Dr. Justin Marchegiani and Evan Brand engage in a discussion about histamine. Listen as they talk about finding the root cause and driving factor of the issues related to histamine. Learn all about the symptoms associated with histamine issues and find out how problems with the adrenals, hormones, gut, diet and lifestyle contribute to these issues.
Know how some of the medications like anti-depressants, immune modulators and beta-blockers are related to nutrient deficiency. Gain information regarding higher histamine foods and natural supplements. Apply some of the natural solutions and recommendations regarding diet and lifestyle that would address histamine issues.
In this episode, we cover:
04:12 DAO& HNMT: role in our bodies
08:13 Medications and nutrient deficiencies
10:38 Higher Histamine Foods
18:39 Natural Supplements to lower histamine
21:57 Toxic mold
28:42 Diet and Healthy enzymes
Dr. Justin Marchegiani: And we are live on YouTube. Evan, to it’s Dr. J here. How are we doing today, man?
Evan Brand: Hey, man, Happy Wednesday! You and I have been pulling out the research books today. We’re like, “Hey, let’s make sure we know everything as— as much as possible about histamine.” A few have been asking you, asking myself, you've done interviews with histamine experts and what was it, the histamine chef is that who you chatted with?
Dr. Justin Marchegiani: Yeah. Yup. Yasmina Ykelenstam. She's the histamine chef and we did a podcast last year on this topic. And uhm lot of good stuff, we’re kinda rehash some of the key take homes, we’ll talk about getting to the root cause and we’ll also talk about ways that we can supplement and just support histamine issues in general, more specifically.
Evan Brand: Yeah. So what you and I were talking about affairs. We— we don't really market ourselves necessarily, it’s like, “Hey, histamine practitioner” There's a lot of people the kind of attached the word “histamine” to their name or to their marketing efforts, but, you and I, as we start to dig deeper and find root causes of the histamine intolerance which we’ll talk about exactly what this means, we’re fixing histamine intolerance just as a side effect of doing all the other good work we’re doing to support the adrenals and support the immune system and ensuring that people are free of infections and fixing neurotransmitters like all the stuff, Oopp, it just happens to fix histamine intolerance.
Dr. Justin Marchegiani: Exactly. Like in the functional medicine world, you know, there is ways that you can market to so you can kinda row people in specifically coz you talk to their issues, but again, if you really are a good functional medicine practitioner, clinician, you're hitting all of the body system. So in general, you’re not gonna really miss anything but there are ways that we can dive in deeper to issues such as histamine. And we’re gonna try to do that today. We’ll kinda zone out a bit. So we have like the big picture perspective, so people don't forget what the root causal things that can't be ignored are, and then we’ll also talk about you know, palliative things we can do on top of just the—the functional medicine principal stuff to get even better results.
Evan Brand: Sure. So should we start with some symptoms? What exactly people are noticing when they're coming to us and they’re saying, “Hey, I think I have a histamine issue and I believe it could be coming from my diet.” We’ve got symptoms like headaches, could be anxiety, it could be your face flushing, it could be an itchy tongue or runny nose. What— what else am I missing symptom wise?
Dr. Justin Marchegiani: Yeah. Headaches. All those different things. It could be flushing, it could be even hives or the eukaryotes, those wheels that come up on the skin uhm— those can be all, you know, things that are happening. And again, what's histamine doing? Histamine is a neurotransmitter. And there are various receptor sites for histamine in the body. There's you know, H1 or histamine 1. Histamine 2, 3 and 4. And again, these things can control for instance, smooth muscle and endothelial tissue that affects blood vessels. This is what like Benadryl and like Claritin would—would utilize. So if you have like an allergic reaction and like your skin get super blown up, right? That’s why you do like Benadryl, right? Or histamine two controls acid secretion and abdominal pain. So histamine can also increase acid as well. It can also increase the heart rate. Histamine three has an effect on controlling the nerves, sleep behavior, appetite. Histamine four has an effect on the intestines, the spleen the colon, white blood cells and the inflammatory response. So it's kind like this, right? You take your hammer; you whack your thumb, and all of these different reactions that happen, right? So you can look at all of the clotting factors and the cytokines and all of the inflammation and the white blood cell mobilization. And if you just kinda zone back, zone back, zone back, what caused it all? The hammer. So we’ll kinda zoom in, alright, what's happening and the nitty-gritty, but then we’ll kinda zoom out and say, “Okay, what's the hammer in this analogy?” Coz if we can focus on the hammer, it’s way easy to wrap your head around, “Don't whack your hand—don’t whack your thumb with a hammer than it is to look at all of the nitty-gritty. But we’ll kinda do both. So people that are looking to nerd out a little bit, kinda get satisfied and the people that just want the action items get satisfied, too.
Evan Brand: Sure. So let me just pronounce what we’re actually talking about. Diamine Oxidase also known as DAO, so basically, this is an enzyme that we’re making on our own in our body which is basically just like when we’re talking about proteases and lipases and lactases and just different digestive enzymes. DAO is an enzyme that's basically going to find, it’s gonna seek out like the CIA, it’s gonna find the bad guy which is gonna be excess histamine in your foods and it's can help break those down it could be foods or beverages so we'll talk about the alcohol component in DAO when it works properly, it can break down up to 99% of the histamine. And then there's 1% of histamine that actually enter circulation but we’ll talk about some of the root causes here. There could be going on with the gut. When you're deficient in DAO, which is why you can supplement, which Justin told me off air, “Man, this stuff is sold out everywhere.” But when you're supplementing with it or you’re fixing the root causes, and your getting your DAO in time to be back in adequate amounts, you're able to break down the histamine and you no longer have histamine intolerance, which is why people can take DAO supplements and they can feel better but you've always got to work back to the root cause of other issues why is it not working in the first place.
