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Histamine Intolerance and Root Causes | Podcast #289

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Hey, guys! We have a new podcast today with Dr. J and Evan Brand talking about histamine intolerance and possible root causes. We start with symptoms of histamine intolerance. While mostly linked to allergic reactions, they can be IBS, cramping, anxiety, dizziness/vertigo, fatigue, flushing, hives, brain fog, and more. Often, you’ll see these overlap as symptoms of hypothyroid, adrenal issues, or Hashimotos. So, what next?

Nutrients important to helping break down histamine are DOA enzymes, Vitamin C, Copper, and B6 (very important to neurotransmitters). We know that gut permeability and absorbing the nutrients you need can be difficult in itself when mixed with gut irritation, stress, and/or certain symptoms and this becomes a triple-edged sword. You need the nutrients to break down the histamine but your body can’t break them down because it’s stressed, overwhelmed, or not working as it should and you don’t want to eat certain foods you used to be able to consume because the histamine’s memory is messed up and you’re exhibiting more food allergies. It can be overwhelming, so then what?

Dr. Justin Marchegiani shares common foods that increase the histamine response, palliative solutions for relief, and the reality behind finding the root cause.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:00 Symptoms of histamine intolerance

10:57 How to metabolize histamine

12:59 Testing for histamine, histamine markers and root cause

19:03 Histamine medications

24:06 Hormonal link

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Dr. Justin Marchegiani:  Hey, guys! It’s Dr. Justin Marchegiani here.  I hope you guys are having a fabulous week.  We are gonna be diving in to histamine intolerances and functional medicine solutions and what we do in our clinics.  Evan, welcome to the show, man.  How are we doing brother?

Evan Brand:  Hey, I’m glad to be here and glad to talk about this subject.  Something that I used to look at and I was confused by.  I would look at these histamine issues and I would say, “This just doesn’t make sense.”  Why does Jane Doe over here, why is she able to eat XYZ food and then you’ve got the other lady over here, and she can’t eat leftovers and she can’t eat mushrooms, and she can’t eat smoked meats, and she can’t eat ketchup, and she can’t do dried fruit without having problems?  And I was like, “Okay, what the heck is going on?”  Why, why, why.  I didn’t understand it and now that you and I have worked on this issue a thousand plus times, we start to find some connections.  And so, let’s first talk about some of the symptoms of histamine intolerance.  Many of these are similar to allergic reactions and allergic reactions can create histamine.  It could be anything from gut symptoms like IBS could be related to histamine, so abdominal cramping.  Anxiety could be part of it.  Dizziness, believe it or not, dizziness, vertigo could be part it.  Fatigue could be related.  Flushing, so when you rash out like on your skin or it could be your face from certain foods, like when you see people rashing out from alcohol, like red-faced from alcohol that could be histamine.  Alcohol is high in histamine and then it’s also gonna reduce DAO, right?  It’s gonna block the enzyme that helps metabolize histamine.  I believe that’s true.  Is that right that alcohol is high histamine?  I know it messes with DAO but is it high histamine as well?

Dr. Justin Marchegiani:  Um, alcohol—what alcohol does, it’s also a histamine blocker.

Evan Brand:  Right.

Dr. Justin Marchegiani:  It also blocks the metabolism of histamine and it just depends because a lot of alcohol, there’s fermentation in the alcohol.  So of course, the fermentation will create histamine as well.  So it’s a combination of the two.  I’m pretty sure there’s gonna be histamine in it due to fermentation, right?  Like wine will be, you know, fermented or beer, and then of course, if there’s gluten in there, the inflammation could create more histamine and then you have the effects of blocking histamine as well.

