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The End of Food Allergy: The First Program to Prevent and Reverse a 21st Century Epidemic

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A life-changing, research-based program that will end food allergies in children and adults forever.

The problem of food allergy is exploding around us. But this book offers the first glimpse of hope with a powerful message: You can work with your family and your doctor to eliminate your food allergy forever.

The trailblazing research of Dr. Kari Nadeau at Stanford University reveals that food allergy is not a life sentence, because the immune system can be retrained. Food allergies--from mild hives to life-threatening airway constriction--can be disrupted, slowed, and stopped. The key is a strategy called immunotherapy (IT)--the controlled, gradual reintroduction of an allergen into the body. With innovations that include state-of-the-art therapies targeting specific components of the immune system, Dr. Nadeau and her team have increased the speed and effectiveness of this treatment to a matter of months.

New York Times bestselling author Sloan Barnett, the mother of two children with food allergies, provides a lay perspective that helps make Dr. Nadeau's research accessible for everyone. Together, they walk readers through every aspect of food allergy, including how to find the right treatment and how to manage the ongoing fear of allergens that haunts so many sufferers, to give us a clear, supportive plan to combat a major national and global health issue.

352 pages, Hardcover

First published April 28, 2020

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617 people want to read

About the author

Kari Nadeau

5 books3 followers
Kari Nadeau, MD, PhD, is the director of the Sean N. Parker Center for Allergy and Asthma Research at Stanford University and is one of the world's leading experts on food allergy. Dr. Nadeau holds the Naddisy Foundation professorship in medicine and pediatrics at Stanford University and as well as both an MD and PhD from Harvard Medical School. She is a member of Stanford's Maternal and Child Health Research Institute and the Stanford Institute of Immunity, Transplantation and Infection. Her work has been featured in major broadcast and print media around the world.

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5 stars
56 (28%)
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84 (42%)
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45 (22%)
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12 (6%)
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Displaying 1 - 30 of 30 reviews
Profile Image for melhara.
1,857 reviews90 followers
April 6, 2021
3.5/5

This was an interesting non-fiction book about raising kids with food allergies, living with food allergies, and more specifically, about immunotherapy treatments that are currently available to treat allergies.

The first half of the book is a deep dive into the types of allergic reactions (along with the differences between food allergies and food intolerances), possible causes for allergies, common food allergies and things to look out for if you or a family member has food allergies.

The second half of this book explores the world of immunotherapy treatments for food allergies, most of which are still in the clinical trial stages (long-term effects and results are still being studied), but have resulted in patients being "cured" from their allergies or having a higher tolerance before allergy reactions kick in. These treatment options essentially consists of people with food allergies eating a specific dosage of their allergens (in a controlled environment, monitored by a team of doctors) to help the patient build more tolerance towards the food that they were originally allergic to (kind of like mithridatism - in which you continuously self-administer non-lethal amounts of poison in order to become immune).

I thought it was also interesting that the authors included discussions about climate change and how it can play a role in the increasing number of food allergies occurring worldwide. As temperatures changes, plants have to evolve and adapt. This may mean that they will produce more proteins that are the cause of allergy symptoms.

The target audience of this book though appears to be parents with children with food allergies as it offers a lot of advice on how to adapt and accommodate to a potential lifestyle change when it comes to food avoidance.
When it comes to infant diets, variety isn't just the spice of life; it's essential.

I think one of the key takeaways from this book is that if you want to prevent infants from developing food allergies later in life, you need to ensure that they have a diverse diet and to try all foods once they're able to eat solid foods.

The 6 D's at the end of the book (detergent, dogs, diversity, vitamin D, dryness, and dirt) also offers great advice for making lifestyle changes to reduce the risk of food allergies (by avoiding harsh detergents, introducing our immune system to various microbes, diversifying our diets to improve immunity and cultivate a healthy gut microbiome, etc.).

As for immunotherapy, I personally don't think it is worth the pain and discomfort, unless the child (or adult) is severely sensitive to the allergen or if they have multiple (severe) food allergies. With that being said though, I don't have any food allergies so can't speak to whether or not people with food allergies would be interested in pursuing this. I just don't think this is the path for people with milder symptoms (ex. my mom is allergic to eggplants, and her lips would swell whenever she eats a certain amount of it. As the allergy reaction is not life-threatening, her allergy threshold for it is quite high, and eggplants are easy enough to avoid, I don't think immunotherapy would be worth it for her to pursue). If you're worried that even coming into contact with a peanut would kill you (or your child) though, then perhaps this treatment is worth considering.

