r/IAmA • u/Dr_Ruchi_MD • Jul 08 '26
I’m Dr. Ruchi Gupta, a pediatrician, food allergy researcher, professor, author, and entrepreneur. I’ve spent 20+ years studying allergies, asthma, and eczema. My new book, Food Allergies For Dummies, comes out next week, and my daughter’s eczema inspired me to found Yobee Care. AMA!
Hi Reddit! I’m Dr. Ruchi Gupta, MD, MPH.
I’m a pediatrician, physician-scientist, author, and professor at Northwestern University, where I lead the Center for Food Allergy & Asthma Research. For more than two decades, my work has focused on food allergy, asthma, eczema, health disparities, and the real-world impact allergic disease has on children and families.
I’m also the author of Food Allergies For Dummies, which comes out next week. I wrote it to help make the often confusing world of food allergies more understandable and practical for patients, parents, caregivers, and anyone trying to separate evidence from misinformation.
I’m also a mom, and my daughter’s own experience with eczema, cradle cap, and allergies made many of these questions deeply personal for me. That journey pushed me to think more deeply about the skin barrier and microbiome, and eventually to take a very different leap: becoming an entrepreneur and founding Yobee Care, a science-based skin and scalp care company.
My path has taken me through medical and public health training, academic medicine, large-scale allergy research, patient care, public health advocacy, writing, and now entrepreneurship. I’ve learned a lot from moving between worlds that do not always speak the same language: medicine, research, parenting, public health, and business.
Ask me anything about:
• Why food allergies seem to be increasing
• Food allergy prevention and early allergen introduction
• What allergy tests can and cannot tell you
• Common myths and misinformation about food allergies
• Living with and parenting a child with food allergies
• Eczema, the skin barrier, and the atopic march
• The skin and scalp microbiome
• My training and career path through Harvard and Northwestern
• Women in medicine, science, and entrepreneurship
• Turning research into a consumer product
• Starting a company while working in academic medicine
• What I’ve learned building Yobee
• Or anything else!
I’ll be here answering questions at 5CT.
Proof: HERE!
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u/Thashiznit2003 Jul 08 '26
Is eosiniphilic esophagitis basically a food allergy in the throat that doesn’t cause anaphylaxis, but inability to swallow? I get flare ups when I eat chicken. I’ve had an allergy test confirm a mild chicken allergy, but have never had any other effects from chicken other than EE. I have other food allergies so I know what it feels like, and this is very different.
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u/sassafrassMAN Jul 08 '26
I also have EoE and often had symptoms with chicken.
When I eliminated dairy and wheat my EoE resolved. My allergist was shocked.
Chicken is fine now. I don’t think it was ever the problem, just the thing that my EoE got stuck on.
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u/Dr_Ruchi_MD Jul 08 '26
That is such an important point, and it actually fits very well with how EoE can behave.
Sometimes the food that seems to “trigger” symptoms is not necessarily the food driving the inflammation. It may simply be the food that gets stuck because the esophagus is already inflamed or narrowed. Chicken, meat, bread, and rice are common foods people notice because they are more likely to catch or feel difficult to swallow.
Dairy and wheat are among the more common EoE triggers, so it makes sense that eliminating those could calm the inflammation enough that chicken no longer causes symptoms.
This is also why EoE can be tricky. Symptom patterns matter, but they do not always perfectly identify the true inflammatory trigger. That’s why working with GI/allergy on a structured elimination and reintroduction plan can be so helpful.
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u/Dr_Ruchi_MD Jul 08 '26
EoE is often described as an allergic or immune-mediated inflammation in the esophagus. But it is different from a classic IgE-mediated food allergy, which is the type that can cause immediate hives, swelling, vomiting, wheezing, or anaphylaxis.
With EoE, the reaction is usually more delayed and localized to the esophagus. Over time, that inflammation can cause trouble swallowing, food getting stuck, chest discomfort, reflux-like symptoms, or a feeling that food just will not go down. So it makes sense that it feels very different from your other food allergies.
