Interview with Dr. Tania Elliott, Board-Certified Allergist and Immunologist

Table of Contents

• Overview
• About Dr. Tania Elliott
• Interview
• Top 10 Practical Takeaways
• Where to Learn More
• FAQ
• Final note

Overview

Dr. Thais Aliabadi and Mary Alice Haney sat down with Dr. Tania Elliott to unpack what every woman should know about allergies, hormones, and immune health. Her answers combine clinical clarity with real-world practicality. Below you will find focused questions and concise answers designed to help you take control of symptoms, recognize when to seek specialty care, and make home and lifestyle changes that actually move the needle.

About Dr. Tania Elliott

Dr. Elliott is dual board-certified in Internal Medicine and Allergy/Immunology. She teaches at NYU Langone, serves as a spokesperson for the American College of Allergy, Asthma, and Immunology, and helps translate complex immune topics into actionable advice for patients. Her focus is detective-style medicine: identifying triggers, testing thoughtfully, and building long-term solutions.

Interview

How did you choose allergy and immunology as a specialty?

We chose this field because it is clinical detective work. Often, people come to us after seeing several doctors with persistent, puzzling symptoms. Allergists are trained to ask precise questions about recent exposures, stressors, diet, and environment, then correlate those details with symptom patterns. Allergy and immunology sit at the intersection of environment, lifestyle, and biology, which makes solving problems both challenging and rewarding.

When should someone consider seeing an immunologist rather than a primary care doctor?

If you or a child is having recurrent infections or infections that do not follow the typical pattern, it is worth evaluating the immune system. Red flags include:

• Four or more sinus infections per year that required antibiotics.
• Two or more episodes of pneumonia in a lifetime.
• Frequent need for antibiotics or unusual infections that seem disproportionately severe.

Primary care physicians are excellent at general care, but allergists and immunologists have additional training for screening immune function and ordering the right tests when something is off.

What tests differentiate allergies from immune deficiency?

Allergy testing and immune evaluation are related but distinct. Allergy tests typically look at the immediate-type allergic response driven by IgE antibodies. Immune system testing evaluates both the quantity and function of immune cells and antibodies that protect against bacteria, viruses, and fungi.

• Allergy tests: skin prick testing or IgE blood tests identify environmental or food-specific IgE antibodies.
• Immune testing: blood tests that measure immunoglobulin levels (IgG, IgA, IgM), specific antibody titers following vaccination or infection, and cell counts (B cells, T cells, natural killer cells) assess immune competence.

The immune workup is a blood test. We evaluate both numbers and function to determine whether someone mounts an appropriate immune response.

How often should immune tests be repeated?

There is no universal schedule. In childhood, some immune deficiencies are identified early; in adults, we often assume stable, lifelong titers after vaccines and infections. However, long-term longitudinal studies on how antibody levels wane in adulthood are limited. If there are clinical signs such as increasing infections, recurrent pneumonia, or poor vaccine responses, retesting is reasonable. Otherwise, follow-up is individualized.

What is long COVID from an immune perspective, and how do you diagnose it?

Long COVID appears to be an immune-mediated aftermath in many people. Two mechanisms we see:

1. Persistent or reactivated immune memory that overreacts to triggers, producing wide-ranging symptoms.
2. Autoimmune activation, where immune cells begin attacking the body’s own tissues, leading to chronic inflammation and multi-system symptoms.

Diagnosis today is largely clinical: history of prior COVID infection and a consistent constellation of lingering symptoms. Because research evolves rapidly, seek care from clinicians who stay current and use specialized clinics when available. Advocate for yourself if symptoms persist and you feel unheard.

Why do food allergies seem more common in some countries than others?

The rise in food allergies—peanut allergy being the most cited—has roots in public health guidance and environmental changes. About 20 years ago, pediatric recommendations pushed the delayed introduction of peanuts to reduce choking and theoretical allergy risk. Subsequent studies showed the opposite: early oral exposure in the first year builds tolerance.

Two important contributors:

• Hygiene and microbiome changes: Lower exposure to environmental microbes and increased antibiotic use can cause dysbiosis, which alters immune development and increases allergy risk.
• Timing and route of exposure: Introducing foods orally helps the gut build tolerance. Sensitization through the skin—especially when the skin barrier is disrupted, like in eczema—can prime the immune system toward allergy.

