Podcasts about Ige

Could recurring hives be caused by something more than an allergy? In this episode of Common Sense MD, Dr. Tom Rogers sits down with dermatologist Dr. Joni Sago to discuss the difference between acute and chronic urticaria, common triggers, and the connection between chronic hives and autoimmune conditions. Dr. Sago also explains the role of IgE in the immune response and how treatments that target IgE may help patients struggling with chronic hives. Connect with Performance Medicine! Check out the DOCTOR ROGERS Multivitamin: https://docrogersvitamins.com/products/super-vitamin Subscribe and Save 15% on all DOCTOR ROGERS vitamins (Free Shipping On All Orders Over $70): https://docrogersvitamins.com/pages/subscribe-and-save Sign up for our weekly newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://performancemedicine.net/doctors-note-sign-up/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

If you want to win government contracts with no experience, a former government-side contracting officer's rep explains why the door you think is closed is only regulated, and how a small business gets through it. Remi Bankole spent years inside federal contracting as a COR and contracting specialist, a US Army reservist since 2001, pushing out solicitations and vetting the vendors who won. He breaks down how to position yourself, why aligning with a contract vehicle is gold when agencies need someone fast, and the prime partnership hack where you run the work a prime can't touch and split the profit. It is systematic, not daunting, and being small can be the edge that gets you selected.  CHAPTERS 00:00 The door is only regulated 02:15 Both sides: government and business 03:39 Inside the COR and contracting specialist roles 06:26 What market research really means to a buyer 08:26 IGE, SOW, and PWS made simple 10:36 The real mistakes small businesses make 13:22 What has changed: more scrutiny above $20M 16:19 Why contract vehicles are gold right now 17:48 The prime crumbs partnership hack 22:55 Three tiers: from no experience to scaling Market Intelligence gives you the federal opportunities, agency signals, recompete intel, and pursuit briefs that tell you not just what contracts exist, but which ones to chase and how to win them. Sign up for free Daily Alerts and get opportunities delivered to your inbox before the day starts.

Gluten causes a transient leaky gut in everyone who eats it — not just people who are gluten sensitive. In Part 1 of this two-part deep dive, Dr. Steven Noseworthy breaks down what gluten actually is, the two "universal" reactions your gut has to wheat whether you're sensitive or not, and why food allergy, food sensitivity, and food intolerance are three completely different things your doctor may be using interchangeably.You'll learn what gluten is made of (gliadin and glutenin), why celiac disease research spent decades hyper-focused on just one gluten subtype, and how the 1940s wartime observations of a Dutch pediatrician named Willem Dicke first cracked open the gluten-celiac connection.Then Dr. Noseworthy explains the two reactions to wheat that happen to everybody, sensitive or not: how gliadin binds the CXCR3 receptor in your gut lining to release zonulin and transiently open your gut barrier, and how a separate wheat protein family called ATIs (amylase trypsin inhibitors) triggers inflammation through your innate immune system's TLR4 receptor — whether or not you have any gluten sensitivity at all.Finally, he untangles one of the most misused sets of terms in nutrition: allergy, sensitivity, and intolerance are not interchangeable. A wheat allergy is a fast, IgE-driven histamine reaction. Gluten sensitivity is a slower, IgG-linked, symptom-dependent reaction that looks different from person to person. And an intolerance — like lactose intolerance — isn't an immune reaction at all, it's a missing enzyme. Knowing which one you're actually dealing with changes everything about how you test for it and treat it.In This Episode:- What gluten actually is — gliadin, glutenin, and why gluten-free baking is its own science project- The real history of celiac disease, from ancient Greece to a WWII bread shortage in the Netherlands- Why "non-celiac gluten sensitivity" wasn't even named until 2011 — and why the term is already being replaced- The two gluten/wheat reactions that happen in everyone: transient leaky gut (zonulin) and gut inflammation (ATIs/TLR4)- Food allergy vs. food sensitivity vs. food intolerance — the real immunological differences- A preview of Part 2: celiac disease vs. non-celiac gluten sensitivity, gluten's contested link to Hashimoto's and your thyroid, and how gluten may affect blood flow to your brainThis is Part 1 of a two-part series — Part 2 drops soon and covers celiac disease vs. gluten sensitivity, the gluten-thyroid connection, and gluten's effect on brain blood flow.Timestamps0:00 Gluten and Gut Health1:47 Introduction to Gluten and Recent Research2:24 Gluten: Hype vs. Reality4:06 What Is Gluten?5:56 Celiac Disease and Wheat Sensitivity9:15 How Gluten Affects the Gut12:33 Wheat Allergy vs. Gluten Sensitivity17:11 Part Two PreviewLink to Episode Page: https://www.drnoseworthy.com/gluten-leaky-gut-part-1Want help figuring out where you actually land on the gluten spectrum instead of guessing from an elimination diet? Dr. Noseworthy runs a virtual functional medicine practice based in Florida, working with clients across the US and internationally. Reach out through the contact form at https://www.drnoseworthy.com.

Sponsored by Genentech, a member of the Roche Group, and Novartis Pharmaceuticals Corporation. Intended for US Audiences. This information is for general purposes only and is not a substitute for consulting your healthcare provider about food allergy treatment. Brooke and Dr. Ari Zelig have been financially compensated by Genentech and Novartis for their participation in this episode. What does it actually look like to build a full, independent life while managing severe food allergies? In this episode, Whitney is joined by Brooke, a 28-year-old medical student living with food allergies, alongside board certified allergist and immunologist Dr. Ari Zelig, for an honest conversation about navigating everything from childhood birthday parties to dating, travel, restaurants, and everyday situations involving food. Brooke shares how being diagnosed with multiple food allergies forced her to become her own advocate at a young age, and how they ultimately shaped her confidence, relationships, and the physician she hopes to become. Dr. Zelig also discusses the importance of individualized food allergy management and shares information about a treatment option, XOLAIR (omalizumab), an FDA-approved prescription medication for subcutaneous use that can help reduce allergic reactions to multiple foods that may occur after accidental exposure in people with IgE mediated food allergies one year of age and up. While taking XOLAIR you should continue to avoid all foods to which you are allergic. Together, Dr. Zelig and Brooke explore how patients can work with their allergists to create a plan that helps them navigate life while prioritizing safety. Whether you're living with food allergies yourself, supporting someone who is, or simply want to better understand the daily realities, this episode offers practical insights, encouragement, and a reminder that food allergies don't have to define your life. If you or a loved one has been diagnosed with food allergies, talk to your allergist and ask about XOLAIR. You can also find more information at XOLAIR.com. XOLAIR is one of several available treatment options for IgE-mediated food allergy and it may not be appropriate for all patients. What is XOLAIR? XOLAIR® (omalizumab) for subcutaneous use is an injectable prescription medicine used to treat food allergy in people 1 year of age and older to reduce allergic reactions that may occur after accidentally eating one or more foods to which you are allergic. While taking XOLAIR you should continue to avoid all foods to which you are allergic. It is not known if XOLAIR is safe and effective in people with food allergy under 1 year of age. XOLAIR should not be used for the emergency treatment of any allergic reactions, including anaphylaxis. What is the most important information I should know about XOLAIR? Severe allergic reaction. A severe allergic reaction called anaphylaxis can happen when you receive XOLAIR. The reaction can occur after the first dose, or after many doses. It may also occur right after a XOLAIR injection or days later. Anaphylaxis is a life-threatening condition and can lead to death. Go to the nearest emergency room right away if you have any of these symptoms of an allergic reaction: • wheezing, shortness of breath, cough, chest tightness, or trouble breathing • low blood pressure, dizziness, fainting, rapid or weak heartbeat, anxiety, or feeling of “impending doom” • flushing, itching, hives, or feeling warm • swelling of the throat or tongue, throat tightness, hoarse voice, or trouble swallowing Your healthcare provider will monitor you closely for symptoms of an allergic reaction while you are receiving XOLAIR and for a period of time after treatment is initiated. Your healthcare provider should talk to you about getting medical treatment if you have symptoms of an allergic reaction. Please listen to the end of the episode for additional Important Safety Information. See full Prescribing Information, including Medication Guide, at bit.ly/XOLPI. This episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct, or indirect financial interest in products, or services referred to in this episode. Produced by Dear Media.M-US-00032950(v1.0) 9/26 See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Trust your gut—it might be FPIES! Pediatric allergist Dr. Jessica Macdougall joins us to break down food protein-induced enterocolitis syndrome (FPIES), from the vomiting infant in the ED to the baby with chronic GI symptoms and poor growth. Learn how to distinguish FPIES from IgE-mediated food allergy and “milk protein allergy” (FPIAP), recognize common triggers and mimickers, manage acute reactions, and safely navigate food reintroduction.

Co-hosts Ryan Piansky, a patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Science Advisory Council, interview Timothy Buckey, MD, MBE, an allergy and immunology attending physician with a joint faculty position at the Hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [00:48] Co-host Ryan Piansky introduces this episode, brought to you thanks to the support of APFED's Education Partners AstraZeneca, GSK, Sanofi, Regeneron, and Takeda.   [1:04] Ryan introduces co-host Holly Knotowicz. Ryan just returned from APFED's 24th Annual EOS Connection Patient Education Conference. It was a wonderful time. Listeners can still check out the resources on demand online.   [1:26] Ryan mentions that a handful of people came up to him at the conference to say how much they appreciate the Real Talk podcast. It was wonderful to hear how impactful the podcast has been for them.   [1:53] Holly introduces today's topic: how parents and caregivers can help children and teens with eosinophilic disorders build the skills and confidence they need to manage their health as they grow and navigate transitions from pediatric to adult care teams.   [2:06] Holly introduces and welcomes today's guest, Dr. Timothy Buckey, an allergist and immunologist at the University of Pennsylvania and the Children's Hospital of Philadelphia.   [2:14] Dr. Buckey's research interests include eosinophilic esophagitis, food allergy, medical ethics, and improving access to medical care for vulnerable populations.   [2:24] Dr. Buckey thanks Ryan and Holly for having him on the program. He's a long-time listener and is looking forward to the conversation on this important topic.   [2:32] Holly comments on Dr. Buckey working with children and adults. Dr. Buckey says he sees patients of all ages, from a few days old at the Children's Hospital through the end of life at the adult hospital. He loves that there's no patient he cannot see.   [3:10] Dr. Buckey says, in addition to seeing patients as an allergist/immunologist, he is also a medical ethicist or bioethicist. He is trained in medical ethics, and he utilizes that approach in shared decision-making, trying to understand his patients' goals and values for their health, and making a plan that works for them.   [3:31] Holly says her allergist/immunologist at Massachusetts General also sees teens and adults.    [3:53] Dr. Buckey says a special aspect of the relationship he has with his patients is that he has been in a fairly similar position, as someone who has dealt with many different allergic or atopic conditions for his whole life.   [4:08] Dr. Buckey says his conditions started with asthma as a young child, which he still manages, allergic rhinitis, and environmental allergies. He has been on allergy shots. He deals with atopic dermatitis, or eczema. He has seen an allergist/immunologist his whole life. It feels like full circle to be one now.   [4:29] Ryan feels like it's easier from a patient perspective if your physician gets it and can understand what you're going through.   [4:41] Ryan says that eosinophilic disorders generally require lifelong management, especially when diagnosed in children. Over time, a patient may need to transition from being treated by a pediatric care team to an adult care team.   [4:57] Ryan says that Dr. Buckey, through his work with the University of Pennsylvania, provides a lot of support for young adults going through that transition. Ryan asks Dr. Buckey to explain the importance of transition of care.   [5:14] Dr. Buckey breaks down the term into its two words: transition and care.   [5:24] Transition of care is a process in which we are shifting from a pediatric health model, in which a parent or guardian is the primary historian, or person managing the patient's care, to one in which the patient becomes the primary point of contact.   [5:49] Dr. Buckey says that during this process, our overarching goal is for an individual to begin to develop ownership of their health so that they can take care of their medications, schedule appointments, and know their bodies.   [6:05] Dr. Buckey says the second part is care. Not only medical care, but it is a period of life of going through a lot of personal growth. Dr. Buckey's goal is for patients to know themselves and learn to support themselves as independent individuals.   [6:30] Holly appreciates that Dr. Buckey talked about the transition at that age when there are so many things going on with becoming an adult.   [6:40] Holly says when she worked at the Children's Hospital of Colorado, we thought about this a lot.   [7:00] Holly said that when she interacted with patients, she tried to look at them, even if they were little. If they were three or four, she asked them what their favorite foods were.   [7:17] Holly says she was trying, as young as possible, to have them feel that they have some say and control over their health, and they can start developing how to be a historian of their medical journey.   [7:36] Dr. Buckey says every person matures or develops at different times. Having a strict age cutoff may ignore the unique aspects of each person and their history. Dr. Buckey generally begins that conversation in the teenage years through the early 20s.   [8:02] Dr. Buckey says that with some kids, he will introduce the idea earlier than a teenager, based on how much they understand about their health. As they start to switch to adult care, he emphasizes that the transition process is not over at their first adult visit.   [8:24] Dr. Buckey says it takes additional visits for that person to understand themselves, to know how to request a refill of their medication, to know how to make the appointment, and to know how to contact Dr. Buckey if they have questions.    [8:38] Dr. Buckey says it is a continual process, and it doesn't just stop at that first visit with an adult doctor.   [8:45] Holly agrees that people reach maturity at different ages. Holly remembers that when she was in college, she asked her mom to schedule her dentist and doctor appointments.    [9:17] Dr. Buckey says it's overwhelming and it can be quite scary. It takes a team.   [9:30] Holly notes there are age ranges on the Healthcare Transition Timeline Toolkit for what the provider should be doing to help the patient get ready for transition, and what the caregiver and the patient should be doing. She invites listeners to check it out at eoscare.apfed.org.   [9:45] Holly asks about ages when a child would meet alone with their physician for part of the appointment to talk about things they don't want to say in front of their parent.   [10:18] Dr. Buckey says it depends on age and individual factors. He says he has met some very mature 10-year-olds and some not-as-mature 17-year-olds.   [10:38] Dr. Buckey says he understands how it might be nerve-wracking for parents to ask them to step out, but it is an important part of that person starting to know their own body.   [10:50] Dr. Buckey says if he's seeing an individual with asthma, he will have the parents step out briefly from the clinic room so he can have a conversation about possible triggers they may not be comfortable talking to their parents about, such as vaping or cigarette use, and if they have tried them or friends have tried them.   [11:20] Dr. Buckey says they will discuss that, and that's not something they always feel comfortable sharing with their parents because they feel like they may be disappointing them. The doctor needs to know it to keep them healthy.   [11:44] Holly says in her practice, a lot of teenagers will ask to meet with her if they have IgE-mediated food allergies on top of eosinophilic-related disease.   [11:51] They want to know if it's safe to kiss a person if they've eaten this or what to do to protect themselves. If they get this symptom, what should they do? They feel comfortable asking Holly. She's trying to coach them to feel confident in their bodies.   [12:22] Ryan comments that he's gone through the transition of care process relatively recently. The conversation has touched on so many things he remembers from the last 10 years of trying to transition.   [12:28] Even before that, at eight or nine, when the doctor asked what medications Ryan was on, his mother looked at him and said, You should know this; you take them every day. What medications are you on?   [12:43] Ryan says that was super helpful to him, as a young patient, that his parents supported him in making sure he was aware of his health, his treatment options, and was able to guide his own medical appointments, with supervision.   [12:57] Ryan had had no idea that he was choking on food or taking extra time to chew. It felt normal, so it was helpful to have a caregiver in the office. His caregiver would say it takes him half an hour to have a handful of crackers. That should not be happening.   [13:20] Ryan asked about caregivers helping with appointment management and prescription management. Until recently, Ryan's parents helped him.    [13:50] Ryan says, even into your 20s, that transition process is still happening. Ryan asks Dr. Buckey for advice on teens and young adults making their own appointments and dealing with healthcare systems.   [14:04] Dr. Buckey says it's difficult to navigate our healthcare system. There are questions about insurance and what is in-network vs. out-of-network. How do you get prescriptions filled? What's covered? Cost? So it's complicated.   [14:21] Dr. Buckey emphasizes that when we're talking about this transition process, sometimes a part can get misconstrued: that we don't want parents or caregivers involved. We do.   [14:35] Dr. Buckey says his goal is for people to have the community, however they define that, to still be a part of their healthcare. What he is aiming for with this transition is that the individual starts to take control of their own health.   [14:50] If making appointments is something they still need some help from their parents, that is them recognizing what they need. [14:57] If they want to come to the visit but have Mom or Dad or their significant other on the phone, because that is the support that they need, then absolutely do that.    [15:08] Dr. Buckey says, as we are generally switching over, at 18 into our early 20s, recognizing the support you need is an important part of knowing your own body.   [15:20] Holly says that's an important stage, and she got there later. She needed help when she was younger; then, in her teens, she said, "No, I've got it." Now, in her 40s, she would like some help again.   [15:37] Holly says it's OK to ask for help when you're feeling overwhelmed, and you can't navigate all these chronic diseases on your own.   [15:42] Ryan says this is a topic we're both passionate about. At APFED, we see younger patients stop seeing their care team when they get to their college years.   [15:54] Ryan says part of it is they get busy and are not able to engage with the patient advocacy community as much, and part of it is they drop out of care. It's important to have caregivers or your community to support you through that process.   [16:07] Ryan says, whatever it takes to stay in care and make sure you're healthy is super important.   [16:14] Ryan brings up legal age cutoffs. In his 20s, he has access to his medical records; his parents don't. He still wants their take on some stuff. After he gets an endoscopy, he pulls up MyChart to show his parents his results.   [16:38] Dr. Buckey says once we turn 18, we are legally adults. At that point, the patient is the owner of their health and their information. They have to provide access to their parents to be able to see it. That can be done in several different ways.   [16:55] If you have an electronic health record, sometimes you can add a proxy, or you can just pull up the results and choose to show your parents.   [17:05] Dr. Buckey says if he is seeing an 18-, 19-, or 20-year-old at the Children's Hospital, he will tell them that once they turn 18, he only communicates results to them.   [17:16] Of course, they can have their parents, caregiver, or significant other present. That is their choice to invite them into that conversation. That is very helpful for many people.   [17:30] Dr. Buckey is a proxy for his parents. Holly is also a proxy for her parents.   [17:41] Holly says that having somebody who is in your corner to talk about your results with and talk about the next stages of treatment is always important because it can be overwhelming.   [17:51] Dr. Buckey gives kudos to pediatric providers. They are so wonderful, and they build such a great relationship that it makes it hard for us to want to leave.   [18:03] When Dr. Buckey was at the point of applying to medical school, his pediatrician told him they needed to have him see an adult doctor. He was reluctant to transition. His pediatrician inspired Dr. Buckey to go into medicine.   [18:25] Ryan says it can be a hard transition, with so much else going on that you want to stay in that familiar environment.   [18:31] Ryan shares how he recently dealt with transitioning insurance plans.   [18:55] Dr. Buckey says the general rule is that you can stay on your parents' health insurance until you are 26. There are caveats for individual persons and individual insurance plans.   [19:05] Some people start working and may get health insurance through their job, so you may have your own health insurance at 18 and no longer be on your parents' insurance.   [19:16] When you're 16 or 17, it's an important time to talk to your parents, or whoever's insurance you are on, about what's going to happen when you turn 18.   [19:26] Ryan says it's specific to each medical plan. He says when he went to college, he was offered a student health insurance plan, but his specialty medications, like biologics, were not covered, only hospitalizations.   [20:00] Ryan says it's always good to double-check what your plan options are and what those plans cover, to make sure that you're able to maintain the care you need.   [20:12] Holly says that something really helpful is to sit down with the family and help them identify an adult care team that will fit them best as they transition.   [20:33] Dr. Buckey says sitting down and having that conversation is an important part of the visit. Talk to patients about where they will live. If you're living away at college or moving away for a job, what geographic area are you moving to?   [20:53] If you're going to be on a different coast or city, do you want to switch your care over to that area? Or do you want to keep your care in the area where your parents live and come back during your breaks and see your physician?   [21:09] Dr. Buckey says it's also important to have a local provider to go to if something comes up. Talk to your pediatric provider about whether they know adult clinicians who care for the condition that you have in the area where you will be living.   [21:30] Dr. Buckey says another important thing to think about is,  when we are in pediatric care, we are often follow-up or return patients. Visits may be of a different duration. Sometimes it's easier to schedule a follow-up visit than a new patient visit.   [21:48] Planning that new patient visit in your new area, sometimes weeks or months ahead, is an important part of this transition process to ensure that there are no gaps in the care you're going to be having.   [22:08] Holly mentions the APFED Specialist Finder on the APFED website. It's a tool for when you are not part of a multidisciplinary setting or wherever you're going, no one knows who they would recommend in that part of the country.   [22:25] There are a lot of good people listed on the APFED Specialist Finder if you are going to be moving somewhere else or getting your care in another place. Dr. Buckey proudly shared that he is on that Specialist Finder. So is Holly.   [22:51] Ryan recently moved to California, and he is trying to find care teams there that specialize in EoE.   [23:12] Ryan asks if patients transitioning to a new doctor typically need a referral from their existing physician, or do you chat with your insurance company first to help find new care teams?   [23:25] Dr. Buckey says some insurance policies do require a referral for each visit you are going to have with your provider. For many policies, you can look online to see who is in-network vs. out-of-network.   [23:52] Sometimes there are different costs to see someone who is in-network vs. out-of-network. The differences can be dramatic. Discuss it with your physician or clinician, but also with your insurance company.   [24:13] Dr. Buckey says make sure there's no lapse in care. We don't want someone to go without their medication. If you're no longer seeing your pediatric provider, make plans to see an adult provider who can continue your prescriptions.   [24:45] Ryan says we see a lot of patients who have an EGID and also other conditions. We see a lot of comorbidities within our community. We have multiple things going on, which can make this transition process especially complicated.   [25:15] Dr. Buckey says many people are experiencing different things and may need to see more than one clinician. They probably also have a primary care doctor. They are going to have to switch from each of those clinicians to an adult provider.   [25:38] That transition takes time and effort. It can sometimes be a long wait. Beginning that process early will only set you up for success. Dr. Buckey says different health systems will accept different insurances.   [26:01] Dr. Buckey says sometimes for specialty medicines, when you switch health systems, the specialty medication may be provided by a different specialty pharmacy than it was when you were seeing a pediatric healthcare team.   [26:13] How you schedule appointments, how you speak to someone if you're having new symptoms, all changes as you're switching to adult care. Dr. Buckey says because this is complicated, we do worry that sometimes things can get lost during the transition.   [26:37] Planning will only set you up for success, so that nothing gets missed in the switchover process; you have no lapse in medications or procedures that you need, and you can continue to see the clinicians you need to keep you healthy for your best life.   [27:03] Holly has learned from her healthcare and working in different hospitals to ask, before picking a specialist, what electronic medical records (EMR) the practice uses. Some can communicate with each other, and it makes the transition smoother.   [27:25] Holly says some places have EMRs that don't communicate with other places, and that makes sharing information tricky. Holly has experience dealing with EMRs that do not talk to each other at all.   [28:05] Dr. Buckey says if you use an EMR that communicates with others, your care can easily be accessed at different institutions. Dr. Buckey explains how that helps make the transition smooth if transferring to adult care or switching healthcare systems.   [28:56] Dr. Buckey says things you need for a helpful transition are to know your medical history, your diagnoses and how they were made, your current medications and dosing, and medications or therapies you tried before that weren't successful for you.   [29:31] Dr. Buckey says, as we approach the era of precision medicine where we are treating each person in a different way, knowing what did or did not work for you is so helpful for your clinician so they can continue to help you feel good.   [29:49] Holly suggests a role-play. For example, if she's going to see Dr. Buckey with her records from Maine, which do not communicate with his EMR. What should she physically bring to the visit?   [30:23] Dr. Buckey says to know what health conditions she is being treated for. In Holly's case, they will talk about asthma and EoE.   [30:33] Dr. Buckey would like to know if Holly has ever been hospitalized for asthma, what inhalers she takes, what inhalers she tried before, and if she is on any biologic medicines, the doses and the frequency, and what she tried in the past.   [30:53] Dr. Buckey would ask if she's ever had breathing tests, called spirometry or pulmonary function tests.   [30:58] Having paper copies is wonderful. You can bring them in, and he will review them at the visit. Dr. Buckey always appreciates it when patients send them to him ahead of time, so he can review them and prepare for a successful first visit for both of them.   [31:18] Dr. Buckey says if we're talking about EoE, he will ask when the diagnosis was made, what symptoms led her or her parents to do that first endoscopy or see an allergist, immunologist, or gastroenterologist, when the most recent endoscopy was, and what medications she was on when she had her different endoscopies.   [31:40] Dr. Buckey says usually clinicians are keeping track of this, so Holly could ask them for copies of procedures she has had, the last two or three office visits, which are usually pretty comprehensive, and a list of any medications Holly takes.   [32:00] Holly appreciates having the ability to send paper records in advance. When Holly sets an appointment, she will fax Dr. Buckey some of her tests and important facts to look at before her appointment.   [32:20] Holly says some places won't look at the reports in advance, so she brings a bullet list with her of all the things Dr. Buckey listed for them to look at when she checks in to the appointment.   [32:39] Dr. Buckey responds that healthcare is very busy and some clinicians don't have the time to look at reports ahead of the visit, but can take five or ten minutes to look at them at the start of the visit to be successful and have a comprehensive visit.   [32:59] Ryan appreciates Holly's point to bring a bulleted list to the visit. Ryan is grateful that his parents kept his records organized throughout his life. For any caregivers listening, set your patients up for success by keeping track of these things over time.   [33:24] Ryan has a one-page summary he gives to all new providers of all his hospitalizations over the last 20 years, the medications he has been on, with date ranges, his diagnoses with dates, and different procedures and endoscopies.   [33:46] Ryan says that one-page summary is in 6-point font to squish it down to one page. It's helpful to have all that information organized together.   [33:55] Ryan invites caregivers: If you have a young patient and you're starting to think about the transition process, start keeping track of all that if you haven't before.   [34:03] Dr. Buckey says our health can be complicated. We can have periods when we're feeling great and periods when we're having more symptoms. Having it written down is an easy way to keep track so things don't get forgotten or lost.   [34:22] Dr. Buckey often says he appreciates when patients come in with that sort of list of their history because it shows how invested you are in your health and keeping yourself healthy. It's a wonderful way that you can be proactive.   [34:40] Ryan says it can feel like a big undertaking if you start now and you're in your 20s. Whenever you can start keeping track of how you're feeling and why, what treatment and symptoms you're having, it's good to have more information than less.   [34:58] Dr. Buckey says there's never a period when it's too late. If you are in your 30s or 40s and just starting out, it's very helpful. The provider can prompt you with questions that will help you recall things you had in the past and add them to the document.   [35:21] Ryan says it's a very collaborative process. Discuss it with your clinician, who may point out symptoms you should note.   [35:40] Ryan asks, when you are transitioning from pediatric to adult care, is it typical for an adult care provider to call a pediatric care provider with questions? Dr. Buckey says in his system, doctors have those conversations, which is a great asset to patients.   [36:33] Dr. Buckey says, for example, if I were not their pediatric allergist, but I would become their adult allergist, I would reach out to their pediatric allergist and ask details about their history. I would also reach out to their dermatologist and gastroenterologist.   [36:59] It's helpful to ask each other questions, know things to look out for, or things in a person's history that might be helpful as therapies and medications continue to advance that might be a good fit. It helps us to have a good comprehensive plan in place.   [37:26] Dr. Buckey says talking to each other helps to provide good longitudinal care.    [37:39] Ryan asks about having procedures and allergy testing in a pediatric setting and switching to a new provider. Do adult providers typically want to repeat testing?   [38:04] Dr. Buckey says it will depend on each person, when they were performed, and what was performed. If Dr. Buckey is seeing someone for food allergies, was skin or blood testing done last year or 10 or 20 years ago? Last year is pretty current. If it was 20 years ago and you're 22, your body is very different from when you were two.   [38:40] Dr. Buckey says if you have asthma and you had a breathing test two weeks ago, that's very recent. If you have not had a breathing test done in 10 years, I probably would repeat it on your first or second visit.   [38:56] Dr. Buckey says, for endoscopies, if you have EoE of another EGID, it would depend on timing. Was this done recently or in the remote past? Was it done on the current regimen you are on? Was it done on a different regimen?   [39:14] Dr. Buckey says I'm going to ask you if you're having any changes in symptoms recently. If anything has changed how you're feeling, it's probably going to prompt me to do a new set of testing and not just rely on the ones you had before.   [39:31] Dr. Buckey says, if you could bring the previous tests to me, I can compare. I can see what your endoscopy looks like now vs. two years ago. It's helpful to have that baseline to compare to.   [39:48] Dr. Buckey adds that knowing how you're feeling, or what's been done before, or your medical history, helps clinicians to take care of you as best we can.   [40:15] Holly says this is such a needed conversation. It will be helpful for our listeners, both practicing physicians and patients.   [40:37] Holly asks what advice Dr. Buckey gives for navigating challenges during the transition of care.   [40:51] Dr. Buckey says for every new EoE patient visit, he shares a link to the APFED website because there are such wonderful resources and references there. He explains to them what APFED is, and he provides resources to other websites or research that he thinks is helpful for them, depending on what each person is looking for.   [41:31] Talking with your doctor about what you are looking for is very helpful.   [41:38] In terms of the transition process, it's an exciting period. We're often going through a lot of big life changes. It could be our first time living away from our parents, having a job, or going to college.   [42:05] Know your own health. Learn about your body. We are the best advocates for ourselves. Only you know what you are feeling. Only you can tell your doctor what you're feeling. Taking ownership of your health will set you up for success for a healthy, long life, achieving your goals. Holly says that sums it up beautifully.    [42:40] Holly says for listeners who are feeling overwhelmed, unsure, or want to find out more about the transition, eoscare.apfed.org is a great site that helps you navigate healthcare for eosinophilic conditions. It also has a tab for building a care team.   [43:05] Ryan says it's great when the guest plugs APFED resources! For those who are looking to learn more about transition of care, please visit apfed.org and check out the links in the show notes below.   [43:25] If you're looking to find specialists, as you're going through this transition process, who treat eosinophilic disorders, we encourage you to use APFED's Specialist Finder, available at apfed.org/specialist.   [43:36] If you would like to hear some recent sessions from the 24th annual Eos Connection conference, we had a session focused on transition of care. Those are available on demand online.    [43:50] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at apfed.org/connections.   [44:00] If you have personally been impacted by eosinophilic disorders and are interested in sharing your experiences, please check out apfed.org/shareyourstory.   [44:09] Ryan thanks Dr. Buckey for joining us today. It was such a great conversation. This will be so helpful for the community. Dr. Buckey says the work of this podcast and of APFED as a whole is so important.   [44:36] Dr. Buckey thanks all the patients and colleagues that he has. He has a job where he walks with a smile on his face every day. It's a privilege to take care of his patients and work with his colleagues. Thank you all for listening today.   [44:56] Holly thanks APFED's Education Partners AstraZeneca, GSK, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode:   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.orgapfed.org/specialist apfed.org/connections eoscare.apfed.org Eos Connection 2026 Timothy Buckey, MD, MBE Hospital of the University of Pennsylvania Children's Hospital of Philadelphia Department of Medical Ethics and Health Policy Healthcare Transition Timeline Toolkit Education Partners: This episode of APFED's podcast is brought to you thanks to the support of AstraZeneca, GSK, Sanofi, Regeneron, and Takeda.   Tweetables (Edited):   "I am trained in medical ethics, and I utilize that approach, particularly in shared decision-making, trying to understand my patients' goals and values for their health, … and making a plan that works for them." — Timothy Buckey, MD, MBE   "During this [transition] process, our overarching goal is for an individual to begin to develop ownership of their health so that they can take care of their medications, schedule appointments, and know their bodies." — Timothy Buckey, MD, MBE   "Having a strict age cutoff may ignore the unique aspects of each person and their history. I generally begin that conversation [about transition of care] in the teenage years through the early 20s." — Timothy Buckey, MD, MBE   "Healthcare is very busy, and some clinicians don't have the time to look [at reports] ahead of time, but often, we can take five or ten minutes to look at them at the start of the visit … to be successful and have a comprehensive visit." — Timothy Buckey, MD, MBE   "We are the best advocates for ourselves. Only you know what you are feeling inside. Only you can tell your doctor what you're feeling. Taking ownership of your health will set you up for success for a healthy long life, achieving your goals." — Timothy Buckey, MD, MBE   Guest Bio: Timothy Buckey, MD, MBE, is an allergy and immunology attending physician with a joint faculty position at the Hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia, and a secondary academic appointment in the Department of Medical Ethics and Health Policy. Dr. Buckey completed his allergy and immunology fellowship training at the Hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia. He attended Georgetown University School of Medicine. He also received a Master of Bioethics from the Perelman School of Medicine at the University of Pennsylvania.   Several of Dr. Buckey's research interests include eosinophilic esophagitis, food allergy, medical ethics, and improving access to medical care for vulnerable populations. He was the lead author on one of the largest studies evaluating the rate of eosinophilic esophagitis during food allergy oral immunotherapy. Dr. Buckey was also the lead author on the pivotal 2024 food allergy study, which utilized allergist-performed oral food challenges to demonstrate there are no differences in food allergy outcomes based on race or ethnicity. Dr Buckey has also become a pioneer in investigating the intersection of medical ethics with allergy and immunology. Dr. Buckey developed the first comprehensive ethical framework for the specialty of allergy and immunology to assist clinicians with navigating ethically complex decisions in their clinical practices. He utilizes this patient-centered approach in the clinic when caring for patients with allergic and immunologic conditions of all ages.   Website profile: pennmedicine.org/providers/timothy-buckey