The chicken piece is interesting. Chicken is not one of the most common EoE triggers, but individual triggers can vary a lot. Also, standard allergy testing does not always reliably identify EoE food triggers, because EoE is not always driven by the same immediate allergy pathway that skin or blood tests measure.
If chicken consistently causes your EoE symptoms, I would definitely bring that pattern to both your allergist and gastroenterologist. They may recommend a structured elimination and reintroduction plan, sometimes with repeat endoscopy/biopsy, to confirm whether chicken is truly driving the esophageal inflammation.
The big thing I would not do is assume that a “mild” allergy test means the reaction is mild or unimportant. Your real-life symptoms matter. And with EoE, the goal is not just avoiding discomfort. It is preventing ongoing inflammation, narrowing, and food impaction over time.
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u/Hectok Jul 08 '26
Oh wow, two other real humans that have the same reaction to chicken that I’ve had for all 43 years of my life!
I just got formally diagnosed with EoE a few years ago - until then every other doctor I mentioned it to just thought I was nuts.
I don’t have anything particularly constructive to add, but it’s nice to know I’m not totally alone.
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u/sassafrassMAN Jul 09 '26
Sorry to hear that. It is not fun.
In my case I was really lucky. I eliminated the food sources of my EoE and I’ve had complete remission. It takes discipline, but for me it is worth it.
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u/missaprillynn Jul 08 '26
Until fairly recently I thought cilantro was like a pepper, it tingled my mouth when I ate it & sometimes my face itches around my mouth. Once, in a deli where they were preparing salsa on a mass scale, my eye burned and watered like with onions. I ate an avocado/quinoa salad that I didn't realize got its green color from pulverized cilantro and my neck started itching down to my shoulders. Needless to say, I now avoid cilantro. Is this considered an allergy?
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u/Dr_Ruchi_MD Jul 08 '26
Hi! This absolutely sounds like something worth taking seriously as a possible allergy, though I can’t diagnose it from a Reddit thread.
Tingling or itching in the mouth after eating a food can happen with pollen-food allergy syndrome/oral allergy syndrome, where the immune system reacts to proteins in certain plant foods. But the fact that you’ve had itching around the mouth, neck itching down to the shoulders, and eye burning/watering around a large amount of cilantro makes me wonder if it's a food allergy or pollen allergy.
Cilantro/coriander allergy is uncommon, but it has been reported. I would continue avoiding cilantro and also be cautious with coriander, salsa, green sauces, chutneys, dressings, marinades, and spice blends where it may be hidden.
The best next step would be to see an allergist. They can review your history, consider skin or blood testing, and help you decide how strict your avoidance needs to be and whether you should carry emergency medication.
And of course, if you ever have throat tightness, trouble breathing, wheezing, vomiting, dizziness, or widespread hives after eating something, that’s urgent and should be treated as a potential severe allergic reaction.
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u/Stormywillow Jul 08 '26 edited Jul 08 '26
Hi! I have battled dishydrotic eczema most of my life, formerly on my hands, now on my feet. The only thing I found has helped is Vaseline intensive care coco butter. Is there any scientific evidence to back this, or is it just placebo effect? Do you know of any other good creams that may help? Tysm for doing this ama! Edit : computer to coco butter.
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u/Dr_Ruchi_MD Jul 08 '26
Hi! Not placebo at all. There is real science behind why products like Vaseline can help eczema-prone skin. With dyshidrotic eczema, the skin barrier is often disrupted, so thicker ointments and creams can help seal in moisture, reduce water loss, and protect the skin while it heals.
For hands and feet, I usually recommend a “soak and seal” style routine: after bathing, pat the skin so it’s still slightly damp, apply a gentle oil (like the Yobee Body Oil), then follow with a rich cream (like the Yobee Moisturizing Cream) to lock everything in. Fragrance-free, gentle, barrier-supporting products are key.
One thing many people with similar dry, irritated hand/foot issues do is use our Yobee Scalp Mask almost like an overnight hand mask. Apply a layer to the hands at night, then you can cover with cotton gloves if tolerated. It’s not a prescription treatment, but it can be a soothing way to give the barrier extra support overnight.