Practical implication: introduce common allergenic foods early (when appropriate for age and not a choking hazard), avoid excessive skin exposure to food-derived products before oral introduction, and support a healthy microbiome.

Why should we avoid using food-based products on a baby’s skin before the baby eats those foods?

The skin is an immune organ. Applying food-based oils or oatmeal baths can expose a baby to food proteins through the skin. If their skin barrier is compromised (for example, with eczema), this skin exposure can sensitize the immune system. Later, when the food is introduced orally, the immune system may recognize it as a threat, increasing allergy risk. Avoid topical food exposures before oral introduction if there is concern about eczema or family history of allergy.

How do allergy drops differ from allergy shots?

Both are forms of immunotherapy that build tolerance by exposing the immune system to gradually increasing doses of the allergen. Key differences:

• Shots: injected subcutaneously, can use higher concentration with less volume. They require weekly visits during the buildup for about six months, then monthly maintenance for two to five years. Many patients see symptom improvement at 10 to 12 weeks and a long-term reduction in allergic disease.
• Drops: sublingual administration. They require higher cumulative doses and daily adherence. They are effective, but formulations and standards vary more between providers, so choose a reputable clinic and ask about concentrations and outcomes.

Immunotherapy is a long-term commitment but can be curative or disease-modifying for many patients.

 

Can adults suddenly develop food allergies, like shellfish, later in life?

Yes. New-onset food allergy in adulthood can occur. Contributing factors include:

• Changes in stomach acid: Use of acid-suppressing medications can alter protein digestion and increase the chance of sensitization.
• Cross-reactivity: Proteins in shellfish can resemble proteins in dust mites or cockroaches. People with severe indoor allergies may later react to shellfish.

If a life-threatening reaction occurs (throat swelling, difficulty breathing), epinephrine is the first-line treatment. Antihistamines are supportive but not a substitute for epinephrine.

How reliable are commercial food sensitivity panels and IgG testing?

We see a lot of misuse of broad, direct-to-consumer food panels. IgG testing often reflects exposure, not clinically relevant allergy, and can produce positive results that lead people to unnecessarily restrict diets. The best approach for food-related symptoms is a careful food diary and guided elimination and reintroduction under a clinician’s supervision. If a true immediate allergic reaction occurs (swelling, hives, wheeze), objective testing (skin test or IgE blood test) and clinical correlation are appropriate.

What practical changes can families make around pets when one person is allergic?

There is no such thing as a truly hypoallergenic dog or cat. If one family member is allergic but others want a pet, consider immunotherapy for the allergic person. Allergy shots or drops are often the best long-term solution and have high efficacy when done correctly. Keep in mind:

• Treatment is a commitment: frequent clinic visits initially for shots or disciplined daily dosing for drops over two to five years.
• Ask about concentrations and outcomes at the clinic—standards vary.

How do hormones affect allergies and asthma in women?

Hormonal fluctuations—during pregnancy, perimenopause, and with certain hormonal contraceptives—can alter immune cell activity. Estrogen fluctuations are particularly implicated in activating allergic cells, which explains why some women experience worsening hives, nasal symptoms, or asthma flare-ups during hormonal transitions.

Asthma behaves variably: roughly one-third of women get worse, one-third stay the same, and one-third improve. If symptoms change with reproductive milestones, review management with a clinician who understands both respiratory and reproductive health so treatment can be tailored.

Are at-home allergy tests useful?

At-home IgE tests for environmental allergens (pollen, pets, dust mites) are useful and accurate when they measure specific IgE. They can be a good starting point for people who do not have immediate access to an allergist.

For food allergy evaluation, be cautious. If you suspect true IgE-mediated food allergy—immediate hives, swelling, wheeze—seek professional testing and guidance. For intolerances or GI-driven sensitivities, a food diary and elimination diet supervised by a clinician are more informative than broad IgG panels.

How should people approach mold in the home?