*** #37 of my 2021 Popsugar Reading Challenge - A book you think your best friend would like ***
Profile Image for Ariela.
534 reviews12 followers
November 29, 2020
As someone with a food allergy and as a parent of a food allergic child, I wanted to learn more. This book is a helpful resource for anyone starting from scratch in this daunting world, but with a few caveats. First, the authors are involved with oral immunotherapy, a new and increasingly popular way of desensitization for allergic people. As such, they are fairly clearly coming from a place of “this is better than the alternative,” when that may not be true for all. My shellfish allergy, for example, is much easier to avoid than paying $$$ and spending many 6-hour sessions in a doctors office. Further, the many heinous examples of reactions throughout the book don’t do much in service of the information and just kind of seed the anxiety the book purports to be empowering laypeople to avoid. 2.5 stars.
Profile Image for Scott.
172 reviews7 followers
October 20, 2020
Super informative book that is a medical history, how-to guide, and a survey of medical advancements all in one. I can't say I've read a lot of books about food allergies, but of the ones that I am aware of, this is probably the most informative one. Nadeau and Barnett write in an honest and straightforward manner, as researchers but also as parents. It's written primarily to parents of young children with food allergies, but I still found it very enjoyable to read. They present a lot of fascinating research, but remain mostly unbiased and express both skepticism and optimism where appropriate.

As a millenial-aged food allergy sufferer, I felt a wide range of emotions reading this book. I'm more grateful for my parents who had to deal with my food allergies at a time in the late 80's/early 90's when researchers were seeing scary, drastic increases in food allergies and were trying everything to explain why and how to prevent it. I'm in awe of how complex food allergies are in terms of what might cause them, how they differ from each other, and how we still know so little about them. And, I'm excited because of the breakthroughs in immunotherapy that has been occurring as well as the large number of experimental treatments being conducted. I'm grateful to have contributed a little bit to food allergy research as a clinical trial participant whose experience was briefly recounted on page 189 of the hardcover.

My one very minor gripe is with the organization of the book. While it's divided into Understanding, The Science, and Perspectives, it jumps around a bit in terms of history, practical advice, and research. It didn't make the book any less readable, but I would have organized the book more around the latter themes I suggested.

