Explore every episode of the podcast The Allergist
| Title | Pub. Date | Duration | |
|---|---|---|---|
| Stopping strictures before they start | 29 Sep 2026 | 00:28:18 | |
"This is an allergic disease, and allergists need to help take care of this person." Dr. Seema Aceves Found yourself scratching your head about how to approach EoE in young patients? Who will go on to develop chronic disease, facing stricture and food impaction from remodelling? Our current approach can feel like it is stuck in the Stone Age. But not to worry, Dr. Seema Aceves will rocket us to the cutting edge of EoE diagnostics and treatment. Dr. Seema Aceves is Professor of Pediatrics and Medicine at the University of California, San Diego, and Rady Children's Hospital. She directs the Eosinophilic Gastrointestinal Disorders Clinic and leads an NIH- and CURED-funded research program focused on the mechanisms and clinical impact of tissue remodelling in eosinophilic esophagitis. On this episode, they discuss:
Dr. Aceves keeps returning to one idea: this disease starts early and builds quietly, and allergists have a key role in detecting its advance in time to prevent strictures. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Breaking down the epithelial barrier hypothesis | 15 Sep 2026 | 00:27:20 | |
There’s a question that’s been circulating widely these days. It’s in the clinic, it’s in the news, and it’s on patients' minds. Why do allergies appear to be increasing? Enter the epithelial barrier hypothesis. This is a developing theory that sees a connection between the ‘atopic march’ and the breakdown of the epithelial barrier. On today’s episode we speak with Professor Cezmi Akdis. Professor Akdis is a director of the Swiss Institute of Allergy and Asthma Research in Davos and professor at the University of Zurich. His research has been instrumental in the development of the epithelial barrier hypothesis. We cover:
It can seem like the sources of epithelial dysfunction are just about everywhere but the solution may begin at home. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Drop the SABA-only reliever. It’s not worth the risk | 01 Sep 2026 | 00:43:45 | |
"I don't think any asthmatic in this world should have a SABA, ever." —Dr. Paul O'Byrne Is it asthma? Is it a cold? Will symptoms go away? Will they come back even worse? And how about an inhaler? Do we give one? Which one? And for how long? Diagnosing and managing mild and moderate asthma can feel like a game of what-ifs. Worse, the treatment only works if patients stick with it, and that's hard when they feel fine. On this episode of The Allergist, we speak with one of the world's leading authorities in asthma research. Dr. Paul O'Byrne is a professor of medicine at McMaster University whose landmark START and SYGMA trials reshaped how we think about treating mild asthma. Key points:
Getting the diagnosis right takes time but is critical because it's a potentially lifelong label. Keep patients off SABA alone, and make sure every reliever carries a steroid. Simple? Not quite, but a lot clearer. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| ENCORE—Epinephrine Essentials: Balancing Confidence, Safety, and Misconceptions | 18 Aug 2026 | 00:29:12 | |
“If that medicine is associated with fear of an injection, then we are giving the impression that a diagnosis of food allergy is worse than a life sentence.” — Dr. Paul Turner When it comes to managing anaphylaxis, epinephrine is the gold standard. But even with its life-saving potential, misconceptions abound, and newer delivery methods like nasal and sublingual formulations are raising questions for allergists and patients alike. In this episode, Dr. Mariam Hanna sits down with Dr. Paul Turner, pediatric allergist, clinical immunologist, and global expert on anaphylaxis, to explore the science, controversies, and clinical realities surrounding epinephrine use. On this episode:
Whether you're an allergist navigating these evolving treatment landscapes or a clinician seeking clear guidance for patient care, this episode provides critical insights and practical advice. Tune in to strengthen your understanding of epinephrine’s role in anaphylaxis management and gain clarity on when—and how—it should be used. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Milk and egg: different ladders, different outcomes | 04 Aug 2026 | 00:23:41 | |
"Food, milk and egg ladders look the same, but they're not the same." — Dr. Juan Trujillo Ladders are close to standard in some clinics now. The evidence that they change the course of anything is still thin. So families are climbing, clinicians are advising, and nobody has settled the question underneath: is a ladder modifying the disease, or is it keeping everyone busy while a child outgrows it on schedule? On this episode, Dr. Mariam Hanna puts that to someone who has lived with the question longer than most. Dr. Juan Trujillo is a consultant paediatric allergist at Cork University Hospital and a senior lecturer at University College Cork. He is careful not to oversell. There isn't much literature to go on, he says, so ladder practice ends up tracking something else: how many appointments a clinic can offer. In a stretched service, a ladder can mean fewer visits rather than more. When it comes to egg and milk allergies, different ladders, different timelines, different success rates. Clinics tend to treat them as one thing. Trujillo doesn't. Key points
In young children, selected carefully and supported properly, ladders are worth doing on practical grounds, whether or not they turn out to be disease modifying. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Managing the child-to-adult transition | 21 Jul 2026 | 00:28:19 | |
