The Itch: Allergies, Asthma, Eczema & Immunology

If you have asthma, there is a good chance you have learned to live around it. You sleep with your inhaler on the nightstand. You skip the walk because you know it will leave you breathless. This is called uncontrolled asthma, and it is more common than you think. But here is the thing: none of that is normal, and none of it is something you have to accept. Dr. Juanita Mora, allergist and immunologist, joins Kortney and Dr. Gupta to help patients figure out whether their asthma is actually being managed the way it should be, and what to do if it is not. What we cover in this episode about asthma symptoms and control What well-managed asthma actually looks like. Dr. Mora explains what life should feel like when your asthma is properly treated, and why so many patients have accepted a version of their life that is smaller than it needs to be. Why frequent flare-ups are a warning sign. Why underlying airway swelling is dangerous and why catching it early matters. The Rules of 2. Five questions covering daytime symptoms, nighttime waking, rescue inhaler use, inhaler refills, and steroid use that can help you figure out if your asthma needs more attention. When to ask for a referral. If you are answering yes to any of these questions and your treatment plan is not changing, it may be time to push for a referral to an allergist or pulmonologist who has more tools to help. First steps you can take with ControlYourAsthma.org. Dr. Mora walks through the campaign website, available in English and Spanish, including videos, the Rules of 2 quiz, and access to a free asthma coach. More resources ControlYourAsthma.org ControlarTuAsma.org Free Asthma Coach Program __________ Made in partnership with The Allergy & Asthma Network. Thanks to Sanofi-Regeneron for sponsoring today’s episode. This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

If you treat patients with asthma, this episode is for you. Not just allergists, but GPs, pediatricians, family medicine doctors, urgent care providers, and anyone who sees a patient with asthma in their practice. Dr. Cherie Zachary, current president of the American College of Allergy, Asthma and Immunology, joins Kortney and Dr. Payel Gupta to talk about why uncontrolled asthma remains a serious and largely preventable problem, and what providers can do differently starting with their next patient visit. What we cover in this episode about uncontrolled asthma The data behind the problem. ER visits, hospitalizations, and asthma deaths have not improved in years, and Dr. Zachary explains why that should concern every provider who treats asthma patients. An ER visit is a treatment failure. Dr. Zachary makes the case that any asthma patient who ends up in urgent care or the emergency room should trigger an immediate reassessment of their treatment plan, not just a course of steroids and a send-home. Five questions every provider should be asking. The episode walks through a standardized set of control questions designed to help providers catch uncontrolled asthma before it becomes a crisis, covering steroid use, ER visits, rescue inhaler use, nighttime waking, and daily activity limitations. Why patients normalize their symptoms. Providers hear what controlled asthma should actually look like, and why patients often don't volunteer the information needed to catch a problem. Who is most at risk. Dr. Zachary shares which patient populations are most likely to have uncontrolled asthma and least likely to be identified, and what providers can do to close that gap. More resources about uncontrolled asthma ControlYourAsthma.org Free AAN Asthma Coach Program Find an allergist Understanding Oral Corticosteroid Overuse in Asthma Made in partnership with The Allergy & Asthma Network. Thanks to Sanofi-Regeneron for sponsoring today’s episode. This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Kortney and Dr. Payel Gupta sit down with Nissa Shaffi, MS, Director of Advocacy at the Allergy & Asthma Network, to talk about what patient advocacy really means, how the healthcare system works as a whole, and how everyday people with allergies, asthma, and related conditions can learn to use their voice to push for real change. What we cover in this episode is patient advocacy for allergy and asthma Anyone can be an advocate. Advocacy is not just for politicians or lawyers. It is for anyone who sees a problem and wants to do something about it, from patients, caregivers, doctors, and everyday people alike. Forms of advocacy, from social media to Capitol Hill. You do not have to fly to Washington to make a difference. Advocacy starts with education, storytelling, and showing up in whatever way you can. How the healthcare system actually works. No single insurance company, hospital, or drug maker is to blame for everything. Understanding the whole system is what makes advocacy effective. Why your story can change a law. Personal experience is one of the most powerful tools in advocacy. Real patient stories have driven landmark legislation and saved lives. PALI, the Patient Advocacy Leadership Initiative. A free monthly program from the Allergy & Asthma Network that teaches patients the language, tools, and knowledge they need to advocate confidently at any level. More resources PALI (Patient Advocacy Leadership Initiative): Allergy & Asthma Day on Capitol Hill (AADCH) AAN Advocacy Center, take action today! Bills Allergy & Asthma Network is prioritizing this year: Safe Step Act EPIPEN Act HELP Copays Act One School One Nurse Act See all the bills on the Network’s Advocacy page *********** Made in partnership with The Allergy & Asthma Network.