Choosing Wisely Portugal (Recomendações) Realização de testes de rastreio (testes de IgE) para alergias alimentares sem uma história consistente com uma alergia alimentar específica - Link ---Nova Android & iOS app MGFamiliar - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Link⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠---Subscreva o Podcast MGFamiliar para não perder qualquer um dos nossos episódios. Além disso, considere deixar-nos uma revisão ou um comentário no Apple Podcasts ou no Spotify.---MusicSummer in Colombia · Carmen María and Edu Espinal - Link—Este podcast destina-se a médicos e os conteúdos nele partilhados não devem ser usados para decisões individuais sem aconselhamento médico. Para tal, fale com o seu médico.

Broadcast from KSQD, Santa Cruz on 8-20-2026: An emailer asks about amlexanox for mast cell activation syndrome (MCAS). Dr. Dawn first walks through MCAS diagnostic criteria—requiring symptoms across at least two of four categories (skin, low blood pressure, abdominal, respiratory), with serum tryptase testing performed both during and after a flare. She grades amlexanox as a C: originally FDA-approved only as a topical paste for canker sores, later approved in Japan as an asthma treatment, but never validated for MCAS and pushed largely by a single compounding pharmacy and its influencer clones. She recommends conventional agents first—antihistamines, montelukast, cromolyn, quercetin, aspirin for flushing, and Xolair anti-IgE antibodies for severe cases—plus microcrystalline cellulose as the safest capsule filler if compounding of amellanox is pursued. Most ovarian cancers—including nearly all fatal cases—actually originate in the fimbriae of the fallopian tubes rather than the ovaries themselves. Opportunistic salpingectomy tacks a five-minute fallopian tube removal onto any abdominal surgery (tubal ligation, hernia repair, gallbladder, appendectomy), potentially reducing lifetime ovarian cancer risk by 65% -80% based on epidemiological data from Swedish, Canadian, and Danish registry studies. Dr. Dawn recommends particular consideration for non-childbearing women with BRCA1/2 or family history of breast or ovarian cancer. Deep brain stimulator devices manufactured after 2020 (about 40,000 U.S. patients) contain adaptive-DBS capability that can be activated via firmware upgrade without additional surgery. Rather than delivering constant stimulation like older devices, adaptive DBS reads beta oscillations (13-30 Hz motor-control brainwaves) in the basal ganglia and modulates output in real time—reducing stimulation as L-DOPA peaks from drugs and increasing it as medication wears off, smoothing the swings between agitation and freezing. Sleep improvement has emerged as a notable secondary benefit, potentially slowing disease progression. The technology is also being investigated for dystonia, essential tremor, OCD, and Tourette's syndrome. Chinese company StarMed is developing brain-computer interfaces closely resembling Neuralink designs, benefiting from aggressive government funding, large patient populations, and reduced tort liability. One trial uses an eight-probe device placed atop the dura mater (avoiding brain penetration) connected to a pneumatic glove that has restored eating and drinking function in about twenty paralyzed patients over twenty months. A more invasive Shanghai trial implanted 256 probes on the neural cortex of a woman with epilepsy who could operate social media and control a wheelchair within two weeks; a related U.S. system using 65 hair-thin sensors enabled speech with just ten-millisecond delay. An emailer describes recurring two-week viral illnesses (sore throat, swollen glands, congestion, cough, body aches) recurring every 4-6 weeks. Dr. Dawn frames the question as either impaired immunity or changed exposure. She recommends starting with a CBC to rule out blood dyscrasias like leukemia, checking urine mycotoxins for mold exposure, then examining behavioral changes—new job, handling cash before eating, and the well-documented protective effect of masking in public that dramatically reduced cold rates during COVID. Dr. Dawn covers three health policy items. The good: new USDA dietary guidelines flip the food pyramid, putting protein, dairy, healthy fats, vegetables, and fruits at the top, with whole grains reduced to a small band, and it's recommendation 1.2 g/kg protein daily. The bad: an executive order attempting to reduce childhood vaccines from 18 to 11 and separate MMR into individual components—impossible since no U.S. manufacturer makes the individual antigens, and misguided since infant hepatitis B vaccination prevents mother-to-child liver cancer transmission. The ugly: a 26-year-old heart transplant recipient whose insurer initially dropped coverage of her generic anti-rejection drug, then "ghost approved" it at $1,000 for 90 days versus the previous $180. Mark Cuban's Cost Plus Pharmacy now supplies her the same medication for $300 (cost plus 15% profit plus 5% handling), highlighting the massive markups embedded in the standard pharmacy chain. For a time before that, the mother of the heart donor stepped up and paid for the recipients anti-rejection drugs to keep her son's heart beating.

What Blocks Brain Recovery After Stroke: The Exposures Nobody Tests For Introduction In 1987, Dr. Robert Hedaya found an office he loved. It overlooked a stream and a forest, and it had a balcony. Within about an hour of arriving each morning, he would become tired and mentally foggy, something he describes as unlike him. It took him time to work out what was happening. The building had mold. He is a Clinical Professor of Psychiatry at Georgetown University Medical Center and a pioneer of functional medicine psychiatry. He had spent his career studying why brains underperform. And he still didn’t see it until it was affecting him personally. That story is worth sitting with, because it goes to the heart of a question most stroke survivors eventually ask: if I’m doing the therapy, the exercises, the sleep, the diet, why am I still stuck? Why this question matters more than any rehab program When Dr. Hedaya returned to Recovery After Stroke for his third conversation with Bill Gasiamis, the topic was not a new treatment. It was the opposite: the things that get in the way of treatments already working. His argument is structural. After a stroke, the brain rebuilds by growing new connections between neurons. That process is physical. It requires materials, energy, and an absence of interference. If something is interfering, no amount of repetition in a rehab gym will overcome it. So the useful question is not only what helps my brain recover but also what blocks brain recovery after stroke and whether any of it is happening in your own house, your own mouth, or your own bloodstream without anyone having looked. Dr. Hedaya raised three: mercury, mold, and Lyme. Mercury: how a metal stops neurons from branching Picture a neuron as a tree in winter: a trunk with branches extending outward. After a stroke, under the right conditions, neurons grow new branches to make new connections. To do that, the cell has to lay down a structure for the new branch to grow through. It uses a protein called tubulin, small oval molecules that link together into a tube, the way Lego pieces connect to form a ring. Mercury interrupts that linkage. Dr. Hedaya points to footage from the University of Calgary, filmed in 1999, showing the process under a microscope: the growing nerve branch shrivels and retracts within seconds of mercury exposure. It runs about two and a half minutes and is worth watching, because seeing it is more persuasive than reading about it. Where does mercury come from? Two main sources. Dental amalgam fillings, the dark grey ones, were largely phased out from roughly the 1970s onward, which means people now in their fifties and sixties are the most likely to still have them. And fish. Mercury accumulates up the food chain, so large predatory fish such as tuna and swordfish carry substantially more than small fish. Sardines, anchovies, herring, and mackerel carry very little, and bring DHA and B12 with them, the raw materials neurons need. Testing involves a baseline urine sample, then a challenge dose of DMSA (a sulfur-containing compound), then a second sample. A jump between the two indicates mercury was being stored and is now being pulled out. If you have amalgam fillings removed, Dr. Hedaya is emphatic that it should be done by a biological dentist who follows a protocol: preparation with sulfur-containing compounds beforehand, a dam in place during the procedure, and rinsing afterward. Removal done badly can expose you to more mercury than leaving it alone. Mold: the ceiling Dr. Hedaya says he has never seen broken This is his strongest claim, and he states it without hedging: he has not seen anyone fully recover from a neurological problem while living in a mold-exposed environment. His estimate of the ceiling is around fifty percent improvement. There are two separate things at work. The spores the visible organism. And the mycotoxins, which are molecular, airborne, invisible, and travel far beyond the patch you can see. They inhibit mitochondria, which is how cells produce energy, and they increase oxidation, which is hard on neurons. You cannot rule mold out by smell or by looking. Dr. Hedaya has every patient run an ERMI test Environmental Relative Mold Index. You mark ten areas in the home that don’t get cleaned, wipe them down, leave them for a month, then collect dust with a supplied cloth and send it to a lab. He uses Mycometrics. The second test asks a different question: is your immune system actually reacting? A lab such as MyMycoLab measures IgE (an immediate response, within minutes to hours) and IgG (a delayed response that can begin a day or two later and persist for weeks). You then compare which molds are in your home against which ones your immune system is responding to: Aspergillus, Cladosporium, Chaetomium, Stachybotrys, and others. In Dr. Hedaya’s experience, the two lists usually overlap. Remediation is where it becomes expensive and inconvenient. Cleaning the visible growth achieves little on its own. You have to find the water: poor grading, a roof leak, blocked downspouts, a badly installed HVAC system, damp ductwork, because if the water source remains, so does the mold. As Bill put it in the conversation: there is no point putting a year of work into a rehabilitation program and then walking out of it into a moldy house. The cost of remediation is real. So is the cost of never getting past fifty percent. Lyme disease: the great imitator Lyme is a close relative of syphilis, which was historically called the great imitator because it could present as almost any disease. Lyme behaves the same way, and a single tick can carry around twenty pathogens that affect humans, including Bartonella and Babesia, both of which drain cellular energy. Dr. Hedaya’s issue is with the testing. It relies on antibodies, and antibodies take weeks to develop, so testing soon after a bite returns a negative that means nothing. The result is also reported as a binary against an optical density threshold: above the cutoff you have it, below it you don’t. His comparison: a blood glucose of 120 is not diabetes; 121 is. The line does not reflect biology. He also rejects the common reassurance that a tick embedded for under 24 hours is safe. His word for it was “insanity.” Where to start Asked which of the three to address first, his answer was immediate: mold. Mercury needs no test to begin acting on; switch to smaller fish, eat more cruciferous vegetables, garlic, cilantro, and greens, and you are doing something useful whether or not you had a problem. Test in six to twelve months if you want to know. Lyme comes last, unless you have had a recent tick bite. And mold has to be dealt with before Lyme treatment is worth attempting. How to raise this with your doctor Dr. Hedaya’s advice here is practical, and it applies well beyond this topic. Don’t arrive with a theory. Arrive with a literature review. He suggests using SciSpace over PubMed; ask it for a literature review on the effects of mold on the human nervous system, and it will assemble one in fifteen or twenty minutes. Print it, along with a couple of the underlying papers. Then add the step most people skip: ask it for the counter-argument. Ask why mold might not be a factor in brain function. You are not there to win. You are there to have a real conversation, and a doctor is far more likely to engage with someone who has already tested their own position. If they refuse outright to order the testing? His view was blunt: find another doctor. Getting out of your own way None of this replaces rehabilitation. It removes the obstacles to it. That distinction matters, because the work you are already doing is not wasted; it may simply be running into something invisible. Checking your fillings takes a minute and someone willing to look in your mouth. Testing your house takes a month and a cloth. Neither is a treatment. Both are ways of making sure the treatment can do its job. This is the third conversation with Dr. Hedaya on this show. The first covered photobiomodulation and laser therapy (https://recoveryafterstroke.com/photobiomodulation-stroke-recovery/). The second covered hormones, thyroid function, and fatigue (https://recoveryafterstroke.com/hormones-and-stroke-recovery-dr-robert-hedaya/). Both are useful companions to this one. If you want a fuller framework for thinking about recovery, Bill’s book The Unexpected Way That A Stroke Became The Best Thing That Happened walks through ten tools for recovery and personal transformation. You can find it at https://recoveryafterstroke.com/book. And if this show has helped you, you can support it financially at https://patreon.com/recoveryafterstroke. Footer Disclaimer This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. Related links: Dr. Hedaya’s practice First conversation, photobiomodulation Second conversation, hormones The mercury video, University of Calgary Background on that video ERMI mold testing lab Mould antibody blood testing Tick-borne and Lyme testing Literature reviews in minutes Research database The toxins textbook he mentions The post The Things Getting In The Way Of Your Recovery – Dr. Robert Hedaya appeared first on Recovery After Stroke.