"...these are chronic conditions that are not going to magically go away when a patient turns 18 or 21." — Dr. William Anderson Adolescence and early adulthood tend to be a rough stretch for patients with allergic disease. Asthma that used to be well controlled can start to drift. Teenagers take more chances with foods they are meant to avoid, and they show up for fewer of their appointments. Meanwhile the daily management is sliding off the parent and onto a patient who often is not ready to carry it, from refills to the action plan to knowing what to do in an emergency. On this episode, Dr. Mariam Hanna welcomes back Dr. William Anderson, a pediatric allergist and director of the transition program at Children's Hospital Colorado. Their conversation is about why the shift from pediatric to adult care should begin years before a patient turns 18, how a clinic can actually build a young person's independence, and why he treats transition as a core piece of managing the disease itself. Key Points Transition is something you plan for over years, not something that happens on a birthday. Teenagers and young adults are more likely to lose disease control, miss follow-up, and land in the emergency department. Starting at 12 to 14 leaves runway to build skills before adult care becomes urgent. Parents stay in the picture, but the patient has to start talking in appointments and handling refills. A tool like TRAQ helps, but confirm the answers with the patient. The work does not have to fall on the physician alone. Nurses, staff, and care coordinators can carry a lot of it. The real obstacle is usually cultural. Handing over control feels like a loss. The goal is not to push patients out early. It is to keep a young person from vanishing into the gap between pediatric and adult care. Someone who knows their own medications and can handle a refill or a scare without a parent is far safer than someone who just ages out and hopes. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| New Epinephrine Options. Fewer Fears? | 07 Jul 2026 | 00:28:50 | |
“If you are willing to use it and use it quickly, that's what I want you to have.” Epinephrine is everywhere in allergy practice. Prescribed, refilled, demonstrated, repeated. And still, it carries a strange kind of fear. Patients hesitate. Clinicians sometimes hesitate too. Is it dangerous? Is it a last resort? How bad does the reaction have to be before it counts? On this episode, Dr. Mariam Hanna is joined by Dr. Jay Lieberman, professor of pediatrics at the University of Tennessee and interim division chief of allergy and immunology at Le Bonheur Children's Hospital. He talks through what epinephrine does in the body, where the evidence is still messier than many assume, and how new needle-free options may change whether patients actually use it when it matters. Key Points
Needle-free epinephrine won't answer every question in anaphylaxis care. But it may change the most practical one: not whether patients know they should treat, but whether they actually will. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| CVID? No. SAD? Maybe. | 23 Jun 2026 | 00:27:41 | |
“You can have a patient that has normal immunoglobulins and abnormal responses to protein antigens as well. Historically, I’ve seen these patients. They do happen. They are out there.” — Dr. Benjamin Prince Specific antibody deficiency (SAD) has never been a clean diagnosis. Some patients carry normal immunoglobulins and still land in clinic with recurrent infections and poor vaccine responses. The newer pneumococcal vaccines have scrambled the old testing pathways. This episode covers which parts of the workup still hold up, and where a titre should actually change what you do next. Dr. Mariam Hanna is joined by Dr. Benjamin Prince, Associate Professor of Pediatrics and Associate Division Chief of Research in Allergy and Immunology at Nationwide Children's Hospital in Columbus, Ohio. He walks through the shifting definition of SAD, what pneumococcal titres can and can't tell you, and how to read testing in the Prevnar 20 era. Key Points
A useful listen for any clinician who has stared at a borderline pneumococcal panel and wondered whether to keep pulling the thread. The lab pathway exists, but the history is still what tells you whether the result will mean anything. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| When It’s Not Asthma, Think Larynx | 09 Jun 2026 | 00:25:04 | |
“If the asthma is under good control but they are still having these episodes, then I do think that maybe they have a PVFMD component to their breathing issue.” Dr. R. Jun Lin Patients come into clinic short of breath. It hits during exercise, it looks dramatic, and they may even describe noisy breathing or the feeling that they “can’t get air in.” So we do what clinicians do: we think asthma. We try inhalers. But sometimes, no matter how many puffers are thrown at the problem, nothing changes. That’s when it may be time to look higher, to the larynx. On this episode of The Allergist, Dr. Mariam Hanna is joined by Dr. R. Jun Lin, a fellowship-trained laryngologist and chief of the Division of Laryngology at the University of Toronto, for a practical discussion of vocal cord dysfunction, inducible laryngeal obstruction, and paradoxical vocal fold motion disorder. Dr. Lin walks through how these patients present, how to distinguish laryngeal obstruction from asthma, when both may be present, and why respiratory retraining therapy is often the cornerstone of care. Key Points
For clinicians, this episode is a reminder that not every dramatic breathing episode starts in the lower airway. When the history points to trouble getting air in, especially with poor response to inhalers, PVFMD deserves a place on the differential. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| When AI meets the allergy clinic | 26 May 2026 | 00:27:26 | |
“AI might feel like magic at times, but mostly it's just powerful technology, and with any technology, it's a tool.” —Merlijn van Breugel AI is no longer a future-tense possibility for allergists. It is already shaping diagnosis, prediction, documentation, patient communication, and the way clinicians think through complex decisions. But if AI can process more than we can, what still belongs to the clinician? On this episode of The Allergist, Dr. Mariam Hanna is joined by Merlijn van Breugel, a data scientist and philosopher whose work focuses on AI in allergy and immunology. Together, they get into where AI may be most useful now and in the near future, including phenotyping asthma and eczema, supporting diagnosis in young children, combining genetic, environmental, wearable, and clinical data, and reducing the administrative work that pulls clinicians away from patient care. But the episode does not dodge the hard stuff: hallucinations, bias, validation, liability, overtrust, and the very human problem of changing behaviour in real clinics. Key Points
For allergists, the message is not to fear the machine or blindly follow it. AI may help identify patterns, reduce administrative work, and open new research possibilities, but the clinician still brings the judgment, context, accountability, and critical eye. The future is not AI instead of allergists. It is allergists who understand how to use AI well. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| The Expanding Toolbox for Food Allergy | 12 May 2026 | 00:28:24 | |
