The Gut Histamine Connection | Podcast #384

Dr. Justin and Evan Brand discuss the gut-histamine connection in this video. They point out that many patients with digestive issues, skin problems, mood issues, and fatigue often have sensitivities to histamine-rich foods. They suggest focusing on root causes, such as overgrown bacteria in the gut, gut inflammation, and processed food consumption, as the key to improving histamine issues instead of relying on antihistamines or other medications.

Additionally, Dr. Justin and Evan mention other contributing factors to histamine issues, including tick-borne infections, mold mycotoxins, chemical exposures, and heavy metals. To address these issues, they suggest a holistic approach using herbal medicine and aligning puzzle pieces to help patients get better without worsening.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

00:20 – Common Digestive Issues
06:40 – Can H. Pylori cause Histamine Intolerance
10:05 – Ginger as Stimulant
14:02 – Over the Counter and Natural Remedies
19:47 – How Do You Know if You Have a Histamine Problem?
21:32 – What is Histamine?
24:33 – Takeaways

Dr. Justin Marchegiani: And we are live! Dr. J. here in the house! Evan Brand here as well, we are excited to talk to you guys about the Gut-Histamine connection. This is a common question that we get a lot while in the trenches daily with our patients. Really excited to dive in, Evan what’s going on man? It’s been a hot minute, how you’ve been?

Evan Brand: Yeah, I’ve been really well, and this issue, I think, I don’t know if it’s because you and I are recognizing it more or if it’s just because it’s more common. Maybe it’s a combination of both. But you know, I see so many issues where people start out with a digestive problem. Like they’ll complain about stomach pain or cramping, or diarrhea, or constipation, maybe some skin issues, maybe some mood issues, anxiety, depression, fatigue and then all of a sudden histamine comes into the equation.

And people start realizing, “Wow! I’m actually allergic or I’m having these sensitivities to histamine-rich foods!” Like, maybe avocado, that was a big one for me. I would eat avocado I’d get a headache from it then I learned about histamines, and sure enough when I went low histamine, a lot of my symptoms resolved. So I think this is an important piece of the puzzle especially, depending on when people are listening, things are starting to bud and bloom.

And so people may be reacting to outdoor allergens, pollutants, pollen, et cetera things, blooming. I think it’s because their bucket is already so full because of gut, in the histamine-producing bacteria, that now they’re reacting to the outdoor environment. So people go to the ENT, they jump on the allergy med but that’s not necessarily the root cause solution.

Dr. Justin Marchegiani: 100%! I see it all the time where you know, you’ve got patients that go to you know, the conventional doctor like, “Oh I have mast cells!” And then they’re just basically managing that patient with a lot of fancy antihistamines, different things like that to kind of decrease the ability to either make histamine or, help your body kind of degranulate it or break it down. And they’re like, “Well this is what I have.” and they’re so focused on the actual diagnosis like the diagnosis is its own entity, where the diagnosis, I always tell patients is just a manifestation of a lot of upstream issues working their way down.

And so it’s kind of like, you have all these systems that are out of whack whether it’s gut, gut bacteria, and we know, for instance, that there’s different bacteria when overgrown can drive histamine, you were mentioning that. Morganella, Klebsiella, Pseudomonas, Citrobacter, Proteus. These are all bacteria that are common, like in SIBO and just in general dysbiosis, and these bugs can actually produce a lot of the histamine.

And then, of course, if your gut’s inflamed, you’re eating lots of processed flours, acellular carbohydrates, that’s what’ll feed a lot of these things and then, God forbade, you come in there and you have some antibiotics, over the course of your lifetime, maybe more than you should. Now you have this perfect storm of like processed foods, you have antibiotics maybe you come in there and you have a lot of glyphosate and roundup exposure, and now that whacks out your brush border, that creates rebound overgrowth as well.

Maybe you have some mold exposure, now you’re overly stressed, you have low stomach acid, low enzymes, low bile salt, so you can see how this storm isn’t just like this, “Oh! I just have a Zyrtec, or an Allegra, or a Pepcid-AC deficiency.” It’s like no no no, that may help you palliatively control some of the histamine symptoms right? Brain fog, dizziness, vertigo, obviously like you to carry a hive skin stuff, it may control some of that fatigue but it’s not going to fix it and so you always want to go upstream to the root.

Evan Brand: Yeah and this is not a sexy idea because it’s not one silver magic bullet that you and I can offer. We have to tease it apart and go, okay, well over here we have on your stool test for example. We see five, six different bacteria, all producing histamine. We see here you have an older home, you don’t have any air purification in the home, so there may be indoor pollutants kind of creating a mast cell reaction.

Then you may have tick-borne infections that I always factor that in, just with my own personal suffering. Lime, Bartonella, Babesia, these things also drive histamine and mast cell activation. Mold, Mycotoxins, those drive it. You mentioned Glyphosate, other chemical exposures, I would assume heavy metals are probably aggravating the mast cells and creating a histamine response as well.

So, when you tell someone, “Hey get rid of the Zyrtec. Let’s do this, that, that, that, and that.” It’s a little bit harder of a cell but I wouldn’t encourage you guys to just take things one at a time, and if you’re working with someone like Dr J or myself, we’re going to help you to align the puzzle pieces in a way that’s going to slowly get you better without getting you worse.

Because the problem is, we’ll see people that’ll go do Rifaximin and this is their naturopath, or some supposedly Integrative Medical Doctor that went functional, and they’ll go put them on Rifaximin or something else for the SIBO, and they flare up worse or maybe they get relief for a month or two, and then they call us. “Hey, I’ve already been to five, six people. Can you help?” And usually we can we like the high pressure environments

Dr. Justin Marchegiani: Yep 100%! And so, I always try to be the most conservative as possible. Try to use more herbals and get to the root first. Obviously, like the first thing is if you’re coming in, and you’re super inflamed, you’re overly sensitive to histamine, and you’re already on some medications, and those medications are typically are they helping you? Whether it’s like an H1 receptor antagonist, or an H2 antagonist, or an H1 blocker right? There’s typically the H1 and H2 kind of antihistamine type of families right? Whether it’s, I think Allegra is one I think Zyrtec one, Pepcid-AC is one, I think Zyrtec is an H2 blocker right?

So there’s different families of drugs that fit into those categories. There’s obviously some more experimental drugs that are coming out down the pipeline but these are just common ways that your conventional doctor may be managing it. I tell patients, “Hey, if you do that medication, how do you feel? Do you have an improvement?” If you do, that tells me something right? Because if your histamine bucket is full and those medications help, well the root cause now is to pull out the antigens or the foreign material that’s filling up that bucket.

Now in some people, I’m like “Hey! What’s your environment like? Do you have a bunch of seasonal allergies coming in and impacting your sinuses? Do you have mold in your home?” Because the easiest thing out of the gate is get your air quality in the home clean and flush out your sinuses because a lot of times you’re outside, and during the daytime, you’re bringing all those weeds and pollens into your sinuses. You’re bringing them in even though you’re inside in a good environment. You got to get those things flushed out so we’ll do saline, we’ll do Xylitol, or some biofilm busters and we’ll flush that stuff out once or twice a day, and we’ll make sure the air in the home is super clean and will rule out any mold issues or environmental issues in the home too.

Evan Brand: Yep they had a question come in about H.Pylori. Can H.Pylori cause histamine intolerance? My gut feeling was yeah. I would throw it in the category of any of the gut bacterial overgrowth. Well, here’s the paper on it right here, from an Immunology Journal 2004. Effects of helicobacter pylori on gastric inflammation and local cytokine production. And long story short, it says here results suggest H.Pylori induces lower TNF Alpha and interleukin-6 secretion in the mice. So this is a mice study, they’re saying here that H.Pylori produces considerable cytokine production in the infected groups.

Now they did something here, this is kind of interesting. I don’t know how they do this. I guess they mess with the enzymes, the histidine decarboxylase, in these mice, so that’s interesting. Because they’re kind of comparing like a regular mice versus this altered mice, and then they gave the mice H.Pylori, and yeah, I mean, it’s a piece of the puzzle right? So I can’t say if you just had H.Pylori would that create a histamine intolerance? But it’s rare to see that by itself wouldn’t you say? Most commonly we’re going to see candida or maybe some other bacterial overgrowth with the H.Pylori.

Dr. Justin Marchegiani: Well, also too. If you have H.Pylori right? We don’t have to go too far to kind of make it make sense just with the deductive reasoning right? So we know H.Pylori can decrease stomach acid and we know low stomach acid impairs digestion. We also know stomach acid also has a mild antimicrobial effect, right? This is the reason why people make you know, homemade topical cleaners out of like white wine or apple cider vinegar because the acidity actually kills stuff.

And so we know if we have good acidity levels in our gut it’s going to make it easier to keep the bug level down in our gut. We also know women that do birth control pills increase the vaginal pH, makes it more alkaline, that makes it easier for yeast to grow, right? We know these! So, we can kind of use deductive reasoning and say, “Hey! If we impact the pH and raise it above where it should be, that can make it easier for bugs to grow. It’s very possible.”