Mold can produce two main problems:

1. Allergic reactions to mold spores, which present like any environmental allergy: congestion, post-nasal drip, coughing, and asthma exacerbations—often worse during outdoor mold seasons in the fall.
2. Toxic exposures from certain molds that produce mycotoxins. These can cause systemic symptoms—fatigue, headaches, dizziness, and cognitive complaints. Toxic mold can hide in walls, behind furniture, under carpets, or near plumbing.

Practical steps:

• Keep indoor humidity between 20% and 50%. Higher humidity promotes mold growth.
• If you use a humidifier, monitor humidity carefully; don’t create a breeding ground for mold.
• Look for musty smells; these often indicate mold presence.
• Do basic detective work: inspect under sinks, behind appliances, window seals, and carpet edges.
• Use an activated carbon air filter if concerned about toxins; allergen HEPA filters remove spores but do not remove many toxins.
• If symptoms improve away from home and return upon re-exposure, consider a professional mold remediation and testing service with good reviews.

What are microplastics, and should we worry?

Microplastics are tiny plastic particles now detectable in blood and tissues because of improved scientific techniques. They are pervasive across food, packaging, household items, and even personal care products. While research into long-term health consequences is ongoing, associations with fertility issues, hormone disruption, and other chronic conditions raise concern.

Practical consumer actions reduce exposure and are reasonable to adopt:

• Avoid heating food in plastic containers and throw out plastic Tupperware that is scratched or old. Prefer glass or stainless steel for storage and reheating.
• Replace plastic cutting boards with wood, titanium, or high-quality alternatives—plastic boards gouge and shed particles.
• Less synthetic fragrance: synthetic fragrance chemicals are linked to endocrine disruption. Choose fragrance-free or naturally scented products.
• Prefer solid wood furniture rather than composite wood that off-gasses adhesives and flame-retardant chemicals.
• Avoid black plastic kitchen utensils that may have been produced from mixed recycled streams containing flame retardants and other toxins. These can contaminate food, especially when heated.

Are plastic water bottles a major concern?

On the margin, single-use plastic water bottles are not the biggest daily risk for everyone. The primary concern is heat exposure: when plastic is heated—left in a hot car or near heat sources—leaching increases. Use reusable bottles and avoid leaving bottles in hot environments. When possible, choose glass or stainless steel.

What practical daily strategies help reduce allergy symptoms and toxin exposure?

Small, consistent habits add up. Here are the top lifestyle and household changes we recommend:

1. Start allergy meds before the season begins. For seasonal allergic rhinitis, begin maintenance therapy a few weeks before expected pollen peaks. That prevents chasing symptoms.
2. Use nasal steroid sprays consistently. Nasal steroids require daily use for several days before relief. Place the spray by your toothbrush and use it every day during the season.
3. Limit synthetic fragrances. Swap scented cleaning products, perfumes, and candles for fragrance-free or naturally scented options.
4. Control humidity and inspect hidden spaces. Keep humidity 20% to 50%, use a dehumidifier if needed, and check under sinks and behind appliances.
5. Minimize plastic exposure in food prep. Use glass storage, avoid microwaving plastic, and replace black plastic utensils.
6. Introduce common food allergens early in infants. When developmentally appropriate, oral exposure in the first year promotes tolerance.
7. Maintain a diverse microbiome. Avoid unnecessary antibiotics early in life and support a varied, fiber-rich diet to promote gut health.
8. Use activated carbon filtration for toxin concerns. HEPA removes allergens; activated carbon removes many volatile organic compounds and odors.
9. Keep up with vaccinations and discuss immune function if infections are recurrent. Antibody titers can reveal inadequate vaccine responses and prompt further evaluation.
10. Advocate for specialty care when needed. If infections or allergic disease are severe or unusual, seek an allergist/immunologist for a focused workup.

Medicines: When and how to use antihistamines, nasal steroids, and decongestants?

Timing and proper use matter.

• Start maintenance medicines before allergy season. Antihistamines and nasal steroid sprays are most effective when they are already in your system.
• Nasal steroid sprays like fluticasone are maintenance therapy. Use daily; expect at least five days for benefit, and place them by your toothbrush for consistency. Typical dosing is two sprays per nostril once daily unless instructed otherwise.
• Non-sedating antihistamines such as cetirizine or loratadine can be taken daily during seasons or as needed for itchy eyes and throat. They do not have the same sedative or cognitive side effects as older antihistamines.
• Decongestants with pseudoephedrine (meds labeled with D) should be limited to short courses (no more than five days) due to rebound effects and cardiovascular stimulation. Take them in the morning to avoid insomnia.
• Benadryl (diphenhydramine) is no longer recommended for routine allergy or sleep use because of its cognitive and dementia-associated risks. For acute, life-threatening allergic reactions, use epinephrine first, not diphenhydramine.