Evan Brand:  Yeah that, it is a double whammy.  Yeah, here it is right here.  It talks about how like for example, red wine has up to 24 mg per liter of histamine while champagne has 670 mg of histamine per liter.  So of course, heart rate, flushing, those type of symptoms from drinking alcohol is no good.  But the problem is you’re depleting DAO.  DAO is what’s gonna help you—diamine oxidase.  It’s gonna help you to break down histamine that you ingest and so if you’re putting in histamine and reducing the ability to metabolize it.  You get in bad shape.  I got a few more symptoms and we can go on and on and one.  I mean, any list online you look at may have 50 different symptoms.  So blood pressure issues or blood pressure changes, itching—

Dr. Justin Marchegiani:  Yup.

Evan Brand:  So like the back of legs, you could just have itching.  I mean, for lack of a better word, it’s not necessarily a rash there but you could just be itching.  Nasal issues, sinus problems, nausea, and then swelling.  So like—

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Tissue swelling.

Dr. Justin Marchegiani:  Yeah.  I mean you see a lot of it with Asians and alcohol.  For instance, Asians typically will get flushed when they drink alcohol because they’re missing genetically some enzymes to be able to handle it and they take a lot of Pepcid AC which is like an H2 blocker.  So a lot of times you’ll see that with alcohol and you’ll see it in certain ethnicities.  They’ll miss certain enzymes to be able to metabolize it.  I’d be curious how someone of that ethnicity would do with like extra DAO.  I wonder if the DAO would work over just a—over a histamine blocker so to speak.  Because we know the side effects in some of those medications, you know, can be drowsiness, brain fog, you know, not so good symptoms either and a lot of times you’re just trading one symptom for another.  Hope—

Evan Brand:   I bet it would—

Dr. Justin Marchegiani:  Side effects or less.

Evan Brand:  I bet it would work great.  I mean, I’ve done some experimentation with DAO.  If I have certain foods that will irritate me, like a big spice blend of you know, curry and cayenne and chili powder and cinnamon and those type of things.  Those can all irritate things, so I’ll take some DAO if I’m gonna do something with like a mixed spice blend and I feel fine with it.  I don’t really have any issue with dried fruit.  I know that’s an issue for some people but I’ll do like some freeze-dried blueberries just to see what happens and I feel fine.  So I think some of this stuff is there’s gonna be a spectrum of sensitivity with this.  Some people are gonna be extremely histamine-intolerant and then some people are gonna be totally fine.  So we’re trying to cater to all of those people.  If you’re somebody who—you can’t do fish, for example.  If it’s fresh-caught and freshly eaten or fresh-caught and flash-frozen for example.  That should be okay but if you’ve had, you know, fish that’s kinda sitting out at the market, open-air, you know that may be a bigger problem than if it were flash-frozen like on the ship,  I know there’s a couple of companies out there like Vital that they’ll freeze the fish as soon as they catch it.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  And those are supposed to be well-tolerated.

Dr. Justin Marchegiani:  100%.  So you kinda went over like some of the symptoms, right?  The common ones, the flushing, the wheels or the urticaria, kinda hives on the skin, brain fog stuff, headache stuff.  It could just be allergy stuff like itching or sneezing or eye wateriness.  It could be fatigue.  It could be breathing issues.  It could be just swelling or inflammation or heart rate.  It’s just pounding, kind of the abnormal heart rate beating.  Now the problem is a lot of these symptoms can overlap with hypothyroid.  A lot of these symptoms can overlap with Hashimoto’s and adrenal issues.  This is the problem.  It’s this big overlap so that you get people that are like the histamine person or the adrenal person and you’re like, “But what’s the issue?  Is it an adrenal issue?  Is it a histamine issue?”  And this is where it gets really tough because you’re trying to seek out whose that person that can help me with this issue and the problem is everything overlaps.  So imagine like a venn diagram and then you have all these different issues, adrenal or thyroid, or histamine or gut, and then they all overlap in the middle and a lot of times that’s where people’s health issues, you know, really sit and you need a very good generalist to kinda parse these out because sometimes when we have these issues we don’t really focus on histamine, we focus on other things.  Like when you just magically reduce inflammation in the body through diet, lifestyle, supplement strategies, magically histamine can drop.  And we actually do need some histamine because histamine is a big stimulator of hydrochloric acid.  So it’s like, well, if you don’t have no histamine then we’re not gonna have good HCl stimulation and we know HCl is so important for digestion.  So it’s this, you know, it’s not like one of these things where we wanna just knock histamine down to nothing, right?  But we wanna modulate and prevent the, you know, the abnormal highs of it which tends to be driving a lot of the symptoms.

