#90 Understanding the Tolerance Induction Program (TIP) with Dr. Inderpal Randhawa

In this episode, Dr. Inderpal Randhawa, founder of the Tolerance Induction Program (TIP) for allergies, joins the podcast to discuss his program and its approach to food allergy treatment.

As part of this season exploring emerging and evolving allergy management options, this conversation aims to provide information directly from the source. TIP has generated both interest and debate within the food allergy community.

In this episode, we discuss:

• The foundational principles of TIP
 • How the program is structured
 • Patient selection and goals
 • How TIP fits into the broader treatment landscape
 • Areas of ongoing discussion within the field

This episode does not serve as an endorsement of any specific treatment. The intention is to offer balanced access to information so families and clinicians can make informed decisions in partnership with their own medical teams.

As always, we also consider the mental health dimensions of navigating complex medical choices.

Special thanks to Kyle Dine for permission to use his song The Doghouse for the podcast theme!
www.kyledine.com

Find Dr. Whitehouse:
-thefoodallergypsychologist.com
-Instagram: @thefoodallergypsychologist
-Facebook: Dr. Amanda Whitehouse, Food Allergy Anxiety Psychologist
-welcome@dramandawhitehouse.com

Transcript

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Welcome to the Don't Feed the Fear podcast, where we dive into the complex world of food allergy anxiety. I'm your host, Dr. Amanda Whitehouse, food allergy anxiety psychologist and food allergy mom. Whether you're dealing with allergies yourself or supporting someone who is, join us for an empathetic and informative journey toward food allergy calm and confidence. 

Dr. Amanda Whitehouse:

Welcome back to Don't Feed The Fear. This season, we are exploring the expanding landscape of food allergy management. With more options available than ever before. Families are often sorting through excitement, uncertainty, and at times conflicting opinions. 

Today's conversation is one that many of you have asked for. I'm joined by Dr. Inderpal Randhawa, founder of the Tolerance Induction Program, often referred to as TIP. Before I share my conversation with Dr. Randhawa, I want to offer a little bit of context because if you've been around the food allergy community for a while, you have probably heard some very differing perspectives about the tolerance induction program. I get questions about it all the time, and when there's something that I don't understand or when there's something where there are strongly differing opinions, I try to get curious rather than avoiding the conversation or choosing sides. 

So for this episode, I invited Dr. Randhawa to join me himself and directly explain the program in his own words. I'm very grateful that he was willing to join me on the podcast and have this conversation knowing that I have a different background from the people that he treats and who are in his program. I also want to be very transparent about my perspective. I'm a psychologist and a food allergy parent, not a physician or an allergist, and I don't have personal experience with TIP. I'm on the East Coast, so most of my clients have not been patients of his, and so the information that I had about this firsthand was very limited. 

Obviously, I feel more comfortable speaking about OIT and SLIT because I have the personal experience and my professional experience with many clients during their treatment, and connections to many physicians who are offering those treatments. But in addition to that, what made me feel comfortable making that decision for my son was that in addition to anecdotal experiences and things that I had heard from people online, I was able to read the peer-reviewed research. There's publicly available outcome data. The treatment protocols that were being used were available and could be examined and discussed by other professionals and researchers, and that all felt very transparent to me. 

Though Dr. Randhawa has published a limited amount of data, his protocols are proprietary, and therefore, the general public and other professionals can't see the specific statistics or the protocols that he uses. So I do also want to recognize that no research or peer review system is perfect, and Dr. Randhawa will address some of those concerns in our conversation and why he made a different choice and took a different path. And at the same time, transparency, access to information, and the ability to critically evaluate evidence were important factors for me in my own decision-making. 

The tougher part of this for me personally is that since recording this episode and learning more about TIP, I've also, of course, been paying more attention to anything I hear about the program. And since I've been looking more closely, I have seen claims coming both from individuals speaking publicly about TIP and in the TIP marketing materials that make factually incorrect statements about OIT when comparing the two treatments. 