Evan Brand: Yeah and you know, the person commented that they have H.Pylori and histamine intolerance they don’t want to go to conventional doctors. What can you do to feel better? Well, number one would be get a full workup done. You know, we’d like to look at stool and urine to figure out what all is happening and then we come in with herbal antibiotics and you can knock this thing out within a couple of months unless you have a spouse that’s reinfecting you, then we may want to get them on board, but you know, between Dr. J and I, mean we’ve probably fixed thousands of cases of H.Pylori.

So the cool thing is, with herbs we don’t appear to have the same antibiotic resistance that we see with the conventional drugs because now they’re moving on to quadruple therapy, which is four different antibiotics at the same time to treat this. So, it’s a real mess, and as you know, we’ve talked about before, as soon as you wipe out one thing then other things are likely to move back in, so maybe you do clear H.Pylori with triple or quadruple therapy. I have seen it be successful but then we see all the other crap move in. the Klebsiella, the Citrobacter, C. diff, other types of Clostridia, those move in, and then those create other problems.

So, it’s kind of like you played whack-a-mole, right? Like you knocked the one pathogen out and now you’ve got these other histamine-producing bacteria that move in so you’re still in the trenches here.

Dr. Justin Marchegiani: 100%! And so, I look at it like this: Stomach acid is a really good and first important step. We need that. We know most people stomach acid and bile acids drop and bile acids they’re they’re slightly acidic but they can also prevent a lot of bugs from growing, right? So, this is really important. People that have sibo tend to have lower bile acids as well. And so, one of the first things that we’ll use to kind of stimulate motility and stimulate acid production, we’ll use a bitter call Ginger, and Ginger is also a mild H2 blocker.

So, it can also help modulate histamine a little bit which is really cool while also stimulating digestion. which is really interesting. And then we’ll use like, people will use like you know, an H2 blocker like Pepcid-AC, but the problem is that drug actually will block hydrochloric acid levels, where some of the natural H2 blockers like ginger won’t actually block it, it will actually stimulate it which can be much better. This is why drugs have side effects, they tend to disrupt and block inhibit enzyme pathways so you tend to have more side effects. Where herbs just tend to enhance and support.

Evan Brand: Yeah, well said and I was just going to throw in Ginger too is always helpful when you have nausea because a lot of these gut bugs can produce nausea, I told you years ago when I had H.Pylori. Not only did I have anxiety, but man, my nausea was out of control especially on an empty stomach, it was awful. So, I would just do these Ginger chewables and that would really help tamp it down.

Dr. Justin Marchegiani: Yeah! yeah exactly. Now I tell patients like, obviously, lifestyle is a foundation, like the food you eat, diet, sleep. But if you’re eating like really good high-quality grass-fed steak or salmon but you’re not able to break it down well that’s a problem. So that’s why like foundational digestive support is going to be the foundation it’s almost equal that up with food because if you can’t break the food down, the food even though it’s healthy, can also be a stressor on your body.

So, I really want to get the HCL, get the enzymes dialed in. Now some people when their guts really raw and they have a lot of histamine issues, they may not be able to handle much hydrochloric acid and that’s where working with a clinician, like some patients, they kind of jump to conclusions they like try HCL, they have a negative reaction like no it’s not for me and they kind of just jump ship. It’s like, “Wait a minute!” Like utilize the thousands of patients that we have data points from and figure out what does that mean? What’s plan C? What’s Plan D? What’s plan E?

Because there’s ways that we can either lower the dose, increase enzymes and bile acids, use bitters, there’s other little tweaks that we can make to make that work and then also what does it tell you about your body? It tells you you probably have atrophic gastritis. You probably have a really thinned out gut lining, and we really have to work on building up those enterocytes, building up you know those goblet cells, building back up those parietal cells, really that mucosal lining really building it back up.

Evan Brand: Yeah and question came in about gastritis. Well figure out what’s causing it, you know. Gastritis is just the, it’s like the upper GI IBS. What I mean by that is like you go to the conventional doctor if you get referred to the gastro, with diarrhea, constipation, they’ll throw the IBS label on you like they did to me years ago. If you have any kind of issues up north, you know say stomach or higher, then you may get this gastritis diagnosis.

And often what’s going to happen is, they may throw in that acid blocker, reducing stomach acid further, now your food’s not digesting well, now you’re getting a buildup of these histamine producing bacteria, now you develop histamine intolerance all because the doctor was trying to fix the gastritis and put you on the acid blocker. So he screwed up this whole, there’s a negative domino effect that happens once the pharmaceutical is put in for gastritis.

So, our remedy would be to come in and say number one, do a stool test. We would likely run the GI map, that’s our favorite at the time of this recording. And with that stool test, we would look at cow protectant, which is your gut inflammation, we would look at pancreatic enzymes, look for H.Pylori, look for all the bacteria, and then we would do it in the proper order. So maybe there are some soothing herbs like you mentioned in the beginning and then ultimately knocking the infection down that’s causing gastritis.

So, you can’t just glutamine your way out of this. You can’t just chamomile tea your way out of this. Ultimately there’s something driving it. So I’m cool with the the natural, soothing remedies. You could drink a gallon of aloe juice a day if you want but it won’t clear the bugs. So really got to figure out what’s driving it.

Dr. Justin Marchegiani: Yep exactly! And so one of the big things I’ll use, I’ll use Manuka Honey because I find it can have a natural antihistamine benefit. It can release, it can reduce the body’s production of histamine plus it’s very soothing. They use it in burn victim units in hospitals. It’s also antibacterial. So if you have a you know, higher level bacterial load in your gut let’s say H.Pylori, it could probably start knocking it down a little bit. I would say I would never rely on Manuka Honey to addressH.Pylori by itself but it’s a gentle way to start.

Again, I don’t like to come in there and throw heavy herbs out of the gate because I just find if someone’s gut is raw and we throw a whole bunch of clove or mastic, or whatever oregano, or berberine, that can sometimes irritate an already sensitive gut lining. So we want to really work on getting everything dialed in the first month or two and you know, how that food is cooked and prepared makes a big difference as well. So I like ginger, I like Manuka Honey.

Again, glutamine or glycine or collagen, so a good building block, but like Evan said, if I throw a whole bunch of building block, let’s say, wood into a burning building, does that really fix anything? It’s like “No! We got to get the fire down!”, right? So yeah, here’s this building block, but we got to get the fire down, and it’s not bad to throw it in there, maybe with some aloe, or some DGL, or some ginger, or some Manuka Honey, or something that’s really anti-inflammatory and gentle. I have no problem with it, but you got to look at it talk about it with your functional medicine doctor. Have the big picture plan. Don’t just go and throw stuff at it at like willy-nilly.

Evan Brand: Yeah and the truth is, when you’re desperate and you’re miserable, you’re gonna run somewhere and do something. So, I would encourage people, if you are in the current state of suffering, you have histamine issues, you have gut issues, you’re having this gut histamine problem happening. Just either reach out ASAP to us so we can help tamp it down, or do something gentle and slow. Don’t just go jump on three, four, five drugs.

I’ve seen it they get on Chromolin and you named several other pharmaceuticals, they jump on those and then now you have to clean up the issues with that. Now there’s potential Osteopenia or Osteoporosis because they’ve been on acid blockers for 20 years screwing up their mineral absorption. So, now you have a bone density problem, or now there’s a mobility problem because their hips are weak, right? So, it’s like there’s other collateral damage that happens when you are incorrectly tamping down the acute situation of stomach burning, GI pain, gut issues of any kind, histamine problems.

I would encourage people pace yourselves but you know, don’t. I don’t want to talk people out of getting care, I’m not saying that like if you need a colonoscopy because you’re bleeding out of your butt, yeah you got to figure it out. If you’re vomiting blood, yeah you got to figure it out ASAP. But if it’s this subpathological issue, meaning there’s no formal diagnosis you’ve been given, they just kind of brush you off and send you home with a couple over-the-counter remedies, then you really got to start digging.

So get your stool looked, at get your urine looked at, and check out your partner too. Your partner could be a vector. So that’s why I always ask the question, “Hey, you know you have these gut issues what about your spouse or your partner? Do they have the same issues? Yep they sure do! What about your kids? Oh yeah, my kids guts are messed up too.” Okay then we find out this infection is whole family-wide, so if we can, sometimes we’re working on the whole family.

Dr. Justin Marchegiani: Yeah 100%! And again, you know, most diagnoses, you know, really aren’t that helpful like let’s say, you have some inflammation in your stomach, you’re like, “I need to go to my doctor and get a diagnosis.” So, let’s say they just look at symptoms and they say, “Okay, well, you know, we’re gonna just try to give you an acid blocker because, we, you have irritation, right? That sounds like a gastritis, which just means gut tissues inflamed. Itis means inflammation. Gastro means gut, stomach. And then, maybe we’re going to give you Gaviscon, kind of coat that stomach, maybe we’ll recommend Tums or an acid blocker. Maybe we’ll give you a steroid.”

