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

 

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

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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.


References:

https://justinhealth.com/

https://justinhealth.com/water-pitcher

Audio Podcast:  

 http://justinhealth.libsyn.com/sibo-can-cause-histamine-intolerance-heres-how-podcast-268

Lowering Histamine Naturally – Getting to the root cause of high histamine – Podcast #154

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.

 Woman-sneezing-due-to-allergies

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

 

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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.

 


 

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https://justinhealth.com/products/detox-aminos/

https://justinhealth.com/products/gi-clear-1/gi-clear-1-2/

https://justinhealth.com/products/j-bio-serum/

https://www.kettleandfire.com/

http://mycadia.com/

https://www.nuttzo.com/

https://realsalt.com/

http://www.celticseasalt.com/

https://www.seasalt.com/gourmet-salt/himalayan-salt.html

Organic Grass Fed Meat

Everything You Need to Know About Histamine and Histamine Intolerance

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!

 

Yasmina Ykelenstam – Are histamines wreaking havoc on your health – Podcast #106

Dr. Justin Marchegiani interviews health journalist, Yasmina Ykelenstam, in this podcast episode where they go into an in depth discussion about histamine, diet and foods that you may want to keep an eye out for. There are a lot of knowledge bombs dropped in this conversation about inflammation and other gut issues so be sure to tune in and listen closely. 

Learn about the different types of histamine and the symptoms associated with histamine intolerance. Find out how Yasmina got around to getting her life and her health back on track after being diagnosed with histamine intolerance (HIT). Discover how good nutrition helped her cope with her health challenges and get a load of all the brain candy which may be the answers you’re looking for when you listen to this interview.

 

In this episode, topics include:Yasmina Ykelenstam low histamine chef yasmina

11:15   Testing histamine

19:00   Histamine symptoms

32:03   Histamine categories

36:33   Histamine offenders

43:20   Summary and recommendations

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Dr. Justin Marchegiani:  Hey, there! It’s Dr. Justin Marchegiani with Beyond Wellness Radio. We have an awesome guest today. I’ve had a couple of my patients who are dealing with histamine issues, so back by popular demand, we have one of the biggest histamines experts out there, Yasmina Ykelenstam is here on the show.  Yasmina is a former CNN producer. She had her own health challenges where she was able to come up with dietary changes; part of that was cutting out gluten and also reducing histamine from her diet and she has a great site over at thelowhistaminechef.com—thelowhistaminechef.com. Great references. Great blog articles there. So everyone, head over there and check it out. But Yasmina, welcome to the show. How you doin’ today?

Yasmina Ykelenstam:  I am doing wonderful. Thank you so much for having me. I’m really excited to be here. I’m a big fan of your work.

Dr. Justin Marchegiani:  Thanks a lot and me as well. I mean, you got a great site up here. I mean, one of the things I see in my functional medicine practice is that I see a lot of patients with histamine issues and we’ll talk about what that is in a bit. But one of the triggers that I see is parasites. People come in, they have a lot of gut bugs which typically equals a lot of inflammation. The more inflamed your gut is, it’s like a ticking time bomb for histamine and I know one of your most recent blog kinda touched upon that, so that really hit close to home for me. So I wanna to just kind of get everyone to get a sense of where you are in this journey. Because you were a producer, you were in media, how did you get over into this natural health side of the world?

Yasmina Ykelenstam:  Ah, well, my body broke down basically and I thought I was dying. And I—I really didn’t have a choice. I mean, I’ve never liked cooking. I—I mean I was always kind of interested in health but I’ve, you know, to me health meant buying an organic pizza from Whole Foods, you know?

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  And—and having an organic – with it?

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  You know, that kind of thing. And so it was really kinda fooling with myself thinking that I was doing the right thing for my body but so it was really all born out of necessity. I mean, for me, stress is my biggest trigger in addition to other issues. But really stress, so working as a journalist in war zones was really not the smartest thing I could for myself and a huge part of the, you know, recovery process was learning how to manage this stress, but you know, the kinda of emotional aspect of it but also the physical aspect and you know, it was born of necessity as it is for so many of us, you know, the kind of wounded healer archetype that is so apt for–

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  So many of us.

Dr. Justin Marchegiani:  Absolutely.

Yasmina Ykelenstam:  And—and so you know, I started my journey in a very kind of methodical journalistic way, just trying to apply everything I had used as a journalist, you know, I interned at 60 minutes. I worked for the BBC. I started out as a researcher, you know, and then worked my way up to a producer so I was very familiar with kind of intensive like research sessions that go on for you know, 12 hours at a time, when—when–

Dr. Justin Marchegiani:  Mmm.