Scott Smith talks about his research on cloned individual antibodies and how those studies have shifted his thoughts on the role of IgE in parasite defense and food allergy. Host: Cindy Leifer Guest: Scott Smith Subscribe (free): Apple Podcasts, RSS, email Become a patron of Immune! Links for this episode MicrobeTV Discord Server Complement control proteins in poxvirus evasion (J Virol, 2000) Complement control protein reduces xenotransplant rejection (Transpl Proc, 2002) Engineering therapeutic antibodies (J Allergy Clin Immunol, 2023) Antigens in peanut allergy anaphylaxis (J Allergy Clin Immunol, 2025) Using human antibodies to identify parasite antigens (J Allergy Clin Immunol, 2022) Time stamps by Jolene Ramsey. Thanks! Music by Tatami. Logo image by Blausen Medical Send your immunology questions and comments to immune@microbe.tv Information on this podcast should not be construed as medical advice.  

"Food, milk and egg ladders look the same, but they're not the same." — Dr. Juan TrujilloLadders 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 question longer than most.Dr. Juan Trujillo is a consultant paediatric allergist at Cork University Hospital and a senior lecturer at University College Cork. He is careful not to oversell. There isn't much literature to go on, he says, so ladder practice ends up tracking something else: how many appointments a clinic can offer. In a stretched service, a ladder can mean fewer visits rather than more. When it comes to egg and milk allergies, different ladders, different timelines, different success rates. Clinics tend to treat them as one thing. Trujillo doesn't.Key pointsThe evidence base is incomplete. Practice moved ahead anyway, largely because indefinite avoidance is not a neutral default.In resource-limited systems, ladders can reduce appointments rather than generate them.Milk and egg are not interchangeable and should not be presented to families as though they are.Skin testing, specific IgE and components will diagnose the allergy. They will not give you the threshold, and they will not tell you who is going to climb.Counting milligrams of protein overcomplicates what is, for most young children, dietary advancement.Age matters. The younger the child, the better the prospects. Older than five, Trujillo approaches with caution.Patient selection is doing more of the work than any step-by-step protocol.In young children, selected carefully and supported properly, ladders are worth doing on practical grounds, whether or not they turn out to be disease modifying. Have an idea for the show or a comment, send us a text!Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions

Dans cet épisode d'Ophtalmos, les docteurs Maxime Delbarre et Camille Rambaud reçoivent le Pr Bruno Mortemousque, ophtalmologiste à Bordeaux, Professeur des Universités et ancien chef de service aux hôpitaux de Bordeaux, spécialiste des pathologies de la surface oculaire et de l'allergie oculaire.Dans ses formes sévères, comme la kératoconjonctivite vernale de l'enfant, l'allergie oculaire peut menacer la vision. Entre corticoïdes, cyclosporine, tacrolimus et biothérapies ciblées, la prise en charge évolue.Notre spécialiste partage son expérience du terrain, ses schémas thérapeutiques et les pièges à éviter.Les Ophtalmos abordent avec lui :

You've eaten red meat your whole life, so why does a steak dinner suddenly leave you covered in hives at 1 AM? A single Lone Star tick bite can rewire your immune system into a delayed allergy to red meat, and most people (and even their doctors) never connect the two.In this solo episode, Dr. Gabrielle Lyon discusses:Why alpha-gal reactions are delayed 2–6 hours after eating meat, and how that delay causes ER visits to be repeatedly misdiagnosedHow your blood type changes your risk (type A and O are higher-risk; type B appears protected) and why a mismatched transfusion has proven fatalThe simple alpha-gal IgE blood test to ask for, and what the numbers meanThe hidden sources beyond food: gelatin, vaccines, heparin, thyroid meds, and even heart valvesThe tiered treatment approach that resolves symptoms in about 80% of patients on meat-avoidance aloneLearn to recognize a condition that's increasingly common yet widely missed, so if it's happening to you, you'll know exactly what to test for and how to get your life back. It's not all in your head.Thank you to our sponsors:Cozy Earth - Go to https://bit.ly/3RLZNEv for up to 20% off!Timeline - Get 20% off your Mitopure order at https://bit.ly/4ptIchfSquare - Get up to $200 off Square hardware when you sign up at https://bit.ly/4gOCfZP #squarepodExplore More from Dr. Gabrielle LyonWeekly newsletter: Recipes, podcast updates, and practical weekly insights https://drgabriellelyon.com/sign-up/Apply to become a patient: Personalized care with Dr. Lyon's clinical team https://drgabriellelyon.com/new-patient-inquiry/Connect with Dr. Gabrielle Lyon:Instagram: https://www.instagram.com/drgabriellelyon/TikTok: https://www.tiktok.com/@drgabriellelyonX (Twitter): https://x.com/drgabriellelyonFacebook: https://www.facebook.com/doctorgabriellelyonChapters00:00 - Introduction00:38 - How to spot the Lone Star tick02:15 - Why this tick hunts you03:40 - Where the tick is spreading now05:10 - Diseases the Lone Star tick carries06:30 - What alpha-gal syndrome is08:45 - Why the reaction is delayed 2 to 6 hours10:20 - Cofactors that make reactions worse12:05 - Blood type and your risk level14:30 - The transfusion danger nobody screens for16:15 - The blood test and what the numbers mean19:40 - Foods and hidden sources to avoid23:10 - The three-tier treatment approach27:00 - Hidden alpha-gal in meds, vaccines, and implants31:20 - Preventing tick bites and getting testedIf you found this episode valuable, share it with someone who would benefit from it.Disclaimers: This episode includes paid sponsorships.The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.

Fulton v. Mullin, et al., No. 25-194 (2d Cir. July 14, 2026)habeas; release pending appeal; Mapp; end stage renal disease Matter of N-E-R-S-, 29 I&N Dec. 753 (BIA 2026)ACA with Ecuador; implementing agreement; interlocutory appeal Matter of E-A-R-M-, 29 I&N Dec. 746 (BIA 2026)IJs cannot consider anything when DHS makes an asylum pretermission motion based on ACA with Ecuador; DHS failure to comply with IJ scheduling order Matter of L-R-M-C- & V-A-M-M-, 29 I&N Dec. 757 (BIA 2026)Lozada compliance; ineffective assistance of counsel; requirement to provide contents of bar complaint and proof of filing Matter of Lopez-Davila, 29 I&N Dec. 763 (BIA 2026)exceptional and extremely unusual hardship; Ige presumption that child will join parent abroad; foster care not bad enough; nonparent can care for child Burey v. Blanche, No. 25-1869 (4th Cir. July 14, 2026)VAWA motion to reopen deadline; ECAS and filing window rejection; failure to file I-360 before moving to reopen not fatal; attorney affidavit; deadline to file motion to reopen possible begins after appeal period ends Flores-Turcios v. Blanche, No. 24-1338 (4th Cir. July 16, 2026)nexus; gang recruitment; extortion; CAT review – fact and law; Guatemala Montesinos Cisneros v. Blanche, No. 23-1090 (4th Cir. July 17, 2026)admitted in any status; LPR cancellation of removal; DED; admission; statutory interpretation; lawful and unlawful statusKurzban Kurzban Tetzeli and Pratt P.A.Immigration, serious injury, and business lawyers serving clients in Florida, California, and all over the world for over 40 years.eimmigration"Immigration law software you'll love to use."get.eimmigration.com/IRP Gonzales & Gonzales Immigration BondsP: (833) 409-9200immigrationbond.com Stafi"Remote staffing solutions for businesses of all sizes"Click me!Want to become a patron?Click here to check out our Patreon Page!CONTACT INFORMATION:Email: kgregg@kktplaw.comFacebook: @immigrationreviewInstagram: @immigrationreviewTwitter: @immreviewAbout your hostCase notesRecent criminal-immigration article (p.18)Featured in San Diego VoyagerSupport the show

