Meet Allergist Dr. Garen Wolff

Kerry 0:28

All right. Hi, everybody. Welcome back to the Get Healthy Tampa Bay podcast. I'm your host, Dr. Kerry Reller, and today we have Dr. Garen Wolff. Welcome the podcast. Why don't you tell us a little bit about who you are and what you do?

Garen 0:40

So I am Dr. Garen Wolff an allergist immunologist. I trained at Indiana University School of Medicine for my allergy immunology fellowship. So I'm internal medicine trained, and then I specialized. I am private practice. I am in solo practice, so it's just me in the office. I'm located in Detroit, Michigan. My office is in the Fisher Building, which is home of the Fisher Theatre, and I see both adults and children for allergies, environmental, food asthma, hives, urticaria is the medical term for hives, and disorders of the immune system. That's me

Kerry 1:18

Awesome. And you do a lot of, speaking it seems engagements, and are an entrepreneur at heart, like I saying before we got on. So I know you have fun stuff share with us in a bit. But how did you get into, allergy and immunology, and what made you pursue this field?

Garen 1:34

So my first week of intern year, the first week they call you a doctor, I, like Monday, or I think it was like Sunday, I woke up in the middle of the night. I did my residency at Summa Health, which is in Akron, Ohio, and I woke up in the middle of the night and my bottom lip was swollen. And I thought, "Oh my gosh," "What is this?" And so I went to sleep 'cause I thought, who knows what happened. I woke up maybe two or three hours later and my lip

The angioedema experience that inspired her career

Garen 2:02

was even more swollen. It was painful. Couldn't recall the last time I t- I spoke with my chief. I think probably when I interviewed there. And when I saw her during orientation. But I called her. And I was so scared to call her because I thought "I cannot believe that I have to tell them that something's wrong with me." So I called her and I told her that I was having swelling. And she said, "You need to go to the ER." And I was like, "I have to go to the ER? Really? I have to go to the ER that I'm gonna work in? I have to go to the ER that I'm gonna send patients to?" Seriously? She said, "You need to go like yesterday." So I went to the ER. I was diagnosed with idiopathic angioedema. I had no hives. And so they said we will give you some medication, and we will give you a referral to see an allergist." I said, "Okay. Sure." I really didn't know much about allergy immunology at all. I had never really interacted with an allergist, specialist, and I have allergies. Anyway, so I saw Dr. Johnson, and he said what happened?" And I said I ate chicken from from the doctor's lounge." I snuck in there, so perhaps this was punishment. I said, "I had chicken and banana." And I said, "Could I be allergic to chicken and banana?" He said, "You're not allergic to chicken and banana." I was like, "Are you sure?" And he said 30% of people will experience an, a hive, an urticaria, or angioedema incident in their life. And so because I had angioedema, which is our medical term for swelling, as opposed to hives, we did a couple other blood tests to see if I either had inherited angioedema or I had a complement deficiency in which I acquired angioedema. 'Cause that is different when someone presents just with swelling versus hives. All the tests came back negative. And he also tested me for chicken and banana 'cause I insisted. That was negative. He said, "Why don't you follow me for a month and just see what allergy immunology is like?" I said, "Okay." 'Cause it was interesting to me. I was fascinated And so the first month, the first, I think, week, I had a young man in his 30s with scrotal swelling. He and his girlfriend came. And he was just completely You know, appalled. He said, "I'm a healthy guy. What did I do to deserve this?" And I said what Dr. Johnson said to me, "30% of people might have a angioedema or a hive episode." He did not have hives, so we did the test to ensure that he didn't have the inher- the acquired angioedema. He didn't. But anyway, I said from that point on that I thought allergy immunology was very interesting and I decided to pursue it. So I spent a month with him at Akron Children's Hospital, and then I also spent a month at Cleveland Clinic as well with their allergy immunology department. And I just fell in love with allergy immunology, and I decided I would pursue that a- and as a fellow

Kerry 4:47

I think that is the most fun story I've heard. haven't heard any, allergists that have actually been impacted by angioedema. Did you have, do you have hereditary angioedema or no? I don't. I don't.