Some of those include things like saying that OIT cannot be used for adults, that it's not individualized to the patient, that it can't get patients to free eating, that it requires daily dosing indefinitely. I can say from my own personal experience that my son, who didn't start OIT until he was six, was cleared to eat his allergens freely, which meant basically that he didn't have to measure them anymore. He could eat regular servings whenever he wanted, which he didn't want to. His dosing has gradually decreased, and we only have to dose a very few number of days now over time, and that all of the doctors that we worked with responded individually to both his testing, his clinical history, and his response to treatment in their approaches. So he did not just follow a rigid protocol that wasn't designed for him, but it was based on all of that research that I mentioned that those doctors have shared and collaborated on. I also personally do know adults who have done OIT, who have done SLIT, who have had great experiences with it. Another claim I've heard is that with OIT, multiple allergens can't be treated at the same time. And again, I have first-hand experience that that's not the case, and my son did treat multiple food allergens at the same time with his OIT provider. 

Now, of course, I don't have the experience to speak about TIP and the claims that are being made and whether those are accurate or not. But I do know that some of the things that are being shared about OIT in the context of TIP are inaccurate And I do know families who have achieved greater safety through the TIP program, some of them very simply and easily, some of them with setbacks and reactions, just like patients sometimes have with OIT. 

So I want to make sure that everybody listening knows that I'm not criticizing any patient, any parent, anyone's choice about treatment for themself or for their child, and I support all patients in getting as much information as possible and making the choice that they feel most comfortable with. My goal in sharing this conversation is not to tell you what you should choose, what you should not choose, and it's also not to endorse or condemn TIP. But I want to make sure the information that I'm sharing on my podcast is accurate. Rather than ignoring the questions because I simply can't answer them all, I wanted to create space for people to hear directly from Dr. Randhawa and encourage you to consider these things for yourself, ask your own questions, look at the information available, as well as considering what information might not be available to you, and make decisions with the support of your own medical team. 

And I want to continue that exploration beyond this conversation this week, so the next two episodes of the podcast in the weeks that follow will feature personal accounts from two different TIP patients. One is a parent of a child who is undergoing treatment, and one is an adult patient who has gone through the program, had setbacks, had to pause and regroup, and is going to be doing some additional treatment with the program. So I encourage you to listen to those conversations for yourself as well to round out this topic for you. As always, take what is useful, ask questions, talk with your medical providers, and remember that one person's experience, including mine, is not a substitute for data and individualized medical advice. 

With that context established, I do want to say thank you again to Dr. Randhawa for joining me. Let's get into the conversation so you can hear from him for yourself.

Dr. Amanda Whitehouse:

Dr. Randhawa, thank you for being here and for taking the time to chat with me on the podcast You've been doing this for a while, but now we're at a point where things are just exploding in terms of options. I think people are excited and they're overwhelmed. So I'm doing this season to help people sort through everything that's out there and try to make the best choices for them. 

Dr. Inderpal Randhawa:

No, I think it's really important. The space of food allergy, I've been in it now for about 25 years, and you're absolutely right. In the last roughly eight or nine years, there's a lot more available. And I think it's important for the consumer to really understand what everything is. 

Dr. Amanda Whitehouse:

Yes, which is tough. And, and there's a lot of information out there. I've listened to some of your past interviews, but even listening repeatedly, I think it's hard to sort out and understand the details, so I'd like you to talk about that. But would you start first by telling us how you ended up developing your treatment program? 

Dr. Inderpal Randhawa:

If I could, I would like to kinda start off with, the, the general picture of kind of what r and d development looks like in healthcare. So, you know, I'm a, I'm a. Pulmonary, ICU transplant immunologist, who happens to be an allergist. And, you know, I've been in, in many different fields, , from rare lung disease to rare immune-based disorders, really a whole spectrum across all ages. So I, I've actually. Um, had a lot of experience working in the classical medical system or what I call the medical industrial complex. And if you look at that complex and how it operates, it's been studied now for about 50 to 60 years. You have pharmaceutical companies and device companies that are funded by venture funds and private funds. Those organizations will also fund scientists in different universities, in different laboratories, will then work with those scientists and essentially use that intellectual property to then develop a product, typically a drug or a device then has to go through clinical trials and eventually become a commercial product. influence from that system is pretty heavy. 