Maybe the next thing is, that doesn’t work then they’re going to recommend a scope. Let’s say they see an ulcer there, they may test for H.Pylori, they may be getting closer. But now they’re throwing a whole bunch of antibiotics at it that only works seventy percent of the time, and can create bacterial overgrowth in other areas. And so, they may not get to the root underlying issue and they may just try to symptom spot and so I always tell patients how does the diagnosis get to the root cause?

Now if you’re bleeding, you have a serious ulcer, you may need something to reduce in the inflammation acutely. But in the end what happens next because you still didn’t get the root cause addressed? Why did you have that to begin with? What foods were you eating? What kind of imbalances do you have in your gut? What kind of lifestyle problems do you have? So you have to look deeper.

If I go to the doctor and I have knee pain, right? All the doctor is going to say is “Oh my gosh! You have arthritis in your knee!” He literally said the same thing back to you, just in Latin, right? She said you have arthritis which means joint, arthro-itis means inflammation of the joint. He literally just said the same thing back to you! You said, “Hey Doc! My knee hurts!” and he just said, “Of course! You have inflammation of the joint.” Which you’re like, “Of course! Like, no crap right?” Now, question is why? They may say, “Well, your cartilage is wearing thin, we need to put a total knee in there.” But how did that happen, right? Should I add in collagen? Is my exercise wrong? What caused that? “Hey! Should I look at Prolotherapy or stem cells?”, right?

There’s so many other means of looking at things that may have helped you in between, and now again if it’s so far gone, and you’re not willing to make a change in your diet or lose weight, that may be your only option, right? But I always tell patients, “You want to know all your options!” You want to understand kind of the diagnostic language. A lot of times, they’re just telling you the same thing back and they’re just spot treating symptoms. Sometimes that may be necessary but most times you’re just ignoring the root cause.

Evan Brand: Yeah and we jumped into the nitty-gritty quick. So if people got lost in the weeds of “How do you know you have a histamine problem”, a lot of people don’t. So this could be allergies, where you’re reacting strongly to the outdoor environment. Like when pollen starts blooming and the flowers are coming on the trees, all of a sudden you’re reacting, you’re getting stuffy, you’re getting brain fog, you mentioned dizziness, vertigo, you mentioned the rash on the skin, it could be flushing, you could have a stronger reaction to leftovers, so the longer protein is going to sit, you’re going to have more histamine.

So, if you eat yesterday’s burger for lunch and you feel weird after that, that could be a sign. Spices and herbs could aggravate that too.

Dr. Justin Marchegiani: Fermented foods! Do you have a reaction without it? Do you get a lot of brain fog when you have kombucha or sauerkraut?

Evan Brand: Yeah, spicy foods like chips. Like even if you’re doing these avocado oil barbecue chips and all those spices if you kind of feel weird woozy after that. Alcohol intolerance, if you take a sip and you’re already toasted, you know, that’s a potential histamine issue. what else?

Dr. Justin Marchegiani: Well you see it, you see it with a lot of Asians too, right? Asians typically get that like red glow and and what do they take? They take Pepcid-AC, which is an H2 receptor blocker. So a lot of Asians are very sensitive to alcohol. So they intuitively know that’s why you see Pepcid-AC being consumed typically by Asians because of the alcohol sensitivity, right? And so, it’s important to know that. Now, anything else you want to add there Evan?

Evan Brand: Native Americans too. They’re pretty sensitive to alcohol. I’ve seen that.

Dr. Justin Marchegiani: Oh yeah, oh yeah. I mean you can go back to the, you know, hundreds of years ago. That was clear with, you know, different hard alcohol cause major problems for sure.

Evan Brand: Insomnia because you know, histamine is a neurotransmitter too so it can really make you alert, it can make you anxious too. Fatigue even. I’ve seen histamine issues driving fatigue but the anxiety, heart palpitations. I’ve seen in more extreme cases, chemical sensitivity, reacting to fragrances, that’s a lot of it.

Dr. Justin Marchegiani: Good, now like what is histamine guys? Right, histamine is actually made from the amino acid histidine. So histidine’s a nutrient, it’s an amino acid your body will make it. Now, the more you are inflamed, the more the gut bacteria is off, the more you’re low in certain nutrients, because certain nutrients that actually help you make the DAO enzyme, Diamine Oxidase, which actually helps you break down histamine, right?

Or also, the N-Methyl Transferase, HNMT is another enzyme but these enzymes are commonly found in kidney, kidney tissue but that will help break it down. Now, SIBO can impact it, copper, vitamin C, B6, these are all nutrients that are needed to help break down histamine, by making those enzymes. Now histamine, right? It can actually make acid in your stomach so it could actually potentially cause a little bit of reflux. It can cause issues with sleep, memory, cognitive issue, brain fog.

Histamine is a vasodilator. Think like if someone punched you in the eye, and it gets swollen, there’s actually a histamine response. So, histamine acutely is it’s good, right? You bump your elbow, it’s opening up the vessel so you can get blood cells there to attack and get the damage down and then also bring the inflammation out. So, histamine acutely is totally fine, it gets a bad rap. It’s when you’re in a chronic state that’s where it’s problem because now it’s causing everything to kind of dilate and swell and you have this chronic kind of bloat and inflammation issue, right?

Obviously, chronically inflammation is typically going to cause blood vessels to narrow because that’s typically what chronic inflammation does but histamine the goal is to dilate. So you want to look at a big picture. Now you have the H1 receptors, these are going to be your smooth muscle cells. H2 are going to cause abdominal and nausea issues, right? So when you take a lot of the H2 blockers like Pepcid-AC, that may help with nausea. Your H3 are going to impact sleep and appetite and your central nervous system and then H4 are going to impact your spleen, your white blood cells, your colon.

So again, histamine by itself it’s normal, it’s when it’s in that chronic inflammatory state that it’s a problem.

Evan Brand: Well you know, what’s interesting too, this is all involved in blood flow, kind of a tangent here, but I just think it’s interesting, you know. Erectile dysfunction and loss of libido happens often during the H2 receptor agonist. This is like a 75% occurrence. So these people are having sexual issues now, where maybe they’re getting put on testosterone or something else to try to help the erection issue but really, they’re just on a histamine antagonist that’s screwing up that pathway. So, once again it’s like a side effect if something leads to another issue so.

Dr. Justin Marchegiani: Yeah, but we talked about like Pepcid-AC is an H2 blocker, right? But also ginger can block, pin block H2 as well, but it also can have a stimulatory effect on the hydrochloric acid. Kind of a little bit contradictory from what Pepcid is so it’s interesting.

Evan Brand: Yeah, well, we ought to wrap this thing up, but I do want people to have resources. Well, we’ve covered the test, the urine, the stool, get your gut looked at with the gut bugs. If you’re on drugs, let’s try to find a better solution than being stuck on those. Let’s heal up your gut. If your gut is leaky or you’ve got some gastritis going on, low histamine diet we covered that. Actually, we have a low histamine diet guide that I put together, like a PDF, it’s free, there’s no catch or anything, so I’ll put a link on my podcast when we upload this. There’ll be a link in the show notes for that.

Dr. Justin Marchegiani: Yep! I would say gluten sensitivity of course, anything processed, gluten, any of those, things can increase it. Again, there’s certain medications that can also increase it so if you’re chronically ill, you have a lot of health issues, and now you start getting into this poly-pharmacy cycle, guess what? That could also cause histamine problems. So NSAIDs, if you’re taking ibuprofen, or aspirin every day, could be a problem. If you’re on antidepressants, Prozac’s, Olaf, right? Think about it. I think it was, I saw an article like, is it 20% of boys in fifth grade or on antidepressants. That’s crazy!

Immune modulators right? The big drug by Abbott I think is Humira right? Because the patents running up this year, they use that for a lot of I think, a lot of chronic gut issues right? A lot of chronic inflammation, Humira is a big one. Enbrel, Plaquenil, you have other anti, things that help blood pressure, (inaudiblke) Metoprolol right? Then you have your Allegra, your Zyrtec, and then you have your your Tagamet, your Pepcid your Zantac, all your H2 blockers.

Evan Brand: Yeah, this is a crazy list. I was just looking at medications and histamine and how it affects DAO, yeah you covered almost all of them. Those immune modulators are huge too because you know, let’s say you have some gut issue like, we know, there’s certain bacteria in the gut that can drive things like rheumatoid arthritis, so Proteus, Citrobacter, some of these autoimmune triggering bacteria. So, let’s say you have that bacterial overgrowth from antibiotics, now that drives some sort of autoimmune joint issue like RA, and then you get put on an immune modulator like Humira, now you develop histamine intolerance if you didn’t already have it, then you get put on a mast cell stabilizer like Chromalin or a histamine blocker there. I mean man it turns into a mess quick doesn’t it?

Dr. Justin Marchegiani: Oh my gosh! Yeah! Like you mentioned with the Humera right? You could have RA, or some kind of a chronic gut issue, Psoriasis, and now you’re on this drug and then that creates more histamine issues, and then you never fix the underlying issue to begin with. Now, in functional medicine world right? We’re going to get to the root cause there may be some things that we use that are palliative to work on supporting what’s happening right?