Evan Brand:  Yeah, that’s a great point and many people don’t hit that if you talk about the word histamine.  It’s sort of like a bad bacteria.  It’s just kill, kill, kill, kill, knock it down, knock it down, knock it down, knock it down but yeah, you’re right.  I mean, it’s a neurotransmitter and it does affect the immune system, too.  So it’s not something that you want zero off.  I know—I don’t know the exact mechanism but I know histamine has some role on energy like your sleep-wake cycle is somehow related to histamine.  Appetite, I know is involved with histamine.  So there’s a lot of things that people just, they skip out on and then they get on these H1, H2 blockers and then who knows what’s happening downstream?

Dr. Justin Marchegiani:  Yeah, I mean histamine is part of the stress or inflammation response.  I mean, it can cause clots.  It can cause cells to get more sticky.  It can cause your lungs to constrict a little bit more.  It can cause more swelling and fluid retention.  It can open up the blood vessels partly because imagine if you bang your elbow, right?  What happens?  Does it get more swollen or less swollen?  It gets more swollen.  Why?  Because of the inflammatory response.  It’s driving vasodilation, meaning it’s opening up the blood vessels.  Why?  Well, to help bring the immune cells there to help kind of bring the inflammation and recovery process under control.  So the problem is a lot of these mechanisms, they’re acute punctuated mechanisms.  They’re on then they’re off.  With chronic inflammation in the system through gut or other hormonal imbalances, it’s on and then it stays on and then now that it’s on, certain foods that may have been—may have not been a problem before, now perpetuate the problem.  Does that make sense?

Evan Brand:  Yes, it does.

Dr. Justin Marchegiani:  So it becomes this vicious cycle where like, yeah, you may be fine.  You should be able to have some kombucha and some bacon, but now because of the inflammation.  Now that bacon’s a trigger, now the kombucha is a trigger, now the citrus fruits are a trigger, now the good avocados are a trigger, and it’s like people are pulling their hair.  They’re like, “What is going on?  I don’t get it.  These are good foods.  What’s happening?”  And they have to look deeper at of course, you know, when we look at the symptoms, the first thing I do is I say, “Okay, let’s try cutting some of these histamines out of our diet food-wise, do we feel better?  Yes or no?”  That tells me something and if that helps, then we look at, okay, let’s work on better digesting our foods, number two.  Let’s work at gut infections because we know the microbiome, if out of balance, can really create these abnormal histamine responses and we know how the microbiome is so important with gut permeability and that increases autoimmune issues, hence, thyroid, hence adrenal, hence gut issues, irritable bowel disease, so everything can just really spiral out of control if the microbiome is not there, if the food is not there, and of course, if stress is there, we know what the sympathetic nervous system response does in regards to burning up our B vitamins and decreasing HCl and enzymes and decreasing dopamine and adrenaline over the time and then we also know that certain nutrients are gonna be vital for histamine—for making the enzymes to break down histamine, right?  We know certain enzymes, the DAO enzymes are really important and we know vitamin C.  We know copper.  We know B6.  B6 gets burnt down so much during stress, it’s very important for our neurotransmitters, and we also know that if we have low stomach acid levels and we’re stressed, we’ll be burning them up at a much higher level and we know that when our gut microbiome is out of balance, we have more bad stuff than good stuff.  We know that the bad microbes will be eating those nutrients versus making it and we know those bad microbes will be actually making more histamine byproducts as well.  So it’s this double-edged sword, when the gut’s out of balance, we eat the nutrients we need to break down histamine, the bad bacteria makes more of the histamine and then we don’t get a lot of those nutrients absorbed that help us make the enzymes to degrade histamine.  It’s a triple-edged sword.

