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Regina Barber
Hey, Shore, waivers. Real quick, before the show, let's talk about public media. Public media has been in the news a lot this year, and public media is what makes NPR shows like Short Wave Special it's made for you. When you listen to an NPR podcast, the people who make it aren't thinking about shareholders or advertisers. We're thinking about you and delivering on a promise to help you understand the.
Dr. Gina DePoul Hidalgo
World a little better.
Regina Barber
From its founding in the US Public media was always meant to tell stories from underrepresented communities, providing cultural insight that expands your perspective. At npr, we still believe all of that. We always will. But as of this fall, federal funding for public media, including NPR and local NPR stations, has been eliminated. And now we're heading into an uncharted future. But we know you won't let public media go away. We rely on your support to bring you shortwave now more than ever. This year, we have loved bringing you stories about what happens inside a top secret nuclear facility, whether kids should be taking melatonin, why flowers are blooming early, how nightmares work, and what happens when AI cannibalizes its own data. And we can't wait to bring you more episodes like that in 2026. So thank you if you already go the extra mile as an NPR supporter. If not, you can join the PLUS community. Get a bunch of perks like bonus episodes and more from across NPR Podcasts. Support public media by signing up for NPR today@plus.NPR.org you're listening to Shortwave from NPR.
Hey, Shortwavers, it's Regina Barber with a very important message. I hate allergies. Itchy nose, runny eyes. When my throat gets scratchy, it's like my own body is rebelling against me. And it's not just seasonal allergies. My allergies can strike when I'm cleaning the house, when I'm mowing the lawn, at any time of year, when I move to DC and after too many sneezes, I was like, it's time to take action. What is up with this?
Dr. Gina DePoul Hidalgo
So the idea behind allergies is that your body is overreacting to something harmless, Right? So we're not supposed to be allergic to pollens, cats, dogs, foods, drugs. But if you are, your immune system encounters these allergens and it's thinking danger danger when it's really something harmless.
Regina Barber
That's Dr. Gina DePoul Hidalgo. I, I invited her to the NPR studios because she's a pediatric and adult allergist in the D.C. suburbs. And she very patiently began our conversation with a recap of what allergies are.
Dr. Gina DePoul Hidalgo
You usually had to have been exposed to the allergen in the past. And it's that first exposure where your body ends up making allergic antibodies, what we call IgE, or immunoglobulin E, antibodies to those allergens.
Regina Barber
People's bodies have been doing this, encountering allergens, overreacting, creating these allergic antibodies for a long time, which means doctors have been trying to treat it for a long time.
Dr. Gina DePoul Hidalgo
Most patients, we end up recommending things like antihistamines, nasal sprays, eye drops, really more symptomatic treatments to help decrease your symptoms so you can, you know, be around the allergen and be somewhat okay.
Regina Barber
Claritin, Zyrtec, Allegra.
Dr. Gina DePoul Hidalgo
They're really temporary kinds of treatment options.
Regina Barber
But what if I told you there was another kind of treatment that worked for all but the most severe allergies, one that didn't just treat the the symptoms of your allergies, but the actual cause of them?
Dr. Gina DePoul Hidalgo
The idea is that you build tolerance over time by giving you what you're allergic to, you get desensitized to those allergens that you're being treated with. Unlike medicines, which only take care of the symptoms, allergy shots are actually training your immune system to react differently when you're exposed to the allergens.
Regina Barber
So today on the show Allergy Treatments, we're learning where our allergies come from, how they're detected, and even how to treat them so they're effectively gone. You're listening to shortwave from NPR.
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So, Dr. Gina.
Regina Barber
Can I call you Dr. Gina?
Dr. Gina DePoul Hidalgo
Yes, you can call me Dr. Gina.
Regina Barber
Excellent. Let's start with allergies. I was well into my adulthood when I finally, like, did the allergy panel to check if I had allergies. Cause I suspected. Can you, for our listeners, tell us how does this test work? Yes.
Dr. Gina DePoul Hidalgo
So how it works is that we're actually introducing these allergens into your skin. There's different forms of testing, but the main common one is what's called a skin prick.