That could be Coresatin, could be vitamin C, it could be stingy nettle, it could be NAC, it could be ginger, right? We may use some natural, just getting inflammation down will actually reduce histamine. So, we may do some of these things, if necessary, we may work on the environment stuff. We may say, “Hey, we’re going to get you an Austin Air or an Air Doctor, high-quality HEPA filter for your home because you’re getting too much antigens from the foreign environment that are stimulating histamine.”, right?

And so, you’ve got to look at the root. Now, we want to just make sure we round everything up. There could be some tests that you do from your conventional medical doctor. You can do the N-methyl transferase, 24-hour urine. You could do a histamine plasma, right? These are some tests, but it’s not going to tell you what to do. It may give you a baseline, “Hey, my histamine’s in the top 10% of the reference range.” “We’re going to do some of these things. Come back in a month.” “Oh, look! It dropped!” So it could just kind of give you an indication that it’s, you’re moving in the right direction. It’s not going to tell you what to do because your conventional doctor will just say, “Hey, here’s some, right, antihistamine medication, fill in the blank to reduce it, that’s not going to fix it. We may do other things, but that at least gives you a baseline or a starting point.

Evan Brand: One other question this really opens up the ability for us to do part two, part three on this, the hormonal connection to histamine. Question came in, Adam asked, “Can women cycles cause issues monthly with histamine?” And then, you wrote about mast cell, and the answer is yeah. That estrogen will actually stimulate the mast cells. I’ve looked at a few papers on this before. So, estrogen will cause mast cells to release more histamine, and it will actually down-regulate DAO.

So, you see, so many women having issues now, I mean there’s so many xenoestrogens and things from the environment, combine that with plastics and other things affecting estrogen. A lot of these women are estrogen dominant, so then when they have the spike in estrogen throughout the menstrual cycle, for sure, you’re going to have a histamine flush.

Dr. Justin Marchegiani: Yeah, so in general what happens with histamine just to kind of echo. Histamine can stimulate the ovaries to actually make more estrogen. That creates more estrogen dominance so think of any of your PMS symptoms, breast tenderness, cramping, mood issues, sleep issues, irritability, back pain, that’s going to cause more of those symptoms.

Progesterone at the same time does stabilize your mast cells. It does upregulate DAO. So it helps you deal with it better. So you’re going to create more estrogen dominance,e and that’s not going to be good. Anytime you create more inflammation also too, your progesterone tends to have a very anti-inflammatory effect, and so the more you stimulate your progesterone to be used for your anti-inflammatory cortisol, you tend to increase this estrogen-dominant situation.

Evan Brand: Yep, all right, well let’s wrap this up. I know I got to run it, you gotta run here. I think we did great but let’s do a hormonal histamine one. I think we could unpack that. I think we could do half an hour just on that topic if not longer.

Dr. Justin Marchegiani: Yeah I’ll come back here after guys to answer some more Q7A stuff. But Evan, great chatting with you all. You guys want to reach out to Evan – evanbrand.com. Sees patients worldwide, get to the root cause. Dr. J., justinhealth.com, feel free myself. Reach out to patients worldwide. We’re here to support y’all! Take action! Action! Action! Action! Think of one thing you can execute on today guys.

Evan Brand: Heck yeah! All right, man, it’s a pleasure!

Dr. Justin Marchegiani: Hey! Pleasure is mine! Take care all right,!

Evan Brand: See you soon! Peace! Bye!

References:

https://justinhealth.com/

Audio Podcast:

SIBO Can Cause Histamine Intolerance, Here’s How. | Podcast #268

For today’s podcast, we’re focusing on SIBO, gut infections and more histamine issues, and how SIBO can cause histamine intolerance. Last podcast about histamine went well last week, so today we’re going deeper into these topics. Check out this podcast with Evan Brand.

Dr. Justin Marchegiani

In this episode, we cover:

1:43 Histamine, symptoms and solutions

8:21 Diet recommendations

15:20 Fat Consumption

17:07 Gallbladder issues

22:10 Solutions

Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan brand, Evan, how you doing today, man?

Evan Brand: Hey, man, Happy Monday. I’m doing really well.

Dr. Justin Marchegiani: Happy Monday to you as well. I know we chatted, kind of in our pregame interview, we chatted about what we’re going to talk about and we kind of chatted about histamine, histamine went really good last week, we see a lot of patients with potential histamine sensitivity. And the histamine a lot of times may not be– a little reverb there. histamine may not be a root cause of the issue. It may just be a symptom of other issues going on in the gut. We always kind of keep that in mind. A lot of people. You know, if you don’t have a lot of experience, clinically, it’s easy to think that histamine is the root cause. And then you feel like you have all these food restrictions and you’re not sure what next steps to do and that’s tough. So we’re going to be focusing on SIBO we can even expand that to gut infections, and histamine issues. So I’m really excited for today’s topic.

Evan Brand: Yeah, you made a great point right from the gate which is people that are focusing on The nutrition piece too much or focusing on maybe some of the supplemental things correct. Many people discuss DAO, which is something I’m experimenting with just to play with it and see how it works. DAO is the enzyme in your body that naturally helps to grade histamine. But as you have infections and stress and toxins, you are either unable to produce less, I mean, we’re not 100% confident with the mechanism, you may produce less or maybe is less effective. So people will do a DAO supplement say, Oh, well, I feel better. I’m not having these food reactions, and they’ll just stop there. But this is where we’re starting now at the end of that rope, and then we’re taking you to the whole next level, because if you stop there, you’re just you haven’t addressed what’s actually going on.

Dr. Justin Marchegiani: Exactly. So in general, histamine is a neurotransmitter made from histidine. It’s designed to help with the inflammatory response. It’s designed to vaser dilate open up the blood flow of the blood vessels so you have better blood flow, which helps with an inflammatory response. So you bumpy your elbow, right, you bump your head there’s a histamine response that helps vaser dilate helps migrate a lot of those white blood cells into that area kind of helps promote healing. The problem is acute acutely and acute situation not that big of a deal because it happens and then your body recovers. We’re more talking about a chronic kind of low grade inflammation or low grade histamine issue where you’re chronically swollen, you’re chronically inflamed. You may have a lot of chronic histamine symptoms, this could be headaches, it could be flushing, right, that chronic red and flushing symptoms. It could be nausea, it could be hives, right, those kind of wheels are you to carry a hives and the skin could be fatigue, it could be brain fog could be just kind of chronic low grade swelling could be allergic shiners under the eyes with a lot of lymphatic pooling in the face. So it’s good to keep an eye on these symptoms as they could be part of what’s going on. And then of course, there’s a lot of medication that are typically treating these things, whether it’s Xurtak or [inaudible] or Pepcid AC, different medications. The problem with a lot of the medications, they tend to have more side effects, whether it’s fatigue or brain fog. And a lot of people, they just get knocked out when they take a lot of these medications. So they’re kind of stuck because their performance and ability to function at work, if they’re doing hard work are dealing with their kids, they’re going to be pretty much a zombie or zonked out for a lot of them. So we want to really get to the root cause of why these symptoms are present. And a lot of times the guts going to be a big role because a lot of chronic inflammation is going to be at the gut level, whether it’s inflammation from food that you’re dealing with, whether it’s gluten or dairy, and or other histamine foods, right fermented foods or age meats or citrus or avocados, or it could be from a deeper infection that sets you up to be more sensitive, right. If you have SIBO or bacterial overgrowth, or other infections, it’s going to potentially make it harder for you to digest food, the harder it is for you to digest food, the greater chance that you’re going to develop food allergens. And also the more inflammation in your gut, the greater chance that you’re going to have gut permeability. So the more permeable your gut is, the more these foods have a way of getting into the bloodstream, the more your immune system sees them and an undigested state increases the chance that we’re going to make antibodies for those foods. And then also just the fact that we have other bacteria that may be slipping into the bloodstream. These compounds are lippo polysaccharides these can also go and create histamine issues. They can also go to the up to the brain hit and hit a lot of brain fog and mood issues. So there’s a lot of like dominoes they get hit. His to me maybe one of those dominoes, but there’s a lot of dominoes that get me hit. And then you have a lot of symptoms happening from it. And then the question is you have to kind of corral all these symptoms in to a root cause of like, what’s the next step but it gets very, really overwhelming.