So then those same pharma companies who are able to get something to the finish line, they have heavy influence on the FDA, right? If you actually look at it, most of the members of the FDA eventually become nicely paid individuals who work for pharma companies. That is the cycle. then ultimately the same form of companies will influence universities and academic centers to go ahead and produce guidelines. And these guidelines are then trickle down to the rest of. Doctors and communities and eventually it hits the consumer, the patient who's goes to a doctor and says, oh, okay. So what I have to offer to myself is these guideline based recommendations and for the space of food allergy for really the entirety of its time, that guideline has said avoidance, EpiPen, and that's what you should do. Everything I just described again, I, I've certainly partook in it. I mean, I'm well-published scientist. I've received NIH funding. I've received plenty of other grants, I found that it really stymies innovation. It does not allow systems to operate and move, uh, particularly quickly or well. 

So everything, literally, everything that the Tolerance Induction program has built from day one, which, uh, now has, you know, 22,000 plus patients historically, all with Food anaphylaxis has been built. outside of that medical industrial complex, the whole thing. indeed, it's part of the reason why it has to be built that way. So I know it's a very lengthy kind of explanation of things, but it's important to kind of hear that because I think a lot of people wonder why, like, why did you build it that way? And the answers are actually quite straightforward. When you're trying to investigate novel areas in food allergy, which I did because of my background in the transplant space. There is no funding for it, Think about it. The NIH has the ability to fund billions of dollars every year, and they fund 15 to $20 million to food allergy, a disease that affects 35 million individuals. That's what you're dealing with. in order for me to do anything, I had to fund it myself. And so I had to work and fund and build. 

So, within my organization, I've had to build over time a molecular research laboratory. I've had to build a data laboratory, basically data software, ai, machine learning. I had to build a diagnostics laboratory that had to produce very, very highly accurate results in data critical to the entire process of TIP. I had to build a food science laboratory to actually produce proteins and things of this nature. Then of course, we have our clinical. The clinical care that we provide as well and beyond. So imagine all those things that had to be built outside of the medical industrial complex, and the result of that is remission and perhaps the closest thing to a curative state to the disease. 

Dr. Amanda Whitehouse:

Maybe that's a good point then for you to explain to us, what is the Tolerance induction program.

Dr. Inderpal Randhawa:

Absolutely. When I first got into this space, my goal was to answer two simple questions, just two. I wanted to first understand what amount of protein would trigger what grade of reaction. a question that almost no one has been able to understand. But I had to understand that question. I wanted to know what amount of protein would trigger what greater of reaction in 95% of the food allergy population. That was a critical set of information. the second question I had to figure out was, once you know that level of reactivity. are the processes that can actually downregulate that level of reactivity to a point of remission? Those are my two primary questions. Right. We first needed to understand the risk of what we were dealing with, what was that risk? And then if we were dealing with that risk, how do we predict that risk? how do we go ahead and mitigate that risk over time in the safest way possible? 

So again, as a, as a transplant immunologist, I'm looking at this very differently. When you come in, we're running 400 biomarkers per patient, including lots and lots of blood tests, skin tests, patch tests, lung based tests and more. These have to assess the immune system's baseline landscape for that patient. Every single patient has the same 400 biomarkers run. It has to be done that way. When you build data sets, everything has to be equivocal. When the patients come in, they run all those tests. The next step is we feed that information into our AI system. The AI system will produce a snapshot of risk, so every single patient has this snapshot of risk. It'll tell them what they're anaphylactic to, how anaphylactic they are to those foods, what they're sensitized to, and what they're clearly tolerant to. And that is critical information for the family. They can now kind of move forward, certainly open up their diet very quickly, and then we utilize that information through additional AI segmentation and machine learning to actually now conduct TIP. 