Dr. Justin Marchegiani: Yeah. It’s also this DAO which is Diamine Oxidase and there is also another one called HNMT Histamine N-Methyl Transferase and these both have an effect of breaking down histamine. So if we take off our functional medicine root cause hat and we put on our palliative natural medicine hat, we wanted to just control symptoms, well, we can give enzymes like DAO which has been backordered for years. They are typically extracted from kidney or thymus tissue and big back order for a while, but we can give those to help lower histamine, alright? Coz that enzyme helps break histamine down so, you know, it's like someone that has a lactose intolerance issue, they may take Lactaid which is milk enrich with lactase, the enzyme, right, to break down the milk, the milk sugar and they have less diarrhea. So kinda into that perspective where we’re adding in the enzyme to be able to break things down uh— which can be helpful from a palliative perspective. Uh— number two, we can avoid— we can make sure we have all the nutrients required to make a lot of these enzymes. So like the HNMT enzyme, we need SAMI, right? We need SAMI, S- Adenosyl Methionine which is really important for MTHFR. Uhm the Diene Oxidase we also need B6, we need copper, some of these other enzymes to for histamine processing, right? We need B2; we need iron; we need B5, right? And a lot of these nutrients we’re also gonna deplete with adrenal dysfunction, too. So you can see how adrenal issues and low histamine can be affected. Anytime you see B vitamins we know how important healthy gut bacteria is for producing B vitamins. So you can see, if we have a dysbiosis or SIBO, we have food allergens driving inflammation, driving leaky gut and/or gastrointestinal permeability, that can all affect our ability to make enzymes to lower and process histamine.
Evan Brand: Well said. So any gut infection, I mean, Justin and I that's one of the things that we work on so much because it's so common you probably heard our stories but, you know, I had H. pylori, I had parasites, I had bacterial overgrowth, I had yeast and all that's driving leaky gut. So if you got something like H. pylori, for example, which we see every single week on lab results when we’re looking at people, the H. pylori is going to suppress the stomach acid and so if you've got undigested food, even that alone, could be causing leaky gut, therefore causing low DAO, therefore causing you to have “cortical histamine intolerance”. So if you work with a practitioner on histamine, we’ll talk about the diet piece in a second, but you've got to get the gut in healthy spot. You've got to fix the—the diet. Make sure that the gluten is out of the diet, or anything that could be causing a leak ego situation; otherwise, you're just setting yourself up for failure. And then, surprisingly enough, which maybe you know more about this than I do, but it's interesting that a lot of these medi—medications, I don’t know the mechanism but like antidepressants like Cymbalta, Prozac, Zoloft, you’ve got the immune modulators like Humira and Enbrel. You’ve got the Metaprololol, the beta-blockers; you've got Zyrtec and Benadryl. All of these things are causing the DAO enzyme to become deficient. I mean I guess the mechanism isn't too important but it is interesting.
Dr. Justin Marchegiani: Well I think some of the mechanism pretty straightforward. Uhm— a lot of this is via nutrient deficiencies. A lot of these medications create nutrient deficiencies and a lot of these nutrition these nutrient deficiencies and a lot of these nutrition deficiencies revolve primarily around B vitamins and minerals. So it makes sense. If we create deficiency with B vitamins and minerals, of course, that's gonna create more issues. I mean it’s like blood pressure. If you look at the acid block—the beta-blockers or the uhm—water pills like hydrochlorothiazide or the Lasix.
Evan Brand: Yup.
Dr. Justin Marchegiani: They are either diuretics but they create deficiencies with potassium and magnesium, which are really important for blood pressure. So you can see a lot of these drugs actually can make the problem worse. It's an amazing business model if you're only looking at you know the money factor, but if you're looking at fixing the root cause, like we are, it's definitely not good. You wanna really back up.
Evan Brand: Agree. Well said. You wanna talk about diet?
Dr. Justin Marchegiani: Just to kinda—just to kinda back out just a little bit. Uhm—we talk about the nutrient deficiencies, right? We talked about medications and antibiotics, antacids, antihistamines, right? Uhm—We talked about uhm—well, I’m gonna add it, nutrient stressors. So if we have more stress, more adrenal stress, more fatigue, poor sleep, inflammatory diet, that’s gonna drive more in a higher increase in histamine. If we have hormonal imbalances whether we’re estrogen dominant or that we have adrenal dysfunction, right? Imbalance in our stress hormones, cortisol, rhythm issues, a lot of that’s gonna be driven by a lot of these lifestyle stressors. That’s gonna really create more histamine issues. Now, I always backup. How do we know someone has a histamine issue? Well, do they have any of those histamine symptoms we mentioned in the beginning? Coz we know histamine does a few things. It helps increase heartbeat; it helps with gastric acid secretion; it opens the blood vessels, hence why when, you get allergies or allergic reaction, you swell. It helps increase bronchial dilation; it helps with gut permeability; it increases adrenaline. But if people get headaches or flushed or rashes or headaches with higher histamine foods, we definitely take notice. And those higher histamine foods, the big one, is going to be fermented foods. Do you get worse with fermented foods? Do things like teas create, you know, problems? If you have bone broth, does that create problems? Does citrus fruits create problems? Do meats over, you know, they’re too old, create problems? Uhm—does chocolate and coffee create problems? So if we start seeing issues with some of those symptoms, I really look a little bit closer to see what could be the driving factor.
Evan Brand: Yeah. I’ll list down a couple of more, too. Kombucha—that’s gonna be popular for our crowd, our community.
Dr. Justin Marchegiani: Yup.
Evan Brand: Yogurts, even if it's like a grass-fed yogurt, your sauerkraut, if you're having flare-ups, I've had some women that said have flare-ups on their skin after doing sauerkraut, that's a sign right there and then alcohol, too. So wine, beers, champagnes even if it's organic wine, it’s not gonna matter. Cured meats— so salami, could be pepperoni, the beloved bacon—bacon an issue, unfortunately for the time being. You mention the citrus fruit, aged cheese and then nuts— walnuts, cashews, peanuts, avocados. I believe— I don't know if it was histamine, but I had something going on where I had to pull out avocados for like six weeks. I was having headaches from them. It was no other foods. It wasn't any other nuts and seeds but I believe I had—I’m gonna guess a histamine issue because why else would avocados give me a headache?