Garen 4:58

It, but it's never happened again. But it was definitely, was definitely angioedema. But yeah, it never happened again. And so yeah

Kerry 5:06

Yeah, so it's definitely, one of the, the hereditary type. Obviously one of the more of the rare findings that we encounter. But there's lots of treatments it now. So if anybody is suffering Yes ...from that, from that, they should definitely find an allergist to help them with that, for sure. For sure. Yeah. I'm sure we could talk a lot about that, but I know you wanted to talk more about, seasonal allergies, spring allergies, things like that impact patients everything. So how would you like to start with how you would manage that? Or would, kind of... when do people walk in your door with these kind of problems?

Garen 5:38

Yeah, so I, y- the past three or four years allergies have really gotten worse. And some of that is global warming, so our world is warming, which means the seasons are a lot longer, Which means plants have an opportunity to germinate, so we have more pollen in the air as well. Number two, pollution. Once you mix nitrous oxide with the pollen in the air, that can upset allergies as well. And then the wildfires. If

Why seasonal allergies are getting worse

Garen 6:06

you're someone... We're in Michigan, and the Canadian wildfires significantly affected us, and it also affected patients in New York, kind of those that are around Canada the wildfires there, and then of course, the fires in california. And again, a lot of that is due to the climate, you know, ...and global warming. So these past three years, allergies have been a lot worse, especially allergic conjunctivitis, which is allergy of the eyes. I've had people come to my office with their eyes swollen shut because of how bad their their allergies are. And so you can always start with the brand name over-the-counter, Zyrtec, Allegra, Claritin, xyzal. If you are someone who is afraid of drowsiness, I do have patients that are afraid of becoming drowsy, then Allegra is the one for you, because it's the only one that doesn't cross the blood-brain barrier. So I had a patient who was a pilot he wrote on his application, or it was some form he had to fill out, that he took Benadryl, and they just like, no. No." And so he came to me and he said, "They won't let me fly because I said I took Benadryl." He's "What's wrong with Benadryl?" I said it's a first generation antihistamine, which means it makes you extremely drowsy and that is not a- allowed, permitted by the F- the FAA. In fact the only one is Allegra. 'Cause Allegra's the only one that doesn't cross the blood-brain barrier. So if drowsiness is a concern for you, then you could start with Allegra. If you are still having symptoms, like I have a lot of people who've rotated them. Our bodies get used to allergy medication, some, for some people. So you have to rotate every six months, every 12 months. And if you've found that you're, like continuously rotating then you need to see an allergist because there are more treatments. Of course you can buy Flonase over the counter. But sometimes a lot of people don't know how to use the Flonase. I have found that a lot of people use their Flonase or nasal sprays incorrectly, which means they're not really getting the medication. Some people think they can just use it as needed. Steroid nasal sprays have to be used every single day for them to work. If y- you know, if it's working every now and then, it's more of like a placebo effect maybe. So coming to an allergist, immunologist or someone who has allergy immunology background is helpful because you can be provided with a lot of information. And it's just not medication. Sometimes your environment, right? I definitely recommend air purifiers for people. I do not recommend humidifiers for people who have dust mite allergy. But how would you know you have dust mite allergy? You come to see me and you get tested. So it's not only medication, but it's also modifying your environment as well. And so when I see patients, I pursue this very holistically, and we talk about various different ways we can treat their allergies

Kerry 8:46

yeah, we just had a, a great episode on, HEPA filters and air filters and purifiers, Yes ...and how they can help improve our, living spaces essentially. And it is interesting that you say, allergies got worse, because I would agree with you. And, with the irony there is I think I my father, was an allergist, he said, "Don't go into allergy. It'll be cured by the time you'd be a doctor." So here we are, and it's all getting worse, right? But what is good is we do have, pretty good treatments that are, available and effective

Common allergy symptoms people overlook

Kerry 9:14

if you use them correctly, like you were saying. So what are some other kind of symptoms, you mentioned the eyes, that people might be experiencing during, these high pollen seasons or whatever they might be to?

