Advertise on podcast: My Allergist Dad

On this episode of My Allergist Dad, Drew and Dr. Z are joined by Dana Amore, a patient with a chronic cough that worsened over 6–12 months despite asthma testing, allergy testing, a chest CT, and an endoscopy.During the endoscopy, an abnormal EKG revealed a left bundle branch block, prompting urgent follow-up, an echocardiogram, and an unexpected hospital stay for heart failure; after treatment with multiple medications and diuretics, Dana’s cough and unrecognized shortness of breath resolved and her ejection fraction improved. Dr. Z explains how chronic cough and shortness of breath can be mistaken for asthma or allergies, what heart failure means physiologically, why symptoms can be subtle and progressive, and how testing like methacholine challenge helps rule out asthma, emphasizing that chronic cough may signal non-allergic causes that require broader evaluation.00:00 EKG Surprise00:13 Echo Turns Serious00:34 Show Intro01:17 Mouth Taping Talk02:30 Breathing And Blood Pressure03:15 Meet Dana Amore04:20 Chronic Cough Workup05:15 Endoscopy Finds LBBB07:20 Heart Failure Explained16:09 Treatment And Ejection Fraction23:52 Asthma Testing Deep Dive27:23 Wrap Up And Disclaimer

On this episode of My Allergist Dad, Drew and Rhode Island allergist Dr. Z welcome comedy writer Lauren Bans to discuss a severe reaction she had in college after eating shrimp with lobster sauce and then going straight to the gym, where she developed itchy eyes, breathing trouble, and red blotches and was treated at urgent care. Lauren avoided shellfish for a year or two, later had mild symptoms at a Providence clambake, then gradually resumed eating shellfish and now can eat shrimp or lobster without issues. Dr. Z explains this pattern may not be true desensitization and could reflect a non-IgE “allergic-like” histamine reaction influenced by factors like preservatives/MSG, food sitting out, alcohol, exercise, hormones, and overall tolerance, and he emphasizes testing and that epinephrine is first-line treatment for severe reactions. 00:00 Comedy and Shrimp Setup 01:04 Meet Drew and Dr Z 01:17 Introducing Lauren Bans 02:17 Al Forno Family Lore 05:07 The PF Changs Reaction 07:19 Clambake Self Testing 08:10 Dad Breaks Down Desensitization 11:09 Histamine and Pseudo Allergies 15:08 Exercise Alcohol and Hormones 18:12 PF vs PJ Changs Jokes 19:21 Is Allergy Always Constant 19:33 Tests vs History 20:15 Drug Allergy Logic 20:58 Tolerance and Tipping Points 24:20 Reaction Risk and EpiPens 26:39 Family Allergies and Microbiome 31:44 Testing Anxiety and Mindset 33:19 Alpha Gal and IBS Clues 36:09 Eating Out Safely 37:51 Wrap Up and Epinephrine 40:11 Medical Disclaimer

This week on My Allergist Dad, Drew and Dr. Z discuss key takeaways from James Nestor’s book Breath: The New Science of a Lost Art, prompted by listener Richard Kowal’s question about nose breathing, asthma/allergies, and mouth taping during sleep. Dr. Z explains that many patients who feel they “can’t take a full breath” may be dealing with nasal congestion and upper-airway issues rather than lung problems, and why nasal breathing—humidifying and filtering air via the turbinates—can improve comfort and help asthma symptoms.  They talk about how chronic mouth breathing can affect teeth and facial structure, why severe nasal blockage can feel suffocating, and Dr. Z’s own experience trying mouth taping at night (including practical downsides). They also touch on breathing techniques, sleep quality, anxiety around shortness of breath, and how better breathing can improve overall function. 00:00 Breath Power Teaser 00:37 Show Intro and Hosts 00:52 Listener Question Setup 01:43 Book Overview and Nose Focus 03:14 Mouth Taping Experiment 07:28 Nasal Congestion vs Asthma 10:53 How the Nose Works 12:50 Breathwork and Whole Body Health 15:20 Athletes Musicians and Breath 19:02 Breathing Anxiety and Patient Stories 20:33 Wrap Up and Book Recommendation 21:14 Final Thoughts and Disclaimer