Ep. 150: What Allergists Really Think About Your Allergy Nasal Spray If you have ever grabbed a nasal spray off the pharmacy shelf, used it for a few days, and given up because nothing seemed to be happening, you are not alone. And according to the allergists we spoke to at the AAAAI conference in Philadelphia, that is not uncommon. In this episode, Kortney and Dr. Payel Gupta share real conversations with allergists from across the US about what they actually think about allergy nasal sprays. What we cover in this episode about allergy nasal sprays Why allergists love nasal steroid sprays. They work at the source of the problem by calming swelling inside the nose before your symptoms have a chance to take hold, and you can pick them up at the grocery store without a prescription. You may not feel the nasal spray work right away. Nasal steroid sprays need about two weeks of consistent daily use before you feel a difference. The medication is working, you just cannot feel it yet. Do not give up early. When to start before allergy season. Starting your spray a couple of weeks before your season hits means you go in with as little swelling inside your nose as possible, giving the medication the best chance to work. Why so many patients stop using their spray. Incorrect technique causes irritation and nosebleeds, and means the medication is not landing where it needs to. Not all nasal sprays smell or feel the same. If the smell or taste of your spray puts you off, there are options without it, and that is worth a conversation with your allergist or pharmacist. Thank you to our allergists A huge thank you to every allergist who stopped what they were doing at the AAAAI conference to talk to us. We could not make this episode without you. Dr. Jessica Hui, Instagram | LinkedIn Dr. Jamie Rutland, Instagram | Instagram: The Health Exchange Podcast Dr. Juan Carlos Murillo, Instagram | LinkedIn Dr. Tobi Olayiwola Dr. Jake Rosenblum, LinkedIn Dr. David Wertheim Dr. Sonali Majmudar, Instagram | LinkedIn Thanks to Opella for sponsoring today’s episode. This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Chronic hives that come and go without warning are exhausting physically and emotionally. But here is something many patients don't realize: feeling "okay" is not the same as being well controlled. Kortney and Dr. Gupta are joined by Dr. Tom Chacko, a board-certified allergist and immunologist based in Atlanta, to discuss what good hives control actually looks like and what to do when you are not there yet. From "just living with" your condition to managing a bad flare, tracking your symptoms, and preparing for your follow-up appointment, this episode gives you the tools to stop just coping and start getting better care. What we cover in our episode about what chronic hives control looks like: Chronic spontaneous urticaria. The plain-language definition of CSU, including why hives appear without a clear trigger and what angioedema is. The trap of normalizing symptoms. Why patients adjust their lives around hives without realizing it, and how to spot the signs that your condition is not actually controlled. How to track your hives. Why symptom tracking helps with diagnosis and better care, and how to use tools like the UAS7 score. What to bring to your follow-up appointment. The concrete information your doctor needs to work with you to find the best treatment plan. This includes information about sleep, daily activity, and medication side effects. How to ask for more help. What to say when antihistamines are not enough, and what newer treatment options exist for CSU patients today. More resources about chronic hives UAS-7 Urticaria Activity Score worksheet Allergy & Asthma Network chronic urticaria resources More episodes about hives *********** Made in partnership with The Allergy & Asthma Network. Thanks to Novartis for sponsoring today’s episode. This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Chronic rhinosinusitis with nasal polyps, or CRSwNP, is a condition driven by ongoing inflammation. That is why treatment is not a one-time fix and why polyps can come back even after surgery. In this episode, Dr. Payel Gupta and Kortney are joined by Dr. Maeve O'Connor, a board-certified allergist and immunologist, to walk through CRSwNP treatment options. This episode is released around World Anosmia Day because loss of smell is one of the most frustrating and most common symptoms of CRSwNP, and one that treatment can actually help with. What we cover in this episode about nasal polyps treatment Nasal therapies as your base management: Saline rinses and nasal steroid sprays are the foundation of CRSwNP treatment. They need to be used consistently as part of your daily routine, not just when symptoms flare. Why nasal polyps keep coming back: CRSwNP is driven by ongoing inflammation, not just the polyps themselves, so removing them does not address the root cause. When surgery is the right choice: Sinus surgery can open blocked passages and help nasal sprays reach deeper into the sinuses, but works best as part of a long-term plan, not a one-time fix. What biologic medications actually do: Biologics target the underlying inflammation causing CRSwNP. Four are currently approved for CRSwNP: dupilumab, omalizumab, mepolizumab, and tezepelumab. Why follow-up care matters even when you feel better: Inflammation can return before symptoms become noticeable, so regular check-ins with your allergist or ENT are key to catching early signs of polyp regrowth. About our guest Dr. Maeve O'Connor, MD, FACAAI, FAAAAI, is a board-certified allergist and immunologist and founder of Allergy Asthma & Immunology Relief (AAIR) of Charlotte, North Carolina. She treats patients of all ages, practices integrative medicine, and has been named a Top Doctor by Charlotte Magazine since 2007. More resources What is Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)? What are nasal polyps? What is AERD? Biologics for Allergic Disease What to know before starting a biologic Oral Corticosteroid Stewardship ********* Made in partnership with The Allergy & Asthma Network. Thanks to Sanofi-Regeneron for sponsoring today’s episode. This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

We spend about 90% of our time indoors. But what's actually in that air we breathe, and why does it matter so much for people with asthma, allergies, and eczema? This is a two-part series about indoor air quality. In the first part, we break down the three main categories of indoor air pollutants: particulate matter (PM2.5 and PM10), volatile organic compounds (VOCs), and biological allergens like dust mites and mold. Dr. G explains how each one affects the body differently and why people with allergic disease are especially vulnerable. In part two, we discuss how you can improve your indoor air quality. What we cover in part one about indoor air quality What's actually in your indoor air: The three main categories are particulate matter (PM), VOCs, and biological allergens. Why PM2.5 is more dangerous than PM10: PM2.5 is small enough to enter your lungs and bloodstream, while PM10 mostly irritates your nose and throat. How we create particulate matter: PM2.5 comes from burning things like cooking, candles, and gas stoves. PM10 comes from dust, construction, and dirt tracked in on shoes. The difference between particles and gases: PM2.5 is like tiny specks of dust or smoke. VOCs are invisible gases that cause smells, like that "new car" scent. Indoor allergens: Dust mites, mold, pet dander, and cockroach allergens are biological triggers that can cause allergic reactions and worsen asthma. More resources Allergy & Asthma Network: Healthy at Home Allergy & Asthma Network: Healthy at Work EPA Indoor Air Quality Tools for Schools EPA Safer Choice Cleaning Products EXHALE Resources This series is part of the EXHALE project, a set of six evidence-based strategies designed to help people with asthma achieve better health and improved quality of life. This series supports the last "E" in EXHALE by reducing asthma triggers in indoor environments. This podcast is made in partnership with Allergy & Asthma Network

Allergy & Asthma Network has spent more than four decades helping people living with asthma, allergies, and related immune conditions navigate care, access trustworthy education, and make their voices heard. In this episode, we talk with Lynda Mitchell, CEO of Allergy & Asthma Network. Lynda shares how becoming a food allergy and asthma mom in the early 1990s shaped her career and led her into patient advocacy work. We get into how Allergy & Asthma Network supports patients and families through four mission pillars: education, outreach, advocacy, and research. What we cover in our episode about Allergy & Asthma Network Trusted Messengers and culturally responsive education, and why information is more effective when it comes from people who reflect and understand the community Free virtual asthma coaching, and how one-on-one self-management education helps people improve daily asthma control and reduce emergency care Patient voice research, what it is, how it differs from clinical trials, and why diversity in clinical trial participation matters Advocacy efforts like Capitol Hill Day and PALI, and how patient stories influence laws and policies that affect asthma and allergy care Ways to get involved, including resources for patients, caregivers, and healthcare providers who want to support or participate in Allergy & Asthma Network’s work More resources about Allergy & Asthma Network Allergy & Asthma Network Sign-up for the Allergy & Asthma Network’s Newsletter Get involved with clinical trials and research More about the PALI information session (February 18, 2026) Advocacy information Virtual asthma coaching program (free asthma self-management education) *********** Made in partnership with The Allergy & Asthma Network.