Yasmina Ykelenstam:  Pursuing a story and I wanted to do something different with my blog which was—I mean maybe not different, but there aren’t many bloggers who kind of approached things from the scientific standpoint–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Which is, you know, we’re not doctors, but we’re you know, looking at the medical studies that come out–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  And sharing that information with readers so that they can make better informed decisions with their physicians rather than trying to go at it alone. For example, with this parasite thing that I just recently blogged about, showing that parasites are a major trigger of histamine-related inflammation–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  In the body. So you have all of these inflammation symptoms. You know, doctors can’t really pin down. You may be misdiagnosed with other issues and you know, maybe then you find out it’s a parasite issue but your doctor maybe doesn’t wanna test you for parasites which is where somewhere like—someone like you would come along in functional medicine who is more open to kind of thinking out of the box and accepting that, you know, sometimes we need to look beyond the tip of our nose for an explanation and but you know, so the—the information that I share in my post on parasites for example, you know, touches upon different ways of treating them. You know, what tests to ask your doctor for, but also I say, you know, I’m not a doctor, so I’m not sharing exact dosages of herbs that—that you might go out and try and treat yourself with because that’s not the aim of this blog. It’s just to share the information with you so you can share it with other people who are better informed to make those medical decisions with you.

Dr. Justin Marchegiani:  That’s great. So you started having these health challenges back I think in the mid-2000s, you mentioned I think you were oven in Iraq, and how did you come across the histamine approach? Because histamine’s—it’s—it’s getting more popular but 10 years ago, it had to have been more nuance. I mean, Paleo was just kinda coming out. You had the gluten-free thing kinda happening, too. So how did you grab the—the low histamine piece and make that your niche?

Yasmina Ykelenstam:  Ooh, wow! That was a—that was sheer luck. That was–

Dr. Justin Marchegiani:   Hmm.

Yasmina Ykelenstam:  Unbelievable. I literally just—I lost my mind after tracking my symptoms and which foods were bothering me–

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  For about 6 months, and then I finally just put everything into Google and it just came up with a forum where I met this wonderful woman who was also a blogger and she was in contact with a practitioner in London who tested for histamine issues. So I flew from Bangkok to London, I think it was a few days later to—to get tested and—and that happened. I—I received a diagnosis of histamine intolerance which was too much histamine in my blood, too little of the histamine degrading enzyme in the body–

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  Diamine oxidase–

Dr. Justin Marchegiani:  Yup, DAO. Yup. Uh-hmm.

Yasmina Ykelenstam:  DAO and you know, some people may not know this but histamine is necessary for healing. It’s used as a neurotransmitter. It’s necessary for digestion. You know, histamine is a good thing. You know? Too much histamine is a bad thing. You know, without histamine we wouldn’t be able to fend of viruses or you know, fight bacterial infections or parasites for example. But at the time that I was diagnosed, there was absolutely no information out there and I mean, it was—it was actually quite distressing. There was literally nothing. I was researching and researching and researching. There was one paper at the time and that was pretty much it. But slowly, slowly I started looking deeper into the medical journals and you know, I found out histamine was related to mast cells which were part of the white blood system and that, you know, the origin of histamine release is actually from mast cells–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  As well as foods.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  So and that’s where I came up with this idea that turned out to be transformative. I mean, it completely changed my life that avoiding histamine containing foods wasn’t going to heal me. It was an overall anti-inflammatory diet with the focus on excellent nutrition that was going to.

Dr. Justin Marchegiani:  Great points. Yeah, one of the things I always tell my patients is kinda this metaphor of the histamine bucket, and basically in that bucket environmental toxins kind of fill up in that bucket. Dietary stress fills up in that bucket. Various drugs or hormonal imbalance or nutritional deficiencies or infections, they fill up that bucket and so essentially some of the histamine foods or the higher histamine foods can just be enough to overflow that bucket and a lot of those symptoms start to occur, whether it’s the urticaria or hives, or whether it’s just fatigue or skin issues, or brain fog, etc. and it’s interesting because it’s never just one thing, like the parasite article or some of the higher histamine foods, it tends to be a couple of different things. And—and what are those couple of things that you—that were specific to you and most of the people that write to you?