“It’s a fun time to be a food allergist”—Dr. David Fleischer Food allergy treatment is no longer just about avoidance, epinephrine, and hoping for the best. With high-dose OIT, low-dose OIT, SLIT, EPIT, Xolair, and other biologics entering the conversation, allergists now face a more practical question: what are we trying to achieve, and what approach best fits this patient and family? On this episode, Dr. Mariam Hanna is joined by Dr. David Fleischer, section head of allergy and immunology and director of the Allergy and Immunology Center at Children’s Hospital Colorado, and professor of pediatrics at the University of Colorado School of Medicine. He walks through how dose, route, safety, family goals, practicality, and flexibility all shape the choice of therapy. Key Points
With more tools in the food allergy toolbox, the future may not be one perfect protocol for everyone. It may be choosing the right therapy for the right patient, then having the flexibility to change course when life, goals, or tolerance change. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Evidence-Based or Autopilot? A review of systematic reviews | 28 Apr 2026 | 00:26:09 | |
“We need more than just random care. We need randomized care.” — Dr. Derek Chu For years, the allergy world has been drowning in a sea of data—risk factors, prevention strategies, and enough diagnostic tools to fill a warehouse. But how do you translate 340 different risk factors into a cohesive plan when an anxious parent is sitting in your clinic demanding a skin test for their four-month-old?. On this episode, Dr. Mariam Hanna is joined by "systematic review genius" Dr. Derek Chu to unpack the evidence-based roadmap for food allergy and atopic dermatitis. It’s time to move past the "noise" and start reading between the lines of what our patients actually need. Key Points:
Dr. Chu walks us through the "diagnostic momentum" that often leads clinicians to over-test and over-restrict, and why your Royal College exam cutoffs might not be as definitive as you remember. From the major and minor predictors of food allergy to the "multimorbid" patient with eczema, this conversation is a masterclass in being sensible and judicious at the bedside. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Microbiome in IEI, Much More Than Probiotics | 14 Apr 2026 | 00:26:24 | |
“We came up with the idea of testing a ketogenic diet… which in mice, it’s basically a lot of Crisco… giving a keto diet to mice with CGD… led to a decreased susceptibility to colitis.” —Dr. Emilia Liana Falcone The microbiome isn’t something sitting on the sidelines. It’s part of the immune system, interacting with the barrier, shaping responses, and, in IEI, reflecting the underlying defect. On this episode, Dr. Mariam Hanna is joined by Dr. Emilia Liana Falcone, physician-scientist and director of the Microbiome and Mucosal Defense Research Unit at the Montreal Clinical Research Institute, to walk through how these host–microbe interactions drive disease. From early-life immune programming to microbial signals that activate inflammatory pathways, this is a shift from association to mechanism. And a step toward therapies that target both sides of the equation. Key Points:
This is not about adding a probiotic. It’s about understanding how immune defects reshape the microbial environment, and how that environment feeds back into disease. Get that interaction right, and you’re not just managing symptoms. You’re changing the system driving them. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Small Risks Big Rewards with SCIT | 31 Mar 2026 | 00:28:22 | |
“This is a safe and very effective therapy, which is probably underutilized within our own community.” —Dr. Susan Wasserman Subcutaneous immunotherapy (SCIT) sits in that uncomfortable space between routine and risk. It’s one of the few interventions in allergy that can actually modify disease. But it also carries a small, very real risk of severe reactions. On this episode, Dr. Susan Wasserman, professor at McMaster University and a national leader in immunotherapy, walks through what safety really looks like in practice. And where things still go wrong. Key Points:
SCIT is one of the few tools we have that can actually change the trajectory of allergic disease. But it demands discipline. Careful screening. Reliable processes. And a team that’s ready to act when things go sideways. Because most of the time, it’s safe. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Rewriting the Immune Code | 17 Mar 2026 | 00:28:13 | |
"So the future is one IV infusion, likely no chemotherapy, and that'll cure our IEIs." — Dr. Nicola Wright For children born with inborn errors of immunity, bone marrow transplant has long been the closest thing medicine had to a cure. It works — but it comes with chemotherapy, graft-versus-host disease, and a donor search that doesn't always end well. Gene therapy is changing that calculus. Dr. Mariam Hanna speaks with Dr. Nicola Wright, a pediatric hematologist and clinical immunologist at the Alberta Children's Hospital and holder of the Barb Ibbotson Chair of Pediatric Hematology, whose research focuses on developing gene editing platforms for blood and immune disorders. On this episode, they discuss:
The science is outpacing the infrastructure. Dr. Wright's vision of shipping cells instead of patients, in vivo delivery via lipid nanoparticle, no chemotherapy required isn't speculative. The runway is being built. The plane is already flying. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Consent is a Conversation | 03 Mar 2026 | 00:24:51 | |
"That wholesome conversation that you take a minute or two to go through really creates a physician-patient relationship, expands that communication. Probably will not only improve patient outcomes, but reduce medical-legal risk for physicians in the consent process." — Dr. Lisa Thurgur A signed form isn't consent. It's paperwork. On this episode, Dr. Mariam Hanna is joined by Dr. Lisa Thurgur — emergency physician, award-winning educator, and a physician advisor with the Canadian Medical Protective Association — to unpack what meaningful consent looks like in daily practice. Inadequate consent is one of the most common allegations in CMPA cases, across every specialty. On this episode:
