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Just diagnosed with a food allergy and feeling lost? You're not alone and don't have to figure out food allergy life by yourself. We're here to help you understand food allergy basics: what causes allergic reactions, how to recognize symptoms, and how to manage your allergy safely, every day. This is the second episode in our Food Allergies: Ages & Stages, and it's all about building a strong foundation after a new diagnosis. Whether it's your child, your partner, or you who was recently diagnosed, Kortney and Dr. Payel Gupta walk through everything you need to know in those early days. From understanding how allergic reactions work to learning about life-saving tools like epinephrine, and new management options like OIT and omalizumab. Dr. G explains what causes your immune system to misfire, how fast symptoms can appear, and why no two reactions are the same. We also dive into real-life strategies like carrying your epinephrine device, knowing when and how to use it, and navigating social situations. Plus, Kortney shares personal tips that have helped her live safely with food allergies for over 30 years. What we cover in our episode about managing a new food allergy diagnosis What just happened?! We explain what causes allergic reactions, including the roles of IgE, histamine, and mast cells. Are all allergic reactions the same? Learn how quickly reactions can occur and why symptoms aren't always predictable. Why is epinephrine so important? When to use epinephrine, how to use it, and why antihistamines aren't enough. New options to help manage food allergies. A look at treatments like OIT and omalizumab (Xolair) and why you still need to carry your epi. Peace of mind with an action plan. What to include in a Food Allergy Action Plan and how to help others take your allergy seriously. Episode 2 in our “Food Allergies: Ages & Stages” series Across six episodes, we explore how food allergies show up and shift through different phases of life, from introducing solids in infancy to navigating school and adapting in adulthood. We're here with evidence-based info, expert insights, and lived experience to guide you through it all. Episodes mentioned to help build your foundation: Episode 59: What is Anaphylaxis and When to Use Epinephrine Episode 95: The Science Behind Allergic Reactions Episode 98: Food Allergy Treatment and Management Ep. 110: Early Introduction of Allergenic Foods – Preventing Food Allergies Before They Start Made in partnership with The Allergy & Asthma Network. Thanks to Genentech and Acuqestive for sponsoring today's episode. This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.
Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks… Bryan: Hi Dr C. A couple weeks ago I noticed a skin rash running up the side of my back and on both sides of my lower abdomen. I chalked it up as a fluke and it went away for a while. Until this morning. I figured out the culprit seems to be my portable steam sauna which I have in my room. I've been using a steam sauna for years and never had this happen before. Wish I could upload a photo but is there anything you could recommend for this kind of problem? It doesn't hurt, the skin just feels warm and looks red. Could it be Rosacea? Appreciate any insight. Best, Andy: Hey any idea how to cure eye floaters I haven't seen any protocols on how to cure them? Deanna: Thank you for your informative podcast and for sharing your expertise. My two-year-old son has been diagnosed with Food Protein-Induced Enterocolitis Syndrome (FPIES) to oars, and I'm seeking guidance on potential triggers or the best approach to testing and managing this condition. For some context, he also has IgE-mediated food allergies to peanuts, certain tree nuts, and eggs and eczema so I thought the gut could be a place to start. I would greatly appreciate any advice or recommendations you may have. Thank you in advance for your help! Lana: Hi Dr Cabral, thank you for taking the time to answer the community questions, very much appreciate this gift. My daughter is 8 years old and I have found a couple of grey hairs in her head, root to tip. Why could this be? Anonymous: In the last two years, I've been through all the protocols. Labs are looking good. Continually working on stress reduction. I sleep well, move a lot, eat a healthy diet with lots of grass fed/finished beef from our ranch, dark greens, try to eat the rainbow. I'm taking Cardio, Vision, Cell Boost, multi, omegas, balanced zinc, magnesium. I keep constantly get light headed every time i move too fast, winded easily, yawn a lot. After your episode on low iron, I just ran blood labs and my iron (29), ferritin (3), iron sat (7%) hematocrit (33.7%), hemoglobin (9.8), MCH (23.6), MCHC (29.1), RDW (19.6%), and Alk Phos (14) are all really low. I am not sure what else could be causing these low levels; I have struggled for many years. any advice is appreciated. (37 female, normal cycle) Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes and Resources: StephenCabral.com/3383 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!
Description: Co-hosts Ryan Piansky, a graduate student and 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 Sciences Advisory Council, interview Dr. Melanie Ruffner, an Attending Physician with the Division of Allergy and Immunology and the Center for Pediatric Eosinophilic Disorders at Children's Hospital of Philadelphia. Dr. Ruffner describes her work in clinic and the paper she co-authored about pediatric and adult eosinophilic esophagitis (EoE). She covers the questions they considered in the paper and the conclusions they reached. Disclaimer: The information provided in this podcast is designed to support, not replace the relationship that exists 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: [:49] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners Bristol Myers Squibb, GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz. [1:17] Holly introduces today's topic, pediatric and adult eosinophilic esophagitis (EoE), and introduces today's guest, Dr. Melanie Ruffner. [1:23] Dr. Melanie Ruffner is an attending physician with the Division of Allergy and Immunology in the Center for Pediatric Eosinophilic Disorders at Children's Hospital of Philadelphia. Holly welcomes Dr. Ruffner to Real Talk. [1:50] As an attending physician in the Center for Pediatric Eosinophilic Disorders at Children's Hospital of Philadelphia, Dr. Ruffner sees patients who have eosinophilic esophagitis and other eosinophilic disorders, including eosinophilic GI tract disorders. [2:09] Dr. Ruffner also leads a research group that studies how the immune system causes inflammation in response to certain foods, leading to EoE. [2:20] Inflammation in the esophagus is tied to other diseases like epithelial barrier dysfunction and fibrosis. [2:28] Our bodies use many different proteins that allow cells to communicate with one another. One type of signaling protein that causes inflammation is called cytokines. [2:41] Dr. Ruffner's group is interested in how these signaling proteins called cytokines interact with epithelial cells and how that impacts the oral function of the esophagus in patients with EoE. [3:02] In training, Dr. Ruffner became interested in eosinophilic esophagitis and other non-IgE-mediated food allergies because we don't have a lot of clear treatments or clear mechanisms that cause them. [3:21] Dr. Ruffner felt there was a lot of work to be done in that area. It was rewarding to be in clinical encounters with those patients. Often, patients had spent a long time trying to find out what was happening and to find a treatment plan that worked for them. [4:31] Dr. Ruffner's group sees some patients who have eosinophilic gastroenteritis and patients who are referred for hypereosinophilia with impacts of inflammation in other organ systems. [5:06] Dr. Ruffner co-authored a paper about pediatric and adult EoE published in the Journal of Allergy and Clinical Immunology. It explored if EoE in pediatric patients and adult patients is a spectrum or distinct diseases. [5:29] EoE is a chronic allergic condition that affects the esophagus. The esophagus carries food from the mouth to the stomach. In people with EoE, the immune system overreacts to foods and causes inflammation in the esophagus. [5:47] Eosinophils are a type of white blood cell. Eosinophils infiltrate the tissue in the esophagus of people with EoE. Doctors look for eosinophils in the tissue of the esophagus as a sign that inflammation in the esophagus is EoE. [6:04] The symptoms of EoE can vary in children and adults. That was one of the things the doctors were interested in when they were thinking about this paper. There are no blood or allergy tests that make it easy to diagnose EoE, which requires an endoscopy. [6:31] An endoscopy is performed by a gastroenterologist. The gastroenterologists look at the appearance of the esophagus and take biopsies. [6:49] A pathologist counts the eosinophils in the tissue to determine if there are eosinophils present. If there are more than 15 eosinophils in the high-powered field of the microscope and symptoms and clinical conditions are present, EoE is diagnosed. [7:25] One of the variables Dr. Ruffner considers is that symptoms can be different in children versus adults. In older adolescents and adults, the classic symptom is difficulty swallowing or dysphagia. That is often caused by fibrosis in the esophagus. [7:54] In younger children this is often not how EoE presents. They may vomit or refuse food. They may experience more weight loss. Symptoms vary over the lifespan. Pediatric EoE symptoms of nausea and abdominal pain can also show up in adults. [9:54] Atopy refers to allergic conditions. In the paper, a history of atopy means a history of allergic conditions, like atopic dermatitis, IgE-mediated food allergy, allergic rhinitis, or asthma. [10:37] These disorders tend to cluster together, over time, because they share many common genetic risks. They cluster in families because some of the genetic risks are the same. Not every family member will have the same atopic or allergic conditions. [11:07] In families, perhaps one person will have atopic dermatitis and allergic rhinitis while another will have atopic dermatitis, allergic rhinitis, asthma, and EoE. They may have inherited different genetics or had different environmental exposures. [11:50] Ryan says that describes his family. They each have different atopic conditions. Ryan got them all! Dr. Ruffner says it describes her family, as well. [12:26] Dr. Ruffner says it's understandable for families to stress about atopic conditions. Unfortunately, right now, there's no way to predict who will develop which atopic conditions. It's on the minds of the medical and research communities. [13:10] IgE is an antibody that binds to food allergens and mediates anaphylaxis, usually within 30 minutes, with hives, vomiting, and difficulty breathing. Not everyone with a diagnosed food allergy will be given an epinephrine auto-injector. [13:44] IgE-mediated food allergies are influenced by type 2 cytokines. Cytokines are immune system signaling proteins that have been labeled as groups. The group that is involved in allergy most heavily is under the label type 2. [14:15] These type 2 cytokines are responsible for influencing B cells to make IgE. In the tissue in EoE, we find that there is a large amount of these type 2 cytokines present. [14:37] This is quite relevant because dupilumab, the monoclonal antibody that has been approved to treat EoE, targets type 2 inflammation by blocking type 2 cytokines. [16:04] Dr. Ruffner says one of the biggest challenges in the field of EoE is we don't have a way to stratify who should get which treatment for EoE. Patients have to choose between diet and pharmacologic therapy. [16:48] We don't know enough about the inflammatory profiles to give any patient the specific guided information that one therapy would be better than another. [17:11] Pediatric and adult patients are given the same treatment options. Some dosing, such as proton pump inhibitors and dupilumab, is weight-based so different doses are needed. [17:36] Over time, people's needs change. From early school age to when people leave home, they may have very different needs. They may do well on diet therapy when their diet is controlled by parents, but, on their own, that may not be the best option for them. [18:20] Therapy may change over time to support each patient's individual goals. It can be challenging because therapies are imperfect. Each therapy has a percentage probability of success. Not every therapy is guaranteed to work for every individual. [19:01] There is some flexibility and possibility of switching between therapies to support people. Ryan shares one of his experiences in changing treatments. [20:03] Some patients are stable on a therapy for a time but then see symptoms creep back up. Dr. Ruffner strongly suggests they talk to their care team for an endoscopy and biopsy to see if they need to switch therapy and if their diet has changed. [21:31] In young children, Dr. Ruffner sees a much higher incidence of feeding refusal. The child may have a preferred food or a preferred texture like puree, long past when that would be appropriate for the age. [22:41] It can be very difficult to move past this learned behavior even if remission is achieved through therapy. The child may need feeding therapy to help with that. [22:59] Feeding behaviors in older individuals may be much more subtle. Talk about them with your care team. Needing water to eat, cutting food very small, and fearing to eat around people are common eating behaviors to discuss in older patients. [23:53] These eating behaviors affect people's well-being deeply because they affect how social they feel when they are around people. Ideally, you want to be around people and share in social times. [24:16] Holly has used these eating behaviors herself and notices them in other people. When adults come to her for therapy, she asks how many times they refill their water when they eat, and if food ever gets stuck. They are surprised that those are symptoms. [26:01] Dr. Ruffner says it's important to recognize the difference in symptoms in diagnosing EoE. The main risk factor of EoE is fibrosis, over time. The thought is that early in EoE there is an inflammatory phenotype, but later, there is a fibrotic phenotype. [26:51] The phenotype refers to the presentation or characteristic of disease. What is the appearance at endoscopy? What do we see in the biopsied tissue? Is there fibrosis or not? [27:15] This is the crux of the paper: Is this on a spectrum, that the inflammation is driving the fibrosis, or are these two different things altogether? There is some evidence to suggest that the inflammation contributes to this fibrosis over time. [27:40] One thing that is missing is following a group of patients from the start and having that evidence. There is mechanistic evidence from studies to show that inflammation can contribute to fibrosis. That was one of the discussions in the paper. [28:29] In endoscopies, something that can be seen with fibrosis or fibrostenotic features is more of an appearance of rings and narrowing of the esophagus. A proportion of patients with strictures or narrowing need to have them dilated. [29:11] For patients who have dilation, it can help with symptoms significantly. When pathologists look at the tissue with fibrosis, they can see changes in the protein structure. There is more collagen and other changes in the tissue, causing fibrosis. [30:03] Some patients use adaptive eating behaviors to adapt to significant changes in their esophagus and go for many years without being diagnosed until they present with an impaction when food becomes stuck in their esophagus. [30:46] This makes EoE a challenging disorder for many because it can be very difficult to diagnose. The journey to a diagnosis is very individual. As a group, adults are much more likely to have fibrosis, leading to dysphagia, strictures, or impaction. [31:25] Statistically, across all patients, you see fibrosis more in adults than in children. [32:42] In the paper, Th1 cells are mentioned. Th1 is an immune system term referring to a cell that produces interferon-gamma. Studies show there may be differences in interferon signaling in different age groups but it needs to be studied further. [33:57] Dr. Ruffner's team had looked at a small group and saw that interferon signaling seemed to be relatively similar between children and adults. Both CD4 and CD8 T cells (types of immune system cells) are potentially producing interferon in the esophagus. [34:32] More study needs to be done around those immune system cells and their potential significance in EoE, if any. [35:33] The paper suggests that EoE in children and adults is essentially a spectrum of the same disorder rather than distinct diseases. [35:42] Aspects of immunology, responses to different treatments across children and adults, the similar responses to diet and different medications, and over time in the same individuals, indicate these are changes and complications over time. [36:41] Dr. Ruffner suggests that medical researchers need to understand which patients are at the highest risk of complications and work to identify the best treatments to prevent those. [37:14] Dr. Ruffner is thinking about the response to proton pump inhibitor therapy. One of the things she is looking at is whether or not proton pump inhibitors affect how eosinophils migrate into the tissue. [37:33] They are finding that it seems that PPIs can decrease the degree of migration of eosinophils into the tissue. They are very interested in looking at that. Ryan says when Dr. Ruffner gets that paper published, she'll have to come back on the show! [38:06] Ryan thanks Dr. Ruffner. For our listeners who would like to learn more about eosinophilic disorders, including EoE, please visit APFED.org and check out the links in the show notes. [38:15] If you're looking to find a specialist who treats eosinophilic disorders, we encourage you to use APFED's Specialist Finder at APFED.org/specialist. [38:24] 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. [38:33] Ryan thanks Dr. Ruffner for participating in the podcast episode. Holly also thanks APFED's Education Partners Bristol Myers Squibb, GSK, Sanofi, Regeneron, and Takeda for supporting this episode. Mentioned in This Episode: Dr. Melanie Ruffner, MD, PhD, Attending Physician with the Division of Allergy and Immunology and the Center for Pediatric Eosinophilic Disorders at Children's Hospital of Philadelphia “Pediatric and adult EoE: A spectrum or distinct diseases?” by Stanislaw J. Gabryszewski, Melanie A. Ruffner, and Jonathan M. Spergel APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections Education Partners: This episode of APFED's podcast is brought to you thanks to the support of Bristol Myers Squibb, GSK, Sanofi, Regeneron, and Takeda. Tweetables: “EoE is a chronic allergic condition that affects the esophagus. The esophagus carries food from the mouth to the stomach. In people with EoE, the immune system overreacts to food allergens and causes inflammation in the esophagus.” — Dr. Melanie Ruffner “In EoE, there are no blood or allergy tests that make it easy to diagnose EoE without an endoscopy.” — Dr. Melanie Ruffner “Is EoE on a spectrum, that the inflammation is driving the fibrosis, or are these two different things altogether? There is some evidence to suggest that the inflammation contributes to fibrosis over time.” — Dr. Melanie Ruffner “When pathologists look at the tissue with fibrosis, they can see the changes in the protein structure.” — Dr. Melanie Ruffner “There are some folks who have adapted their eating behavior quite significantly and may have quite a number of chronic changes in their esophagus that they have adapted around, and they go for many years without being diagnosed.” — Dr. Melanie Ruffner
Gary Falcetano, Scientific Affairs Manager for Allergy at Thermo Fisher Scientific, is a leader in allergy and autoimmune diagnostics, providing specific IgE tests and the instruments to run them. Accurately diagnosing allergies can be challenging, but specific IgE testing can help confirm the underlying causes by looking at individual allergen components for precise diagnosis. This is the first step in determining the appropriate management approach to potentially interrupt the atopic march, where allergies can progress or even be life-threatening. Gary explains, "It runs the gamut of just about anything that could potentially be an allergy disease. So I think the majority of our testing is done in both environmental allergies and food allergies. What people think about when we, especially this time of year in the US, with spring about to become a big onslaught, are environmental allergies, including pollens, grass, trees, and weeds. Also, looking at some of the indoor triggers to environmental allergies like dust mites, pets, molds, and mice is pretty key when assessing for respiratory-type symptoms. On the food side, any of a number of foods can potentially cause a patient to produce specific IgE, which is the sensitization that allows us to become allergic." "We all think of respiratory allergies as straightforward, but there's an overlap of symptoms, especially from non-allergic causes, that can cause similar symptoms. So when thinking about respiratory allergies, we think about nasal congestion, post-nasal drip, and cough. Those symptoms can all be certainly caused by allergies, but they also can be caused by non-allergic triggers. That's one of the places where diagnostic allergy testing or specific IgE testing comes in to confirm whether we're dealing with an allergy. Then, if it's an allergy, what specifically is driving the symptoms? Once we rule out allergy, we can go down a whole other diagnostic pathway for all the various causes, like non-allergic rhinitis." #ThermoFisherScientific #Allergies #AllergyTesting #ClinicalDiagnostics #PatientCare #IgETesting thermofisher.com Download the transcript here
Gary Falcetano, Scientific Affairs Manager for Allergy at Thermo Fisher Scientific, is a leader in allergy and autoimmune diagnostics, providing specific IgE tests and the instruments to run them. Accurately diagnosing allergies can be challenging, but specific IgE testing can help confirm the underlying causes by looking at individual allergen components for precise diagnosis. This is the first step in determining the appropriate management approach to potentially interrupt the atopic march, where allergies can progress or even be life-threatening. Gary explains, "It runs the gamut of just about anything that could potentially be an allergy disease. So I think the majority of our testing is done in both environmental allergies and food allergies. What people think about when we, especially this time of year in the US, with spring about to become a big onslaught, are environmental allergies, including pollens, grass, trees, and weeds. Also, looking at some of the indoor triggers to environmental allergies like dust mites, pets, molds, and mice is pretty key when assessing for respiratory-type symptoms. On the food side, any of a number of foods can potentially cause a patient to produce specific IgE, which is the sensitization that allows us to become allergic." "We all think of respiratory allergies as straightforward, but there's an overlap of symptoms, especially from non-allergic causes, that can cause similar symptoms. So when thinking about respiratory allergies, we think about nasal congestion, post-nasal drip, and cough. Those symptoms can all be certainly caused by allergies, but they also can be caused by non-allergic triggers. That's one of the places where diagnostic allergy testing or specific IgE testing comes in to confirm whether we're dealing with an allergy. Then, if it's an allergy, what specifically is driving the symptoms? Once we rule out allergy, we can go down a whole other diagnostic pathway for all the various causes, like non-allergic rhinitis." #ThermoFisherScientific #Allergies #AllergyTesting #ClinicalDiagnostics #PatientCare #IgETesting thermofisher.com Listen to the podcast here
Schlammpackung beim US SX in Foxborough, Sandstrahlen beim MXGP auf Sardinien, Red Plate und Döner beim Auftakt der Open DM in Schnaitheim und last but not least ne Packung von allem für Jan und Benedikt beim IGE in Mernes.Und nun, viel Spaß mit dieser Folge Mischbenzim - eurem Motocross Podcast.Folgen!IG: @coach_janIG: @benzim .officialIG: @benzim_fashionDu willst Factory-Rider Feeling? Gestalte dir deine eigene Signature Gear Combo auf: Custom MX gearHandgemachte Qualität aus den Niederlanden.Händeranfragen zur Einbindung des Konfigurators für deine Kunden an: m.asbroek@jopa.nl
MMALOTN is back to give you breakdowns and predictions for UFC 314: Volkanovski vs Lopes. THIS PATREON IS FOR THE FIGHT LINK DATABASE, NOT MY PICKS/BETS/WRITE UPS.