Dr. Justin Marchegiani: Oh, exactly. Yeah, totally. So—
Evan Brand: I was doing like everyday they’re so good and so easy to add to a meal, so.
Dr. Justin Marchegiani: Totally. And then we also have things like mast cell activation disorder, right? Histamines produced by mast cells, so you got these like basophils, which are like in our white blood cells, right? They’re like one of the smallest amount of white blood cells are basophils. And these basophils go into our blood straight to our tissue. They become uhm—mast cells. And these mast cells will produce histamine, alright? So then you have this thing like called mast cell activation disorder. So like the more inflamed you become, right, the more your body tends to dysfunction. And—and you get more names for that kind of inflammation whether it's IVD or IBS or mast cell activation disorder or some type of you know, allergic issue or some type of autoimmune issue. You can just go through all the different names. The more inflamed someone gets, the more symptoms. And basically diseases are nothing more than grouping a constellation of symptoms together. That’s why it's funny when people tell me, “I just need a diagnosis.” Well, a diagnosis is nothing more than someone in the medical field taking a set of symptoms that have been, you know, trace for you know, many, many years into a disease name and someone studied and published. But it doesn't do anything, it just basically groups these symptoms together and maybe there’s a drug for it, which is typically how a disease, you know, gets name because of the drug or treatment for the most part. But in the end, does it really help you fix the issue? A lot of times, “No”. But it gives people relief to know that it’s something, but again, if you're depressed and you're stuck on antidepressant your whole life, well, do you really feel good about that if you’re not fixing the issue? Maybe not.
Evan Brand: Right and I had a—I had a diagnosis of IBS, right?
Dr. Justin Marchegiani: Yes.
Evan Brand: We have no idea what's going on but here's some acid blockers I was never talked to about the root cause ever. So, for me, if you're seeking a diagnosis, I would just let that attachment go because you really don't need a term for the symptoms. We just need to figure out what's going on. So, you mention the diet piece, we hit the gut piece, we hit the—
Dr. Justin Marchegiani: Adrenal and hormone deficiency, too, I think.
Evan Brand: Say that again.
Dr. Justin Marchegiani: We hit the adrenal and hormone piece, too.
Evan Brand: Yeah. Adrenals. That’s very important. So, how should we go about this? I mean, we've— we put all the pieces on the table, now how should we arrange this kinda step 1-2-3-4-5? Diet first?
Dr. Justin Marchegiani: So, off the bat, I would say, look at like kind of like your histamine bucket or your stress bucket. Everything goes in that bucket. Some people—it just sucks, they are brought into this world with the poor genetic constitution and their bucket’s smaller. What that means is they just can't tolerate as much stuff. That means, hey, if they got a little bit of gluten and a little bit of stress, their bucket is full. Some people can have a lot more things. They could have some medications in there, some stress and sleep, some poor food, some nutrient deficiency, and then maybe their symptoms start to increase. Now, again, over time, we naturally have a smaller bucket overtime because our hormones become less restorative the older we get. So we just want to make sure that we know that theirs is bucket mindset and the more we take stressors out of the bucket, we can make a small bucket uhm— we can add more space to it. So someone that’s got a big bucket but is three quarters full, well, if we have a smaller bucket that’s a hundred percent empty, we may create more resiliency for us, even though our bucket, genetically, is smaller. So we have control. We’re not victims. We just got to be honest with ourselves. If we got a small bucket, we just gotta be on point more frequently. So, we do that by working on blood sugar stability, we do that with the baseline Paleo template, that you can work on customizing with your functional medicine doc regarding what that looks like macro wise and whether or not uhm—you have to add an extra digestive support to be able to breakdown the proteins and fats that's important. Now we can look at the hormones, if there are significant hormone or adrenal issues, we gotta work on it because that helps improve our ability to regulate blood sugar inflammation and stress. And then, we also got to look at our hormones, too. We have significant hormonal imbalances, we have to work on supporting that so we can develop our healthier cycle or healthier anabolic hormones. We could put on muscle and recover. And then, of course, this goes without saying, gut issues. Coz if we have dysbiosis, leaky gut, we have chronic infections like H. pylori or Blasto or Crypto or Entamoeba histolytica or Giardia. Any of these parasites are gonna create leaky gut. They’re gonna create more nutrient deficiencies. And a lot of these nutrient deficiencies are needed to make healthy DAO or HNMT enzymes to break down histamine. And these enzymes, all these nutrients also help make healthy uh— nutrients for a detoxification system as well.
Evan Brand: Well said. So you got to get tested. That's our philosophy—Test, don't guess. I mean, you could probably fix maybe 50% of the issue just by working with a good nutritionist, their practitioners are gonna help you dial in the diet, right? Just getting that piece started even if you're closer to an AIP approach, you are already gonna be eliminating a lot of the problematic foods including alcohol. So if you're working with a nutritionist, you make it 50% there, but to get fully better, adrenals— test them, we’re gonna run the stool panel, we’re gonna look for infections that way. We’re gonna look for a lot of problems on the organic acids, too. Fungus, yeast Clostridium bacteria, uh— detox problems. I mean, all of that is a factor, so there's never gonna be just one silver bullet. If somebody tries to sell you my online histamine course and there's like one silver bullet they’re promoting, I would be skeptical because like any topic we discussed, there’s 20-30 maybe 50 factors that all need to be factored into that pie chart which is the pie chart being your problem. How is that problem broken down? Maybe it’s 50% adrenals for one person, but it could be 5% adrenals for another person. If they’ve got a super positive attitude about it, that could change things, too.