Done well, consent isn't something you do in addition to practicing good medicine. It improves outcomes, strengthens adherence, and reduces medical-legal risk. In other words, it is good medicine. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Infant anaphylaxis: What it looks like when they can't tell you | 17 Feb 2026 | 00:28:25 | |
"I have come across allergists in different countries who often don't even prescribe epinephrine for very young children that have only had a history of mild reactions." — Dr. Katherine Anagnostou An inconsolable cry. A baby who's just not acting right. Tongue thrusting. Lip licking. Scratching at their own tongue. These aren't the symptoms that make it into standard diagnostic criteria — but they might be the clearest signal a non-verbal child can give. On this episode, Dr. Mariam Hanna is joined by pediatric allergist and immunologist Dr. Katherine Anagnostou to explore how anaphylaxis presents in infants and toddlers, why the standard criteria don't always apply, and how allergists can help caregivers recognize — and treat — serious reactions in children who can't yet put words to what they're feeling. On this episode:
Dr. Anagnostou returns to one principle throughout: parents generally know their children pretty well. The job of the allergist isn't to create fear or overcomplicate recognition — it's to help families spot what's different, understand the context, and feel equipped to act when it matters. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| The many faces of milk problems | 03 Feb 2026 | 00:29:17 | |
“There is nothing magical that happens in your gut that says, ‘oh, now you’re ready for cow’s milk.’ — Dr. Farah Khan Milk has a special talent for creating chaos in clinic. One day it’s mucousy stools and a terrifying diaper photo, the next it’s hives after yogurt, delayed vomiting with lethargy, or a family that’s been dairy-free for years with no improvement in eczema. On this episode, Dr. Mariam Hanna is joined by pediatric allergist and clinical immunologist Dr. Farah Khan to walk through the many ways “milk problems” show up — and how allergists can avoid overdiagnosis, unnecessary testing, and prolonged elimination diets that may do more harm than good. On this episode:
Across each of these scenarios, Dr. Khan returns to the same principle: eliminating dairy should never be a one-and-done decision. Revisiting the diagnosis, retrying thoughtfully, and weighing quality of life alongside risk are essential — especially when prolonged avoidance can set the stage for the very allergy clinicians are trying to prevent. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Developing that immunology spidey sense | 20 Jan 2026 | 00:26:37 | |
“It’s not about knowing each one. It’s about knowing the patterns, the warning signs, the general pathways, and knowing when to ask a friend when you’re a little bit lost.” —Dr. Tamar Rubin On this episode of The Allergist, Dr. Mariam Hanna turns the focus to how allergists LEARN to recognize when common presentations may signal a deeper immune problem — and how that diagnostic instinct is built, taught, and sustained. She’s joined by Tamar Rubin, pediatric allergist and clinical immunologist, Assistant Professor at the University of Manitoba, and a national leader in immunology education. Dr. Rubin makes the case that inborn errors of immunity are not a fringe interest, but central to understanding immunology across allergy, asthma, infection, and biologic therapies — and that allergist-immunologists are the specialists uniquely trained to recognize and teach this. On this episode, they discuss:
Because in the end, inborn errors of immunity aren’t just about rare diseases. They sharpen how allergists think, teach, and listen when the immune story doesn’t quite fit. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Highlights from the 2025 allergy literature | 06 Jan 2026 | 00:34:04 | |
Keeping up with the allergy literature can feel like a second job layered onto an already full clinic day. Between evolving guidelines, expanding biologic options, and long-held assumptions quietly being challenged, it’s hard to know which papers are worth slowing down for. This episode takes a deliberately selective approach. Dr. David Khan — chair of the American College of Allergy, Asthma, and Immunology literature review — walks through five papers from 2025 that stood out not because they were flashy, but because they asked practical questions allergists actually wrestle with in clinic. Timing of repeat epinephrine to inform pediatric anaphylaxis observation periods: a retrospective cohort study Two-year data of tapered dupilumab shows high effectiveness in chronic rhinosinusitis with nasal polyps with NSAID-exacerbated respiratory disease Remibrutinib and chronic spontaneous urticaria A randomized trial comparing direct challenges to penicillin skin testing for outpatient low-risk penicillin allergy evaluations in pregnancy Age differences in inducible laryngeal obstruction in adult populations Taken together, these papers reflect a broader shift in allergy care: less reflexive caution, more precision, and a growing willingness to question long-standing habits when better data emerge. Whether it’s shortening observation times, tapering biologics, simplifying drug allergy evaluations, or recognizing long-ignored mimics of allergic disease, the 2025 literature nudges allergists toward care that is more precise, less reflexive, and still clinically vigilant. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| ENCORE: New Rules for Old Hives | 23 Dec 2025 | 00:27:01 | |
== Happy holidays to our audience around the world! As a gift, and a break for The Allergist team, we are replaying our most popular episode from 2025. We hope you enjoy it as much this time around. See you in the New Year! == “We have to keep in mind that urticaria has to be treated until it's completely gone. So, absolute control of the disease.” — Dr. Hermenio Lima Chronic spontaneous urticaria has long been managed with the goal of complete symptom control. But for many patients, that goal remains elusive. In this episode of The Allergist, Dr. Mariam Hanna talks with dermatologist and clinical immunologist Dr. Hermenio Lima about the updated urticaria guidelines—and how new treatment options are giving clinicians more ways to act, and more hope for getting patients all the way to control. On this episode:
Complete control is still the destination, but the path to get there is about to get a lot more flexible. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Nutrition and food allergy with Dr. Carina Venter | 09 Dec 2025 | 00:27:59 | |