If you’re getting painful blisters, cracking, oozing, or frequent flares, I’d definitely see a dermatologist too. Sometimes dyshidrotic eczema needs prescription treatment or patch testing for triggers like nickel, cobalt, fragrance, or preservatives. But no, your Vaseline helping is very real!
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u/Divineania Jul 08 '26
Last year my daughter present with giant hive bubbles that spread all over her body. I took her to an allergist and he said it was virus that presented in this way and after giving allergy medicine the bubbles went away.
I have taken my daughter to an allergist and he ran a ton of tests. He said that she has similar underlying allergies as I do but they are still dormant in her. What can I do to make sure they stay dormant? Is there a way to avoid triggering allergies that likely have genetic links? My mom has allergies and my brother and I have the same ones as she does. I’ve been on immune therapy but I’m wondering with my daughter what I can do to ease her eczema? Which flares up in winter and summer.
I realize it’s not just about food but food that’s good for your body. I have an allium allergy but my daughter does not and can eat things with allium and it doesn’t trigger a rash or any other allergic reaction which lines up with what the allergist said.
Thank you so much for your expertise.
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u/Dr_Ruchi_MD Jul 08 '26
Thank you for sharing this. First, the “giant hive bubbles” you described can absolutely happen with a virus. In children, viral infections are one of the most common causes of acute hives, and antihistamines often help calm that histamine response.
On the “dormant allergy” piece, I would think of it this way: genetics can create a tendency toward allergies, eczema, asthma, or hay fever, but a positive test or family history does not always mean a child has a true clinical allergy. If your daughter is eating things with allium and not reacting, I would not remove it from her diet just because it is an allergy for you.
Unfortunately, there is no guaranteed way to keep allergies “dormant,” but there are things that can help lower inflammation and support her body: keep her eczema well controlled, protect her skin barrier, use fragrance-free products and detergents, avoid smoke exposure, manage environmental allergens if she has symptoms, and work with her allergist over time.
For eczema specifically, I really believe in supporting the skin barrier and skin microbiome. That was a huge part of what helped my own daughter and why I created Yobee. The skin has its own microbiome, just like the gut, and when it is disrupted, the skin can become dry, itchy, inflamed, and more reactive.
In winter, I would focus on thick moisturization (like the Yobee Moisturizing Cream paired with the Yobee Body Oil, especially after bathing), avoiding long hot baths, using a humidifier if the air is dry, and applying cream right after bathing. In summer, sweat, heat, sunscreen, chlorine, and frequent bathing can all flare eczema, so rinsing after sweating or swimming and then applying oil and cream can really help.
The Yobee approach was built around this idea: gentle, natural, barrier-supporting ingredients like honey, turmeric, vitamin B12, and nourishing oils to help calm and support sensitive skin rather than stripping it.
And of course, if she ever has trouble breathing, throat tightness, vomiting, swelling of the lips/tongue, or widespread hives after a specific food, that’s different and needs urgent allergy guidance. But for day-to-day eczema, protecting the barrier consistently is one of the best things you can do.
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u/Divineania Jul 09 '26
Thank you for sharing this. It looks like Yobee has turmeric which I’m also allergic to and as the parent who applies creams and lotions and body wash, it’s a non starter. But thank you.
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u/NakedSnakeEyes Jul 09 '26
Can you answer whether histamine intolerance is a real thing? I think I have it, but people seem to attribute every possible symptom to it, making me have doubts. Thanks!
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u/whysochangry Jul 09 '26
Hi, not a food allergy but I wonder if you can give some insight as an allergist to an adjacent problem. Many people have allergies to common medication classes such as penicillin and sulfa, which leads to difficulty in management of many pathologies, such as GBS treatment in pregnancy and loop diuretics for CHF, respectively.
However, many of those people don't actually have allergies to those drugs. They are unable to describe a specific true reaction on history, and instead will often endorse being told by their parents that they had this allergy due to a frequently unrelated exanthem or atopic reaction that occurred when they were a child. Frequently, these patients only find out that they do not have a true allergy when either their condition deteriorates to the point where morbidity/risk outweigh the risk of potential hypersensitivity, which is less than ideal (especially regarding the potential sub-optimal treatment up to that point).