Yasmina Ykelenstam:  Well, I look at it—the histamine bucket is an excellent analogy—analogy, metaphor, I always get those mixed up—it’s—for me, it’s the inflammation bucket in the end–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Which is that things like–

Dr. Justin Marchegiani:  Yes, I like that.

Yasmina Ykelenstam:  Gluten–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Become a problem, because you know, the latest research shows that weak—that certain people cannot—are not celiac–

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  But still have an immediate, acute inflammatory reaction that it—a systemic reaction. So for me, you know, things like gluten, even pets, hay fever, I mean just being exposed to pollen, you know, but for me, stress—stress was really, really the biggest–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  Trigger and you know, I eventually figured out that I could provoke an inflammatory reaction that was very severe just by experiencing some kind of major stress and then I realize that being stressed while eating was a huge issue and that’s–

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  Where the whole amygdala thing comes in.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  You know? And you know, I realized that if I was able to stay calm while enjoying my food or actually just enjoying my food, not eating a desk, not eating on the run, not worrying about what food was going to do to me, instead focusing on the positives of the food–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  As long as I was able to do that, that made a huge difference.

Dr. Justin Marchegiani:  Yeah, that whole Fight of Flight nervous system response really messes up your body’s ability to—to digest and break down foods. So every time you can be on that parasympathetic state, you get more enzymes, you get more hydrochloric acid. There’s a better chance of you breaking down that food fully and being able to utilize it nutritionally.

Yasmina Ykelenstam:  Exactly. There was a very interesting study. It was a few year’s old but it was about rat brains and they—

Dr. Justin Marchegiani:  Cool.

Yasmina Ykelenstam:  They put rats in front of—and they had to open cages to get to their food and they measured the release of brain histamine. When the rats had to figure out how to get to their food or experience any kind of stress, there was a significant release of histamine in the brain.

Dr. Justin Marchegiani:  Mmm.

Yasmina Ykelenstam:  When they were given free access to food and didn’t have to work anything out have any kind of stress, there was no release of histamine in the brain. Now they were only measuring histamine in the brain in this particular study but it’s not unreasonable to—to think that, you know, it might be systemic rather than just in the brain.

Dr. Justin Marchegiani:  That’s excellent. I love the brain candy, so good. You really—you really referenced a lot of these scientific studies which is great. It makes it a really good reference not only for patients but also for physicians. I mean, you have this really good blog up here now. I’m looking at it and it’s talking about testing for histamine. And this is really interesting because I typically don’t do a lot of testing for histamine unless I have a lot of overt symptoms. Typically we do a lot of food elimination and if we pull out certain foods, or we see probiotic intolerance or we cut out fermented vegetables or the higher histamine foods, or teas or—or DAO-blocking foods and see improvements. That’s kind of how I clinically diagnose, but you talked about of couple of different tests on your site. You talked about testing histamine plasma, looking at DAO or diamine oxidase.

Yasmina Ykelenstam:  Right, well, I–

Dr. Justin Marchegiani:  Go ahead. Uh-hmm.

Yasmina Ykelenstam:  The goals and­—sorry.

Dr. Justin Marchegiani:  You’re good.

Yasmina Ykelenstam:  The—indeed, the golden standard for diagnosis is still considered to be responsiveness–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  On the elimination diet and when I run workshops, I tell people that, you know, working with a doctor obviously but to keep very detailed food diaries and to figure out what’s bothering you and that’s—that’s kind of your approach, rather than just saying, “Well, I think I have a histamine issues. I’m not just gonna eat any histamine foods because–

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  The—the food lists tell me this.”

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  It’s kind of like figure out your own sensitivity and, you know, I—I tell people to—to put them in a spreadsheet, you know, from the foods you are least reactive to, to most reactive to, and then work towards trying to incorporate foods from the further list on a very long rotation and the ones that you are least reactive to more regularly, obviously.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  But the—the testing that exists at the moment for histamine intolerance is only the—the plasma levels of histamine.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Which are unreliable because histamine fluctuates wildly throughout–

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  The day and throughout the week and obviously if you haven’t been eating high histamine foods, the amount of histamine in your plasma is gonna be different and then we have also the diamine oxidase test which is also fairly unreliable because, I mean, when I look at the research about DAO, there’s still not entirely sure as to how it’s actually working with the histamine whether it’s indicative of high histamine levels or that’s just enough DAO for some people and also it fluctuates depending on what you’ve eaten and whether you have enough nutrients to manufacture the DAO of that particular day. So the—the 2 tests that we have that most people may be familiar with, the practitioners that—that are going them–

