Dr. Prathyusha Savjani

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Adult & Pediatric Allergy & Immunology | Whole Health Allergist at CLS Health – Houston Heights |
Practicing good medicine, educating, and empowering patients to take control of their health

MCAS is one of the most misunderstood diagnoses on the internet right now.There is SO much content online suggesting tha...
05/22/2026

MCAS is one of the most misunderstood diagnoses on the internet right now.

There is SO much content online suggesting that nearly any combination of fatigue, flushing, brain fog, dizziness, GI symptoms, itching, anxiety, palpitations, headaches, “food reactions,” or chronic symptoms automatically means MCAS.

That is simply not true.

MCAS is a REAL condition — but it is considered relatively uncommon and has very strict evidence-based diagnostic criteria.

Current guidelines require:
• recurrent multisystem symptoms
• objective evidence of mast cell activation
• and improvement with mast cell-targeted therapy

Symptoms ALONE do not diagnose MCAS.

Many patients absolutely have real symptoms and are suffering. But there are MANY other conditions that can cause overlapping symptoms:
• chronic spontaneous urticaria (CSU)
• anxiety and panic disorders
• dysautonomia/POTS
• GI disorders
• medication side effects
• autoimmune disease
• hormonal changes
• chronic pain syndromes
• neurologic conditions
• sleep disorders
• and more

In medicine, it is important to avoid forcing every complex symptom pattern into one diagnosis just because it is trending online.

Unfortunately, much of the information circulating online about MCAS is inaccurate, exaggerated, or not based on current allergy/immunology guidelines.

As allergists, one of the hardest parts of evaluating these patients is that many individuals have multiple overlapping medical conditions, chronic symptoms, anxiety, trauma, or mental health struggles that are all interacting together. That does NOT mean symptoms are “fake.” It means the human body is complex.

Patients deserve compassion, validation, and careful evaluation - but they also deserve accurate diagnoses grounded in evidence.

The goal should never be to dismiss symptoms.

The goal is to identify the REAL cause so patients can get the right treatment.

This post is for education only and is not personal medical advice. Please discuss your specific situation with your own physician.

Shrimp allergy is one of the most misunderstood food allergies we see in allergy clinic 🦐Yes - true shrimp allergy absol...
05/20/2026

Shrimp allergy is one of the most misunderstood food allergies we see in allergy clinic 🦐

Yes - true shrimp allergy absolutely exists, and some reactions can be severe.

BUT…

Many people are labeled “shrimp allergic” based only on testing, without ever actually reacting to shrimp.

One major reason is cross reactivity.

Shrimp shares similar proteins with dust mites and cockroach (tropomyosin), so people with environmental allergies can sometimes have positive shrimp bloodwork or skin testing even if they may tolerate shrimp just fine.

This is especially important because:
• many patients have NEVER eaten shrimp before
• some avoid it for years “just in case”
• shellfish is socially and culturally important for many families
• unnecessary food avoidance can create anxiety and reduce quality of life

At the same time, shrimp reactions can be nuanced.

Some patients have mild oral or facial symptoms related to cross reactivity.

Others have true systemic shrimp allergy with hives, vomiting, wheezing, or anaphylaxis.

And sometimes cofactors matter:
🏃 exercise
🤒 illness
💊 NSAIDs like ibuprofen
🍷 alcohol

These can lower the threshold for a reaction.

One of the most important takeaways:
A positive shrimp test does NOT automatically mean someone should avoid shrimp forever.

For the right patient, a supervised oral food challenge with an allergist can be life changing.

In one real-world study, about 91% of shellfish oral food challenges were passed.

One more myth to clear up:
Shrimp allergy has NOTHING to do with “iodine allergy.” There is really no such thing as an iodine allergy. Reactions to iodinated CT contrast dye are a completely separate issue and are unrelated to shrimp or shellfish allergy.

Not medical advice. Please discuss your individual situation with your own physician.