Drew and his dad, allergist Dr. Z, discuss what really drives fall allergy symptoms and how to prepare. Dr. Z explains that while fall weeds like ragweed, mugwort, and pigweed typically run from mid-August to the first frost, warmer weather can extend symptoms, and many people who think they’re reacting to pollen are actually reacting to outdoor mold spores—especially on dry, windy days after rain, in leaf piles, hayrides, and around pumpkins.  He also highlights how high humidity increases dust mites and indoor mold, especially when people stop running AC, and notes that mold can feed dust mites. Tips include identifying triggers with testing, pre-treating with non-sedating antihistamines before exposure, wearing a mask for raking/cleaning, reducing indoor humidity below 50% with dehumidifiers, having floors rather than carpet, and considering desensitization drops. 00:00 Leaf Pile Mold Warning 00:27 Fall Allergies Kickoff 01:43 Why Fall Feels Worse 02:33 Ragweed Season Explained 04:11 Outdoor Mold Spores 06:52 Humidity And Dust Mites 08:44 Leaves Pets And Indoors 09:42 Prevention And Treatment Tips 11:36 Home Controls And Cleaning 14:35 Moldy Food Reactions 15:49 Petrichor Vs Mold Smell 18:00 Ticks And Seasonal Wrapup 20:31 Final Takeaways And Signoff

On this episode of My Allergist Dad, Drew and Dr. Z are joined by Drew’s uncle, dentist Dr. Sam Zwetchkenbaum (former chief of the oral health program at the Rhode Island Department of Health), to discuss how oral health connects to allergies, asthma, and whole-body inflammation.  They explore how the oral and gut microbiomes influence each other, how mouth breathing from untreated allergies can affect palate development and orthodontic needs, and how asthma and allergy medications (including inhaled steroids and drying drugs) can increase cavity risk by reducing saliva.  Sam explains fluoride’s role in protecting teeth, highlights findings from Medicaid claims showing kids on asthma medications needed more restorative care and extractions, and stresses brushing, flossing, rinsing after inhalers, healthier snacks, and consistent dental checkups—especially for older adults on multiple drying medications. 00:00 Dentistry Meets Allergies 00:40 Meet Dr Sam Z 01:41 The Dr Z Name 03:20 Oral Gut Microbiome 04:08 No Brushing Experiment 06:21 Allergies Change Mouth 07:31 Palate Growth Explained 10:05 Diet And Jaw Evolution 12:29 Meds Dry Mouth Risks 14:59 Fluoride Basics Debate 16:39 How Fluoride Works 17:31 Acid Sugar And Bacteria 18:31 Baking Soda Toothpaste 19:19 Sensodyne Family Stories 20:00 Fluoride Microbiome Debate 20:24 Inflammation And Oral Health 21:39 Flossing Diabetes Connection 22:24 Dog Teeth And Whole Body 24:12 Dry Mouth Med Side Effects 26:30 Dental Chair Allergy Myths 30:55 Metals Crowns Biocompatibility 32:18 Burning Mouth Syndrome 34:54 Asthma Meds Teeth Dominoes 38:28 Snack Swaps For Cavities 40:13 System Gaps And Messaging 43:13 Final Takeaways And Disclaimer

On this episode of My Allergist Dad, Drew and Dr. Z discuss practical ways to prevent and treat symptoms from wildfire smoke inhalation and air pollution, especially for people with asthma and sensitive airways. They explain how fine particulate matter can bypass normal airway defenses, worsen inflammation, and—along with sunlight-driven ground-level ozone—trigger bronchospasm and breathing problems, even in people whose asthma has been “in remission.” Key strategies include reducing exposure by staying indoors, sealing windows and doors, using air conditioning and HEPA purifiers, wearing an N95 or P100 respirator outside, limiting strenuous outdoor activity, and washing off residual particulates. Dr. Z emphasizes taking asthma medications consistently—particularly inhaled steroids (including budesonide/formoterol like Symbicort per GINA guidance)—and notes that recovery depends on limiting ongoing exposure, contrasting it with the cumulative damage from daily smoking.00:00 Wildfire Smoke Episode01:33 Dad’s Smoke Story02:47 Wildfire vs Cigarettes07:25 Pollution Ozone Double Hit10:00 Reduce Exposure Basics11:23 Asthma Meds During Smoke14:47 Asthma Can Return16:08 Why Fires Feel Worse Now24:21 Clean Air Policy Talk28:37 Practical Symptom Relief29:32 Wrap Up and Call In📩 Have a question for the show?Email: [email protected]

