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    “A lot of people are either being diagnosed or self-diagnosing (with MCAS), I would say somewhat inappropriately, without any actual evidence of mast cell activation. We're seeing it more and more commonly.” -- Dr. Tim Olynych

    On this episode of The Allergist, Dr. Mariam Hanna teams up with Dr. Timothy Olynych, a clinical immunologist and allergist and PhD in mast cells, to unravel the mystery of mast cell activation syndrome (MCAS). This elusive condition requires some serious detective work, with clues scattered across a complex array of symptoms that don’t always add up. Together, they crack the case on how to spot MCAS in its various disguises and offer a roadmap for managing this puzzling disorder.

    On this episode:

    Understanding Mast Cell Activation Syndrome: MCAS is a complex condition characterized by a constellation of symptoms rather than one clear diagnostic feature. Dr. Olynych highlights why it’s often confused with other conditions, making diagnosis a challenge for clinicians.The Role of Tryptase Testing: Learn how tryptase testing is crucial in diagnosing MCAS, especially when levels spike during symptom flares, though normal levels don’t always rule out MCAS.Common Misconceptions and Comorbidities: Dr. Olynych addresses the frequent confusion between MCAS and conditions like POTS and Ehlers-Danlos syndrome. Treatment Approaches: Dr. Olynych outlines a treatment approach that mirrors how chronic spontaneous urticaria is managed, using H1 and H2 blockers and mast cell stabilizers like cromolyn sodium. Patient Care Beyond the Allergist’s Office: This episode highlights the importance of a multidisciplinary approach to MCAS, including when to refer patients to other specialists.

    Join us as we dig deeper into the enigma of mast cell activation syndrome, uncovering practical clues and actionable insights for healthcare providers eager to crack the case on this complex and often misunderstood condition.

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    The Allergist is produced for CSACI by PodCraft Productions

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    “Introduce those allergens early, diversify that microbiome, and don't let fear rule you.” -- Dr. Priya Bansal

    On this episode of The Allergist, Dr. Mariam Hanna teams up with Dr. Priya Bansal, a triple board-certified allergist, to tackle the challenges of managing food allergies and the anxiety that often comes with them. Together, they walk through real-world cases that allergists frequently encounter, offering practical strategies to support patients and families.

    On this episode:

    Introducing Allergens at Home: Handling parents’ hesitancy to introduce allergens like tree nuts in infants who already have a known allergy. Dr. Bansal offers approaches for building trust and using shared decision-making.What’s Not a Food Allergy: Dr. Hanna and Dr. Bansal discuss the common misconceptions around what qualifies as a food allergy and how to communicate with patients who might confuse intolerances or other reactions with true food allergies.Self-Carrying Epinephrine in Schools: Practical tips for helping children and teens manage epinephrine autoinjectors at school, including discussing comfort levels, age appropriateness, and new technologies like nasal epinephrine.School-Wide Allergy Bans: The pros and cons of school-wide bans on allergens like peanuts, and why such bans may cause more harm than good. Dr. Bansal shares alternative strategies for managing food allergies in schools without increasing social isolation.Health-Related Anxiety After a Reaction: Managing patients, especially children, who develop restrictive eating behaviors or heightened anxiety following a food allergy reaction. Discover when to involve mental health professionals and how to address fear in the clinic.

    Join us as we explore food allergy management and anxiety, with actionable insights designed to support both healthcare providers and patients navigating the challenges of food allergies.

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    Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

    The Allergist is produced for CSACI by PodCraft Productions

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    “A desensitization is really the assumption that they're allergic. It's not a test, it's not a test dose, it's not a graded challenge. A desensitization is the assumption or the confirmation that they are truly allergic to this drug.” -- Dr. Christine Song

    Managing drug allergies can be a delicate balancing act, especially when life-saving medications are involved. On this episode of The Allergist, Dr. Mariam Hanna is joined by Dr. Christine Song, an Assistant Clinical Professor at the University of Toronto and drug allergy lead at St. Michael’s Hospital. Together, they unpack the complexities of drug allergies, from distinguishing them from other adverse drug reactions to navigating the tricky terrain of desensitization.