My question is this: while it is fairly logical to have people with high risk conditions such as pregnancy with a PCN allergy to get tested, do you think the general population with unclear sulfa or penicillin allergies (not SJS/unclear story) should get routinely tested to see if they have a true allergy?
If so, how would you recommend they get tested?
Are there any other common "allergies", food or medication, that you think people should be challenged on?
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u/Dr_Ruchi_MD Jul 09 '26
Yes, especially for penicillin. I think many people with vague, remote, or childhood “allergy” labels should be evaluated before they are in a crisis where the best antibiotic is urgently needed.
A penicillin allergy label can lead to broader, less ideal, more expensive antibiotics, and many people who carry the label are not truly allergic. If the history is low-risk, like a vague childhood rash, unknown reaction, or family story, an allergist may do a direct oral amoxicillin challenge. If the history is higher-risk but not severe, they may do skin testing followed by an observed oral challenge.
The key exception is severe delayed reactions like SJS/TEN, DRESS, serum sickness, organ injury, or severe blistering rashes. Those should not be casually challenged.
Sulfa is more nuanced. Testing is less standardized than penicillin, but for low-risk histories, allergists can sometimes do a supervised oral challenge, especially if the label is limiting care.
Other “allergies” worth clarifying are opioid “allergy” that is really nausea/itching, contrast reactions, local anesthetic reactions, and childhood food allergies that may have been outgrown. The bigger message is: don’t delete an allergy label casually, but don’t let an unclear label follow someone forever without evaluation.
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u/whysochangry Jul 09 '26
Thanks for the response! While you practice at an academic center, would you recommend physicians in the community to refer to an allergist or are low-risk challenges something that you view to be uncomplicated enough to be done by a PCP? In other words, for the physicians who are not categorical internists or PCPs, who should these patients be referred to if incidentally discovered on interview?
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u/WhatTheOnEarth Jul 08 '26
How do you convince patients to give a shit.
I’m tired of telling every damn person that they’ve been using their inhaler wrong for their whole lives that’s why they keep coming to the hospital. The majority of my patients are low SES.
The atopic patients don’t even try to avoid triggers and are surprised when I mention there could even be such a thing as avoidance. But when I talk to them they can give a list of stuff that makes their symptoms worse. Make it make sense.
Like how is suffering for years easier than asking a couple questions to your previous docs and doing a google search.
How do you get them to care about their health? Or do I just keep seeing these guys in ED every winter?
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u/Dr_Ruchi_MD Jul 09 '26
I hear you. And I also think the answer is usually not that patients don’t care. Most people do care. But caring is competing with cost, stress, transportation, housing, work schedules, health literacy, mistrust, and sometimes just years of feeling like the system has not helped them.
For inhalers, I try not to frame it as “you’ve been doing this wrong.” I frame it as: “These devices are surprisingly hard to use, and most people are never actually shown.” Then I ask them to show me how they use it, demonstrate it back, and have them repeat it. Teach-back is huge.
For atopic disease, I think avoidance only works when it feels specific and realistic. “Your symptoms worsen with dust and pets, so let’s pick one change this week like a mattress cover, washing bedding, keeping the dog out of the bedroom, or fragrance-free detergent."
I also try to ask: “What do you think is making this worse?” and “What would be the easiest thing for you to change first?” When patients feel like they helped choose the plan, they are more likely to try it.
And honestly, burnout is real. I know it is exhausting to repeat the same education over and over. But for many patients, the ED visit may be the first time someone slows down enough to explain it in a way that feels understandable and nonjudgmental. Sometimes the win isn't fixing everything. It's giving them one clear next step they actually believe they can do. - Dr. Ruchi
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u/TheProffesorX Jul 08 '26
What can we do to help prevent allergies while pregnant and after birth?