Evan Brand:  Yeah and then think about, too, you need vitamin C to help reduce or sort of metabolize histamine for lack of a better word and a lot of people are gonna be pulling out citrus, even like lime-lemon.  Those are kinda demonized in the histamine world, if you are reacting to it.  So now, you don’t have enough vitamin C.  So I’ll try to supplement vitamin C personally and clinically and see if it helps and in many cases, it does.  So we’ll have people do quercetin which is in the vitamin C family to help stabilize mast cells that way we can prevent the release of histamine.  At least in theory, if we take a, you know, a shot of 500 mg of quercetin before—when I say a shot, I mean a powder, put in a shot glass with a shot of water and I’ll shoot it down like a 500 mg quercetin before a meal and then mix a little vitamin C with it and that tends to help reduce some of the reactions and then also the DAO before meals.  Let’s go in, just real quick list and then we’ll keep talking because you hit on something that I think people miss the boat on which is that and this is something you and I talked about before we hit record, which is that histamine intolerance or histamine issues are in effect.  What is the cause?

Dr. Justin Marchegiani:  Correct.

Evan Brand:  So if histamine issues—

Dr. Justin Marchegiani:  Correct.

Evan Brand:  Are in effect, what is the cause?  So let’s rant on that more in a minute but we hit the alcohol, fermented foods, cheeses, smoked foods, shellfish—many people that say they have a shellfish allergy, we suspect it’s a histamine issue—beans, nuts—my voice cracked, I said nuts, almonds, nuts.  I don’t know why but certain nuts get moldier than others, so for example like macadamias, for some reason, those and cashews tend to be more intolerable versus I find a lot of people do well with almonds.  Chocolate, vinegar, tomatoes, citrus.  So those are kinda like the histamine triggers but let’s go back to the gut because what you were saying is that the gut bacteria are gonna be doing several things.  They’re gonna messing up the gut barrier.  They’re gonna be producing histamine.  So regarding testing, if someone says, “Hey, how are you gonna test me for histamine?”  Let’s dive into that because the answer is we’re not directly gonna test you for histamine, correct?  We’re gonna be—

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Looking deeper.