    On this episode:

    Understanding Drug Allergies: What distinguishes a true drug allergy from other adverse reactions, and why some medications are more prone to trigger allergies?Common Triggers and Mechanisms: Insights into why penicillins, beta-lactams, and fluoroquinolones frequently cause allergic reactions, and how both immediate and delayed allergic mechanisms play a role.Diagnostic Challenges: The importance of a thorough patient history, the role of skin testing, and why timelines and details are critical.Shared Decision-Making: How allergists work with patients to prioritize which allergies to test, de-label, or manage, with special considerations for pediatric and adult populations.Desensitization Protocols: The art and science of safely reintroducing necessary medications through desensitization, and why this process isn’t one-size-fits-all.Pre-Medication Strategies: Why there’s no ‘right’ premedication protocol due to a lack of strong evidence supporting their overall effectiveness.Unique Cases and Exceptions: From managing chemotherapy allergies to tuberculosis treatments, when and why allergists might push the boundaries of traditional desensitization protocols.Practical Tips for Healthcare Providers: Best practices for referring patients, documenting allergic reactions, and communicating effectively to ensure patients receive the care they need.

    Prepare to learn how to navigate the complex world of drug allergies with confidence and care.

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    Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

    The Allergist is produced for CSACI by PodCraft Productions

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    “Don't give a bad antihistamine masking as a sedative. If a person truly needs help with their sleep, then give them a proper sedative.” -- Dr. Marcus Maurer


    As allergy seasons ebb and flow, there’s one drug that maintains its place in household medicine cabinets: Benadryl. On this episode, Dr. Mariam Hanna sits down with Dr. Stuart Carr, Chief Medical Officer at Snö Asthma and Allergy in Abu Dhabi and past president of the CSACI, to tackle the lingering myths and outdated uses of first-generation antihistamines. From their history to their ongoing role in primary care, they uncover the risks of these older drugs, and the clear benefits of second-generation antihistamines.

    On this episode:

    The pharmacology of first-generation antihistamines: How do they really work?Are first-generation antihistamines still necessary?Debunking the myth of Benadryl as a first-line treatment for allergic reactions.Undesirable side effects: impaired cognitive function, disrupted sleep, increased risk of dementia, and cardiac risks like ventricular arrhythmias.Special considerations for pediatric and elderly populations.The future of antihistamine treatments: What’s on the horizon?

    Arm yourself with the latest knowledge to “fight the good fight” against first-generation antihistamines.

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    Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

    The Allergist is produced for CSACI by PodCraft Productions

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    "History, history, skin test or serum IgE, and then consider doing the other test just to round out your testing until you're sure you've detected everything you need to detect.” -- Dr. David Golden

    As the leaves begin to fall, and the wasps begin to invade every patio lunch, Dr. Mariam Hanna sits down with Dr. David Golden, a leading expert on venom allergies and retired associate professor from Johns Hopkins. Together, they explore the swarm of complexities surrounding venom immunotherapy, from the nuances of diagnosis to emerging treatments on the horizon.

    In this episode:

    Understanding venom allergies: The basics and beyondLarge local reactions vs. systemic reactions: What’s the real risk?The role of skin testing vs. serum IgE in diagnosing venom allergiesVenom immunotherapy: How effective is it, really?Emerging trends and treatments in venom allergy managementPractical advice for managing venom allergies

    Prepare to get the buzz on everything venom-related in this insightful conversation. Tune in now!

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    The Allergist is produced for CSACI by PodCraft Productions

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    “FPIES is real, both acute and chronic FPIES. It's not a myth, and it can be an allergic emergency.” -- Dr. Nowak-Wegrzyn


    Join Dr. Mariam Hanna for a comprehensive discussion on Food Protein-Induced Enterocolitis Syndrome (FPIES) with Dr. Anna Nowak-Wegrzyn, a leading expert in pediatric allergy and immunology at NYU Grossman School of Medicine. Dr. Nowak-Wegrzyn sheds light on this unique and often perplexing condition, offering critical insights for healthcare providers.