Sleep plays a critical role in managing allergies, asthma, and eczema, yet it is often overlooked in conversations about allergic disease. Sleep affects mood, focus, immune function, and inflammation, all of which influence how allergic conditions show up day to day. Poor sleep can worsen asthma symptoms, increase allergy flares, and make eczema harder to control. At the same time, allergies and asthma can disrupt sleep, creating a cycle that is difficult to break. Dr. Carol Yuan-Duclair, a sleep specialist, joins us to explore how sleep impacts allergic conditions and overall health. She breaks down what good sleep actually looks like, how to know if you are getting enough rest, and how sleep quality can directly affect allergies, asthma, and eczema. This conversation focuses on practical guidance for patients and families, including environmental changes, medication considerations, and when it may be time to seek help from a sleep specialist. What we cover in this episode about sleep and allergic disease Why sleep is essential for health and immune function: How sleep affects inflammation, mood, and overall health, and why poor sleep can worsen allergic disease. What good quality sleep actually looks like: The difference between sleep quality and sleep quantity, and how to tell if your sleep is truly restorative. The two-way relationship between sleep and allergies: How allergies can disrupt sleep, and how poor sleep can worsen allergy symptoms, creating a difficult cycle. Practical ways to improve sleep when you have allergies: Sleep hygiene basics, exercise timing, and creating a healthier bedroom environment. When medications or symptoms mean it is time to see a specialist: How allergy medications can affect sleep, how eczema fits into the picture, and when ongoing sleep issues may signal the need for a sleep specialist.

Clonal mast cell disease is often missed because symptoms vary from person to person, tryptase levels can be normal, and bone marrow biopsies are hard to get. For some people, unexplained or very severe anaphylaxis may be an early sign of a clonal mast cell disease. In this episode, we review “Prevalence of KIT D816V in anaphylaxis or systemic mast cell activation,” published in October 2025 in the Journal of Allergy and Clinical Immunology. This paper, known as the PROSPECTOR trial, is looking at how often the KIT D816V mutation can be found using a blood test in adults who have had anaphylaxis or systemic mast cell activation symptoms. We break down why KIT D816V matters, how it connects to systemic mastocytosis, why HaT needs to be considered, and how newer blood tests may help doctors catch clonal mast cell disease earlier. What we cover in our episode about KIT D816V and anaphylaxis: Setting the stage: Understanding mast cell activation and anaphylaxis. Why KIT D816V matters: How this mutation fits into clonal mast cell disease, what blood testing can reveal, and when doctors still turn to a bone marrow biopsy. Making sense of tryptase and hereditary alpha-tryptasemia (HaT): Why baseline tryptase, the “20% + 2” rule, and HaT can make screening more complicated than it seems. What the PROSPECTOR trial uncovered: How often KIT D816V appeared in people with anaphylaxis, and other results on tryptase and HaT. How this helps patients: What these findings mean for anyone with unexplained or severe anaphylaxis, and how doctors combine KIT testing, tryptase, HaT, and symptoms to decide on next steps. Other podcast episodes about mast cell disease: Ep. 127: Management of indolent mastocytosis - A clinical yardstick Ep. 126: Management of mast cell activation syndrome - A clinical yardstick Ep. 121: Avapritinib vs Placebo in Indolent Systemic Mastocytosis - PIONEER Trial Ep. 118: The ISM Disconnect - Do Patients and Providers Agree on Symptom Control? Ep. 70 How do stress and low histamine diets impact mast cell disease? Ep. 63: Mast Cell Diseases & Systemic Mastocytosis: The Basic Science Ep. 65: The Symptoms and Triggers of Mast Cell Disease *********** The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference. *********** Made in partnership with The Allergy & Asthma Network. Thanks to Blueprint Medicines for sponsoring today’s episode. This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Avoidance has long been the standard for managing food allergies. But new options, such as oral immunotherapy (OIT) and biologic medications like Xolair (omalizumab), are changing the landscape. With more choices available, many patients and parents are wondering how to start the conversation with their allergist and what questions to ask. Kortney and Dr. Payel Gupta talk with Dr. Shahzad Mustafa, a board-certified allergist and immunologist, about how patients can navigate today’s food allergy treatments with confidence. Together, they explore what to consider before starting OIT or Xolair, how to set realistic expectations, and why strict avoidance is still the right choice for many families. What we cover about food allergy treatment options: Food Allergy Avoidance: Why it remains an effective and valid approach for many, and how to make it work in daily life, including the nuances that make every case unique. Oral Immunotherapy (OIT): What it involves, who it’s best suited for, and what families should know about time, cost, and safety. Xolair (omalizumab): How this injection therapy works to reduce reactions from accidental exposures and what it doesn’t do. Setting expectations: How to talk with your allergist about your goals, quality of life, and what “success” really looks like. More episodes about food allergies Ep. 129: Omalizumab for Multiple Food Allergies – The OUtMATCH Trial Ep. 98: Food Allergy Treatment and Management More resources about food allergies Food Allergy Treatment & Management ___ Made in partnership with The Allergy & Asthma Network. Thanks to Genentech 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.