Dr. Deb Muth 0:05What if your immune system isn’t broken, it’s just confused? What if chronic Lyme, the autoimmune condition, the food sensitivities, the exhaustion that never lifts what if those aren’t separate problems but one problem? A misfiring immune system that nobody taught how to stand down. Today’s guest has spent over 15 years doing exactly that, retraining the immune system from the inside out with a therapy so precise, so safe, and so effective that it has changed the lives of thousands of people who’d been written off by conventional medicine. Stay with me. This one changes everything.Welcome back to Let’s Talk Wellness Now, the show where we pull back the curtain on chronic illness, challenge outdated medical thinking, and hand you the real tools to heal from the inside out. I’m Dr. Deb, integrative and functional medicine practitioner, medical detective, and your straight-talking guide through the world of root cause medicine. Today, we’re going to dive deep into the immune system, specifically something called low-dose immunotherapy or LDI, and also into some hormones, chronic fatigue, and what it actually looks like to treat the cause instead of suppressing the symptoms. If you or someone you love has been told there’s nothing more we can do, this episode was made for you. Grab your cup of coffee, Settle in and let’s get to work. Now, before we bring in today’s guest, a quick word from our sponsor, and then we are diving straight in. I promise. Did you know sweating can literally heal your cells? Infrared saunas don’t just relax you, they detox your body, balance hormones, and boost mitochondrial energy. I’m obsessed with my HealthTech Sauna, and right now you can save $500 with my code at healthtechhealth.com/dr-muth-req-25.I want to start you with a story because this is one I’ve heard hundreds of times in my own practice, and I’m guessing you’ve either lived it or know someone who has. She’s 42. She’s been sick for years. Fatigue that doesn’t lift with sleep, joint pain that migrates, brain fog so thick she can’t finish a sentence, and a gut that seems to react to everything she eats. She’s been to her GP, rheumatologist, gastroenterologist, maybe even an immunologist, and every single lab comes back within quote unquote normal limits. She’s handed a prescription for something to manage the symptoms and sent home. Maybe she’s been told it’s anxiety. Maybe she’s been told it’s aging, or maybe and this one always breaks my heart she’s told it’s all in her head. That woman is not imagining it. She is not anxious and she’s not aging poorly. Her immune system has lost its ability to tolerate things it’s supposed to tolerate, and no one has offered her the therapy that could actually fix that. And what we’re talking about today with my guest has been practicing integrative medicine for over 15 years. Ty Vincent holds a medical degree from the University of Washington. He completed his family medicine residency in Anchorage, Alaska, and since has built one of the most impressive clinical repertoires I’ve seen anywhere in this field: acupuncture, Chinese medicine, environmental medicine, bioidentical hormones, hyperbaric medicine, chelation, regenerative peptide therapy, psychedelic-assisted therapy, and nutritional medicine.He lives and practices on the Big Island of Hawaii. He is married has 9 children. Oh my gosh, 9! And he has personally navigated type 1 diabetes, which, as you’ll hear, is not separate from his mission. It actually is his mission. And most importantly, he is a world authority on low-dose immunotherapy, a therapy he pioneered in 2008 and since has trained over 200 providers globally and changed the course of chronic illness care as we know it. I have had the pleasure of learning from Dr. Ty Vincent. I have had pleasure of taking his low-dose immunotherapy course when he first started back in like 2008 or 2009. I remember doing it back then and learning more about it in 2011. And this is going to be a great conversation for us. So one quick ask that I have for you guys, if this sounds like something that you want to learn more about and you’ve listened to some of our shows, please share like, subscribe. It means a lot. It helps us grow our channel. It helps us continue to provide for you different topics, different speakers, and really give you what it is that you’re looking for.So without further ado, I’d like to introduce you to Dr. Ty Vincent. All right, so Dr. Ty Vincent, this is gonna be a great conversation. We were just chatting before we went live of my training with you guys way back in like 2015, and I’m excited to hear all the new things that you’ve got going on. But introduce yourself to the audience. Tell us a little bit about you, how you got involved in this, uh, where you’re at, all that good stuff. Tyvincent 5:29Okay. I, uh, it’s a long story, but some of the highlights, I guess I was born in Alaska in the early ’70s and grew up there kind of wandering around in the woods with my dogs with no one around all day long. It was amazing. You don’t get kids don’t get that experience anymore. So you kind of learn to be an independent thinker, I think, you know, because latchkey kid, parents weren’t home till 6 and you’re on your own from early. Dr. Deb Muth 5:49That was a great time, wasn’t it? Yeah. Tyvincent 5:51I mean, I have, I have 9 children now and none of them grew up like me. And despite my effort, I mean, I’d have to basically like helicopter them out in the woods and drop them off for a few hours for them to understand what independent kids today are so dependent and parents are so helicopter that, uh, it’s changed. Anyway, I, I grew up just really liking science and really loving science, a huge nerd. And, um, and, uh, when I went into college, when I wanted to be a marine biologist and I thought that that was my passion of the ocean wildlife and all that, and then halfway through college, personal Couple things made me change my mind. It was a girl, you know, the usual. And I decided to go to school in Anchorage instead of going I was, I was transferring to Hawaii and I was going to study marine biology. And then, uh, my girlfriend moved back to Alaska where we were from. And I decided to do that instead. And then they didn’t have a marine science program.So I decided I’ll just get a biology degree and go to medical school. I’m a smart guy. I can do that, but I had no awareness of medicine. I really didn’t have any, you know, the passion some people have to be a healer and to go help people wasn’t part of the calculus at all for me. I was kind of an Asperger’s kid, so that really wasn’t the way I thought, honestly. And then I went into medicine and I was really interested in the science, the biology, the biochemistry, all the stuff, the physiology. And before I started medical school, I was reading some Andrew Weil’s books and I was, I decided to get a book on nutritional biochemistry because I naively thought that’s what they were going to teach me, right? This is how you make people healthy. You figure out how it works and you give them the things that make their body work right. Yeah. And we all know that that’s. Not been true for over 100 years now since the Flexner Report. And, you know, the rich people steered the government towards pharmaceuticals. Dr. Deb Muth 7:26Yeah. Tyvincent 7:26But that was my interest. And when I went through the first 2 years of medical school, I just really devoured all of the basic science stuff. And that was what I thought was the most important. And I honestly mastered all that. I scored in the top 1% in the country on all the exams and everything. And it was the top, in the top of my class at the University of Washington. And then you start doing clinical medical training and you discover that they don’t use any of that knowledge anymore, really, unless it pertains directly to pharmaceuticals, and that pharmaceutical research is extremely narrow and reductionist, and they only want to try to prove one little effect, and it doesn’t translate to real health. So as I got into clinical work and started residency, you know, by the third year of residency, I was like, they didn’t really teach me how to help people with chronic illness. You know, I was, I went to family medicine residency, so I was delivering babies.I was assisting with surgeries. I was in the ER. I was doing colonoscopies. I actually did colonoscopies in practice after residency, which family Doctors almost never get to do, but I’m a small town in Alaska. So I managed my own ICU patients and did everything, literally circumcisions in the office. And you’re dealing with like hospice and end of life care, just both ends, right? Pregnancy to death. And so I’d realized that if I really wanted to do the job well, which was my goal, I needed to learn other things. And in my, in my third year of residency, I actually did the extra, like, like additional training in medical acupuncture that was put on by the Helms Medical Institute then with Joseph Helms.And that was great. And I had to learn Chinese medical theory and I learned, I did the extra module on Chinese herbal medicine. And it was wonderful because I had to open my mind to a completely different way to evaluate people and illness. And I thought, okay, well then there’s got to be more. And as I went, I just became this voracious consumer of broad medical knowledge, not conventional medicine. You notice how a lot of the conventional people call it traditional medicine? Dr. Deb Muth 9:07Yes. Tyvincent 9:07Which annoys the crap out of me because there’s nothing traditional about something that’s been around for 100 years. I mean, you need time, you need like an epoch to say something’s traditional. But they’re like, no, I’m like, and then we were considered alternative medicine minded and everything like, oh, well, Well, it’s an alternative to real medicine. The vernacular in our culture really dictates thinking, unfortunately. I went on to learn functional medicine. So like 2005, I did the acupuncture training. 2006, I found the IFM and I read their entire textbook in a few months. And I went to the trainings. I was like, okay, now I know what you guys have to teach me. And then I found a bioidentical hormone therapy training course that was like Jonathan Wright and Terry Hertog. Dr. Deb Muth 9:46Terry Hertog, yes. My favorite guys. Tyvincent 9:49They were great. Dr. Deb Muth 9:50Pioneers, right? Tyvincent 9:51Yeah, exactly. And, you know, I learned what their opinions were and all that. And then you don’t really learn how to use a tool or you don’t get really get facile with something until you are using it and you’re applying it to your patients. And I went beyond that. I learned all kinds of IV nutrition. I learned chelation therapy. I joined the Environmental Medicine Academy and I learned how to do various forms of immunotherapy, eventually leading to learning LDA, low dose allergy therapy, through them in 2008. And for those of you listeners who don’t know about low-dose allergy therapy, when you learn about it, basically it’s like homeopathic dilutions of antigens.But instead of single antigens, like if you go to that regular allergist, they’ll just prick test you, blood test you, whatever, and say, oh, you react to mold, you react to chicken, you react to your husband’s whatever. They don’t test for that. I sometimes do. And they’re very narrow-minded about it. And it’s like you just give the antigens that the person tested for and you’re always missing something. With LDA, you get these huge broad mixtures of antigens, like for foods, it’s just hundreds of foods compiled into one for environmental allergens. And the reason you can get away with it is that the dilution factor is so far out. There’s no physical interaction with the body and you can’t, there’s no risk of inducing allergy, right? Whereas conventional shots might be 1,000 to 1, 100 to 1 dilution. We’re out at like a billion to 1 or further in most of these. And it sounded like nonsense to me, right? Despite all of my training I’d already had and all these things and being open-minded, it still sounded ridiculous. Pointless, right?But at least I was willing to give it a try because I had patients in my clinic, my family medicine clinic in Alaska, that had horrific allergies. Just like kids with eczema from head to toe. They look like they’ve been set on fire. Half their hair wouldn’t grow out of their head. They’re just miserable. They won’t grow. They’re on steroids. And I just thought, if there’s if this has any chance of working for these kids, I’m going to give it a try. Plus, two of my kids at the time had eczema, like persistent eczema that was really annoying. And I kids with eczema is a near and dear thing to me now. I like, I get emotional treating these kids, but, but that’s because it’s miserable for the families. Right. So I took it hard and I started treating my kids and, and, uh, kids in my clinic with LDA and it worked like magic because magic is just science we haven’t figured out yet. Right. We just, you know, some, but it was undeniable that it was working incredibly well. And then I was like, well, what is going on here? How does this work? And you learn the whole history of it. It goes back to the 1950s. I’m like, but, but it’s still so limited. There’s so much more as you start to treat patients with every tool in your toolbox, you run into these walls occasionally where you’re like, okay, everything I’m doing now isn’t working. And this patient has some kind of chronic inflammation, which is a very general term.People go, I have inflammation. Yeah, yeah. What we all do every day, all the time. But they would have these chronic inflammatory disorders that really seem to be immune driven. And then I thought, well, in terms of understanding low-dose allergy therapy, if I can identify what the target antigen really is that’s underlying this patient’s condition, and I can restore tolerance to that, which is basically how LDA works, then you could resolve it. And so I set about experimenting with all kinds of autoimmune disorders. I mean, at the time, LDA and the predecessor therapy called EPD, they had a few bacterial antigens, and we knew that there were connections between like rheumatoid arthritis and the bacterium Proteus. So that was in one. Klebsiella was the target antigen for ankylosing spondylitis. I’m thinking, well then, what about all these other autoimmune disorders? So I started just treating people creatively and trying all kinds of different things. Luckily, I had a contact in Orange County who had a warehouse, like a biomedical sample warehouse, and he was willing to give me antigen mixtures almost anything you could imagine in the biomedical world.The first thing I had him put together was Candida. I found those of us in the medicine space realize that some people have this huge problem with Candida. The conventional medical world thinks, well, yeah, everybody’s got Candida. That’s not a thing unless it’s an infection, blah, blah, blah. But you see these patients that are super ill, persistently ill, and you give them antifungals because you think, okay, well, you have these red rashes and itching and constipation and fatigue and muscle pain, blah, blah, whatever. It sounds like a yeast problem. Some of them, interestingly, if you do stool analysis, they show no yeast on their stool, which is a clue to me with a different thinking process that the reason the yeast isn’t growing in their stool is their immune system must be attacking it and killing it off in the gut, right? Because who doesn’t carry Candida? So the, the tests that run those are the stool company the test the companies that run the stool test, they don’t flag that result as abnormal because, yay, good, you have no yeast. But it’s horribly abnormal, right? Like if you saw somebody with no, no ears, you’re like, that’s not right. And so I thought, well, maybe they’re immunologically hypersensitive Candida. And so I, I was able to purchase a mixture of Candida species. And it occurred to me that I should include Saccharomyces cerevisiae in there because baker’s yeast and brewer’s yeast, people become sensitive to that too.So I made this and some of the patients that I was seeing where I would put them on Diflucan and Nystatin and all their symptoms would just evaporate, right? But you try to stop the medications after a month or whatever, and within 48 to 72 hours, their symptoms are right back. And that was one of the things, another clue to me, like, well, then that’s not an infection. I mean, they’re not taking antibiotics. They’re not eating a ton of sugar. Why would this regrow? And one of my criticisms of our integrative medicine world is we have just as many fairy tales and dogmatic beliefs as the conventional medical world. They’re just more colorful. Dr. Deb Muth 14:59That is true. That is very true. Yeah. Tyvincent 15:01And people were saying, oh, well, it’s because Candida lurks and hides in these nooks and crannies and corners in your body. And I’m like, I’ve done colonoscopies for years. I don’t know what you’re talking about. Like, it’s sparkling clean in there after some Go Lightly or whatever you torture your patient with the day before a colonoscopy. I was like, well, that doesn’t make sense. And they’re like, well, it’s because Candida uses mercury as a weapon to fight off your immune system. I’m like, you’re anthropomorphizing this organism as if it had agency to make tools, right? It doesn’t make sense. So then I came up with this idea to desensitize people to Candida. And it was incredibly effective.These patients, when you find the right dilution, you know, and for those who don’t know, it’s just a couple of drops of water put under your tongue, taken out of a syringe from multiple different dilution steps of the mixture, whether they’re using, right? So these people would respond. Most things I’ve developed, people respond. Somewhere near a trillion to one mathematically. And it was incredible. And I was like, okay, this is something that I’m sure relates to other chronic illness problems. And I started experimenting with I had a couple of patients with inflammatory bowel disease, ulcerative colitis, both of them early on. That was 2009. And I was like, well, they didn’t respond to the yeast mixture. They didn’t respond to the food mixture. And I was like, well, they’re reacting to something.And presumably that something is living in their gut. Right? I now know people react to different bacteria. There’s a ton of different bacteria and other organisms in your stool. So I came up with the crazy idea after seeing Dr. Bill Ray at an environmental medicine meeting talk about what he called autologous vaccines. Dr. Deb Muth 16:29Right? Tyvincent 16:30And I want to be clear, the way a vaccine works is probably the total opposite of how LDA works. It’s not the same thing. You’re restoring tolerance with LDA, LDI, and you’re promoting a robust immune reaction to a target antigen with a vaccine. At least that’s the theory. And now I’m not. It’s true. But Dr. Ray was talking about that and I thought, well, that’s a cool idea. And I went up and I asked him like, how do you do this?How do you make these things? And he kind of gave me like a very brief, you know, brush off. He didn’t know me very well. He’s like, oh, you get these Millipore filters, these little things you put on a syringe and you can dilute something and pass it through into a vial and it’ll be a sterile solution and you can dilute it. I was like, oh, great. So I collected one of my ulcerative colitis patients’ stool who was having at the time like 12 bloody bowel movements per day, every day. He’d seen all the conventional gastroenterologists. He tried the different drugs. They weren’t working. He went to some really special integrative greater clinic in California that primarily dealt with gastrointestinal disorders, and he did everything they wanted him to do, and it also didn’t help.I did discover that he was sensitive to gluten, and when he went off gluten, his, his gut still didn’t improve. So I made this autologous stool, um, LDA I called it then, which now I change it to LDI because LDA is a proprietary term and it’s also very narrow in scope. And I gave him doses and looked like the second dilution maybe that I went through hit. Literally his, his diarrhea and bleeding stopped overnight. And by 3 days he was having completely normal stools and no pain, nothing. And that taught me a couple of things. One, this theory works, right? And two, you know, we talk about the concept of leaky gut in the alternative medicine world, like integrative medicine world, sorry, a lot.And I’m like, yeah, but that’s not a diagnosis. That’s a symptom. You know, you still figure out what’s causing inflammation. And people are like, I just have leaky gut. It’s chronic. And you know, what do you do? And what I found was if you just put the fire out, the house rebuilds itself. Health very quickly. You know, we know that the lining of the gut turns over extremely fast. That’s why it is one of the first things to go when you do chemotherapy. And these people were basically healed to normal within less than a week. Same thing with kids with eczema that had these horrible oozing, weeping skin patches. Dr. Deb Muth 18:25I would. Tyvincent 18:25Or psoriasis even. When I developed some things that would treat psoriasis later on, you, you give this person with just, you know, deforming sort of rashes the right antigen, within 3 to 5 days they have normal looking skin except for maybe residual depigmentation or scarring if but it just blew me away. Dr. Deb Muth 18:42That’s crazy. 3 Days. Tyvincent 18:44The key to solving these problems was to restore immunological tolerance for the thing that it had lost tolerance for. Dr. Deb Muth 18:50Right. Tyvincent 18:50And it just really made me think about everything we were taught about chronic illness and everything we’re taught about the immune system in a very different way. And so since 2009, I’ve developed I’ve continued to develop new mixtures for new things because I run into patients. I can treat so many more things now highly successfully than I could before, but there’s still always the failures. People would ask me over the years, you know, why did you pick up all these skill sets?Like I learned acupuncture and Chinese medicine. I learned bio I became a Reiki master even, because I’m like, well, energy is a thing too. And so I get into the energy medicine world and that also works. And especially if you add it to acupuncture, it’s a great combination. All this stuff. And I would still fail. And I, it occurred to me when people ask me the question, like, I’m driven by failure. I really don’t like it. And I said, uh, and I thought that was how everybody believed, you know what everybody thought, right? But then you when you study our conventional medical colleagues and a lot of our people in the integrative medicine world too, that are doing the same things, the same protocols.And I hate the word protocol because it’s a poor substitute for thinking, right? It’s so that you don’t have to think here, follow this list, but everybody’s so different. So I never developed a protocol for anything to this day. I don’t, that’s not what I do. I was like, despite all of this, their patients aren’t getting better either. And it’s like, well then, you know, just philosophically, which I was a big philosophy student in college too. I thought if, if what you’re doing doesn’t work, do something different, you know, make new mistakes, figure things out. And I just got really creative. And by now I have, my gosh, I have 100 different kinds of antigen mixtures. And to be very honest, half of them have never worked for anything because that’s how it works, right? You got to. Dr. Deb Muth 20:17You’re trying it. Geez. Yeah. Tyvincent 20:19You’ve got to be willing to be wrong if you ever want to be right. One of the things I’ve noticed about humans in general is they’re very unwilling to see when they’re wrong because it’s emotionally painful to let go of something that has maybe been a part of your self-identity or especially like when you get experts in a field and they’re famous for some theory or treatment or whatever they developed, even if evidence shows up later, which it inevitably does, to show that what they’re doing isn’t complete, maybe not wrong, but not complete, there’s huge resistance, right, to the change. Dr. Deb Muth 20:49No one will admit that there’s something that didn’t work initially when they thought it did. Tyvincent 20:54Right. And nobody wants to admit I’ve been doing something wrong or ineffective or less than it could be for 20 years. You know, that’s unsettling. But to me, I’m like, well, isn’t it worse to keep doing it wrong? Right? Dr. Deb Muth 21:06That’s the whole idea. Like, right? We’re supposed to be bettering ourselves. Medicine’s supposed to be adapting and changing, and we don’t. Like, there’s a lot of things that we still do the same way we did in the 1950s and ’60s. Cancer treatment is one of them, right? We don’t really do anything different than we did back then. And when you look at precision medicine, we have all these new tools, but people stay stuck in their way of doing things just because maybe it’s easier, they’re comfortable or whatever. It doesn’t always make it the best interest for the client. Tyvincent 21:36No. And that is the goal we all need to keep in mind. Dr. Deb Muth 21:38Yeah. Tyvincent 21:39What I thought was like the job is to fix the problem the person has. And if the tools you currently have don’t do that, you need to learn something else. Dr. Deb Muth 21:48Yeah. Tyvincent 21:48And eventually I got a little saturated with learning new things. Dr. Deb Muth 21:51I’ve been there. Tyvincent 21:54Turns out there’s a limit. You know, we use the term drinking from the fire hose for everybody who like comes, like conventionally trained doctors who first get into the integrative medicine world. You’re just like, what are you talking about? It’s all so foreign and new. And then you have to use it and realize, okay, there’s, there’s a lot of truth here. But I got to a point where it’s like, I just don’t have the time in my day to use every tool. Like I bought an Indigo machine. I don’t know if you’ve heard of it. So the old EAV technology from Germany long ago, electrodiagnostic things and Then they developed computer programs and software that could analyze 11,000 different frequencies. It’s all energy frequency based. And I bought one of these for like $25,000. I still have it in the case collecting dust because I just didn’t have time to learn how to use the tool. And I was like, all right, I got to just get really, really good at some things and then let my colleagues who are good at other things help people with the things I can’t treat and I’ll tell them where to go. You know, it’s a collective, it’s a team effort. Dr. Deb Muth 22:47Right. It’s got to be a team effort. I’m curious what you’re finding these days with the newfound for mass cell, right? MCAS, everybody’s problem child, and nobody has a good answer. And it’s, it’s an immune reaction, right? It’s not just that I’m allergic to everything situation. Back in the day, 20 years ago, you and I would have called these the chemically sensitive people, and now we at least understand what’s going on. It’s an immune reaction. But I’m curious what you’re finding with LDI and that population of people. Tyvincent 23:19It’s a really good question. I know, I know you’ve had other interviews where people have discussed it philosophically to start the conversation. I really have found over the years that a diagnosis is the least helpful thing you can give your patient. Dr. Deb Muth 23:31Agreed. Tyvincent 23:31But we love labels. We love names. And we, and the problem is when you give something a name that does not reflect what’s actually going on, it just leads everybody’s brain in the wrong direction. And so there’s nothing wrong with these people’s mast cells. And that’s why I’m like, I despise the term mast cell activation disorder, but It is okay that they may be the end of the line releasing histamine and whatever, but a lot of these people have tons of inflammatory symptoms that have nothing to do with histamine, right? There are lots of mechanisms in the immune system that can give you cell-mediated inflammation or humoral, like antibody-mediated inflammation, different things. And mast cells are kind of an IgE thing, but it’s way more complicated than that.And when you work with these people, because a lot of them have found me because they have a very difficult time finding answers and solutions. I’ve been at most of us in this field have been at the bottom of a funnel where the options decrease because you try more and more therapies and they don’t work and the desperation increases kind of inversely proportionally. And then they’re trying weirder and weirder things that like people think are bizarre, you know, like you can eventually sting yourself with 20 bees a day, do apitherapy or something. Dr. Deb Muth 24:36I remember that therapy. And you know, as a practitioner too, it becomes more and more frustrating because it’s like, I’m trying all these things and nothing is working. What am I missing? And you keep trying different things until they just give up on you or you give up on them or whatever ends up happening, you know. Tyvincent 24:52Right. But again, like philosophically, every failure should lead you a step closer to success. Dr. Deb Muth 24:58Yeah. Tyvincent 24:58If you can look at it and you can learn from it what is possible from it and go, okay, I got to do this different or change this, or perhaps my entire theory about this problem is just dead wrong. Yeah. So if what I think is happening isn’t what’s happening, what else could be happening? And then you, you know, you come up with a theory and then you have to devise a way to test test it. And so like a lot of people probably tossed around theories about things being immune related or whatever over the years because it becomes a little obvious at a certain point, but they didn’t have a tool to test the theory.So that was the, the unique position I found myself in from 2009 onward was I’ve got a way to test this if I can figure out what antigen to try. And so I got a lot of mast cell people with that diagnosis. And, you know, my assessment of the problem is that when they come into my office, because like you and like most of people that are kind made it a little further in the integrative medicine world. The patients that find you have already seen 20 of your colleagues at the Mayo Clinic and the Cleveland Clinic and Germany, like Mexico, whatever. They’ve had exosomes infused up their nose or whatever. Like, all right, so what has not been explored yet? And you got to realize, okay, these, these people are there’s something going on. It’s very inflammatory. It’s probably immune related, but where is it coming from? Again, you mentioned root cause. You’ve got to trace the steps backward and try to figure out where is the point of intervention that will actually work and that’s feasible. And so what I found in these people, most of them have a pretty common early story of having had one or a few immune reactions that first began the process. And they might’ve been fairly benign and not that big of a deal.And then they go through some kind of immunological stress, whether it’s, well, some kind of stress, whether it’s a direct immune stress, like a vaccination or an infection or something like that. Like with COVID I’ve had an equal number of people who developed chronic immunological disorders after having the virus infection or having the vaccine. And the things that develop are virtually identical. So people are like, I should be gotten the vaccine. I’m like, it really doesn’t make any difference. Dr. Deb Muth 26:53Right. And I’ve seen the same thing with the HPV vaccine too. Like a lot of young people, they get that and all of a sudden their whole system is torn off after that. It’s very common. Tyvincent 27:03Except in that example, just getting HPV doesn’t do it. It’s the vaccine that does it. Dr. Deb Muth 27:07Vaccine that does it. Yes, exactly. Tyvincent 27:10Because everybody’s got HPV, you know, some other, and that is not in and of itself enough of an inflammatory trigger to lead to these chronic illness, right? You can lead to cancer, sure. Which is focal and it’s not a hypersensitivity problem. It’s a failure of immune defense problem. It’s a little different. So I would get these people and I’m like, okay, what happened first? What’s the beginning of the story? Because if you talk to them about how they’re feeling today, and a lot of your listeners, this will resonate with them. If I ask you how you’re doing today, the real cause of your problem is buried under a snowstorm of constant inflammation and your life experience is utter hell. And you have no clue what’s really triggering anything anymore. It’s like at a certain point, the immune system has developed PTSD, right? It’s just, it’s hypervigilant. Anything you give these people to take, even like vitamin C or whatever, then they go, ah, it made me worse.Ah, it made me worse. Because their immune system is now seeing anything foreign as an invader, as an enemy. So if you ask people just about how they’re doing today, you get absolutely nowhere. With these people. The one theory I had though was, well, maybe they’re reacting to histamine itself. Okay. I think is a beautiful theory. Makes total sense. Didn’t work at all. Spoiler alert. It’s not that it doesn’t work. It’s easy to get a sample of histamine, you know, and I also, I also got histidine, the amino acid from which it’s derived. I’ll say I’ll just put them together. So at least I want to say 12 years ago, I made like a histamine histidine LDI and everyone who had kind of the mast cell picture portfolio of illnesses, I would try it on. It has to this day, it’s never worked for anybody that I’ve tried it on. And I haven’t had another LDI practitioner tell me that it did. But again, that failure made me think about it in a different way. And so the success I’ve had with that population is not monolithic. It’s not one part. From an LDI perspective, figuring out what it is that they began to react to first, like, did you still have, do you have food problems originally?Oh yeah, I was kind of sensitive to gluten, but I just ate it anyway because I would just get some diarrhea and some, okay, it it was, it was livable, right? But they just keep exposing themselves to this trigger. And eventually something snaps in their immune system. Like they live in a moldy dorm room for 6 months and that all of that immune activation will kick off whole new immune response problems. And the world of mold is another area where I think people don’t, do not really understand what’s going on. And a lot of our treatment approaches don’t work for a large portion of these people. And it has to be kind of thought of in a broader sense. They could go through a divorce. They could have a car accident. They could have a surgery. A woman could have a baby, which is one of the biggest immunological triggers, unfortunately, is having a baby or early pregnancy miscarriage even is enough to do. Emotionally stressful. It’s physically stressful. It’s immunologically stressful.And then it swings your estrogen back up and you get this hypersensitive profile. But so all of these, what I call catalytic events were common in these people. And it’s not just one, it’s any one of them. And what I found was if I could identify what their initial triggers were categorically, right? Environmental things, chemical things, food. And if I could desensitize them to those, everything would settle down. And, and that was, that’s been the key to working with those people. But they want to tell you how horrible their life is today. Dr. Deb Muth 30:17Yeah. Tyvincent 30:17And you got to listen to that because you need the connection. You need to understand what they’re dealing with. You need to understand what their baseline is so that you can compare going forward. But the answers, the solutions aren’t in that story. And the solutions are in the history. And like, what’s the first thing you remember? And all this, like, okay, well, let’s go with foods. Let’s go with chemicals, whatever. And if somebody has distinctly worst triggers, right? Because right now they react kind of to everything. Any foods that you absolutely don’t eat because they give you the absolute worst reaction pattern, right? Oh yeah, I can’t eat these things. They’re the worst. Okay, well, maybe we’ll start with those and you can use those foods as your test exposures to determine if the dose works each time. So that’s one of the things I’ve developed stylistically over the years is the use of a test exposure if we’re using an allergen extract so that you can confirm or deny whether the therapy worked, right? Because people will tell you, oh, I feel better.Turns out that’s not worth much. You really need like, I mean, And belief is a huge part of that. Placebo effect is a huge part of that. You want to find something relatively objective, you know, so will you still vomit when you have chicken? You know, cause that’s like, that’s pretty obvious. And then go with that, you know, or do you still get a rash when you put on a bandaid? I love it when people get rashes from contact cause they can show me pictures and it’s not subjective, turns out. But even those reactions can go away 100% with placebo doses. It’s fascinating how people respond to placebos. So anyway, I try to find like the root beginning allergens. And then a lot of these people also accumulate other target antigens as they go through their process of being ill. Their immune system is so upset and it’s, it’s also just blurry vision, right? It attacks anything. Angry dog on a chain. If you get close enough, it’ll bite you. It doesn’t care who you are. And that’s how their immune systems get.So finding the antigens that are root cause is key. But a lot of these people have developed over time total adrenal burnout. Out, right? Because they’re in state of chronic inflammation, everything. So I also found that I had to lean on my skill in bioidentical hormone therapy, which over all the years I’ve been in integrative medicine, the two major skill areas that gave me the best results in general were hormonal management and immunological modulation. I got so many of the prior failures I was able to solve with those two things. And so if I would support these people’s adrenal, like hormones, you know, DHEA, cortisol, to optimal levels, a lot of them, their symptoms would cut by half, number one. And you would have a little more clarity as to what their actual triggers were.So in a lot of these cases, I learned to start with that before I even decided what antigens to pick. You can kind of get the snowstorm to calm down. You can start to find the snowmen in the blizzard that you couldn’t see before with all the chaos. I was like, okay, now that you’re feeling better most of the time, you can tell that these chemicals bother you, that mold exposure bothers you, that whatever, and then you can target things But the other third kind of leg of the tripod that I found are the keys to success with our most complex patients is to address like the hormonal issue, the immunological issue, but the subconscious fear response, the subconscious stress response in them. Dr. Deb Muth 33:14Trauma. Tyvincent 33:15And I saw that you’ve also people, yeah, trauma and people have medical trauma, not just trauma from their illness itself, but trauma from seeing 12 doctors that treated them like they were a head case and ignored what’s going on. Dr. Deb Muth 33:25Of the medical community, right? Tyvincent 33:27Oh God, you know, like people— yeah, the more doctors you see, the more your trust in doctors goes down. Dr. Deb Muth 33:34Yes, exactly. Tyvincent 33:35They see one of us and some of them just automatically are like, whatever, here’s another failure coming my way, kind of thing, you know, realistic. Partly because it becomes too risky to have hope, right? Like after a while you’ve had hope, hope, and it’s been dashed, and you just can only handle that so many times. It’s like you fall in love and then they dump W. And after a while you’re like, I’m celibate. I don’t care anymore. Um, so you get these people and what we have found, my wife and I started doing psychedelic-assisted therapy with patients a few years back. In fact, this little cottage on my property we built specifically for that purpose. People can come and stay here for a couple of days.There’s a bedroom on the other side of this wall. And we do therapy with them. We have a very good process of getting their hormones tested before they come, trying to correct any deficiencies or imbalances, especially cortisol and DHEA. We try to make sure that if they have immune problems that seem manageable, we maybe try to control those first. But in a lot of these people, we have to get their subconscious fire alarm to go off first because anything new that enters into their sphere of existence is seen as this, you know, scary thing. Dr. Deb Muth 34:36Yeah. Tyvincent 34:36And so what we found is getting their subconscious to settle down, getting them to integrate past whatever trauma they’ve had so that it’s no longer causing harm today from an experience 20 years ago, right? Because that’s not fair. A lot of these people, all of their immune stuff stops and I don’t even have to do LDI. And that’s fascinating. And some of them, we put them on hormone replacement, everything calms down enough. It’s like one of these things sometimes works. And in other people, they need all three. And the trick in those people is to figure out what thread you have to pull on first. You know, it’s like, well, okay. And we spend a lot of time, my wife and I both work with patients together. She’s amazing. She’s not a trained clinical clinician. You know, she had a business degree, but she’s like, she tells people I attended the school of Dr. Ty Vincent for 10 years. Dr. Deb Muth 35:20Yes. Tyvincent 35:21Heard him say all this a million times. And when we first started seeing patients from home together, she read all of my patient notes and just great. So she. Dr. Deb Muth 35:28Yeah, that’s how you learn. Tyvincent 35:30Yeah. And people like, well, I didn’t go she’s like, I didn’t go to medical school. I’m like, that’s an asset, trust me. Dr. Deb Muth (35:34-35:40)Exactly. Oh my God, you haven’t been brainwashed. Exactly. Tyvincent 35:40And you know, it’s not even so much washing as it is like throwing mud all over the walls. All of these false beliefs you’re given, and, you know, not just the beliefs, but the disbeliefs, both of those hold people back. And I was like, it’s your disbeliefs that are the bigger problem because you don’t even realize they’re there. Like when I learned about LDA, I’m like, that’s nonsense. No, it’s not. Dr. Deb Muth 36:02I’m curious, when you treat some of these complex people with LDI, are you using multiple modalities at one time, or are you being really cautious with them and using one at a time? Time, because some of them won’t let you do more than one thing at a time with them. Tyvincent 36:16And so by modalities, you mean like, are we also doing hormone therapy? Are they also doing like IV, like other things? Or you mean multiple antigens within? Dr. Deb Muth 36:24Multiple antigens, yeah. Tyvincent 36:25Um, it really depends. And early on, so I everything I know about LDI, I learned through experience, paying attention, putting connecting dots over you. And it’s been been a very long process, right? Early on, like a kid in a candy store, you see a patient and you find out, oh, they’re allergic to some foods, they’re allergic to some chemicals, they’re allergic to cats and birch tree pollen, and they also have psoriasis or whatever. And you’re like, ooh, I’m going to give you all 4 of these antigen mixtures because you have all 4 of these issues. And by 6 months in, if you’re paying attention, you are completely confused and lost. Dr. Deb Muth 37:03Yeah. Tyvincent 37:04I did that for a number of years and I thought, well, this will be the fastest way to figure things out. It turns out it’s not, unfortunately. Um, what I’ve found is more successful is if I can figure out either what the most important underlying immune reaction is for them that might be cascading into other problems, or you figure out what’s the easiest one to solve first. So if somebody has like the whole mast cell picture and they got all this stuff going on, but they say the biggest thing is I have horrible chemical reactions. I’m a tr I’m trapped in my home. I created an oasis of safety here, but I can’t go anywhere. Anyone who comes to my house has to go into the entryway and take all their clothes off and put on a jumpsuit, right? There are those people. I work with them. Dr. Deb Muth 37:40Oh yeah, I have those clients. Tyvincent 37:42They’re like, oh my God. Well, if we can fix that first, your world will open up a ton. Your fear will come down. Your immune response will come down. And so sometimes it’s a matter of which one seems the most important or which one seems easiest. Like, okay, the test exposures that they have are the most obvious and distinct. For foods and not chemicals or whatever. And the reactions people have to these different antigens can overlap tremendously or even look exactly the same, which is why you kind of need to use one at a time. Because if you’re trying to ride a bike and a motorcycle at the same time, it doesn’t go so well. Dr. Deb Muth 38:16Yeah. Tyvincent 38:16Like, let’s find where you do with where you respond to this one, and then we will have less stuff to deal with. We might have a little bit more clarity as to what you’re reacting to in other categories. And then you kind of go through them sequentially. But if I have somebody who’s not like just in a real state of immunological distress like that, and they go, yeah, I’m allergic to cats and I have a cat because I’ll never get rid of my cat. I don’t understand those people, but, but there are a lot of them. They love their cats. Dr. Deb Muth 38:43A lot of them. Yes. Tyvincent 38:44I’m like, okay, or dog, you know, I’ve had people that are horribly allergic to dogs and the dog still sleeps in bed with them every night. Dr. Deb Muth 38:50Okay. Tyvincent 38:51Um, they’ve got that, that’s very clear, very distinct. And it’s, and it’s like a rash or a runny nose. And then they also have have celiac disease, let’s say. Like, well, we can treat both of those at the same time because the symptoms are totally different. You have test exposures in both categories and you’re not so sick that you’re in a constant state of like trauma response where you can’t even pay attention to anything. Right. And so it’s kind of case by case. And my style is very, very individualized. Like I said, there’s never a protocol. It’s like, I got to talk to people for about I usually talk to people for about an hour. Yeah. More than isn’t really helpful. You know, like, in an hour of time, you’re, you’re kind of saturated with how much you can invest your bandwidth into this particular issue. Now, like, okay, I know where we’re going to start. I don’t know where we’re going to end up, but I know where we’re going to start. And so we encapsulate that and then go, let’s do this. And then everything you do teaches you more about what else you need to do.And it’s a process. I my ego used to be more tied to guessing correctly at the beginning about what was going to work work and to fixing things quickly. And over time I realized like your ego really has no place in the exam room. Like that is a very, very challenging thing for practitioners to try to figure out is how to get your ego out of this because it biases you intellectually, emotionally, and it’s a problem. And our medical colleagues probably have bigger egos than the average human in the population. Let’s be honest. Um, there’s something that comes with the years of study and the investment and the status you have, and it’s a challenge. But if you be like, I just need to be clear about what’s happening, what’s not happening, and you figure things out. And so I was able to have a much better success rate approaching things that way.And every time you put out one little fire for people, one kind of immune response, it, you, you get a better picture about what else is going on. And then eventually all their problems have stopped and you’re okay, cool. I guess we’re done. But it’s, it’s hard. And you do learn that there are still major gaps in your knowledge. And, and you asked earlier about new developments in LDI. And whatnot. And I could literally talk all day about the things that I’ve developed over the years, but I still keep making new antigens. So just last year in the area of food allergy, so like your Mast Cell people, a lot of them have food allergies that are a big part of the underlying problem, and this will be relevant to them. But what I found is a lot of the people who seem to clearly react to food, and I put food in quotes because most of what Americans eat isn’t food, right? It’s it’s at least it’s not just food, or it used to be food and now it’s not. It’s like Frankenfood, and it’s got chemicals in it. It has molecules that don’t exist in nature, so you can react to them.So I found some of these people that would say, oh, I react to processed food items horribly, but if I eat the whole foods, organic whole foods at home, I don’t react. And, um, some of those people will resolve those problems with the chemical LD mixture. So they’re reacting to chem with that. A lot of them will tell you, oh, I also react to perfume. Or gasoline or whatever. Dr. Deb Muth 41:46Yeah. Tyvincent 41:46Okay. And so you can use that and some of those cases will resolve, but a lot of them don’t. And I had increasing failures. Like I’ve been doing this long enough to see and observe that early on I had much better success with these antigen mixtures than over time. People are the pattern and the causes and the manifestations of illness today are evolving right before our eyes because of what we’ve done to our environment and our food and ourselves. So what I came to to sort of theorize about was that maybe some of these people are reacting to processed cooking oils, like seed oils, plant oils that are put into processed foods, right? Because they would tell me a couple of key cases gave me that insight. They would say, well, I still react to all these processed foods.I can’t eat at restaurants, and I’m still reacting horribly to sesame seeds, or I’m still reacting horribly to flax, or I’m still reacting horribly to, like, one of these other things we make processed seed oils from. Well, maybe they’re reacting to the oils. And when we made the food mixture, you use whole food samples, right? So you use like a, a ses like sesame seeds, or I use tahini paste because it’s easier to mix in water. But maybe the antigen, the target antigen, is something inside that that is not properly like, what’s the word I’m looking for properly given to the immune system, or, or like exposed, shown to the immune system, right, in the way that their immune system is reacting to it. Maybe it’s a molecule in there that when you use a whole food antigen is not adequately represented. It’s like, so an oil would do that.And I had actually already years ago realized that some people react to essential oils, like flower extracts or tea tree oil or lavender or whatever. Right. And so I made an essential oils mixture from plant oils from the doTERRA and the Young Living products. I had a couple of patients that were like distributors for these things. And I said, just take an empty vial and put one drop of every single product you have in it and just mail it to me. And they both did that. So I have this huge compendium of essential oils, and I would get people that would still react to oranges and lemons and citrus fruits despite the food mixture. And then the essential oils mixture would totally stop that reaction. So I’d already kind of proven that this was the case with some of those more aromatic oils, right? Now I was like, well, people are reacting to the processed cooking oils because when you take oils out of the plant, if you ever do this at home, they’re opaque and gooey and viscous. And then somehow it’s this really pretty homogeneous, clear liquid that doesn’t separate at all. It has no nothing you see in there.And then you got to wonder, how the hell did they do that? What did they do to make that? And there are all these chemical processes and heat and everything. I’m like, well, it just makes new molecules that your immune system has never seen before. So in May of 2025, I bought 18 different kinds of plant oils, and some of them are really pure, like carrot seed oil, cottonseed oil. But there’s peanut oil and avocado oil and olive oil and, you know, all the seeds and things we use in there. And I even have a video on our Facebook page and probably Instagram of me making this mixture in my kitchen.I was like, people are kind of interested how this works. And I just made it right there on camera because it’s really simple. I started using it in some of my failure cases that had really seemed like they had food allergy responses, but the food mixture didn’t work. And the first one was actually one of our employees who does our social media management. She had a 3-year-old son, I think, probably 2 years old when we started working with him, with really bad body-wide eczema, right? And he never really responded to the food mixture, essential oils, skin bacteria, skin fungi, yeast. I tried all the things that usually work. I’m like, it’s something. And so he made the oil mixture. He was they were the first one. I just sent the doses like, hey, let’s check it out. And I think he got for I started 6C for most things, which is a truly and then it’s like 5.5C, 5C. We got to 3.5C, I think, is where he is, which is a dilution of of 10 million to 1, I believe. And 95% of his eczema just completely went away. Dr. Deb Muth 45:38Wow. Tyvincent 45:39The only thing left was a couple of those patches on his feet. And one of the things I learned about people with eczema is they will have localized, like geographically local consistent reactions to different things. This is crazy, right? Dr. Deb Muth 45:53Yeah. Tyvincent 45:53Your immune system has kind of a, you know, like an overall regulatory system, but it also has regionalized systems, just like the government federal government, state government, county government, city government. It’s, it’s divided like that. So the people will eventually learn, oh, if I eat gluten, I get these itchy bumps on the side of my hand, and if I eat carrots, I get a rash on top of my head, you know. And it’s very, very clear once you identify it. So there’s still something that kid’s reacting to that I haven’t quite solved on his feet. But, um, yeah, that worked amazingly, and it actually made me cry when I got the pictures She’s like, oh, finally, after probably a year and a half of flailing, you know, we got it right. And so now I’ve been using the cooking oils mixture more and more and more. Just yesterday I got an email. I have a teenager, he’s 8, he’s maybe 18, 17, 18, with just really horrible cystic acne, painful, erupting. And the before pictures are just hard to look. I mean, he’s got horrible involvement of both sides of the face, the chest, all over his back, and you can just see the scarring and the redness and the inflammation.And we went through the food mixture with him and whatnot, and it really didn’t touch it. So yesterday I got the report. He got up to the cooking oil mixture at 2.5C, which is 10,000, 100,000 to 1, and, and his cystic acne stopped. Like, he’s getting zero new lesions. All the redness, pain, inflammation is gone, but he still has all this just scarring from it because that’s permanent, right? You have to get that repurposed. And all he has left is little tiny whitehead pimples, like maybe one new one per day here and there. You can see them now in the midst of all this. So acne is diversified. There are different kinds of acne and people can have more than one type and they can react to hormones. They can react like I’ve had guys with bad acne respond to desensitization with testosterone, for example, or women desensitizing them to estrogen or progesterone and the acne will go away sometimes. Some people respond to yeast, some people respond to skin bacteria, skin fungi. And so this is another thing. And my wife actually is one of the more complicated immunological cases I’ve ever had to work with. Working together for 10 years, um, you know, like the first time I saw her, she had Lyme disease and the Lyme LDI just totally stopped those symptoms like magic, which is great.That’s one of my favorite things to treat. Um, because the beliefs we have about Lyme disease, I have found completely untrue because using a different tool. I’m like, oh, it’s an immune problem, not an infection. So anyway, so that, that worked for her. Some of her food reactions went away, but she still continued to get like deep painful cysts if she would have nuts or dairy. And so the cooking oil mixture now, after 10 years of being together, totally stopped those reactions. Peanuts, nuts, dairy. And the dairy one is interesting to me because it’s not a plant oil, right? It’s an animal oil and it’s not represented. And we have dairy products in our other mixture. But I think what’s happening is when cows are fed grain, sometimes what an animal is eating carries through some essence or nature of that substance into the milk. Um, and the thing I’ve seen this the most clearly with is corn. Corn allergy is a very unique situation. The way people deal with it, the way it manifests, the way you have to treat it is different from every other energy. And I don’t have an hour to talk about that specifically, but I observed primarily with corn that anywhere along the food chain, you’ll still react to that food if the animal at the beginning was ever fed corn. Multiple I’ll have babies that get an eczema reaction or a GI reaction if mom eats corn-fed beef. But if mom eats grass-fed beef and then nurses the baby, they’re fine. Dr. Deb Muth 49:33Yeah, I’ve seen that too. Tyvincent 49:34It’s bizarre. Dr. Deb Muth 49:35Yeah. Tied. This has been really so amazing. Um, tell us how people can find you if, if this is resonating with them and they’re like, I need him to figure out the puzzle for me. How do they find you? Tyvincent 49:49So the best thing to do is to go to our website. Our, our business name is Global Immunotherapy, and the website is just http://www.globalimmunotherapy.com. We have, we have a much better website than we did years ago. People schedule directly through the website. Right? There’s all kinds of information. I’ve been making YouTube videos and informational videos for people for more than a decade now because nobody has any idea what I’m talking about. The more they understand it beforehand, one, they get to decide if they just think I’m crazy, right? And they don’t want to waste their time. And there are plenty of those people, but a lot end up talking to me 3 years later because after they’ve tried everybody else and there’s nothing left to try, right? Yeah, yeah, like being at the bottom of the desperation funnel. Yeah, people like, well, I heard about you 5 years ago and didn’t make sense. I’m like, yeah, cool. But then I had 3 or 4 other people over the years tell me I should talk to you. So here I am. That’s, that’s right. And people can watch all these educational instructional videos about how LDI works, what it can be used for. So the more you learn and understand what you’re getting into ahead of time, the less time we have to spend during our hour trying to explain to you the therapy., which to take up half the time and better results you’re going to get because you’re educated and it’s a partnership.Like all of us in the world of integrative medicine, one of the big differences between us and conventional medicine is we understand that it’s a partnership. You have to listen to the patient, you have to educate the patient, you have to engage them in their own health. You can’t just say, here, take this pill and come back in 3 months and I’ll check your labs again to see that you still have the same illness. It’s just and people have a lot of our population has been led to believe that just swallowing a pill is going to fix your problems. But That doesn’t work. And we have to develop a relationship and an understanding and shared knowledge and beliefs. And so people now, they have this opportunity to watch all the videos. And I really want people to do that before they ever schedule, because one, you’ll, you’ll feel like it’s the right therapy for you. And that helps a lot. Having optimism going in is super helpful. And then two, you already know a lot. So you’ll know more about what questions I might ask you and how to answer them. You’ll know more about about how the therapy works, and I won’t have to explain it to you, and we’ll get a better use of our time. And then people can schedule right through the website with either myself or my wife Jeanette. And anybody who Jeanette talks to, she reviews every case with me, and we work together with stuff. And, but in terms of like using LDI, she’s probably the second or third best practitioner in the world. I

