-taking, and peer pressure. Welcome to the teenage years with food allergies!

Managing food allergies during the teen years poses new challenges. Tweens and teens are gaining independence, navigating social pressures, and taking more responsibility for their health. But this is also the stage where risky behavior peaks, and the risk for severe allergic reactions is highest. That’s why clear communication and trust matter more than ever.

In this episode of our Food Allergy Stages Series, Dr. Travis Miller joins Kortney and Dr. Payel Gupta to unpack how food allergy management changes from ages 12 to 18. We talk about empowering teens through shared decision-making, building trust between parents and teens, and developing essential life skills like label reading, restaurant communication, and self-advocacy. We also dive into difficult topics like bullying, alcohol, and mental health. Finally, we address why emotional support is just as important as carrying an epinephrine auto-injector.

What we cover in our episode about managing food allergies in teens:

• Why trust matters. Teens are more likely to follow allergy routines when they feel heard and involved.
• Empowering independence. From grocery shopping to reading labels, this is the age to start turning over the reins.
• Talking about risky behavior. Alcohol and dating can put teens with food allergies at higher risk.
• Bullying and boundaries. Learn how to spot signs of bullying and who can help your teen feel safe and supported.
• Mental health and identity. Food allergies can affect confidence. We share ways to support emotional wellness and self-esteem.

Episode 5 in our “Food Allergies: Ages & Stages” series 

Across six episodes, we explore how food allergies show up and shift through different phases of life, from introducing solids in infancy to navigating school and adapting in adulthood. We’re here with evidence-based info, expert insights, and lived experience to guide you through it all.

• Episode 110: Early Allergen Introduction
• Episode 111: Food Allergy Basics for Newly Diagnosed Families
• Episode 112: Managing Food Allergies in Babies and Toddlers
• Episode 113: Managing Food Allergies in School-Age Children

Thanks to Genentech and Aquestive for sponsoring this 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.