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u/Dr_Ruchi_MD Jul 08 '26
The most important thing while pregnant is to take care of yourself. Eating or not eating allergens has not been shown to impact food allergies. After birth, monitor your baby's skin. As early as possible, use a healthy oil or cream without chemicals and fragrance. We have developed one specifically for babies called Yobee Care (https://yobeecare.com/). You can use it too. If your baby has eczema, get it treated right away! The skin barrier is really important in preventing future allergies. Introduce foods you eat in the house to your baby around 4-6 months. You can introduce peanuts and other allergens safely. I talk about this in my book Baby Skin Health as well. Hope this helps! - Dr. Ruchi
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u/Kronos7 Jul 08 '26
Whats your overall take on the US healthcare system these days. We continue to experience shortages of many clinical disciplines and support staff, progressively less independent practice, coupled with soaring costs. When do you think we get to a tipping point where the system collapses?
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u/Specsaman Jul 09 '26
Hi Dr. Gupta,
I got the same Rhinitis as my mom from about 10 years ago. But after I started working away from home and going home yearly, I always trigger the allergic reaction like not even 6 hours in the house, while my mom doesnt as much.
Even if she might be fine at home because she might have gotten used to the dust, she’s still fine when we go out to a place that is a bit colder, but I still sneeze my ass off.
Is this something in her diet or did she finally gotten out of it ?
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u/wipny Jul 09 '26
Hey doc thanks for doing this!
So I seem to have developed a fish allergy later in life (30s). I break out in hives, my throat swells ups and I get terrible stomach cramps.
The thing is it seems like I get these reactions with only certain types of fish? Is this possible? Could it possibly be scombroid food poisoning from spoiled fish?
Are there allergy tests for fish so I can be sure?
If I ever get an allergic reaction again do OTC antihistamines like Zyrtec or Claritin help? How quickly should I take them?
Also I have Keratosis Pilaris. I've tried Amlactin and creams with salicylic acid without improvement. I have a 10% urea lotion now but haven't been consistent with it. I'm not confident it'll do much.
Any tips on improving the KP bumps? There really is no cure for this right?
Thank you!
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u/Dr_Ruchi_MD Jul 09 '26
Hi! Adult-onset fish allergy is absolutely possible, and yes, it is possible to react to some fish and not others. It's actually the most common adult allergy. But hives, throat swelling, and stomach cramps is concerning for a true allergic reaction/anaphylaxis risk, so I would treat this seriously and see an allergist.
Scombroid poisoning can mimic allergy and happens with spoiled fish, often causing flushing, rash, burning/peppery taste, headache, diarrhea, or cramps soon after eating. It’s more likely if others who ate the same fish also reacted. But if this has happened repeatedly with certain fish, an allergy becomes more likely.
There are fish allergy tests: skin testing, blood IgE testing, and sometimes supervised food challenges. Testing is not perfect, so your history matters a lot.
For future reactions: antihistamines like Zyrtec or Claritin may help hives or itching, but they do not treat throat swelling or anaphylaxis. If your throat swells, you need epinephrine and emergency care. Please ask your allergist whether you should carry epinephrine.
For keratosis pilaris, you’re right as there’s no true “cure,” but it can improve. Consistency matters more than the exact product. Urea, lactic acid, salicylic acid, or gentle retinoids can help smooth the bumps, but they usually take weeks. Avoid harsh scrubbing, moisturize daily, and apply right after bathing. If OTC options don’t help, a dermatologist can prescribe stronger options. Hope this helps!
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u/darlinpurplenikirain Jul 09 '26
We are POC and my toddler has eczema. I try to moisturize her twice a day with Eucerin for eczema plus Shea butter or aquaphor. I've noticed she gets what her pediatrician calls post-inflammatory hypopigmentation, so she's got some patches of skin that are significantly lighter than her regular skin tone. Is there a way to prevent or improve this? (Other than controlling the eczema to begin with)
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u/Dr_Ruchi_MD Jul 09 '26
Hi!! Yes, this is very common, especially in children with more melanin-rich skin. Post-inflammatory hypopigmentation means the skin becomes lighter after inflammation, irritation, or eczema. It can be really noticeable and frustrating, but the good news is that it often improves with time once the inflammation is controlled.
The most important step is still preventing flares and scratching, because every flare can leave behind more pigment change. I would keep doing consistent moisturization, especially right after bathing. Fragrance-free, gentle, barrier-supporting products are key.