Dr. Justin Marchegiani:  Correct.  I mean, there’s the markers like the, you can do the tryptase marker.  It’s a tryptase enzyme marker that you can do.  When you break down histamine.  DAO is one of these enzymes that helps break it down and there’s also histamine N-methyltransferase (HNMT).  I think you can also test some of those enzymes.  But for me, I just—I make clinical changes with the diet and I also give specific supplements and I let those symptoms kinda dictate.  But we also understand that that’s not root cause and this is where it’s very important where a lot of functional medicine people.  I see it a lot with naturopaths where they’ll kinda come in there and they’ll use supplements to just treat symptoms and they’re not getting to the root cause.  So we always have—I always draw a line with patients.  What’s gonna be palliative changes to allow you to feel better in the meantime and then number two is what’s gonna be more root cause.  Because sometimes root cause stuff’s a little bit slow and that’s not good if you need relief now.  So we need to figure out a way to get relief now, like you mentioned some of the natural antihistamines—stinging nettle, quercetin, NAC, bromelain, kidney tissue that has the DAO enzyme, maybe B6, copper, zinc, good quality multi.  So we’ll do those things.  We’ll make the diet changes.  We’ll look deeper at the gut and the adrenals because we know steroids also are part of what’s given to address some of these issues, right?  From a symptomatic standpoint.  We know steroids, like the big medication we know are the H1 receptors and H2 receptors are the big ones, right?  We know the H1s like your Benadryl and your Claritin, these are the H1 histamine receptor blockers.  The Benadryl, the Claritin, right?  And then the H2 ones are gonna be like your Peptid AC, right?  H1 is gonna be more the histamines in the muscles, where H2 histamine is gonna be more in the intestines in the abdomen and that’s gonna be affect the heart.  So H1, H2, so keep that in mind.  Those are the big ones.  There’s actually H1 through H4, but the big meds are H1, H2 and we know that the medications can be helpful but they have a lot of side effects and we have to be very careful with that.  And we also know that the gut and all these nutrients play a huge role and when we look at the nutrients, we have to one, get a good quality multivitamin there that’s gonna have a lot of these nutrients that are gonna be bio-available so we can absorb it easily and number two, we have to get our digestion under control and number three, we have to look at other issues deeper.  That could be a mold issue or it could even be a Lyme or a co-infection issue.  I always table Lyme stuff unless there’s a strong history of tick bites, I always table it and deal with the gut first and the adrenals and hormones even before that and then personally after that I’ll—I typically will deal with mold—Evan and I may differ on this.  I’ll typically look at and test mold right away if there’s a strong history, water damage in the home, history of visible mold or if we’re on the fence, we do a plate test or a urinary mold test or hey, do you feel better when you leave your house for a week, right?  If those symptoms are there, we’ll look a little bit deeper and we’ll test.  I typically don’t go after and address mold right away because a lot of how the mold is removed is via the hepatobiliary system so that’s liver, gallbladder, gut, and the stools.  So if we don’t have great gut issues, a lot of times we can re-absorb stuff.  A lot of the binders that we may give to help pull out mold can actually cause constipation, so I always fix the gut, fix the gut motility, fix digestion before going after mold but we can at least test in the person, the patient.  Test it in the house and we can at least start making house changes right away.

Evan Brand:  Yeah, so I go after it straight away regarding testing but yeah, you’re right.  You gotta get people pooping before you go and do binders.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  And a lot of times like some of the binders you and I are using have folic acid so constipation is really an issue and if you’re bumping up magnesium and vitamin C and that kinda stuff, generally it’s no big deal but how I approach it is that way you mentioned, plus what will make me go after it more beyond just history is just looking at the mold symptoms.  So in my intake form now, I’ve got like 25 different symptoms and if they check off more than a handful, we’re like, “Huh, this doesn’t look good.”  So we’ll look into it and a lot of times, I mean, it’s showing positive.  One thing I wanted to mention on the drug piece, you did a great job talking about like all the over-the-counter stuff that people get into on their own now.  So the Zantac and the Pepcid and the Benadryl and the Zyrtec and the Allegra that kinda stuff, those antihistamines may work in the short term but we’re gonna downregulate DAO and you get for lack of a better word, you get stuck on it because now you don’t have enough DAO so, therefore, histamine rises more than it did before.  And then one other thing, too, is that—and there’s a lot of people talking in forums about this on antidepressants and I don’t know exactly the mechanism.  Maybe it’s depleting DAO, maybe it’s increasing histamine.  I don’t have the mechanism and the study right in front me but if you just look at histamine intolerance Zoloft or histamine intolerance Cymbalta, Effexor, these really, really extremely in fact common prescribed and commonly dosed antidepressants—those cause histamine problems.  So how many people out there, in fact, there was a lady who had a big website dedicate to this which was histamine intolerance after discontinuing Zoloft, and so I don’t even know if the science is clear on it but a lot of people are talking about this.  So if you have been doing an antidepressant and now you’re reacting to more foods that may be something to look into.