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  Are unreliable, which is why the elimination diet is the standard.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  When we’re talking about mast cell activation which is a related disorder that doctor Afrin one of the leading specialists in the field has—he wrote a book recently and he says that it’s believed that maybe 1 in 6 Americans suffers from some kind of mast cell activation. Now mast cells as part of the white blood cell system as you know, but just for–

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  Just for anybody out there listening, mast cells are part of the white blood cell system and within them are contained histamine, interleukins, heparin, prostaglandins which are all inflammatory molecules. They’re needed for healing but when mast cells become activated such as provoked. Let’s say you’re—you have an allergy.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  And—and so the mast cells break open, process called degranulation–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  And they splurged these inflammatory molecules all through the body and they cause inflammation. Now if you need that, if it’s not provoked by allergy, by stress or by trigger foods or by medications that are inappropriate or whatever it is, then we have too much inflammation in other kinds of, you know, inflammation in the body which is another reason that I don’t focus on just a low histamine diet, because we have other types of inflammation in the body. There are foods that correspond to prostaglandins and interleukins also. So we can either drive ourselves insane following you know, a hundred different lists or do what you do—if I have switches to work out our individual triggers and go from there.

Dr. Justin Marchegiani:  That’s great.

Yasmina Ykelenstam:  Oh, so sorry. For testing for mast cell activation is fairly difficult because you need to find an immunologist who’s willing to test you for it. I’ve had situations where people have gone to doctors and attempted to pay out of pocket and been told that they would not give them some tests which is frankly something I’ve really just don’t understand. At least they could give them a referral to somebody else who would be willing—because I accept that people need to work with a—with a physician.

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  But you know, refer them to somebody who’s open to working with them on it, just don’t tell them mast cell activation is so rare which it absolutely isn’t, that you know, it’s not worth testing, you know. So for mast cell activation, we have as you know, basic inflammatory panels, you know, for the—for the molecules that I just mentioned a moment ago and—and yeah, I’m hoping that more doctors will—will start getting into these tests but they are very expensive and most are not available on insurance which is why many people don’t offer it even if they’re open to it.

Dr. Justin Marchegiani:  And is that the mastocytosis you’re referring to when you had that just accelerated histamine in the body? Is that where you’re looking to get diagnosed by your conventional doctor with?

Yasmina Ykelenstam:  No, actually, well, there—mastocytosis is one of them. We have—we have histamine intolerance. We have mast cell activation which is just the unstable mast cells, then we have mastocytosis which is a more serious incarnation of mast—well, people with mast cell activation would be happy to hear me say that because they can be just as severe.

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  But the mastocytosis is linked to a type of leukemia called systemic mastocytosis, technically, a myeloperative—I can never pronounce this.

Dr. Justin Marchegiani:  Yup, yup.

Yasmina Ykelenstam:  And incarnation, but so we have different—they’re all linked. They differ—they can differ in intensity, severity, and progress but they are linked by the mast cells and by the histamine. Mastocytosis is believed to be rare.

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  As is the systemic obviously highly rare, but mast cell activation on the other hand—the—can be triggered by so many different things, as we said the parasites, the stress–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  The—you know, exposure to chemicals which is why it’s becoming more and more common because we just live in a more toxic world generally.

Dr. Justin Marchegiani:  Uh-hmm, right. So like mastocytosis is kinda like the pathological expression vs the histamine intolerance is kinda more of the—the functional kind of impression where you go to a conventional doctor, they may not even recognize it because it’s more in that functional realm where the mastocytosis is more of that in the pathological realm. Is that correct?

Yasmina Ykelenstam:  Absolutely. I—I would love to see more functional doctors getting into the mast cell activation because that seems to be exceedingly common and I have so many people who—who have turned out to—who have gotten their diagnosis and it’s really quite astonishing.

Dr. Justin Marchegiani:  I agree and I like how you hit the inflammation piece. You talked about some of the prostaglandins and we know like prostaglandin E2 is one of the ones that’s more of the inflammatory. We get that with a lot of refined vegetable oils, excess sugar. You also talked about a lot of the immune system upregulation that happens. Well, we have 5 kinds of immune cells typically. In—in doctorate school, we—we learn them by the acronym. At least I did, Never Let Monkeys Eat Bananas. Neutrophils, Lymphocytes, Eosinophils, Monocytes, and Basophils—and a lot of them live in the—in the gut, in the MALT and the GALT. They’re inside the—the gut lining. And the big ones are the basophils and these guys in your blood cell, they’re basophils but when they go into your tissue, they become mast cells and mast cells just they—they are the ones that erupt the histamine like you mentioned and histamine’s job is to vasodilate so blood can get in there to help heal, but what’s happening as you mentioned before, Yasmina, is the chronic inflammation that histamine’s just coming out all the time and then you’re getting all of the symptoms of—well, let’s touch upon that. Let’s talk about what are the common histamine symptoms that you’re seeing with people and yourself?