    On this episode:

    Understanding FPIES:

    Dr. Nowak-Wegrzyn explains FPIES, a non-IgE mediated food allergy that manifests differently from traditional food allergies. She details the typical presentation of FPIES, including severe vomiting, lethargy, and pallor, which can occur a few hours after food ingestion.

    Difference in Presentation Between Children and Adults:

    Learn about how FPIES presents in different age groups. While it typically begins in infancy, Dr. Nowak-Wegrzyn discusses the mysterious cases where FPIES emerges in adults who have tolerated the triggering food for years.

    How FPIES Differs from IgE-Mediated Food Allergies:

    Understand the key differences between FPIES and IgE-mediated food allergies. Dr. Nowak-Wegrzyn outlines why skin and blood tests may be negative in FPIES cases, despite the severity of symptoms.

    Prognosis and Counseling Parents:

    Discover the prognosis for children with FPIES, with many outgrowing the condition by age three to five. Dr. Nowak-Wegrzyn emphasizes the importance of educating and empowering parents through careful counseling and shared decision-making.

    Management and Treatment:

    Dr. Nowak-Wegrzyn discusses current strategies for managing FPIES, including dietary modifications, careful introduction of new foods, and the potential use of ondansetron for managing symptoms at home. She also addresses the use of epinephrine in atypical FPIES cases with IgE sensitization.

    Tune in to this episode for an in-depth exploration of FPIES, offering practical advice and valuable insights for healthcare providers navigating this challenging condition.

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    Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

    The Allergist is produced for CSACI by PodCraft Productions

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    “I feel like the term "immunity debt" has become fashionable but has lost all its meaning for me." -- Dr. Samira Jeimy

    Join Dr. Mariam Hanna for a deep dive into secondary immunodeficiencies with Dr. Samira Jeimy, an assistant professor in the Division of Clinical Immunology and Allergy at Western University. Dr. Jeimy shares her extensive knowledge on acquired immunodeficiency, providing valuable insights for healthcare providers.

    On this episode:

    Understanding Acquired Immunodeficiency:

    Dr. Jeimy explains acquired immunodeficiencies, also known as secondary immunodeficiencies, and how they result from external factors rather than genetic anomalies.

    Types and Diagnosis:

    Understand the diagnostic process, including measuring immunoglobulin levels and considering clinical and family history.

    Clinical Manifestations and Triggers:

    Learn about the diverse clinical manifestations of acquired immunodeficiency and common triggers, such as infections, chronic diseases like diabetes and renal failure, and medications.Dr. Jeimy discusses the controversial and often misunderstood causes of immunodeficiency, including stress and post-COVID conditions.

    Management and Treatment:

    Discover current strategies for managing acquired immunodeficiencies, including the use of immunosuppressive treatments and the importance of early diagnosis and intervention.Dr. Jeimy emphasizes the need for personalized medicine and collaboration among healthcare providers for effective treatment.

    Patient Care and Support:

    Dr. Jeimy underscores the importance of comprehensive care and support for patients with acquired immunodeficiencies.She highlights the significance of early involvement of immunologists in the patient journey to optimize treatment outcomes.

    Tune in to this episode for an in-depth exploration of acquired immunodeficiency, offering valuable insights and practical advice for healthcare providers.

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    Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

    The Allergist is produced for CSACI by PodCraft Productions

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    “HAE is a different disease than it was because of the advancement of treatments
make sure that you're offering the best form of therapy available to patients and their families.” -- Dr. Stephen Betschel

    Join Dr. Mariam Hanna in an enlightening conversation with Dr. Stephen Betschel, an associate professor in the Department of Medicine and Clinical Immunologist and Allergist at St. Michael's Hospital, University Health Network. Dr. Betschel, a global authority on hereditary angioedema (HAE), shares his extensive knowledge on this rare and potentially life-threatening condition.

    On this episode:

    Understanding Hereditary Angioedema:

    Dr. Betschel provides a detailed explanation of HAE, an autosomal dominant condition characterized by C1 inhibitor deficiency. He discusses how this deficiency leads to the overproduction of bradykinin, causing swelling in various parts of the body, including the hands, feet, face, abdomen, and throat.