If you've optimized your health but still struggle, this episode is for you. My friend Chris joins me to break down lab work, individualized interventions, and why test interpretation matters as much as the results.Chris has a powerful story—growing up with severe eczema, nearly becoming a doctor, and ultimately choosing to help people outside the medical system. Now, he works with complex cases, helping my community troubleshoot persistent health challenges. We cover mitochondrial support, circadian alignment, diet pitfalls, and the importance of finding the right practitioner.Book with Chris | https://www.sarahkleinerwellness.com/private-coaching-with-team-skwTopics Discussed: How can lab testing help identify hidden health issues?What are the pros and cons of HTMA hair testing?How does mitochondrial support impact overall health?What are common pitfalls of the repeat and carnivore diets?Why is it important to find the right practitioner for lab work interpretation?Timestamps: 00:00:00 - Introduction00:04:01 - How I met Chris00:05:58 - Chris's health journey00:11:36 - Challenges in personalized care00:16:17 - Importance of circadian alignment00:21:36 - Coaching protocol insights00:24:03 - Mitochondria and genetics00:26:28 - Eczema and skin health00:31:02 - Chronic allergies00:33:53 - LDA treatment & biofilms00:37:08 - IgE scores in allergy testing00:38:10 - Issues with HTMA hair testing00:45:34 - Mineral levels & digestion00:47:07 - Chronic illness & holistic care00:51:18 - Nutrition myths & influencers00:57:55 - “Safety weight” & hormones00:59:55 - The carnivore diet01:06:37 - Genetics & diet01:11:02 - Where to find ChrisSponsored By: Viva Rays | Go to vivarays.com & use code: YOGI to save 15%Check Out Chris: Book with Chris | https://www.sarahkleinerwellness.com/private-coaching-with-team-skwWebsite Instagram Twitter 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/coursesSign up for my newsletter to get special offers in the future! -https://www.sarahkleinerwellness.com/contactFree Guide to Building your perfect quantum day (start here) -https://www.sarahkleinerwellness.com/opt-in-9d5f6918-77a8-40d7-bedf-93ca2ec8387fMy free product guide with all product recommendations and discount codes:https://www.sarahkleinerwellness.com/resource_redirect/downloads/file-uploads/sites/2147573344/themes/2150788813/downloads/84c82fa-f201-42eb-5466-0524b41f6b18_2024_SKW_Affiliate_Guide_1_.pdfMy Circadian App - AppleMy Circadian App - AndroidMy Circadian App - Youtube
Description: Co-hosts Ryan Piansky, a graduate student and 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 Sciences Advisory Council, interview Dr. John Accarino, an allergist and immunologist at Massachusetts General Hospital and Mass General for Children, on the topic of immunology support for eosinophilic esophagitis (EoE). Dr. Accarino shares his experiences as a person living with food allergies, allergic asthma, peanut allergy, and eosinophilic esophagitis. He tells how his experiences help him in his work with patients. Dr. Accarino shares some education on a variety of allergy mechanisms and the treatments that mitigate them. Disclaimer: The information provided in this podcast is designed to support, not replace the relationship that exists 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: [:49] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners Bristol Myers Squibb, GSK, Sanofi, and Regeneron. Ryan introduces co-host Holly Knotowicz. [1:14] Holly introduces today's topic, immunology support for eosinophilic esophagitis (EoE), and introduces today's guest, Dr. John Accarino, an allergist and immunologist at Massachusetts General Hospital. Holly welcomes Dr. Accarino to Real Talk. [1:49] Holly notes that Dr. Accarino is her allergist and immunologist. [2:03] Dr. Accarino works at Massachusetts General Hospital and Mass General for Children. Allergy and Immunology is a field where he can see pediatrics and adults. Originally trained in pediatrics, now Dr. Accarino sees patients of all ages. [2:23] Dr. Accarino grew up with allergies. He has experienced food allergies since he was young, along with allergic asthma, and some eczema, which he grew out of. Later in life, he was diagnosed with eosinophilic esophagitis. He talks with his patients about his experiences. [2:47] Dr. Accarino also does research on drug allergies in the context of certain drug interactions that involve eosinophils. [3:06] When Holly was referred to Dr. Accarino, it was for multiple sclerosis (MS). He told her, “It looks like you have EoE. I have EoE.” It was a huge relief to Holly not to have to explain EoE to her doctor. [3:41] Some patients start to explain their EoE to Dr. Accarino, and he assures them he understands where they're coming from. Sometimes, he has to be careful not to think everyone has his symptoms, as there is a large spectrum of presentations. [4:26] Dr. Accarino wasn't diagnosed with EoE until he was in his allergy fellowship, after he suspected it when he had a food impaction at a steakhouse at a graduation party from his pediatric residency. He tried to manage the EoE with lifestyle changes. [5:39] Dr. Accarino didn't often go to see a doctor during residency, but he realized it was probably a good time to get an endoscopy. [5:52] Holly shares how she was also diagnosed as a clinical fellow. She was subbing for someone on the GEDP team at Children's Hospital in Colorado. Listening to all the patients, she realized, “This sounds a little bit like me … What is going on?” [6:23] Even with his medical background, it took Dr. Accarino some time to decide to get the endoscopy and biopsies. You or your doctor have to have a high level of suspicion to realize this isn't just reflux. Food doesn't get stuck in every person's throat. [7:01] Thinking back, Dr. Accarino remembers an instance as a child when a dry muffin got stuck in his throat. He stayed calm and waited for it to pass. He thought it was normal. [7:39] He drank a lot of water and chewed his food a lot. Those are markers of potential esophageal inflammation. [8:20] Different groups have different management strategies for EoE. Dietary management, topical steroids, biologics. A subgroup of people with EoE are responsive to proton pump inhibitors (PPIs). Finding the best management strategy is a work in progress. [8:53] With pediatric patients, the parents control the diet, and the children eat what is prepared. He notes that with adult patients, sometimes they let foods slip through. [9:10] If you want to do a single-food elimination diet with dairy, there's a lot of dairy in the American diet. Dr. Accarino tried eliminating dairy and wheat, but he still had persistent eosinophils with dietary elimination. [9:24] Dr. Accarino then tried PPIs. To know if you have PPI-responsive EoE, you might do twice-daily omeprazole at a significant dose. Have the endoscopy after a few weeks pass and see if the eosinophils are still present in the biopsy. [9:59] Dr. Accarino did that recently and still has the eosinophils. He plans to talk to his gastroenterologist about considering dupilumab, but he feels that he can mitigate his subjective day-to-day experience of symptoms with dietary elimination and PPIs. [10:24] If you still have the presence of eosinophils on biopsy, there's still inflammation happening. In the long term, you still have to worry about fibrosis and narrowing. [10:34] The last treatment Dr. Accarino tried was as a research participant in a study for dissolvable fluticasone. He received either the medication or a placebo; he doesn't know which. [11:01] To stay in the study, he had to journal and report his symptoms regularly. He didn't have enough symptoms to stay in the study. They were looking for a baseline to see how it changed with either the placebo or the medication. [11:20] In research, you have to have a baseline to start, and then you want to see improvement, plus or minus. With EoE, it's difficult. You have the biopsy and eosinophils, but there's a large spectrum of symptoms that people may experience. [12:40] Holly appreciates Dr. Accarino's unique perspective as a doctor with EoE who has experienced various treatments and diets. He understands the concerns of his patients. [12:43] Dr. Accarino says even taking a twice-daily PPI or other medication is difficult for a lot of people, and that's the most simple of these therapies. [13:06] Dr. Accarino wants to validate everyone's experience in terms of how difficult it is to treat this disorder, how it may present in different ways, and how there may be a delay in diagnosis. [13:16] This isn't IgE-mediated immediate food allergy, where you eat a food and may have swelling within minutes; you may have flushing or hives. That's very clear. With EoE, it's a different mechanism; in many cases, there is a delay. [14:37] Allergy, in general, is under the purview of clinical immunology. Dr. Accarino is allergic to peanuts and has an IgE-mediated immediate reaction to them. If he eats a peanut, he has symptoms within minutes. He could have anaphylaxis. As a result, he carries an epinephrine auto-injector. [15:01] If Dr. Accarino has a skin test, it will be positive for peanut. He has IgE antibodies to peanuts. He also has oral allergy syndrome where the body mistakes certain fruits, vegetables, or nuts with certain tree pollens or grass pollens. [15:23] Oral allergy syndrome is usually a lower-risk condition where it's a less-stable protein that once cooked might not produce any symptoms. If it's raw when you consume it, you may have oral itching, a bit of throat discomfort, or tongue itching. [15:54] Your stomach acid breaks it down so it doesn't get into your bloodstream and you shouldn't have a systemic reaction. [16:01] If Dr. Accarino eats a peanut, his stomach acid doesn't break down the high-risk, stable peanut protein, it gets into his bloodstream, and he can have a systemic anaphylactic reaction. [16:20] Chronic EoE symptoms can present with something like a food impaction, or bad reflux or belly pain, and nausea. The reaction may not be immediate. It may be progressive over days or weeks. [16:38] FIRE is an interesting condition that takes some time to narrow down. It's an immediate response of the esophagus, but we don't think it's histamine-mediated. [16:56] We don't know, exactly, the mechanism but it's in people with eosinophilic esophagitis. They feel differently, and there would be different specific food triggers. [17:11] It took some time to figure out what was going on. Dr. Accarino felt like he had a lump in his throat, then a lump in his chest, nausea, and belly pain. It felt like a slow progression of EoE symptoms, and it was from specific food triggers, in his case. [17:30] In some of the FIRE literature, they looked at banana and avocado. For Dr. Accarino, it took a couple of exposures to protein bars and milk protein whey isolate, specific to protein bars he had multiple times, until he figured out that was the trigger. [17:50] Another protein whey isolate that Dr. Accarino scooped as a powder and made into a shake also led to FIRE. [17:55] It took that event for Dr. Accarino to figure out it wasn't just a flareup of EoE or reflux but some trigger that caused this response that wasn't anaphylaxis but may be due to the recruitment of eosinophils or some immediate process not well understood. [18:18] FIRE is going to be very hard to research. How would we figure this out? Would we bring someone in and do an endoscopy immediately and see what happens? There's a lot of descriptive data and case series. [18:32] Dr. Accarino has had experiences when he knew it wasn't an immediate anaphylactic reaction, oral allergy, or reflux. He asked what else it could be in the context of EoE. When he looked at different case series, that's the presentation he had. [19:17] Dr. Accarino acknowledges that having personal experience with FIRE, oral allergies, and IgE-mediated allergies, on top of EoE, has influenced his work as a medical professional. He can share anecdotes with patients as he explains the available testing. [19:39] Dr. Accarino says a lot of immunology and allergy is explaining the diagnostic tools and management strategies we have and what we think is going on. [19:50] The immune system is infinitely complex, and a lot of the practice is making a digestible analogy, not just in the context of allergic conditions but also everything with the immune system. There are so many cells doing so many different things. [20:04] Dr. Accarino explains false positives in testing. He has positive scratch tests for peanuts, cashews, and almonds, which shows he has IgE for each of them. He is allergic to peanuts, but he can eat cashews and almonds. Those are false positives. [20:56] When a scratch test is negative for immediate food allergy, it's a powerful predictive tool. But you may get false positives. How positive is it? There might be room for more discussion. [21:10] There may be more hesitation for people who do large panels of food testing without any history of reacting to any foods. [21:31] Some people have EoE triggered by milk or wheat but have negative skin tests. That doesn't mean they aren't triggered by these foods. The skin test is an IgE histamine mast cell mechanism, not for eosinophils, which are other immune cells. [21:58] We go down these steps of thinking about diagnostic triggers and eventually treatment for those immediate symptoms mentioned for EoE. [22:09] Dr. Accarino doesn't expect FIRE to be responsive to epinephrine. He doesn't have to stabilize the mast cells. It's a chronic disease that's flaring up. You treat it with a chronic type of treatment. [24:10] Dr. Accarino says that for a doctor, immunology is rewarding, interesting, and complex, but it's intimidating until you get your foothold and see patients and clinical experiences. [25:14] A lot of medical students and residents are a little fearful of immunology. They might not think about it too much. Dr. Accarino loves to talk about it and think about it. He can't think of anything more complex in terms of systems within our body. [25:37] Ryan comments on his experiences with IgE-mediated food allergies, some environmental allergies that he has no idea how they work, and EoE, which he believes he has a good grasp on. [25:55] Ryan imagines that having a physician with a good understanding of the immune system and also personal experience would be helpful for a patient with multiple allergic conditions. [26:13] Dr. Accarino sees a large overlap of seasonal or year-round environmental allergies and EoE. There are some studies that show that endoscopies on patients with EoE may change at different times of the year if they have underlying seasonal allergies. [26:33] Some people who have food allergies also have EoE or other eosinophilic disorders. Some discussions with them may be about blood tests that detect eosinophils in the bloodstream versus biopsies of the esophagus, stomach, or colon. [27:15] It's thinking about what tests are available, what they tell us, and how to use them to predict the next steps, things like dietary changes or for immediate food allergy, considering challenges versus full avoidance. Each test has its pluses and minuses. [27:35] People like a clear test, and they like an easy fix, but sometimes there's a lot of nuanced conversation of shared decision-making and trying things in a supervised setting. [27:57] Holly speaks as a patient of the investigative testing Dr. Acarino is doing with her immune system trying to figure it out along with her MS and EoE. [28:14] Dr. Accarino says the words immune system, immunity, and inflammation are used a lot in talking about foods. Dr. Accarino uses the framework of the immune system trying to help you. [28:42] Sometimes, instead of making helpful antibodies to things like vaccines or viruses, that give you protection, the immune system makes antibodies that attack a certain organ or your joints. [29:02] Dr. Accarino thinks of treatments that suppress the immune system in certain ways. Some treatments cool down the populations of many different immune cells. Oral steroids and prednisone are used for many conditions for autoimmune flares. [29:29] Oral steroids, in the long term, may lead to weight gain, bone density changes, and diabetes. The big push for many diseases is toward non-steroidal biologics to target specific cells that cause disease. [29:59] For Crohn's disease, a specific monoclonal antibody is used to target TNF-alpha molecules and blocks that inflammation pathway. [30:14] For EoE, dupilumab, a specifically designed antibody, blocks a specific receptor in a specific pathway so the immune system doesn't have to be shut down and the patient doesn't have the side effects of steroids. It's a targeted therapy. [30:32] What you see in commercials for injectable medications are large, designed antibodies that, if you took them in a pill form, your stomach acid would break down and digest. So they are injections and infusions that go directly into the bloodstream. [31:22] Medications that end in -mab are monoclonal antibodies. They are very large molecules that would not be stable in stomach acid. [32:09] Dr. Accarino talks of eosinophil normal function and aberrant function. IgE-mediated reactions are usually related to mast cells, a type of immune cell that shouldn't be in the bloodstream. [32:54] Dr. Accarino can do a CBC with differential to see the number of white blood cells and the number of red blood cells. The differential of white blood cells will include neutrophils, lymphocytes, and eosinophils. It shouldn't show mast cells. [33:19] If you have mast cells in your bloodstream, that's mastocytosis, a different problem. Mast cells live in your skin, in your gut, and around your blood vessels. They're full of granules like histamine and tryptase. [33:38] Dr. Accarino explains how mast cells release their contents and how he would treat the resulting swelling or itch with an antihistamine or epinephrine. Epinephrine treats systemic reactions and stabilizes the mast cells. [34:16] Mast cells have many receptors and may be triggered by many things other than IgE. This is a conversation Dr. Accarino has with patients who have chronic hives unrelated to any foods. [34:29] Some people get hives from non-steroidal anti-inflammatory drugs NSAIDs. Some get hives from vancomycin. Some get hives when the temperature changes, from tight clothing, or from IV contrast. It's not an IgE-mediated mechanism, but it's still mast cells being degranulated. [35:45] Dr. Accarino says people see hives and they think allergy. But, like EoE, it doesn't involve histamine. There can be hives that aren't related to allergies. This can be idiopathic urticaria or spontaneous urticaria. [36:04] Sometimes, when switching from a day shift to a night shift, hormonal changes will trigger hives. Sometimes, the stress of having a family member in the hospital will cause hives. An accumulation of triggers can lead to mast cell degranulation. [36:38] There are many ways that allergy can have different mechanisms and treatments, with different cells involved. There are different molecules that cause symptoms and manifestations. [36:50] Navigating that and understanding what might be going on can give people a sense of reassurance. The biggest fear is a life-threatening allergic reaction. People will read about fatal anaphylaxis and wonder if it will happen to them with their condition. [37:16] Sometimes, thinking of the cells involved and the pathways may give a level of reassurance that this may not be the same thing that they read about. [37:28] Ryan thanks Dr. Accarino for joining us today. [37:37] Dr. Accarino says it was nice to reflect on things and to go through different scenarios and experiences he has gone through. It was nice to have the opportunity to share them with Ryan, Holly, and all the listeners. [37:57] For our listeners who would like to learn more about eosinophilic disorders, including EoE, please visit APFED.org and check out the links in the show notes. [38:06] If you're looking to find a specialist who treats eosinophilic disorders, we encourage you to use APFED's Specialist Finder at APFED.org/specialist. [38:15] 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. [38:25] Ryan thanks Dr. Accarino for joining us today for this fun conversation. Holly also thanks APFED's Education Partners Bristol Myers Squibb, GSK, Sanofi, and Regeneron for supporting this episode. Mentioned in This Episode: Dr. John Accarino, MD, Allergist and Immunologist at Massachusetts General Hospital and Mass General for Children Episode 034: Food-Induced Response and Eosinophilic Esophagitis APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections Education Partners: This episode of APFED's podcast is brought to you thanks to the support of Bristol Myers Squibb, GSK, Sanofi, and Regeneron. Tweetables: “Allergy and immunology is a field where I can see pediatrics and adults. I was originally trained in pediatrics, but now I see all ages, from infants up until older adults.” — Dr. John Accarino “Part of the conversation sometimes is trying not to overly bias myself, where I say, ‘Oh, this is my experience.' … Like many diseases, there's a large spectrum of presentations, … different symptoms that people have.” — Dr. John Accarino “We don't think [Food-Induced Response in Eosinophilic Esophagitis is] histamine-mediated. We don't know exactly the mechanism, but it's in people with eosinophilic esophagitis. They feel differently, and there would be different specific food triggers. It took some time to figure out that was going on.” — Dr. John Accarino “When a scratch test is negative for immediate food allergy, it's a very powerful predictive tool. But there are times that you may get false positives. How positive is it? There might be room for more discussion.” — Dr. John Accarino “There are a lot of ways that allergy can have different mechanisms and different treatments, with different cells involved.” — Dr. John Accarino