So TIP, the tolerance induction program is done through biosimilar protein immunotherapy, and what that means at a very high level is we are going to identify and utilize for you specifically the number of biosimilar proteins that are available in specific food proteins that are not your primary allergen. We will dose you through those in a very clear set of sequences and we will lower your immune response to peanut or milk or egg or anything before you ever consume that protein. And we have to reduce it pretty significantly often by 50, 60, 70%, which is pretty remarkable. Nobody else has ever attempted that or is was even kind of processing that concept. But when you do that effectively, after just a number of months, we can then introduce this patient to peanut and they'll go from zero peanut to a 24 peanut challenge, depending on their level of severity, often within four to six months. We do this across not just one protein class, but all of 'em. 

And we're doing this simultaneously. So that's why TIP looks a little bit complicated. 'cause when you kind of stand back like, wow, these patients are consuming multiple foods simultaneously, and they're going through these different sets of cycles. But ultimately it is all targeting the primary allergens. Most patients, as you know, are allergic to typically three to four foods primary, and we're downregulating all of them simultaneously. So when they actually hit remission, they are cleared on all foods. When you complete TIP, you are consuming dairy like a non-allergic person. Our patients will finish drinking the equivalent of 10 ounces. 10 ounces. They're consuming very large amounts of protein like that of an non-allergic person. 

Dr. Amanda Whitehouse:

Right. So I think that explains one of the biggest misconception. People see that people participating in your program are eating something all along the way, but the majority of the stage is this preparation where they're eating biosimilar proteins, but not the actual allergen yet. Do I understand it correctly? 

Dr. Inderpal Randhawa:

I would say if you look at a typical patient, they're spending roughly one third of the time eating biosimilar Okay. and then, and then again, we are treating all protein allergens at the same time. So if you're anaphylactic to dairy and milk and various tree nuts, we are doing all of those simultaneously. So these cycles are all interwoven, if you will through AI from a safety standpoint, because it's done so nicely, uh, that's why we have such a high success rate and such a low adverse event rate. 

Dr. Amanda Whitehouse:

So you mentioned, the AI piece of what you do and the data that you collect, but you've been doing this for so long. Most of us think of AI as something that really has only existed for the last five years or so. But how, how did that come into the picture? Explain that to us please. 

Dr. Inderpal Randhawa:

Yeah, that's a story. I've always been an applied math guy, that's for sure. By 2006 and 2007, and, and again, just to back up as a transplant immunologist, you have to remember that. We are used to mass scale data, right? When you're like dealing with a transplant, it is very complicated. You're doing lots of panel reactive antibodies. I mean, you're looking at hundreds and hundreds of data just for single patients. So, when I started moving into this world of data science across the food allergy spectrum and across the immune system, I was able to accumulate large amounts of data very quickly, and then I was able to build some algorithms. So just kind of decision making trees, if you will. I knew that the patterns were, were much deeper than that. 

So around 2008, you know, we deployed our first kind of learning network or what would be called machine learning at that at, at today's time. And I realized I didn't know very much. I didn't understand it well enough, so I spent about a summer learning python and learned how to code, right? I was like, all right, I need to understand how to code this up and out. Built my first applied math team back then. And really by 2010, had what was a pretty archaic version of a machine learning system. So archaic that the couple doctors I hired to kinda work with me did not like it. They were like, I can't think like this. It was very difficult for me to find physicians who actually wanted to partake in this process. And these, these were allergists, by the way. at that stage, I realized very quickly that I needed to build a user interface with all of this data that actual clinicians could utilize and deploy. Otherwise we would never be able to treat a mass amount of patients. 

So starting around 2010, that's when that whole process started. And obviously, yeah, we've been doing this for a long time. Way before Chat GPT ever got popular. 

Dr. Amanda Whitehouse:

Right. Well, I think my audience probably knows by now, I've done OIT with my son. We started back in probably 2016, but around 2014, I was researching, I found your program, and I'll be honest with you, I was so terrified to fly with him. And I know that most of your patients travel, I think you told me before, is it 60% of your patients travel? What do you tell people who that's like one of the most intimidating pieces when you have a kiddo with a really sensitive peanut allergy? 