“We should stop being scared of food, and we really should just let babies eat.” — Dr. Carina Venter Dr. Mariam Hanna sits down with Dr. Carina Venter, a leading dietitian and researcher in food allergy prevention and management. They get into the everyday realities of feeding infants and children in allergy practice, from early introduction to texture challenges, growth concerns, and the rise of allergen-free processed foods. On this episode
This episode brings nutrition back to the centre of allergy practice. Dr Venter’s guidance keeps things practical — diverse diets, consistent allergen exposure, and attention to growth and texture — so families can feel confident and kids can learn to enjoy food safely. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Managing the Confident but Incorrect | 25 Nov 2025 | 00:26:58 | |
“It's kind of like we opened a Pandora's box and trying to close it up again is going to be very hard.” —Dr. Zachary Rubin Dr. Zachary Rubin joins Dr. Mariam Hanna for a candid look at the “difficult and misinformed” patient — the growing phenotype every allergist now manages weekly. A double board-certified pediatrician and allergist-immunologist with a massive social media footprint, Dr. Rubin breaks down how misinformation spreads, why it resonates, and how clinicians can approach these encounters without burning out or burning bridges. From TikTok-fuelled certainty to patients demanding full panels, he offers a practical, clinician-first playbook for navigating the mess. On this episode:
A grounded, real-world conversation for clinicians who balance patient frustration, digital misinformation, and the realities of modern allergy practice. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Can sinusitis be solved? The view from the ENT clinic | 11 Nov 2025 | 00:24:46 | |
“People know that asthma sucks. They don’t know that sinus disease sucks. It really impacts people's quality of life. It impacts their function. It needs to be taken very seriously.” — Dr. Andrew Thamboo Chronic sinusitis doesn’t just clog the nose—it can drag down quality of life, complicate asthma, and leave patients caught between specialists. Dr. Mariam Hanna talks with Dr. Andrew Thamboo, rhinologist at St. Paul’s Sinus Centre in Vancouver and clinical associate professor at UBC, about how to identify, manage, and treat this stubborn condition. A leader in chronic sinus disease research, Dr. Thamboo explains how understanding inflammation, using the right investigations, and choosing the right therapies can make a real difference for patients who feel like nothing works. In this episode:
Sinus disease may suck, but as Dr. Thamboo explains, understanding inflammation, anatomy, and timing can make all the difference for patients and physicians alike. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Tregs: The Peacekeepers of Immunity | 28 Oct 2025 | 00:23:26 | |
“The immune system generally likes to be a well-balanced machine. It’s kind of like Goldilocks — too much is no good, too little is no good, and it’s finding that balance.” Dr. Vy Kim Tregs have been called therapists, peacekeepers, and now—thanks to this year’s Nobel Prize—front-page immunology. Dr. Vy Kim joins Dr. Mariam Hanna to unpack why these cells might hold the key to everything from tolerance to therapy response, and what allergists should be watching for next.
It’s not every day the Nobel Prize lines up with what’s happening in your clinic. This is one of those days. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| A Clear-Eyed Look at the Red-Eye Culprit | 14 Oct 2025 | 00:28:00 | |
“Don't just rely on the textbook definition of when the pollen seasons are. You need to have reliable data to know when the pollen seasons are starting, when they're ending, and when they're peaking.” Dawn Jurgens Allergy season may be winding down, but for allergists, the work never really stops. This is the moment between ragweed and winter — a brief respite before the cycle begins again. On this episode, Dr. Mariam Hanna is joined by Dawn Jurgens, Director of Operations and Quality Management at Aerobiology Research Laboratories. She breaks down the science behind pollen and spore counts, why forecasts matter, and how shifting seasons are changing the game for patients and clinicians alike.
Pollen season may be taking a break, but planning for the next wave starts now. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Standard Vaccines And Special Cases | 30 Sep 2025 | 00:28:07 | |
“Vaccine counseling is really a team sport. — Dr. Anne Pham-Huy Vaccines can stir anxiety for patients and confusion for clinicians, especially when biologics enter the mix. Dr. Mariam Hanna is joined by Dr. Anne Pham-Huy, clinical immunologist at CHEO, member of the Special Immunization Clinic Network, NACI member, and chair of Immunize Canada. Together, they break down the science of vaccine responses and tackle some of the trickiest questions allergists face in daily practice. On this episode:
The questions are simple — are they vaccinated, special, or special enough — but the answers matter. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| No to Olive Oil, Yes to What Works in Eczema Care | 16 Sep 2025 | 00:28:35 | |
“Atopic dermatitis is not just about what you see on the skin. It's about what the patient's experiencing.” Dr. Melinda Gooderham Eczema care has become a world of creams, cleansers, oils, and myths — but what actually works? Dr. Mariam Hanna is joined by Dr. Melinda Gooderham, assistant professor at Queen’s University and consultant physician at the Peterborough Regional Health Centre. As principal investigator for more than 250 clinical trials, Dr. Gooderham brings both evidence and practical wisdom to the table. On this episode, they explore:
Eczema may be complex and misunderstood, but Dr. Gooderham reminds us that consistent barrier care, adequate product use, and asking the right questions about itch can simplify management and improve patient outcomes. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Solving the Mystery of Mastocytosis — Tests, Treatments and Triggers | 02 Sep 2025 | 00:28:13 | |
