The Itch: Allergies, Asthma, Eczema & Immunology

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

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Made in partnership with The Allergy & Asthma Network.

If you have ever taken an antihistamine labeled "non-drowsy" and still ended up foggy and tired, you are not imagining it. Allergists have a lot to say about that label and about the foggy feeling that comes with allergy season in general.

In part two of our live recordings from the AAAAI conference in Philadelphia, Kortney and Dr. Payel Gupta talk to allergists from across the US about what they actually think about antihistamines.

What we cover in this episode about antihistamines:

Non-drowsy does not mean the same thing for every antihistamine. Zyrtec, Claritin, and Allegra are all labeled non-drowsy, but some are more likely to make you sleepy than others.

Why allergists have moved away from Benadryl. First-generation antihistamines cross into the brain more easily, causing drowsiness and a range of other side effects that are far less common with newer antihistamines.

The foggy feeling might not be your medication. Congestion from untreated allergies disrupts your sleep, and poor sleep creates its own fog. Sometimes it is the disease, not the drug.

Timing your antihistamine makes a real difference. Taking it before you head out gives it the best chance to work. And if it makes you drowsy, switching to a nighttime dose is a simple fix.

Not all second-generation antihistamines are approved for pilots. Fexofenadine has the lowest penetration into the brain of any antihistamine tested, which is why the FAA cleared it as the only option pilots can take while flying.

Second-generation antihistamines (non-sedating or minimally sedating)

Cetirizine — Zyrtec

Loratadine — Claritin, Alavert

Fexofenadine — Allegra

Levocetirizine — Xyzal

Desloratadine — Clarinex (prescription only)

First-generation antihistamines (sedating)

Diphenhydramine — Benadryl, ZzzQuil, Unisom

Chlorpheniramine — Chlor-Trimeton

Brompheniramine — Dimetapp

Dimenhydrinate — Dramamine

Hydroxyzine — Atarax, Vistaril (prescription only)

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. Mansi Kotwal, Instagram

Dr. Lauren Davidson, Instagram

Dr. Joel Brooks, LinkedIn

Dr. Pratibha Vakharia, allergyv.com

Dr. Rathika Gupta

Dr. David Wertheim

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.

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 sinusitis without nasal polyps is the most common form of chronic sinusitis. Even so, most patients spend years without a clear explanation, cycling through antibiotics that do not address what is actually going on.

In this episode, Kortney and Dr. Payel Gupta are joined by Dr. Michael Blaiss and Dr. Anju Peters, an allergist and immunologist at Northwestern University who co-authored the 2025 Adult Sinusitis Clinical Practice Guideline. Together, they break down what chronic sinusitis without nasal polyps (CRSsNP) actually is, what the real quality-of-life impact looks like, and how a proper diagnosis is confirmed.

What we cover in this episode about chronic rhinosinusitis without nasal polyps

Not an infection. Chronic sinusitis without nasal polyps is driven by inflammation lasting 12 weeks or more, not by bacteria or a virus, which is why antibiotics often do not help.

The hidden quality of life burden. Beyond congestion and sinus pressure, patients commonly experience fatigue, poor sleep, anxiety, depression, and social isolation.

Why so many patients go years without a correct diagnosis. Symptoms overlap significantly with conditions like allergic rhinitis or migraines. Many patients adapt to feeling unwell rather than seeking answers.

How doctors confirm the diagnosis. A diagnosis requires objective evidence of inflammation, as seen on nasal endoscopy or a CT scan of the sinuses, not symptoms alone.

The connection between sinusitis and asthma. The nose, sinuses, and lungs share one connected airway, and about 60% of people with this condition also have asthma, with each capable of making the other worse.

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Made in partnership with The Allergy & Asthma Network.

Thanks to Insmed 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

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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.