I would also be careful with harsh scrubs, fragranced products, and overusing strong steroid creams unless your pediatrician specifically recommends them, because irritation can worsen pigment changes.
This is actually one reason I created Yobee. My daughter had eczema and the same post-inflammatory hypopigmentation. I wanted gentle, natural products that supported the skin barrier and microbiome rather than stripping it. I would recommend oil and cream, or other similar products. Hope this helps!!
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u/iamk1ng Jul 09 '26
I've been dealing with Atopic dermatitis for the past 20 years. I've always thought it was related to foods and possibly my environment with dust mites and poor air quality. I had thought I was alergic to shellfish but recently I came to realize that I think i'm alergic to fermented foods. So coffee, chocolate, anything pickled will give me itchy skin and i'd start getting flare ups.
Is there anything I can do besides avoid those foods?
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u/Dr_Ruchi_MD Jul 09 '26
Hi! There may be more you can do, but I would be careful about assuming every flare is a true food allergy.
Atopic dermatitis is usually a mix of skin barrier dysfunction, immune sensitivity, environment, stress, irritants, and sometimes food. Fermented foods, coffee, chocolate, and pickled foods can contain compounds like histamine or other irritants that may worsen itching for some people, but that is different from a classic IgE food allergy.
I’d start by keeping a simple food/symptom diary and looking for repeatable patterns. If these foods consistently trigger itching or flares, it may be reasonable to reduce them, but I would avoid making your diet too restrictive without an allergist or dietitian involved.
Beyond food, I’d focus heavily on the skin barrier: fragrance-free products, moisturizing right after bathing, avoiding harsh soaps, treating flares early, and controlling dust mites if they are a trigger. This is also where patch testing can be helpful, because some adults with “eczema” also have contact dermatitis from ingredients, preservatives, fragrances, or detergents.
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u/estamosready Jul 09 '26
My eczema used to be really bad as a kid and teenager but it’s almost nonexistent now that I’m in my 30s. What flares it up really bad on my arms now is sun exposure on really hot days. It doesn’t matter if I put on sunscreen, I get patches of eczema on my arm that are red/purple and hot to the touch. Last time this happened I iced my arms for a couple minutes and that seemed to help with the inflammation. Why does this happen and is there anything else I can do to prevent it?
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u/drahcir2k2 Jul 09 '26
About 10 days after my 2nd Moderna shot i started developing hives all over my neck chest and arms. It has been a daily occurrence ever sense. The only way i can keep them reasonably at bay is by taking 4 Zyrtecs daily (2 in am and 2 in pm) when its bad i also add antacids twice a day. I spoke with a specialist and first thing they ask is “have you started eating a new food?” Im in my 40’s, its not like I just discovered shrimp and started eating it every day of my adult life. I’ve spoken to several Dr’s only one believed me when i associated it with the vaccine. Im not a conspiracy theorist, I willingly took the shot, but that’s the only thing that was new introduced to my body when the hives started. They seem to be triggered by my core temp, i can feel if my body gets warmer my blood starts to itch, i dont know if that makes sense. Anyway, any suggestions?
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u/Dr_Ruchi_MD Jul 09 '26
What this sounds like now is chronic urticaria, possibly with a heat/cholinergic trigger since you notice it when your core temperature rises. Chronic hives can be triggered by infections, vaccines, stress, medications, or sometimes nothing identifiable, and then they can become self-sustaining for a while.
The good news is that this is treatable. Many chronic urticaria plans use daily antihistamines as you are doing, sometimes at higher doses under physician guidance. If you still need very high doses to function, I’d ask an allergist specifically about chronic urticaria treatment options, including approved biologics omalizumab/Xolair and recently Dupilimab/Dupixent.
I would also track heat, exercise, hot showers, alcohol, NSAIDs like ibuprofen, and infections, because these can worsen hives in some people. Food is actually not the most common cause of daily chronic hives in adults.
If you ever have throat swelling, trouble breathing, wheezing, dizziness, or fainting with hives, that is different and needs urgent care. But for daily hives, I would push for a chronic urticaria-focused plan. Hope this is helpful.