“You will think it is mastocytosis much more often than you'll actually diagnose mastocytosis.” — Dr. Matthieu Picard Mastocytosis is rare, complex, and often confused with other mast cell disorders. To help clinicians cut through the confusion, Dr. Mariam Hanna welcomes Dr. Mathieu Picard, allergist and clinical immunologist, who has built a dedicated practice caring for patients with mast cell diseases. Together, they explore what physicians need to know about diagnosis, monitoring, and management. On this episode:
Mastocytosis may be rare, but it doesn’t take uncommon skill to spot — just the right tools, a sharp eye, and maybe a tongue depressor scratched five times. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Finding the Fix for Chronic Cough | 19 Aug 2025 | 00:27:26 | |
“At least 60% don't respond to anything or who have been to somebody else before and they've come to me and they've tried everything and failed” — Dr. Imran Satia Dr. Imran Satia, Respirologist and Associate Professor at McMaster University and Canada Research Chair in Chronic Cough, joins Dr. Mariam Hanna to walk clinicians through a practical, evidence-based approach to diagnosing and managing chronic cough. With decades of research and clinical experience, Dr. Satia explains how to define chronic cough and its subtypes, recognize red flags, and navigate the common — and less common — causes that keep patients coughing for years. On this episode, you’ll hear:
By the end of the episode, you’ll have a clear, step-by-step framework for assessing chronic cough, avoiding unnecessary treatments, and helping even the most refractory patients find relief. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Going viral for the right reasons: join the fight against misinformation | 05 Aug 2025 | 00:22:03 | |
“Putting yourself out there online as a doctor is not easy. But staying silent while misinformation spreads—that felt worse.” —Dr. Amiirah Aujnarain Dr. Amiirah Aujnarain has built a community of 80,000 followers by blending evidence-based allergy education with a candid, human presence online. On this episode of The Allergist, she joins Dr. Mariam Hanna to examine how social media is shaping allergy conversations—sometimes for better, sometimes for worse. From Benadryl challenges to dupilumab searches on TikTok, patients are turning to social media for answers long before they see a specialist. Dr. Aujnarain shares how she’s meeting them where they are, and why she sees it as both a responsibility and a creative outlet. This episode covers:
Whether you’re thinking about launching your own account or simply wondering how your patients are being influenced online, this conversation is an honest look at the power and pitfalls of digital engagement. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| The GI Guide for Allergists: A Deep Dive with Dr. Avinashi | 22 Jul 2025 | 00:31:03 | |
“I can’t think of any medical condition where you can have this type of fry but not that type of fry.” —Dr. Vish Avanashi Pediatric gastroenterologist Dr. Vish Avinashi joins Dr. Mariam Hanna for an episode that jumps head first into the overlapping world of allergy and GI. From ARFID to EOE, they talk about the murky middle ground where food fears, immune triggers, and gut symptoms collide—and how allergists can better navigate it all with the help of a friendly gastroenterologist.
When it comes to navigating the overlap between allergy and GI, remember: always learning, always listening, always befriending a gastroenterologist. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| What Allergies to Expect When You’re Expecting | 08 Jul 2025 | 00:26:31 | |
“They may worsen, they may improve, or they might not change at all, and it really is patient-dependent.” —Dr. Lana Rosenfield On this episode of The Allergist, Dr. Mariam Hanna welcomes Dr. Lana Rosenfield to unpack the complexities of managing allergic conditions during pregnancy and postpartum. With hormones shifting, the immune system recalibrating, and anxiety about medication safety running high, allergic disease can be especially tricky to manage during this time. Dr. Rosenfield offers practical insights for clinicians supporting pregnant patients with conditions like asthma, rhinitis, chronic urticaria, and food allergy, while navigating a landscape of limited data and heightened patient concerns. On this episode:
Dr. Rosenfield emphasizes shared decision-making, lowest effective dosing, and the clinical resources she trusts when evidence is limited. It’s a thoughtful and clinically grounded conversation to support allergists managing allergic conditions through pregnancy and beyond. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Taking the sting out of diagnosing contact dermatitis | 24 Jun 2025 | 00:27:58 | |
“Have a high clinical suspicion for contact allergens or irritants in anyone presenting with eczematous rash.” —Dr. Rebecca Pratt Creams that sting and rashes that won’t quit —welcome to the complex world of contact dermatitis. Dr. Rebecca Pratt joins Dr. Mariam Hanna to unpack why diagnosing and managing this condition is anything but straightforward. Dr. Pratt is an allergist and clinical immunologist in St. Catharines, Ontario, with a passion for dermatoimmunopathology and practical tools that empower patients. She breaks down when to patch test, what to suspect, and how to help patients take control. On this episode:
There may be no cure for contact allergy, but there’s power in knowing what to avoid. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Trust your gut and test for primary atopic disorders | 10 Jun 2025 | 00:24:32 | |
“If you're already wondering if a patient has an underlying inborn error of immunity, then it’s worthwhile to do that testing.” — Dr. Catherine Biggs What if that tough case in your allergy clinic isn’t just unusually severe, but fundamentally different? On this episode of The Allergist, Dr. Mariam Hanna speaks with pediatric immunologist Dr. Catherine Biggs about primary atopic disorders, rare inborn errors of immunity that masquerade as everyday allergy but demand a very different approach. Dr. Biggs breaks down the clinical signs that should raise your suspicion and explains why early recognition and genetic testing can make all the difference. From STAT6 gain of function to when (and when not) to reach for dupilumab, this episode offers a roadmap for spotting zebras. On this episode:
Don’t let these patients fall through the cracks, because sometimes, it’s not “just” allergy. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| How to accidentally become a researcher | 27 May 2025 | 00:20:34 | |