Drew and Dr. Z welcome Dr. Chris Dalldorf, a computational biology and bioinformatics researcher at Brigham and Women’s Hospital, to discuss his machine-learning research on chronic obstructive pulmonary disorder (or COPD) and related lung diseases using large human lung tissue datasets. They clarify how COPD differs from asthma, why smoking is a major risk factor but not the sole cause, and how microRNAs regulate gene expression by silencing messenger RNAs.  Chris explains that smoking can strongly alter microRNA expression, that certain microRNAs (including microRNA-29) and mutations may be associated with COPD and IPF, and that proving causation in human disease is difficult. They also discuss extracellular matrix genes as potential drivers of fibrosis and how microRNA regulation of these genes could point toward future therapeutic approaches. 00:00 Meet Chris Dalldorf 00:26 Show Intro Theme 00:43 Providence Catch Up 02:41 Why Rhode Island 03:36 MicroRNA Basics 05:47 COPD Versus Asthma 11:40 Why Study COPD 13:24 Smoking And MicroRNA 14:42 Inflammation Parallels 19:37 Causation And Controls 24:09 Animal Models And Data 28:08 Machine Learning Role 32:41 Extracellular Matrix 33:34 Wrap Up And Disclaimer 📩 Have a question for the show?Email: [email protected]

Drew and Dr. Z welcome Dr. Stephanie Culler, co-founder and CEO of Persephone Biosciences, to discuss the infant gut microbiome and findings from the MyBabyBiome study, the largest U.S. infant gut microbiome study published. Culler explains that 9 in 10 U.S. babies are missing one or more key Bifidobacterium, and that by age two, babies with low or absent levels were three to four times more at risk for atopic dermatitis, food allergies, and asthma. They discuss how the microbiome develops from birth through early childhood, how factors like C-sections, antibiotics, and diet shape it, and why breast milk HMOs support Bifidobacterium. Culler describes Persephone’s infant/toddler synbiotic combining Bifidobacterium with HMOs, its safety, and parent- and clinician-reported improvements including sleep and mood, plus broader links between microbiome, inflammation, and immune function.00:00 Shocking Baby Biome Data00:39 Welcome And Guest Intro04:49 Microbiome Basics And Timing08:28 Allergy Desensitization Parallels11:39 Beyond Gut Skin And Airways14:32 Immune Programming First 100 Days15:27 Gut Brain And Behavior Links19:21 Diet Fiber And Lifestyle Synergy22:07 Safety And Modern Microbe Loss23:39 Founder Story From Cancer To Babies28:12 New Mom Moment And Missing Bifido29:30 Reflux Colic And EOE Questions35:06 Root Causes And Public Health40:40 Generational Shifts And Food Additives41:49 Product Details Discount And Wrap Up43:44 Final Takeaways And Disclaimer

In this episode of My Allergist Dad, Drew and Dr. Z discuss a phase 3 trial for severe cat allergy targeting the Fel d 1 allergen with a monoclonal antibody injection lasting about three months, improving ocular symptoms and reducing skin test reactivity, with potential seasonal/targeted use and related work in birch pollen.They also talk about a patient who experienced a life-threatening reaction during anesthesia induction for a hernia repair, including severe bronchospasm and hypotension, and how timely tryptase testing helped support that it was true anaphylaxis rather than medication side effects. Dr. Z explains baseline vs reaction tryptase levels, the mast cell activation formula, and why tryptase must be drawn within 2–3 hours, then shares that the patient is being referred to Brigham’s Drug Hypersensitivity and Desensitization Center to test likely triggers such as neuromuscular blocking agents and cefazolin (Ancef). 00:00 Cold Open Breakthrough00:34 Show Intro Theme00:51 Meet Drew and Dr Z01:14 Diet Restrictions Dinner02:34 Anesthesia Anaphylaxis Case06:17 Tryptase Test Explained09:33 Referral and Key Triggers12:35 Haircut Tangent and Shoutout14:40 Cat Allergy Shot Trial20:36 How Blocking Antibodies Work25:46 Timing Shots and Future Uses27:05 Wrap Up and Disclaimer📩 Have a question for the show?Email: [email protected]