Dr. Justin Marchegiani:  Yeah and also, so we talked about some of the big medications, right?  A lot of the Allegra, the Zyrtec, the Benadryl, a lot of the H2, 1 blockers, right?  Here’s the rub here and this is where it gets really, really, really, really confusing is that we talked about how histamine is actually needed to make hydrochloric acid.  So guess what happens with this histamine medications.  They also reduce acid levels and guess what happens when you reduce your acid levels.  Now your digestion goes down south.  What happens when your digestion goes down south?  Now you start to have more SIBO and bacterial overgrowth.  Guess what SIBO and bacterial overgrowth does.  It produces more histamine metabolism.  So it’s this unbelievable vicious cycle people get on and it’s—

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Very, very frustrating.  Not to mention that okay, there’s the other class of medications that help with histamine, guess what.  They’re corticosteroid-based.  You see it with Singulair, right?  Or a lot of these steroid-based medications, well, maybe our adrenals are so weak, we don’t have enough of our natural cortisol, corticosteroids, so we’re not—we have to fix the adrenals with it as well because the adrenals help make that that corticosteroid called cortisol which helps with our natural inflammation and if we can’t put the fire of inflammation in our body out every day that fire is gonna run rampant and create more inflammation and that inflammation is gonna drive more histamine issues and like we talked about before, all of those histamine medications, they deplete the DAO enzyme so then the histamine that’s made, it hangs out way, way longer so it’s not just about making histamine.  It’s about now you can’t break it down so now it stays at the party.  It’s like it’s the guy at the party that just lingers way too long.  It’s like you should be out of here, dude, right?  Closing time.  But that’s what’s happening with histamine in our body.

Evan Brand:  Oh, man.  Well, it’s not to say that we’re saying, “Hey, don’t do those drugs.”  But man, it would be a lot of better if before you get to the point where you get put on a daily Zyrtec or a daily Allegra or something like that or a Zantac or a Pepcid, it would be so much better if we could just stop those people and just say, “Hang on, hang in there.  I know you’re symptomatic.  I know you need relief.  Hang on.  Let’s try some of these herbal antihistamines.  Let’s give you some extra Vitamin C, maybe some extra DAO.  Let’s get you on maybe some leaky gut support.  Let’s get you on low histamine diet for now.  Let’s run a stool test.  Let’s run organic acids.  Figure out what’s going on.  Let’s test your environment.  Hang tight.”  And then if we could do that, it’s just such a deep rabbit hole.  It seems like every time you and I do a conversation on a different health aspect, there’s always a drug that’s involved in terms of being palliative but it seems like there’s always a double-edged sword to that.  No matter what the topic is.  Isn’t it funny how you and I always end up here?  It’s like crap.  The drug helped but now it actually put us in a bigger hole and now we gotta get them out of this hole because now they are downregulated of DAO even more than they were before.  It’s like, ugh!

Dr. Justin Marchegiani:  Exactly.  This is the problem, right?  And so, in general we gotta look at the adrenals, gotta look at the inflammation because if you’re taking steroids, we need to have our natural anti-inflammatories going.  We have to be very careful of the medication.  If we’re using the medication, fine, use it sparingly, but just know it’s gonna create more dependency in the long run.  Also, I’d say a big thing is environmental allergens.  Environmental allergens can dry histamine.  So imagine like we have this big stress bucket, right?  And I’ve given this analogy a lot over the years.  We put our stress balls in this bucket.  When that bucket fills up and overflows, this is where symptoms happen.  So, some people they come in genetically with a big bucket.  They can handle a lot.  They can deal with more stress and they have more adaptability.  Some come in with a small bucket and that bucket is already half full because they are exposed to mold, right?  Or heavy metals or they’re not eating organic.  So that now they’re bucket’s already at the very top and then you add in a little bit of gut dysbiosis or you add in some environmental allergens—BOOM! Histamine symptoms are going crazy now.  So we have to look at that.  So one of the first things is get the stressors out of that bucket and a lot of times so those stressors could be things unrelated to histamine, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So that could be just eating organic, clean water.  The other component is environmental allergens can be a big deal.  If you’re out in Austin.  Cedar is big this time of the year.  You’re breathing in cedar and that hangs out in your sinuses all day and you don’t have a good air filter at home at night then you’re in this stressed-out state because that cedar’s up in your nose causing problems.  So my protocol with patients is we have a really good sinus irrigation system to flush thing’s out.  We clean it out with saline and Xly or Xylitol to knock out any biofilm.  We do it twice a day especially once we come in for the day, we are flushing our sinuses out so it’s clean for the day and we have really good air filtration so then when we are resting at night we are not in this fight or flight state because all the cedar is up in our frontal sinuses creating inflammation all night.  We flush it out once we come inside.  We flush it out when we start the day.  We may even do it midday if we’re really bad just to keep our immune system from overreacting and then we gotta have that clear air filtration at night so when we come home our immune system can relax.  Because if these environmental things are just keeping us in a fight or flight state, it’s gonna be hard to feel better.