    Types and Diagnosis:

    Explore the different types of HAE (type 1, type 2, and hereditary angioedema normal) and the importance of accurate diagnosis. Dr. Betschel explains the diagnostic process, which includes measuring C4 and C1 inhibitor levels and function, and emphasizes the role of clinical and family history in identifying potential cases. Genetic testing can also be useful in certain cases.

    Clinical Manifestations and Triggers:

    Learn about the varying clinical manifestations of HAE, which can differ significantly even among patients in the same family. Dr. Betschel highlights common triggers for HAE attacks, such as infections, trauma, and spontaneous episodes, emphasizing the importance of understanding these triggers for effective management.

    Management and Treatment:

    Discover the latest advancements in HAE treatment, including on-demand therapies for acute attacks and long-term prophylaxis options. Dr. Betschel discusses medications such as Icatibant, intravenous and subcutaneous C1 inhibitors, and the promising future of oral treatments and gene therapy.

    Patient Care and Support:

    Dr. Betschel underscores the importance of providing comprehensive care and support for HAE patients. He advises healthcare providers to engage with patients actively, optimize attack control, and improve quality of life through personalized treatment plans.

    Tune in to this episode for an in-depth exploration of hereditary angioedema, offering valuable insights and practical advice for healthcare providers.

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    Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

    The Allergist is produced for CSACI by PodCraft Productions

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    “It's important to recognize that fresh fruits and vegetables can cause local reactions in the mouth and gut. But if they're not causing symptoms of a more severe allergic reaction, don't panic. Chances are good that this is not something that's going to lead to more worrisome features.” -- Dr. Anne Ellis

    Dr. Mariam Hanna sits down with Dr. Anne Ellis, professor of medicine and chair of the Division of Allergy and Immunology at Queen's University, to explore the intricacies of Pollen Food Allergy Syndrome (PFAS), also known as Oral Allergy Syndrome. Dr. Ellis, a leading expert in allergic diseases, guides listeners through the complex landscape of PFAS, offering insights into diagnosis, management, and patient care.

    On this episode:

    Understanding Pollen Food Allergy Syndrome:

    Dr. Ellis provides a comprehensive overview of PFAS, explaining how it affects primarily the mouth and tongue but can impact the entire GI tract. She discusses the common allergens associated with PFAS, such as birch pollen, and the cross-reactivity from fruits like apples and tree nuts.

    Diagnosis and Misconceptions:

    Explore the diagnostic process for PFAS. Dr. Ellis clarifies the difference between PFAS and other food allergies, emphasizing the role of accurate diagnosis through skin tests and serum-specific IgE testing.

    Management Strategies:

    Learn about effective management strategies for PFAS. Dr. Ellis shares insights on how to reduce symptoms through avoidance of raw fruits and vegetables and the role of immunotherapy in treating underlying environmental allergies.

    Patient Care and Red Flags:

    Dr. Ellis highlights key aspects of patient history that may indicate more severe allergic reactions, discussing the importance of distinguishing between local symptoms and systemic IgE-mediated reactions.

    Advice for Primary Care Providers:

    Gain valuable tips for primary care providers on recognizing and managing PFAS. Dr. Ellis emphasizes the significance of a detailed medical history and the reassurance that most PFAS cases do not require an epinephrine auto-injector.

    Tune in to this episode for an in-depth discussion on Pollen Food Allergy Syndrome, offering practical advice and expert insights for both healthcare providers and patients.

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    The Allergist is produced for CSACI by PodCraft Productions

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    “I'm still getting told from families and other physicians that you can't make a diagnosis of asthma until they're six. Why? Why is this still happening? We can diagnose preschoolers with asthma.” -- Dr. Tiffany Wong


    Join Dr. Mariam Hanna as she sits down with Dr. Tiffany Wong who pushes back on the persistent and unfounded skepticism about whether preschoolers can be diagnosed with asthma. Dr. Wong is an associate clinical professor at the University of British Columbia and the medical lead of the BC Children's Hospital allergy clinic. She covers the intricacies of diagnosing and managing preschool asthma, dispels common myths and emphasizes the importance of accurate diagnosis and effective management in young children.