Daniel Cormier is joined by UFC featherweight star, Dan Ige, in the NEWEST EDITION of the Daniel Cormier Show! Ige talks about taking the Diego Lopes fight at UFC 303 on four hours notice, and what made him take on the challenge. Hear what happened that day, and how Ige came to the decision to fight featherweight contender Diego Lopes. Plus, Ige talks about what it was like training with UFC GOAT Khabib Nurmagomedov and Islam Makhachev, and why he was Khabib's "favorite training partner." And don't miss Dan and DC dive into his family life, his relationship with Max Holloway, Alexander Volkanovski's title reign, trying to make a name for himself when times were tough, and so much more! #VolumeSee omnystudio.com/listener for privacy information.

Few scientists have shaped modern allergy medicine as profoundly as Dr. Thomas Platts-Mills. From pioneering research on dust mite allergens and environmental drivers of asthma to helping uncover the IgE-mediated mechanism behind alpha-gal syndrome, his discoveries have transformed how clinicians diagnose and manage allergic disease. In this special episode, Dr. Platts-Mills shares the stories behind some of allergy's most important breakthroughs, including the landmark studies that established allergen exposure as a key factor in asthma, the surprising path that led to the discovery of alpha-gal syndrome, and practical lessons for identifying allergic triggers in clinical practice. Topics include environmental exposure reduction, regional allergen patterns, skin testing versus specific IgE blood testing, component diagnostics, interpretation of sensitization, and the evolving understanding of alpha-gal syndrome. Clinicians will gain both historical perspective and actionable diagnostic insights from one of the most influential investigators in allergy and immunology.  Resources and references: https://www.thermofisher.com/phadia/us/en/resources/immunocast/alpha-gal-syndrome-dust-mite-Tom-Platts-Mills-specific-ige.html?cid=0ct_3pc_05032024_9SGOV4

(00:00:00) 222: A Tick Just Stole Your Steak. Here's How to Get Revenge (00:00:11) Welcome to the Itchy and Bitchy Podcast (00:00:42) Doc Itchy Medical Pet Supplements (00:01:13) Introducing Alpha-Gal Syndrome (00:04:51) The Tick's Deadly Spit (00:06:32) Symptoms and Diagnosis of Alpha-Gal (00:07:47) Dietary Avoidance and Prevention (00:12:56) Tick-Borne Diseases: The Scary Truth (00:15:09) Accurate Diagnosis and Treatment Challenges (00:21:39) Tick Prevention and Safety Tips (00:23:33) Isoxazolines: A New Era in Tick Prevention Ticked Off,The Tiny Bug That Could End Your BBQ ForeverTopic: Alpha-Gal Syndrome (AGS) | Tick-Borne Food Allergy | Red Meat AllergyHost:What Is Alpha-Gal Syndrome?Alpha-gal syndrome is an IgE-mediated food allergy triggered by lone star tick bites. Symptoms  including hives, abdominal pain, and potentially life-threatening anaphylaxis, typically occur three to eight hours after eating meat, making the connection easy to miss.The Diagnosis ProblemAs of 2022, 42% of U.S. healthcare practitioners had never heard of alpha-gal syndrome, meaning patients often suffer for years without answers. What You Can DoManagement focuses on avoiding mammalian meat and products containing alpha-gal, preventing future tick bites, and referral to an allergist for severe reactions. The good news: the syndrome tends to wane over time with strict avoidance. Itchy & Bitchy is the podcast for anyone who has ever felt dismissed, misdiagnosed, or gaslit by a broken medical system.  From gut health and hormone health to autoimmune disease and chronic pain, we investigate what science actually says. We examine functional medicine, holistic health, and alternative medicine with the same skeptical If it's pseudoscience, we'll call it. If it's medical gaslighting, patient advocacy failure, or misdiagnosis we'll call that too. For chronic illness warriors, self-advocacy seekers, and wellness skeptics WE OFFER  No filters. No BS. Just the truth your doctor didn't have time to tell you.Become a supporter of this podcast: https://www.spreaker.com/podcast/itchy-bitchy-podcast--4303608/support.Itchy & Bitchy: Have you felt dismissed, misdiagnosed, or gaslit by a broken medical system.  From gut health, hormones, autoimmune disease, chronic pain, holistic health, and alternative medicine ... medical gaslighting, patient advocacy , or misdiagnosis we'll call that too.  For chronic illness warriors, self-advocacy seekers: WE OFFER  No BS 

In this episode of the UConn Internal Medicine Podcast Series, we discuss the evolving role of biologic therapies in asthma and COPD. We review how biologics target Type 2 inflammation, how to identify patients with severe asthma who may benefit from therapy, and how biomarkers such as blood eosinophils, FeNO, IgE, and allergic sensitization guide treatment selection.We also explore newly approved biologics for COPD, practical differences between available agents, expected benefits, steroid-sparing effects, safety considerations, pregnancy counseling, helminth screening, and real-world barriers such as cost and insurance approval.This episode is designed for internal medicine trainees and clinicians looking for a practical framework to understand when to consider biologics, how to choose the right agent, and what to monitor after starting therapy.Hosts:Dr. Hossam Albeyoumi Mohammed, and Dr. Simran Umra, Chief Medicine Residents, UConn.Dr. Alisa Pasichnik, and Dr. Caroline McCauley, 3rd year medicine residents, UConn.Guests:Dr. Ethan Bernstein, Associate Program Director of the Department of Pulmonary and Critical Care Medicine, UConn.Dr. Angela Quental, incoming Assistant Professor in the Department of Pulmonary and Critical care medicine, UConn.Edited by:Dr. Hossam Albeyoumi Mohammed, Chief Medicine Resident, UConn.Music:LoFi Girl by Snoozy Beats | Free Music Archive | Livense: CC BY.