Dr. Inderpal Randhawa:

Absolutely. One of the best things about I think our program is, is even before you're really starting the process of TIP, is that we are very good at offering control back to families. Right? So even if you haven't started the program, the control side is important. What does control mean? means understanding what anaphylaxis looks like for your kid. It is different. All children are different. They're different based on weight, based on age, but they're also different based on their level of reactivity. And by running data you can actually start to pull that apart. And we give every one of our patients a very specific. Anaphylaxis plan a scenario kit. All our patients know what that is. They carry around these, these little kits that have all kinds of tools in there that they can use. 

We also provide 24/7 command center support, and this has been since the inception of the program, literally 24/7/365, anytime from anywhere. You call us if there's any level of symptoms and you're gonna get a provider or a physician on the on the line walking you through your scenario situation, how to make sure everything turns out just fine. That type of security and control is really, really helpful. So when parents kind of get into this program, flying becomes a lot easier. So I think giving them back that level of control and the amount of support that the institution provides is quite big. 

We have well over 200 employees in this system we have 125,000 square feet of space. This is not a small, this is not an allergist office is what I always try and tell people. This is a big system that's supporting a lot of people.

Dr. Amanda Whitehouse:

Yeah. That then opens the window to something that you and I have discussed previously, and I'd love your thoughts on how quickly the mental health piece shifts and the anxiety lifts for your patients. It's a big undertaking, but then to see that freedom and that shift, I bet is a big change. 

Dr. Inderpal Randhawa:

Yeah. You know, it's a great point. Look, so when I got into this space 20 plus years ago, I, to be honest, did not understand the psychological impact that this disease has on people. I was used to dealing with organ transplant patients, they were very, very sick. And so it was just never top of mind. And I still remember, you know, my first patient who finished what was was TIP now, and, and he finished back then and hit remission it was for peanut and this big guy who was a football player. I was trying to explain to him what I thought the biggest gain was, you don't have to read labels anymore. It saves you so much time. That's great. But man, think about the safety effect now, right? Like, you don't have to worry like you were before. This is just gonna change everything. I'm trying to talk to him about this and his response to me was, yeah, that sounds great, but listen, I'm just no longer an anxious person. And that kind of stuck with me. I was like, wow, that's something unique, right? 

Over the next few years, I started to really understand and see that because the initial patients in my program were clearly patients who did not have any other options. They typically had five to six primary allergens or more. They had lots of comorbidities. And they're coming here as the last chance that was that's who we are. And that's where the anxiety comes out. And you can really see what the mental health is of not only these young people, but then their parents and their extended family. I did try early to see who's interested, how could this be studied? And sadly, even to this day, I feel like it's kind of been pushed to the side. I mean, like I've worked with NAMI, the National, association for Mental Illness, and I've tried now for several years to get them to recognize this as a unique subset of a condition. It hasn't gone very far. 

I still remember, there was this one family where this young boy had, anaphylactic to milk and a number of primary allergens. He had severe eczema, very, very severe eczema. He came in and he was often bleeding, actively bleeding around the neck and so forth. Extremely nervous. His mom would pace all the time, constantly pacing very nervous and seven, eight months into the program, gained some weight, he looks good, his skin's under better, much better control. We do treat the entire patient as we manage these cases. And I still remember his mom sitting on the chair sideways, lying down with her phone up. And I stopped her and I said, I said, wow, do you remember what that was like? And you know, it was still there. The trauma is still there. Right. But it's just amazing when you give folks some control back. It has a major, major benefit. Is it perfect for everyone? Unfortunately not. I mean, we still have some cases who go through and they finish, they're in remission, and they're still very nervous and they still have mental health issues that we are trying to find resources such like as yourself that can try to help us. But I really think at a national level, this is a, a really, really important issue. 