Regina Barber
Yeah. It looks like a meat tenderizer. Just boom. On your skin.
Dr. Gina DePoul Hidalgo
Right on the skin, yes. So the idea is that by exposing your skin to that, if your body has made those allergic IGE antibodies, it recognizes it, it binds to it, and then within 15, 20 minutes, you get a little red itchy spot at the site of where those allergens are.
Regina Barber
Yeah, I found out I was allergic to. Let me read this, starting from most intense to least intense. Basically all grasses, dust mites, some tree pollen and weeds. Cats. I have four cats. Cockroaches, equal to cats, feathers, mosquitoes.
What's happening in my body when I encounter these allergens?
Dr. Gina DePoul Hidalgo
So what happens when you encounter the allergen is that your body is exposed to that allergen. Let's just use cat, for example. And then the IGE is waiting for its partner, and then it binds to that allergen. That ige again, is an immunoglobulin E, which is the allergic antibody. And then within 15, 20 minutes, it releases chemicals like histamine, prostaglandins, leukotrienes. It's these chemicals that actually cause the symptoms that are related to allergy within 15, 20 minutes.
Regina Barber
The itchy, the water. Yes.
Dr. Gina DePoul Hidalgo
Itching, congestion, sneezing, all of that.
Regina Barber
So why am I not bothered by my four cats? Like, I've had four cats for the last year and a half and I'm just not that bothered by it. But it's like in the middle of my, my allergy spectrum of like.
Dr. Gina DePoul Hidalgo
Of reactivity.
Regina Barber
Of reactivity. Yeah.
Dr. Gina DePoul Hidalgo
Got it. So the fact that you don't have symptoms means that you might not have a clinical allergy or clinical significance to the allergy test, but you're primed for. So there may be certain breeds of cats, for example, that you might have issues with. Yes. And maybe not necessarily your cats. So it's the idea of you've made these allergic antibodies that are waiting on your mast cells, and then when you are exposed to it, there are certain ones that may say, oop, I'm going to be releasing my histamine from these mast cells and cause the symptoms. So the way to see it is that you are sensitized, meaning you were exposed to it. Your body made those allergic antibodies. But now not everybody actually has a clinical reaction, but a majority of people do.
Regina Barber
Oh, wow. I was also fascinated. I asked the doctor this, the allergist. I do feel like, a little bit bothered by them, but not a lot. And he's like, well, you'll notice if you go on a long trip and come back.
Dr. Gina DePoul Hidalgo
And come back. Exactly.
Regina Barber
So why is that?
Dr. Gina DePoul Hidalgo
So we have people, you know, who really experience that. For example, you lived with a cat, and then you go off to school, and then you come back home and all of a sudden, like, to college. Yes, to college. And then you come back home for break or the summers, and you're like, oh, my goodness, why am I having this? And, you know, the opposite of allergy is tolerance.
Regina Barber
Yeah. Okay.
Dr. Gina DePoul Hidalgo
So when you're exposed to something quite frequently, then you're not going to be allergic to it because your allergic antibodies are not going to be, you know, releasing these chemicals all the time. So if you are around something, then it's likely that you're more tolerant to it than allergic.
Regina Barber
And. But those. That panel still picked up that I am allergic to cats.
Dr. Gina DePoul Hidalgo
I wouldn't say allergy necessarily, but that you're sensitized to it.
Regina Barber
So this is where this idea of, like, allergy immunotherapy, basically exposure therapy through allergy shots comes in. After I did that allergy panel we were talking about, the allergist came back and he was like, oh. And he was like, wow, you would be a great candidate for allergy shots. And I had never heard of these shots before. So can you tell me a little bit about the history, like, who first came up with these allergy shots and when?