Evan Brand: Yeah, I want to go back to the symptoms real quick. Something that’s really interesting is the fact that you could have issues with your sleep, you know, trouble falling asleep or even dizziness. You know, I noticed when I went low histamine with my diet, some of this Kind of disequilibrium, dizziness stuff that I was having that I thought was mold exposure, or possibly co infections I bartonella. I noticed when I went lower histamine, it got better, like my head got more clear and then I was able to go to sleep better. So this is kind of why you mentioned some people do the anti histamines and then they get knocked out. You know, I think part of the reason that some people’s nervous systems are so revved up is excess histamine, but here they are taking melatonin. Now, that may help or passionflower or, you know, we’d like to use like, Mother Ward or Valerian or Thean or Skullcap there’s a ton of good sleep options, but you may be missing the boat so those herbs are fine. Those are much safer than a sleep drug which are extremely hard to get people off of. But this the the sleep herbs may not be the root cause it may be histamine. So you could try going with a lower histamine diet during the meantime, that’s something we may recommend you do is go lower histamine while we’re working on labs are waiting on labs. And then if we find that just by lowering histamine in the diet, All the sudden, you have less blood pressure problems, you fall asleep easier, you’re not flushing, you’re not having the nasal congestion, you’ve got rid of headaches, maybe your energy’s better, well, then that’s a great clue that we’re onto something. But we don’t want to get you stuck on low histamine forever. I just don’t think that’s a way to live. So that’s when we’re going to go into these gut infections. So you mentioned bacterial overgrowth, and how we’re going to be looking at that as with stool and urine. So, Justin, I run honor, no problem between us both probably thousands of labs per year. And I would say, Now, granted, we’re a little bit biased, right? Because people that come to us have already been to many practitioners, and so they often are going to have real problems. But I would say 90% of people we look at are going to have some sort of a bacterial overgrowth problem that’s leading to these issues.

Dr. Justin Marchegiani: 100%. So histamine, it’s an important first step to look at and kind of know the histamine foods. We’ve already talked about some of the foods last time And we I think there’s a handout up there from last time as well from last week. So take a look at last week’s podcast. Try to put some of those links down below so you can access them but more common histamine foods are going to be ones that are rich in probiotics fermented foods. And that’s tough because people are following the Paleo template or following Weston a price or understand the benefits of probiotics and fermented foods. That’s kind of a curveball. And a lot of people kind of walk into this and they’re like, wait a minute, that’s supposed to be good for you. Yeah, it should be good for you. But for some people, it may be a problem with histamine and if they have SIBO it could be a problem as well. I call it probiotic intolerance. And that’s very possible. That’s what’s happening. Next are going to be your citrus foods, your age meats. Of course, a lot of paleo foods are going to be on that list. So if you’re just going paleo you cut about half of them out anyway, just by default.

Evan Brand: You know what got me in trouble though? coconut aminos I love-

Dr. Justin Marchegiani: Yeah, and amino acids are pretty high.

Evan Brand: Super high. And I was for I was, you know, there’s basically fermented coconut blossom nectars what it is, but of course The longer things ferment the higher the histamine so I was making my steaks and marinated steak and then maybe even add a little extra coconut aminos during the cooking process. Yes. And I was going too crazy with it. So I’m taking a break from coconut aminos that’s something that gets heavily used and abused and healthy foods because people are trying to ditch soy sauce for example.

Dr. Justin Marchegiani: Exactly. And that’s a good first step. And if you don’t have a histamine issue, that’s a really good first step. But if you do and you have some symptoms, like we mentioned earlier, then you know what, where to look. But in general, regarding histamine, we want to keep those foods down. So I mentioned some of the avocados, the tomatoes, the egg plan. So if you’re cutting out night shades, you may get that out. By default, avocados are kind of a curveball, right? Because that’s a really good fat. We also have the age meat, so try not to let meat sit around longer than a day or two, or even meats that tend to be preserved, whether it’s jerky or, or bacon are those kind of things. And then of course we have your probiotic foods and then our citrus So those can be curveballs. And then obviously teas and coffee, and britisher teas are the big one teas and energy drinks. That’s a DAO inhibitor. So they’re not really high in histamine, but they inhibit that enzyme DAO that helps break down histamine. So, you know, keep that in the back of our mind. So in general, the more information we– go ahead, yeah.

Evan Brand: I was just gonna say one thing about drinks. I’ve had some people that go on to like a CVO like these natural stevia sodas, where you’re doing carbonated water and a lot of time there’s added citric acid to those. And so there’s a lot of citric acid added to some of those drinks and I’ve had people drink those and then all sudden they flush out and so just cutting the drink out with the citric acid that could be something that kind of created some type of either a mast cell response or a histamine response. So that’s just one other one other potential cause and it’s tough because if you’re eating like if you’re drinking a carbonated drink and you’re doing a steak with coconut aminos, and then you’ve got your sauerkraut or kimchi on your plate with your whole grass fed dairy, it’s tough to know what you’re actually responding to. So sometimes you really have to just keep a food journal and go really simple where you just drink that carbonated drink for 15 minutes and then wait, see if you get a response and then move on to the next food item and the next food item. Hopefully, the average person it’s not that tricky, but for some it can be.

Dr. Justin Marchegiani: 100%. And of course, we already mentioned the kombucha, there’s some higher sugar ones, there’s some lower sugar ones. If you’re probiotic intolerant, that’d probably be something you want to pull out for at least a couple of weeks to a month and see kind of where you sit after after the fact. It’s got to make sure that we’re fixing digestion. We have enough HCl and hydrochloric acid and enzymes and good digestive support. Foods not being digested appropriately are going to create stress and inflammation in the gut. And then we got to look deeper at you know, making sure the common food allergens are out because a lot of times regular food allergens like you get from grains or dairy, or lentils or the goons, those can create similar symptoms of histamine and the question is welcome Is there a histamine response to these foods from an inflammatory perspective as possible, right? Because the more you create inflammation, we know that histamine is a part of the inflammatory response. It’s it. It’s part responsible for the vaser dilation that happens. So it’s possible that inflammation from other foods that aren’t necessarily histamine sensitive foods could potentially drive histamine symptoms, we have to keep that in the back of our mind. And this is why it’s so hard because you’re like, wait a minute, this foods not a high histamine food, yet I’m having high histamine symptoms, how do I connect the dots and that’s how it’s all from inflammation. inflammation is the first domino and there’s many different Domino pastor trails that could take based on inflammation being present. Now, the hidden sources of inflammation are things that we don’t really see or we’re not aware of like low stomach acid low enzymes are not necessarily aware of that we may be aware of the fact Hey, I take hydrochloric acid, I feel better, I have less bloating and less gas and more regular or I do a SIBO test, I treat my SIBO and my motility My histamine symptoms improve after the fact that’s also another thing that can create awareness, but you may not be aware of it unless someone helps guide you in the process and does some testing as well.

Evan Brand: Yeah, and I’m not going to say that all the time it happens to older people, we’re talking 40 50 60 70 80. But in general, I think it’s going to be more common for someone who is older because they’re going to make less stomach acid just due to age. Now we have seen kids and teenagers that have a lot of skin issues and gut issues, and I was one of those teenagers. And that’s because my diet was terrible, right? So you’ll still get younger, younger people that have these histamine intolerance issues, mainly because their guts been wrecked by antibiotics or they just had a bad diet to begin with. But if we’re just saying, as you mentioned, some of these dominoes that fall, one of the dominoes that falls with age is just HCl, so you become at a higher risk of getting bacterial overgrowth because now you don’t have enough acid to neutralize what you get exposed to from your foods.

Dr. Justin Marchegiani: 100% And again, I think part of it As you get older, there’s a natural drop in hydrochloric acid and enzymes as you get older. So there’s that. So I think age does play a role because of stomach acid dropping. And we need stomach acid to activate our enzymes and we need stomach acid to activate our bile salts. And we know bile has natural antibacterial effects. So the less bile you have, the more easy it is for bad bacteria to grow. So if we have good stomach acid, that’s going to provide an anti microbial environment meaning harder for bad critters to grow. And then with good HCl we also produce better bile salts. bile salts have that good acid byproduct that keeps bacteria down as well. That’s why you see a lot of people that have SIBO they’re also typically taking bile salts to help with one the environment but also to being able to break down fats really, really important.

Evan Brand: So how about people with had a gallbladder it sounds like they would be brain risk for this problem, then?

Dr. Justin Marchegiani: Well, they have to be on bile support for life now. Because what’s happened is that don’t really have a gallbladder anymore. They’re common hepatic bile doc and the liver is now the gallbladder. And so it doesn’t hold bile. Like the gallbladder concentrates bile like 15 to 20 x. And then it contracts and punctuates to release a bile at the right time, ie you have a fatty meal. Do you have a hormone that’s produced or a neurotransmitter kind of peptide called coli sista kinda, and that triggers the gallbladder to contract, it releases all this stored bile that’s been concentrated. And that bile can now come in and hit that fat and digest it and emulsify it. The problem is, you don’t have that punctuated release, because the gallbladder is gone. So it just kind of drips, it just drips drip strips, like a leaky faucet all day long. And then you don’t have the concentration of it. So it’s kind of a little bit more watered down. It’s a little bit weaker, and you don’t have the concentrated release at time of that fat being ingested. So that’s the problem.

Evan Brand: Yeah, well, you know, conventional doctors don’t educate people on this when they go into a potential gallbladder removal surgery. They’ll just say, Yeah, you’re Liver still is going to make some bio for you, but they don’t talk about that concentration factor and how it’s literally, you know, that’s like taking a, you know, a little fairy dust of some HCl and throwing it in and hoping it works. It’s not a therapeutic amount that’s going to come without that gallbladder, I mean, no still going to survive, right? I mean, there’s tons of people living but it’s just they’re not thriving.