This spring, patients may be reporting that some foods cause their mouth to itch. Is this a food allergy? Or is this pollen food allergy syndrome (PFAS)? In this episode of ImmunoCAST tackles the clinical challenge of distinguishing this condition from more severe food allergies. We explore the mechanisms behind PFAS, its relationship to seasonal allergies, and the importance of comprehensive allergy evaluation. Key topics include the role of specific IgE testing, differentiating between true food allergies and cross-reactivity with pollen, and management strategies such as avoiding trigger foods and processing methods to denature allergens. Gain valuable insights into improving patient outcomes through accurate diagnosis and tailored management plans. Episode resources and references available at https://www.thermofisher.com/phadia/us/en/resources/immunocast/%20pollen-food-allergy-syndrome-ige-testing-cross-reactivity.html?cid=0ct_3pc_05032024_9SGOV4
Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let's dive into the latest updates impacting clinicians and healthcare providers like you! Interested in a more traditional, text rundown? Check out the HCPFive! Top 5 healthcare headlines for March 9-16, 2025: 1. CagriSema Yields Nearly 16% Weight Loss in Phase 3 REDEFINE 2 Trial In the Phase 3 REDEFINE 2 trial, CagriSema showed weight reduction in adults with obesity or overweight and type 2 diabetes, outperforming placebo. 2. Lorundrostat Significantly Lowers Blood Pressure in Key Hypertension Trials The Phase 3 Launch-HTN and Phase 2 Advance-HTN trials showed lorundrostat effectively reduced blood pressure in uncontrolled or resistant hypertension with a favorable safety profile. 3. PharmaTher Receives New Early June FDA Goal Date for Ketamine PharmaTher announced the FDA set a new Priority Review goal date of June 4, 2025, for ketamine to treat anesthesia, pain, mental health, and neurological conditions. 4. FDA Awards Fast Track Designation to ATSN-201 Gene Therapy for XLRS The FDA granted Fast Track designation to ATSN-201 for X-linked retinoschisis, allowing Atsena Therapeutics to seek Priority Review for their gene therapy. 5. FDA Approves First Interchangeable Biosimilar for Omalizumab The FDA approved omalizumab-igec (OMLYCLO) as the first interchangeable biosimilar to Xolair for asthma, CRSwNP, IgE-mediated food allergy, and CSU.
Description: Co-hosts Ryan Piansky, a graduate student and 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 Sciences Advisory Council, interview Dr. Wayne Shreffler, Chief of Pediatric Allergy and Immunology and Co-Director of The Food Allergy Center at Massachusetts General Hospital. Dr. Shreffler is also an investigator at The Center for Immunology and Inflammatory Disease and The Food Allergy Science Initiative. His research is focused on understanding how adaptive immunity to dietary antigens is both naturally regulated and modulated by therapy in the context of food allergy. This interview covers the results of a research paper on The Intersection of Food Allergy and Eosinophilic Esophagitis, co-authored by Dr. Shreffler. Disclaimer: The information provided in this podcast is designed to support, not replace the relationship that exists 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: [:50] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners Bristol Myers Squibb, GSK, Sanofi, and Regeneron. Ryan introduces co-host, Holly Knotowicz. [1:15] Holly introduces today's topic, the intersection of food allergy and eosinophilic esophagitis. [1:26] Holly introduces today's guest, Dr. Wayne Shreffler, Chief of Pediatric Allergy and Immunology and Co-Director of The Food Allergy Center at Massachusetts General Hospital and an investigator at The Center for Immunology and Inflammatory Disease and The Food Allergy Science Initiative. [1:43] Dr. Shreffler's research is focused on understanding how adaptive immunity to dietary antigens is both naturally regulated and modulated by therapy in the context of food allergy. [1:54] Holly welcomes Dr. Shreffler to Real Talk. When Holly moved to Maine, she sent her patients to Dr. Shreffler at Mass General. [2:25] Dr. Shreffler trained in New York on a Ph.D. track. He was interested in parasitic diseases and the Th2 immune response. Jane Curtis, a program director at Albert Einstein College of Medicine, encouraged him to consider MD/PhD programs. He did. [3:31] Jane Curtis connected him to Hugh Sampson, who was working with others to help understand the clinical prevalence of food allergy and allergens. [3:51] As a pediatric resident, Dr. Shreffler had seen the burden of allergic disease, caring for kids in the Bronx with asthma. His interest in Th2 immunity, the clear and compelling unmet clinical need, and the problem of food allergy guided his career. [4:31] Dr. Shreffler's wife has food allergies and they were concerned for their children. Fortunately, neither of them developed food allergies. [5:21] Dr. Shreffler thinks the food allergy field has a lot of people who gravitate toward it for personal reasons. [5:53] Food allergy is an adverse response to food that is immune-mediated. There is still uncertainty about this but Dr. Shreffler believes that a large percentage of patients with EoE have some triggers that are food antigens. [6:27] The broad definition of food allergy would include things like food protein-induced enterocolitis syndrome (FPIES). [6:47] The way we use the term food allergy in the clinic, there are two forms: IgE-mediated allergies and non-IgE-mediated allergies, including EoE. [7:40] Some patients have food-triggered eczema, some have FPIES. [8:04] In 2024, Dr. Shreffler and Dr. Caitlin Burk released a paper that looked at the triggers of EoE, particularly the intersection of IgE-mediated food allergy and EoE. [8:41] Dr. Caitlin Burk joined the group as they were publishing papers on IG food allergy and EoE. It was a moment where things unexpectedly came together. [9:17] Adaptive immunity to food proteins comes from antibodies that cause milk allergy, egg allergy, peanut allergy, or multiple allergies. The IgE has specificity. [9:40] T cells also are specific to proteins. They express a host of receptors that recognize almost anything the immune system might encounter. They have a long memory like B-cells. [10:09] The overlap in these two threads of research was regarding a population of T cells that are important for mediating chronic inflammation at epithelial sites, including the gut. [10:36] These T cells have been described in the airways in asthma, in the skin in eczema, and the GI tract. Researchers years ago had also described them as being associated with IgE food allergy. People with IgE food allergies avoid allergens. [11:13] T cells, being associated with chronic allergic inflammation, now being associated with food allergies which are not having chronic exposures to the allergen, was interesting and surprising. [11:30] Dr. Shreffler and his group found the T cell subset in patients who don't do well with Oral Immunotherapy (OIT) and patients who have EoE with immediate symptoms. [12:01] Dr. Shreffler notes differences. There are immediate symptoms of IgE food allergy. There is a subset of patients with EoE who have immediate symptoms that are not fully understood. Maybe IgE plays a role there. [12:28] There are different mechanisms for how symptoms are caused and so different ways of making a diagnosis. A food allergy with an IgE antibody can be measured through skin tests and blood tests. This can help identify which foods are the trigger. [12:57] This common T cell subset that we see in EoE and food allergy, helps to explain why IgE alone is not always a very specific marker for identifying people who will have immediate reactions when they're exposed to the food. [13:17] For patients who react at low levels, it's not just that they have more or better IgE but they also have an expansion of these T cells that are common between EoE and other chronic forms of allergy and IgE food allergy. [13:41] There's a lot to learn that might be relevant for patients about this T cell subset. [14:23] These T cells are a specific subset of the group of Th2 T cells, which are a subset of all CD4 T cells. Some CD4 T cells are important for responding to viruses and tumors. Others are important for responding to outside allergens. [15:01] In an allergy or a parasite infection, Th2 T cells are important. There is a subset of T cells that is driven by repetitive and chronic exposure to the triggering protein, antigen, or allergen. [15:47] Most antigens are proteins that trigger an immune response. An antigen that elicits an allergic response is an allergen. [16:30] A food trigger is a protein antigen that is an allergen. In IgE, food allergies, milk, and eggs are prevalent triggers early in life. For reasons not well understood, a lot of people outgrow them. In older patients, peanut and tree nut allergies are prevalent. [17:01] In EoE, milk is one of the most common dietary triggers into adulthood. Some patients with IgE allergy to milk can tolerate it if it's well cooked. Patients with EoE are less likely to be able to get away with regular and ongoing exposure to milk protein. [17:54] Milk, eggs, and nuts are common triggers in both conditions. There can also be rare food allergy triggers. That's part of the early evidence that the adaptive immune response was likely to be involved. It can be so specific for some people to rare things. [18:20] Hallmarks of something being immune-mediated are that it is reproducibly demonstrable as a trigger. It's going to be long-lived. It's going to be generally relatively small amounts. The immune system is good at detecting small exposures. [19:07] EoE is tricky because there's not that clear and easy temporal association between an offending allergen exposure for most people and their symptoms. People don't associate the symptoms with the triggers. [20:14] A history of having blood in the stools can be milk-allergen-driven and was associated with a diagnosis of EoE in those kids when they're older. [20:26] There are a lot of commonalities in the allergens but it's not always obvious clinically. [22:40] A challenge in diagnosing EoE is that providers have to be on guard against their biases. They have to give a patient good advice. In EoE there is no test to identify triggers, except rigorous introduction, elimination, reintroduction, and endoscopies. [24:18] For some of Dr, Shreffler's patients, it becomes less important to know their dietary triggers. They gravitate toward an approved form of treatment that may, if successful, allow them to have a more normal diet because of effective medication. [24:50] Dr. Shreffler thinks there are other triggers, including pollens. There is evidence of seasonality of active EoE in patients shown to have allergic sensitization to pollens. That's indirect evidence. If the body is making IgE, it's likely making other responses. [25:32] There are questions about how large the population of patients is who have EoE that may be more intrinsically than extrinsically driven because of genetic variations. [25:54] Dr. Shreffler believes that EoE in some patients is allergen-driven and in some patients EoE is food-driven. Food is a trigger for the majority of pediatric patients and a large percentage of adult patients but not necessarily the exclusive trigger. [27:04] If a patient is motivated to learn what dietary triggers may be at play, Dr. Shreffler often makes assessments outside of pollen season for allergens to which the patient has demonstrated positivity. [28:09] Looking at the epidemiology, both EoE and food allergy are atopic disorders. You see an increased prevalence of asthma, hay fever, eczema, and even allergic proctocolitis in infancy. You see an enrichment of one disorder to another. [28:29] The overlap of food allergy to EoE is stronger than you might expect. About 30 to 40% of patients with EoE will also have IgE food allergy. A higher rate will have IgE positivity, whether or not that food is a trigger of immediate symptoms. [28:48] Patients with food allergies are about four times more likely to have EoE than the general population. That's a stronger association than the risk of eczema or other atopic conditions to EoE. [30:09] There are differences between IgE food allergy and EoE. The presence of IgE gives a useful tool for identifying the food trigger in food allergy, but not in EoE. Identifying rare triggers in EoE patients is done by clinical observation. [31:46] Epinephrine and antihistamines are not useful in treating EoE. Blocking IgE with Omalizumab has not been effective in trials in treating EoE. PPIs, topical steroids, and dupilumab are helpful for many EoE patients. [32:38] Dupilumab has been evaluated a bit in food allergy in combination with OIT, and there was no statistically significant benefit from dupilumab in food allergy. [33:25] A group in Pennsylvania has been evaluating epicutaneous immunotherapy as a modality to treat EoE. It's also being evaluated for IgE food allergy. Dr. Shreffler thinks it's something to keep an eye on. [33:40] The oral route for immunotherapy can drive EoE for patients. As they become less sensitive from an immediate reactivity viewpoint, a significant percentage of patients develop GI symptoms. This has also been observed with sublingual therapy. [34:14] Iatrogenic EoE, caused by the treatment, may resolve on the cessation of the immunotherapy treatment. [36:25] Dr. Shreffler says in some cases, the shared decision is a decision where he has a strong evidence-based opinion. In some cases, there's a lot more room for a range of clinical decisions that could be equally supported by what we know right now. [36:57] We've said that EoE is a contraindication for OIT. There is a shift happening. Dr. Shreffler sits with families and has a conversation about restricting diet or trying chronic therapy and keeping an ad-lib diet. [37:38] What about doing the same thing by treating the immediate-type food allergy with chronic allergen exposure and then ameliorating the effects of EoE if it emerges, with another therapy? A hundred providers would have a diversity of responses. [38:19] When there is a history of EoE in a family, Dr. Shreffler advocates for getting a baseline scope. It becomes an important “ground zero.” [38:28] The goal is to have less invasive ways to monitor these conditions. [39:32] Chronic inflammation, which is the hallmark of EoE, is well-targeted by therapies like PPIs and steroids. Steroids don't help with IgE-related food allergies. They're not effective at blocking the IgE-driven immediate response. [41:13] Until recently, IgE food allergy has only been managed with avoidance. We have some other tools now. Xolair is not effective in EoE but is effective in two-thirds to three-quarters of patients with immediate-type food allergies for preventing anaphylaxis. [41:45] Dr. Shreffler refers to an upcoming study on the effectiveness of Xolair in treating people with food allergies. Those who were able to tolerate a minimum amount were allowed to begin consuming allergen. We'll get insight into how those patients did. [43:08] Food-induced immediate response of the esophagus (FIRE) is immediate discomfort with exposure to some allergens. Dr. Shreffler explains it. Data supports that these patients are experiencing an IgE-mediated but local response to those triggers. [44:59] If FIRE is IgE-mediated, it may be that Xolair would help suppress it in these patients. It's worth looking at Xolair for this subset of EoE patients. [45:20] Ryan invites any listeners who want to learn more about FIRE to check out episode #34 with Dr. Nirmala Gonsalvez. [45:37] In the paper, Dr. Shreffler wrote about what he hopes will be the practical usefulness of the finding, the intersection between IgE food allergy and EoE. [45:56] A subset of Th2 T cells express a protein called GPR15. It appears to be a marker for the subset of cells that are playing a role in the EoE. [46:36] Caitlin Burk's work now is looking at their activation status in active disease and post-diet elimination and remission. She is developing a data set that is leading us toward the possibility of focusing on that cell subset and techniques to adopt in clinics. [47:12] She is also working out more advanced techniques to look at the receptors. Dr. David Hill at CHOP is working on similar research. This research has the potential to lead to the development of better tests for EoE. [47:44] Holly tells Dr. Shreffler this has been such an informative episode with so many tidbits of things to help patients advocate for themselves. Holly thanks him for sharing all of that. [48:12] Dr. Shreffler is trying to see what can be utilized from their research to make non-invasive tests to identify food allergen triggers for patients so they don't have to go through so many endoscopies. He sees it as a huge unmet need. [48:31] Ryan thanks Dr. Shreffler for joining us. For our listeners who would like to learn more about eosinophilic disorders, including EoE, please visit APFED.org and check out the links in the show notes. [48:41] If you're looking to find a specialist who treats eosinophilic disorders, we encourage you to use APFED's Specialist Finder at APFED.org/specialist. [48:50] 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. [49:00] Ryan thanks Dr. Shreffler for joining us today for this interesting conversation. Holly also thanks APFED's Education Partners Bristol Myers Squibb, GSK, Sanofi, and Regeneron for supporting this episode. Mentioned in This Episode: Dr. Wayne Shreffler, MD, Ph.D., Chief of Pediatric Allergy and Immunology and Co-Director of The Food Allergy Center at Massachusetts General Hospital “Triggers for eosinophilic esophagitis (EoE): The intersection of food allergy and EoE” Dr. Caitlin Burk Dr. David A. Hill APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections Education Partners: This episode of APFED's podcast is brought to you thanks to the support of Bristol Myers Squibb, GSK, Sanofi, and Regeneron. Tweetables: “This fascinating problem of food allergy: why does the immune system do that for some people — recognize what should be nutritive and innocuous sources of energy as an immunological trigger? ” — Dr. Wayne Shreffler “A food allergy; because there is this IgE antibody, we can do skin tests. We can measure that in the blood. It's a useful marker for helping to identify which foods are the trigger.” — Dr. Wayne Shreffler “EoE is tricky because there's not that clear and easy temporal association between an offending allergen exposure for most people and their symptoms. People don't associate the symptoms with the triggers.” — Dr. Wayne Shreffler “Everything is shared decision-making. In some cases, it's a shared decision where I have a strong evidence-based opinion. In some cases, there's a lot more room for a range of clinical decisions that could be equally justified.” — Dr. Wayne Shreffler “Steroids don't help with IgE-related food allergy. They're not effective at blocking that IgE-driven immediate response.” — Dr. Wayne Shreffler “I'm trying to see what we can utilize from our research to make non-invasive tests to identify food allergen triggers for patients so they don't have to go through so many endoscopies. I think that's a huge unmet need.” — Dr. Wayne Shreffler
Why do conditions like asthma, nasal polyps, or eczema become more severe when they coexist? Kortney and Dr. Payel Gupta are joined by Dr. Michael Blaiss to explore the common thread linking multiple allergic and inflammatory diseases: Type 2 Inflammation. If you've ever wondered why certain conditions often appear together, this deep dive will help you connect the dots. Type 2 Inflammation is a hot topic in immunology because it's the engine that drives many allergic and inflammatory diseases. It's also the key to modern treatment strategies, including targeted biologic therapies. Dr. Blaiss explains how clinicians recognize multiple Type 2-driven conditions in the same patient, why it is important to know the connection between multiple conditions and Type 2 inflammation, and the big-picture benefits of treating inflammation aggressively to prevent complications. What We Cover in our Episode about The Diseases Related to Type 2 Inflammation Conditions Related to Type 2 Inflammation: Explore how chronic rhinosinusitis with nasal polyps (CRSwNP), rhinitis, asthma, atopic dermatitis (eczema), prurigo nodularis, eosinophilic esophagitis (EoE), and food allergies can all share a common inflammatory pathway. The Likelihood of Having Multiple Type 2 Conditions: How often do patients have more than one condition related to Type 2 Inflammation, and why is recognizing overlap a potential game-changer for diagnosis and treatment? Treating the Root Inflammation vs. Individual Symptoms: Discover how clinicians decide whether to address each condition separately or tackle the underlying Type 2 inflammatory process affecting them all. Markers & Personalized Medicine: Dr. Blaiss discusses whether potential tests, such as eosinophil counts or IgE levels, can confirm Type 2 inflammation. He also explains how knowing you have Type 2 Inflammation can help guide targeted therapy. Prevention & Aggressive Intervention: Understand why it's crucial to treat inflammation early to reduce the risk of developing multiple Type 2 conditions and how this proactive approach benefits long-term health. Want to know more? Type 2 Inflammation Overview – Explains the role of Type 2 inflammation in conditions like asthma and nasal polyps. This podcast is for informational purposes only and does not substitute for professional medical advice. If you have any medical concerns, always consult with your healthcare provider. Produced in partnership with The Allergy & Asthma Network. Thanks to Sanofi and Regeneron for sponsoring today's episode. While they support the show, all opinions are our own, and sponsorship doesn't influence our content or editorial decisions. Any mention of brands is for informational purposes and not an endorsement.