    On this episode:

    Diagnosing Preschool Asthma:

    Dr. Wong clarifies the myths and realities of diagnosing asthma in preschool children. She emphasizes that a detailed medical history and physical examination can often suffice, debunking the misconception that spirometry is always necessary.

    Management Strategies:

    Gain insights into effective management strategies for preschool asthma. Dr. Wong discusses the importance of categorizing patients according to their risk of future exacerbations, which helps in tailoring treatment plans for both healthcare providers and families.

    Follow-Up Care:

    The critical role of regular follow-up in managing preschool asthma is highlighted. Dr. Wong stresses that continuous monitoring allows for better understanding of each patient's evolving clinical narrative and ensures timely adjustments to treatment plans.

    Empowering Families:

    Learn how to support families dealing with preschool asthma. Dr. Wong provides valuable tips on training families to recognize and report symptoms accurately, ensuring they are equipped to manage their child's condition effectively.

    Tune in to this episode for a deep dive into preschool asthma, with practical tips and expert insights for both healthcare providers and caregivers.

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    Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

    The Allergist is produced for CSACI by PodCraft Productions

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    “When you fly, the flight attendant is always telling you, put on your oxygen mask first before you help somebody else. And it's so true. We’re way more efficient in a clinic setting when we have taken care of ourselves.” -- Dr. Maureen Petersen

    Dr. Mariam Hanna sits down with Dr. Maureen Petersen, a pediatric allergist and immunologist from North Carolina Chapel Hill to explore the challenges of managing chronic illness from the perspective of both the physician and the parent. Dr. Petersen brings a unique personal connection to this topic, having navigated her daughter's chronic illnesses while pursuing a medical career.

    On this episode:

    Navigating Chronic Illness: Dr. Petersen shares her experiences with treating chronically ill children, emphasizing the importance of empathy and understanding in patient-caregiver relationships. She illustrates the unique challenges faced by families and offers strategies to improve communication and support.

    Physician's Perspective: Dr. Petersen discusses the impact of chronic illness on physicians, highlighting techniques for maintaining compassion and methods to avoid burnout while delivering high-quality care.

    Self-Care for Physicians: Practical advice on how physicians can manage their well-being amidst demanding careers. Dr. Petersen emphasizes the importance of finding joy, setting personal goals, and prioritizing self-care to maintain a balanced and fulfilling medical career.

    Empowering Families: Learn how to support families dealing with chronic illness. Dr. Petersen provides valuable tips on encouraging open communication, validating parent’s experiences, and offering necessary resources without overwhelming them, ensuring they feel seen and heard.

    Tune in to this episode for an insightful discussion on the intricacies of chronic illness care and the vital role of self-care for physicians, offering practical advice and expert perspectives for healthcare providers and caregivers alike.

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    Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

    The Allergist is produced for CSACI by PodCraft Productions

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    “I felt I was actually controlling my condition. It wasn't controlling me.”

    -- Patient of Dr. Philippe Begin

    Join Dr. Mariam Hanna as she sits down with Dr. Philippe Begin, a renowned expert in allergy and immunology from the University of Montreal. They dive into the complexities of adult food allergies, distinguishing them from childhood allergies and discussing both clinical insights and patient experiences.

    On this episode:

    Understanding Adult Food Allergies: Dr. Begin explains the unique characteristics of adult food allergies, including the differences in allergens and symptoms between adults and children. He sheds light on the under-researched area of adult food allergy practice.

    Diagnosis and History: Learn about the critical elements in diagnosing IgE-mediated food allergies in adults. Dr. Begin emphasizes the importance of timing, symptom duration, and consistency in patient history to accurately identify food allergies.

    Management Strategies: Dr. Begin shares his approach to managing adult food allergies, highlighting the importance of recognizing patients' experiential knowledge and their tolerance to risk. He discusses the role of food challenges and the careful use of food diaries.

    Psychosocial Aspects: Explore the psychological and social dimensions of living with food allergies as an adult. Dr. Begin talks about the varying reactions to food allergies, from fear to confidence, and how past experiences shape these responses.

    Empowering Patients: Discover how empowering patients to manage their food allergies can transform their lives. Dr. Begin's stories of patients taking control of their conditions provide valuable insights for both patients and healthcare providers.