Dr. Justin Marchegiani: Exactly. So we fix the nervous system stimulation, the stress— that's the diet and lifestyle, that’s also the adrenals. We fix the gut bacterial imbalance, which could be infections, it could be just low beneficial bacteria. We cut out the high histamine foods. We cut out the histamine blocking, the DAO blocking foods: coffee tea etc. And we try to add lower histamine, paleo foods, in the meantime, which typically are gonna be uhm— low sugar fruits, the citrus-free, typically vegetables are gonna be okay, uh—typically fresh meats are gonna be okay. Healthy fats, maybe minus avocado, are gonna be okay. Uh— avoid the—you know, the aged meats and fermented foods for a period of time. But as we get the gut healed and we fix these issues, we should be able to get better and better and better. And then there also additional supplements we can add in as well. They can make a difference. So in my line, we use one called, Aller Clear, that I formulated that has things like, stinging nettles, it’s got promalin, potassium bicarb uh—these are things that have been used for a long time to help lower histamine naturally. Uhm— big big fan of that. Uhm—let’s see. What else can we do on top of that? I got my list here. Quercetin, like I mentioned, vitamin C, these are in Aller Clear as well to help lower histamine levels naturally. Well I also did a research on that. Grapefruit, seed extract and pycnogenol, which are in these kinda category of league Proantothocyanidin which are these kinda antioxidant bioflavonoid and some of these really good uhm—fruits that can be helpful. We have green tea. Again, it can be a natural antihistamine but can also be a DAO blocker so you got take that with a grain of salt. Uh—magnesium can also be very helpful, stinging nettle can helpful, omega-3 fatty acids uh—can be helpful, uh— some essential oils— peppermint, lavender, lemon can also be helpful. Again, but be careful because some of them are citrus there. You just got to test it out. And of course, a lot of the herbs to help knock down dysbiosis can help in the long run so like the berberines and the goldenseal can also be very helpful as well. So a lot of different alternatives there. Any other comments or concerns, Evan?
Evan Brand: Yeah. I’m guessing some of the medicinal mushrooms can help, too. I’m not too familiar on the exact mechanism, but I'm assuming things like reishi, cordyceps mushrooms. I’m guessing those may help too depending on how they were grown, of course, uh—would probably make a difference modulating the immune system can be helpful.
Dr. Justin Marchegiani: Absolutely. Is there any other questions or comments you wanna add before we start hitting up some of our listeners questions. I don't think so. Let’s hit the questions. I’m gonna pull them up, so I can see here, too.
Dr. Justin Marchegiani: Cool. And if you guys uhm—putting comments in the live chat if you can kinda keep the questions kinda pertinent to the topic, it always helps and again, right now, for answering your question and you like it, give us a thumbs up right now, give us a share, give us a like. We appreciate it. We get really pumped and motivated coz of that.
Evan Brand: Should you—should you interview—uh, not interview—Should you introduce us, I mean I don’t know, maybe we've got new people that don't even know who are these two guys talking about histamine all of a sudden. Should we briefly do that?
Dr. Justin Marchegiani: Yeah. Absolutely.
Evan Brand: Alright. Tell us who you are.
Dr. Justin Marchegiani: Well, I’m Dr. Justin Marchegiani, a functional medicine specialist, a functional medicine Doc and yeah, I see patients all over the world and we work on chronic health issues, from hormone to gut, to detox autoimmune issues and you know, we’re trying to always get to the root cause so that’s me.
Evan Brand: Absolutely. I'm Evan Brand, functional medicine practitioner and Justin and I been doing this— doing this hustle on the podcast for— for several years. We've got hundreds of episodes together and I also work virtually with people via Skype and phone. And we do the live thing because we get comments like this, so let’ dive in.
Dr. Justin Marchegiani: And we’re the real deal. We don’t get a script here. We’re, we’re on-the-fly taking our clinical knowledge and plugging it into you guys, so you guys, the listeners can get healthier which—which is our purpose here.
Evan Brand: Yup.
Dr. Justin Marchegiani: So off the bat, couple things, uhm— I just saw here, Dale made a comment here about toxic mold. So yeah, I’ll connect Dale’s comment to toxic mold. But yeah, mold can definitely be a stressor that can fill up that histamine bucket.
Evan Brand: Yeah.
Dr. Justin Marchegiani: So of course, things that we use to help with mold is number one: good quality or filtration. If the house is really bad with mold, we got to get that remediated maybe even move depending on how bad it is. I never have someone move unless they can—they leave the house for a week or two and they're like, “Oh my God, all of my issues got so much better!” And again, we gotta be careful because if you’re leaving for a week or two, it may be a vacation where you're not –
Evan Brand: Yeah.
Dr. Justin Marchegiani: We gotta kinda like control those variables. Maybe you get a hotel room or you go somewhere else and you work outside of the house for a week. But if you notice significant improvement, there could be a mold issue. So air filtration can be good uh—do that little one to two-week test that I mentioned and binders such as modified citrus pectin, zeolite activated charcoal, liposomal glutathione these are all great things to use. A lot of the nutrients to help improve phase I and phase II detoxification. So, in my line, we use Liver Supreme or antioxidant uhm— Antioxidant Supreme or we’ll do Detox Aminos. which have a lot of those phase I and phase 2 nutrients. That's very helpful there.
Evan Brand: Good. I just wanna double comment on that with the recent hurricanes that have hit people in Florida, Georgia, Texas, all the other states affected this mold issue is probably gonna be a lot bigger. A lot of people will probably try to remediate their old mold. Uh—one of my wife's friend down in Texas posted a picture of her car, they got flooded in Houston. Her entire car, I believe it was leather, may be a fake leather, her entire car was covered in mold that look like a lab experiment, so—
Dr. Justin Marchegiani: Oh my gosh! Sounds terrible.
Evan Brand: So if there's mold there, please please please don't try to mitigate that stuff unless you’ve got like proper mask and all that coz you can make yourself sick.