Drew and Dr. Z welcome Drew’s fiancée, Sydney, to discuss her experience living with two autoimmune diseases—Type 1 diabetes since age five and Hashimoto’s since adolescence—and how autoimmune conditions overlap with allergies through inflammation and the immune system. They explore genetic predisposition plus triggers, the importance of taking control of chronic illness through education and daily habits, and how technology like CGMs and insulin pumps has transformed diabetes management. The conversation covers nutrition, walking after meals, preparedness, and the mixed value of non-diabetics using CGMs. Dr. Z shares a case linking Hashimoto’s, celiac disease, and hives, and they discuss reducing inflammation, gluten-free eating, gut health, probiotics, and how medical advances have dramatically improved outcomes across many conditions.00:00 Welcome and Teaser00:36 Meet Sydney02:23 Sydney Autoimmune Story02:59 Autoimmune Continuum Explained06:16 Taking Back Control09:25 Diabetes Tech and CGMs12:06 Should Non Diabetics Track Glucose16:55 Hashimotos Celiac and Inflammation23:47 Medical Progress Then and Now30:06 Diabetes Camp and Daily Habits34:36 Gut Health Food Sensitivities38:32 Fasting Probiotics and Dog Talk43:09 Wrap Up and Final Thoughts📩 Have a question for the show?Email: [email protected]

Drew and Dr. Z discuss the 2026 cyclospora outbreak and practical steps to reduce exposure, including washing hands, thoroughly scrubbing produce, cutting away bruised areas, and cooking produce to at least 158°F/70°C since washing alone can’t guarantee removal. They note CDC reports of at least 10,000 laboratory-confirmed domestic cases since May 1, 2026, and talk about how food-system factors limit individual control, while lifestyle and microbiome health may influence how severely someone is affected. Dr. Z shares an “aha” about chronic hives potentially worsening after unhealthy meals and alcohol due to liver strain, estrogen and histamine backup, and effects on mast cells, especially in menopausal women with fatty liver. They also cover rebuilding the microbiome after GI illness with improved diet and possible probiotics.00:00 Cyclospora Outbreak Intro00:35 Show Theme Song01:01 Fatty Liver And Hives06:29 Agency And Food Safety09:25 Cooking Produce Tips10:25 Where Cyclospora Comes From11:22 Taco Bell Talk14:12 Rebuilding The Microbiome16:00 Gut Parasites Q And A18:26 Wrap Up And Disclaimers📩 Have a question for the show?Email: [email protected]

This week on My Allergist Dad, Drew and Dr. Z sit down with fine art photographer and longtime family friend Lucas Foglia to talk about health, happiness, and how lifestyle and mindset can shape stress, immunity, and overall well-being. Lucas shares the inspiration behind his book and exhibition Constant Bloom, which follows the painted lady butterfly migration from Kenya to Norway as a symbol of connection across borders, and describes turning photography into a purpose-driven way of living. They discuss balance and stress as both fuel and risk, the “dirt” and allergy conversation, why some people are more allergy-prone, and how food culture and dietary restrictions show up differently in the Bay Area versus Paris. He also recounts a powerful encounter in Tunisia that led him to volunteer with refugee resettlement groups and reflects on art, family connection, and living with meaning.00:00 Butterflies And Allergies Cold Open01:02 Show Intro And Guest Welcome02:36 San Francisco Check In03:09 From Photos To Film04:59 Purpose Fuels Health07:19 Doughnut Economics And Welfare11:17 Constant Bloom Migration Story13:37 Dirt Exposure And Allergy Debate16:35 Food Restrictions And Dinner Parties22:40 Stress Balance And Immunity26:57 Vaccines And Modern Anxiety28:29 Borders Migration And Meaning30:00 Closing Thoughts And Art Connection34:27 Outro And Medical Disclaimer 📩 Have a question for the show?Email: [email protected]