    Tune in to this episode for a comprehensive look at the evolving field of adult food allergies, offering practical advice and expert perspectives that are essential for anyone dealing with this condition.

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    The Allergist is produced for CSACI by PodCraft Productions

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    "Usually when patients have really strong feelings, what they're really trying to tell you is what their priorities are and what they are most afraid of" -- Dr. Michael Cyr

    Join Dr. Mariam Hanna as she welcomes Dr. Michael Cyr, a leader in allergy and clinical immunology, to explore the vital role of shared decision-making in the modern practice.

    On this episode:

    Understanding Shared Decision-Making: Dr. Cyr breaks down the concept of shared decision-making, emphasizing its importance in integrating patient preferences with evidence-based medicine. He highlights the need for physicians to present all treatment options and their associated risks and benefits clearly.

    Recognizing and Overcoming Biases: Dr. Cyr discusses the cognitive biases that affect both patients and physicians. He shares strategies for identifying these biases and ensuring they do not impede the decision-making process.

    Effective Communication: Dr. Cyr stresses the importance of taking time to listen to patients. By understanding their priorities and fears, physicians can better guide them through their treatment options. He provides practical advice on framing risks and benefits to help patients make informed choices.

    The Art of Medicine: Highlighting the art of medicine, Dr. Cyr shares his approach to balancing strong medical advice with patient autonomy. He uses examples such as oral food challenges to illustrate how different patients may make different decisions based on their unique perspectives.

    Building Therapeutic Relationships: Dr. Cyr emphasizes the importance of maintaining a strong therapeutic relationship. He advises physicians to be patient and persistent, acknowledging that not all decisions will be straightforward and may require ongoing dialogue and trust-building.

    Join Dr. Hanna and Dr. Cyr for an enlightening discussion on how shared decision-making can enhance patient care and improve outcomes in allergy and immunology. This episode is essential for healthcare professionals seeking to refine a balanced approach to patient-centered care and evidence-based practice.



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    The Allergist is produced for CSACI by PodCraft Productions

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    “Early introduction is the time-proven and research-proven prevention target for every child and every food.” -- Prof. Jonathan Hourihane


    Venture into the evolving landscape of food allergy management as Dr. Mariam Hanna welcomes Professor Jonathan Hourihane, a leading figure in pediatric allergy and immunotherapy from the Royal College of Surgeons in Ireland. Together, they explore the latest strategies in dietary advancement therapies and the critical role of early food introduction.


    On this episode:


    Early Introduction: Professor Hourihane emphasizes the importance of introducing allergenic foods early to prevent long-term allergies. He challenges traditional cautious approaches and highlights the effectiveness of starting reintroductions at home for allergens like milk and egg.

    Impact of Parental Anxiety: How parental emotions play a crucial role. Professor Hourihane shares his findings on the negative effects of high parental anxiety on the success of food reintroduction. He underscores the need for allergists to provide support to help parents navigate these challenges confidently.

    Advocacy in Allergy Management: Reflecting his passion for patient advocacy, Professor Hourihane advocates for a proactive approach to managing food allergies. He discusses the necessity of empowering both patients and their families to take informed steps toward reintroducing allergenic foods safely and effectively.

    Shifting Perspectives: They discuss how these approaches necessitate a shift in how allergists view food allergies—from a condition to be feared to one that can be actively managed through strategic, informed actions.

    Join Dr. Hanna and Professor Hourihane for an insightful discussion that promises to reshape your understanding of food allergy management, emphasizing early intervention and patient empowerment. This episode is a must-listen for anyone involved in allergy care, offering essential insights that could transform your clinical approach.



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    The Allergist is produced for CSACI by PodCraft Productions

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    “I guarantee you, within the next five years or within my lifetime, there may be a permanent solution to a lot of medical conditions including (asthma)." -- Dr. Jason Lee

    Asthma remains a formidable foe, particularly when it escalates to its severe form. This episode of "The Allergist," Dr. Mariam Hanna, explores the complexities of severe asthma and the revolutionary impact of biologic therapies.