“It doesn’t have to start with a huge trial. It starts with a patient and it starts with a problem.” —Dr. Gord Sussman How do we move from the exam room to the frontlines of discovery? On this episode of The Allergist, Dr. Mariam Hanna talks with Dr. Gord Sussman about how curiosity—not a research grant—launched his decades-long contribution to allergy science. From identifying the early signs of latex allergy to shaping the treatment landscape for urticaria and hereditary angioedema, Dr. Sussman shares what keeps him asking the next question, and how any allergist can get involved. On this episode:
You don’t need a lab coat to help change practice. Just curiosity, commitment—and maybe a really good clinical coordinator. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| New Rules for Old Hives | 13 May 2025 | 00:27:01 | |
“We have to keep in mind that urticaria has to be treated until it's completely gone. So, absolute control of the disease.” — Dr. Herminio Lima Chronic spontaneous urticaria has long been managed with the goal of complete symptom control. But for many patients, that goal remains elusive. In this episode of The Allergist, Dr. Mariam Hanna talks with dermatologist and clinical immunologist Dr. Herminio Lima about the updated urticaria guidelines—and how new treatment options are giving clinicians more ways to act, and more hope for getting patients all the way to control. On this episode:
Complete control is still the destination, but the path to get there is about to get a lot more flexible. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Biologics, Polyps, and the Power of Collaboration | 29 Apr 2025 | 00:27:37 | |
"The emergence of biologics has really significantly transformed the management of these patients for me." When it comes to nasal polyps, the landscape is shifting fast. On this episode of The Allergist, Dr. Mariam Hanna is joined by otolaryngologist Dr. Yvonne Chan to talk about how biologics, surgery, and multidisciplinary care are working together to reshape care for this stubborn condition. From recognizing key symptoms to navigating the latest therapeutic options, Dr. Chan shares practical insights to help physicians better support patients with nasal polyps. On this episode:
Listen now, because when it comes to managing nasal polyps, the right team and the right tools can make all the difference. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Teaching with Feedback, Not Fireballs | 15 Apr 2025 | 00:27:53 | |
"We are all learning and we are all teaching." – Dr. Lori Connors What makes a great medical educator—and how do you actually become one? On this episode, Dr. Mariam Hanna is joined by Dr. Lori Connors, an allergist, seasoned teacher, and newly appointed Associate Dean of Continuing Professional Development and Medical Education at Dalhousie University. They explore the journey to becoming a great medical educator, how competency by design is reshaping training, and how to support the next generation of learners. Here’s what you’ll learn:
Whether you're shaping the next generation or figuring out your own place in it, this episode offers practical insights and a reminder that great educators never stop learning themselves. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Find time, to make time, to fix time | 01 Apr 2025 | 00:28:10 | |
“We need time to fix our time problem. And we can get stuck in this loop where we’re like, ‘I have no time to find time to make time to fix time.’” – Dr. Scott Cameron Is your schedule running you—or are you running your schedule? On this episode of The Allergist, Dr. Mariam Hanna is joined by pediatric allergist and clinical immunologist Dr. Scott Cameron to talk about the chaos of clinical practice and how to take back control. With tips that go far beyond time management, Dr. Cameron shares practical strategies for streamlining clinic operations, handling unpredictable days, and investing in smarter workflows—without burning out. On this episode:
Get practical. Get faster. Get home on time. It’s all about working smarter—not harder. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| The Suspect? Inborn Errors of Immunity | 18 Mar 2025 | 00:28:05 | |
"The key to the diagnosis of these disorders is the suspicion of these disorders." — Dr. Luis Murguia Favela Immune dysregulation isn’t just about infections—autoimmunity, inflammation, and even malignancy can be clues that something deeper is at play. With over 500 known inborn errors of immunity, allergists are increasingly on the front lines of identifying these conditions. But when should we suspect immune dysregulation, and what does cutting-edge treatment look like today? Dr. Mariam Hanna is joined by Dr. Luis Murguia Favela, pediatric immunologist and founding chair of the Clinical Immunology Network for Canada, to break down the growing world of immune dysregulation and how allergists can spot it. On this episode:
With a growing number of identified inborn errors of immunity, the role of allergists in spotting immune dysregulation has never been more critical. Be suspicious, always. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| The Penicillin Allergy Puzzle: Who’s Really Allergic? | 04 Mar 2025 | 00:27:14 | |
“Most penicillin allergy labels are not indicative of any meaningful penicillin allergic reaction, and the vast majority can be de-labelled with direct oral challenges of amoxicillin." — Dr. Kimberly Blumenthal Penicillin allergy is one of the most commonly reported drug allergies—but here’s the twist: most people who carry this label aren’t actually allergic. So how did we get here, and what can be done to fix it? On this episode, Dr. Mariam Hanna sits down with Dr. Kimberly Blumenthal, an allergist, immunologist, and clinical researcher at Massachusetts General Hospital, and an associate professor at Harvard Medical School. Dr. Blumenthal is internationally recognized for her work on penicillin allergy and the real-world impact of unnecessary labels on patient care, antibiotic resistance, and health equity. We cover:
With the vast majority of penicillin allergy labels being inaccurate, this episode highlights why it's time to stop assuming and start testing. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Crossing the threshold of more precise allergy care | 18 Feb 2025 | 00:27:49 | |