Dr. Gina DePoul Hidalgo
So it was actually introduced over 100 years ago. So in 1911, a brave British physician named Dr. Leonard Noon started purifying the grass extracts because he hypothesized that there's some toxin. They used the word toxin back then, that there was some kind of toxin that was causing these symptoms and that by inoculating these patients with increasing doses of grass pollen, that it would decrease the symptoms and desensitize them. And so those were the first reports in the early 1900s that allowed us to see what we now call allergen immunotherapy and allergy shots. That's the history behind when it started.
Regina Barber
Yeah, and it's since developed. So how has it changed then? As you know, time has gone on.
Dr. Gina DePoul Hidalgo
So now it's more refined. There are actually companies that make the allergen. You know, they grow the pollens, they grow the plants, and it's purified and extracted so that it's much more refined than when it was many, many years ago.
Regina Barber
Got it. Okay, so can you tell our listeners like how that process works? Like it's not just one shot, it's a series of shots?
Dr. Gina DePoul Hidalgo
Yes. So there's different protocols, but exactly what you're going through is the typical, you know, standard schedule. So the idea is that you're starting off with very dilute doses and then you come once a week for several months. And then at some point when you reach this target dose or maintenance dose, then you can come every two to four weeks, depending on the protocol. So it's two phases, what we call the buildup phase, which is all that going once a week, coming, coming, and then, then there's the maintenance phase, which is then the once every four weeks. And the idea is once you get to that maintenance dose, the amount that's in that maintenance dose has been calculated. So it contains the amount that has been shown to be effective.
Regina Barber
But does it always work? Like, am I cured? Like do I have to do shot every month for the rest of my life or no.
Dr. Gina DePoul Hidalgo
So this is something we get asked all the time. So the idea is that by getting to the maintenance dose, you actually we recommend about a three to five year.
Regina Barber
Therapy of just going once a month. Yes.
Dr. Gina DePoul Hidalgo
And there is no cure for allergies per se, which is why we can't say this is going to cure you.
Regina Barber
But I was telling everyone that I'm like, these shots are going to cure me.
Dr. Gina DePoul Hidalgo
And they're like, no, the closest thing to a cure. But in general it's long lasting effect. And I have had some patients who did this years ago because. Right. This has been out for a over 100 years. Some that did this in their like middle elementary school. They'll come back to me in their 60s and say, oh, Dr. Gina, I want to start shots again because I feel like my Symptoms have come back. So in that case, that was decades of being asymptomatic to their allergen. So again, it's very individualized, which is why we can't say, oh, you know, this will cure you. But really, the percentage that we really tell patients, it's anywhere from 80 to 90% effective for those who start shots.
Regina Barber
Okay. So, you know, I'm not asking for myself, just for a friend, like, is there any side effects from these allergy shots that I've been taking?
Dr. Gina DePoul Hidalgo
So there is the potential for something to happen in the sense that you can get a little swelling at the site of where the injection is.
Sponsor/Advertisement Voice
Right.
Dr. Gina DePoul Hidalgo
Because technically those are the allergens being introduced. But another potential reaction can be what we call a systemic or anaphylactic reaction, where it's whole body reaction, you know, from hives, trouble breathing, nausea, vomiting, swelling, which is very, very rare if it's again administered safely. But all of these side effects are typically mitigated because you are usually observed for a certain period of time.
Sponsor/Advertisement Voice
You are.
Regina Barber
Yeah. They're like, gina, you should stay here for a little while. And I had to do that four times in a row.
Dr. Gina DePoul Hidalgo
Exactly. So there's an observation period to make sure that these reactions don't happen. And of course, wherever you are getting the allergy shots, there's usually trained staff. So if something were to happen, again, very, very rarely, we're able to administer the proper treatment to reverse it. Right.
Regina Barber
So, you know, we've been talking a lot about cats. What about food allergies? Thankfully, I'm not allergic to any food. But are food allergens any different from the allergens we've been talking about?
Dr. Gina DePoul Hidalgo
So, yes, actually, the mechanism is the same, but the treatment is potentially different depending on what the allergen is. So there's no allergy shots for foods that is not yet available, but there is therapy that's called oral immunotherapy, where it's giving you increasing doses of the food, similar to how we talked about with allergy shots. But it's the food that you are actually getting increasing doses of orally. So some allergists practice this.