05/20/2026

So many patients are told they’re “allergic to shrimp” based only on allergy testing and never actually find out if they can safely eat shellfish.

Today’s shrimp oral food challenge was a success 🦐

Not every patient is a candidate, but in the right setting, supervised oral food challenges can safely rule OUT food allergy and dramatically improve quality of life. We probably should be doing more of these for patients who truly want answers and would love to eat shellfish again.

This child had positive shrimp testing and no prior shrimp exposure… yet tolerated shrimp in the office today. Allergy testing alone does not equal clinical allergy.

Not medical advice. Please discuss your individual situation with your own physician.

Most people have never heard of alpha-gal syndrome… but it may be one of the most fascinating and misunderstood food all...
05/19/2026

Most people have never heard of alpha-gal syndrome… but it may be one of the most fascinating and misunderstood food allergies we see.

Yes - a tick bite can trigger a delayed allergic reaction to mammalian products like beef, pork, lamb, gelatin, and sometimes even dairy.

What makes this condition especially confusing is that reactions often happen HOURS after eating. Many patients wake up in the middle of the night with hives, stomach pain, vomiting, diarrhea, swelling, or even anaphylaxis and never connect it back to dinner.

And here’s another important detail: many patients do not even remember a tick bite. These bites can be tiny, painless, and easy to miss.

Because of the delayed timing and variable symptoms, patients are often misdiagnosed with IBS, chronic hives, anxiety, “random reactions,” or idiopathic anaphylaxis before someone finally connects the dots.

Diagnosis is not just a blood test. Some people can test positive and never have symptoms, while others with a convincing clinical history may have low or even negative levels depending on timing and exposure history. The clinical pattern matters.

As tick exposure increases and geographic ranges expand, awareness of alpha-gal syndrome is becoming more important for both patients and healthcare providers.

This is for educational purposes only and is not personal medical advice. Please discuss your individual situation with your own physician.

One of the biggest misconceptions I see in allergy medicine is that some people who truly SHOULD have epinephrine availa...
05/17/2026

One of the biggest misconceptions I see in allergy medicine is that some people who truly SHOULD have epinephrine available don’t carry it… while many others are carrying it for conditions where it may not actually be necessary.

This topic is much more nuanced than social media often makes it seem.

There are absolutely situations where carrying epinephrine can be lifesaving:
• Current IgE mediated food allergy
• Venom allergy with systemic reactions
• Exercise induced anaphylaxis
• Certain mast cell disorders

But there are also many situations where people may not actually need to routinely carry epinephrine:
• Large local insect sting reactions
• Chronic spontaneous urticaria
• Idiopathic angioedema without anaphylaxis
• Some medication allergies
• Remote food allergies that have resolved
• Positive allergy tests without any actual history of reaction

I also see many patients who were prescribed epinephrine “just in case” before anyone was fully sure what was actually going on. Sometimes after a more detailed allergy evaluation, we realize the person may not truly be at risk for anaphylaxis.

This matters because carrying epinephrine can come with both financial and psychological burdens. At the same time, epinephrine absolutely saves lives when truly indicated.

The goal is accurate diagnosis and individualized risk assessment — making sure the right patients have epinephrine available, while avoiding unnecessary fear and burden in those who may not need it.

And important reminder:
“EpiPen” is just one brand name. We really mean epinephrine in general, including Auvi-Q, generic auto injectors, and neffy.

This post is for general educational purposes only and is not personal medical advice. Please discuss your own situation with your physician.

I hear this misunderstanding from new parents all the time When pediatricians say “no milk before 12 months,” they mean ...
05/16/2026

I hear this misunderstanding from new parents all the time

When pediatricians say “no milk before 12 months,” they mean no cow’s milk as a primary drink instead of breastmilk or formula - NOT that babies can’t have milk products like yogurt or cheese during solid food introduction.

In fact, early regular exposure to dairy protein may actually help maintain tolerance in many babies. One thing we’ve been noticing more often is milk protein allergy developing in babies who had brief early exposure to cows milk based baby formula and then went long periods without continued milk protein exposure afterward.