Dr. Amanda Whitehouse:

I agree, I've seen that with so many of my patients where people would come to me because they know what I do, but almost thinking, well, I'm just an anxious person, or My kiddo is just an anxious kid and we're managing this food allergy, thinking it's just who they are in their makeup, not realizing how the medical experience has shaped them so deeply. It is a real thing. It's very unique, the way that it affects us. You mentioned barriers. I'm wondering are there certain comorbidities or certain instances where there's a medical barrier to people completing your treatment? 

Dr. Inderpal Randhawa:

If you kind of look up my background, I've always been very, dedicated to the rare and orphan disease world. And so, these are conditions that are very severe, very serious genetic disorders. Bone marrow disorders, things of that nature. So that part of my career, which I continue to do to this day, means you have to have an open door. You can't say no to anybody. And that's how we operate. So yes, we take extremely complicated cases. Uh IgE levels of 40,000, nine plus primary allergens, severe asthma, uncontrolled, severe eczema uncontrolled, severe EOE uncontrolled, mast cell based diseases. again, it's not that we are looking for all those cases. They tend to come here anyway, but you know, we are not gonna be the individuals to turn them away. We are confident in our work and our ability. We're confident in our data science modeling. We have an incredible number of multidisciplinary specialists who actually work with us, not only locally in Southern California, but across the country and the world at this stage. And I'm particularly proud of those cases. We don't talk about them enough, frankly. You know, we have cases come in where, you know, they essentially had a G-tube, right? I mean, they, they can't consume food because they have such bad eoe and they're done with this program. They're consuming their primary allergens like a non-allergic person. They get that tube out. It's life changing, right? And so we, we will not have exclusion criteria. And, you know, with that, you build the right type of safety parameters, the right type of forecasting parameters, then it becomes a much more manageable thing. 

Dr. Amanda Whitehouse:

So patients have been traveling from all over to get to you, but you're also expanding to reach more people, right? Uh, you know, so, yeah, absolutely. Look, um, you know, starting in 2009 and 10, I, my intent was very clear at that time is that whatever was built had to scale. There was no choice. Um, I mean, the fact that patients were flying in back then from other countries blew my mind. I mean, honestly, I mean, to this day, I mean, you know, they fly from the Middle East, they fly from Africa, and, and I'm, I mean, that is serious pressure to get it right. mean, really think about it, right? I mean, Yep. have to get it right for these patients. And so in order to get there, I've always been careful about expansion, balancing that with safety. We will never sacrifice safety ever as long as I'm at the home of the organization. And, we had to build levels of AI and levels of machine learning over the last decade and decade and a half now. And it's, it's gotten very good. I mean, it's gotten very good. You build a lot of confidence in the system. Are we done yet? No, but we're getting very close. I think what's unique about our expansion model moving forward is we're actually moving our expansion model to an affiliate model. So we are actually working with doctors and allergists now. all the work we've done for the last decade, talking to doctors and allergists, very much willing to learn what we do. They want to be be the referral partner and, and, and do a little bit of co-management, but what they don't want is the risk. 

And so what we're doing is actually taking our employees and our staff, we're hiring them locally. We're gonna affiliate them to an affiliate allergist. And I think that's gonna be a great thing for not only the community, it's gonna be a good thing to get broader coverage. 'cause we'll work through that specific allergist, try and get the cost as low as possible. And that opens up these opportunities. So that's a, that's a model we're working with and absolutely the goal is to get a site up on the east coast here. The issue again is we are not a company that has done things the normal way, We didn't do the, we didn't do the medical industrial complex. We're a medium sized company by all measures. And yet, we haven't taken any significant investment dollars. So, we're doing this fully bootstrapped, which is a very odd story, right, to kind of get to that scale. I believe. Especially given the pandemic, we did a lot of things right. We have not sacrificed, as far as patient safety and, and, and, and the goals for every single patient. Our mission is held. And so yes, I think we're, we're pretty confident, pretty set to get a, a bunch of more sites open up. People should look for that and they should be excited. I would say that I don't think there's going to be any difference. They're still gonna have the same treatment, the same effect, the same support. And I think if anything, we're just getting a bit more digital as far as engagement. 