Mucus plugging is a challenge in asthma care. It’s thick, sticky mucus that blocks the airways and doesn’t respond to regular inhalers. Even when inflammation improves, these plugs can lower lung function, limit how well medicine works, and make asthma harder to control. In this episode, we break down the study: “Effect of Dupilumab on Mucus Burden in Patients with Moderate-to-Severe Asthma,” published October 28, 2025. The analysis looks at whether dupilumab (Dupixent), a biologic that blocks IL-4 and IL-13, can lower mucus burden and improve lung function, especially in people who start with a high “mucus plug score.” What we cover in our episode about dupilumab and mucus plugging Why mucus plugging matters in asthma: Discover how thick, sticky mucus can block airways, make it harder to breathe, and why standard inhalers and steroids don’t clear these plugs. How dupilumab may help: Learn how this biologic blocks IL-4 and IL-13, two key drivers of type 2 inflammation that increase mucus production and thickness. Inside the VESTIGE study: Hear how researchers measured mucus burden using CT scans and “mucus plug scores” to see if dupilumab could reduce plugging in moderate-to-severe asthma. What the results showed: Find out how dupilumab lowered mucus plug scores, reduced airway inflammation, and improved lung function (FEV₁), especially in people with high mucus burden. What this means for patients: Learn why identifying and treating mucus plugging may help improve breathing, reduce flare-ups, and make asthma easier to manage day to day. 📌INFOGRAPHIC to follow along RESOURCES: What is asthma? What is type 2 inflammation? When Asthma Is More Than Just Asthma: Type 2 Inflammation More about dupilumab (Dupixent) The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference. ___ A special collaboration with the American Thoracic Society. This podcast was made in partnership with Allergy & Asthma Network. This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Navigating food allergies is tough enough, but adding family dynamics to the mix can make things even more complicated. When loved ones don’t understand you or your child’s allergies or dismiss the rules meant to keep them safe, it can lead to conflict, hurt feelings, and stress for everyone involved. Kortney and Dr. Payel Gupta sit down with psychologist Dr. Amanda Whitehouse to talk about how families can find common ground when emotions run high. Together, they unpack what it means to stay regulated in difficult conversations, how to set healthy boundaries with family members, and why understanding different coping styles can help prevent conflict before it starts. What we cover about communication and boundary-setting for food allergy families: Coping styles and conflict: Learn how different stress responses, such as “fight” versus “flight,” shape how partners, parents, and relatives react to food allergy challenges. Staying calm and regulated: Understand how your body reacts to stress and how recognizing those signals can help you stay grounded during tough conversations. Setting and holding boundaries: Get practical tips for explaining what feels safe, keeping communication clear, and responding calmly when others push back. Working together as a team: Whether it’s with your partner, kids, or extended family, learn how to support each other and stay united when emotions rise. Bridging family differences: Explore ways to include children and siblings in allergy safety, and approach older relatives with patience and compassion when views or communication styles differ. ___ Made in partnership with The Allergy & Asthma Network. Thanks to Genentech 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.