Regina Barber
This is, like, so interesting, right? Because I remember when I was pregnant with my daughter, this was more than 15 years ago, the advice that was being given to us was do not expose your kids to certain foods like peanuts and eggs and even strawberries before, like, I think, 1 years old or something like that. And I've noticed that the guidance has basically reversed since then in favor of the like early introduction. Why did that change?
Dr. Gina DePoul Hidalgo
Yes, so it's exactly what you're saying, which is we didn't have it. Right, Right. So it was like 2008. Ish.
Regina Barber
2008. She was born in 2008.
Dr. Gina DePoul Hidalgo
Yes. And the guidance back then was avoid the allergenic foods until age 3. And we're like, okay, we're gonna avoid these allergenic.
Regina Barber
And then my Chinese mother just gave her everything and she was like, not even one. And I was like, well, I guess she's fine.
Dr. Gina DePoul Hidalgo
Yes. And so after those recommendations back then we saw this huge prevalence of peanut allergy and we're like, what is going on here? And then there was a game changing study in 2015 that was actually about a peanut allergy and high risk patients and babies. And they found that by introducing peanut between four to six months of age, but definitely before one of age, it actually decreased the incidence of peanut allergy in these high risk kids. So after then. So now for a decade we've been telling parents and you know, advising our pediatrician colleagues, early introduction of allergenic foods. Early introduction of allergenic foods.
Regina Barber
So my mom was right. Please don't tell her.
Dr. Gina, thank you so much for talking to us today.
Dr. Gina DePoul Hidalgo
Thank you so much for having me, Regina.
Regina Barber
If you like this show, we have done so many episodes on allergies. We'll link those episodes in the show notes. This episode was produced by Hannah Chin. It was edited by our showrunner, Rebecca Ramirez, and the facts were checked by Tyler Jones. Kwesi Lee was the audio engineer. Beth Donovan is our vice president of podcasting. I'm Regina Barber. Thank you for listening to Shorewave from npr.
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Com.
Date: December 9, 2025
Host: Regina Barber, NPR
Guest: Dr. Gina DePoul Hidalgo, Pediatric & Adult Allergist
This episode of Short Wave dives deep into the science of allergies: why they happen, how they’re diagnosed, and the most effective treatments available today. Host Regina Barber shares her own allergy journey and seeks expert insight from Dr. Gina DePoul Hidalgo. Together, they explore how immunotherapy (especially allergy shots) works—making it the closest thing to a cure for most allergies—and clarify the evolving thinking around food allergies in children.
Allergies Defined ([02:26])
"We're not supposed to be allergic to pollens, cats, dogs, foods, drugs. But if you are, your immune system... is thinking 'danger, danger' when it's really something harmless." ([02:26])
Initial Exposure and Antibody Creation ([02:56])
"They're really temporary kinds of treatment options." ([03:39])
Allergy Shots Explained ([03:52])
"You build tolerance over time by giving what you're allergic to... allergy shots are actually training your immune system to react differently." – Dr. Gina ([03:52])
How Diagnosis Works: Allergy Panels ([05:41]–[06:26])
"Yeah. It looks like a meat tenderizer. Just boom. On your skin." – Regina ([06:05])
Sensitization vs. Clinical Allergy ([07:22]–[08:22])
A 100+ Year-Old Therapy ([09:43])
How Allergy Shots Work ([10:51])
"Anywhere from 80 to 90% effective for those who start shots." – Dr. Gina ([12:40])
Regina: "I was telling everyone... these shots are going to cure me."
Dr. Gina: "The closest thing to a cure. But in general, it's [a] long-lasting effect." ([12:02])
"Yeah. They're like, Gina, you should stay here for a little while. And I had to do that four times in a row." ([13:22])
"There was a game changing study in 2015... introducing peanut between four to six months... decreased the incidence of peanut allergy in these high-risk kids." ([15:13])
"So my mom was right. Please don't tell her." ([15:52])
For more on allergies, check the show notes for related Short Wave episodes.