    Dr. Jason Lee, a leading expert in allergy and immunology, sheds light on the evolution of asthma treatment. Gone are the days when inhalers and corticosteroids were our only options. Today, biologics offer a promising frontier, not just to manage but potentially to rewrite the course of the disease. Dr. Lee demystifies these powerful medications, tackling common concerns and highlighting the essential role of patient education in fostering adherence.

    Dr. Lee offers several actionable tips for physicians on managing severe asthma with biologics. He advises on the importance of patient education about the mechanisms and benefits of biologics to enhance adherence and reduce anxiety about these new treatments. He emphasizes the need for regular monitoring of lung function and inflammation markers to tailor therapy effectively. And Dr. Lee highlights the use of stepped-care approaches and discusses strategic timing for introducing or discontinuing biologic therapy based on patient response and overall asthma control.

    For allergists and healthcare professionals keen on cutting-edge treatments for severe asthma, this discussion is a treasure trove of practical insights and innovative strategies.

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    The Allergist is produced for CSACI by PodCraft Productions

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    “(Urticaria) is not an allergic condition, it's an autoimmune condition, one. Two, it's not dangerous, but it can last long. Three, we have very good strategies to control it.”
    - Dr. Moshe Ben-shoshan

    Hives are probably one of the most misunderstood rashes by the general public. Hives are not life-threatening, but they're debilitating. They're not an allergy, but they're often blamed for being one. They're a marker of autoimmunity with little to do with one particular disease and their course and triggers in one particular person is at best challenging to predict.

    Dr. Moshe Ben-shoshan tackles the intriguing world of chronic urticaria; cutting through common misconceptions, and walking us through the latest in diagnostic strategies and management options for hives. From the targeted effectiveness of second-generation antihistamines to the advanced treatment possibilities offered by biologics like omalizumab, and even the role of immunosuppressants such as cyclosporine. Special attention is given to the nuances of chronic urticaria in children versus adults.

    Emphasizing the critical role of disease scoring systems, Dr. Ben-shoshan explains how these tools are vital for assessing severity and guiding treatment decisions. The conversation also sheds light on the diagnostic value of blood tests, showcasing the multifaceted approach required to effectively manage hives.

    Dr. Ben-shoshan tip-toes into the delicate territory of how to handle the increasing requests for testing and dietary modifications. We also take a quick glimpse into the future of urticaria management including targeted pediatric guidance and new biologics on the horizon.

    This episode offers an indispensable resource for allergists and healthcare professionals seeking to enhance their understanding of chronic urticaria. It’s packed with practical insights and a look towards promising advancements in the field.



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    The Allergist is produced for CSACI by PodCraft Productions

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    “Worst allergy season ever? Might not be an exaggeration for that patient.”
    -- Dr. Adam Byrne

    On this episode, Dr. Mariam Hanna is joined by Dr. Adam Byrne, an expert allergist and clinical immunologist, to unravel the complex relationship between climate change and allergic diseases. Dr. Byrne sheds light on how rising global temperatures, increased pollution, and changing ecosystems are not just environmental issues but are directly impacting the prevalence and severity of allergic conditions.

    Together, they dissect the science behind why we're seeing an uptick in cases of asthma, allergic rhinitis, and atopic dermatitis. But the conversation doesn't stop at diagnosis and treatment; it also covers practical advice for allergists and patients alike on mitigating the health impacts of climate change. From advocating for cleaner air policies to adjusting daily routines, Dr. Byrne offers actionable strategies to address the evolving landscape of allergies.

    This episode is essential listening for anyone in the allergy field, providing a comprehensive overview of the challenges and opportunities that lie ahead in managing allergies in a changing climate. Whether you're a healthcare professional or someone navigating the complexities of living with allergies, Dr. Byrne's insights offer valuable guidance for adapting to our planet's new normal.



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    The Allergist is produced for CSACI by PodCraft Productions

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    “Food allergy tests are not screening tests
I will pause for dramatic effect
Food allergy tests are not screening tests.” Dr. David Stukus

    Dr. Mariam Hanna is joined by Dr. David Stukus, a leading pediatric allergist and clinical immunologist from Nationwide Children's Hospital in Columbus, Ohio. Together, they dive into the critical issues surrounding food allergy diagnostics and the latest advancements in treatment options, including developments in the field of oral immunotherapy (OIT) and the recent FDA approval of Omalizumab for food allergies.