Note: I received a free copy of this book because of my contribution to one of the chapters.
Profile Image for Chintushig Tumenbayar.
464 reviews33 followers
December 27, 2020
Хоолны алерги хичнээн төвөгтэй зүйл болохыг бид гадарладаг шүү дээ. Энэ төрлийн нарийн судалгаанууд ганц лабораторт бус бас дэлхийн бусад улс орнуудын иргэдийн хэрхэх аж төрж байгаагаас анзаарсан дүгнэлтүүд ихээхэн үр дүнтэй байгааг онцлон хүргэсэн ном байлаа. Сайн цаг удахгүй ирнээ.
Profile Image for Ângela Maresch.
53 reviews
June 11, 2023
I thought this book was fantastic! A great effort to collect the most important state of the art on allergy, carefully written, resulting in a book that is both informative for the allergic patients and their families, and also enticing for the health professionals! As a health professional in contact with food allergy diagnosis I was informed on the advances in immunotherapy, vaccines and other interesting technologies emerging for the food allergic. I also learned how turbulent was the history of food allergy, and how allergies truly change the way people live and feel about themselves. If you would like to learn more about the world of food allergy, this book is a precious nugget!
Profile Image for Sophie.
422 reviews
June 3, 2021
This was a slow and plodding read, with what felt like too much repetition between chapters and too much padding. Still, the research that they report on is fascinating. If you're pressed for time, I suggest focusing on Chapter 7, where they explain about immunotherapy.
Profile Image for TJ.
289 reviews28 followers
June 6, 2021
As someone who had immunotherapy for 4 years and living with eczema, I picked this up to satisfy my need for validation lol. I didn’t learn much new stuff though.
Profile Image for Lloyd Downey.
759 reviews
January 28, 2025
The main message of this book appears to be that allergies seem to have been increasing but much of it can be attributed to kids not being exposed to the allergens at an early age. And that by exposing people to regular small doses of the allergens they can build up a resistance or tolerance to the allergen. However, I was slightly put off by the note that “Don’t try this at home” plus the other word of advice at the end, that this doesn’t work for all allergens.
So certainly interesting ....but I was aware of these procedures before plus the idea that by preventing our kids from having exposure to animals and dirt that we were actually creating these allergic situations.
What was new to me were the various food experiments: LEAP, EAT, HEAP, STAR etc., that proved that exposure worked. Results like 86% improvement and 70% improvement are pretty impressive; you don’t need statistics to make the case. But I have only read the Blinkist summary version of the book. Maybe the full book has more qualifications and nuances. But I think I’ve got the gist of the arguments and I’ve extracted a few nuggets that caught my attention, below:
“Allergist Gideon Lack developed a revolutionary hypothesis about food allergies. More British parents than ever were following the standard medical advice of the time. It boiled down to a simple message: don’t feed your baby peanuts. That way, you’ll avoid the risk of them developing a peanut allergy.
Sounds logical–but apparently it wasn’t working, and no one knew why. [At a conference in Israel] He asked “Who here has treated at least one case of peanut allergy in the past year?
Whenever he asked this question in the UK, nearly all the hands would go up. But there, in Tel Aviv, only a couple did.......It turned out that Israeli babies were eating food containing peanuts at a much higher rate than British babies–seven times higher (69 versus 10 percent) by the age of nine months old, he later determined.
Could early exposure to peanuts actually help children to be less likely to develop peanut allergies, rather than the other way around?
In 1997, less than 0.5 percent of American children had peanut allergies. By 2018, that percentage had more than quadrupled to 2.2.....The key message here is: Food allergies are a global problem, afflicting both children and adults at alarmingly growing rates.
All the way back in the fifth century BC, the ancient Greek physician Hypocrites observed people suffering from cheese allergies. He theorized that their “constitutions” were simply “hostile” to the dairy product.....Essentially, allergic reactions to a certain type of food happen when the body’s immune system mistakes that food’s proteins for dangerous foreign substances. People with food allergies usually have high levels of IgE. Those levels, in turn, seem to be determined by certain genes. But not everyone with high amounts of IgE ends up developing a food allergy, so this theory alone can’t explain the phenomenon......In all likelihood, food allergies are the result of a complex array of interconnected factors
Lack and his colleagues collected data on 8,826 Jewish children in both Israel and the UK.
The children of both countries also had similar rates of asthma, so Lack and his colleagues could control for that variable as well. If the two groups of children still had different rates of peanut allergies despite sharing these similarities, that would seem to rule out genetics and asthma as an explanation......What could a skin condition like eczema possibly have to do with an allergy to eating peanuts? The connection isn’t immediately obvious.....Nonetheless, it definitely exists.
The dual-allergen exposure theory suggests that our skin might be one of the main conduits of developing food allergies......There’s a slight chance some peanut proteins will sneak their way into your body through your skin–a risk that becomes much greater if you’re suffering from a condition like eczema.....How’s your immune system going to react?.....It will increase the chance that the immune system will trigger an allergic reaction
The problem isn't skin exposure per se; it's skin exposure combined with the tendency to avoid feeding infants food containing potential allergens-also known as allergenic food. And this brings us back to Gideon Lack's hypothesis......The key message here is: Gideon Lack hypothesized that eating food containing allergens could help babies avoid food allergies-and vice-versa.
In fact, the opposite advice might be in order: parents should actively try to include allergenic foods in their babies' diets, rather than avoiding them-and mothers shouldn't avoid eating them during pregnancy or breastfeeding either.......But only if Lack was correct-a very big if.
The key message here is: [A major study] The LEAP study confirmed Lack's hypothesis that early exposure makes children less likely to develop peanut allergies.
Among the peanut-eating babies who didn't have peanut allergies before the study began, there was an astonishing 86 percent fewer who'd developed peanut allergies. And even among the babies who were allergic to peanuts before the study began, there was an astounding 70 percent reduction in peanut allergies.
Food allergists from around the world were inspired to pursue many avenues of follow-up research........The key message here is: Introducing babies to allergenic food seems to be a generally good idea, but there are some important caveats.
The EAT study [another food study] then showed that it was safe for babies to eat sesame, milk, fish, eggs, and wheat during the first six months of their lives......For the rest of the alphabet soup of studies, the results were also a little mixed. All of them focused on egg allergies, and most of them showed analogous results to the LEAP study: feeding babies eggs appeared to decrease their risk of developing egg allergies. But the effect was slight in the STAR study, and it was contradicted by the HEAP study.
The key message here is: Oral immunotherapy [OIT] can reverse already-existing food allergies....That points to an obvious way of reversing food allergies: re-educate the immune system....But how do you do that? Very gradually, is the short answer......By getting more and more familiar with it, the patient's immune system becomes less and less prone to perceiving it as a threat.....Other patients want to go further and be able to tolerate larger quantities of the food-perhaps even an entire serving of it.
The key message here is: OIT is becoming less demanding, dangerous, and time-consuming.
If she just wants to be safe from accidental exposure to an allergen, it takes about six months. If she wants to be completely desensitized to the allergen and be able to eat full servings of the food in question, it takes about two years.......Sometimes, that brink is exceeded, and the patient has to suffer the consequences......Meanwhile, an array of alternative treatments are also in the works, ranging from food allergy vaccines to gene therapy,
Thanks to some recent advances in science and medicine, food allergies could soon be a thing of the past. Introducing babies to allergenic foods at an early age can help prevent them from ever developing food allergies. Oral immunotherapy can help other people overcome the food allergies they already have. In both cases, careful exposure, rather than avoidance, appears to be the key to success.
If you or a loved one suffers from a food allergy and you're interested in trying out oral immunotherapy (OIT), this is the first step you should take.....But OIT can be highly dangerous, and it's something you should definitely not try doing on your own.”
So what’s my overall take on the book?...Certainly found it interesting. Learned a bit more. Easy reading. Happy to give it 4 stars.
Profile Image for Julie.
226 reviews1 follower
November 20, 2020
This was a good book, and I am impressed with how they are working with peanut and other allergies to make it possible to not have deadly reactions from accidental exposures. Fear of feeding a child with allergies must be terrifying.