Dr. Justin Marchegiani: Totally. Couple of questions here. “What are the best herbs for parasites?” Again, I would go look at some of our parasite podcast, we dive into it. Again, in my line, we have GI Clear 1-6 that we use for herbs uhm—to help knock down these infections. Evan has some similar ones in his line as well. So you can check out either Evan site, evanbrand.com or mine at justinhealth.com for more information on that by clicking on the store button.
Evan Brand: Yeah. I’ll hit the second part of the question there. “Are herbs usually enough to beat up parasites?” The answer is, “Yes” We do not prescribe drugs herbs is what we use for bugs and yes bacteria fungus, yeast, parasites. With the right protocol, the right approach, all the other factors, yes, you can successfully get rid of it. I’m a success story. Justin is a success story.
Dr. Justin Marchegiani: Yeah.
Evan Brand: And you know, thousands of people in our belts that we’ve been able to successfully eradicate parasites with herbs.
Dr. Justin Marchegiani: And just to highlight one thing, I think you put in there, but just to make sure any new listeners don’t assume it, we’re also factoring in diet and lifestyle changes into that because that is a massive effect on changing and making the immune system more resilient which has a huge effect on decreasing the chance of reinfection, too.
Evan Brand: Yup, well said, well said. Yeah, you can just take one magic pills, you got to do the hard work, too, which is putting a fork to your plate with good food on it, is organic as much as possible.
Dr. Justin Marchegiani: Totally. 100%. And then, again, some people here talking about H. pylori and SIBO and eradicating H. pylori, uh—they still have stomach issues. So I’ll connect this persons question to the issue. But if you have SIBO and H. Pylori, does that go into your histamine bucket? Yes. So these type of critters and infections can increase that histamine bucket which can create more histamine reactions like Evan and I talked earlier and the breathing issues and the burping constantly, yep. Those are all symptoms of that and that can drive histamine problem. So we got to get to the cause of those infections and again, I refer you back to our H. pylori or SIBO podcast where we spent a full hour talking about that one topic.
Evan Brand: Yup. Well said. Get that test to get that treated. Rosalin, she has itchy skin, scalp. “Is that a symptom of too much histamine in the body always itchy?” What would you say? Sounds like probably.
Dr. Justin Marchegiani: It could be a histamine issue, it could also be just a fungal issue, too. Seborrheic dermatitis is what affects scalp like that or a.k.a. dandruff and that can be fungal in nature. So I would just look at just the whole gut biome imbalance and/or histamine as a byproduct of that, right? Remember I gave you the a hammer and the thumb analogy, right? The— the histamine is just the collateral damage caused by the— the hammer, right? That’s kinda the whole idea. But, yes, it could definitely be— be part of it but more than likely, not the whole thing.
Evan Brand: Yeah. Kelly had a question, “Thoughts on the Biome test worth the money?” So Biome is a pretty new company who's running stool testing. I met the guy who created the test. I've had a few clients who’ve had that run and they sent it to me. And the readout is— is terrible. I hope they improve on it, but currently, I've had a few clients send me their readouts, it's crap. There's a bunch of information but there's no real action.
Dr. Justin Marchegiani: Not actionable, right?
Evan Brand: Yeah. It’s not actionable at all. It’s just too much data. So, Kelly, I do not use and Justin. Neither of us use the Biome test. We use more functional test that are available through practitioners. Which I like the idea Biome give people the power to get their own testing, but we still are gonna use other companies like the G.I. MAP on our clients.
Dr. Justin Marchegiani: Exactly. But the biggest issue is like you get companies that are trying to give you like more information, they’re trying to like dazzle you with all this information, but then you sit back and you’re like, “What the hell can I actually do with it?”
Evan Brand: Yup.
Dr. Justin Marchegiani: What lifestyle change? What diet change? What supplement? What can I eradicate? What can I support or balance based on this information that will help the patient get better? That's always the question. And the second question is, well does this test allow me to leverage my patient to make an action to allow them to get healthier? And if I don't get one or two—if I don’t get an answer for one, primarily maybe two, then it just—it becomes not worth it. Kind of you know, glittery, you know, it’s very like, it’s kinda like glittery and flashy and like, “Ooh, look at this!” but it doesn’t really do much to me.
Evan: Yup. Should we get James’ question.
Dr. Justin Marchegiani: Yeah.
Evan Brand: Yeah. So James put friends nine-year-old sons on a new drug, which I looked it up here, Spinraza for spinal muscular atrophy. And it's a brand-new drug looks like December 2016, it was the first drug approved for this disorder. Now he’s having swollen lips and hives. Any suggestions will DAO help enzymes? That’s a hard one. Coz who knows if that's a side effect of the drug or is that some type histamine issue.
Dr. Justin Marchegiani: Yeah. Number one, the kids—Again I don't know enough about this patient. So this is, take it with a grain of salt, this is a medical—medical uh—you know, uhm—advice. This is just me kinda talking here. So off the bat, kids notoriously have the worst, freaking diets in the world, okay? Especially if they go to school and they're eating the school lunch and they trade in with their kids. They eat like crap. So number one, clean up the diet. And again, it's hard because if you're a parent who's not eating healthy then it’s your house is full of crap. So first thing is the parent, get all the crap out of your house, create a really good environment, have really healthy snacks, get all of the crap out. So get on the Paleo template to start. Do that for at least a few weeks to a month. That may fix so many of the issues, but in the meantime, yeah, can you had add in enzymes like DAO can maybe hard to get them, but can you add in regular digestive enzymes and HCl, yes. Can you add in things like stinging nettle and bromolein and an acetylcysteine and all of the nutrients that I mentioned, yes, you can. So I would definitely add in all those histamine nutrients. Uhm— I would try maybe be going lower histamine, kind of a Paleo template and really get the diet a hundred percent and make sure they’re able to digest their food. HCl enzymes, all of those really good things and that's a great starting point and then from there, if that still not helping, our only getting part of the way there, you want to really get a functional medicine doc to look deeper at what's happening with the gut and things.