Garen 9:27

Yeah, itchy eyes the postnasal drip. I have a lot of patients that come to me because they're dripping, dripping down the back of throat, and they may not know term postnasal drip, but they know they're clearing their throat all time. Or when they lie down at night, they are uncomfortable. And sometimes I can hear people in my waiting room when they're clearing their throat, and I automatically know, it's postnasal drip. So postnasal drip is a symptom as well. Some people run out the back down the back more than they do out the front. Sneezing as well. And sometimes e- ear fullness, sinus headache. They have pressure in the frontal sinus area as well. That's allergies. I have a lot of patients who come to me from from ENT, ear, nose, throat, and they'll say, the ENT doctor did not wanna do any sinus surgery unless my allergies were investigated, evaluated, and treated," which makes sense. The eyes, the ears, the nose are all connected, which is why when I have patients who come to me with horrible itchy eyes, I actually recommend Flonase. ...Flonase is beautiful for allergic conjunctivitis, and people are always surprised. But, the ears and the nose are all connected, and one affects the other. So ear fullness, frontal pain drippy nose down the front or back, sneezing those are all symptoms of allergies. Mm-hmm. And a cough, because a cough could be postnasal drip.

Kerry 10:50

Absolutely. Yeah. That's awesome. I often hear, patient's significant other also sending them to the allergist for the Yes clearing of the throat and the annoying cough and things like that. Yeah, Yes. sometimes it's not just the patient

Garen 11:02

Exactly. Yeah, I had a husband whose wife sent him. She actually found me on TikTok, she sent him because he was just so bothered by the allergies. And he happened to be a singer, so it was really impacting his quality of life. He couldn't record. He was missing studio sessions, so yeah.

Kerry 11:19

Yeah, I'm sure, those are the great kind of stories that you have from helping people get over and improve their allergy symptoms and everything. Did he have do immunotherapy?

Garen 11:30

No. No, he did not have to do immunotherapy, AKA allergy shots. No,

GMT20260527-140143_Recording_gallery_1280x720 11:34

on Flonase.

Garen 11:36

I started him on Flonase actually, and he did significantly better. That's the only medication he takes is the Flonase.

Kerry 11:42

That's awesome. That's fantastic, and sometimes it is easy enough, like you said, if they're not ...taking

Why Flonase works when used correctly

Kerry 11:47

it or at all or properly, then just a little can help go a long way, and avoidance too. So you mentioned, consistency with the Flonase. Why do you tell patients that?

Garen 11:57

Because, when I see patients, I really believe in shared decision-making. So I give you my recommendations based on evidence-based medicine, and then you tell me how you feel based upon your personal beliefs, based upon your lifestyle. And so some people cannot use Flonase every single They will forget. They just don't want to. They don't like, put medication or a steroid in their nose. And so I always emphasize, Flonase is to be used every single day. But you into any of categories, we can try something else, I like to set expectations, and I like to really look at their lifestyle when it comes to treatment options. Because if you're not gonna be consistent with Flonase, it's not gonna work for you. And don't feel bad about that. Let's just look at another treatment that's better for your lifestyle, your personality, and that's when azelastine, which is AstaPro works really great. Because for those patients, you don't have to use it every single day. You use it 20 minutes, and it works. Y- it doesn't have this buildup effect, and for some people, they prefer that. And then I have other people who are like, "I'm gonna use it every single day. Don't worry. I have medication by my bed. I'm a regimented person," or, "I just feel so bad that's what I want." So I always ask people, how they feel about the treatment. Does it fit into their lifestyle? Just like immunotherapy. Some people don't have time for shots once a week or, twice a week and then for three to five years. It all really depends on their personality and their lifestyle

Kerry 13:23

I think, it hasn't been marketed as such previously, but think one of the earlier fields of medicine has this personalized treatment, right? Because you're creating when creating these plans, but also immunotherapy is personalized to the patient, which I think is interesting.