Three major allergy testing methods—skin prick, blood IgE, and oral food challenges—and how each one helps pinpoint your triggers. Learn when to use which test and why accurate diagnosis matters. WhatAreAllergies.com City: Dallas Address: 3145 Olive Street Website: https://whatareallergies.com

On this week's episode of Sense by Meg Faure we sit down with renowned Clinical Paediatric Dietitian Kath Megaw for the ultimate baby and toddler feeding masterclass. On this week's episode of Sense by Meg Faure we cover everything from the newborn milk phase right through to the picky toddler years, giving you practical, science-backed answers to the feeding questions that keep parents up at night.Is My Baby Getting Enough? The Newborn Milk PhaseIn those brutal first few weeks, nearly every parent wonders whether their baby is getting enough milk. Kath shares the three objective signs to look for: weight gain, adequate wet nappies, and regular stools. She explains why a crying baby is not a reliable indicator of hunger, and sets out a clear, reassuring weighing schedule for new parents.The Weaning Window: When Is the Right Time?The question of when to start solids is one of the most confusing areas of early parenting. Kath cuts through the noise with a three-part framework: the science (look for supported sitting and neck control, and wait past 17 weeks), your cultural context, and your own gut instinct. She is clear that solids are for teaching and joy, not for fixing sleep, reflux, or poor growth.Gagging vs Choking: What Every Parent Must KnowGagging is loud, active, and protective. Choking is silent, limp, and rare. Kath explains the crucial difference so clearly that parents will never react the same way again. She offers practical guidance for anxious parents and explains why an engaged, calm parent is the single best protection against choking at mealtimes.The Picky Toddler: What Is Normal and What To DoToddler fussiness is developmentally normal. Kath explains why toddlers resist variety, the role of routine and timing in appetite, and why filling gaps with non-nutritious foods can backfire. She also clarifies the milk-to-food balance for toddlers, recommending that milk account for no more than 25% of their total daily nutrition.Myth Busting: Allergen IntroductionKath busts one of the most persistent myths in baby feeding: the three-day wait rule between new foods. Current evidence supports introducing allergen foods as quickly as every 24 to 48 hours. She explains exactly what an IgE reaction looks like and what parents should watch for in the first two hours after introduction.About Our GuestKath Megaw is a Clinical Paediatric Dietitian with over 25 years of experience and the founder of Nutripaeds. She is a consultant to the Parent Sense App and has co-authored six bestselling books including Feeding Sense, Weaning Sense, Allergy Sense, and her most recent release Mindful Meals (2025). She sits on international working groups for neonatal nutrition and the ketogenic diet.Find Kath at nutripaeds.co.za | Instagram: @kath_megaw_paed_dietitian Episode References and Links

Dr. Ruchi Gupta, board-certified pediatrician and founding director of the Center for Food Allergy and Asthma Research (CFAAR), and PA Gary Falcetano joined forces on a Food Allergy Research and Education (FARE) webinar to discuss nuances and insights for managing food allergies across a patient's life. In this episode we share some of the important questions that were asked about specific IgE blood testing, skin testing, component resolved diagnostics, oral food challenges, guideline updates, and common pitfalls. We also explore baked egg and baked milk tolerance, access and affordability barriers, and early peanut introduction in high-risk infants. Clinicians will leave with a clearer framework for interpreting results, selecting the right test, and applying diagnostics to improve management decisions. Resources and references: https://www.thermofisher.com/phadia/us/en/resources/immunocast/managing-food-allergies-across-the-lifespan-diagnostics.html?cid=0ct_3pc_05032024_9SGOV4

You may think of allergies as causing sniffly noses and congestion in the spring or fall. But allergies can go far beyond that. As Dr. Kari Nadeau points out in this episode, allergies can affect us from head to toe, including eyes, nose, throat, lungs, sinuses, skin and gut. In the most dangerous instances, the whole body is threatened with an anaphylactic reaction. That's a medical emergency! One in three Americans will develop allergies at some point in our lives, so it's important to know what works to control them. At The People's Pharmacy, we strive to bring you up to date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment. How You Can Listen You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, June 6, 2026, through your computer or smart phone (wunc.org).  Here is a link so you can find which stations carry our broadcast. (Welcome, Huntsville, Alabama!) If you can't listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on June 8, 2026. What Are Allergies? We begin our discussion of your allergy survival guide with an explanation of what is happening during an allergic reaction. The immune system perceives some foreign compound, usually a protein, as dangerous even though normally it would not be. So it reacts by trying to flush the invader out by producing extra mucus. The turbinate sinuses can make one to two gallons of mucus a day, and naturally, it has to go somewhere. That's why you might be congested. Having all that mucus in the sinuses can also encourage bacterial growth, so if the allergic reaction persists, some people have to deal with sinus infections. Emergency Treatment In determining what works, you need to know the nature of the reaction. If you have two or more organs involved, if you are having trouble breathing or if you feel dizzy, you may be in the midst of an anaphylactic reaction. What works for that is an epinephrine injection and immediate medical attention. This is potentially life-threatening, so you will want to figure out what triggered the reaction so you can avoid it in the future. Once someone has suffered one anaphylactic reaction, they should keep epinephrine with them at all times in case of another episode. Epinephrine comes as a self-injector pen or a nasal spray (neffy). Can You Spot Drug Allergies? In the warnings that are rattled off as part of a TV ad for a pricey new drug, we often hear viewers cautioned not to take the medicine if they are allergic to it. That sounds like simple common sense, but it also has a Catch 22 quality. How do you know you are allergic to a medication unless you take it–and experience an allergic reaction for which you might need treatment. Most of these presumably are immune system-mediated reactions, in which the body produces IgE. That is how allergies to penicillin or sulfa drugs work. Some drugs cause a different type of reaction, not IgE-mediated but dangerous nonetheless. Lisinopril is the most commonly prescribed blood pressure medicine in this country. Like other ACE (ACE is short for angiotensin-converting enzyme) inhibitor medications, lisinopril can trigger angioedema. This swelling can affect the face, lips, tongue and throat, where it can compromise breathing. The most insidious aspect of this reaction is that it can occur after the person has been taking the drug without problems for weeks, months or even years. “Red man syndrome” or infusion reactions in people taking vancomycin can likewise occur without warning. The last type of drug reaction is not actually an allergy at all, although people occasionally use that terminology. It is better described as sensitivity. For example, a stomachache is a common reaction to the antibiotic erythromycin. Some people are disabled by this abdominal pain and try to limit their exposure to erythromycin thereafter. What Works and What Doesn't? Since the immune system is acting inappropriately to cause allergic reactions, treatment should involve immunotherapy. Eye drops can help eyes feel less itchy and irritated. Likewise, OTC nose drops or nasal sprays can often help the nose. The corticosteroid Flonase (fluticasone) and the antihistamine Astepro (azelastine) are good examples. During allergy season, some people find that a daily nasal wash (with a neti pot or NeilMed device) can help reduce the mucus and remove the allergens such as pollen causing the reaction. There are also oral antihistamines and inhalers for asthma. For decades now, allergists have offered their patients shots to help desensitize them to the allergen causing their trouble. Joe had these as a child and teenager and has been largely free of allergies since. Not everyone gets such lasting relief. Complications from Current Therapies Medications have side effects, and that is true of allergy medicines as with other drugs. Antihistamines, especially the older ones like Benadryl (diphenhydramine), are notorious for causing drowsiness. That's one reason it is often included in nighttime pain relievers as the “PM” in drugs like Advil PM. We worry about regular use of such antihistamines because it has been linked to a greater risk for dementia. A second-generation antihistamine such as Allegra (fexofenadine) is much less likely to make someone feel sleepy. However, Dr. Nadeau has seen patients on antihistamines suffer worse allergies if they stop suddenly. The People's Pharmacy has received hundreds of reports from people who experienced unbearable itching upon discontinuing Zyrtec (cetirizine) or Xyzal (levocetirizine). This can last for weeks. Doctors don't usually worry much about steroid nasal sprays like Flonase because they are topical. Presumably, nasal tissues pick up most of the dose. Just the same, using such a nose spray day after day for a long time could result in systemic steroid exposure that is not trivial. Stronger Medicine Dr. Nadeau is enthusiastic about the benefits of two potent prescription medicines. One is Xolair (omalizumab). It was originally developed to prevent asthma, but is now approved for chronic sinusitis, food allergies and chronic hives. Paradoxically, Xolair is one of those medicines that could cause a severe allergic reaction even on the first dose, so the FDA warns that the initial injection should be given in a healthcare setting prepared to treat anaphylaxis. This is uncommon, though, occurring in 0.1 to 0.2% of patients. The other medication Dr. Nadeau is prescribing for allergy patients who don't respond well to other treatments is Dupixent (dupilumab). The FDA has approved this medicine to treat a wide range of conditions, including eczema, asthma, chronic sinusitis, allergic reactions affecting the esophagus and chronic hives, among other things. Most insurance companies will not cover this pricey injection unless the patient has failed all other therapies. Fighting Air Pollution: What Works Air pollution makes allergy symptoms worse, so using an effective air filter inside the home is a good step. A HEPA (high-efficiency particulate-arresting) filter is ideal, especially as part of the air-handling system. If that's not possible, utilizing a MERV 13 in the part of the home where you spend the most time is a good second choice. Sonu One new option for treating allergies is acoustic resonance therapy with the SoundHealth Sonu headband. It uses vibration from sound to loosen mucus from the sinuses so that they can clear. The FDA has approved its use for children as well as adults. New research was just published demonstrating its helpfulness in treating children with nasal congestion (Oto-Open, April-June 2026). SoundHealth has underwritten The People's Pharmacy podcast. Dr. Nadeau has also been compensated for her role in conducting studies of this device (International Forum of Allergy & Rhinology, Dec. 2025). Since it does not employ medications, there are no drug side effects. This Week’s Guest Kari C. Nadeau, M.D., Ph.D., is Dean of the UCLA Fielding School of Public Health ( starting July 1 2026). Until then, she holds many other positions. At Harvard T. H. Chan School of Public Health she is: John Rock Professor of Climate and Population Studies; Chair of the Department of Environmental Health; and Director of the Allergy, Extreme Weather, and Exposomics Lab. Dr. Nadeau is Professor of Medicine at Harvard Medical School and serves in the Division of Allergy and Inflammation at Beth Israel Deaconess Medical Center. She is an Adjunct Professor at Stanford Medical School. Dr. Nadeau is also the co-author of The End of Food Allergy, which provides strategies for treating and preventing food allergies in children. Here is a link to the research underway in her Harvard laboratory. PHOTO CREDIT: STACY GEIKENTaken in April 2017 at Kari Nadeau’s professorship dinner The End of Food Allergy: The Science-Based Plan That Turns Food into Medicine The People's Pharmacy is reader supported. When you buy through links in this post, we may earn a small affiliate commission (at no cost to you). Listen to the Podcast The podcast of this program will be available Monday, June 8, 2026, after broadcast on June 6. You can stream the show from this site and download the podcast for free. This episode has additional information about Nasalcrom (cromolyn sodium nasal spray) and its effect on mast cells; alpha gal allergy to red meat; and the latest thinking on preventing peanut allergy among young children. Download the mp3

On the Evolving Wellness podcast, host Sarah Kleiner interviews returning guest Steve about seasonal allergies, histamine intolerance, and MCAS, emphasizing that the root problem is often loss of immune tolerance driven by gut dysbiosis, leaky gut, and Th1/Th2 imbalance from factors like antibiotics, PPIs, stress, mold, and environmental changes. They contrast symptom tools—antihistamines that block histamine receptors and herbs like quercetin/ginger that stabilize mast cells—with approaches aimed at lowering IgE formation and retraining gut–immune “crosstalk.” Steve describes postbiotics and beta-glucans as “tolerization rehab,” highlighting his product HoloImmune (heat-killed strains) and butyrate (TriButyrin-X) for gut lining and mast cell support, plus DAO enzymes for dietary histamine. They discuss safety, dosing, avoiding live probiotics during flares, and examples including motion sickness, bug-bite welts, and a child's post-viral hives.— GUT HEALTH:  Healthy Gut Supplements- discount automatically applied: Holoimmune: https://healthygut.com/holoimmune-now/?rstr=811&coupon_code=Sarah15 Holozyme Link: https://healthygut.com/holozyme-now/?rstr=811&coupon_code=Sarah15 HCL Guard Link: https://healthygut.com/hcl-guard-now/?rstr=811&coupon_code=Sarah15 Tributyrin X: https://healthygut.com/tributyrin-x-now/?rstr=811&coupon_code=Sarah15 Magnesium: https://healthygut.com/magnesiumhp-now/?rstr=811&coupon_code=Sarah15 _________Sponsored By:→ VivaRays | This episode is sponsored by VivaRays - VivaRays Blue - code YOGI https://vivarays.com/→ Bon Charge | Go to https://boncharge.com/products/demi-red-light-device?rfsn=8108115.26608d & use code SARAHKLEINER for 15% off storewide._________Timestamp:00:00 Coming Up01:02 Podcast Intro Disclaimer02:15 Spring Allergies Setup05:05 Loss Of Tolerance08:02 Why Symptoms Worsen10:25 How Antihistamines Work11:59 Mast Cell Stabilizers14:20 Rewiring With Postbiotics16:20 Red Light Sponsor Break17:59 MCAS Pepcid Bridge22:11 Gut Healing Without Probiotics25:45 Blue Blockers Sponsor Break27:12 Mold And Individual Variance29:57 Antibiotics Farm Effect31:39 Dead Bugs Vs Probiotics32:40 Live vs Dead Probiotics33:25 Immune Software Updates35:28 Strawberry Hives Story36:40 Allergy Medicine Toolkit37:25 DAO Enzyme Explained40:05 Springtime Support Stack40:48 Root Causes and Triggers42:38 Immune Rehab and Tolerance45:56 How to Start Dosing49:11 Coaching Over AI51:47 Antihistamines and Acid Blockers53:56 How Long to Take It56:35 Leaky Gut and Butyrate57:39 Hidden Histamine Symptoms58:29 Motion Sickness and Bug Welts01:00:17 Wrap Up and Resources——— This video is not medical advice & as a supporter to you and your health journey - I encourage you to monitor your labs and work with a professional!________________________________________Get all my free guides and product recommendations to get started on your journey!https://www.sarahkleinerwellness.com/all-free-resourcesCheck out all my courses to understand how to improve your mitochondrial health & experience long lasting health! (Use code PODCAST to save 10%) -  https://www.sarahkleinerwellness.com/coursesMy free product guide with all product recommendations and discount codes:https://www.canva.com/design/DAF7mlgZpJI/xVyE4tiQFEWJmh_Xwx8Kbw/view?utm_content=DAF7mlgZpJIFree Webinar on Light & Health (includes free light bulb guide) - https://www.sarahkleinerwellness.com/mycircadianapp-free-webinarGet Early Access to Podcast Episodes & my Seasonal Food Course + UVB+Red Light Therapy course for free -  https://open.substack.com/pub/sarahkleinerwellness/p/uvbred-light-protocol?r=5eztl9&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true

Sponsored by Genentech, a member of the Roche Group, and Novartis Pharmaceuticals Corporation. Intended for US Audiences. This information is for general purposes only and is not a substitute for consulting your healthcare provider about food allergy treatment. Dr. Ari Zelig has been financially compensated by Genentech and Novartis for his participation in this episode. Today, I'm joined by Dr. Ari Zelig, a board-certified allergist and immunologist to unpack what's really happening when it comes to food allergies - and why so many more people are dealing with them today. If you are navigating food allergies, or if you've ever wondered if what you're experiencing might be more than just a sensitivity, this episode features an informative discussion on these topics! In this episode, we dive into the reality of living with food allergies, from the day-to-day challenges that families carry to the misconceptions that still exist around what an allergic reaction to food actually looks like. Dr. Zelig breaks down IgE-mediated food allergies, what's happening in the body during a reaction, and why early exposure guidelines for kids have changed. Plus, we discuss a treatment option, XOLAIR (omalizumab), an FDA-approved prescription medication for subcutaneous use that can help reduce allergic reactions to multiple foods that may occur after accidental exposure in people with IgE-mediated food allergies one year of age and up. While taking XOLAIR you should continue to avoid all foods to which you are allergic. If you or a loved one has been diagnosed with food allergies, talk to your allergist and ask about XOLAIR. You can also find more information at XOLAIR.com. XOLAIR is one of several available treatment options for IgE-mediated food allergy and it may not be appropriate for all patients. What is XOLAIR?XOLAIR®(omalizumab) for subcutaneous use is an injectable prescription medicine used to treat food allergy in people 1 year of age and older to reduce allergic reactions that may occur after accidentally eating one or more foods to which you are allergic. While taking XOLAIR you should continue to avoid all foods to which you are allergic. It is not known if XOLAIR is safe and effective in people with food allergy under 1 year of age. XOLAIR should not be used for the emergency treatment of any allergic reactions, including anaphylaxis. What is the most important information I should know about XOLAIR?Severe allergic reaction. A severe allergic reaction called anaphylaxis can happen when you receive XOLAIR. The reaction can occur after the first dose, or after many doses. It may also occur right after a XOLAIR injection or days later. Anaphylaxis is a life-threatening condition and can lead to death. Go to the nearest emergency room right away if you have any of these symptoms of an allergic reaction:· wheezing, shortness of breath, cough, chest tightness, or trouble breathing· low blood pressure, dizziness, fainting, rapid or weak heartbeat, anxiety, or feeling of “impending doom”· flushing, itching, hives, or feeling warm· swelling of the throat or tongue, throat tightness, hoarse voice, or trouble swallowing Your healthcare provider will monitor you closely for symptoms of an allergic reaction while you are receiving XOLAIR and for a period of time after treatment is initiated. Your healthcare provider should talk to you about getting medical treatment if you have symptoms of an allergic reaction. Please listen to the Important Safety Information throughout and stay tuned for additional safety information at the end of this podcast. See full Prescribing Information, including Medication Guide, at bit.ly/XOLPI. This episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct, or indirect financial interest in products, or services referred to in this episode. Produced by Dear Media M-US-00032583(v1.0) 5/26See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this episode, host Marcella Feathers and Dr. Nicholas Cline examine mail-in allergy tests that use hair or saliva, explaining why experts warn they're unreliable: they're often unvalidated, may measure IgG (not the allergy-linked IgE), produce confusing false positives or negatives, and can be costly. Learn why certain methods of allergy testing are preferred by the specialty and why consulting an allergist before avoiding foods or purchasing an at-home kit can save you money and keep you safe!

In this episode of The Cutaneous Connection, Dermatology Times revisits a recent video episode of the Derm Dispatch show where host Renata Block, DMSc, MMS, PA-C, sits down with Zachary Rubin, MD — allergist, pediatrician, and New York Times bestselling author of All About Allergies — to explore the intersection of dermatology and allergy. Together, they tackle one of the most persistent myths in practice: that food elimination can treat atopic dermatitis. Dr. Rubin breaks down the difference between IgE-mediated allergic reactions and the complex inflammatory nature of eczema, explains the atopic march, and discusses how understanding the gut-lung-skin axis can empower patients to take charge of their care. The conversation also covers the latest treatment advances — from JAK inhibitors to novel biologics — and touches on indolent systemic mastocytosis and the truth about so-called hypoallergenic dogs. A must-listen for any clinician treating allergic and inflammatory skin disease.For more content, visit https://www.dermatologytimes.com/