Yasmina Ykelenstam:  The common symptoms are—okay, let’s see, there’s just—there’s absolutely dozens but here are the most common ones.

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  Migraines, dizziness, brain fog, acid reflux, severe gastric distress, severe bloating of the stomach, inability to pass stools or the opposite, diarrhea, some—some people present with bladder problems. It’s linked to interstitial cystitis by Dr. Theoharides at Tufts.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  Who is the director of immunopharmacology there and he actually makes a supplement for mast cell disorders called NeuroProtek and there’s another called CystoProtek–

Dr. Justin Marchegiani:  Mmm.

Yasmina Ykelenstam:  Which is specifically for people with—with bladder issues. I take NeuroProtek myself.

Dr. Justin Marchegiani:  Got it.

Yasmina Ykelenstam:  Let’s see, what else—there is—those are the biggies. Rashes, you know, urticaria–

Dr. Justin Marchegiani:  Yeah, the hives. Uh-hmm.

Yasmina Ykelenstam:  What else? Hives, severe exhaustion–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Like a chronic fatigue type—type of exhaustion and in fact, many people are diagnosed with chronic fatigue and there is a mast cell link to there as there is to many different things and those are the biggies.

Dr. Justin Marchegiani:  Got it.

Yasmina Ykelenstam:  I would say—and, oh and obviously, intolerance just to foods, food allergy like symptoms, hay fever–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  That kind of thing and the thing is, testing for allergies will often come back negative.

Dr. Justin Marchegiani:  Uh-hmm. Yup, like even–

Yasmina Ykelenstam:  Which confuses people understandably.

Dr. Justin Marchegiani:  Yeah, even like an IgG or an IgA test will still—those delayed one will still kinda come back negative, right?

Yasmina Ykelenstam:  Exactly. You know, my entire life, my test results have unfailingly come back absolutely normal which is why I have been pegged as a hypochondriac and you know, told that it’s psychosomatic, it’s all stress–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  And while they were kind of right, stress is involved–

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  There were very definite issues that people were missing because they were convinced that it was on my head because I was in perfect health.

Dr. Justin Marchegiani:  Right, and I find, too, with a lot of the food allergy stuff, typically all the inflammation like you mentioned earlier we get this phenomenon known as leaky gut or in the medical litera—literature, gastrointestinal permeability where those tight junctions open up and you get all these undigested food particles and even histamine getting into the bloodstream and so you come back with this test of all these food allergens, you switch your diet around, but guess what? If the—the gut’s still permeable, then you just develop more food allergies, so it’s kinda like playing Whack A Mole.

Yasmina Ykelenstam:  Exactly. Exactly, that’s it. I try to explain that to so many people and yes, there is some research I came across recently that—that kinda blew my mind which is at that how you cook your food affects allergenicity–

Dr. Justin Marchegiani:  Mmm.

Yasmina Ykelenstam:  First of all–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  But also can cause mast cell activation even if you don’t actually have a genetic mast cell activation disorder, so for—and it was advance—AGEs—advanced glycation end products.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  That really lovely, crust that you get–

Dr. Justin Marchegiani:  Crème Brulee.

Yasmina Ykelenstam:  When you cook something in the oven and you broil it.  Ex–oh, crème brulee.

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  Wow. Yes, exactly. Crème brulee, you know, potatoes, you know.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  Anything, it’s—it’s the process of sugar combining with—with fat and browning.

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  And so these AGEs contribute to intestinal permeability, aka leaky gut, through the process of mast cell activation and there was more research on how quercetin, which the—the thing that I take, quercetin helps heal the tight junction permeability of the gut and also, ah, the other one, emulsifiers.

Dr. Justin Marchegiani:  Mmm.

Yasmina Ykelenstam:  Emulsifiers causing mast cell activation of the gut but something that really, really blew my mind was that, for example, strongly roasting peanuts–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  According to this one study, typically increases their allergenicity by 30%.