Garen 13:40

I think that, and, And I talk about this in videos that I make on social media, that everyone is different. Everybody's different, not only lifestyle, but finances as well. And medicine is an

Personalized allergy treatment plans

Garen 13:51

art, so you have to work with people, right? And that's one that's something that I learned when I was in fellowship from one of my attendings who really became a significant mentor, and I really credit him as the reason why I could graduate fellowship and start my own practice. I really felt like he trained me to be independent. But anyway insurance has been very interesting over the past couple years when it comes to coverage for inhalers, and they tend to they tend to cover certain inhalers over the others. And so even patients with commercial insurance 'cause everybody thinks commercial insurance, everything's gonna be covered when it's not. And so I've had patients who could not afford an inhaler and so they can't afford two puffs a day. Okay, no problem. I will put you on a higher steroid, and let's do one puff a day. ...And they're doing fine, all right? Or a higher steroid, and Monday, Wednesday, Fri- you have to, like I said, arts and medicine, and that's one thing that I learned from him, 'cause that's what he would do for patients when they were having issues with insurance or, payment, et cetera. And so we ph- physicians learn how to work around and use our creativity along with evidence-based medicine to help patients. So a lot of times I will do that. I will create, like, a personal plan, still basing it on evidence, still basing it on fact that they need an ICS-LABA, meaning they need a steroid, and a bronchodilator, but making it so it can fit them

Kerry 15:17

Yeah, I would agree. I've had to similar things like that, or finding, like, other pharmacies that do have discounted Yes products and helping them with that. And definitely insurance is a pain, 'cause they might cover one and then drop it, and then patient liked this, dry powdered one whatever. It gets be very difficult. But I mean- It does I think nice that you can also give that, a personalized plan as well. You mentioned that you don't recommend the humidifier for patients who have dust mite Can you explain that a little more?

Garen 15:46

Yeah, so dust mites thrive in humid environments. They love pillows sofas, beds. They live off of our skin, and they just thrive on humid environments. So we usually do not recommend humidifiers unless you can keep your humidity below 40% or if you have an air conditioner attached to it, and we really don't recommend humidifiers during the winter because it gets warm. If you have dust mite allergy, if you don't have dust mite allergy, go

Humidifiers, dust mites, and allergy-proofing your home

Garen 16:14

forth with the humidifier. But if you do, just be careful, and you want to also follow the other dust mite preventative measures: washing, laundering your sheets and your pillows in the highest temperature, changing your sheets, once a week or twice a week if, if possible, if that's possible. Those are, the type of things. When people say to me that they are very stuffy at night or they wake up very stuffy, sometimes I think, "Oh, they have dust mites," because their head is rolling around in dust mites. And some people love humidifiers, which is fine, but you just wanna make sure the humidity is kept low

Kerry 16:45

Yeah, I wanted to ask that question, 'cause in Tampa it's super humid here. So most of our air vents, think the newer ones these days, air conditioners, they have, dehumidifiers built in. But I almost, scream that "Do not use a humidifier." But sometimes you still will find people that use it, especially in kids. They think that, oh, you're to... Yes ...If they get sick or something, they a humidifier. But I'm like, "No, that's not a really idea." And it's also not great for that, Exactly. Up or down here as well. Yeah. So so that's a really good teaching we've talked about, avoidance measures, some over-the-counter medicine, some prescription medicine. Azelastine's now also the counter,

GMT20260527-140143_Recording_gallery_1280x720 17:23

it?

Kerry 17:23

Is, Astepro. And then what is the thing in front of you?