So, we have like our patient app. It's not like a basic app. We, we build everything on our own, right? Like we have an entire software department within our company. And so you're talking about full engagement, some level of gamification, things to make this more fun and interesting. So the process itself doesn't have to be a difficult one. It's a level of commitment for a, a couple of years, but when they're in that commitment process, the more that we have this level of digital engagement, it becomes easier at home when you come into our sites. We have a great supportive team. You need after hour support. We work to make that the best it can be. I'm a hundred percent committed to patient experience. We wanna make, make it the best thing possible. 

And, if you ever come see our facilities, most people will go in there and the first thing they say is like, this doesn't really look or feel like a medical facility, even though we're, you know, look like a hospital in some ways in these rooms, right? But like, they don't get that feel because, every kid is generally getting a win. And it's a victory after victory, after victory. And it creates a, an amazing experience, not only for our staff and our company and the culture that we have, but for the whole community that's there. It's quite contagious. 

Dr. Amanda Whitehouse:

All of us will be eagerly awaiting to, to see what other options and locations and, and what the future holds. I'm wondering if there was a certain specific inspiration regarding food allergy that inspired you to pursue this? 

Dr. Inderpal Randhawa:

Yeah. You know, I, I do get asked that question quite a bit. To be just very direct, I had no direct experience with food allergy as a kid. I have three children. None of them have it. I have pretty big extended family. None of them have it. Right. And so it, it just got to me, uh, when I was in the ICU a lot and I had a particular summer where we had a lot of anaphylactic events. And I think what gave me some perspective, perhaps more than others, is that I was very comfortable dealing with organ transplants and imagine how complex and, and difficult that is for families. at the very least, they had one thing. They had time, they had time to process, time to think, time to make decisions. And it just absolutely was bizarre to me that somebody could ingest small amount of something in like eight to 10 minutes, sometimes with the deployment of epi, still have injury or death. There's only so many times you can see that. Um, and yeah, I mean, like I tell people, you choose to be bothered. It's a choice. And you know, I was bothered a lot. 

Keep in mind I do work on a lot of other disease areas, right? So maybe this is part of my, my philosophy or something, but, um, yeah, I latched onto that and I've never, I never, I've never let go in in 20 years. 

Dr. Amanda Whitehouse:

Well, thank you. I'm glad that you haven't, it's really exciting and great to have options, but so interesting to hear your unique take and how you approached it. So thank you so much for taking the time to share it with us. 

Dr. Inderpal Randhawa:

No, it's been awesome. I really appreciate you taking the time as well. 

Dr. Amanda Whitehouse:

If today's conversation sparked curiosity or raised new questions, here are three follow up steps. First, you can learn more about the Tolerance Induction Program by visiting their website and reviewing the information they provide about their approach and protocols. And their website is go.foodallergyinstitute.com. You can also find them on social media @food.allergy.institute. Second, I encourage you to speak with your own allergist about any treatment that you're considering. And if you're lucky enough to know other people who have tried these treatments, speak with them too. I'm trying to share some of that with you here on this season of the podcast, but of course, conversation with people that you know in real life is going to hit home even more. And third, if you are navigating the emotional weight of choosing among treatment options and navigating them. I wrote a workbook just for you. It's called From Fear to Freedom, and it's all about navigating immunotherapy options. Whatever path you choose, I hope you'll feel supported. Thank you for joining us, for liking, for sharing the episodes, and leaving your ratings and reviews that are helping this show to continue growing and reach more people who need this support. I'll talk to you next week. 📍 The content of this podcast is for informational and educational purposes only, and is not a substitute for professional medical or mental health advice, diagnosis, or treatment. If you have any questions about your own medical experience or mental health needs, please consult a professional. I'm Dr. Amanda Whitehouse. Thanks for joining me. And until we chat again, remember don't feed the fear.