Dr. Justin Marchegiani:  Wow, so we–

Yasmina Ykelenstam:  Oh, sorry. No, I have that wrong. Sorry. Sorry. When compared with raw food antigens–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  IgE antibodies were elevated four-fold against processed food antigens in 30% of humans. So 30% of humans experience a four-fold increase in allergenicity when food is cooked. When ro—when peanuts are roasted. Sorry.

Dr. Justin Marchegiani:  So if you’re gonna have your nuts–

Yasmina Ykelenstam:  But peanuts are already highly allergenic.

Dr. Justin Marchegiani:  Got it. So if you’re gonna have your nuts, you wanna soak your nuts essentially.

Yasmina Ykelenstam:  Exactly.

Dr. Justin Marchegiani:  Alright.

Yasmina Ykelenstam:  Which, you know, everyone’s been telling us for a while. But you know, some of us don’t listen.

Dr. Justin Marchegiani:  Yeah and it makes sense because things like a lot of those foods are very high in phytates or oxylates and a lot of these mineral blockers and enzyme disruptors so that kinda make sense, that that—those soaking methods and I know, I think it’s Sally Fallon’s book, what is it? Something traditions. She talks about a lot of the–

Yasmina Ykelenstam:  Oh, I don’t–

Dr. Justin Marchegiani:  I think it’s Nourishing Tradition. That’s the book and she talks about soaking the nuts and thinks like that and helping to deactivate a lot of those things, so these old type of cooking things kinda make sense when the science kinda looks at the nitty-gritty so to speak.

Yasmina Ykelenstam:  Oh, absolutely and you mentioned something super topical which is the ox—oxylates–

Dr. Justin Marchegiani:  Mmm.

Yasmina Ykelenstam:  And for me oxalic acid turned out to be a huge piece of the puzzle. I focused on histamine for so long I wasn’t seeing the wood for the trees.

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  And, you know, oxalic acid, you know, found in kale. You know, all the world’s healthiest–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  Foods, chards, all the histamine foods but oxalic acid, you know, and I explained it to people like this. So oxalic acid is a plant-irritant protection mechanism as you know.

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  And, you know, along with salicylates, fructose–

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  And—and you know, other things, so the way I explained it, the inflammation bucket as I look at it is we—we are the giant bucket–

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  Obviously, as with the histamine bucket, and within us we have lots of tiny little buckets. So we have the fructose bucket, the oxalate bucket, the salicylates, you know, all these different little buckets of things, tyramine bucket, all these different things that are found in foods that have the potential to cause inflammation. Well, it just takes one of those little buckets to spill over, for the entire bucket to spill over and cause inflammatory—an inflammatory response. The gluten bucket, the whatever bucket. So you might think that, “Oh well, I’m on a low histamine diet, but I’m still spilling over. I’m still spilling over.” It might be because your salicyclate bucket is full.

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  But your histamine bucket is empty. So as I tell people, it’s really important to eat a wide variety of foods, and to kind of keep track in your head. Initially, I tell people, you know, use a spreadsheet, write out a weekly meal planner, you know, be aware of the different lists that foods fall into and combine them. I call it the balance plate. So you’ll have a little bit of high salicylate foods, a little bit of low salicylate foods, high histamine, you know, a little bit of low histamine, and just combine it all into one day.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  So that you make sure that you are not making any one of those little buckets overflow.

Dr. Justin Marchegiani:  Really good points. Really good points. I’m gonna put you on the spot. What’s your diet like right now? Because of the things I start off with my patients is typically a Paleo template and then we’ll add on different layers to it, whether it’s like a low salicylate or oxalate kinda thing, with like a specific carbohydrate diet or kind of a GAPS approach or a low FODMAP or even autoimmune approach. I’m just curious to kinda figure out what diet you kinda created for yourself now.

Yasmina Ykelenstam:  My diet is in transition at the moment because I’m traveling for the next few months–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  And that always make things a little bit difficult. I find myself relying more of proteins when I travel–

Dr. Justin Marchegiani:  yup.