Episode 184: Multiple Myeloma BasicsSub-Interns and future Drs. Di Tran and Jessica Avila explain the symptoms, work up and treatment of multiple myeloma. Written by Di Tran, MSIV, Ross University School of Medicine; Xiyuan Yang, MSIV, American University of the Caribbean. Comments by Jessica Avila, MSIV, American University of the Caribbean. Edits by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Di: Hi everyone, this is Di Tran, 4th year medical student from Ross university. It's a pleasure to be back. To be honest, this project is a part of teamwork of two medical students, myself and another 4th year, her name is XiYuan. She came from the AUC. Unfortunately, due to personal matters she was unable to make it to the recording today which makes me feel really sad. Jessica: My name is Jessica Avila, MSIV, American University of the Caribbean.Di: The topic we will present today is Multiple Myeloma. Multiple myeloma is typically a rare disease and it's actually a type of blood cancer that affects plasma cells in the bone marrow.Jessica: Let's start with a case: A 66-year-old male comes to his family doctor for an annual health checkup. He is not in any acute distress but he reports that he has been feeling tired and weaker than usual for the last 3 months. He also noticed that he tends to bruise easily. He has a history of arthritis and chronic joint pain, but he thinks his back pain has gotten worse in the last couple of months. Upon checking his lab values, his family doctor found that he has a calcium level of 10.8 and a creatinine level of 1.2, which has increased from his baseline. Given all that information, what do you think his family doctor is suspecting? And what kind of tests she can order for further evaluation?Di: Those symptoms sound awfully familiar – are we talking about the CRAB? You know, the diagnostic criteria for Multiple Myeloma.Jessica: Exactly! Those are called “myeloma-defining events.” Do you remember what those are?Di: CRAB criteria comes in 4 flavors. It's HYPERCALCEMIA with >1mg/dL, RENAL INSUFFICIENCY with serum creatinine >2mg/dL, ANEMIA with hemoglobin value 10% plasma cells, PLUS any one or more of the CRAB features, we can make the official diagnosis of multiple myeloma. Di: Before we go deeper, let's back up a little bit and do a little background. So, what do we know about the immunoglobulins, also known as antibodies? Back from years of studying from medical school, we know that the plasma cells are the ones that producing the antibodies that help fight infections. There are various kinds that come with various functions. Each antibody is made up of 2 heavy chains and 2 light chains. For heavy chains, we have A, D, E, G, M and for light chains we have Kappa and Lambda.Jessica: Usually, the 5 possible types of immunoglobulins for heavy chains would be written as IgG, IgA, IgD, IgE, and IgM. And the most common type in the bloodstream is nonetheless the IgG. Di: What is multiple myeloma? In myeloma, all the abnormal plasma cells make the same type of antibody, the monoclonal antibody. The cause of myeloma is unknown, but there are lots of studies and evidence that show a number of potential etiologies, including viral, genetic, and exposure to toxic chemicals, especially the Agent Orange, which is a chemical used as herbicide and defoliant. It was used as a chemical warfare by the U.S. military during the Vietnam War from 1961 to 1971.Jessica: We need to order some specific blood tests to see if there is elevated monoclonal proteins in the blood or urine. So, to begin with we'll need to take a very thorough history and physical exam. Next, we'll do labs, such as CBC, basic metabolic panel, calcium, serum beta-2 microglobulin, LDH, total protein, and some not so common tests: serum protein electrophoresis (SPEP), immunofixation of blood or urine (IFE), quantitative immunoglobulins (QIg), serum free light chain assay, and serum heavy/light chain ratio assay.If any of the results is abnormal, we should consider referring our patient to an oncologist.Di: Interesting! I read that Multiple Myeloma symptoms vary in different patients. In fact, about 10-20% of patients with newly diagnosed myeloma do not have any symptoms at all. Otherwise, classic symptomatic presentations are weakness, fatigue, increased bruising under the skin, reduced urine output, weakened bones that is likely prone to fractures, etc. And if multiple myeloma is highly suspected, a Bone Marrow biopsy should be done with testing for flow cytometry and fluorescent in situ hybridization (FISH). Actually, if any of the “Biomarkers of malignancy (SLIM)” is met we can also diagnose multiple myeloma even without the CRAB criteria. Jessica: The diagnosis is made if one or more of the following is found: >= 60% of clonal plasma cells on bone marrow biopsy, > 1 lytic bone lesion on MRI that is at least 5mm in size, or a biopsy confirmed plasmacytoma. Di: Imaging comes in at the final step especially if we able to find one or more sites of osteolytic bone destruction > 5mm on an MRI scan.Jessica: What if the bone marrow biopsy returns > 10% of monoclonal plasma cells, but our patient doesn't have either the CRAB or the Biomarker criteria? Di: That's actually a very good question, since Multiple Myeloma is part of a spectrum of plasma cell disorders. That's when smoldering myeloma comes into play. It is a precursor of active multiple myeloma. Smoldering myeloma is further categorized as high-risk or low-risk based on specific criteria.A less severe form is called Monoclonal Gammopathy of Undetermined Significance, or simply MGUS, with < 10% bone marrow involvement. Those are diagnoses we give once we rule out actual multiple myeloma, which are defined by the amount of M-protein in the serum.Jessica: When to get started on treatment? Multiple Myeloma is on a spectrum of plasma cells proliferative disorders, starting from MGUS to Smoldering Myeloma, to Multiple Myeloma and to Plasma Cell Leukemia. Close supervision/active watching is enough for MGUS and low risk Smoldering Myeloma. But once it has progressed to high-risk smoldering myeloma or to active Multiple Myeloma, chemotherapy is usually required. Some situations may require emergent treatment to improve renal function, reduce hypercalcemia, and to prevent potential infections.Di: As of 2024, treatment of Multiple Myeloma comprises the Standard-of-Care approved by the FDA. In fact, the quadruple therapy is a combination of 4 different class of drugs that include a monoclonal antibody, a proteasome inhibitor, an immunomodulatory drug, and a steroid. Jessica: They are Darzalex (daratumumab), Velcade (bortezomib), Revlimid (lenalidomide) and dexamethasone. Other treatment plans for Multiple Myeloma include chemotherapy, immunotherapy, radiation therapy (for plasmacytomas) and stem cell transplants. The patient will also be on prophylaxis acyclovir and Bactrim while on chemotherapy. Sometimes anticoagulants are also considered because the chemo increases the risk of venous thromboembolic events.Di: Although the disease is incurable, but with the advancing of novel therapies and clinical trials patients with multiple myeloma are able to live longer. Problem is the majority of patients diagnosed with Multiple Myeloma are older adults (>65), the risk of falling is adding to multiple complications of the disease itself, such as bone density loss, pain, neurological compromises, distress and weakness. Palliative care may come in help at any point in time throughout the course of treatment but is most often needed at the very end of the course. Jessica, can you give us a conclusion for this episode?Jessica: Multiple Myeloma may not be the most common cancer, but we have to be aware of the symptoms and keep it in our differential diagnosis for patients with bone pain, easy bruising, persistent severe headaches, unexplained renal dysfunction, and remember the CRAB: HyperCalcemia, Renal impairment, Anemia and Bone lesions.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:International Myeloma Foundation. (n.d.). International Myeloma Working Group (IMWG) criteria for the diagnosis of multiple myeloma. https://www.myeloma.org/international-myeloma-working-group-imwg-criteria-diagnosis-multiple-myeloma Laubach, J. P. (2024, August 28). Patient education: Multiple myeloma symptoms, diagnosis, and staging (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/multiple-myeloma-symptoms-diagnosis-and-staging-beyond-the-basics.University of California San Francisco. (n.d.). About multiple myeloma. UCSF Helen Diller Family Comprehensive Cancer Center. https://cancer.ucsf.edu/research/multiple-myeloma/about Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.
What do asthma, eczema, EoE, and nasal polyps have in common? They all stem from Type 2 inflammation! Type 2 inflammation is a major cause of many allergic and inflammatory conditions, yet it remains widely misunderstood. In this first episode of our four-part series on Type 2 Inflammation, we discuss the basics, unpack its impact on the immune system, explain how it contributes to chronic inflammation in the body, and explain why it matters for treatment and management. What we cover in our episode about Type 2 Inflammation Understanding Inflammation: Inflammation is your body's natural defence mechanism, but it can become problematic when it turns chronic. Normal vs. Chronic Inflammation: Not all inflammation is bad! Learn the difference between the body's normal immune response and long-term chronic inflammation. What Sets Type 2 Inflammation Apart? Unlike other immune responses, Type 2 inflammation involves a specific pathway. Key Players in Type 2 Inflammation: Th2 cells, cytokines (IL-4, IL-5, IL-13), IgE antibodies, and eosinophils. Measuring Type 2 Inflammation: How blood tests can help determine if Type 2 inflammation is contributing to your symptoms. Want to know more? Type 2 Inflammation Overview – Explains the role of Type 2 inflammation in conditions like asthma and nasal polyps. This podcast is for informational purposes only and does not substitute for professional medical advice. If you have any medical concerns, always consult with your healthcare provider. Produced in partnership with The Allergy & Asthma Network. Thanks to Sanofi for sponsoring today's episode. While they support the show, all opinions are our own, and sponsorship doesn't influence our content or editorial decisions. Any mention of brands is for informational purposes and not an endorsement.
Think diagnosing food allergies is as simple as running a test? Think again. Food allergy testing is a maze of gray areas, false positives, and, hopefully, a clear food allergy diagnosis. Navigating food allergy testing can feel overwhelming, with skin pricks, blood tests, and conflicting advice. How do you determine which tests are truly useful? How can you avoid unnecessary dietary restrictions from false results? In this episode, Dr. David Stukus, a board-certified allergist and immunologist, joins Dr. Gupta and Kortney to demystify the science of food allergy testing. From the importance of patient history to the latest diagnostic tools, Dr. Stukus provides clear guidance to help you make informed decisions while navigating food allergy testing. What we cover in our episode about food allergy testing The Crucial Role of History in Food Allergy Diagnosis: Dr. Stukus highlights why understanding a patient's reaction history (symptoms, timing, and context) is critical for guiding effective testing decisions. Choosing the Right Tests: We break down skin prick testing, blood tests like IgE and component testing, and innovations like epitope mapping. Dr. Stukus explains why IgG testing is untrustworthy and emphasizes oral food challenges as the gold standard for diagnosis. False Positives and Negatives: Learn why expert interpretation of test results is crucial and how overtesting can lead to unnecessary restrictions and confusion. When to See an Allergist: Practical advice on when to consult a specialist and what to expect during your visit for evidence-based care. This podcast is made in partnership with The Allergy & Asthma Network. Thanks to Genentech for sponsoring today's episode. About Our Guest Dr. David R. Stukus is a renowned allergist and immunologist at Nationwide Children's Hospital and a professor at Ohio State University College of Medicine. He is known for his dedication to patient education and myth-busting in allergy care and is a trusted expert in food, asthma, and environmental allergies. Follow Dr. Stukus on Instagram: @allergykidsdoc
Have you ever wondered what happens inside your body during an allergic reaction? From itchy eyes to anaphylaxis, the science behind allergies explains why some reactions are mild while others can be life-threatening. In this episode, we break it all down. Dr. Payel Gupta and Kortney unpack the basics of food allergies, starting with what IgE antibodies are and how they play a role in allergic reactions. They explain what happens when your immune system encounters an allergen, breaking it down with our favorite pinata analogy. This deep dive into the immune system reveals why reactions can range from mild to life-threatening and explores the differences between food allergies, intolerances, and oral allergy syndrome. If you're newly diagnosed or curious about the science behind allergies, this episode offers valuable insights to help you understand your body and stay safe. What we cover in our episode about what happens in an allergic reaction What is an allergic reaction? Discover how your immune system identifies allergens and triggers a response involving IgE antibodies, mast cells, and histamine. Confused? We use our pinata analogy to simplify it. The role of histamine and inflammation. Learn how histamine is released during an allergic reaction, leading to inflammation and common symptoms. Understanding food allergies vs. food intolerances. Explore the key differences, including symptoms, risks, and why terminology matters. Oral allergy syndrome and environmental allergies. Understand why some allergies don't lead to anaphylaxis and how cross-reactivity can cause symptoms. Anaphylaxis and severe reactions. Explore why some reactions are life-threatening and how factors like exposure levels and health conditions can influence severity. More resources about allergies: A Complete Guide to Allergies More About Food Allergies More About Anaphylaxis Food Allergy Treatment & Management Living with food allergies guide What Can You Do If You Can't Afford Allergen-Free Foods? What if I Can't Afford My Allergy Medications? This podcast is made in partnership with The Allergy & Asthma Network. Thanks to Genetech for sponsoring today's episode. While they support the show, all opinions are our own, and sponsorship doesn't influence our content or editorial decisions. Any mention of brands is for informational purposes and not an endorsement.