I was surprised that there was no mention of peanut proteins in vaccines being a possible cause for the rapid increase in peanut allergies in the western countries. I am wondering if vaccines did not have a peanut protein in them if there would be the large number of peanut allergies. Why isn't this being studied or mentioned in this book?

Also, simple natural things that you can do cut down on allergies was limited to the 6 D's on two pages at the end of the book. These ideas needed more emphasis.

The biggest takeaway was to feed your child a variety of food as early as you can to help keep them from getting allergies. They used to think you should keep allergens away for as long as possible.
If there are allergies in your families I would definitely read this book.
Profile Image for Zhivko Kabaivanov.
274 reviews9 followers
December 27, 2020
The End of Food Allergy (2020) shows how recent developments in science and medicine are beginning to solve a problem that has plagued humanity for thousands of years. Combining data-driven research with inspirational storytelling, it provides a window into one of the biggest scientific and medical revolutions of our time.

Profile Image for Lauren West.
21 reviews
December 22, 2020
Concise and easy to read collection of past and current food allergy research and treatments. Pretty encouraging for the future of living with (or without) food allergies.
Profile Image for Ryan Kapsar.
Author 6 books4 followers
October 8, 2020
I bought this book, because I'm going through a LOT of food allergies right now. Even though we're in COVID, I'm stuck in the house more than just about anyone else. I have allergic reactions to the pollen outside to the point that my throat feels like it's closing up. On top of that, I keep rolling back my food uncovering new things that I'm struggling with. Testing can be a challenge and it's kind of impossible to test for everything. Just the other day, I figured out that I couldn't have pasta sauce, either because of basil or because of tomatoes. Regardless, things are hard and really stressful for me.

So, I bought this book looking for some other sorts of ideas that could help with my ongoing treatment. I'm currently undergoing Immunotherapy, which this book is basically all about. Well that and preventing food allergies in kids. So, if YOU are expecting and really worried about your kids having allergies, this book is for you! There's seriously a full chapter on the different types of research conducted to uncover the root cause of allergies.

