Eosinophilic Esophagitis (EoE), Food Triggers, and the Gut–Immune Connection (with Dr. Alan Epstein)

Eosinophilic Esophagitis (EoE), Food Triggers, and the Gut–Immune Connection (with Dr. Alan Epstein)

In this episode of My Allergist Dad, Drew and Dr. Z welcome gastroenterologist Dr. Alan Epstein to discuss gut health and its relationship to overall health, focusing on eosinophilic esophagitis (EoE) and why it has become more common since the 2000s. Dr. Epstein explains how EoE is diagnosed by endoscopy and biopsy (over 15 eosinophils per high-power field), how it can cause food impactions, and why triggers can be unclear, sometimes involving foods and possibly environmental factors. They review treatments including proton pump inhibitors, swallowed/topical steroids like budesonide, and dupilumab as a later option, plus the challenges of elimination diets. The conversation expands to celiac testing, microbiome diversity and antibiotics, vagus nerve signaling, and using vibration controlled transient elastography (VCTE) to detect fatty liver early to prevent fibrosis and cirrhosis.00:00 Liver Scan Wakeup Call00:52 Episode Preview and Intro01:45 Meet Dr Alan Epstein03:09 Medicine Beyond Silos06:11 What Is EoE15:46 Treating EoE Options17:08 Root Causes and Diet Triggers20:34 Celiac vs Gluten Sensitivity23:00 Wheat Around the World25:16 Old School Swallow Tests25:50 Why EoE Is Rising26:56 Obesity Toxins and Fatty Liver28:30 FibroScan Explained30:14 EoE Food Impaction Basics32:17 Endoscopic Removal Stories36:13 Ancient Microbiome Findings40:12 Fermented Foods vs Probiotics41:55 GLP-1s and Root Causes45:48 Healthcare System Squeeze48:50 Wrap Up and Disclaimers 📩 Have a question for the show?Email: myallergistdad@gmail.com

How Stress Impacts Allergies, Hives & Your Immune System (with Psychiatrist Dr. Bryson Lochte)

This episode of My Allergist Dad explores how mental stress can affect the body, immune system, and allergies. Drew and Dr. Z are joined by Santa Monica psychiatrist Dr. Bryson Lochte, who discusses treating root causes rather than only symptoms, including psychotherapy, ketamine-assisted psychotherapy, and tools like meditation and breathwork. Dr. Z describes patients with persistent hives, itching, and breathing complaints that don’t respond well to escalating medications, often alongside major life stressors, and explains stress-related sympathetic and cortisol effects, anxiety–allergy connections, and downstream impacts like microbiome changes and mast-cell activation. The conversation covers how stress can worsen existing allergies, how anxiety can mimic asthma or contribute to vocal cord dysfunction, and why a more interconnected, holistic approach is needed alongside standard medical treatment.00:00 What Stress Really Means00:57 Meet Dr. Bryson Lochte01:27 Show Intro Theme03:09 Stress And Allergy Flare Ups08:05 Treating Roots Not Symptoms10:36 Three Ways We Handle Distress12:26 Breathwork And Hidden Emotions14:35 Breathing Problems Or Anxiety16:26 Kids Animals And Culture19:30 Anxiety Allergies Chicken Egg22:04 Immune Domino Effects26:26 Holotropic Breathwork Explained29:48 Wrap Up Final Thoughts32:25 Medical Disclaimer📩 Have a question for the show?Email: myallergistdad@gmail.com

New Food Allergy Test That Predicts Accurate Reactions w/ Dr. Jonathan Friedlander of Atanis Biotech