Real Life Pharmacology - Pharmacology Education for Health Care Professionals
On the top 200 drugs podcast, we cover 5 more medications. The medications covered on today's episode include; omalizumab, nitroglycerin, apixaban, gabapentin, and etanercept. Omalizumab is a monoclonal antibody used in moderate to severe asthma. It targets IgE-mediated asthma attacks and reactions. Anaphylaxis is a significant concern with the use of this medication. Sublingual nitroglycerin is frequently used on an as needed basis for angina symptoms. I discuss major drug interactions and much more. Apixaban is an anticoagulant used to prevent stroke in atrial fibrillation. It can also be used in DVT/PE treatment and prevention. Gabapentin is classified as an antiepileptic agent but is most commonly used for neuropathic type pain. Etanercept targets TNF alpha which plays an important role in autoimmune diseases such as rheumatoid arthritis.
Drs. Siri and Jacobs discuss a typical case of a 4-year-old patient with peanut allergy, reviewing diagnostic and management strategies, as well as considerations such as age, IgE levels, oral food challenge, and current therapies.
Because ethanol is too small of a molecule for the body to make antibodies to, there really is no such thing as an "alcohol allergy," but that doesn't mean patients can't have a reaction to substances found within alcohol. In this episode of ImmunoCAST, we address the clinical challenge of distinguishing between alcohol intolerance and true allergy. Tune in as we explore histamine intolerance, sulfite sensitivity, and ALDH2 deficiency, as well as hidden allergens in alcoholic beverages, the role of alcohol as a cofactor in allergic reactions, and specific allergens found in wine and beer. Discover how to diagnose and manage alcohol-related reactions by learning more about the importance of detailed patient history, specific IgE testing, and the implications of enzyme deficiencies. Episode resources and references available at https://www.thermofisher.com/phadia/us/en/resources/immunocast/s2e10.html?cid=0ct_3pc_05032024_9SGOV4
Make sure to subscribe and follow the show for new weekly episodes.Thank you UnderDog Fantasy for sponsoring the show. All week long Underdog is dropping daily promos for players to cash in on. All new users can earn up to $1,000 in bonus cash on their first deposit and this Thursday will receive a CJ Stroud 'Em special. Support the show by using code "P4P" when signing up: https://play.underdogfantasy.com/p-pound4-poundUFC 308 brought the HEAT and the guys dive into the main card fights and waste no time getting into what's next for the fighters who showed Saturday night in Abu Dhabi. From Topuria's case for Fighter of the Year, Shara's double backfist knockout (!!!) and Adesanya callout, Chimaev's domination over Whitaker and what it means for his journey to the title shot.Enjoy.00:00 - Intro3:00 - Topuria vs. Holloway Breakdown6:00 - Topuria FOTY?10:30 - Next Matchup for Ilia...18:00 - BMF Debate22:15 - Whitaker vs. Chimaev28:00 - Defensive Debate...33:25 - Ankalaev vs. Rakic36:00 - Henry Changes His Pereira Take38:20 - Ige vs. Murphy40:10 - Magomedov vs. PetrosyanFollow the Show on SocialInstagram:https://www.instagram.com/pound4pound/Twitter/X:https://twitter.com/Pound4poundshowTik Tok:https://www.tiktok.com/@pound4pound.podca?is_from_webapp=1&sender_device=pcA Shadow Lion Production.
Relive the magic of UFC 308's live watch party with Mike Heck and Jed Meshew! Check out the original UFC 308 Watch Party here: https://www.youtube.com/live/-F8ZPFzscbg Timestamps: Intro (0:00) Shara Bullet vs. Arman Petrosyan (23:58) Shara Bullet double spinning back fist KO (42:20) Lerone Murphy vs. Dan Ige (59:40) Ige drops Murphy in Round 1 (1:04:25) Murphy wins decision (1:20:42) Magomed Ankalaev vs. Aleksandar Rakic (1:36:27) Ankalaev wins decision (1:55:55) Robert Whittaker vs. Khamzat Chimaev (2:13:17) Chimaev dislocates Whittaker's jaw with crank submission (2:17:15) Ilia Topuria vs. Max Holloway (2:41:50) Topuria knocks out Holloway in Round 3 to retain title (2:55:40) Follow Mike Heck: @MikeHeck_JR Follow Jed Meshew: @JedKMeshew Subscribe to MMA Fighting Check out our full video catalog Like MMA Fighting on Facebook Follow on Twitter Read More: http://www.mmafighting.com Learn more about your ad choices. Visit podcastchoices.com/adchoices
Relive the magic of UFC 308's live watch party with Mike Heck and Jed Meshew! Check out the original UFC 308 Watch Party here: https://www.youtube.com/live/-F8ZPFzscbg Timestamps: Intro (0:00) Shara Bullet vs. Arman Petrosyan (23:58) Shara Bullet double spinning back fist KO (42:20) Lerone Murphy vs. Dan Ige (59:40) Ige drops Murphy in Round 1 (1:04:25) Murphy wins decision (1:20:42) Magomed Ankalaev vs. Aleksandar Rakic (1:36:27) Ankalaev wins decision (1:55:55) Robert Whittaker vs. Khamzat Chimaev (2:13:17) Chimaev dislocates Whittaker's jaw with crank submission (2:17:15) Ilia Topuria vs. Max Holloway (2:41:50) Topuria knocks out Holloway in Round 3 to retain title (2:55:40) Follow Mike Heck: @MikeHeck_JR Follow Jed Meshew: @JedKMeshew Subscribe to MMA Fighting Check out our full video catalog Like MMA Fighting on Facebook Follow on Twitter Read More: http://www.mmafighting.com Learn more about your ad choices. Visit podcastchoices.com/adchoices
Relive the magic of UFC 308's live watch party with Mike Heck and Jed Meshew! Check out the original UFC 308 Watch Party here: https://www.youtube.com/live/-F8ZPFzscbg Timestamps: Intro (0:00) Shara Bullet vs. Arman Petrosyan (23:58) Shara Bullet double spinning back fist KO (42:20) Lerone Murphy vs. Dan Ige (59:40) Ige drops Murphy in Round 1 (1:04:25) Murphy wins decision (1:20:42) Magomed Ankalaev vs. Aleksandar Rakic (1:36:27) Ankalaev wins decision (1:55:55) Robert Whittaker vs. Khamzat Chimaev (2:13:17) Chimaev dislocates Whittaker's jaw with crank submission (2:17:15) Ilia Topuria vs. Max Holloway (2:41:50) Topuria knocks out Holloway in Round 3 to retain title (2:55:40) Follow Mike Heck: @MikeHeck_JR Follow Jed Meshew: @JedKMeshew Subscribe to MMA Fighting Check out our full video catalog Like MMA Fighting on Facebook Follow on Twitter Read More: http://www.mmafighting.com Learn more about your ad choices. Visit podcastchoices.com/adchoices
Powered by BETUS. Use the promo code: YouTube150 for 150% up to $2000 Use our link and claim a free LMNT Sample Pack when they make any purchase! The LMNT Sample Pack includes 1 packet of every flavor, no questions asked refunds on all orders – you don't even have to send it back! This offer may be claimed be first-time and returning LMNT customers, ONLY THOUGH OUR LINK! https://partners.drinklmnt.com/free-gift-with-purchase?utm_campaign=agwp&utm_medium=sponsor&utm_source=weighingin&utm_content=&utm_term=&rfsn_cn=EXCLUSIVE+GIFT+FOR+The+Weighing+In+COMMUNITY Join us on ONLYFANS for FREE! http://OnlyFans.com/WeighingIn Watch WEIGHING IN XTRA here: https://www.youtube.com/c/WEIGHINGINXTRA Listen on iTunes: https://apple.co/37XsRQ9 Listen on Spotify: https://spoti.fi/3jSZSiZ Listen on Google Podcasts: https://bit.ly/3jKXV82 NEW MERCH WEBSITE - https://weighinginmerch.com FOLLOW the team on Twitter and Instagram | @weighingin | @johnmccarthymma | @therealpunk | @podcastdave | @georgeharris48 And Now 00:00 Topuria vs Holloway 04:56 Whittaker vs Chimaev 16:40 Ankalaev vs Rakić 25:10 Murphy vs Ige 28:23 Magomedov vs Petrosyan 30:53 Aslan vs Cerqueira 34:20 Neal vs Dos Anjos 36:00 Rębecki vs Orolbai 38:42 Magomedov vs Ferreira 41:17 Nzechukwu vs Barnett 44:30 Basharat vs Hugo 47:38 Naurdiev vs Silva 49:09 Fakhretdinov vs Leal 51:31 What blew up the UFC/Rogan talk 52:35
MMALOTN is back to give you breakdowns and predictions for UFC 308: Topuria vs Holloway. THIS PATREON IS FOR THE FIGHT LINK DATABASE, NOT MY PICKS/BETS/WRITE UPS.
In our American quest for a more perfect union, we often mistake unity for sameness. We mistake unity for conformity. But the functional unity of a system—seems to actually require diversity, distinction, and difference.In this episode, Christy Vines (Founder/ CEO, Ideos Institute) reflects on the problem of division today; how we increasingly invest our identity in politics instead of faith or spirituality; humility and privilege; the definition of unity and the assumption of diversity in it; the centrality of empathy; and how to cultivate an empathic wisdom grounded in the life and witness of Christ.The Ideos Institute is currently sponsoring 31 days of Unity leading up to the 2024 election. Visit thereunionproject.us or ideosinstitute.org/31-days-of-unity to learn how to participate.About Christy VinesChristy Vines is the founder, President and CEO of Ideos Institute where she leads the organization's research on the burgeoning field of Empathic Intelligence and its application to the fields of conflict transformation, social cohesion, and social renewal.Prior to founding Ideos Institute, she was the Senior Vice President for Global Initiatives and Strategy at the Institute for Global Engagement (IGE) where she served as the managing and coordinating lead for the development of strategic institutional partnerships and global initiatives in support of the IGE mission to encourage flourishing societies and stable states, and promote sustainable religious freedom, human rights and the rule of law globally. During her tenure at IGE she helped expand the organization's Center for Women, Faith & Leadership which supports, equips and convenes religious women peacemakers around the globe.Christy has held senior roles with the RAND Corporation, where she worked with the RAND Centers for Middle East Public Policy, Asia Pacific Public Policy, Global Risk and Security, and the Center for Justice, Infrastructure, and Environment, finally transitioning to interim project manager for the RAND African First Ladies Initiative (now located at the Bush Presidential Center). Christy also held the role of senior fellow at The American Security Project and served as an advisor to the Carter's Center's inaugural Forum on Women, Religion, Violence and Power.Christy is a published writer, speaker, and the executive producer of the 2022 documentary film, "Dialogue Lab: America," a moving take on the current state of division and polarization in the U.S. She has appeared on podcasts like Comment Magazine's “**Whole Person Revolution Podcast”, “**How Do We Fix It” and Bob Goff's “Dream Big Podcast”. She has published numerous articles and op-eds with news outlets and publications, including the **Washington Post, Christianity Today,** and Capital Commentary.Christy received her Master's Degree in Public Administration from the Harvard Kennedy School. She attended both Stanford University and the University of CA, Riverside where she received her B.A. in Sociology and Qualitative Analysis. She currently resides in Pasadena, CA.Show NotesHoward Thurman on Unity, Meditations of the Heart (Beacon Press: 1981), 120–121“Plotinus [205–270 CE] wrote, “If we are in unity with the Spirit, we are in unity with each other, and so we are all one.” (Plotinus, Enneads, VI.5.7.)Sign up for 31 Days of Unity https://www.ideosinstitute.org/31-days-of-unity(Re)Union Project and Ideos InstituteChristy Vines's experience with diversity and unity in her family: differences in faith, race, gender, sexuality, and religionHow Christy Vines came to faithThe problem of divisionHow neuroscience illuminates scripture and offers insight into empathic wisdom“There are so many ways to love God.” (David Dark)How we invest our identity in politics instead of religionMoral absolutism vs moral relativismAbdicating our faith identity for a political identityTechnology and relationships“Loving God differently”“In the cosmic Christ, you have all of the space you need for the kind of diversity in unity that you're talking about.”“It's the expectation that in order to work together, we really do have to look exactly the same, that we have to think the same things. That's the only way to collaborate. So until we can get past those of disagreements, there's just no way to work across the aisle. And that is disastrous to the concept of a democracy and the concept of the church.““There's so many ways to be an American. There's so many ways to be human.”Humility and privilege“There is something about desperation and need that brings, that illuminates God's beauty, majesty, and importance in such a powerful way that I think so many of us that are born into plenty will never experience until the other side of heaven.”The definition of unity: grounded in empathy“Unity is about finding ways to be the body of Christ with all of our diversity and difference and saying that with humility, Here is my perspective. Here's how I understand God. Here's how I live out my faith. Here's what that might mean culturally or politically and all of the other ways we express our faith. And to be unified means maybe we can all be moving in the same direction on different paths, coming at it from different directions, but recognizing we're all trying to reach the same goal. And that maybe in that shared experience, And that rubbing against one another is, our pastor used to say, heavenly sandpaper, refining one another. We may never be on the exact same path, But over time, you find that we get closer and closer together as we share our lives with one another and we influence each other from a position of trust and care. And that can only be done when we actually show up recognizing with humility that we can learn and benefit from others.”Empathy and how to build itEmpathic Intelligence Dr. Rosalind Arnold (University of Tasmania)Empathic intelligence (empathic wisdom) is the lived experience of JesusJesus's empathy“Most of the time we take our own understanding of Jesus and try to impose that on somebody without ever knowing their story.”“What is it like to be you?”“Why is this so hard to do?”Jesus and the woman at the wellAsking questions and listeningEmpathy is contagiousVulnerability, openness, and a space of relational trust(Re)Union Project for Churches—Building unity in the church across lines of differencethereunionproject.usideosinstitute.orgProduction NotesThis podcast featured Christy VinesEdited and Produced by Evan RosaHosted by Evan RosaProduction Assistance by Alexa Rollow, Emily Brookfield, Kacie Barrett, and Zoë HalabanA Production of the Yale Center for Faith & Culture at Yale Divinity School https://faith.yale.edu/aboutSupport For the Life of the World podcast by giving to the Yale Center for Faith & Culture: https://faith.yale.edu/give
Autoimmune conditions are a significant health issue, often shrouded in mystery and confusion. The recent Frequency Specific Microcurrent (FSM) podcast episode featuring Dr. Musnick, hosted by Kim Pittis, offers a wealth of knowledge on potential causes, management strategies, and the role of frequency-specific microcurrent therapy. This blog post distills key points from the discussion to provide a comprehensive understanding of autoimmunity and empowering patients to take charge of their health. 00:43 Autoimmunity and Sleep 04:10 Predictive Antibodies and Screening 10:18 Causes of Autoimmune Conditions 15:50 Food Allergies and Testing 16:49 Chronic Infections and Autoimmunity 23:17 Managing Autoimmune Conditions 33:46 Positive Affirmations and Imagery 47:24 Telemedicine and Licensing 49:19 Conclusion and Final Thoughts 50:57 Introduction and Gratitude 51:23 Discussing Autoimmunity and Sleep 54:51 The Importance of Antibody Screening 01:01:04 Causes and Prevention of Autoimmune Conditions 01:06:50 Food Allergies and Testing 01:07:44 Infections and Autoimmunity 01:17:24 Managing Autoimmune Conditions 01:24:58 Positive Imagery and Healing 01:38:54 Telemedicine and Licensing 49:21 Conclusion and Gratitude 50:46 Introduction and Podcast Overview 51:23 Discussing Autoimmune Topics 52:05 Importance of Sleep and EMF Exposure 54:17 Autoimmune Screening and Antibody Testing 01:01:10 Causes and Triggers of Autoimmune Conditions 01:06:50 Food Allergies and Intestinal Permeability 01:07:44 Chronic Infections and Autoimmunity 01:20:42 Stress, Sleep, and Autoimmune Flares 01:24:58 Positive Imagery and Affirmations in Healing 01:39:07 Telemedicine and Licensing Understanding Autoimmunity and Its Causes In the conversation, Dr. Musnick emphasized that many autoimmune conditions could be traced back to various causes, including infections, toxic burdens, and genetic predispositions. Toxicity, including exposure to mold biotoxins, plays a significant role in triggering immune responses that mistake body tissues for foreign threats. Another critical factor discussed is the concept of barrier dysfunction, particularly intestinal permeability, commonly known as "leaky gut." This condition can lead to a cascade of immune responses, contributing to autoimmune disorders. Interestingly, Dr. Musnick highlighted that leaky gut itself is an autoimmune disorder, often associated with the gut's exposure to harmful substances like glyphosate in genetically modified foods. The Role of Infections and Stress Chronic infections such as Lyme disease and reactivated viral infections are highly correlated with autoimmune conditions. Dr. Musnick stressed the importance of screening for these infections as a preventative measure. Additionally, he pointed out that stress and lack of sleep are profound triggers for autoimmune flare-ups. Patients experiencing prolonged stress should be aware of its potential impact on their immune health. Diagnostic Approaches Dr. Musnick recommended getting comprehensive antibody screening to detect autoimmunity early, even before symptoms develop fully. Labs such as Cyrex offer extensive panels that can identify predictive antibodies for both the body and the brain. These tests provide invaluable insights, guiding patients and practitioners in taking preventative steps. Moreover, he highlighted the need for detailed food allergy panels, considering both IgE and IgG allergies, to tailor dietary adjustments effectively. Managing Autoimmune Conditions with Frequency Specific Microcurrent FSM emerges as a promising therapeutic tool for treating the symptoms and triggers of autoimmune conditions. By targeting specific frequencies, FSM helps in modulating the immune system, healing barriers like the blood-brain barrier, and addressing toxic burdens. Dr. Musnick also highlighted the importance of empowering patients with positive imagery and affirmations during FSM therapy sessions, envisioning a life free from disease constraints and focusing on healing. This psychological aspect is crucial for fostering a conducive environment for recovery. Empowerment Through Knowledge and Positive Thinking Labeling oneself with a disease can hinder healing. Dr. Musnick stressed that the identity associated with diagnosis could be limiting. Encouraging patients to view symptoms as temporary and manage them positively can significantly improve outcomes. This approach aligns with the functional immunology framework, where controlling triggers and balancing the immune system take precedence over merely treating symptoms.
Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks… Raquel: Hi, I wanted to know if it's possible to get rid of food and environmental allergies. I cannot tolerate fruits, vegetables, nuts, and nickel-containing products due to these. Even if I cook everything (OAS), I still get an itchy mouth, wheezing, and/or vomiting/diarrhea (especially with eggplant, coconut, and nuts). I did IgE blood and skin testing and was allergic to everything tested. I also tried allergy shots for 5 years. I also have IBS-D and fiber/grains are a major trigger. The one thing that has worked to reduce my symptoms (hives, itchy mouth, asthma, diarrhea) is to eat an elimination diet (no plants), but I am worried about this long term. I am allergic to your HistPro and Sinus Support supplements I assume due to the plants in them. Any help greatly appreciated, thanks so much! Matthew: My mother saw her doctor and he told her that her heart is not pumping enough blood throughout her body and she needs to see specialist. Now on the allopathic side I know they're gonna have her take heart medication. I know my experience that heart medication causes so many problems overtime just like other medication cause problems. I wanted to know what can she do for a naturopathic/ functional medicine perspective, or should I say try before she goes into the medication aspect? Because from the sounds of it to me, her EF or ejection fracture is lower than it should be. I may be wrong but that's what it sounds like to me. I'm hoping you can help thanks Amy: Should one take a break from berberine need to be stopped after taking it 6 months? It is the only thing that stopped my hot flashes so i don't want to stop. Maria: Why does the heat of the sun make me feel sick? Jillian: My 3.5 year old daughter develops a cough that can last a month+ after being sick. This cough wakes her at night, sometimes causing her to vomit from coughing so hard. During these times she will cough after running around also. This happens every few months, with some time in between of no symptoms. It seems like asthma but I am unsure of what to do. How safe are breathing treatments and inhalers for children? Does this mean she requires antibiotics to clear any infection from a lingering sickness? Most importantly, why would this be happening to her? Would removing tonsils help? I'm trying to weigh the pros and cons of treating her with western medicine letting it be and seeing if it stops as she gets older. She's only had antibiotics once in her life and eats fairly well for a toddler. Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes and Resources: StephenCabral.com/3166 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!
Are you curious about how biologic medications are transforming the treatment of asthma, eczema, allergies, and more? Dr. Perdita Permaul joins Dr. Gupta and Kortney to discuss the available biologic medications for allergic conditions. We walk through the eight biologics currently available for allergic diseases, explaining how these medications target different parts of the immune system to treat allergic conditions more effectively than traditional medications. Dr. Permaul explains how biologics have evolved since 2003 and how they are changing the way allergic conditions are treated. She also explains why some of the biologics treat multiple diseases, whereas some are only approved for one. What we cover in our episode about the available biologics for allergic conditions How biologics work for allergic conditions: We unpack how biologic medications target specific parts of the immune system, reducing inflammation and improving the quality of life for patients with allergic diseases. History and evolution of biologics: Dr. Permaul walks us through the timeline of biologics, starting with Xolair in 2003 and how these treatments have expanded to target other conditions over time. Which biologics treat which conditions: From asthma and eczema to food allergies and nasal polyps, we break down which biologics are available and how they help patients with allergic conditions. Future of biologics: Dr. Permaul discusses the potential of biologics to be used for more conditions in the future, including ongoing research into food allergy treatments. Biologics Cheat Sheet Below is a list of the 8 biologics discussed in this episode. We have briefly outlined their mechanism of action along with the approved conditions and ages the drug is available for presecription. Omalizumab (Xolair) Xolair works by binding to IgE to prevent allergic reactions. It has since been approved for chronic hives, nasal polyps, and food allergies. Allergic asthma: 6+ Chronic idiopathic urticaria (hives: 12+ Chronic rhinosinusitis with nasal polyps (CRSwNP): 18+ Food allergies:1+ Mepolizumab (Nucala) Targets and blocks interleukin-5 (IL-5) play a key role in the activation and priming of eosinophils, a type of white blood cell that causes inflammation in asthma. Eosinophilic Asthma: 6+ CRSwNP: 18+ Eosinophilic Granulomatosis with Polyangiitis (EGPA): 18+ Hypereosinophilic Syndrome: ≥6 months Reslizumab (Cinqair) Targets and blocks interleukin-5 (IL-5). Eosinophilic asthma: 18+ Benralizumab (Fasenra) Binds to the IL-5 receptor, preventing eosinophils from growing and causing inflammation. Eosinophilic asthma: 6+ Eosinophilic Granulomatosis with Polyangiitis (EGPA): 18+ Dupilumab (Dupixent) Targets and blocks IL-4 and IL-13 to reduce inflammation Asthma: 6+ Atopic Dermatitis: 6 months+ CRSwNP: 18+ Eosinophilic Esophagitis (EoE): 1+ (> 33 lbs) Approved for prurigo nodularis (PN): 18+ Tezepelumab (Tezspire) Blocks thymic stromal lymphopoietin (TSLP). Asthma: 12+ Tralokinumab (Adbry, Adtralza) Targets and neutralizes interleukin-13 (IL-13). Atopic dermatitis: 12+ Lebrikizumab (Ebglyss) Targets and neutralizes interleukin-13 (IL-13). Atopic dermatitis: 12+ (> 40 lbs) ________ This podcast is made in partnership with The Allergy & Asthma Network. Thanks to Sanofi-Regeneron for sponsoring today's episode. While they support the show, all opinions are our own, and sponsorship doesn't influence our content or editorial decisions. Any mention of brands is for informational purposes and not an endorsement. Disclaimer: This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.
Does your patient have a food allergy or intolerance? Celiac disease or wheat allergy? When it comes intolerances vs. allergies, there's a lot of symptoms overlap. In this episode of ImmunoCAST, we discuss the mechanisms and differences behind IgE-mediated food allergies, autoimmune conditions like celiac disease, and various types of food intolerances, including metabolic, pharmacologic, and toxic reactions. We also dive into the pitfalls of at-home IgG food intolerance tests that patients may use as well as the importance of clinical history and proper diagnostic testing. Tune in for valuable insights to help optimize your diagnosis and patient management of adverse food reactions. Episode resources and references available at https://www.thermofisher.com/phadia/us/en/resources/immunocast/s2e6.html?cid=0ct_3pc_05032024_9SGOV4
Immune discusses two stories of immune cells eating other cells: microglia engulfing brain neurons to shape cortical development and behavior, and mast cells trapping neutrophils to increase their functional and metabolic fitness. Hosts: Vincent Racaniello, Cindy Leifer, and Brianne Barker Subscribe (free): Apple Podcasts, RSS, email Become a patron of Immune! Links for this episode MicrobeTV Discord Server Microglia shape cortical development and behavior (Cell) Neutrophil trapping by mast cells (Cell) Time stamps by Jolene. Thanks! Music by Steve Neal. Immune logo image by Blausen Medical Send your immunology questions and comments to immune@microbe.tv
Many of our viewers watch our videos to improve their gut health. Did you know that histamine intolerance can directly relate to gut issues? Learn the 5 warning signs that you're histamine intolerant, and what you can do to start healing. Low histamine diet handout: https://drruscio.com/wp-content/uploads/2019/04/HistamineHandout.pdf
Send us a message (with the best way to reply)Can your diet be the hidden culprit behind your sluggishness and digestive woes? Discover the powerful connection between food sensitivities and your overall health in this eye-opening episode of Breaking Boundaries for Entrepreneurs. Jeffrey Mort takes you on a deep dive into IgG food sensitivities, explaining how these delayed immune responses could be at the root of your chronic issues like migraines, digestive discomfort, and skin problems. Learn how you can effortlessly test for up to 190 common food sensitivities from the comfort of your home and take the guesswork out of your diet.In this episode, we break down the differences between IgG sensitivities and other immune responses like IgE allergies. Once you understand how these sensitivities work, you'll be equipped with practical steps to create a personalized wellness plan aimed at healing your gut and reducing unwanted symptoms. Say goodbye to the discomfort and hello to more energy and performance, both in life and business. Don't miss out on this opportunity to take control of your health and unlock your full potential!>Introductory Food Sensitivity TestFrom now until Sunday you can save 40% on the BIG5 and Vita-Min Tox test at-home lab bundles to STOP Guessing and Finally discover the underlying root causes of your chronic health symptoms so that you can finally take control of your health! Ask me about FSA/ HSA savings! Get Your Tests Here! Join us for the 2024 Reimagining Health Summit, hosted by the Integrative Health Practitioner Institute, from October 23-25 in Orlando, FL. Experience cutting-edge wellness innovations, interactive exhibitions, and inspiring talks from top experts. Network with like-minded individuals and connect with health practitioners. Use code LIVE100 to save $100 on tickets. Secure your spot today! [Register here]Support the Show.As a token of gratitude, of course you're interested in these FREE and powerful resources: > Naturally, you'll want to join our Love Energy Wellness Community and Support Group for daily support! > You might be wondering just how full your Toxin-Tank may be: Take your FREE Toxicity Assessment to find out - no email required > You'll discover a new level of self, after your FREE 2-Part audio training for Confidence! > As you already know, you can lean more about Integrative Health on our Blog > I know you're concerned about your future. Schedule your FREE Consultation with Jeffrey > Health Coaches: add Functional Lab Testing to your practice today!
Chiropractor Kim Bruno furthered her training with the Institute of Functional Medicine, ILADS, Horowitz Lyme Master Classes and holds a board-certification as a Certified Clinical Nutritionist. She owned a private practice for 17 years and was the functional medicine medical director for the largest immunology clinic in Colorado. She comes to us today as the Senior Medical Science liaison for Vibrant Wellness Labs. Today we discuss their panel of 48 neurologically-oriented antibodies: the Neural Zoomer Plus. We start by discussing the lab technology itself, which is somewhat unique in the testing world- it's an 'Immunochip', also called a protein-peptide microarray as viewed through chemiluminescence which can be more sensitive than historical Eliza testing. The sensitivity (the ability to find the needle in the haystack) ranges from 95-98% and the specificity (it's definitely a needle, and not a pin or nail or something similar that is not actually a needle) is 96-100%. The range is because each analyte has its own metrics. Here, we take a tangent into describing the limitations of Eliza & Western Blot testing, especially in light of tick-borne testing for Lyme disease & co-infections. Then we touch on PCR- polymerase chain reaction testing and the use of glass beads to break up biofilms in test samples for even more accurate results. Our next chapter (around 14:30) focuses on the immune system itself. Listen in for some helpful analogies for the immunoglobulins-IgM for ‘marines vs IgG for ‘ground troops', IgA with affiliation with mucus membranes like the gut or respiratory linings, and IgE for anaphylactic allergic reaction. This gives the total pool from which the Neural Zoomer Plus antibodies are pulling from as a sort of clinical calibration to weigh the presence of the specific antibodies. At 22:20, we dive into the Neural Zoomer Plus test itself. Dr Bruno shares her brilliant ‘hierarchy of consideration' for putting these antibodies into a context. While she states outright ‘this is not a diagnostic test', the larger truth is that this test cannot be used for diagnosis by clinicians who don't have the scope to make diagnostic conclusions, for example dieticians or health coaches. For our purposes at Neuroveda Health, we absolutely use this test for clinical decision making and diagnosis. Dr Bruno calls out molecular mimicry against pathogens or even foods or toxins that can confuse the immune system. We consider the Cunningham Panel (recently renamed the Autoimmune Brain Panel), which has been used longer for PANDAS evaluation. And we walk through each category of antibody included on this test. We finish with a discussion about treatment approaches based on results from this test, including the Neuroveda Health approach to evaluating and addressing neuroimmune disease. FOR MORE INFORMATION: To look at a sample report of this test: https://hello.vibrant-wellness.com/hubfs/Sample%20Reports/MK-0072-01NeuralZoomerPlusSampleReport.pdf To find out more about the Neural Zoomer Plus test: https://www.vibrant-wellness.com/test/NeuralZoomerPlus To get testing, contact us to schedule an appointment with a clinician at Neuroveda Health: - Phone: 206-379-1213 - Email Reception@neurovedahealth.com To find out more about our clinic (and request a call back): https://www.neurovedahealth.com/
Back from a Fourth of July break, Jim and Matt use today's episode of UFC Unfiltered to chat with a pair of fighters from UFC 303 in Michelle Waterson-Gomez and Dan Ige. Joining first is Waterson-Gomez, who reflects on how family kept her grounded throughout her 17-year journey as a professional mixed martial artist. Having retired as a jiu-jitsu brown belt, the “Karate Hottie” reiterates her plan to stay in the gym in order to secure a black belt while weighing her post-fighting career options as a broadcaster, actress and coach. Just over one week removed from replacing Brian Ortega in the UFC 303's co-main event, Dan Ige joins the show to paint the picture of what went down behind the scenes before stepping up to the plate in legendary fashion against Diego Lopes on the day of the fight. Aware that his stock has still elevated even though he lost, Ige outlines his desire to deliver another all-action scrap in his next fight by calling out Yair Rodriguez ahead of UFC 306 at the Sphere in Las Vegas.
What is the gold standard in diagnosing an anaphylactic food allergy? It's not a skin test. It's not a blood test. It's an ingestion challenge.In this episode,Dr. Alice Hoyt discusses the critical role of ingestion challenges when it comes to accurately diagnosing IgE-mediated food allergies. By consuming the suspected allergen under the careful supervision of a board-certified allergist, patients can achieve a precise diagnosis, which is pivotal before embarking on treatment plans like oral immunotherapy or long-term avoidance strategies. She shares valuable insights and tips on how to prepare for an ingestion challenge, ensuring a smooth and reassuring process for both patients and families.Dr. Hoyt also explores the life-changing impact ingestion challenges can have, especially for young children and their parents. Drawing from the groundbreaking LEAP study, she stresses the importance of confidently introducing potentially allergenic foods to children, highlighting how, in some cases, ingestion challenges provide firsthand safety assurance. Additionally, she touches on the complexities of food allergy skin and blood testing and how these tests should not be considered confirmatory for food allergies. Tune in to learn how ingestion challenges empower food allergy families and, in some cases, confirms that a child is no longer allergic to a food.What's your food allergy question? Subscribe to our newsletter to ask your questions!Looking for one-on-one time with a food allergist to finally get your food allergy questions answered? Sign up for Food Allergy Office Hours for Parents!Engage with us on Instagram!Are you in need of an allergist in your area? AAAAI Allergist FinderACAAI Allergist FinderOIT Allergist FinderWould like to become a patient? Reach out to the Institute! Does your kiddo's school need help with medical emergency response planning? Check out the non-profit Code Ana.This podcast is the official podcast of the Hoyt Institute of Food Allergy. Information on, within, and associated with this site and Food Allergy and Your Kiddo is for educational purposes only and is not medical advice.
Dan Ige reveals how the shortest notice fight in UFC history came together after he got a call asking if he was interested in facing Diego Lopes in just a few hours after Brian Ortega dropped out of the UFC 303 co-main event. Ige details how he got ready, his coaches and teammates who stepped up for him, and how he felt the fight against Lopes went without any actual preparation to get ready for that matchup. Ige also discusses what's next for him, his new and more lucrative contract, no longer competing on July 20 and what kind of plans he has for the Sphere and UFC 306 in September. plus much more. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Dan Ige reveals how the shortest notice fight in UFC history came together after he got a call asking if he was interested in facing Diego Lopes in just a few hours after Brian Ortega dropped out of the UFC 303 co-main event. Ige details how he got ready, his coaches and teammates who stepped up for him, and how he felt the fight against Lopes went without any actual preparation to get ready for that matchup. Ige also discusses what's next for him, his new and more lucrative contract, no longer competing on July 20 and what kind of plans he has for the Sphere and UFC 306 in September. plus much more. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Dan Ige reveals how the shortest notice fight in UFC history came together after he got a call asking if he was interested in facing Diego Lopes in just a few hours after Brian Ortega dropped out of the UFC 303 co-main event. Ige details how he got ready, his coaches and teammates who stepped up for him, and how he felt the fight against Lopes went without any actual preparation to get ready for that matchup. Ige also discusses what's next for him, his new and more lucrative contract, no longer competing on July 20 and what kind of plans he has for the Sphere and UFC 306 in September. plus much more. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Luke and Brian are back in studio to react to a huge weekend in MMA. First, the guys recap to UFC 303 which ended with Alex Pereira completing the short turnaround with a brutal KO of Jiri Prochazka. Poatan's legacy through 9 UFC fights is unique and largely unmatched. If it's not black magic, what is it that makes him so special compared to his contemporaries? Dan Ige literally goes from couch to Octagon in 4 hours to save UFC 303 co-main event. Let's try and put this into words: How insane is what Ige just did? Also the guys recap the weekend in boxing as Teofimo Lopez wins and 'Bam' Rodriguez plows JFE. Luke and Brian are also joined live by UFC welterweight Gilbert Burns! Learn more about your ad choices. Visit megaphone.fm/adchoicesSee omnystudio.com/listener for privacy information.