The general findings are that you need to expose kids early, with a bunch of stuff together, rather than waiting a long time. (There are things that make that easier). That and if your kid has dry skin, you better doing everything you can to heal it, cause that's a major vector for food allergies.

The Authors spend a bit of time scaring the crap out of readers with short cases of allergy sufferers dying. Which kind of sucks to read. Cause they are young kids that unknowingly eat something that kills them. It's a stupid tragic death. It's terrifying, cause I feel like that could happen to me. I'm pretty sure that could happen to me if I eat ginger, so it's looking at death in the face, if you have allergies.

However, there's good news, because they go from talking about kids dying to talking about how they saved a bunch of other kids using Oral Immunotherapy. They also talk about a couple drugs that speed up the immunotherapy from a year or more to less than a few months. However, I'm actually ALLERGIC to that drug, so I hope, in your case, you have much better luck.

In terms of peanut allergy sufferers there's even better luck, because there's something of a "vaccine" that switches your immune system from attacking peanut protein to actually treating it as food. There are a number of studies in progress.

Overall, this book was really well written, there are fantastic layperson explanations of very technical immune system deep dives. There's clear explanations of risks for any and every treatment options. There's a lot of hope in this book. The other thing that's really nice. They talk about the emotional and psychological toll these allergies take on a person. They strongly recommend finding a therapist to talk through the anxiety and stress of the disease.

My biggest complaint is the last of end notes to indicate what study they are referencing at any given time. They often have summaries that are cited at the very end, but it's not like the Body Keeps the Score, which has notes to the actual papers as they are reference.

Highly recommended if someone you know is suffering from food allergies.
Profile Image for Kalisha Grimsman.
120 reviews1 follower
April 11, 2021
I don't think I would quite categorize as "I really liked" this book, but rather it was very helpful as a parent with two kids who have food allergies. Since no one in the family I grew up in has food allergies, this is new territory to me. I have often been disappointed in the advice I received from medical professionals, which is to avoid the allergen at all costs– with no hope of any change. This book covers the science of rising food allergies in the last few decades and some of the theories as to why (although none have been definitively proven), how allergy actually works, the history of some of the treatments used, and the latest science about new desensitization regimens in which small doses of the allergen is administered and gradually increased to allow for greater tolerance. It was helpful to read about all the successful studies and the ways that this method is evolving. I hope that these programs will be fully approved by the FDA soon because it could change so many people’s lives. The author is a researcher at Stanford which has housed many of the clinical trials. I didn’t read this cover to cover since you can explore the chapters based on what information you want to learn.
28 reviews
February 4, 2025
Finding out that your child has a peanut allergy is disorienting because you start realizing how much you need to be aware of in our world. This book did a great job acknowledging the challenges of navigating life with a severe allergy while providing opportunities for hope. Immunotherapy is a new treatment regimen that slowly integrates small doses of the allergen into the body in order to desensitize the body to this harmful allergen. The authors were certainly pro-immunotherapy, but I appreciated their balance in not pushing this agenda with a heavy hand. I'd like to see FDA approval and a little broader implementation in the medical space before having our son embark on this endeavor. In the meantime, I am thankful for all the resources to help our family figure out the best way(s) to move forward in a world filled with peanuts.
Profile Image for Jada.
6 reviews
January 25, 2025
Hello,

This book was an easy read from the perspective of a mother of a child with severe food and environmental allergies. The medical terms used were not foreign to me because I've spent almost eight years researching allergies and their relationship with eczema and asthma. However, if one is not versed in medical terminology, the author does a good job explaining (in my own words, haha) the meanings of such terms.