Evan Brand: Yeah. Well said. That was what—my next thing I was gonna say I’ve seen uh— little girls as young as three and little boys four, five years old with massive gut infections, parasites, and H. pylori and the rest of it. So it’s very possible that that's going on in the gut depending on the history and use of antibiotics in the kid and things like that.
Dr. Justin Marchegiani: Exactly. Patient here— my w— My mom has been diagnosed with lichen sclerosis, that’s an autoimmune condition that affects the skin. I've seen a handful of patients after that cream after cream the probably referring to hydrocortisone, a corticosteroid cream. It gets worse, any tips regarding the root cause of this? Yes. Autoimmune. Get the autoimmune stuff dialed in. I’ll use some stem cell types of creams like J Bio Serum, it’s one of the nice sell that I sell it works great. It’s got some stem cells in it, but you gotta make the diet and lifestyle change. Autoimmune template to start with and then dig in with all the functional medicine principles, next. One of the symptoms of histamine tolerance all the things that we mentioned earlier, from swelling to flushing to headaches to rashes. Anything you wanna add there, Evan?
Evan Brand: Yeah. Fast pulse or a rapid heartbeat. I've had women say they eat the food and then their heart starts racing. So could be mood issues, could be physical changes as well.
Dr. Justin Marchegiani: Yeah. And the best way to test for histamine issues, in my opinion, is I just look at people symptoms and I connect them to higher histamine foods and we just pull those foods down a little bit and if their symptoms get better, then we know. I think for me the telltale sign for histamine issues, fermented foods and citrus fruits.
Evan Brand: Yeah.
Dr. Justin Marchegiani: Those are the big telltale for me. Coz they’re relatively healthy foods. No one’s gonna say like, “Oh, eating a grapefruit is bad.” You know having some low sugar Kombucha or you know some sauerkraut is bad. It’s relatively good but if you're –if we’re doing that history and we see symptoms of those food, then we’re like, “Ooh, there probably is a histamine issue.”
Evan Brand: Yeah. Well said. See, what else we got here. I’ll read a couple off here for you. “Does everyone have some degree of histamine tolerance, don't think I have histamine problems but not sure.” Well, if you say everyone— the average person is very unhealthy. Autoimmune diseases ramp it, the standard American diet which is the same in Australia, the same in Europe, the same and most developed countries are following kind of a standard American diet— processed grains, sugars, conventional pasteurized dairy, meats that are not organic, they contain hormones and antibiotics. So, yes, most of people are taking Ibuprofen and over-the-counter drugs, they’re taking steroids and doing in antibiotics. They’re getting them in the diet. They’re doing acid blocking drugs, they’re not sleeping well, they’re addicted to their smart phones. So, yes, so many people have things in their bucket. Then, yes, I would say everyone has a degree. Now, kind of our tribe that Justin and I are building of you know, healthy people that are doing as many right things as possible, they’re probably gonna have a less risk of—of histamine intolerance.
Dr. Justin Marchegiani: Totally. Hundred percent. Makes sense. And how about the bone broth stuff? I mean, I see, you know, I see uhm— lots of people with issue with bone broth and it kinda falls in and around the fermented food issue, right? If you're having issues fermented foods or things that are slowly cooked, like bone broth, that can increase histamine and that can create a problems. So, again, we may hold off on the bone broth or cook it in a way where it’s cooked shorter. What kind of preparations for bone broth do you do to help lessen it? I know there are some out there.
Evan Brand: Well, I’m spoiled. I haven’t been making it because I've been using Kettle & Fire Bone broth that they sent me, so I literally does have to throw it in a in a pot and heat it up. I've been fine. I know they slow simmer or slow cook theirs for like 48 something hours like it's an extremely long simmer time. So I don’t know how that would affect somebody that they were sensitive. But for me, I feel quite well with that. I don’t have any symptoms.
Dr. Justin Marchegiani: Yeah.
Evan Brand: I don’t know. I haven't had to modified it at all.
Dr. Justin Marchegiani: Yeah. So a couple, you can skim off the scum of the top of the bone broth. You can skim that out. Uh—it may be helpful, you can also do just the shorter brew maybe an 8-12 hour one. Uhm—that can be good. You can also just try buying some maybe your higher-quality or they may have a way of you know, producing it that produces low histamine like the Kettle & Fire. So that could be some good options. But again, if you have a food that we consider to be healthy like bone broth or Kombucha or fermented foods and you can't respond to it, you can always put that food aside. That's kind of like that's like you're free-histamine test, right?
Evan Brand: Yup.
Dr. Justin Marchegiani: So you can work on the gut. You can work on a lot of these hormone and diet things. And then you can add that thing as your free test add back in the future and that’s a good objective marker to see how you’re doing with your gut. And if it’s starting to heal, you may be able to handle more of that yet.
Evan Brand: Yup. Well said.
Dr. Justin Marchegiani: I believe my link should still be active Kettle & Fire sponsored my show for a while. They're not anymore but they should still be giving people 20% discount so you can try it. If you do, evanbrand.com/chicken you should be able to get 20% off— so try it out. I think they pay me like a buck if you buy some, but that's good bone broth and definitely—
Dr. Justin Marchegiani: We’ll support the cause. I know the products—only products that we ever mentioned on our shows are things you believe in. So again, you guys gotta know that we’re coming from a place of authenticity. So if you want to support us and we reference something, just know that it's got to go to the filter of actually being a high-quality product and we actually have to use it on ourselves and our friends and family for us to recommend it.
Evan Brand: Yup.
Dr. Justin Marchegiani: We appreciate that support.