Garen 17:27

So this is, huh, so this is Sniffles. And why did I call it Sniffles? Because when patients come to my office, that's what I hear. I hear patients, I have an office in an office, and so when my office is closed, my office is adjacent to the waiting room. I can hear patients when they sniff and cough. And so when I was thinking of a name, I thought Sniffles was very appropriate because I thought it really, painted the picture of someone who has

The science behind Dr. Wolff's "Sniffles" supplement

Garen 17:55

nasal discomfort. And so I have a lot of patients and we're moving more towards this era of natural treatment. I think we've always been there, but I think as time has marched on, it's gotten a little bit more prevalent as people think about their immune system, especially with, the pandemic that happened, their gut health. We have these soda pops now, Poppi, Olipop, that talk about gut health. I'm gonna put that in parentheses. And so anyway, so people are moving more towards this natural and being more in tuned with their bodies. And I have a lot of patients who say to me, "Dr. Wolf, I don't wanna take, a Allegra, Zyrtec, Claritin. I don't wanna take an over the counter. Do you have anything natural or anything natural you can recommend?" And I'll be honest with you, I- I'd actually tell them, "No, I don't." And so then a couple months ago, like eight, nine months ago, I went on a Saturday, my, my husband took care of our daughter, and I went through PubMed, which is our kind of directory for all the medical and scientific journals, and looked up different papers that looked at chronic rhinitis, which is our medical term for chronic inflammation of the nose, sinusitis, inflammation of the sinuses, and found that there are plants and algae that can be utilized. Now, is this a replacement for Allegra, Claritin? No. I tell patients I believe in medication for sure. There are people that need to be on an antihistamine that has medication. There are people who need inhalers. I do not... This is not a replacement of this. This is like a complement to your nasal routine. So I said, I think I wanna create a supplement." There are a lot of supplement brands out there, but there are very few that are created by a physician and so I wanted to create a brand that was physician founded, physician formulated, and actually had evidence behind it. And so the patients that are in the mast cell activation syndrome world the urticaria world, they are very familiar with quercetin. Quercetin is a plant ...that helps stabilize histamine. So they already know about that because that whole world, they're very big on taking quercetin. Quercetin stabilizes histamine, so it can also be used as, for allergies as well. So one of the plants in here is quercetin. The other one is silymarin, which has antioxidant properties, and then the third is spirulina. And spirulina was popular, I think, like seven or eight years ago. It's actually green, which is why the capsules are green. The powder is green. But it's an algae, and it has anti-inflammatory properties, and all three of these have been linked to helping with chronic rhinitis, interestingly enough. And so anyway, and I also added vitamin D and vitamin C because I have found that with allergies ...tend to get colds more than other people. And I'm someone who gets allergies. My husband does. My daughter has eczema. We're just an atopic, which is our medical term for allergic family. And so I wanted to add vitamin D and vitamin C in there to boost the immune system as well, along with the three plants, and that's how I came up with Sniffles. And I launched it maybe two or three weeks ago. The response has been very good so far. And, we live in a society where people, they like to be helped, immediately and let it work in your system. And so the supplement, like I tell everyone, is not gonna work within the first week or two weeks. It's gonna take at least three weeks for it to kick in, four weeks for to kick, in. That's when I came up with Sniffles Go, which is actually a nasal inhaler. Now, this is not a nasal spray. You do not spray this in your nose. I don't, I didn't wanna put anything up the nose. But there are other companies that have nasal inhalers, and so the purpose of this is to open up your nasal passages. So this is made with eucalyptus and lemon essential oils. You just stick it under your nose, sniff, and it opens your passages up. So there are other there are major companies that create nasal inhalers, but there's, again, evidence base that both of these will open up your nasal passages. So that's how I came up with Sniffles Go. This is for later, and this is for now. And so yeah, that's how I came up with it, and it's non-drowsy. A lot of patients ask me, "Is this non-drowsy?" Because, again, the only medicated non-drowsy is Allegra. And so this is completely a non-drowsy alternative to, what we have on the market.