    Dr. Stukus debunks common misconceptions about testing and emphasizes the importance of a nuanced approach to interpreting results when diagnosing food allergies He advocates for evidence-based practices and the necessity of individualized treatment plans, highlighting the role of clinicians in guiding patients through the complexities of managing food allergies.

    The conversation also explores the future of food allergy treatments, with Dr. Stukus expressing optimism about the potential for more personalized therapies that cater to the unique needs of each patient. He stresses the importance of shared decision-making between clinicians and patients, ensuring that treatment choices are informed, thoughtful, and tailored to achieve the best possible outcomes.

    This episode is a must-listen for allergists aiming to keep ahead of the evolving landscape of food allergy management, offering deep insights into the challenges, innovations, and hopes for the future.

    Visit the Canadian Society of Allergy and Clinical Immunology

    Find an allergist using our helpful tool

    Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

    The Allergist is produced for CSACI by PodCraft Productions

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    “People think leadership has to be a loud person standing in front of everybody, declaring themselves the leader. Leadership isn't a dictatorship. Leadership is not always that loud person.” -- Dr. Zainab Abdurrahman

    On this episode of "The Allergist," we explore what leadership in medicine actually means with Dr. Zainab Abdurrahman, an accomplished allergist and clinical immunologist. Dr. Abdurrahman, who wears many hats including that of an assistant clinical professor of pediatrics at McMaster University and the incoming president-elect of the Ontario Medical Association, shares her insights on what it means to be a leader in the medical field.

    Leadership, as Dr. Abdurrahman explains, is not just about being at the forefront; it's about inspiring and motivating others, guiding teams towards a common goal, and sometimes, leading from behind to allow others to shine. This episode is not just about the theoretical aspects of leadership but also about its practical applications in the challenging landscape of healthcare.

    Dr. Abdurrahman's journey is a testament to the diverse forms leadership can take, from being the team lead in mock codes to shaping the future direction of healthcare in Ontario. She discusses the challenges and opportunities that come with being a female leader in medicine, breaking stereotypes, and paving the way for future generations.


    So, whether you're an aspiring leader, a medical professional, or someone curious about the intersection of leadership and medicine, this episode offers valuable insights and inspiration. Join Dr. Mariam Hanna and Dr. Zainab Abdurrahman on "The Allergist" as they explore the essence of leadership in medicine and how it shapes the healthcare landscape.

    Visit the Canadian Society of Allergy and Clinical Immunology

    Find an allergist using our helpful tool

    Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

    The Allergist is produced for CSACI by PodCraft Productions

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    “We don't do any fresh food skin testing because they have not been validated. And we know, if we put food on skin, we may well get a positive test, but we have no idea how to interpret that. And I think that's really important.” -- Dr. Douglas Mack

    On this episode of "The Allergist," we're climbing the food ladder with Dr. Douglas Mack, a pediatric allergy, asthma, and immunology specialist. Dr. Mack brings his expertise to the table, discussing the nuances of milk and egg allergies in children. Are all allergies created equal? Spoiler alert: they're not. We dive into the world of phenotypes, genetic markers, and the big question – can we predict who's going to outgrow their allergies and who's in it for the long haul?

    We're not just talking science; we're talking practical, real-world applications. Dr. Mack sheds light on the shift from 'ladders' for non-IgE mediated food allergy to IgE mediated ones. It's a journey through the evolution of allergy treatments.

    And for those thinking, "What about the risks?" – we've got you covered. Dr. Mack doesn't shy away from discussing the potential dangers and the importance of understanding patient-specific risks. It's a candid conversation about the realities of treating food allergies, the challenges allergists face, and the hope for future advancements.

    So, grab your headphones and join us. Whether you're a seasoned allergist or just starting to climb the allergy ladder, "The Allergist" is here to guide you every step of the way.

    Visit the Canadian Society of Allergy and Clinical Immunology

    Find an allergist using our helpful tool

    Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

    The Allergist is produced for CSACI by PodCraft Productions