Thyroid Symptoms, Normal Labs, and Root Causes: Dr. Kevin Smith on Hashimoto's, Functional Medicine, and Chronic Conditions | Conversations with a Chiropractor Episode Description In this episode of Conversations with a Chiropractor, Dr. Stephanie Wautier sits down with Dr. Kevin Smith, a functional medicine practitioner and founder of the Chronic Conditions Center in Pittsburgh, Pennsylvania. Dr. Smith specializes in helping people better understand the root causes behind chronic health problems, including thyroid dysfunction, gut issues, autoimmunity, chronic pain, inflammation, peripheral neuropathy, insulin resistance, and other complex conditions. This conversation focuses heavily on thyroid health, especially the frustration many people feel when they have symptoms of hypothyroidism, but are told their labs are "normal." Dr. Smith explains why thyroid symptoms can involve far more than a simple TSH reading, and why many cases of hypothyroidism may be connected to Hashimoto's disease, an autoimmune condition that affects the thyroid. Stephanie and Dr. Smith talk through common thyroid symptoms, including fatigue, hair loss, weak nails, digestive changes, sleep issues, brain fog, mood changes, infertility, and skin problems. They also discuss why a deeper look at the body may include the immune system, gut health, liver function, blood sugar, cortisol, sex hormones, inflammation, food sensitivities, unresolved infections, and nutrient status. The episode also explores the difference between managing symptoms and looking for the underlying reasons a person may not feel well. Dr. Smith shares how he uses detailed intake forms, comprehensive lab testing, metabolic questionnaires, food sensitivity testing, lifestyle changes, nutrition, supplements, and retesting to help patients better understand what is happening in their body. This conversation is educational and is not a replacement for personal medical care. If you are dealing with thyroid symptoms, autoimmune concerns, medication questions, or chronic health issues, work with a qualified healthcare provider who can evaluate your individual situation. In This Episode, Discover Common symptoms of hypothyroidism and low thyroid function Why "normal labs" may not tell the whole story The connection between Hashimoto's disease and thyroid dysfunction Why Dr. Smith describes many thyroid issues as immune system issues How the brain, pituitary gland, thyroid, liver, gut, and carrier proteins all play a role in thyroid function Why every cell in the body depends on thyroid hormone for energy regulation How chronic inflammation, blood sugar issues, cortisol, sex hormones, food sensitivities, and infections may affect thyroid physiology Why comprehensive lab testing may reveal patterns missed by basic panels The difference between food allergy testing and food sensitivity testing How lifestyle changes, nutrition, supplements, and retesting fit into functional medicine care Why patients may need to take a more active role in understanding their health Stay Connected & Explore Learn More About Dr. Kevin Smith & Metabolic Solutions: Dr. Kevin Smith / Metabolic Solutions: https://www.metabolicsolutions.net/ Free 2-Minute Metabolic Health Assessment: https://www.metabolicsolutions.net/metabolic-scorecard/ Chronic Conditions Center: https://www.chronicpa.com/ Connect with Conversations with a Chiropractor: Follow Us on YouTube: http://www.youtube.com/@ConversationswithaChiro Follow Dr. Stephanie on Facebook: https://www.facebook.com/wautierwellness Email for show-related inquiries and sponsorships: drstephaniewautier@yahoo.com Want to be a guest on Conversations with a Chiropractor? Send Stephanie Wautier a message on PodMatch, here: https://www.podmatch.com/hostdetailpreview/drstephanie Credits Podcast production by Brand|Sound. Start your podcast journey by emailing brandsoundpodcasts@gmail.com. Chapters 00:00 Introduction to Conversations with a Chiropractor 00:56 Meet Dr. Kevin Smith 01:55 Why Thyroid Health Is the Focus 02:15 Common Symptoms of Hypothyroidism 04:01 When Symptoms Persist but Labs Look Normal 05:13 Looking Beyond Basic Thyroid Testing 05:47 Hashimoto's Disease and Autoimmunity 07:15 Why the Immune System Matters in Thyroid Health 08:25 Thyroid Medication, Unresolved Symptoms, and the Bigger Pathway 09:04 The Brain, Pituitary Gland, TSH, T3, and T4 10:37 The Thyroid as the Body's Energy Regulator 11:48 Brain Fog, Mood, Gut Symptoms, and Cellular Energy 13:16 Triggers That Can Disrupt Thyroid Physiology 15:13 Hypothyroidism vs. Hyperthyroidism 16:14 Intake Forms, Questionnaires, and Foundational Labs 18:14 What Dr. Smith Looks for in Lab Work 19:53 Insurance, Coverage, and the Limits of Symptom Management 22:29 Managing Symptoms vs. Looking for Root Causes 23:30 Patients Who Feel Like They Are Out of Options 25:24 Medication Side Effects and Patient Education 27:26 Dr. Google, Food Testing, and Objective Data 29:36 IgG, IgE, and Food Sensitivity Testing 31:48 Delayed Reactions and the Long-Fuse Firecracker Analogy 34:43 Celiac Disease, Crohn's, Colitis, and Autoimmune Patterns 35:48 Treatment Through Lifestyle, Nutrition, and Supplements 37:51 Affordability, Priorities, and Investing in Health 40:23 Owning Your Health and Understanding the Problem 43:26 Chiropractic, Functional Medicine, and Knowing the Right Tool 45:11 How to Find Dr. Kevin Smith 46:26 Working With Patients Outside Pennsylvania 47:34 Final Thoughts and Closing

It's one of the most common—and most frustrating—complaints in the Emergency Department: the patient covered head-to-toe in hives, miserable, itching, and desperate for relief. In this episode of EM Pulse, we welcome back ED Clinical Pharmacist Haley Burhans to tackle the “uncomfortable” topic of urticaria. We move past the myths of one-and-done doses and explore why your standard allergy dosing might be leaving your patients itching for more. The Power of Second-Generation Antihistamines Haley explains why second-generation antihistamines (cetirizine, levocetirizine, fexofenadine) should be your first-line ED therapy, rather than the old school standard, diphenhydramine (Benadryl). Xyzal vs. Zyrtec: We break down the L-enantiomer (levocetirizine) and whether it actually beats its predecessor in preventing drowsiness. The “Double Dose” Pearl: For acute urticaria in the ED, 10mg of cetirizine isn’t enough. Haley recommends starting with 20mg for adults (or doubling the weight-based dose for kids) to see relief within 20–60 minutes. The 4x Rule: Guidelines now support up to four times the standard daily dose for refractory cases (usually split BID). We discuss the safety data behind these higher regimens and why they are tolerated so well. The Steroid Trap and the Rebound Effect Patients often come in requesting steroids but they are NOT the primary cure for urticaria. The Antihistamine Backbone: Steroids treat inflammation, but the antihistamine treats the underlying stimulus. If a patient stops their antihistamines and only takes a steroid burst, they are set up for a miserable rebound. Dosing Strategies: If you do use steroids, keep it to a burst or taper of 10 days or less. We discuss the utility of methylprednisolone (Medrol Dosepak) versus a simple prednisone burst/taper or a course of longer-acting dexamethasone. Beyond the Basics: Benadryl and the MABs The Danger of “Dirty” Drugs: Why diphenhydramine has fallen out of favor due to its sodium channel blocking side effects, anticholinergic toxicity, and psychiatric risks. The Future of Itch: A look at emerging biologics like omalizumab. While these IgE-blockers shouldn't be started in the ED, it's important to know about them to treat patients who are taking them, or who present with rebound urticaria after recently stopping them. Key Takeaways Go Big on Second Generation Antihistamines: Start with a double dose of cetirizine in the ED. It's safe, effective, and less sedating than first-generation alternatives. Discharge patients on that double dose twice a day. Think Long-Term: Urticaria pathways need time to “cool down.” Advise patients to stay on the prescribed meds/doses for 1–2 months, not 1–2 days. Steroids are Adjuncts: Use a short burst (

Anaphylaxis explained including anaphylaxis pathophysiology (immunologic vs non immunologic), clinical features, diagnosis, and treatment. Includes recognition of airway compromise, use of intramuscular adrenaline (epinephrine), biphasic anaphylaxis, refractory anaphylaxis, and the immunology underlying type 1 hypersensitivity reactions. PDFs available at: https://rhesusmedicine.com/pages/topicsConsider subscribing (if you found any of the info useful!): https://www.youtube.com/channel/UCRks8wB6vgz0E7buP0L_5RQ?sub_confirmation=1Patreon: https://www.patreon.com/rhesusmedicineBuy Us A Coffee!: https://www.buymeacoffee.com/rhesusmedicineTimestamps:0:00 What is Anaphylaxis?0:32 Anaphylaxis Pathophysiology4:08 Anaphylaxis Causes5:28 Anaphylaxis Symptoms7:44 Anaphylaxis Diagnosis8:32 Anaphylaxis TreatmentLINK TO MNEMONICS:https://www.youtube.com/watch?v=p-XE7PiwGgE&list=PLGNSE_HvIV4t7a33bbHN1fq-j_tge0GmpLINK TO SOCIAL MEDIA: https://www.instagram.com/rhesusmedicine/ReferencesBMJ Best Practice (2025) Anaphylaxis – Symptoms, diagnosis and treatment. Available at: https://bestpractice.bmj.com/topics/en-gb/501British Society for Immunology (2021) Anaphylaxis. Available at: https://www.immunology.org/public-information/bitesized-immunology/immune-dysfunction/anaphylaxisRCEMLearning (2023) Anaphylaxis. Available at: https://www.rcemlearning.co.uk/reference/anaphylaxis/Simons, F.E.R., Ardusso, L.R.F., Bilo, M.B., El-Gamal, Y.M., Ledford, D.K., Ring, J., Sanchez-Borges, M., Senna, G.E., Sheikh, A. and Thong, B.Y. (2018) World Allergy Organization anaphylaxis guidance 2018. Journal of Allergy and Clinical Immunology, 141(2), pp. 419–420.e1. Available at: https://www.jacionline.org/article/S0091-6749(18)30571-2/fulltextTurner, P.J., Worm, M., Ansotegui, I.J. and El-Gamal, Y.M. (2024) IgE and non-IgE-mediated pathways in anaphylaxis. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12350582/Cardona, V., Ansotegui, I.J., Ebisawa, M., El-Gamal, Y., Fernandez Rivas, M., Fineman, S., Geller, M., Gonzalez-Estrada, A., Greenberger, P.A., Sanchez Borges, M., Senna, G., Sheikh, A. and Tanno, L.K. (2020) ‘World allergy organization anaphylaxis guidance 2020', World Allergy Organization Journal, 13(10), p. 100472. doi:10.1016/j.waojou.2020.100472.Please remember this podcast and all content from Rhesus Medicine is meant for educational purposes only and should not be used as a guide to diagnose or to treat. Please consult a healthcare professional for medical advice. 

Asthma affects over 26 million people in the U.S., yet outcomes can vary dramatically based on factors beyond disease severity. This episode explores the critical gap between diagnosis and optimal asthma control, focusing on how socioeconomic status, access to care, and environmental exposures shape patient outcomes. Through a mock case study, we examine disparities in healthcare access, allergist availability, and treatment adherence, alongside key topics such as epidemiology, risk stratification, environmental trigger identification, diagnostic testing and interpretation, and guideline-based management. The discussion highlights the role of allergic sensitization in asthma pathophysiology and emphasizes the importance of comprehensive specific IgE testing in identifying root causes. Clinicians will gain actionable strategies to improve diagnosis, implement cost-effective interventions, and optimize asthma management directly within primary care settings. Resources and references: https://www.thermofisher.com/phadia/us/en/resources/immunocast/asthma-management-disparities-ige-testing-primary-care.html?cid=0ct_3pc_05032024_9SGOV4

This week, Zoë mailed a chunk of her hair to a stranger in Florida. For science. For journalism. For your benefit, really. The $60 hair sample test came back flagging her as "highly reactive" to 210 foods, including emu, ostrich egg, hot dog, and ground horse meat. Reader, she has not eaten ground horse meat in over a decade.The food sensitivity industry is a multi-billion-dollar grift built on real symptoms and fake frameworks. We trace it from 1906, when allergy was first defined as a real clinical thing, through the 1950s clinical ecology movement, through cytotoxic testing, IgG panels, electrodermal screening, and bio-resonance, and finally to the at-home hair test in your DMs. It's the same idea in different packaging every decade. Like a body-snatcher, but for grift. (We use a lot of John Carpenter references in this one.)Then Kylee walks through what the science actually says: the difference between IgE allergies, IgG sensitivities, and intolerances. What real diagnostic testing looks like (skin prick tests, blood panels, hydrogen breath tests, structured elimination diets with a professional). Why hair testing, IgG panels, and bio-resonance devices have no validated diagnostic mechanism. And why these tests disproportionately target women, who are statistically more likely to feel dismissed by their doctors and more likely to seek answers in the wellness market.We also get into why endurance athletes are uniquely vulnerable to this stuff. When your gut acts up during training, the wellness industry hands you a list of 210 foods to eliminate. Your sports dietitian hands you a fueling plan. Guess which one tends to lead to a stress fracture.The bottom line: your symptoms deserve a real answer. Don't let a hair test substitute for actual care.This episode is supported by:rabbit — Use code YOURDIETSUCKS10 for 10% off at runinrabbit.com Their trail line is genuinely the only running gear we actively look forward to wearing.Tailwind Nutrition — Use code YOURDIET20 for 20% off at tailwindnutrition.com. Endurance fuel that doesn't taste like a chemistry set. Try the Mandarin Orange or the Daily Hydration Strawberry Lemonade.Osmia Skincare — Use code YDS20 for 20% off at osmiaskincare.com. Clean, science-forward skincare from a real-deal physician-founder. The Himalayan Salt Scrub and Lavender Body Mousse are the post-long-run reset.Microcosm Coaching — Endurance coaching from people who know what they're doing. Free consultations at microcosm-coaching.com.Website: yourdietsuckspodcast.com — full episode pages, references, transcripts, and the blog.Patreon: patreon.com/YourDietSucks — bonus episodes, monthly Q&As with Kylee, and the community thread. $3/month keeps us independent and ad-manager-free.Merch: teepublic.com/user/your-diet-sucks — TeePublic shop. (Heads up: free Patreon members can win a YDS shirt by joining a paid tier between now and May 31. Drawing June 1.)If this episode helped, send it to a friend who's been thinking about mailing their hair somewhere. Word of mouth is how this show grows.SPONSORSMORE YDS

Alpha-gal syndrome is an emerging and often underrecognized allergy triggered by a tick bite that can cause delayed reactions to red meat and mammalian-derived products. In this episode, host Stacy Lauderdale is joined by clinical experts Zack Stacy and Kyna Henrici to unpack the science behind alpha-gal, its implications in healthcare settings, and the operational challenges providers face in managing this complex condition.    Guest Speakers:   Zachary Stacy, Pharm.D., MS, FCCP, BCPS  Clinical Pharmacy Specialist, Surgery  BJC Health   Kyna Henrici, RN  Medical Evidence Director - Cardiovascular  Vizient, Inc.    Host:    Stacy Lauderdale, Pharm.D., BCPS  AVP, Evidence-Based Medicine  Vizient, Inc.    00:05 – Introduction  Podcast introduction and welcome to VerifiedRx  00:14 – What is alpha-gal syndrome  Overview of alpha-gal syndrome  Delayed allergic reactions after eating red meat  Often linked to tick bites  00:48 – Meet the Guests   Zack Stacy, clinical pharmacy specialist  Kyna Henrici, medical evidence director  01:10 – Understanding the Allergy  Alpha-gal is a carbohydrate in nonprimate mammals that can trigger an allergy in humans  Key difference is delayed reaction timing  Symptoms are not always easy to trace   01:32 – How It Develops  Triggered by tick bites  Immune system produces IgE antibodies   Oral exposure to alpha-gal leads to delayed reactions  IV exposure to alpha-gal can cause immediate reactions  02:17 – Prevalence and Diagnosis Challenges  More common in Midwest and southern United States  Likely underdiagnosed  Often mistaken for general food allergies  Allergy may fade over time  03:07 – Risks in Healthcare Settings  Patient safety concerns beyond food  Mammalian components in medications and devices  Examples include heparin and surgical materials  03:44 – Hidden Medication Risks  Inactive ingredients can be animal derived  Examples include glycerin, lactose, amino acids, stearates  Difficult to identify and track  04:42 – Lack of Transparency  No centralized ingredient database  Sourcing can change frequently  Variability across manufacturers and batches  05:33 – Screening in Surgical Settings  Medication review at NDC level  Identification of active and inactive ingredients  May require contacting manufacturers  06:45 – Timing Challenges  Urgent procedures limit investigation time  Manufacturer responses may take days  Alternative medications often needed  07:14 – Identifying At Risk Patients  Many patients are unaware they have alpha-gal syndrome  Screening includes questions about dairy tolerance  Three patient categories used for evaluation  08:32 – Using Dairy as a Screening Tool   Dairy tolerance helps guide risk level  Food exposure typically higher than medication exposure  Determines need for deeper review  09:12 – Managing Emergencies  Focus shifts from avoidance to risk mitigation  Use of team communication and clear documentation  Preparation for unavoidable exposure  10:03 – Prevention and Preparedness  Stock alpha-gal safe medications when possible  Prepare for allergic reactions with standard treatments  10:47 – Team Based Care Approach  Collaboration across care teams is essential  Premedication strategies may be used  Close monitoring for reactions  11:11 – Gaps in Care  Limited visibility into product ingredients  Need for better labeling and transparency  11:33 – Need for Standardization  Call for clearer guidance and clinician education  Desire for centralized resource for medication ingredients  12:24 – Monitoring Challenges  CDC tracking decreased after privatization of testing  Cases likely still increasing  12:53 – Closing Remarks    Links and Resources: Alpha-gal Syndrome | Alpha-gal Syndrome | CDC    Subscribe Today!  Apple Podcasts  Spotify  YouTube  RSS Feed   

Support the Institute today. https://givenow.nova.edu/the-institute-for-neuro-immune-medicine-inim-2025 In today's episode, Haylie Pomroy is joined by Dr. Andrew Campbell, a specialist in complex chronic illness, toxic exposures, and immune dysfunction. Together, they examine the clinical science behind mycotoxin illness — how mold-derived toxins enter the body, why they are frequently missed or misdiagnosed, and how they may be driving some of the most prevalent and poorly understood chronic conditions of our time. Dr. Campbell shares the evidence base connecting mycotoxins to neurological diseases including multiple sclerosis, Alzheimer's, ALS, and Parkinson's disease, as well as autoimmune disorders, chronic fatigue syndrome, fibromyalgia, autism, and reproductive health conditions. He explains the critical difference between urine and serum mycotoxin testing, clarifies what IgG and IgE antibodies actually indicate about current versus past exposure, and outlines a clinically validated approach to diagnosis and treatment through My Myco Lab. He also addresses environmental sources of mycotoxin exposure, the first rule of toxicology in clinical practice, and why accurate testing is the foundation of any meaningful recovery pathway. Dr. Andrew Campbell is a Medical Clinician, Director, Officer, Advisor, and Medical Consultant, also Editor-in-Chief of several journals and research studies, and was recently selected as Top Medical Consultant of the Year for 2020 by the International Association of Top Professionals (IAOTP) for his outstanding leadership, dedication, and commitment to the healthcare profession. With over 45 years of professional experience as a renowned Medical Clinician, Dr. Campbell has certainly proven himself as an expert in the field of integrative health and traditional medicine. Dr. Campbell is a dynamic, results-driven leader who has demonstrated success by treating the most complex patients and having extensive experience with testing for molds and mycotoxins from environmental and toxic exposures. He is fluent in Arabic, Hungarian, French, Spanish and English. He has also effectively worked alongside medical professionals from other cultures in Central and South America, Western and Eastern Europe, and the Middle East.   Website: https://andrewcampbellmd.com/  LinkedIn: https://www.linkedin.com/in/andrewwcampbell-md/  YouTube: https://www.youtube.com/c/MyMycoLabLLC    Learn more about MyMycoLab: https://mymycolab.com/    Haylie Pomroy, Founder and CEO of The Haylie Pomroy Group, is a leading health strategist specializing in metabolism, weight loss, and integrative wellness. With over 25 years of experience, she has worked with top medical institutions and high-profile clients, developing targeted programs and supplements rooted in the "Food is Medicine" philosophy. Inspired by her own autoimmune journey, she combines expertise in nutrition, biochemistry, and patient advocacy to help others reclaim their health. She is a New York Times bestselling author of The Fast Metabolism Diet.   Learn more about Haylie Pomroy's approach to wellness through her website: https://hayliepomroy.com   Instagram: https://www.instagram.com/hayliepomroy  Facebook: https://www.facebook.com/hayliepomroy  YouTube: https://www.youtube.com/@hayliepomroy/videos  LinkedIn: https://www.linkedin.com/in/hayliepomroy/  X: https://x.com/hayliepomroy    Enjoy our show? Please leave us a 5-star review on the following platforms so we can bring hope and help to others.   Apple Podcasts: https://podcasts.apple.com/us/podcast/hope-and-help-for-fatigue-chronic-illness/id1724900423   Spotify: https://open.spotify.com/show/154isuc02GnkPEPlWfdXMT   Sign up today for our newsletter. https://nova.us4.list-manage.com/subscribe?u=419072c88a85f355f15ab1257&id=5e03a4de7d    This podcast is brought to you by the Institute for Neuro-Immune Medicine. Learn more about us here.   Website: https://www.nova.edu/nim/ Facebook: https://www.facebook.com/InstituteForNeuroImmuneMedicine Instagram: https://www.instagram.com/NSU_INIM/ Twitter: https://www.twitter.com/NSU_INIM

Hva er egentlig “hjernetåke” – og hvorfor opplever så mange i dag å være slitne, ukonsentrerte og ute av balanse? Kan det vi spiser påvirke mer enn vi tror – ikke bare fordøyelsen, men også hjernen, energinivået og hvordan vi fungerer i hverdagen?I denne episoden har jeg med meg lege, forfatter og en av Norges mest profilerte stemmer innen kosthold og helse, Sofie Hexeberg. Sammen med sin mann Erik Hexeberg driver hun Dr. Hexebergs klinikk i Tønsberg og Bærum, og hun har i en årrekke arbeidet med hvordan mat påvirker sykdom og helse. Hun er også medforfatter av flere bestselgende bøker, blant annet Ut av hjernetåken, Nytt blikk på kolesterol og Nytt blikk på autoimmun sykdom.I denne samtalen utforsker vi hva hjernetåke er, hvorfor det kan oppstå, og hvordan kosthold, tarmhelse og individuelle forskjeller kan spille en rolle. Vi snakker også om matintoleranser, “lekk tarm” og MUPS.I episoden lærer du mer om:Hva hjernetåke er, og hvilke symptomer som ofte går igjenMulige årsaker, inkludert kosthold, tarmhelse og livsstilHva vi vet (og ikke vet) om lekk tarm og matintoleranserForskjellen på IgG, IgA og IgE-tester – og hvordan de kan tolkesHvorfor noen opplever bedring ved å endre kostholdSammenhengen mellom MUPS og kostholdOm vi alle bør spise likt – eller om vi er mer ulike enn vi trorHva forskningen sier om lavkarbo og ketogent kostholdHvordan du kan begynne å utforske hva som fungerer for degSofie deler også egne erfaringer som lege, hva hun selv gjør for egen helse, og hvordan man kan navigere i et felt preget av både sterke meninger og ulike perspektiver.Kontakt Sofie Hexeberg:Hjemmeside: www.drhexeberg.noBok: Ut av hjernetåken Tusen takk til ukens sponsor Csoaps! Du får nå 20 prosent rabatt på nettbutikken ved å bruke rabatt koden legeromlivet20 på csoaps.comAlt godt,AnnetteFølg meg gjerne på:instagramNyhetsbrev: annettedragland.noFå bonusepisoder og støtt podcasten på https://podcasts.apple.com/no/podcast/leger-om-livet/id1539212619 Disclaimer: Innholdet i podcasten og på nettsiden er ikke ment å utgjøre eller erstatte profesjonell medisinsk rådgivning, diagnose eller behandling. Søk alltid råd fra legen din eller annet kvalifisert helsepersonell hvis du har spørsmål angående en medisinsk tilstand. Hosted on Acast. See acast.com/privacy for more information.