Kerry 22:09

That is super cool. I al- already can, I don't know, commiserate, empathize with every allergy patient because you said they get sick more and that's totally true. I think it's part of, mucosa and the mucus and, Yes ...viruses and bacteria sticking to it. And then obviously sometimes their immune system is a little bit compromised they have another issue as well. And, I think the vitamin C and D boost, I think while the evidence isn't always great for the D, we all know that everybody needs it. Just can't say, "Oh yeah, your asthma's gonna be better from it." But they do find that relationship too of vitamin deficiency and asthma, and they always are trying to Yes ...do studies to see if there's evidence behind that. That really is, great additions to, the things that you up on PubMed for the other components of it well. And yeah, I There's a big the big MCAS and histamine blocking with, I think there's a big, Yes social media craze on that. think don't know, I either listened to something and then of sudden I was getting all this stuff in my feed, and it was like, "Oh no wonder people are hearing a lot." And sometimes it's not accurate, so it's great to, find that you're looking things up to find it evidence-based ...to find the reason to do that. Because like you said, the, everybody wants natural. I get those questions all the time and I'm like, "I don't know exactly what do." And in our practice we have health coach and I'm, I always am like, what you can find for our allergy and eczema patients," things like that. And, I think we have things, but this seems like it's great product that everything is, in one, essentially. Which is really nice.

Garen 23:41

I think, one thing that we use these over-the-counter antihistamines, I use them not only for people that have allergies, but I use it for people with eczema, some people, their eczema's triggered by seasonal allergies. Triggered by seasonal allergies. And so if I can control their seasonal allergies, their eczema won't flare as bad. I use the over-the-counter for urticaria for patients with allergic asthma. Patients with allergic asthma, if I treat their allergies, their asthma isn't as triggered. So I see Sniffles as a way to look at all of these conditions to help. Because of the histamine and the the two other plants as well it could help with them as well

Kerry 24:18

Have you there was another product that a hives patient was asking me. I think it's- ...NAD. Maybe it was NAD, I don't remember. But ...N-acetylcysteine,

Garen 24:29

Yeah, n-acetyl- Do you feel about that or is there any data? The data is mixed, and I think it can be toxic to a certain point. I'm not quite sure. So I, I was eh, I don't think I'm gonna do NAC. I think quercetin was just a little... There was a lot of evidence for quercetin, so I, I just stayed with the quercetin for kind of the histamine component. Yeah. I think they use N-acetylcysteine

Kerry 24:51

NAC, N-acetylcysteine with COPD patients a lot of times. Yes, they do. They do. I don't know the dose I don't... Yeah. You're thinking could be you're trying find something, more natural and something that can, somebody can do every single day. So ...I think that definitely makes yeah, I'm sure there's lots of other components that could be added to it, but I think what you've, started with really great. So it's so new, you, I guess don't have any I don't know. Do you have any yet? Yeah, N of- Not yet.

Garen 25:18

N of

Kerry 25:18

one,

Garen 25:19

which would be my husband. Yeah. But, that's pretty much it thus far. It's, you can't take it if you're pregnant, that excludes that, and children. So I so many p- why can't you take it if you're pregnant? I didn't hear anything any any supplement is ne- is not r- recommended for pregnancy. Okay. Not any supplement. Prenatals are, but I just caution because the studies I looked at didn't have any pregnant women. And, pregnant women are never in studies anyway. It's very rare. So I say pregnant and nursing no. It may be perfectly fine, but, like, the studies I looked at for these three, like I said, didn't have any pregnant, women in it, so that's why I say that. And then for children. The studies I looked at were all adults. So I say 18 and up. I have so many people who have asked me on TikTok and Instagram, "Can children take it? Can children take it?" And I just say, "18 and up," and I will perhaps look at that down the road. But again, the studies have always been 18 and up.

Kerry 26:18

So where people find it if they want to take it?

Garen 26:22

well, you're in Detroit or you're Michigan, can come to my office. Or you can go to sniflz.com, S-N-I-F-L-Z.com. And then we also are on TikTok shop as well, so I'm on TikTok and I try to do TikTok lives once a week. So anyway, my office, online or TikTok shop you can purchase it

Kerry 26:42

I did not know TikTok had a shop. So clearly I don't go Yeah. Oh my goodness, yes.