Dr. Justin Marchegiani: Well, what tends to happen after that is to cover up a lot of those symptoms. conventional medicine says, Well, you have to be careful of your fat consumption. Well, yeah, you do because you don’t have the same level of bio output, but you need good fat, you need fat soluble vitamins A, D, and K, your long chain omega three fatty acids are really important for your health. So you’re not getting good fats. That’s a bad thing. I mean, we’ve seen with the obesity epidemic over the last hundred years, the last 30 or so years, fat consumption has dropped significantly and weights gone up. So it’s not really a fat issue based on the correlation. It’s really a carbohydrate issue. Maybe a trans fat issue, maybe an excess refined junkie vegetable oil issue but good healthy fats are not part of the play. And if we now affect our digestion when we can’t absorb those things, well every membrane in our body has good fats in them. So we need healthy fats to make our cell membranes. We need vitamin A, which is a fat soluble vitamin for our thyroid receptor sites. We need fish oil for inflammation. That’s our long chain omega threes. We need cholesterol which tends to come trapped in with animal fat for our hormones for our brain mass. So all this stuff is so important for healthy hormones. healthy body healthy brain

Evan Brand: Yep, absolutely. And there’s no education on that. It’s just Yep, you gotta gallbladders gotta come out and then that’s it. And then they don’t have here’s the interesting thing that the surgeon and then the doctors and such they don’t deal with the collateral damage. They just kind of got it out and move on. So then they end up coming to us. Hey, look, here’s this list of 20 symptoms I developed after gallbladder removal surgery. not to get too distracted from our from our topic, but this is all related because it could have been connecting a histamine problem could have been what led up to this and then it could have, you know, continued after the removal.

Dr. Justin Marchegiani: And I’ve done some articles and podcasts on gallbladder issues in the past and there are some common paleo foods that could be a gallbladder issue as well. Porks one of them, especially Bacon is also a histamine overlap there. So is I think sauerkraut as well, onions. There’s a bunch of paleo foods that like, you know, on the surface, you’re like, wait a man, these are pretty healthy foods. But if you have a gallbladder issue, it could be a driving factor and yes, some of these foods overlap with histamines. So take a look at just go to my site JustinHealth.com just type in gallbladder and you’ll find those articles and videos there for y’all.

Evan Brand: Perfect. So we hit on the the SIBO, we often discuss that SIFO small intestinal fungal overgrowth is very commonly occurring at the same time. And so that’s where once we get the proper lab testing, looking at stool and urine primarily, we’re going to be finding the answers that We need to start resolving this. As we mentioned, you may be using extra enzymes and acids. Maybe you’re using histamine degrading enzyme supplementally to try do yeah, you’re using that as a band aid knowing that you’re working backwards. And then once we come in with herbs to address, which is the, the opposite of the conventional neomycin, die flu can Neistat and kind of protocol, we’re going to come in with herbs instead, and then eventually retest and then of course watch symptom improvement at the same time. But with retesting labs, with watching symptom improvement, may be doing those band aids you can reverse this issue.

Dr. Justin Marchegiani: Yeah, we need to calm down the inflammation in the gut because those mast cells are what’s making a lot of histamine right. So your basal fills are in your blood when those basal fills go into the tissue goes into the gut lining there, they’re all become mast cells. And mass cells are what produces histamine and imagine this, you know, this mass cells sitting here, the longer we’re not exposing ourselves to inflammatory food, that mass cells like swelling up because it’s used to having a reserve Now that reserves is kind of like, kind of in gorging itself bigger and bigger and then now you eat some food that’s kind of off your food recommendation, then you get this massive flood of histamine. And when you feel like even worse, and this is what happened with someone’s on a good diet for a while, and then they go off the wagon. They’re like, Holy smokes, I got hit by a bus. What happened? I thought I was doing really good. Why have I not become more adaptable at these foods? Well, it takes some time. And then a lot of times these mast cells are just sitting there in the short run, filling up with histamine waiting for you to just go off your diet.

Evan Brand: Yeah, what about alcohol? Do you have anything to say about that? Because I had a woman who’d been off alcohol for a long time. We kind of discussed Hey, you probably shouldn’t do it. your gut barriers toast and she went to some work party and had two drinks and then she emailed me the next day Oh my god, I’m so miserable. Alcohol has never done this to me before. Granted, she was on a protocol. So some of the herbs mixing with alcohol is not smart, but just from a avoid leaky gut perspective and then going back to it, she seemed like she got worse than alcohol used to make her feel. Do you have any insight on that?

Dr. Justin Marchegiani: Yeah, so I always tell patients like don’t add any alcohol and until we have a level of clarity, a level of improvement. So then if we add an alcohol and we go backwards, we know that the alcohol brought us backwards that way. We’re not feeling crappy. And then we’re putting alcohol in there. And maybe the alcohol is what’s holding us back from getting better. And we don’t know it, right, because we always felt crappy to begin with. Yeah, so kind of get clean first. So then when you get dirty again, you know, okay, I know what clean feels like. There’s something that changed here. So regarding alcohol, there’s different quality of alcohol. So you could have like a mixed drink with a whole bunch of sugar in it, you know, that’s going to cause a whole bunch of problems just because of the sugar and the crap that’s in there. And obviously, there’s like different wines that may have pesticides or sulfates or potential gluten in there. A lot of wines are contaminated because there’s a lot of flour that lines the barrel the wines. So hard alcohol is going to be your cleanest and keeping the sugar content if you do a mixed drink, and then also like a champagne or a dry white wine will kind of be your next step up, right, the dry or whites or the dryer kind of champagne is going to have less sugar, it’s going to have less potential irritants. So you kind of start with the fruit, the kinds of alcohol that will have the less additives and inflammation compounds, and then kind of work your way back. And that wave, it just gives you the chance to have in the least issues now there are some cultures where they just have less da o to hang out with in your in their in their guts in their bloodstream. So they’re going to react to alcohol, they’ll get like a facial flush. You see this in a lot of Asian cultures because they don’t quite make as much do. So they’ll take that Pepsi they see a lot of times and that blocks that histamine response. So a lot of cultures may just have less histamine issues. You see it with Asians and alcohol, they get very flush, so you just got to know where you’re at, and then just try to choose an alcohol that’s gonna have the least possible chance of a reaction. And then you can always do some activated charcoal. In between to kind of help with that, too.

Evan Brand: Yep, that’s good advice. Anything else you think we should say about testing or herbs or things we’re doing to work on this issue?

Dr. Justin Marchegiani: Well, there’s different herbs that we’re going to recommend depending on if we’re methane dominant SIBO or hydrogen dominant SIBO, and a lot of times people have the right to have more than one issue going on at once. So, you could have SIBO and a parasite infection, you could have SIBO and H. pylori, you could have SIBO and SIFO and SIFO is nothing more than a fungal overgrowth. It could be Candida, various different yeast, mainly the main ones, Candida, but you could have all of these things going on together. It may not just be SIBO, you have the right to have more than one issue. People get fixated. They’re like, I know it’s Candida. I know it’s a worm. I know it’s this and it may be but it may be that and a whole bunch of other things. So keep your mind open to all the different stressors that could be going on at the same time.

Evan Brand: Well, the funny thing is to maybe the person’s right and they did have a parasite or they did have Candida, but we may find something even higher up on the priority list and that like if I see, you know, okra toxin levels we know okra toxin and other mold toxins we know those damage that go if I see those things off the chart and I look at dizziness and they can’t sleep and they got heart palpitations and all these other symptoms that don’t sound like SIBO. We might go after that first and SIBO and histamine and all that may be secondary and tertiary problems. So that’s another fun and important reason that we do multiple tests on people is because if you come in and you’re like, hey, Dr. J, I know it’s SIBO just run the SIBO test. He’s gonna say, No, I really think we need to also look at this and this and that. And that’s not just because we like to run labs. It’s because we like to have data so that when our puzzle pieces are on the table, we can make a more complete picture, as opposed to trying to identify your problem and make a protocol based on one little piece if we don’t, I mean, if we’re using the just one little puzzle piece, it’s just not you know, your success rate may be hindered.

Dr. Justin Marchegiani: 100 & 10%, and I think it’s, it’s really important to kind of keep that in the back of your mind. That could be a lot of different things happening. And like you mentioned earlier, an important component is the history. Hey, do you live in a house where there was recent water damage? When you’re in your home, and you leave for a period of time? Do you feel better? Have you rectified the water damage? How did you do it? Is there any visible mold in your home? So these are really important questions to know. And sometimes I’ll see in my history, I’ll see patients Yeah, there’s water damage, and they didn’t really do much to address it. And they really feel foggy in the home. They feel better when they’re outside, getting fresh air. These are important signs and symptoms. A lot of times you’ll see more neurological things like you mentioned, Evan, whether it’s brain fog, or just spaceyness or headaches. And again, we’re looking for that timing in regards to a flood or there could be even a chronic issue where there’s just high humidity in the home. And that’s where doing some of the mold testing for the home is ideal. The multitasking for the home is great because if you have you know, five people in the house We get a positive Mold Test. Well, we know that that could be affecting all five people. So it’s good to know that.