RNA microbiome testing reveals what DNA gut tests fundamentally miss. Your gut bacteria have 3,000+ genes each — DNA tests see zero of their actual activity. Dr. Momchilo (Momo) Vuyisich, Co-founder & CSO of Viome and former Los Alamos National Laboratory scientist, explains why RNA-based metatranscriptomics is a quantum leap over DNA sequencing for understanding your microbiome and personalizing nutrition. Meet our guest Dr. Momo Vuyisich spent 12 years at Los Alamos National Laboratory developing RNA-based technology for digitizing human biology. He co-founded Viome in 2016 with Naveen Jain, and the platform has since tested 500,000+ customers across 100+ countries. His personal journey with NEU5GC autoimmune sensitivity drove his mission to replace opinion-based nutrition with data-driven, personalized recommendations. Thank you to our partners Outliyr Biohacker's Peak Performance Shop: get exclusive discounts on cutting-edge health, wellness, & performance gear Ultimate Health Optimization Deals: a database of of all the current best biohacking deals on technology, supplements, systems and more Latest Summits, Conferences, Masterclasses, and Health Optimization Events: join me at the top events around the world FREE Outliyr Nootropics Mini-Course: gain mental clarity, energy, motivation, and focus Key takeaways DNA microbiome tests show composition only — RNA tests reveal which of 3,000+ bacterial genes are actually active 16S rRNA sequencing cannot distinguish pathogenic bacteria from beneficial ones Akkermansia can protect or destroy your gut lining depending on fiber intake and gene expression Carnitine supplements may cause cardiovascular disease via the TMAO pathway in certain people Viome's biological aging clock shows keto and paleo dieters age faster on average No whole food is universally good or bad — personalization requires your own molecular data The gut microbiome stays stable for 5-6 months; test semi-annually Viome currently measures 25,000 of ~100,000 biochemical reactions powering the body Three randomized controlled trials validate Viome's personalized nutrition approach   Episode highlights 00:00 Introduction 02:44 Why RNA is the single best molecule to study 06:16 RNA instability — why it took 6 years to develop 08:02 Why 16S sequencing is nearly useless 11:02 Akkermansia's 3,000 genes: help or harm? 17:37 Microbiome as a dynamic self-adjusting ecosystem 23:20 NEU5GC sensitivity & mammalian food reactions 25:50 Food sensitivities (IgG) vs allergies (IgE) 29:55 Viome's 3-part approach: seal gut, reduce inflammation, personalize 41:07 Biological aging clock: keto & paleo age faster 49:13 Dry fasting crashed mitochondrial function score 52:07 Machine learning identifies metabolic bottlenecks 1:00:23 Viome measures 25% of human biology, 10% actionable   Links Watch it on YouTube: https://youtu.be/bB8Zj_9pIv8  Full episode show notes: https://outliyr.com/257  Connect with Nick on social media Instagram Twitter (X) YouTube LinkedIn Easy ways to support Subscribe Leave an Apple Podcast review Suggest a guest Do you have questions, thoughts, or feedback for us? Let me know in the show notes above and one of us will get back to you! Be an Outliyr, Nick

This episode examines the spectrum of food allergy, from IgE-mediated disease to food protein induced enterocolitis syndrome and eosinophilic conditions, and explores how diet, skin barrier function, and the microbiome interact in early life. Timestamps: 00:53 – Spectrum of allergic diseases 05:00 – Nutrition and immune activation 07:22 – Atopic dermatitis 08:55 – IgE-mediated food allergy 10:28 – Future management pathways

In this powerful episode of Public Health Epidemiology Conversations, Dr. Huntley speaks with Chicago's first Black woman health commissioner, Dr. Olusimbo "Simbo" Ige, about tackling one of the nation's most alarming health disparities. When Black residents in Chicago were dying 15 years earlier than their neighbors, Dr. Ige stepped into leadership determined to change the trajectory. Drawing on decades of experience across Nigeria, Sub-Saharan Africa, and New York City, she shares how global public health lessons are shaping bold, community-centered strategies in Chicago today. From a 38% reduction in opioid deaths to early signs that the city's life expectancy gap is finally narrowing, Dr. Ige offers a candid look at what it takes to drive meaningful change in complex systems. She also speaks openly about the deeper barrier to progress. Not a lack of data, but a divide in values around who deserves public investment. Along the way, she and Dr. Huntley explore the importance of plain language, trusted community messengers, and storytelling as essential tools for effective public health leadership. This conversation is both inspiring and grounding for anyone committed to improving health equity.   Resources ▶️ Join the PHEC Podcast Community ▶️ Visit the PHEC Podcast Show Notes ▶️ DrCHHuntley, Public Health & Epidemiology Consulting

TWiM explains how to use microbes to enhance maize yield and reduce corn rootworm damage, and how the human microbiota modulates IgE-mediated reactions to foods through allergen metabolism. Hosts: Michael Schmidt, Petra Levin, and Michele Swanson. Guest: Mark O. Martin Become a patron of TWiM. Music used on TWiM is composed and performed by Ronald Jenkees and used with permission. Links for this episode Harnessing Microbes for Crop Production (Phytobiome J) Microbes take on corn rootworm (Science) Microbial metabolism of food allergens (Cell Host Microbe) Take the TWiM Listener survey! Send your microbiology questions and comments (email or recorded audio) to twim@microbe.tv

With 29 million golfers in the U.S. and an estimated 7.25 million affected by spring allergies, seasonal respiratory symptoms can meaningfully affect performance and daily function. This episode explores how tree and grass pollen exposure, overlapping sensitizations, and indoor allergens can combine to drive rhinitis, fatigue, sleep disruption, and reduced daytime performance. We discuss regional pollen patterns, why pine pollen is often less clinically important than oak and juniper, how to avoid assuming a single trigger is the cause, and how localized respiratory allergen profiles with specific IgE testing can help clarify sensitization. Practical counseling includes using specific IgE results to help inform exposure reduction and environmental control to help improve symptom control and guide management. References and resources: https://www.thermofisher.com/phadia/us/en/resources/immunocast/masters-golf-respiratory-allergies-pollen-management.html

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world.Today, we delve into recent significant advancements and strategic maneuvers reshaping the landscape in these dynamic industries. AstraZeneca has made a notable stride with its chronic obstructive pulmonary disease (COPD) drug candidate, achieving remarkable efficacy in Phase 3 trials. This success is particularly significant given the historical challenges in this therapeutic area, where competitors like Roche and Sanofi have struggled to deliver consistent results. AstraZeneca's achievement not only highlights its innovative clinical development strategies but also offers renewed hope for COPD patients who have long awaited more effective treatment options.In a parallel move, AstraZeneca is pioneering in vivo CAR-T cell therapies, showcasing their potential despite safety concerns following a patient death during trials in China. The therapy's ability to eradicate cancer in three out of five patients underscores its promise as a revolutionary treatment for cancer, illustrating the need for ongoing safety evaluations as this technology develops.Meanwhile, Novartis continues to strategically expand its allergy treatment portfolio with a significant $2 billion acquisition of Excellergy. This deal centers around an anti-IgE program poised to potentially replace Xolair, Novartis's leading allergy medication. Such strategic moves underscore Novartis's commitment to remaining at the forefront of allergy therapeutics by harnessing biotechnological innovations to develop next-generation treatments. This acquisition complements existing assets like Xolair, an IgE blocker now approved for treating food allergies across different age groups, aiming to bolster Novartis's competitive edge in allergy therapeutics by providing a broader array of solutions.Otsuka Pharmaceutical is also making waves with its $1.2 billion acquisition of Transcend Therapeutics. This acquisition focuses on an MDMA analog for psychiatric conditions, marking Otsuka's deepening interest in mental health therapeutics and the burgeoning field of psychedelic compounds as viable psychiatric treatments. This move reflects a broader industry trend towards exploring unconventional therapeutic avenues to address complex mental health issues.On the regulatory front, Takeda is undergoing significant restructuring efforts aimed at achieving $1.3 billion in annual savings through reorganization. This reflects a broader industry trend towards optimizing operations to enhance efficiency and maintain competitiveness in an ever-evolving market landscape.In another noteworthy development, Rocket Pharmaceuticals has secured accelerated FDA approval for Kresladi, a gene therapy targeting severe leukocyte adhesion deficiency-1. This approval highlights the growing potential of gene therapies to meet unmet medical needs for rare diseases and sets an important precedent for other companies seeking expedited regulatory pathways for their gene therapy pipelines.In Alzheimer's research, both Eisai and Alzheon have made significant contributions, especially regarding high-risk patient subsets. Eisai presented real-world data on Leqembi at the AD/PD annual meeting, demonstrating safety and efficacy in patients with specific genetic profiles like APOE4 homozygotes. Concurrently, Alzheon provided insights into its candidate's performance in similar cohorts. These findings underscore personalized medicine's growing importance in neurodegenerative disease treatment.Oncology remains a critical area with Merck's announcement of its planned acquisition of Terns Pharmaceuticals for $6.7 billion. Driven by Terns' promising leukemia drug developments, this acquisition exemplifies how major players are diversifying their oncology pipelines to maintain market leadership amid approaching patent expiraSupport the show

Wheat allergy, celiac disease, and non-specific gluten intolerance all share overlapping gastrointestinal symptoms that can confound primary care diagnosis. This episode addresses the core diagnostic challenge of distinguishing IgE-mediated wheat allergy (including ω-5 gliadin–associated wheat-dependent exercise-induced anaphylaxis) from celiac disease and non-celiac gluten intolerance. We cover epidemiology, clinical presentations and timing of IgE reactions, component-resolved diagnostics, serologic algorithms for celiac disease, when to refer for biopsy, and management implications including gluten-free diet counseling and emergency planning for anaphylaxis. Practical takeaways emphasize improving diagnostic yield in primary care, appropriate use of specific IgE testing, and when specialist referral is necessary. References and resources: https://www.thermofisher.com/phadia/us/en/resources/immunocast/wheat-allergy-celiac-differential-diagnosis.html?cid=0ct_3pc_05032024_9SGOV4

In this episode of NP Pulse: The Voice of the Nurse Practitioner®️, Drs. Erin Sinnaeve and Julianne Doucette discuss immunoglobulin E (IgE)-mediated food allergies, current prevention strategies, diagnostic best-practices and evolving treatment options — including early allergen introduction, oral immunotherapy and biologic therapies — to support safe, evidence-based care.   Upon successful completion of this podcast, you will be able to:  Review the pathophysiology and subsequent patient journey associated with IgE-mediated food allergies.    Evaluate the trial data and practice-changing potential of monoclonal antibodies in a new era of food allergy management.    Develop evidence-driven care plans focused on mitigating patient and caregiver burden, and safely and effectively reducing IgE-mediated reactions in patients with food allergies.    A participation code will be provided at the END of the podcast — make sure to write this code down. Once you have listened to the podcast and have the participation code, return to this activity in the AANP CE Center and follow these steps:  Register for this activity.  Click on the "Next Steps" button.  Enter the participation code that was provided.  Complete the activity evaluation.  This will award your continuing education (CE) credit and certificate of completion.  1.25 CE will be available through March 31, 2027.  Listeners are encouraged to explore the accompanying food allergy point-of-care tool to support clinical decision-making.   The Hidden Burden: Understanding Food Allergies and Their Impact This podcast is supported by an education grant from Genentech, a member of the Roche Group. 

Is it really a food allergy or something else entirely?Are stomach aches, bloating, and food fears always caused by specific foods?And how do parents know when eliminating foods is helping… or quietly making things worse?In this episode, we're tackling one of the most confusing topics in youth athletics: food allergies vs. food intolerances  and how both intersect with under-fueling in gymnastics. I'm joined by a repeat guest and allergy-immunology nurse practitioner (and fellow gymnast mom) to break down what's real, what's misunderstood, and what every parent and coach needs to know.Because while true food allergies absolutely exist and require strict management, many gymnasts are unnecessarily restricting foods due to fear, misinformation, or non-specific symptoms that are actually caused by chronic under-fueling. And in a sport where athletes are already at high risk for not eating enough, removing foods without clear evidence can quietly worsen growth, digestion, recovery, and performance. In this episode, we cover: ❗What true food allergies actually look like (and how they're diagnosed) ❗The difference between IgE allergies, intolerances, and gut symptoms ❗Why food elimination is often the knee-jerk reaction to GI issues ❗How under-fueling disrupts digestion and mimics food intolerance ❗The truth about airborne allergies and cross-contamination fears ❗Why IgG “food sensitivity tests” are misleading and often harmful ❗Lactose intolerance, gluten concerns, and when they're real ❗How unnecessary food restriction can worsen growth, hormones, and performance ❗What parents and coaches should watch for in gymnasts with chronic symptomsWe also share real clinical scenarios from gymnasts misdiagnosed with food intolerances to athletes who improved dramatically once fueling was addressed first. If your gymnast has stomach aches, fatigue, frequent illness, food fears, or multiple food restrictions, this conversation is essential.Because here's the truth:Not every stomach ache is a food allergy.Not every reaction needs elimination.And sometimes the real issue isn't what a gymnast is eating but how much. This episode will help you feel more confident navigating food fears, medical advice, and nutrition decisions so your gymnast can stay healthy, strong, and thriving.Links & ResourcesThe Balanced Gymnast® Program (Level 5–10)Connect with Christina on Instagram @the.gymnast.nutritionist christinaandersonrdn.com

Having finally perfected the art of fight picking, Phil is now the main host of Heavy Hands.  Don't miss the first Heavy Henka of the year! Join us as we break down the conclusion of this month's outrageous grand sumo tournament: https://www.patreon.com/heavyhands  Predatory instinct: how Max Holloway attacks: https://open.substack.com/pub/facepunching/p/predatory-instinct-how-max-holloway?r=evbq&utm_campaign=post&utm_medium=web&showWelcomeOnShare=false  Heavy Hands merch: https://www.redbubble.com/shop/ap/64577943?asc=u  CONTENTS: 00:00 Intro 00:30 Strickland vs Hernandez 27:31 Neal vs Medic 36:50 Ige vs Costa 52:45 Moreno vs Kavanagh 1:17:40 Vera vs Martinez  

What makes Lyme disease resolve quickly in some people but turn into a life-altering chronic illness in others? In this episode, world-leading immunologist Dr. Michal “Mikki” Tal, Principal Scientist at MIT, explains what her team is discovering through the MAESTRO Study — the largest clinical research project in MIT's history and the first of its kind to include real Lyme patients in a multi-system biological analysis. Dr. Tal's work sits at the intersection of immunology, bioengineering, and women's health, uncovering how infections like Lyme and COVID can cause persistent inflammation, immune miscommunication, and hormonal imbalance. Through MAESTRO, she's mapping how recovery breaks down — and what can be done to predict, prevent, and ultimately reverse chronic illness.

We've all seen it: the patient whose chart is “flagged” with a penicillin allergy, but when you dig into the history, the story doesn’t quite add up. Maybe it was a stomach ache in the 90s, or maybe they're just carrying a “inherited” allergy from a parent. In this episode of EM Pulse, we sit down with ED Clinical Pharmacist Haley Burhans to discuss why these labels are more than just a nuisance—they're a clinical liability—and how a simple tool can empower you to fix them on the fly. The Hidden Danger of the “Safe” Choice Choosing a non-beta-lactam antibiotic because of a questionable allergy label feels like the path of least resistance, but the data tells a different story. We explore how “playing it safe” can actually lead to: Worse Outcomes: Why second line antibiotics often mean higher treatment failure rates. The “Superbug” Factor: The surprising link between penicillin allergy labels and the rise of MRSA and VRE in our communities. The C. diff Connection: Why alternative choices might be setting your patient up for a much more difficult recovery. The Solution: The PEN-FAST Score How do you move from “I think this might not be a true allergy” to “I am confident this antibiotic is safe”? Haley introduces the PEN-FAST score, a validated scoring tool designed to risk-stratify patients based on a few key historical questions. The Mnemonic: We break down the PEN-FAST acronym so you know exactly which three questions to ask to risk-stratify your patient in seconds. IgE vs. The Rest: Learn to distinguish between the “true” dangerous hypersensitivity and the delayed reactions that shouldn’t stop you from using the best drug for the job. The “Amoxicillin Rash”: We dive into this common pediatric “gotcha.”, why many kids end up with a lifelong allergy label after a routine ear infection, and why it often has nothing to do with the drug itself. The Bottom Line: Patients with low PEN-FAST scores are considered low risk, making an oral challenge under observation in the ED a reasonable option. Higher scores may require shared decision-making or referral. Why the ED is the Perfect Place for a “Challenge” Delabeling isn’t just for the allergist’s office. We argue that the Emergency Department is actually the ideal setting to challenge these allergies. The “Oral Challenge”: Learn the practical steps for performing a trial dose in the department. Safety First: Why your environment and expertise make you uniquely qualified to handle the “what-ifs” better than anyone else. Key Takeaways Question the Label: The vast majority of reported penicillin allergies are inaccurate due to patients outgrowing the allergy or misinterpreting common side effects as allergic reactions. History is Everything: Dig deeper than just “rash.” Ask about the timing relative to the dose, specific appearance (hives vs. flat rash), and what treatment was required (epinephrine vs. antihistamines). Use PEN-FAST: Utilize this tool to objectify the risk. Document Tolerance: Even if you don’t fully delete the allergy label, if you successfully treat the patient with another beta-lactam (like ceftriaxone), document that tolerance clearly to aid future clinicians. Cephalosporins are likely safe: Later-generation cephalosporins generally have very low cross-reactivity and are usually safe options even in truly allergic patients How do you handle documented penicillin allergies? Do you use the PEN-FAST tool? Share your experience with us on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis Resources: PEN-FAST Score on MDCalc Penicillin Allergy Evaluation Should Be Performed Proactively in Patients with a Penicillin Allergy Label – A Position Statement of the American Academy of Allergy, Asthma & Immunology Staicu ML, Vyles D, Shenoy ES, Stone CA, Banks T, Alvarez KS, Blumenthal KG. Penicillin Allergy Delabeling: A Multidisciplinary Opportunity. J Allergy Clin Immunol Pract. 2020 Oct;8(9):2858-2868.e16. doi: 10.1016/j.jaip.2020.04.059. PMID: 33039010; PMCID: PMC8019188. Yang C, Graham JK, Vyles D, Leonard J, Agbim C, Mistry RD. Parental perspective on penicillin allergy delabeling in a pediatric emergency department. Ann Allergy Asthma Immunol. 2023 Jul;131(1):82-88. doi: 10.1016/j.anai.2023.03.023. Epub 2023 Mar 27. PMID: 36990206. *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.  

Contributor: Aaron Lessen, MD Educational Pearls: What is anaphylaxis and what are its treatments?  Anaphylaxis is a broad term for potentially life threatening allergic reactions that can progress to cardiovascular collapse (anaphylactic shock).  It is triggered by IgE and antigen cross-linking on mast cells to induce degranulation and the release of histamines, which can cause diffuse vasodilation and respiratory involvement with end-organ hypoperfusion. First line treatment is the immediate administration of epinephrine at 0.01 mg/kg (max dose for pediatrics is 0.3 mg and for adults is 0.5 mg) as well as removal of the offending agent causing the reaction. Additional pharmacologic treatments such as anti-histamines and steroids should be considered but not used instead of epinephrine when anaphylactic shock is evident as the sole therapy. What is biphasic anaphylaxis and what is its occurrence? Biphasic anaphylaxis is the return of anaphylactic symptoms after the initial anaphylactic event. Previous studies have reported an incidence ranging from 1-20% of patients having an initial anaphylactic reaction having biphasic anaphylaxis, at a range of time from 1-72 hours. The mechanism of biphasic anaphylaxis is not completely known, but can be contributed to by initial interventions wearing off (and why patients will be monitored for 2-4 hours after initial symptoms and treatment), or delayed immune mediators beginning to take effect. Recent studies show that the rate of biphasic anaphylaxis may be closer to 16% occurrence with a median time of occurrence being around 10 hours. What is the key take away and patient education on biphasic anaphylaxis? After patients have been observed for the initial 2-4 hours in the emergency room, they are generally safe to go home. Patients should be informed of the need to carry an Epi-Pen for similar anaphylactic reactions, and informed that there is a chance within the next day (10-20 hours) that they may have the symptoms occur once again. The biphasic reaction may be more mild, and patients should be educated on how to treat it and to seek immediate emergency care if the symptoms do not improve. References Golden DBK, Wang J, Waserman S, et al. Anaphylaxis: A 2023 practice parameter update. Annals of Allergy, Asthma & Immunology. 2024;132(2):124-176. doi:10.1016/j.anai.2023.09.015 Rubin S, Drowos J, Hennekens CH. Anaphylaxis: Guidelines From the Joint Task Force on Allergy-Immunology Practice Parameters. afp. 2024;110(5):544-546. Weller KN, Hsieh FH. Anaphylaxis: Highlights from the practice parameter update. CCJM. 2022;89(2):106-111. doi:10.3949/ccjm.89a.21076 Gupta RS, Sehgal S, Brown DA, et al. Characterizing Biphasic Food-Related Allergic Reactions Through a US Food Allergy Patient Registry. The Journal of Allergy and Clinical Immunology: In Practice. 2021;9(10):3717-3727. doi:10.1016/j.jaip.2021.05.009 Summarized by Dan Orbidan OMS2 | Edited by Dan Orbidan & Jorge Chalit OMS4 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf

MMA Lock of the Night is back to give you breakdowns and predictions for UFC Houston: Strickland vs Hernandez. Also on the card, Neal vs Medic, Ige vs Costa, Spivac vs Delija, and Smith vs Harrell.