Yasmina Ykelenstam:  Because that’s what I can get easily in restaurants or you know, I can pop in to Whole Foods–

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  And buy a—a piece of chicken, you know, some parsnips—not parsnips, sorry, beets.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  I’m thinking of England here. Beet roots and fat, but I consider myself normally to be—I—I don’t really use labels but it would—the closest thing it would be is a plant-based Paleo but not entirely plant-based. So I would say that I’s maybe 70% plant-based with 30% proteins and fats and what’s not. I’m—I’m not including fats there basically. But, you know, for me–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  A typical day is I would wake up. I will have a—a green smoothie–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  With very little fruits–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Or a juice with very little fruit.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  And you know, maybe some nuts because I’m not a big eater during the day.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  For lunch, it’ll be a—a salad with lots of different greens like all of these different very green greens like 5 or 6 different kinds, cucumber, you know, carrots, lots of anti-histamine and anti-inflammatory herbs like thyme, cilantro, basil, parsley, you know, all chopped up. You know, make a nice dressing with maybe a tablespoon—a teaspoon of mustard which will probably be too high histamine for people–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Starting out but it’s fine for me. I’ll add maybe a little bit of protein to that, usually a piece of fish or something like that.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  And then dinner, you know, maybe some noodles made from zucchini.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  With a white bean sauce or I go more protein and you know, more salad, lots of vegetables, just you know, whole foods. My diet changes–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  You know depending on where I’m traveling to.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  What I’m currently doing. Lentil pasta, I love lentil pasta.

Dr. Justin Marchegiani:  Mmm.

Yasmina Ykelenstam:  Pasta made out of lentils, it’s just amazing. But I find myself always wanting to—I find myself drawn to the higher protein idea. But the problem is that when I look at the longevity studies, for example the ones coming out of the University of Southern California–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Under Dr. Valter Longo–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  All of the life extension studies and disease prevention studies seem to indicate that a lower protein diet is what we want to be focusing on.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  But of course, that doesn’t take into account different age groups and you know, different—different protein needs over the years.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  You know, but that—that is something that’s always in the back of my mind when I go higher protein and all of the studies showing that, you know, the lower rates of disease in vegans and vegetarians. Obviously, there’s problems with all of these studies. There’s a problem with every study if you look hard enough.

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  But so maybe my—my—I’m skewed towards the ones that lean towards more plant-based diet because that’s usually my personal preference. I just—I don’t like eating too many animals, it’s I feel bad for the animals.

Dr. Justin Marchegiani:  I—I totally get it. But one of the things that I wish those studies really took into account is number one, typically a lot of people that are—are more plant-based tend to be more healthy to begin with. They’re—they’re more conscious of being active.

Yasmina Ykelenstam:  True.

Dr. Justin Marchegiani:  Or avoiding sugar and avoiding alcohol, so you kinda have that biased, too. And the next one is that we really don’t classify what kind of meat. Like are we talking grass-fed, organic meat or we’re talking grain-fed which means a whole bunch of histamine, too, right? And then a whole bunch of–

Yasmina Ykelenstam:  Oh yeah.

Dr. Justin Marchegiani:  Antibiotics and pesticides, and I think that really matters, too. What’s your opinion on the quality of the meat?

Yasmina Ykelenstam:  Oh, absolutely essential. I mean, I—I actually had quite an amusing moment. I mean grass-fed always top preference.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  You know, budget-permitting obviously.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  And I—I tend avoid chicken unless I’m traveling because of what they’re fed.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  Because of you know, corn being allergenic–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  And the Omega 6 and you know, all of that. And I tend to focus on grass-fed meats, and you know, lamb and things like that and but it was amusing to me, because when I was in France—I lived there for a year recently, and I went into this supermarket. I went to the butcher and I said, you know, in French, “Could you tell me which of your meats are grass-fed?” And he looked and he burst out laughing and he said–

Dr. Justin Marchegiani:  Hmm.

Yasmina Ykelenstam:  “But madam, what else would we feed them?”

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  And I thought that was just an amazing answer. Of course, they eat grass.

Dr. Justin Marchegiani:  Right. Exactly. I know, over here in the US, it’s amazing. It’s totally flipped, right?

Yasmina Ykelenstam:  Oh, absolutely. Yes.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  I’m—I’m terrified when I see some of the things that they’re feeding cattle.

Dr. Justin Marchegiani:  I know. Well, it’s getting better because people are putting their dollars, you know, where their mouth is so to speak and they’re demanding it which is great and we’re getting more access in a lot of these stores. That’s at least a good shift that’s happening.

Yasmina Ykelenstam:  Absolutely, if only it didn’t cost so much then we could include more people on this quest for health. That would be amazing. But you know, slowly.

Dr. Justin Marchegiani:  Slowly. Exactly. You know, when I–

Yasmina Ykelenstam:  Hopefully, one day.