"We use thresholds every day without even thinking about it. When we do a food challenge in our office, whether we know it or not, we're relying on the fact that there is a threshold for every patient. Some are going to be on the first dose, some are going to be at the last. And that's just part of what a threshold is." – Dr. Doug Mack Food allergies aren’t one-size-fits-all, but we don’t talk enough about thresholds—the amount of an allergen it actually takes to trigger a reaction. Should every patient be following the same strict avoidance rules? Or should we be aiming for something more precise? To help us make sense of thresholds, we welcome back Dr. Douglas Mack, pediatric allergist, clinical immunologist, and Vice President of CSACI. Dr. Mack is known for his work on food allergy treatment, including oral immunotherapy, epinephrine use, and—you guessed it—thresholds. On this episode, Dr. Mack and Dr. Mariam Hanna dig into:
Thresholds aren’t just theoretical—they impact how we advise patients, assess risk, and tailor treatments. Dr. Mack walks us through the science behind these numbers and how allergists can apply them in daily practice. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Prescribing Change: Could Omalizumab Transform Food Allergies? | 04 Feb 2025 | 00:25:11 | |
"Although omalizumab is not a cure, it's a major step forward for patients as the first monoclonal antibody or biologic therapy to become FDA-approved to treat food allergy." — Dr. Brian Vickery
Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| When to breathe easy about asthma remission | 21 Jan 2025 | 00:26:46 | |
"I think that asthma’s at a great time right now for some really cool interventions moving ahead that can maybe make big differences in our patients’ lives." On this episode of The Allergist, Dr. Mariam Hanna is joined by Dr. William Anderson to explore one of the most pressing and evolving questions in asthma care: remission. Together, they unpack the concept of asthma remission, what it truly means for patients and physicians, and how modern therapies are shaping its future. Dr. Anderson helps break down:
If you’re curious about the potential for asthma remission or looking for actionable ways to refine your approach to care, this episode is packed with valuable insights. Equip yourself with fresh perspectives and practical tools to help your patients stay on the path to better health. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Is SLIT a Fit for your patients? Sublingual Immunotherapy for Peanut Allergies | 07 Jan 2025 | 00:26:49 | |
“I do think it's important that we understand that not all the foods are the same, and I think anyone who's seen patients in clinics understands this.” – Dr. Edwin Kim Could sublingual immunotherapy (SLIT) be the peanut allergy solution allergists have been waiting for? In this episode, Dr. Mariam Hanna welcomes Dr. Edwin Kim, Division Chief of Pediatric Allergy and Immunology at the University of North Carolina, to dive into the science, practicality, and potential of SLIT. With a reputation for safety and ease of use, SLIT is gaining traction—but as Dr. Kim emphasizes, the evidence for other foods like milk, egg, and tree nuts remains extremely limited. On this episode:
Whether you’re curious about incorporating SLIT into clinical practice or exploring its limits, this episode delivers evidence-based insights. Tune in now to see if SLIT is the right fit for your patients! Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Encore: Don't Delay: Embracing Early Intervention in Food Allergy Management | 24 Dec 2024 | 00:27:29 | |
This is an encore presentation of our most downloaded episode of 2024. 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. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Epinephrine Essentials: Balancing Confidence, Safety, and Misconceptions | 10 Dec 2024 | 00:28:25 | |
“If that medicine is associated with fear of an injection, then we are giving the impression that a diagnosis of food allergy is worse than a life sentence.” When it comes to managing anaphylaxis, epinephrine is the gold standard. But even with its life-saving potential, misconceptions abound, and newer delivery methods like nasal and sublingual formulations are raising questions for allergists and patients alike. In this episode, Dr. Mariam Hanna sits down with Dr. Paul Turner, pediatric allergist, clinical immunologist, and global expert on anaphylaxis, to explore the science, controversies, and clinical realities surrounding epinephrine use. On this episode:
Whether you're an allergist navigating these evolving treatment landscapes or a clinician seeking clear guidance for patient care, this episode provides critical insights and practical advice. Tune in to strengthen your understanding of epinephrine’s role in anaphylaxis management and gain clarity on when—and how—it should be used. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Tiny Plastic Particles, Big Questions for Patient Health | 26 Nov 2024 | 00:23:25 | |
"Plastic has been found everywhere—lungs, breast milk, liver, spleen, placenta, even blood." – Dr. Magdalena Zemelka-Wiecek
On this episode:
Whether you're exploring the intersections of environmental and immune health or seeking guidance for patient discussions, this episode offers evidence-based insights and practical advice tailored to your clinical practice. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||
| Fido’s Got to Go? Managing Pet Allergies Without Saying Goodbye | 12 Nov 2024 | 00:27:36 | |
“I do not think families typically should be getting rid of pets if they're having symptoms. There are very, very well tolerated medications that we can use. We can use desensitization therapy with immunotherapy, and I think that's the discussion that should revolve around how to manage these.” — Dr. Shahzad Mustafa For many, pets are like family, which makes pet allergies a particularly sensitive issue. On this episode, Dr. Mariam Hanna invites Dr. Shahzad Mustafa, Chief of Allergy, Immunology, and Rheumatology at Rochester Regional Health, to explore practical, evidence-based approaches for managing pet allergies in patients who can’t imagine life without Fido or Fluffy. Together, they break down the latest on diagnosis, medical management, and the myths that often cloud pet allergy discussions. On this episode:
Whether it’s dogs, cats, or anything furry in between, this episode offers compassionate, informed guidance for balancing allergy management with the realities of pet ownership. Tune in to get clarity on how to help patients breathe easy—without breaking their bond with their beloved pets. Have an idea for the show or a comment, send us a text! Visit the Canadian Society of Allergy and Clinical Immunology | |||