Evan Brand: Another question here. “What herbs do you suggest for fungal issues?” Once again, I’m gonna say it depends. And I know Justin would say the same thing because we’re gonna make our protocols based on what you're up against. So if it's bacteria plus fungus plus yeast plus parasite, that’s gonna be far far more heavy hitting protocol. If it's just fungus by itself, which is not too common, because most people have a lot of issues together, you may be able to get away with some garlic or some oregano or like Justin mentioned earlier, Berberi or the barberry or the—
Dr. Justin Marchegiani: Yup. Berberines.
Evan Brand: Berberines. That whole can be great and we've got several formulas if you just stalk our stores a bit look on justinhealth and look into his categories and you can check out mine, too. We’ve got many, many different combinations of herbs. Could you go and technically just buy a couple herbs and just you know, shoot a shotgun approach and maybe get success, yes. But I would of course, advise you to get tested because if you have fungal issues, you probably have other issues, too.
Dr. Justin Marchegiani: Yeah. And here’s one like clinical pearl that I've kinda find over the years. I'll throw it out there for everyone listening. How I know fungal issues are more of an issue for— for some people than others, is number one, we’ll see the fungus on a stool test, which will be helpful. We can see either multiple kinds of yeast or fungus where it’s Geotrichum, Microsporidia, Candida, etc. We’ll see different kinds of species. But also on a organic acid test, we’ll see the uhm— D-arabinose, which is a metabolite of Candida but that also kinda means it's gone systemic. It’s gone more more systemic coming up the urine. So if we see something like the D-arabinose is more of a systemic marker in the urine and we see in the gut, then we know that fungal issue is—is a lot deeper. Now a lot of fungal issues tend to be driven by other issues like H. pylori, other parasites are bigger but some people just gonna have a rip-roaring fungal infection. We’ll see it systemically via the organics as well as on the gut, too.
Evan Brand: Let me ask you this. I mean let’s say you see somebody with a really, really gross fungus fingernail like it look like their fingernails about to falloff because it's so infected. Would you assume that person has got a massive amount of fungus in the gut and it's manifesting on the nail on the—on the fingernail?
Dr. Justin Marchegiani: To a certain degree, I would say that's a good, you know, you can’t hurt yourself faulting that, coming to that conclusion. But again, if you knock out some gut stuff, it can be hard for those herbs and for your immune system to get all the weight at that peripheral tip of that nail to knock out the infection. So sometimes we got topically hit things coz they just got to travel a long way so we’ll either topically hit our herbs there or we’ll uhm—have to do some kind of a soak to hit it as well. Even if we were to address the gut, it may not be enough to make its way down there.
Evan Brand: Coz I've seen that. I remember it was a cashier or somewhere, I saw a guy with his finger like his index finger, the nail was literally about the come off and it was completely—
Dr. Justin Marchegiani: There are different degrees, right? There’s like, “Oh, I had a slight fungal nail and I knocked it out with some oregano and a soak and just a few—in a few weeks.” There’s somewhere it’s like nail is incredibly like sclerotic and—
Evan Brand: It was extreme, yeah.
Dr. Justin Marchegiani: Almost falling off and then like totally dis_ that’s like the highest degree. I mean it’s just like, “Oh, it’s a little bit rough and then it's got a slight yellowish hue.”
Evan Brand: No. I’m talking when it was like—it look like if you flicked it, it would fly off.
Dr. Justin Marchegiani: That’s one of the extreme. And then the other extreme is maybe– is a light, it’s kinda like a little bit sclerotic like it’s rough.
Evan Brand: Yeah.
Dr. Justin Marchegiani: And if you were to file it, it would get smooth but it would grow out of the bottom again rough. That's how you know it's fungal. And typically it’s slightly yellowed. And again, it can go really dark and brown, like dark yellow brown the longer it's there.
Evan Brand: So what is that? When is that extreme? I mean how in the world would that happen? What sets the stage for that since we talked about—
Dr. Justin Marchegiani: Just chronicity. It’s just deeper and deeper and deeper and deeper into that nail bed.
Evan Brand: Yeah. Wow! Last question here: “What does it mean if a rash shows up only on the legs and not other parts of the body?”
Dr. Justin Marchegiani: I have no idea. Uhm—again typically the body’s just gonna push stuff out. And again, if things are in the body systemically, where or why the body pushes it out there, beats me. Maybe that's a stronger area for the body to push it out, hard to say. Again, as things get worse and worse, problems tend to be more systemic, so I wouldn't worry about why it's there. Uh the fact that it's in a local spot is better. I would just want to make sure there’s nothing constant— contact dermatitis issue where things are in contact in that spot. And when nothing is contacting, I wouldn't worry about it. We’re treating the body systemically as a whole. We’re really work on lymphatics and the detox so everything will get better.
Evan Brand: Yeah. Well said. And I mean—in a rash in the leg, that could be so generic. I mean, that could be something from your skincare products. That could literally be allergy to parabens or something. My wife—
Dr. Justin Marchegiani: A contact dermatitis issue where something is actually touching it.
Evan Brand: Right. Yeah. My wife she had a reaction on her legs and it had nothing to do with diet or histamine or anything. It was just uh—uh she had a sample of the skincare product and it must had some ingredient in it that we didn't know about and she had a rash on her leg. So don't—maybe don't freak out, don't think too deeply. It could be something that simple.
Dr. Justin Marchegiani: Yeah. And my baby just had some baby acne. My wife is freaking about it a little bit. But it’s just you know, he’s just metabolizing her hormones. So he’s getting over it pretty fast uh— which is good. But again, things happen and if it's a contact issue like control all the vectors of what's going on your skin. And then second is like, what's in your body and just try to decrease inflammation.
Evan Brand: Yup. We got uh—you got time for one or two more?
Dr. Justin Marchegiani: Sure. Let’s do it.
Evan Brand: Alright. James he said, he’s not allergic to nuts and seeds but every time he eats peanut butter, he always gets a fungal rash around his glute region.
Dr. Justin Marchegiani: Don’t touch peanut butter, man. I mean it’s known to be higher in aflatoxin, it’s a legume as well. So that could be some gut-irritating stuff in it. Stay away from that. Switch over to high-quality almond butter instead and let us know how that works.