Evan Brand:  Yeah, so you’re basically saying, “Let’s try to get some of the things in the bucket, the external histamine bucket down, that way potentially you could tolerate that food and then we’re working behind the scenes to work on the gut and reduce some of the bacteria making histamine there.”  Now here’s one thing we didn’t hit upon yet which is the hormonal link and so I have had many women say that they’re symptoms are worse right before their period starts and I’ve heard of many women who are postmenopausal who are now doing like estrogen replacement and other hormones and estrogen decreases the breakdown of histamine because it actually messes up with DAO, too.  Estrogen can lower DAO.  So if you think about all these women that were doing birth control pills or hormones or anything to mess up estrogen or you just think about the thousands of ways we’re exposed to the xenoestrogens in the environment like reheating our food in plastic and drinking from single-use water bottles that got exposed to sun and things like that.  The whole estrogen-histamine link is big and maybe that’s why we see so many more women than men, you know, I would say it’s a vast majority.  We see a lot more women deal with histamine problems than men.  I think it’s probably due to the hormonal changes and so like if we’re looking at that stool, you hit upon the gut bugs.  When we’re looking at the stool, we’re also gonna look at that glucuronidation pathway and if we see that that’s messed up, and if they’re taking hormones or if they just have estrogen dominance as a history, that’s gonna mess them up more.  So we have to address that as well.  So if you go to the gut guy and he hits on your gut and gives you some herbs there and you don’t get better, the hormonal piece and I guess that would factor in to your adrenals, too, because the adrenal test that we’re looking at, you know, that’s gonna look at hormones, too.  So we’d probably kill 2 birds with 1 stone there.

Dr. Justin Marchegiani:   Exactly and also I would say, so you’re—what you’re proposing as a mechanism is that estrogen helps break down histamine?

Evan Brand:  No, so estrogen depletes DAO.

Dr. Justin Marchegiani:  Okay, so when you’re estrogen’s too high, you’re depleting DAO.

Evan Brand:  That’s right.

Dr. Justin Marchegiani:  Okay, so if you’re estrogen-dominant, you’re gonna be depleting DAO.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  I would also say that when a woman goes through PMS, what’s happening in PMS, right? PMS is premenstrual syndrome, so right before menstruation that’s right at the heart of the luteal phase, if progesterone drops out early, that’s a lot of times what’s driving PMS.  That one, that enhances the estrogen dominance, right?  So high levels of estrogen deplete DAO, that supports and kind of, you know, backs up your mechanism there.  The other thing is progesterone is an anti-inflammatory.  Progesterone is a precursor to steroids like cortisol.  What do you get when you take Singulair?  You’re increasing cortisol.  If your progesterone is dropping out too soon?  What does that mean?  Less anti-inflammatory building block, right?  So all of this makes sense.  We’re trying to be the bridge to connect these hormonal issues to the deeper histamine but also connect the gut issues because it’s all connected, you know, in the interwebs of functional medicine.  So progesterone, estrogen dominance, all makes sense.  Progesterone anti-inflammatory.  Progesterone drops out too soon, that’s the PMS symptomatology there and that’s what driving the inability to regulate inflammation and then also estrogen dominance, right?  Estrogen higher in relation to the progesterone will deplete DAO which is the enzyme that cleans us histamine.  So all of this makes so much sense.