Garen 26:47

Yeah. Oh my goodness, yes. You know what? I'll be very honest with you. My best return of investment, my best ROI is TikTok. I mean- It's my- ...I can't say I'm not on it, but I'm not so good on it. But, don't ...that's great. Yeah I don't dance. I don't do skits. I literally... 'Cause, I'm talking to you in my lab. I literally talk to the camera in my lab about allergies and asthma, and it's interesting because if you follow me, you know that's all I talk about. So you have to be invested.

Growing an allergy practice through social media

Garen 27:15

I don't show pictures of my husband, my daugh- Like, maybe for holidays, but not on a regular basis. I don't really bake unless it's a holiday, and maybe it was, like, once. So if you're following me, you know that all she's gonna talk about is allergies and asthma, so that's interesting to me because they're intentionally following me and they're, ...and like said, that's all I really talk about. So yeah.

Kerry 27:37

I think it's obviously a great thing you to do business-wise. So how does someone, know you had some entrene- entrepreneur background obviously, but does someone go ahead and start a supplement Oh my gosh.

Garen 27:47

I've done so many different, i've done so many different endeavors. When I had a nonprofit for girls when I was in middle school for 10 years and th- we, which incorporated a college tour. I went to Wellesley, so Wellesley College allowed the 40 girls and their moms to stay on the campus, and every day we went to a different Ivy. It was an Ivy League college tour. When I was at the NIH, I did a fellowship at the NIH. I... it was interesting. I was working with mice, which I'll never work with mice again. That was terrible. So I applaud a lot of people who work with animals, but anyway, this was before medical school. Anyway I did research by day and then I wrote a book. I wrote a book for girls, middle school girls a series. In fact, one of the books is cataloged in Germany and I did a couple book signings in London, and some around Michigan and Ohio. So being an entrepreneur is in my bones. That, that's my point, right? It's in my bones. Have I done anything else? No, I think that's it. My practice. Yeah. Of course. So yeah, so then I opened my practice after fellowship. During fellowship I applied for the insurance contracts and all that stuff. Had the logo made and all, and created the website and stuff like that. So supplement is an entirely different world. It is not regulated per se by the FDA, meaning you don't have to submit paperwork to the FDA. You cannot make certain claims. You can't cure this, can't... so that's why I don't specifically say allergies. I say seasonal nasal discomfort, even though if you walk down the aisle of all these drugstores, you will see increased memory, incre- which is, they're not supposed to do that. But they're big companies, so they'd probably be able to fight it, but you're not supposed to put an actual disease ...on the bottle. That's not allowed because it's not a medication but what was important to me was to be third-party tested. So you know, recently there was a a brand of formula that a very popular plant-based kind of trendy brand that was... they're probably gonna file bankruptcy because they found that their formula had bacteria in it, and the children were getting, I think it was botulism. Botulism. It was huge, yeah. It broke, three or four months ago. And so it was a husband and wife that created the formula. And anyway, they didn't really... Their quality control wasn't really very good, and about 20 babies were affected with botulism pretty bad. I think all of them have survived. And anyway, my point is that you should... It's not mandatory, but you should get your product tested. So when it comes to supplements, it's the Wild West because no one is really regulating it. But one thing I wanted to do was to make sure that my supplement was third-party tested. So when I went into do I wanna create this, I did the research, then I had to find a supplier. That was a whole 'nother thing. So I had to find a supplier in the United States, and then I looked at other suppliers around the world. Then I looked at creating the logo, how many capsules, and then I needed to find someone to third-party test. And so Eurofins which is an international company, They're all over the world. They test for c- pesticides and metals and bacteria. They do a lot of things. Eurofins does a lot of things. But I sent all the bottles over there and for a very large fee, but it was worth it. They tested to make sure that this didn't have any contamination, contaminants in it. And then I found another company called Alchemist in California to actually test to make sure the spirulina, which is an algae, was actually what was put in the bottles because that's Eurofins does not test for that partic- doesn't test for algae. Plants, yes, but algae's a different organism which is interesting. So yeah. So that... the whole process very long. And it just... Yeah, it was a lot. It was a