Evan Brand: Yeah, absolutely. I had a building I went into when I was in Florida. And I literally got flushed. After entering the building. I had like a reaction to the building. I started to feel off, I was just like, Whoa, this is not a good building. And I look up at the ceiling and there’s water spots, water stains, all over the ceiling. I was like, Oh my god, and this is not. Oh, Evan, you’re crazy. This is placebo. You looked at the ceiling, and then you convince yourself you felt bad. No, I felt bad before I even saw the ceiling. This was on the way, walking out of the building, I look up and see all the water stain. So most people are not that sensitive, and most know are not that in tune to their situation to know, hey, I’ve been in this building for an hour and every time I am in this particular building, for example, like college students, they’ll say when I go to this one classroom, I can’t focus I get brain fog. I get really tired. Maybe the subject is boring and they don’t like the teacher but it could be the building, particularly Making them bad. So I’ve had some college students I work with where I’ll just tell them, hey, try to sit in a different part of that room. Or if it’s a big auditorium, move to a different corner where maybe you’re closer to a door where you get fresh air and see if you feel better. And yeah, obviously, this is a more like, nuanced small percentage of the population, but it does happen. And I want people to know, they’re not crazy. This is a real phenomenon you may be experiencing.

Dr. Justin Marchegiani: Yeah, and the nice thing about it is you should be able to figure out some correlation from this, because you’re in that building, you’re out, you’re in your home, you’re out, maybe you’re walking around all day. So hopefully, you can notice a correlation there. Like you mentioned earlier, everyone’s not going to be that level of sensitive, right? There’s different genetic variation, obviously, depending on how long you’ve been exposed to something and how much is it already in your cells in your fat in your body already can make you more sensitive. So with some of your mycotoxin testing, which will do a lot of urinary testing for mold, will see some of these things and we if we do a urinary test for mold, we have to also challenge it. So we’re going to be using glutathione for at least a couple of days ahead of time. Just because if your detoxification pathways are a little bit weak, or let’s say the molds overwhelm your system, you may have lower glutathione. Anyway, so it may be harder to push the mold out to begin with. So you have to keep that in the back of your head. That’s why we test the home first. Because if we have a high level of mold in the home, we don’t see a lot coming out in the urine. Well, it’s really important that we provoke that and just give you enough detoxification support to at least get a window and how much is coming out in your year and that way, we have a baseline. So as we treat over 369 months, we can come back and see if those levels are dropping.

Evan Brand: Yeah, infrared sauna is great too. For that you can measure a lot of higher increased levels after sauna so somebody can’t tolerate glutathione and for some reason you could do a sauna, and also fasting which is pretty interesting. That’s why a lot of the samples we do in the first thing in the morning because fasting can help excrete some of these toxins too. So we could obviously dive more into that on another show. My mood levels are almost gone. I had okra toxin level of 195 you want it below four.

Dr. Justin Marchegiani: Fasting, though, with fasting, you only can do that really acutely, though. That’s like a short term thing. It’s not a long term strategy, right?

Evan Brand: Yeah, yeah, I’m just talking overnight fasting, but maybe, you know, like intermittent fasting. Maybe in between those meals, you are exceeding a little more and flushing a little more toxin out.

Dr. Justin Marchegiani: God. Okay, so you were saying okra toxin. Go ahead.

Evan Brand: Sorry. Yeah, yeah, that’s okay. I think the reference range was below four is optimal. And I started out at a 195. And here we are talking almost exactly one year later, and my levels are down to a 15. So-

Dr. Justin Marchegiani: 195 to 15. So it’s like, 98% 95% reduction.

Evan Brand: Yeah, it’s a lot but it took a year and that’s hardcore work. That’s conventional and prescription binders that sauna, that’s extreme avoidance. That’s liver lymphatics. I mean, that’s a lot of work. So I just want to end this by putting a realistic timeframe in people’s heads, you know, when they have a reaction They take a Benadryl and they feel better in half an hour. You know, they’re really happy about that, or when they have a headache and they take an Advil, they feel better in 30 minutes, that’s great. But with these issues here, we’re talking reversing potentially 10 20 30 40 50 years of toxins and damaged gut barriers and overgrowth and antibiotic usage and all that crap. So, you know, when we tell somebody, hey, six months to a year timeline, I think that’s extremely short when you factor all that in.

Dr. Justin Marchegiani: 110%. Man, I like it. I think you’re on the right track. with that. I think we’re on the right track with today’s chat, trying to connect the SIBO component, trying to also connect the different gut components that connect the SIBO. And then also I think the mole and we need to do our own little show on mold and histamine. Maybe next week, we’ll come back and do more than his mean, it gets really important. I think it’s a big issue. And the problem is a lot of people have multiple issues at the same time, and this is where it’s really hard. We want to glom onto one thing we want this one, hey, we want to have this one label. This is my issue, it’s kind of easy to wrap your head around that. But it could be a lot of different issues. So everyone that’s listening, keep your mind open to their being lost at problems at the same time. And also, if you’re overwhelmed, this is where it’s good to reach out to a practitioner like Evan. EvanBrand.com, or myself Dr. J. JustinHealth.com if you want to dive in deeper, kind of get your arms wrapped around it with some objective lab testing. So we actually know what is happening underneath the hood, so to speak. Yeah. And anything else you want to add today, man?

Evan Brand: No, I just want to give people a little bit of boost of hope and encouragement. Just say hey, look, as you mentioned, there may be layers to this, but you can peel back the layers you can you can get better, no matter how long you’ve suffered. You can you can you can keep that in mind.

Dr. Justin Marchegiani: Yeah, and your story is great with the mold because you really had some pretty debilitating symptoms. And mold one of those things. It’s like if you don’t know what’s there, man, it’s like, you’re just in it in an environment where there’s just toxins all around you and you don’t even see it and it’s a slow creep and the time symptoms start really in their head, it’s been going on for years. That’s the problem.

Evan Brand: Yeah, I got to give a shout out to our mutual friend, Dr. Jack Wolfson, for telling me that it was mold. I didn’t want to believe it. But I was talking to him and said, Hey, I was waking up dizzy. This is weird blood pressures going all over the place. And he writes back in all caps, one word mold. And that started at all.

Dr. Justin Marchegiani: Yeah, and the thing is, I mean, I’ll give credit to Jack. I think that’s us right on there. The problem is, there are a lot of let’s just say, mold, myopic doctors, where everything’s mold, right? Everything’s mold. And that’s a problem too, because it may not be so the differences with you, you got this feedback from Dr. Jack you tested your home, guess what? Really high mold, you tested your urine, you provoked it really high mold. So we had some objective data to kind of support us. So we weren’t kind of flying blind. So I think you did the right thing. And for people that are listening to this and think it’s mold, get that testing done first so you can be more confident. And then more importantly, because you’ve gone through the whole mediation process that’s even more overwhelming. And that’s where you want to work with an expert because You can feel like you have to spend six figures to get your home remediated. And that’s not the case. You can do it for way, way cheaper. And it can be, let’s just say a process that isn’t as bad as it thinks. Or if you feel like it is based on what you see online and everything.

Evan Brand: Yeah. And into Jack’s defense, you know, he is he works on hearts. You know, he’s not a mold doctor, but his wife was really sick. Yes, last few years from mold. So luckily, he had had first hand experience. So he thought, hey, this sounds kind of weird, and at least had enough in the trenches experience with his own wife to know, hey, that might be it. So very interesting how it all turns out, I think it’s one of the biggest hidden epidemics going on.

Dr. Justin Marchegiani: Yep. I see the whole mole thing and the Lyme thing as well. Anytime there’s some kind of a weird neurological symptom. people throw that out there. And it could be right but get the whole thing worked up. I mean, the thing with Evan Evan had three different other infections to begin with. So you had I think giardhia blast on h pylori.

Evan Brand: Crypto. Yeah.

Dr. Justin Marchegiani: Crypto, Giardhia, H pylori, right. So now just kind of for everyone listening so they can have insight, Evan had already addressed those issues ahead of time. And he gotten a little bit better, but there was still something holding him back. So if Evan just myopically focused on the mold and didn’t get rid of those infections, he may not have the same level of improvement. So there’s kind of an order of operations and how we want to hit this. And because you had three series, I mean, each one of those infections individually is kind of a big deal. The fact that you had all three going on at the same time, I call it the three amigos. It’s definitely going to be a major stressor on your body, and then you throw in the mold and the adrenal stress and then potentially blood sugar issues. Yeah. So you had a whole host of things that we were able to kind of sequence up and have it all makes sense.

Evan Brand: Yeah. And we’re talking we’re talking over a four to five year period, you know, those gun reactions were cleared out almost five years before the mold protocol. And that’s not due to that that’s not the way that necessarily I wanted it or that that we wanted it to happen. It’s just the way it happened. That was you The exposures came later. And so not everything could be perfectly sequenced and care but it’s just a matter of peeling back the layers you can to get some level of improvement. And that quality of life hopefully will continue to motivate you and allow you to pursue other layers of healing.