Luke and Brian are back in studio to react to a huge weekend in MMA. First, the guys recap to UFC 303 which ended with Alex Pereira completing the short turnaround with a brutal KO of Jiri Prochazka. Poatan's legacy through 9 UFC fights is unique and largely unmatched. If it's not black magic, what is it that makes him so special compared to his contemporaries? Dan Ige literally goes from couch to Octagon in 4 hours to save UFC 303 co-main event. Let's try and put this into words: How insane is what Ige just did? Also the guys recap the weekend in boxing as Teofimo Lopez wins and 'Bam' Rodriguez plows JFE. Luke and Brian are also joined live by UFC welterweight Gilbert Burns! Learn more about your ad choices. Visit podcastchoices.com/adchoices
With UFC 303 in the books, Ariel Helwani around (5:04) discusses all the storylines that came out of Las Vegas on Saturday night, including another triumphant title defense by Alex Pereira. They discuss Pereira's pound-for-pound ranking and what's next for him. He also discusses the UFC co-main event drama, Ian Machado Garry's performance, and more. He also talks about PFL 6, Karate Combat, and Invicta FC's return. Payton Talbott around (1:00:38) discusses his UFC 303 performance, his fight day weight, media chats, the vape conspiracy, his first-round knockout at UFC 303, if life is changing, pole fitness, MMA fans, his future at bantamweight, and more. Joe Pyfer around (1:32:05) discusses his UFC 303 performance, his rough trip home, his loss to Jack Hermansson, his injury before the Hermansson fight, his allergic reaction, his knockout of Marc-Andre Barriault, who he wants next, and more. Eric. Nicksick around (1:59:54) discusses how Dan Ige ended up in the UFC 303 co-main event, the timeline of events, how they prepared and rallied the troops, the walkout, the gameplan, Francis Ngannou, and more. Ian Machado Garry around (2:31:09) discusses his win over MVP at UFC 303, why he's upset, how close he was to a finish, if he agreed with the judges, why MVP is so difficult to face, why he didn't throw calf kicks, finishing fights, Demian Maia in his corner, alleged spying in his camp, his son's impersonations, Shavkat callout, purple shorts, and more. Diego Lopes around (3:02:23) discusses his win over Dan Ige at UFC 303, his roller-coaster experience with Ortega and than Ige, if he ever thought about turning down the fight, his coach's visa issues, the hair, and more. Plinio Cruz around (3:25:56), the coach for Alex Pereira, discuses Pereira's performance in the UFC 303 main event, when he first met Pereira and why Pereira took that LFA fight, his toes, sparring Tai Tuivasa, dancing before the fight, the face-off before the fight, the first round, what Pereira should do next, the possible move to heavyweight, and more. The parlay pals around (4:25:15) recap their latest pick, and GC looks back at his UFC 303 picks. If you or someone you know has a gambling problem, crisis counseling and referral services can be accessed by calling 1-800-GAMBLER (1-800-426-2537) (IL/IN/MI/NJ/PA/WV/WY), 1-800-NEXT STEP (AZ), 1-800-522-4700 (CO/NH), 888-789-7777/visit http://ccpg.org/chat (CT), 1-800-BETS OFF (IA), 1-877-770-STOP (7867) (LA), 877-8-HOPENY/text HOPENY (467369) (NY), visit OPGR.org (OR), call/text TN REDLINE 1-800-889-9789 (TN), or 1-888-532-3500 (VA). 21+ (18+ NH/WY). Physically present in AZ/CO/CT/IL/IN/IA/LA/MI/NH/NJ/NY/OR/ PA/TN/VA/WV/WY only. New customers only. Min. $5 deposit required. Eligibility restrictions apply. See http://draftkings.com/sportsbook for details. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Make sure to subscribe and follow the show for new weekly episodes.Thank you to UnderDog Fantasy for sponsoring the show. Right now, all new users to Underdog will receive up to $250 in bonus cash for their first deposit and a Pick'Em Special. Support the show, use Code "P4P" https://play.underdogfantasy.com/p-po...A ton of changes leading into International Fight Week had the war room over at UFC working overtime to make sure 303 stood up to the hype, and while the main card looked different, it certainly didn't disappoint Kamaru and Henry.Alex Pereira continued to prove to the world that...he is THAT GUY. But Kamaru and Henry have words for the Light Heavyweight division contenders, who seem to continuously fall into a striking trap with one of the most lethal left hands in the cage. What do you do with a man who is 3 years into a UFC career with wins over 5 former champions, two division belts and objectively the best 12-fight run in history? Henry has one more LH opponent in mind for Alex before he makes the jump to Heavyweight, and the guys discuss how Pereira would fair in the division above. Is Dan Ige a certified badass? His DM's say so. Not many people on the planet plead for the green light with just FOUR HOURS to prepare. Diego's performance calls for a bit of debate between the guys. One thing was easy to agree on - the experienced 50k Ige deserves respect for his showing, especially for the 3rd round effort. And a wise reminder from the Nigerian Nightmare: Styles. Make. Fights. To that point, Ian Machado Garry's fight IQ showed up on Saturday night as he gets the UD over MVP in what was an extremely even statistical score minus one thing: 7+ minutes of control for Machado. Top control wins fights (even when it doesn't win fans) and Ian Garry didn't leave room for the judges, or Kamaru and Henry, to debate. Also, it caught the attention of Shavkat Rakhmonov. Despite the loss, Michael Venom Page showed his confidence and comfortability in the octagon continues to evolve. A good ol' Underdog Fantasy Sports competition closes the recap - Kamaru and Henry are ready to up the stakes on their next round of picks...whose got thoughts on what they should bet?
I recently had a new client ask about food sensitivity testing and we thought this would make a great podcast episode! What is the difference between food sensitivities, food intolerances, and food allergies? Should everyone get a food sensitivity test? Are there more reputable ones than others? In today's episode, we're going to answer all of these questions and more! For quick reference, below we will explain the differences: Food Intolerances – Completely isolated to the digestive tract. The body doesn't have the necessary enzymes needed to break down a food. I.e. lactose intolerance (inadequate lactase enzyme). Food Allergy: A food allergy is an IgE immune reaction to food. In other words, your body's immune system identifies a specific food as an invader and reacts accordingly by producing antibodies to protect you. These are quick onset reactions (think seconds to hours). They are isolated to the skin, airways, and GI tract- hives, throat closing, difficulty breathing, swollen tongue, etc. There are 8 common allergens: milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soy. Food Sensitivities: Food sensitivities are more of a chronic, low-grade sign of inflammation. They are caused by immune-mediated reactions called mediators (histamines, cytokines, prostaglandins). They are also an immune based reaction, but unlike allergies, they can happen within 45 minutes to 3 days. Because of this, it can be pretty difficult to pinpoint. Examples of symptoms of a food sensitivity can include anything from migraines, bloating, digestive symptoms, brain fog, skin issues, digestive issues, sinus issues, etc. Definitely listen in as we explain some of the nuances of the differences and use easily understandable analogies around these topics. Also, feel free to message us with any questions you might have! Time Stamps: (1:32) Food Sensitivity Testing (3:02) Differences Between Intolerances, Allergies, and Sensitivities (6:25) Food Intolerance (7:44) Food Sensitivities (13:47) What Food Sensitivities Tests Do (18:47) When To Test For Food Sensitivities (20:50) The MRT Test (26:49) Are Food Sensitivities Forever? (30:40) Please Message For More Information---------------------Follow @vanessagfitness on Instagram for daily fitness tips & motivation. ---------------------Download Our FREE Metabolism-Boosting Workout Program---------------------Join the Women's Metabolism Secrets Facebook Community for 25+ videos teaching you how to start losing fat without hating your life!---------------------Click here to send me a message on Facebook and we'll see how I can help or what best free resources I can share!---------------------Interested in 1-on-1 Coaching with my team of Metabolism & Hormone Experts? Apply Here!---------------------Check out our Youtube Channel!---------------------Enjoyed the podcast? Let us know what you think and leave a 5⭐️ rating and review on iTunes!
The longevity research world is exploding right now, it's so exciting and the technology is advancing in leaps and bounds and we are able now to discover faster than ever before thanks to AI and co to test more molecules that can impact human health than ever before in the history of mankind. What would have taken years now takes weeks or months. In this episode I talk to Michael Antonelli CEO and founder of Healthgevity. Michael is a master formulator who has spent decades in the anti-ageing and longevity space learning at the feet of many masters and who is at the forefront of working with companies at the cutting edge in peptide and bioactive ingredient development. All his formulations are science backed with clinical research and I was excited to learn about something of these novel molecules Introduction to Healthgevity and its CEO, Michael Antonelli Overview of Healthgevity's approach: merging clinical research, AI, and medical expertise Exploring the importance of longevity in today's society Michael Antonelli's journey and motivation behind founding Healthgevity The role of cutting-edge science in developing longevity supplements How Healthgevity collaborates with clinical practitioners and doctors Deep dive into Healthgevity's science-backed formulations Examples of specific ingredients and their benefits in promoting longevity The impact of AI in optimizing formulations and personalizing supplementation Addressing common misconceptions about longevity supplements Future prospects and advancements in the longevity industry BIO Throughout a career spanning over 17 years, Michael passionately devoted himself to pioneering methods aimed at enhancing longevity, optimizing healthspan, and elevating overall quality of life. His focus revolves around collaborating with leading healthcare professionals, researchers, and other likeminded healthcare leaders to create natural solutions that elevate patient outcomes. Michael utilizes his past experiences that integrates a diverse range of therapies and services, spanning from precision diagnostics to practice management strategies, hormone optimization, nutritional supplements, and leveraging peptides. Previous roles included Chief Innovation Officer, Executive Director, and Business Development for leading companies within the healthcare industry before founding Healthgevity. His expertise extends beyond conventional approaches, emphasizing holistic well-being and personalized care as essential components to any successful medical practice. By championing novel methodologies and innovative technologies, Michal facilitates transformative changes within the healthcare landscape, fostering advancements that positively impact both practitioners and the individuals they serve. Michael continues to remain dedicated to the pursuit of innovative strategies that enhance health and vitality while reshaping the paradigms of healthcare. Some of the products mentioned in this podcast: CARDIO NAD+ Vascular health and aging are the most important health care problem in the world today. Healthy aging requires healthy arteries and a healthy heart. Cardio NAD+ is a state-of-the-art solution which uses the most novel ingredients available to help optimize cardiovascular health. As one of the most important systems in your body, we have designed this combination to be synergistic to the many different areas of cardiovascular health while demonstrating cardioprotective effects including the emerging connection between NAD+ and heart health. Featured Supportive Benefits: Improves net NAD+ status by supporting both its synthesis and limiting its degradation Supports healthy blood pressure Improves vascular aging and endothelial function Supports healthy fibrinolytic activity and clotting function Promotes healthy circulation and blood flow Inhibits platelet & red blood cell aggregation Decreases blood viscosity Supports clinical measures of inflammation Supports healthy blood sugar and insulin levels Inhibits lipid peroxidation Supports healthy lipid metabolism Demonstrated reduction in various independent cardiovascular risk factors Resolve+ Resolve+ contains numerous compounds that have been found to reduce the inflammatory response by targeting a variety of mechanisms. Acmella oleracea ("jambu") is sourced from Sardinia, Italy and rich in alkylamides mainly represented by spilanthol. Its flowers are widely used in folk medicine to treat toothache due to tingling, numbness, and local anesthesia caused in the mouth. Acmella oleracea has been shown to be active in fatty acid amide hydrolase (FAAH) inhibition the enzyme responsible for the degradation of fatty acid amides and cannabinoid type 2 (CB2) activation. There are almost 100 studies suggesting the supportive potential for anti-inflammatory, antioxidant, and analgesic effects of Acmella. Studies reported in this review confirmed activities of Acmella, postulating that transcription factors of the nuclear factor-κB family (NF-κB) trigger the transcription iNOS and COX-2 and several other pro-inflammatory mediators, such as IL-6, IL-1β, and TNF-α. Curcumin, a natural polyphenolic compound derived from turmeric (Curcuma longa L.), has been well documented to exhibit various health benefits. There have been many claims on the health benefits of curcumin on neurological, cardiovascular, lung, metabolic, and liver function, mainly through its anti-inflammatory and antioxidant properties. Despite its promising potential, the clinical application of curcumin has been limited due to its low bioavailability. To enhance curcumin absorption, we are the first to feature Theracurmin Super® 85X, a proprietary curcumin utilizing the latest technology that transforms standard curcumin into an amorphous structure. Theracurmin Super® 85X uses the latest technology to transform regular curcumin particles into a more bioavailable structure. This is done by splitting curcumin particles' crystal structure amorphous, therefore, making it easily absorbed and bioavailable to maximize its supportive potential. Tetrahydrocurcumin (4-HC) is the key bioactive derivative of curcumin, it's also given credibility as the engine behind all that curcumin brings to the table. With a newfound ability to extract and isolate the compound, research has even seen tetrahydrocurcumin outperform its parent compound in several tests of its capabilities. Researchers have also confirmed that 4-HC attenuated pro-inflammatory indicators like interleukin-1, interleukin-6, TNF-⍺, and prostaglandin E2. After reviewing the data, we found many advantages to infuse tetrahydrocurcumin as CurcuPrime® stacked with Theracurmin Super® 85X into Resolve+. Quercetin is a well-known studied dietary flavonoid ubiquitously present in various vegetables. Quercetin is known for its antioxidant activity in radical scavenging and anti-allergic properties characterized by stimulation of immune system, antiviral activity, inhibition of histamine release, decrease in pro-inflammatory cytokines, leukotrienes creation, and suppresses interleukin IL-4 production. Multiple studies have confirmed its supportive potential as an immune modulator and its ability to support a healthy inflammatory response. It can improve the Th1/Th2 balance, and restrain antigen specific IgE antibody formation However, chemical instability, poor water solubility and low bioavailability of quercetin greatly limit its applications which is why a phytosome technology which we feature in resolve is the preferred delivery system to overcome these limitations. This enhanced form of quercetin has been shown to be as much as 20 times better absorbed than other quercetin options. Casperome® boswellia phytosome is a potent extract made from the resin of Boswellia serrata trees and is also referred as Indian frankincense. Boswellia extracts have been demonstrated to be effective in the management of various inflammatory response functions including those that occur in the bowel, joints, bones, respiratory airways and in the brain. The mechanism of action that involves the modulation of the natural inflammatory response both acting on prostanoid synthesis (mPGE2S) and protein degradation (caspases), and transcription factors (Nf-κB). We have selected Casperome® which is a highly standardized in boswellic acids to match the natural composition of boswellia, formulated with phytosome technology to achieve optimized absorption and has been validated by over 10 human studies. Perilla frutescens is an annual herb belonging to the mint family (Lamiaceae). It is mainly produced in countries like China, Japan, India, Thailand and Korea. Recently, Perilla is gaining more attention because of its medicinal benefits and phytochemical contents. The functional compounds of Perilla Seed Extract are flavonoid Aglycons – polyphenols such as Luteolin, Apigenin, Chrysoeriol, and Rosemarinic Acid. Studies have shown that Perilla seed polyphenols regulate allergic and inflammatory response due to its 5-lipoxygenase inhibitory activity and suppression potential of histamine release from mast cells. AstraGin® is a natural compound derived from the roots of two traditional Chinese herbs: Panax notoginseng and Astragalus membranaceous which contain astragaloside I, II, IV and ginsenoside Rb1. AstraGin® has been shown to provide full-spectrum gut support through enhanced absorption, microbiota and immune cell viability, and supporting a health. AstraGin® has been shown in numerous studies to increase the absorption of peptides, amino acids, fatty acids, vitamins, and phytonutrients by up regulating the absorption specific mRNA and transporters, such as SGLT1, CAT1, and GLUT4. Additionally, AstraGin® was shown to reduce intestinal inflammatory biomarker MPO, the pro-inflammatory cytokines IL-6, IL-17, and IL-1β in ulcerative colitis patients. Prime Gut Health Prime Gut Health was created because the digestive system is the foundation of getting and staying healthy. There are many benefits to an optimal digestive system such as a healthy immune system and the protection against harmful viruses, bacteria, fungi, and yeast. The ingredients selected in Prime Gut Health work together to help restore gut homeostasis and GI barrier function. There are many benefits to taking Prime Gut Health, including: Supports healthy GI barrier function* Helps restore gut homeostasis* Binds and neutralizes bacterial toxins in the gut* Promotes a healthy immune system and respiratory health* Supports digestive health and gut discomfort* Increased nutrient absorption* Supports gut inflammation especially within the intestinal wall* Promotes a healthier GI environment* Promoted regularity and healthy bowel function* WHAT MAKES PRIME GUT HEALTH SO IMPACTFUL? ImmunoLin® is the branded ingredient serum-derived bovine immunoglobulin/protein isolate (SBI) with over 40 human studies demonstrating its clinical efficacy in digestive and immune health. SBI has been shown to be a broad-spectrum modulator of the immune system by targeting excessive or imbalanced immunity.* In addition, ImmunoLin® works by binding, neutralizing, and removing pathogenic bacteria, viruses, and other gut irritants that can lead to inflammation.* It also helps to repair the gut lining and restore gut homeostasis.