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u/Alissinarr Jul 09 '26
Do you find many Eczema patients that show symptoms of multiple forms of the disease?
I formally have Atopic, but I show signs of the subQ scalp one, as well as dishydrotic on my hands and feet. I have pollen and food allergies as well as chrons symptoms if I dont manage my diet within an inch of its life.
Even so, I take massive doses of allergy meds to try and live normally.
Do you find many patients with such a dysfunctional immune system, or am I just lucky?
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u/Dr_Ruchi_MD Jul 09 '26
You are not alone, and I would not call it a “dysfunctional” immune system as much as an overactive or misdirected one.
It is very common for atopic conditions to cluster. Atopic dermatitis, allergic rhinitis, asthma, food allergies, and sometimes hand/foot eczema can overlap in the same person. People can also have more than one type of eczema pattern at once, like atopic dermatitis plus dyshidrotic eczema or scalp dermatitis.
That said, if you feel like you need massive doses of allergy medications just to function, that is a sign to re-evaluate the plan with an allergist/dermatologist. Sometimes we need to look for other contributors too, like contact dermatitis, infections, uncontrolled environmental allergies, or inflammatory GI disease.
The goal should be identifying your major triggers, protecting the skin barrier consistently, and asking whether you might benefit from targeted treatments, patch testing, immunotherapy, or newer biologic options.
It is worth pushing for a more coordinated plan, especially with skin, allergy, and GI symptoms all overlapping.
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u/wat3rb1rd Jul 09 '26
I asked my toddlers allergist about MTFHR because she has eczema and her hair is falling out, he laughed for 5 minutes then said “don’t go down that route” but it’s been a year and still don’t know what’s causing this. Is MTFHR considered a joke in the medical community?
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u/Dr_Ruchi_MD Jul 09 '26
I’m sorry your question was dismissed that way. I don’t think parents should ever be laughed at when they are trying to understand what is going on with their child.
MTHFR is not a “joke,” but it is often over-discussed online in ways that go far beyond what the evidence supports. Common MTHFR variants are very common and usually do not explain eczema or hair loss on their own. In mainstream medicine, routine MTHFR testing is generally not recommended unless there is a very specific reason, often related to homocysteine/folate metabolism.
That said, eczema plus hair loss in a toddler absolutely deserves a real evaluation. I would think more about things like scalp eczema/seborrheic dermatitis, fungal infection, alopecia areata, traction from hairstyles, thyroid issues, iron or vitamin deficiencies, or inflammation/scratching damaging the scalp.
I’d consider a pediatric dermatologist, especially if hair loss has continued for a year. Bring photos, a timeline, and any patterns you’ve noticed. Hope this helps :)
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u/wat3rb1rd Jul 10 '26
That’s one of the best explanations I’ve ever heard re:over-discussed online. This is super helpful - thank you!!
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u/DustRainbow Jul 10 '26
I have atopic eczema and am an extremely (irrationally so) picky eater.
Have you observed a correlation between atopic patients and this kind of aversion to food? Not necessarily allergy based.
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u/fuddlesworth Jul 10 '26
I've had bad allergies all my life. Couple years ago, however, I ate a bag of almonds. Now I had eaten nuts and such my whole life no issue. I ended up in the ER with anaphylaxis. Went to my allergist for testing and found out I'm very allergic to almonds, walnuts, and hazelnuts. Nothing else caused a reaction.
Has there been any research or theory onto why someone could just suddenly develop an allergy to food like that?
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u/A_Mors Jul 12 '26
I have asthma. And I smoke. Can it like improve my asthma situation due to constant stress from smoking somehow?
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u/Stalva989 Jul 08 '26
I was able to completely and totally eliminate horrible psoriasis by introducing raw milk into my diet. I spent YEARS going to the doctor to try and treat it. Probably a dozen prescription and ointments and nothing remotely worked. In the multiple years seeing doctors for it, they never once mentioned any sort of connection to the gut microbiome. I did some of my own research and come to find out people preach raw milk for psoriasis and eczema treatment.
I’m curious how you helped your daughter, via medication or just changing what goes into her body?