In an allergic emergency, what should caregivers know?

If someone has signs of a severe allergic reaction—throat tightness, difficulty breathing, wheeze, swelling of the face or tongue—inject epinephrine immediately and call emergency services. Antihistamines are not first-line treatments in anaphylaxis and can delay life-saving care. Teach caregivers how to use autoinjectors and have a clear plan.

Top 10 Practical Takeaways

1. Think prevention: Start nasal steroids and antihistamines before allergy season.
2. Early oral exposure: Introduce common allergens early in infants (when age-appropriate) to promote tolerance.
3. Be cautious with skin exposure: Avoid applying food-based topical products to infants before oral introduction if eczema is present.
4. Replace plastics: Use glass or stainless steel for food storage and avoid microwaving plastic.
5. Monitor humidity: Keep indoor humidity 20% to 50% to prevent mold growth.
6. Choose filtration thoughtfully: HEPA filters for allergens; activated carbon for toxins and odors.
7. Avoid Benadryl for routine use: Prefer non-sedating antihistamines and epinephrine for anaphylaxis.
8. Consider immunotherapy: Shots or drops can be disease-modifying for pet, pollen, and dust mite allergies.
9. Be an advocate: If infections are recurrent, ask for immune testing from an allergist/immunologist.
10. Limit unnecessary antibiotics early in life: Protect the microbiome to reduce allergy risk.

Where to Learn More

For ongoing tips and clear explanations about immune health and allergies, follow Dr. Tania Elliott on social platforms and visit clinical resources. Her practice and educational channels provide practical guidance for patients navigating allergy and immune concerns.

Guest resources:

• Dr. Tania Elliott website and resources: drtaniaelliottmd.com
• Social: @drtaniaelliott on Instagram and @drtaniaelliott on TikTok
• Professional organizations: American College of Allergy, Asthma, and Immunology (ACAAI)

FAQs

When should I see an allergist versus my primary care doctor?

If you have more than four sinus infections per year, two or more episodes of pneumonia, recurrent unusual infections, or severe allergic reactions, see an allergist/immunologist. They can screen immune function and create tailored management plans.

Are food sensitivity (IgG) panels useful?

IgG panels are often misleading; positive results frequently reflect exposure rather than true intolerance or allergy. A food diary, elimination diet, and reintroduction under clinician guidance are more reliable for identifying triggers.

Can allergy shots cure pet allergies?

Immunotherapy can significantly reduce or even eliminate symptoms for many people. It requires commitment—typically months of buildup, then two to five years of maintenance—but offers durable benefits in a high proportion of patients.

Is Benadryl safe for sleep or allergies?

No. Avoid routine use of diphenhydramine for sleep or allergy relief because of its links to memory impairment and dementia risk. Use non-sedating antihistamines for allergies and epinephrine for anaphylaxis.

How do I reduce mold risk at home?

Keep humidity 20% to 50%, repair leaks promptly, inspect hidden areas (under sinks, behind appliances, around window seals), address musty smells, and use dehumidifiers or activated carbon filtration for toxin concerns.

When should infants be introduced to common allergens like peanuts?

Current evidence supports early introduction—within the first year for most infants, when developmentally appropriate—to build oral tolerance. Consult with your pediatrician if there is a history of severe eczema or prior food allergy in the family.

Final note

Allergy and immune care blend science, observation, and practical behavior change. Small daily habits—smart medicine timing, humidity control, careful food introduction, and reduced exposure to plastics and synthetic fragrances—add up to better symptoms and long-term health. If you feel something is off, be persistent. Your health is worth the detective work.

This article was created from the video What Every Woman Should Know About Allergies, Hormones, & Immune Health ft. Dr. Elliott | SHE MD for Dr. Thais Aliabadi’s website.