* Tributyrin (as CoreBiome®) is a postbiotic and the most important short-chain fatty acid (SCFA) for supporting digestive, gut, immune and gastrointestinal health. CoreBiome® is a unique butyrate formula intended to pass intact through the stomach and small intestine to deliver butyrate right where it's needed—the colon. CoreBiome® supports: Delivery of butyrate to the colon where it helps maintain the integrity of your intestinal lining* Helps repair the gut lining and restore gut homeostasis* Tight junctures in the intestinal lining* Regularity and regulation of a normal inflammatory response* Sporebiotics: Soil-based probiotics have been touted for their stability, ability to improve digestion, stimulate the immune system, and help maintain a healthy gut microbiota. Bacillus coagulans SNZ 1969®, Bacillus subtilis SNZ 1972 and Bacillus clausii SNZ 1971 are supported with an over 50 year history of use and over 30 human studies covering gut health, gastrointestinal discomfort, immunity against GI tract pathogens, inhibition of food borne pathogens, inhibition of bacteria causing dental carries and gingivitis along with bacterial vaginosis. AstraGin® is a 100% natural compound derived from the roots of two traditional Chinese herbs: Panax notoginseng and Astragalus membranaceous, containing astragaloside I, II, IV and ginsenoside Rb1. AstraGin® enhances nutrient absorption by up-regulating nutrient transporters, such as CAT1, SGLT1, and FR. AstraGin® restores gut wall integrity by triggering an anti-inflammatory response and activating the mTOR pathway for rapid intestinal stem cell migration and differentiation in the inflamed intestinal mucosal barrier (epithelial cell and tight junction). AstraGin® promotes gut ecosystem homeostasis by the symbiotic effect of restoring gut wall integrity and increasing microbiota-immunity communication. AstraGin® activates the immune system through the symbiotic effect of improved gut wall integrity and enhanced microbiota-immunity communication. AstraGin® demonstrated in a recent published human clinical trial, to improve upon a number of measurable factors relating to gut health making it an ideal addition into Prime Gut Health. PrimeTime Prime Time is a comprehensive blend of 12 key natural ingredients shown to have a role in supporting age management powered by industry leading 10mg's of spermidine per serving. Prime Time has been formulated with ingredients to mimic fasting and catalyze your body's natural ability to rid itself of aged cells. Various publications demonstrate the potential this formula will have in your longevity protocols as Prime Time was formulated to support: Epigenetic aging* Boosting autophagy and promote cellular renewal* Fasting* Memory, cognition, and brain health* Cardiovascular health* Beauty from within* Mitochondria* WHAT MAKES PRIME TIME SO IMPACTFUL? Spermidine Spermidine, a natural polyamine, plays a critical role in molecular and cellular interactions involved in various physiological and functional processes. Spermidine has been shown to modulate aging, suppress the occurrence and severity of age-related diseases, and prolong lifespan. The concentration of spermidine declines with age, and exogenous spermidine supplementation reverses age- associated adverse changes and supports health span. Given that it interacts with various molecules, spermidine influences aging through diverse mechanisms. Autophagy is the body's way of cleaning out damaged cells, to regenerate newer, healthier cells and is the main mechanism of spermidine. In addition, spermidine exerts its effects through other mechanisms, including anti-inflammation, histone acetylation reduction, lipid metabolism and regulation of cell growth and signaling pathways. Nicotinamide mononucleotide Nicotinamide mononucleotide, a naturally occurring molecule present in all species. NMN is rapidly absorbed and converted to NAD+, which evidence shows declines as we age. In numerous studies, supplementation has increased NAD+ biosynthesis, suppressed age-related adipose tissue inflammation, enhanced insulin secretion and insulin action, improved mitochondrial function, and improves neuronal function in the brain among much more. Epigallocatechin-3-gallate (EGCG) Epigallocatechin-3-gallate (EGCG) is the major catechin in green tea. There is consistency in the literature about the beneficial role of green tea on senescence-related mechanisms, thanks to its scavenging properties against reactive oxygen species (ROS) and reactive nitrogen species (RNS) and its ability to stimulate autophagy Alpha-ketoglutarate (AKG) Alpha-ketoglutarate (AKG) is a molecule involved in several metabolic and cellular pathways that declines with age. It works as an energy donor, a precursor in amino acid production, and a cellular signaling molecule, and it is a regulator of epigenetic processes. Dihydroquercetin (Taxifolin) Dihydroquercetin is a powerful antioxidant of plant origin that can protect cells from the harmful effects of free radicals and protect cell membranes against damage Apigenin Apigenin is a natural bioactive plant polyphenol with antioxidant, anti-inflammatory and immune system boosting properties. It also helps to support against oxidative stress for better cellular function. Studies have shown that apigenin prevents excessive loss of NAD+ by reducing the amount of circulating CD38, allowing NAD+ stores to remain at higher, more youthful levels. Luteolin Luteolin is a flavonoid naturally found in plants. Flavonoids like luteolin have been found to have beneficial effects on human health by reducing oxidative stress. Trimethylglycine (TMG) Trimethylglycine (TMG) is an amino acid derivative that occurs in plants and has been shown to support methylation which, in turn, supports the homocysteine levels. Taking TMG along with NMN provides the ideal balance for NAD+ production in the body. Resveratrol Resveratrol is part of a group of compounds called polyphenols, which act as antioxidants to protect the body against age-related conditions.The anti-aging mechanisms of resveratrol are mainly modulating oxidative stress, relieving inflammatory reaction, improving mitochondrial function, and regulating apoptosis. Resveratrol is considered for the prevention and support of aging and age-related diseases as it mimics the effects of calorie restriction. Pterostilbene Pterostilbene is a phenolic compound in the same family as resveratrol and is present in small amounts in a large variety of foods and beverages like blueberries or red wine. Multiple studies confirm pterostilbene's remarkable anti-aging effects. Cell and animal studies have shown that pterostilbene can extend the lifespan of various animal models of human longevity by regulating three major pathways linked to longevity: mammalian target of rapamycin (mTOR), AMP-activated protein kinase (AMPK), and sirtuins Bergamot Bergamot (Citrus bergamia) is a type of citrus fruit native to Italy. It has been shown that bergamot juice exerts antioxidant, cardioprotective properties and antisenescence effects. AstraGin® AstraGin® is a natural compound derived from the roots of two traditional Chinese herbs: Panax notoginseng and Astragalus membranaceous. AstraGin® increases the absorption of peptides, amino acids, fatty acids, vitamins, and phytonutrients by up-regulating absorption-specific m RNA and transporters such as SGLT1, CAT1, and GLUT4. Check out all the healthgevity products in our shop. Personalised Health Optimisation Consulting with Lisa Tamati Lisa offers solution focused coaching sessions to help you find the right answers to your challenges. Topics Lisa can help with: Lisa is a Genetics Practitioner, Health Optimisation Coach, High Performance and Mindset Coach. She is a qualified Ph360 Epigenetics coach and a clinician with The DNA Company and has done years of research into brain rehabilitation, neurodegenerative diseases and biohacking. She has extensive knowledge on such therapies as hyperbaric oxygen, intravenous vitamin C, sports performance, functional genomics, Thyroid, Hormones, Cancer and much more. She can assist with all functional medicine testing. Testing Options Comprehensive Thyroid testing DUTCH Hormone testing Adrenal Testing Organic Acid Testing Microbiome Testing Cell Blueprint Testing Epigenetics Testing DNA testing Basic Blood Test analysis Heavy Metals Nutristat Omega 3 to 6 status and more Lisa and her functional medicine colleagues in the practice can help you navigate the confusing world of health and medicine . She can also advise on the latest research and where to get help if mainstream medicine hasn't got the answers you are searching for whatever the challenge you are facing from cancer to gut issues, from depression and anxiety, weight loss issues, from head injuries to burn out to hormone optimisation to the latest in longevity science. Book your consultation with Lisa Join our Patron program and support the show Pushing the Limits' has been free to air for over 8 years. Providing leading edge information to anyone who needs it. But we need help on our mission. Please join our patron community and get exclusive member benefits (more to roll out later this year) and support this educational platform for the price of a coffee or two You can join by going to Lisa's Patron Community Or if you just want to support Lisa with a "coffee" go to https://www.buymeacoffee.com/LisaT to donate $3 Lisa's Anti-Aging and Longevity Supplements Lisa has spent years curating a very specialized range of exclusive longevity, health optimizing supplements from leading scientists, researchers and companies all around the world. This is an unprecedented collection. The stuff Lisa wanted for her family but couldn't get in NZ that's what it's in her range. Lisa is constantly researching and interviewing the top scientists and researchers in the world to get you the best cutting edge supplements to optimize your life. Subscribe to our popular Youtube channel with over 600 videos, millions of views, a number of full length documentaries, and much more. You don't want to miss out on all the great content on our Lisa's youtube channel. Youtube Order Lisa's Books Lisa has published 5 books: Running Hot, Running to Extremes, Relentless, What your oncologist isn't telling you and her latest "Thriving on the Edge" Check them all out at https://shop.lisatamati.com/collections/books Perfect Amino Supplement by Dr David Minkoff Introducing PerfectAmino PerfectAmino is an amino acid supplement that is 99% utilized by the body to make protein. PerfectAmino is 3-6x the protein of other sources with almost no calories. 100% vegan and non-GMO. The coated PerfectAmino tablets are a slightly different shape and have a natural, non-GMO, certified organic vegan coating on them so they will glide down your throat easily. Fully absorbed within 20-30 minutes! No other form of protein comes close to PerfectAminos Listen to the episode with Dr Minkoff here: Use code "tamati" at checkout to get a 10% discount on any of their devices. Red Light Therapy: Lisa is a huge fan of Red Light Therapy and runs a Hyperbaric and Red Light Therapy clinic. If you are wanting to get the best products try Flexbeam: A wearable Red Light Device https://recharge.health/product/flexbeam-aff/?ref=A9svb6YLz79r38 Or Try Vielights' advanced Photobiomodulation Devices Vielight brain photobiomodulation devices combine electrical engineering and neuroscience. To find out more about photobiomodulation, current studies underway and already completed and for the devices mentioned in this video go to www.vielight.com and use code “tamati” to get 10% off Enjoyed This Podcast? If you did, subscribe and share it with your friends! If you enjoyed tuning in, then leave us a review and share this with your family and friends. Have any questions? You can contact my team through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa and team
As Coach Jenny continues to be mindful of the needs of, surround herself with and inspire women in their 40+ journey through life, she dives into a super informative and in depth conversation about hormones and aging thoughtfully with her personal ND Dr. Nadia Saleem.Dr. Nadia Saleem is a board certified naturopathic doctor who takes a holistic approach to hormone health and has extensive experience in supporting the well-being and optimal physiology of women. Jenny and Dr. Nadia discuss some questions Jenny received from her community and audience that center around understanding and defining perimenopause and menopausal transitioning, and explore the signs and symptoms of our changing female bodies. Important Links:Follow Dr. Nadia Saleem on IGE.B.L Naturopathic Clinic Join The Team Strong Girls Body Transformation Group Start Your Body Transformation NOW!Get Your Perfect Sports 20% Discount here by using coupon code: JVBSave $100 off Your MAXPRO Fitness hereApply for the STRONG Formula Certification ProgramSTRONG Fitness Magazine Subscription Use discount code PODCASTIf you enjoyed this episode, make sure and give us a five star rating and leave us a review on iTunes, Podcast Addict, Podchaser and Castbox.Resources:STRONG Fitness MagazineSTRONG Fitness Magazine on IGTeam Strong GirlsCoach JVBFollow Jenny on social media:InstagramFacebookYouTube https:// DISCLAIMER: The opinions, beliefs, and viewpoints expressed by the hosts and guests on this podcast do not necessarily represent or reflect the official policy, opinions, beliefs, and viewpoints of Disenyo.co LLC and its employees.
DR BRS: A Házibuli Doktor New Yorkban is házhoz jön New York utcáin autókázunk Dr. BRS-sel, vagyis Béres Attilával, aki már járt nálunk a stúdióban is. Most Amerika legkedveltebb gyorsétterméhez a Chick-fil-a-hez Queens center Mall-hoz tartunk, miközben a város látványosságait csodáljuk. Vagyis nem… Attila most nem egyedül van – családjával érkezett, hogy kisfiának megmutassa a Nagy Almát. Attilával beszélgetni mindig élmény, de most különösen. Mesélt nekünk idei látogatásáról, kisfiának mutatta meg Times Square fényáradatát és a Central Park zöldellő fáit. Együtt fedezték fel a várost, mintha csak egy modern kalandfilm főszereplői lennének. Ige, igen a Pókemberről beszélek. De nem csak New Yorkban járt ám! Floridában is kalandozott, ahol a napfény és a tengerpart helyett egy fergeteges bulit csapott. Természetesen a karrierjéről is beszélgettünk. A DJ szakma csillogó felszíne alatt ott rejlik a sok kemény munka és az éjszakázás árnyoldala is. Attila őszintén beszélt arról, hogy a sok fellépés és utazás mennyire kimerítő lehet, valamint az alkohol hatásáról. Az egészséges életmód és az éjszakai élet egyensúlyáról. DR BRS mostanában sem tétlenkedik. Három új dallal is dicsekedhet ami minden bizonnyal a slágerlistát is maghódítják. Izgatottan mesélt a jövőbeli terveiről, amelyek között további kollaborációk és izgalmas projektek és előzenés nagykoncertek is szerepelnek. Ahogy mondta, mindig a következő nagy dobáson gondolkodik, mert a zene nem állhat meg! Ahogy elhagytuk az éttermet, és folytattuk utunkat a városban, egy dolog biztos volt: Dr. BRS zenéje továbbra is velünk lesz, bárhol járunk. A new yorki kalandok, a floridai napfény és a zenei inspirációk mind hozzájárulnak ahhoz, hogy Béres Attila mindig megújuljon, és újabb slágerekkel örvendeztesse meg a közönségét. Tarts velünk a mi kis utazásunkon Dr. BRS-sel, ahol a zene és az élet keveredik, mint egy tökéletes remix. Maradjatok velünk, mert a legjobb sztorik még csak most jönnek!
If you've ever wondered the best way to test for food allergy sensitivity, this episode is for you!What do I mean by food allergy sensitivity?Many people think that you're either allergic (and thus highly reactive) to specific foods or you're not. And that's not actually true as there's a scale of reactivity or sensitivity that you could be on for IgE food allergies.Making this even more complex is that your level of reactivity can change with time (this is especially true for children) which is why today's episode is so important!Food allergy testing isn't perfect and can sometimes show false positives. Unfortunately, many practitioners (including many in the functional or integrative space) may recommend unnecessary elimination of foods that came back as a positive IgE reaction yet lacked any real-life reactivity.Though it might seem harmless, it deserves to be repeated that unnecessary food eliminations can potentially lead to IgE food allergy reactivity if left out of your diet for too long.Throw in chronic skin rashes like eczema, which increase the risk of food allergy (especially in children), and the question of what food is safe becomes increasingly confusing.That's why I wanted to bring in a food allergy immunotherapy specialist to talk about this important topic.So if you're wondering if skin tests are the gold standard, whether blood tests are accurate, and what the pros and cons are when trying oral food challenges or subcutaneous allergy shots, tune in to this fascinating episode with my guest, Dr. David Fitzhugh.Dr. Fitzhugh is an allergist/immunologist in private practice in Chapel Hill, North Carolina.He specializes in food immunotherapy for children and adults with severe food allergies but treats a wide variety of allergic and immunologic conditions, including allergic rhinitis, asthma, atopic dermatitis, mast cell disorders, and anaphylaxis.In This Episode:Options that test for food allergyCan positive serum IgE blood tests be wrong?Food sensitivity vs food allergyBenefits of doing oral food challengesWhat is more likely to trigger a reaction like food allergy hives: subcutaneous allergy shots or oral food challenges?Is it possible to tolerate (to some degree) something you're allergic to?Oral food challenges dos and don'tsHow to reduce your food allergy reactivitySublingual versus oral immunotherapyThoughts on elimination diets and food allergiesQuotes“In our field, we consider someone sensitized who's test-positive to an IgE test. That could be a skin test or a blood test. So you are sensitized. But if you're test-positive and you eat the food routinely with no issue, you're not allergic, right? Allergic means a clinical syndrome of having an allergic reaction. And where we see this most commonly is the eczema kids.”“...every allergist in North America is doing subcutaneous allergy shots. These are the typical allergy shots to desensitize people against hay fever, grass pollen, dust mite, et cetera. And we see a decent rate of really serious reactions that occur with those. And so every allergist needs to be prepared to manage an allergy shot reaction, sometimes requiring multiple rounds of epinephrine, IV fluid. Those don't happen commonly, but they do happen. But yet the dichotomy is, there's in many ways a reluctance to do oral food challenge because parents and/or providers are worried about the possibility of reaction. And the thing is with carefully selected food challenges, we have the luxury of knowing where most kids will tolerate, following the blood test to the skin test.”LinksFind Dr. Fitzhugh online
If you've found it frustrating that no one can tell you why you have chronic urticaria hives (including chronic spontaneous urticaria, dermatographia, and even angioedema), I feel you.Especially when IgE allergies are ruled out (testing is negative) or even avoiding what you're allergic to isn't helpful. At that point, most doctors will say that there is no answer or clear trigger to what causes urticaria, basically leaving you with an increasing number of medications that may or may not help to control your skin.To say that this leaves many like you feeling enormously helpless and hopeless is an understatement.In my clinical practice, I've worked with many cases of chronic urticaria hives around the globe, helping to troubleshoot when doctors have all but given up in seeking an answer. Some cases have dated back decades, often having been seen at some of the most prestigious health institutions only to be told that there's nothing to be done beyond antihistamines (which have their own problematic side effects) and biologics like Xolair.I love helping people stop having hives and urticaria, especially since I get to explore the complex causes of chronic urticaria, which conventional medicine often ignores or assumes is impossible. So when new research starts pointing out connections to what I have seen in practice, I must share it!If you missed my previous article on hidden causes of chronic urticaria, check it out here! This will help you see that what this new paper demonstrates is highlighting a big missing link to chronic spontaneous urticaria, hives, and other histamine-driven issues.Before we dig into gut-chronic urticaria hives connection, I highly recommend that you download my Skin Rash Root Cause Finder. This is the exact method I've used with thousands of my private clients to help them discover what's really causing their rash (and yes, this works for hives, dermatographia and angioedema issues) >> Get the easy-to-use Skin Rash Root Cause Finder.In This Episode:Chronic urticaria (hives) gut causesProblems with urticaria treatment options (even Xolair)Gut imbalances noted in chronic spontaneous urticaria (hives)What are lipopolysaccharides + short-chain fatty acids (and why are they important)?Key findings from new research on gut-skin connection (specifically for hives)Quotes“The incidence of true histamine intolerance is much lower than you're led to believe and is based on old assumptions that need a serious update.”“Nearly 50% of those living with urticaria experience depression and anxiety (especially when the flare-ups are severe).”LinksGut microbiota facilitate chronic spontaneous urticariaHealthy Skin Show ep. 261: Chronic Hives: Why Aren't They Going AwayHealthy Skin Show ep. 265: Problem with Antihistamines That No One Tells You w/ Dr. Chris Thompson, MDHealthy Skin Show ep. 317: Itchy, Painful Rash From Thyroid Disease: Your Guide to Stopping ItHealthy Skin Show ep. 188: Histamine Intolerance + Skin Rashes (PART 1)