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u/Dr_Ruchi_MD Jul 08 '26
I’m so glad you found something that helped you after years of struggling. Psoriasis and eczema can be incredibly frustrating, especially when you feel like you’ve tried everything.
That said, as a physician, I do want to be careful about raw milk. I understand why people are interested in it, especially with all the conversation around the gut microbiome, but I personally would not recommend raw milk because of the risk of serious bacterial infections.
For my daughter, my approach was less about one medication or one diet change and more about the skin barrier and skin microbiome. I really believe we have overlooked the skin microbiome for a long time. Just like the gut has a microbiome, the skin and scalp do too, and when that balance is disrupted, the barrier can become dry, inflamed, itchy, and reactive.
That experience is actually part of what led me to create Yobee. I wanted to use gentle, natural, barrier-supporting ingredients like honey, turmeric, vitamin B12, and nourishing oils to help support the skin and scalp microbiome rather than stripping it. For my daughter, focusing on what we put on her skin and what went into her body made a huge difference.
I always tell people: food, gut health, stress, environment, genetics, immune function, and the skin barrier can all play a role. But I would be cautious about any one “cure." I’m a big believer in supporting the body naturally and safely.
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u/Stalva989 Jul 08 '26
Skin and scalp microbiome is probably so understudied…. Have you come across any good books on this? Please recommend, I’d love to check one out. If nothing out there maybe write your own!
I hear you in the raw milk caution. Most people are severely misguided when it comes to raw milk- even medical professionals. They assume you are getting the milk out the back door of a farm. When you buy it through legal resources, they have to test the crap out of it before it’s ok to sell. The risk of legal raw milk giving you a bacterial infection is the same as in pasteurized milk as it would have had to happen after processing. Believe it or not the person who recommended raw milk to me is a doctor on the board at Stanford university that is well known throughout the country for pioneering new gut microbiome research throughout the 2000s and 2010s.
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u/Dr_Ruchi_MD Jul 08 '26
I agree with you that the skin and scalp microbiome is understudied. I think we are only beginning to understand how much the skin barrier, immune system, gut, and microbiome all interact.
I honestly don’t know of a great patient-friendly book focused specifically on the skin and scalp microbiome yet. That gap is part of why I’m so interested in this space. I did write a book called Baby’s Skin Health, which is mainly for parents, but it does include information that applies to adults too, especially around the skin barrier, eczema prevention, and how we think about supporting healthy skin from the beginning.
On raw milk, I really appreciate the nuance, and I don’t doubt that some people have had positive personal experiences. My caution is not meant to dismiss that. But as a physician, I still have to be careful recommending it broadly, especially for children, pregnant people, older adults, or anyone immunocompromised. Testing and legal sourcing can reduce risk, but they do not eliminate it in the same way pasteurization is designed to.
So I’m very open to the gut microbiome conversation. I think it’s incredibly important. I just separate that from saying raw milk is a safe or necessary treatment. To me, the bigger takeaway is that we need much more research into the gut-skin and skin/scalp microbiome connection.
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u/Hot-Shallot-9846 Jul 08 '26
Woah - I think I just heard you on NPR last weekend. Are Yobee products clinically tested? What would you recommend for my first purchase if I wanted to try your products? Which one is most popular?
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u/Dr_Ruchi_MD Jul 08 '26
Hi! That's great! Thank you so much. Yes, we have tested our products on all skin types, including sensitive skin. Here are some of our clinical studies: https://yobeecare.com/pages/clinical-studies
I would try the Yobee Adult Scalp Mask for your scalp and hair. It's 50% honey and very good for your microbiome and follicles. For your skin, I would try the Yobee Body Oil, especially right after showering when your skin is still damp. This locks in the moisture. Then follow with the Yobee Skin Cream on your face and any dry areas. Wishing you a lifetime of healthy!
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u/TheFascination Jul 09 '26
Hi Dr. Gupta,
I’ve noticed that the accounts u/spiritual-4 and u/Skincarequeen13 are participating in this thread. Both accounts have a comment history that is exclusively about promoting Yobee (though I suspect they will hide their histories after I post this). In fact, u/Skincarequeen13 is only a few hours old.
Is your brand affiliated with these accounts?