Drew and Dr. Z welcome Dr. Elizabeth O’Day, CEO, CSO, and founder of Olaris, to discuss how her company combines biology, metabolomics, and machine learning to create diagnostics that support real clinical decision-making. Liz shares how her brother’s childhood cancer experience motivated her to pursue tools that reduce today’s trial-and-error medicine and better match therapies to individuals. She explains biomarkers (genomic, transcriptomic, proteomic, and metabolomic), describing metabolites as small molecules that reflect real-time body function and are often the “fingerprint of phenotype.” The conversation focuses on Olaris’ urine-based test for kidney transplant recipients, which uses metabolite patterns to distinguish stable grafts from rejection, borderline rejection, or infection—conditions with opposite treatments—along with new work on a pediatric transplant assay to reduce reliance on biopsies.00:00 Meet Dr. Liz O'Day01:57 Olaris Mission Overview04:16 Why She Founded Olaris08:05 Precision Medicine In Practice11:05 Biomarkers And Phenotypes13:27 Metabolites 101 Explained14:30 Lifestyle, Diet, And The Metabolome19:12 Genes Versus Metabolites22:35 Urine Tests And Ancient Clues23:42 Metabolites Guide Immunity25:27 Transplant Test Explained27:32 Rejection Versus Infection29:37 Precision Medicine Landscape33:39 Pediatric Transplant Breakthrough36:12 Digestive Rest And Fruit Talk38:18 Coconut Stories And Metabolites40:11 Wrap Up And Future Promise41:43 Show Outro And Thanks📩 Have a question for the show?Email: [email protected]

FARE criticized the show Not Suitable for Work for portraying a character repeatedly eating shellfish despite an allergy and self-injecting epinephrine, then going to the ER for “adrenaline poisoning,” prompting Drew and Dr. Z to discuss how allergies are depicted in film and TV and what’s medically accurate. Dr. Z emphasizes epinephrine as the first-line treatment for anaphylaxis and explains why Benadryl is not adequate for life-threatening reactions, the need for emergency evaluation due to risks like biphasic reactions, and the real side effects and dosing concerns of epinephrine. They also address correct EpiPen technique, risks of incorrect injection (including to the neck), newer options like Auvi-Q and nasal epinephrine, and review portrayals from Hitch, Horrible Bosses, Malcolm in the Middle (poison oak timing and rash type), Royal Pains, Jury Duty Presents: Company Retreat, and Pulp Fiction, noting some accuracy but frequent exaggeration.00:00 FARE Calls Out TV Scene00:50 Show Setup And Alpha Gal01:28 Not Suitable For Work Breakdown02:52 Epinephrine Versus Benadryl06:41 Risks And Repeat Dosing10:26 Proper EpiPen Use11:40 Accidental Injection Effects15:46 Jury Duty And Chronic Hives20:16 Triggers And Enabling Factors21:38 Hitch Reaction Accuracy24:55 Poison Oak Mythbusting26:46 Royal Pains And Pulp Fiction29:12 Poison Ivy Timing Explained31:22 Wrap Up And Final Thoughts34:16 Medical Disclaimer 📩 Have a question for the show?Email: [email protected]

Drew and Dr. Z discuss Alpha-gal syndrome, a tick-bite–associated allergy to non-primate mammal products that can cause delayed reactions, including hives, throat tightness, GI symptoms like diarrhea, and even anaphylaxis hours after eating. They explain that Alpha-gal was once tied mainly to the lone star tick in the South but is now being seen more widely, including Rhode Island, with other ticks like the blacklegged and western blacklegged ticks. Dr. Z shares real patient cases—from cookout-triggered reactions to chronic GI and skin symptoms resolving after eliminating mammal-derived foods—and emphasizes that testing (alpha-gal IgE) must be interpreted with symptoms in mind, since positive tests without symptoms may not require avoidance. They also note growing concerns about links to medications, medical devices, and possible cardiac implications, and stress balancing awareness with avoiding unnecessary anxiety.Here's a recent article about the rise of Alpha-gal syndrome:https://www.wsj.com/health/the-ticks-that-cause-red-meat-allergies-are-on-the-move-this-summer-b53d01eb?st=JWadDx&reflink=article_imessage_share00:00 Alpha-gal Overview01:03 Show Intro Theme01:20 Zoo Penguins Detour03:01 What Is Alpha-gal?03:44 Ticks And Spread05:23 Real Anaphylaxis Cases07:05 Testing And Diagnosis08:32 GI And Skin Symptoms10:17 Avoidance And Hidden Sources11:50 When To Stop Meat12:33 Why Testing Can Backfire13:58 Lyme Trial Screening16:27 How Clinicians Decide18:47 Elimination Diet Approach21:46 Lyme And Tick Prevention23:29 Treatment And Delayed Reactions27:33 Balancing Risk And Anxiety28:48 Wrap Up And Disclaimer📩 Have a question for the show?Email: [email protected]