On this episode of My Allergist Dad, Drew and Dr. Z talk with Dr. Jonathan Friedlander, Chief Business Officer at Atanis Biotech about FAST-PASE®, a diagnostic test that uses a stable, functional engineered mast cell line to measure whether a patient’s serum actually triggers mast cell activation when exposed to specific allergens. Unlike basophil activation testing that requires fresh whole blood, FAST-PASE® removes cells, uses serum to sensitize lab mast cells with the patient’s IgE, IgG, and other factors, then adds allergens at multiple concentrations and measures activation, aiming to reduce false positives from IgE-only tests and better predict clinical reactivity and thresholds for oral food challenges. They discuss applications to food allergy, immunotherapy monitoring (OIT/SLIT), alpha-gal syndrome and widespread sensitization vs true allergy, and broader future uses for environmental allergens and drug allergy, plus Jonathan’s recent Capitol Hill visit and plans to start testing at Dr. Z’s clinic.00:00 Basophil Test Limits00:59 Why This Test Matters01:56 Show Intro and Guest04:18 Origins of Atanis Biotech06:16 Immortal Mast Cells08:08 How FAST-PASE® Works10:08 Compared to IgE Tests13:32 IgG Protection Nuance16:02 Desensitization and Challenges17:55 Alpha Gal Confusion19:25 Alpha Gal Biology21:04 Need Functional Testing22:37 Tick Season Anxiety23:12 Alpha Gal Case Story23:52 Hidden Alpha Gal Exposures24:31 Gene Edited Pig Organs24:46 Sausage Trial And Food Questions26:26 Therapies And Monitoring Progress28:30 Beyond Food Allergens29:35 Drug Allergy And Testing Limits30:54 Advocacy On Capitol Hill32:56 Access And Allergist Shortage34:07 Mast Cell Confusion And Root Causes36:55 Launching In Europe Too39:15 Wrap Up And Next Steps40:24 Clinic Testing And Farewell📩 Have a question for the show?Email: myallergistdad@gmail.com

Hives Explained: Triggers, Stress, and Chronic Urticaria Treatments, Plus Oral Allergy Syndrome Tips

Drew and Dr. Z answer a listener question about a nine-year-old with severe seasonal oral allergy syndrome, explaining cross-reactivity between pollens (often birch) and raw fruits, vegetables, and nuts, how cooking can denature allergens, and how immunotherapy (shots or sublingual drops, sometimes seasonal or year-round) and microbiome-focused habits like reducing processed foods and sugar, managing stress, and considering probiotics may improve tolerance. They then discuss hives (urticaria). Dr. Z covers common non-allergic causes of prolonged hives (viral illness, stress, infections like Lyme, alpha-gal), appropriate evaluation, and stepwise treatment with daily second-generation antihistamines, higher dosing when needed, and biologics such as omalizumab and dupilumab for chronic spontaneous urticaria.00:00 Listener Question: Oral Allergy Syndrome!00:33 What Are Hives?01:02 Show Intro Theme01:33 Listener Question: Oral Allergy Syndrome02:47 Why Symptoms Are Seasonal04:26 Food Prep And Allergy Shots05:47 Microbiome Diet And Stress08:10 Immunotherapy Options11:35 Pivot To Hives Topic12:07 How To Recognize Hives14:06 ER Fear And Stress Cycle17:15 Prague Story & Calming Hives21:04 Is It Really Hives?23:00 Triggers, Tests, And Causes26:20 Chronic Hives Treatment Plan27:46 Biologics: Explained!31:59 Wrap Up And Final Thoughts33:37 Disclaimer And Outro 📩 Have a question for the show?Email: myallergistdad@gmail.com

Food Sensitivity Testing Explained (Inflammation and “Leaky Gut”) | My Allergist Dad

On this episode of My Allergist Dad, Drew and Dr. Z talk with James White, the CEO of KBMO Diagnostics, about where food sensitivity testing fits in for patients with chronic symptoms that don’t show up on standard IgE allergy tests. James explains KBMO’s patented approach that combines IgG exposure markers with innate immune inflammation markers to reduce false positives and narrow results from dozens of foods to a more practical list, contrasting it with hair-based tests that he says are not reproducible. Dr. Z clarifies IgE versus IgG and why food sensitivities can be delayed up to 72 hours, discusses how testing can guide elimination diets for GI symptoms like IBS and sometimes conditions like eosinophilic esophagitis, and shares patient stories of symptom improvement after removing trigger foods. They also cover KBMO’s added gut barrier (“leaky gut”) panel, retesting strategies, and how gluten sensitivity differs from celiac disease.00:00 Inflammation And Food Inputs00:36 Show Intro Theme00:50 Meet James White, CEO of KBMO01:51 Patriots Shirt Story03:24 Where Testing Fits In04:27 How KBMO Tests Work07:50 IgG Vs IgE Explained11:23 Hair Tests And Reproducibility13:52 Gut Barrier Panel Added15:34 Real Patient Success Stories19:28 Who Benefits The Most24:15 FODMAP Vs Inflammation27:15 Hosts' Personal Results29:44 Pets And Food Inflammation32:27 Leaky Gut And Retesting36:49 Celiac Versus Sensitivity40:01 Wrap Up And Takeaways42:13 Outro And Disclaimer📩 Have a question for the show?Email: myallergistdad@gmail.com