Evan Brand:  Yeah, and there’s a couple of papers on this, too, about the estrogen effects and allergy and asthma, and there are these papers kinda talking about women that are doing supplemental hormones and all of a sudden they’ve got new-onset asthma when they’ve never had it before and it started after they were doing hormones, and so that talks about how boosting up the hormones is affected the mast cells too much and then that’s creating more of an inflammatory chemical-release of histamine and probably other mediators, too.  So this is interesting and I think this is probably the answer.  I didn’t really know this but until I looked at it but it makes sense why we see so many more women than men suffering.  What you say clinically, I mean, women as a whole more in general but with this specific issue, would you say what you’ve seen is more women than men?

Dr. Justin Marchegiani:  Women’s hormones are much more of a symphony that happens throughout the month and it’s very easy for a symphony to turn into noise, right?  If the strings aren’t in there with the percussion instruments, you’re gonna get noise.  So when you start to have hormones a little bit out of balance, it’s gonna affect women in their ability to deal with stress and part of those stressors could be histamine.  So that’s really important and with stress in our environment, we are going to knock down progesterone and with a lot of the estrogens being in our environment, in plastics, pesticides, various chemicals, water, it just only drives more estrogen dominance, right?  It just drives more of these histamine issues.  So it totally makes sense but we have solutions and functional medicine is gonna be the best thing because we know just throwing birth control pills in there, guess what?  That depletes DAO further because that’s just heightening estrogen dominance, right?  And then just throwing in there antihistamines, well, guess what?  That creates more low stomach acid situations.  That’s gonna make digestion harder, breaking down proteins and fats harder, and that’s gonna perpetuate more SIBO, right?  Because if we don’t have good digestion, bacteria proliferate and an environment where there’s not good digestion.

Evan Brand:  Humans always have to complicate things, don’t they?  Will all the drugs, it’s like, “Darn it!”  I mean, without the drugs, I know drugs save lives, drugs save people, antidepressants prevent people from committing suicide and you know, heart drugs help stabilize the heart rhythm and blood pressure drugs help get the blood pressure down so they don’t have stroke.  I mean, I know drugs are needed, but man, every time we uncover some of these connections between the medications and these deeper issues, it’s just like ahhh.  I wish—

Dr. Justin Marchegiani:  I know.

Evan Brand:  We could save people from getting on them.  Yeah, if people just wanna look up, you just put in like estrogen DAO or you put in like sex hormone DAO, you’ll find some papers on this stuff.  It’s just—it’s pretty crazy how connected this stuff is and so.

Dr. Justin Marchegiani:  It is.

Evan Brand:  We’re trying to cover it all.  It’s tough to do what we’re doing in half an hour but we’re trying to make sure you address hormones, you address gut, you address adrenals, you address the sleep, you address the diet, you have to hit all of these pieces if you fully wanna beat this issue.

Dr. Justin Marchegiani:  Exactly.  Well, to get more info on this, guys, head on to evanbrand.com to reach out to Evan and schedule with him.  You can also head over to Dr. J, myself, at justinhealth.com.  We’re here to help you guys.  We’re available worldwide via Skype, Facetime, phone, video consultation.  We’re here to help.  Just make sure you guys take one piece of intel from this conversation today.  Apply it to your health and life.  We hope that you guys understand some of the deeper mechanisms and why some of the medications may help acutely but long term may set you up for more problems.  I hope you guys enjoyed it.  Sharing is caring.  Give us a share.  Put your comments down below.  If you’re suffering from histamine, let us know.  We’re curious about it.  We wanna engage in a deeper conversation and hope you guys enjoyed the podcast.  Evan, anything else?

Evan Brand:  No, that’s it.  Y’all take care.  Have a great day.

Dr. Justin Marchegiani:  Take care, guys.  Bye y’all.

Evan Brand:  Bye.


References:

https://justinhealth.com/

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