And just to clarify another common misconception: whether mom eats dairy during pregnancy or breastfeeding does NOT determine whether a baby will or won’t develop a milk allergy.

As always, some babies truly are allergic to milk, especially babies with moderate to severe eczema or existing food allergies, so introductions should be thoughtful and age appropriate and individualized. Luckily, milk protein allergy usually resolves with time.

This is general educational information and not personal medical advice. Please discuss your child’s specific situation with your own doctor.

“Milk allergy” is one of the most misunderstood terms in medicine.Because the reality is… there are several COMPLETELY d...
05/13/2026

“Milk allergy” is one of the most misunderstood terms in medicine.

Because the reality is… there are several COMPLETELY different milk-related conditions that people often lump together:
• True IgE-mediated milk allergy
• Lactose intolerance
• Allergic proctocolitis
• FPIES

And they are NOT the same thing.

True IgE-mediated milk allergy is the classic immediate food allergy that can cause hives, swelling, wheezing, vomiting, and anaphylaxis. Fortunately, many children eventually outgrow it — although some patients continue to have persistent allergy long term.

Some children can even tolerate baked milk while still reacting to less-cooked dairy products like cheese, yogurt, or ice cream.

Meanwhile, lactose intolerance is NOT an allergy at all, and conditions like allergic proctocolitis and FPIES behave very differently from classic IgE-mediated food allergy.

Understanding these distinctions matters — because accurate diagnosis helps families get the right guidance, the right level of concern, and the right treatment.

This content is for educational purposes only and is not personal medical advice. Please discuss concerns with your own physician.

05/13/2026

To be clear - I’m talking here about TRUE IgE-mediated cow’s milk protein allergy, not lactose intolerance, bloating, stomach discomfort, or vague food “sensitivities.”

Fortunately, persistent true IgE-mediated milk allergy in an older child or adult is relatively uncommon. But for the families who DO live with it, it can be incredibly difficult and life-altering.

Milk is everywhere in our food system, accidental exposures are common, and some patients can react to extremely small amounts of milk protein.

That’s why it’s so important that we use the word “allergy” carefully and accurately - because the patients with real allergies deserve to be taken seriously. 🤍

This content is for educational purposes only and is not personal medical advice. Please discuss concerns with your own physician.

One of the ways babies can develop food allergies is through exposure of inflamed eczema skin to food proteins. That’s w...
05/12/2026

One of the ways babies can develop food allergies is through exposure of inflamed eczema skin to food proteins. That’s why many allergists are cautious about putting food-based products directly on eczema skin - even if they’re “natural.”

Be careful what you put on broken skin, especially in babies.

This is educational information only and not personal medical advice. Please discuss concerns with your own physician.

05/12/2026

Cashew is one of the food allergies I always take very seriously.

This is one that many allergists get especially nervous about because reactions can be severe, and sometimes even very small amounts can trigger symptoms in people who are allergic.

What also makes cashew difficult is that it is often hidden in foods people would never expect. It’s commonly used in vegan and dairy-free products because it creates a creamy texture. It can show up in sauces, curries, pesto, desserts, protein bars, “cheese” substitutes, and many restaurant dishes without people realizing it.

I’ve unfortunately seen teenagers and adults discover they had a cashew allergy after eating at a vegan restaurant or trying a dish they thought was safe. In some cases, cashew was not a food they ate regularly growing up, so nobody even knew they were allergic until they had a significant reaction.

This is why clear communication and labeling matter so much. If a food contains cashew, people need to know. Restaurants should be very careful about cross-contact and ingredient transparency. Friends, schools, and family members should take it seriously too.

And for anyone with a known cashew allergy: always carry epinephrine and make sure the people around you know how serious this allergy can be.

Not medical advice - please discuss your individual situation with your own doctor.

Address

1740 W 27th Street Suite 100
Houston, TX
77008

Telephone

+13462505521

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