Dr. Justin Marchegiani: Well, the nice thing with us is we’re getting better because we’re also treating ourselves and thousands of patients so because of that, it’s not just like you know, textbook information, it’s real world actual results kind of driving treatment, driving protocols, driving kind of our perspective on what the next steps are for patient so it allows your treatment allowed me to get better at this and allow you to get other patients better so we just continue to grow like that which is excellent.

Evan Brand: Yeah, it’s a very, very, very cool place to operate.

Dr. Justin Marchegiani: Anything else you want to add Evan?

Evan Brand: That’s it. mentioned the links again, you can reach out to Justin, Dr. J, at JustinHealth.com my website’s EvanBrand.com. We both offer intro console where you can book 15 20 minutes, you can chat about your symptoms and goals. See if you’re good Fit for care if so, we’d love to help you. We’re very grateful to be in this position. So we honor it and we’ll be back next week.

Dr. Justin Marchegiani: Excellent. You guys have a phenomenal day. Look forward to checking in soon. Take care y’all. Bye now. See ya.

Everything You Need to Know About Histamine and Histamine Intolerance

By Dr. Justin Marchegiani

What is Histamine?

At one point, we’ve all heard of antihistamines, but unfortunately for most us, we aren’t aware of histamine’s existence. Antihistamines are what most of us know what we use to “fight- off” of allergies. What we don’t know is that histamines are actually the ones that fight off allergies, and antihistamines are just fighting off the symptoms that histamines cause when fighting off the allergens out of your body.

The histamines are naturally occurring chemicals inside your body.Your immune system is the one responsible for making them. And if there is anything that’s bothering your body, histamines help you get rid of that. Histamines can, therefore, be termed as warriors fighting off evil inside your body.

What is Histamine’s Role in your Body?

Every time you sneeze or feel itchy when you are near something that causes you allergens, remember that is your body’s defense mechanism acting up. That’s histamine in action. So, when you’re allergic to dust and it gets inside your nose, histamines make you sneeze that dust-out. When you’re allergic to peanuts, and you ingest them, histamines make your throat swell up, preventing the peanuts to go further inside your body.

Though at times, our bodies tend to overreact, though its only intention is to protect us. One of those overreactions is swelling up of our breathing passages, like your throat, which then causes blockage in our breathing. And that’s why we have antihistamines. Antihistamines prevent overreaction to allergens that are caused by histamines.

What is Histamine Intolerance?

Experts are still quite unsure what is the cause of histamine intolerance. Most of them though have hypothesized that histamine intolerance occurs when there is a build of histamine. If you’re a healthy person, your histamine will be broken down by two enzymes regularly. These two enzymes are called DAO and HNMT. The DAO enzyme comes from your intestine, while HNMT can be found on your liver.

If either of your liver or intestine gets compromised, then this will probably result to your histamine not broken down regularly. When your histamine is not broken down regularly, there will be build up, thus your allergic reaction becomes an overreaction. Most experts have also hypothesized that people who have gastrointestinal and liver disorders will also most likely have histamine intolerance.

What are the signs that you’re Histamine Intolerant?

Symptoms of Histamine Intolerance

If you’re histamine intolerant, these are the signs that you’d need to look out for:

Getting headaches or migraines even if you have slept for at least 8 hours and is well hydrated all day.
You get easily aroused for no reason at all.
You have difficulty in sleeping even if you aren’t stressed or is an insomniac.
You have hypertension, even if you exercise regularly and have a balanced diet
You get dizzy all of a sudden. You also get nauseous and then vomits.
Your heart rate accelerates even if you are doing minimal work.
You are encountering difficulties in regulating your body temperature.
You get anxious about simple things.
You get abdominal cramps, even if you don’t have your period. And your menstrual cycle seems abnormal.
You encounter difficulties in breathing, you sneeze for no reason and get nasal congestions.
You feel exhausted even if the day has just started.
You flush for no reason, and hives appear out of nowhere.

If you are encountering any of these, make sure to see your physician at once. You may be histamine intolerant, or these things might just happen randomly. These could also be signs of another sickness or illness. But whatever the reason may be, it is always best to get a Doctor’s advice.

What should you do & eat if you’re Histamine Intolerant?

Histamine Rich Foods

When you are Histamine Intolerant, diet is not the only things that you should change. The treatment for this does not solely depend on what you should eat and what you shouldn’t eat. A holistic approach to treating histamine intolerance is always best. Yes, eating healthy is one way to treat this, but if you’d want to get better, why not do it all, right?

First of all, if you’re histamine intolerant, you should get enough sleep. 7-8 hours of sleep during the night. If you are working during the night, and sleeping during the day, it would be advisable to sleep in a room that’s relatively dark. You should make sure that there’s no amount or very little amount of light when you prefer sleeping during the day.

Second, regular exercise is highly advised. Exercising does not only help you in your histamine intolerance but will also help you maintain or lose weight. Remember that two signs of having histamine intolerance are hypertension and shortness of breath. If you exercise regularly, you’ll increase your body’s stamina and also burn out those unnecessary calories.

Third, learn when is the right time to relax. Even a well-oiled machinery needs to stop working every little while, and so should you. Relaxation may not mean an extravagant vacation to the Bahamas, but a time off from anything that tires you. You can just grab a book, or buy a movie, and sit back, enjoy, and relax. Relaxation doesn’t necessarily mean that you’d only do it when you can barely from overworking, it can also mean those short coffee breaks and enjoying stress-free minutes.

And lastly, go on a low histamine diet. Eat fresh foods as much as possible. Processed and fermented foods are usually high in histamine liberators, or chemicals that trigger an increase in your histamine level. Eat fresh meat and fish, also a regular consumption of eggs would be great. Eat fresh fruits like mangoes, apples, kiwis, watermelons, and grapes. Fresh vegetables are also advisable, though you may want to avoid eating tomatoes, eggplants, and spinach. Using virgin coconut oil and olive oil when cooking is also advised. And exchanging your coffee for tea would do you wonders too, especially herbal teas.

What are Low Histamine Foods?

If you have histamine intolerance, these are the food that you should eat:

Freshly served Meat and Poultry, either fresh or frozen
Fresh Fish
Extra Virgin Olive Oil
Farm Fresh Eggs from organically fed chickens
Brown rice, Quinoa, and other gluten- free grains
Fresh Fruits
Fresh Vegetables
Dairy products from Coconut, Rice, Hemp, and Almond
Butter from grass fed goats and almond
Organic Coffee
Leafy vegetables
Herbal and Green Tea

What are High Histamine Foods?

If you have histamine intolerance, these are the food that you shouldn’t eat:

except for spinach and eggplant
Fermented alcoholic drinks like wine, beer, and champagne
Fermented food and ingredients like vinegar and soy sauce
Food with vinegar in them like mayonnaise and pickles
Cured meat like bacon and salami
Soured food like sour milk and sour cream
Dried fruit like apricots, mangoes, and raisins
Most citrus fruits, bananas, pineapples, tomatoes, and strawberries
Aged Cheese
Peanuts, cashews, and walnuts
Vegetables: avocados, eggplant, spinach, and tomatoes
Smoked fish, especially mackerel, Mahi- Mahi, anchovies, sardines, and tuna
Processed and Preserved foods of any kind

What are the Supplements for Histamine Intolerance?

Histamine Supplements

Here are the supplements that you can take to help you with your Histamine Intolerance:

Copper: Copper is said to help increase DAO level in your blood, which will in turn help break down histamine. Just be careful in taking a copper supplement, it would be wise to check your blood’s copper level first. Too much copper in your body can be toxic.
Vitamin C: Vitamin C does not only boosts your immune system, it also helps increase your DAO production. It would be advisable that you procure yourself a Vitamin C that’s ascorbic acetate instead of ascorbic acid.
Vitamin B6: Vitamin B6 is DAO enzyme’s helper, or can be called as Cofactor molecule.
Quercetin: When you intake Quercetin, you’re helping your body to calm the inflammation. It also blocks the releases of histamine from your mat cells.
Bishop’s Weed: Or as it’s more commonly known as Khella. It’s a plant based mast cell stabilizer. It can help reduce respiratory symptoms that are caused by histamine intolerance.

These supplements may help you in your histamine intolerance, but as I’ve said earlier, a holistic approach is always best. Also, self-medication is not advisable, as there are may be more underlying conditions that need to be treated. Always ask for a professional opinion, and follow your doctor’s orders. As soon as you’ve confirmed that you’re histamine intolerant, start getting better by sleeping early, exercising regularly, learn to relax, and eating healthy. You may not be bothered by the symptoms right now, but you don’t have to wait for it to get worse before taking an action. Prevention is in any illness and disease, and histamine intolerance is no exemption. Be healthy and be happy!

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Everything You Need to Know About Histamine and Histamine Intolerance

What is Histamine?

What is Histamine’s Role in your Body?

What is Histamine Intolerance?

What are the signs that you’re Histamine Intolerant?

What should you do & eat if you’re Histamine Intolerant?

What are Low Histamine Foods?

What are High Histamine Foods?

What are the Supplements for Histamine Intolerance?

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