Evan Brand: Yeah. There’s a brand I use—what is it? Cadia. C-A-D-I-A. It's like the only organic almond butter I found that’s less than 20 bucks a jar.
Dr. Justin Marchegiani: I actually created my own brand called Justin's. You’ve seen that brand at Whole Foods?
Evan Brand: I did. Good job!
Dr. Justin Marchegiani: Nah, I’m just kidding. It’s convenient to say it, but, no. Not my brand.
I won't take credit for it. But I do like Justin's. Uh—I will do that a little bit sometimes. And I do like just the whole food 365. I’ll get the organic. It’s also a cool one. Its’ really expensive! It’s called, NuttZo, in an upside down container so like the lid is on the bottom and it’s upside down kinda thing. That’s kinda cool. Really expensive, but it's really a nice treat.
Evan Brand: Here's another question. Uh—little bit off-subject. How is holy basil an adaptogen for stress?” Uh—we’ve done—I could go so long on this.
Dr. Justin Marchegiani: Yeah.
Evan Brand: That I’ll have to shut myself up right now. You just have to check out our other episodes on adaptogens because I love them and Holy basil, __rhodiola, ashwagandha, all the ones you mentioned.
Dr. Justin Marchegiani: Good.
Evan Brand: We do use all those. They’re great.
Dr. Justin Marchegiani: Yup. I think it’s good. It’s good to kinda rotate through some or use a combination to use them individually and have a rotation to it. I think that’s great. Evan Brand: Yeah. “Is water sounding in ears related to histamine?”
Dr. Justin Marchegiani: The first thing I would look at are just food allergens in general. Uh– especially mucus-producing food, so like dairy and things coz anytime you get more mucus that could go in the ear and that can create issues. Just gluten and inflammatory foods to begin with. So, yeah. Definitely kinda hit that overall Paleo template, you’ll hit a lot of those things out.
Evan Brand: I think that’s it. We should probably wrap it up. We’re gonna turn into a pumpkin here.
Dr. Justin Marchegiani: I know.
Evan Brand: If there’s any last questions please ask us.
Dr. Justin Marchegiani: How much salt did you ingest for every liter of water you drink replenish lost—I mean, I would just do half a teaspoon to a teaspoon twice a day of high quality mineral base salt. So like my favorites, Real Salt, or you can do Celtic, or Himalayan, just really good minerals that you’re gonna put back into your body. I like that.
Evan Brand: Yeah. I saw a new study about sea salt. I posted it up—I think I put it up on my twitter account where all the sea salt from US and Europe was contaminated with micro particles of plastic and so I'd support your idea of using the real salt which is gonna be an inland sea as opposed to the ocean sea salt that’s contaminated. Dr. J, do you think Tom Brady is on a low histamine diet?
Dr. Justin Marchegiani: Well, let’s breakdown Tom Brady's diet. He's eats 20% meat. There’s a lot of means out there. If Tom Brady goes vegan, no—you’re not vegan if 20% of what you eat is meat—not even close. But, as a qualifier there his meats are organic and grass-fed, so there's really good quality meats. He avoids nightshades, tomatoes, potatoes, eggplants, peppers. He eats lots of vegetables. He eats very little starch. He eats a little bit of fruit. So I would say relatively speaking, yeah. I mean, his kinda thing is, “Oh, I’m eating acid alkaline kinda thing”, right? That may be the result of—that may be what he thinks he's doing, but my thing is he's really just doing an anti-inflammatory diet.
Evan Brand: Yup.
Dr. Justin Marchegiani: I’m not worried about acid alkaline. If he is worrying about so being alkaline a hundred percent, he’d avoid the meat, right? But we know that meat has a lot of important nutrients and it’s balance the meat with a lot of the veggies that are very alkaline. I don't worry about that so much. Most of the acid your body’s gonna get is from inflammation. Inflammation is like 1000 times more acidic than actually eating an acid-base food. So I’m more worried about the food’s inflammatory qualities that I am about whether it's acid or alkaline. But, again, grains are 10 times more acidic than meat. So if I can leverage that conversation or that idea with the patient, I’ll say, “Hey, if you really wanna be more alkaline, at least meat’s 10 times less acidic than grains.
Evan Brand: Well said.
Dr. Justin Marchegiani: I would think he would be indirectly not his goal but again, anyone that’s on anti-inflammatory diet indirectly, would be lower histamine outside it may be citrus and fermented foods and such.
Evan Brand: Yup. Well said. Well, we’ll wrap this thing up. We hope you enjoy it. If you have more questions, more ideas, more things that you want to hear us cover in terms of topics, reach out. We both got contact forms on our website. Send as an email.
Dr. Justin Marchegiani: Subscribe. We appreciate it. Give us a share, give us a thumbs up.
Evan Brand: Yeah. Justin— Justin's over 30,000 on the YouTube, man. So great job! Keep it up. Hit the subscribe button so that we can keep pushing up this content in helping you guys achieve the most optimal health on the planet to help us get more people healthy we really appreciate health on the planet.
Dr. Justin Marchegiani: Help us get more people healthy. We really appreciate it. Healthy people make healthy decisions. They’re better parents, they’re better employees they’re better bosses, they’re better everything, so—
Evan Brand: Yeah. I saw Mark Hyman he was talking about autoimmunity and how it's twice or even up to 10 times more expensive to take care of a sick patient with autoimmune disease and so we guys want you to be healthy because to save our population from collapsing. We’re kind of in the midst of healthcare collapse. Basically, the health of society falling apart. We’re trying to make a healthy dent in the universe by helping you guys. So thanks for the feedback. It means a lot to us.
Dr. Justin Marchegiani: Love it, Evan. Alright, man. Great chat today. I appreciate it.
Evan Brand: Take care. Bye.
Dr. Justin Marchegiani: You too, take care.