I am taking away one star because of the title. It seems a bit misleading because all the information in the book can easily be found through internet searches and even an AI assistant. Admittedly, not everyone interested in learning more about allergies is internet savvy. Furthermore, food allergies are not going anywhere. Thus, the title is misleading.
Profile Image for Emily Mellow.
1,633 reviews14 followers
November 2, 2021
It's comprehensive regarding severe food allergy: why it is thought to be on the rise, how to prevent it, and finally how to treat it. Unfortunately, they say over and over that they don't address food intolerance or sensitivity, which is also hugely on the rise, and might in fact be what the high numbers of people claiming "allergy" are actually experiencing, making the failure to address it a problem. This book unfortunately does not have helpful information for much of the population, who still can't eat so many foods without huge health problems or discomfort.
Profile Image for Dave Conroy.
34 reviews1 follower
December 28, 2020
This book is a deep dive into case study upon case study involving the world of food allergies. As a casual reader, I found this book to be a grind to persevere through. However, there are a number of helpful tips for supporting families members with food allergies (I have two family members with food allergies) and this book provides hope for a route out of the food allergy world.
Profile Image for Melodie.
68 reviews1 follower
December 3, 2020
THE BOOK I wish had been written when my son was first diagnosed!! A great reference and very easy to understand.

I also recommend The Other Side of Impossible by Susanna Meadows if you are looking for hope :)
48 reviews
June 3, 2021
I wish I had this book 22 years ago when my child was first diagnosed! It's a complete handbook for how to cope. Too late for that for us, but it was inspiring to learn about emerging treatments and research.
2 reviews
October 9, 2021
Must read for food allergy families

Great book for anyone who is impacted by food allergies. Authors give great data on latest science around immunotherapy and well as calling out common myths.
Profile Image for Christina.
152 reviews
November 15, 2021
This book made me feel so depressed. Like it would be a great book to read BEFORE you have kids. It didn’t offer me much guidance, but it did help me understand the process of clinical diagnosis and oral immunotherapies.
153 reviews
May 27, 2021
Very interesting topic. Make me understand more of all the aspects of food allergy.
Profile Image for Douglas Bowen.
164 reviews2 followers
June 1, 2021
Pretty interesting read and I learned a fair bit.would be extremely helpful if I or a loved one had a food allergy
Profile Image for Michelle.
3 reviews
April 17, 2024
The title of this book is misleading. The authors promote oral immunotherapy as the best treatment for food allergic reactions. They present many scientific research studies that contradict each other. I have a science background and still found it to be confusing. There is no “end” to food allergies for all people, just treatments to make living with them more manageable.
Profile Image for Eva Haneborg.
113 reviews18 followers
June 26, 2024
Not much new, but well structured and easy to leaf through. Mostly focused on children and what you can do to prevent them from developing allergies.
I can not explain the explotion og allergies and auto-immume desises og the last 30years. I have astma and pollen allergies myself and find this field bevildering. It seems like it has a lot to do with us not being in nature and dirt.

Tips for kids:
Dogs
Dirt
Vitamin D - preferably from sunlight
No detergents
Diverse diets
Avoid dry skin.

Interesting facts
- if proteins from food get in via the skin the child is more likely to get an allergy.
Profile Image for CRG.
72 reviews7 followers
January 19, 2022
What a great book! It guides people with food allergies over real scenarios and helps you understand the magnitude of the problem.

It also tells about alternative treatments for peanut allergies and discusses the possible treatments the author’s children did at Stanford University.

I found this book through FARE videos, and I had read and re-read few times.

Now, I am revisiting (12/6/21).

Overall, I have the feeling that the use of pesticides, food preservatives, and other chemicals are the root of all food allergies, but, yeah, genes are part of the culprits.
1 review
May 7, 2023
I would highly recommend this book to any parent of children with allergies who live in fear and who like me were given little information or support by the health services. By understanding causes, the global scale of the issue, management, possible treatments and the future of allergies I felt much more confident and hopeful. It also sparks reflection on the impact humans are having to the planet and positive actions to take. Given the speed of research, it would be great to get an updated reprint in the near future.
1 review
November 19, 2020
A very informative book for people living and managing allergies. Although I have probably read most of the studies mentioned here about allergies, the way they have been presented and critically analysed is just so mind-provoking and empowering at the same time. I’ve always wondered how my son developed his allergies and whether I could have prevented them from happening or not. Evidences are still inconclusive but I am hopeful that someday allergies will be a thing of the past.
148 reviews
January 14, 2021
Perhaps I had greater expectations for this book than I should have. I appreciate the science provided, but an adult allergy is quite different, I'm afraid.
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