Kerry 31:28

You say that, but you said you had the idea eight or nine months ago, and here you are

Garen 31:31

Yeah, eight months, Yeah, about eight. I made a TikTok video because I had so many patients ask me, and I made a TikTok and I asked my followers on TikTok, I said, "Do you think I should do this?" And so many people were like "Yeah, yeah, yeah." So then I told my husband, I said, "For the next couple Saturdays, you're gonna take care of Madison. I'm gonna go to to the library," and I stayed at the library, like, all day going through papers, printing papers. I went to Office Depot, printed 20 pages, when you're a physician, you remember how to go through research papers. Underline, I created outlines, and really, Anyway, so it was a lot. The research end was a lot. But then of course finding producers and then making sure that the supplement facts were correct. And was there was a lot that goes into... And then getting an attorney, for product liability. Yeah, it's

Kerry 32:15

That's a lot. I commend you. Very exciting, That's- and I know that's not even marketing part. Yeah. That's

Garen 32:21

a whole nother... the influencer world is so interesting. I was, I contacted three influencers. They all had agents. They were all in their 20s, and I asked them if they would try it, and post if they want. Guess how much they were charging? These are 20-year-olds that have agents.

Kerry 32:38

I have no idea

Garen 32:38

eight, $8,000. I said, "What? For one post? amazing. for them. That's ridiculous. Wow. It is ridiculous. I the lowest was $5,000, and when I told them it was too much, they were like we're willing to negotiate." I'm, I'm like, my budget's like 100. N- that's not n- that's not negotiation to me. That's like insulting them, I was like, "I can't negotiate- Yeah with you guys. $5,000?" Anyway, so that's a whole nother world is, getting people to try it and post and all of that. Very... it's exciting. Yeah, that's awesome.

Kerry 33:12

So hopefully, that with the, the supplement, avoidance, the over-the-counter medicine. We didn't really into immunotherapy, but we've got lots of things that you can offer all of your pateints. Is there anything else that you'd like to share with the listeners today?

Final advice for people living with allergies

Garen 33:29

Know that allergies are not your fault. They can be treated, and we, physicians are happy to listen to you. I had a woman say to me, because she just told me all her symptoms, and then she stopped and she said, I sound like a hypochondriac, don't I?" I said, "No, you sound like a human who's been impacted by something that's affected their quality of life." So we are here to listen and to help,

Kerry 33:52

Yeah no think that's excellent. That's something I, like to that I do as is I'm a good listener, whereas, not all of of the doctors there are. So That's true. find the right one is not for you. But I think people are getting better at that too, and where... you mentioned a couple things already, but where can people find you if they wanna follow you? Obviously TikTok is your hot spot, but any- anywhere else Yes or they wanna work with you?

Garen 34:14

I'm wolff with two Fs allergy on Instagram and TikTok and Facebook and YouTube. I'm

Kerry 34:22

And

Garen 34:22

on all those platforms.

Kerry 34:23

And

GMT20260527-140143_Recording_gallery_1280x720 34:23

your practice is in Detroit in... Detroit, Michigan. Yeah. We're in

Garen 34:27

Midtown Detroit, not too far away from Henry Ford Hospital and the Motown Museum. We are in the beautiful Fisher Building. It's... I think it's... I actually think it's the prettiest building in Detroit. A lot of people think the Guardian Building is, but I think this building is incredible. Very beautiful architecture

Kerry 34:42

That's very unique a medical practice, that's pretty cool. Yeah. Awesome. Thank you so much for, all of your education and exciting product that you developed, and hope that everybody will like and follow you. And thank you so much for coming today, and everybody stay tuned next week for next week's episode

Garen 35:00

Thank you

Kerry 35:01

All right. Get healthy, Tampa Bay.