Dr. Justin Marchegiani:  Yeah, absolutely. Now when I educate my patients on histamines, I kinda break them into like 3 categories. Now I don’t wanna be too nary, if I go over the top, you know, I’ll back up a little bit. But we kinda have like histamines that are just foods that are high in histamines. Like the foods, histamines actually in the food. Then we have like histamine-releasing foods where there may not be a lot of histamine in it but it stimulates a release. And then we have like the histamine enzyme blocking food, the—the DAO or the DAO—the diamine oxidase blocking foods. So I just kinda wanted you to touch upon them briefly and just—I have a list in front of me. I don’t expect you to remember it, but it’s quite a list but the foods that are higher in histamines are gonna be like your nuts and your vinegars and your fermented foods and your aged meats and citrus. The foods that are gonna be histamine-releasing are gonna be like more of milk, chocolate–

Yasmina Ykelenstam:  Citrus choc–

Dr. Justin Marchegiani:  Citrus fruits, bingo. Yeah, you got it. And then the blocking foods are gonna be like your teas and—and such. But what’s your take on that? Just in general.

Yasmina Ykelenstam:  I mean, you know, it’s difficult because unless you’ve done genetic testing–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  For example, I mean you know, you can—you know, you can figure out if your DAO is impaired or if your HNMT, the histamine-methyl transferase–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Which is the other histamine degrading enzyme which is only possible to figure out via genetic testing.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  And also you need to look at the MAO genes and you know–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  All of this because for example, you can have a food like I—I was very upset for a number of years because one of the most popular high histamine food list had turmeric marked as high histamine.

Dr. Justin Marchegiani:  Wow.

Yasmina Ykelenstam:  And I just kept saying over and over again, turmeric is not high histamine. It is an antihistamine. It is a mast cell stabilizer. But what it can do is block the DAO. But if you have a person who does not have a DAO problem, then turmeric would be very healing to them. You know?

Dr. Justin Marchegiani:  Mmm.

Yasmina Ykelenstam:  So what I say is, you know, we have—and this is a concept that I struggle to communicate to people some—you know, that I’ve worked with in the past is that foods can have opposing properties. You know, you can have like the turmeric that blocks something and there’s also antihistamine, you know, as you explained there’s many different types of inflame—inflammatory cells in our body and you know–

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  What’s good one might not be good for the other.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  You know? So it’s—it’s all a balancing act and unless you want to live your entire life in fear–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  And so focused on your health that you forget to live–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  Then my advice to people is just you know, for a couple of months, track what works for you.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  You know? And—and try and—and figure out what your tolerances are. You know, try to see how far you can get without filling your bucket and see what it is that helps you empty the bucket. Here are the general guidelines that seem to work for many people based on the research bearing in the mind that a lot of the research is conducted on animals, not humans.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  You know, and at quantities that—at dosages that are much higher than what we would normally get from foods, you know, extracts and what not. So and just—and try and make something for yourself that—that doesn’t completely kill your enjoyment of life and that allows you to have a social life because–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  You know, the unhappiness that is created by keeping your—by separating yourself from society by not eating out with friends–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  Not eating with your family, you know, serving different foods at home, being you know, terrified of the outside world really because you are so focused on your health is counterproductive because that stress actually causes more histamine release.

Dr. Justin Marchegiani:  Mmm.

Yasmina Ykelenstam:  So you know, it’s—it’s kind of a never-ending cycle of—of pain and misery and so yes, we have all these different foods with the different properties and with different properties and you know, for example, the—the stem of a—of a plant might have a different property to the fruits or the left or whatever, so you know, the—the studies need to be taken with a pinch of salt and all of that.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  But you know, I think it’s good to be aware of all of this stuff and then kind of step a step back and say, “How can I protect my—my sanity?”

Dr. Justin Marchegiani:  Yeah. Yeah.

Yasmina Ykelenstam:  And have a good quality of life and still have fun.

Dr. Justin Marchegiani:  Got it.

Yasmina Ykelenstam:  You know?

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  So that’s—that’s my approach.

Dr. Justin Marchegiani:  Got it. That’s great. And then the people that have written to you and that you’ve worked with, and also yourself, what have been the major histamine offenders? Like what have really been their kryptonite? Is it more of the histamine-releasing, the—the DAO-blocking or more of the—the high histamine foods based on your experience?

Yasmina Ykelenstam:  It’s—it’s really the fermented foods, number one.

Dr. Justin Marchegiani:  Fermented, yeah.

Yasmina Ykelenstam:  So, yeah, the fermented foods, and the—especially the vinegars, the alcohols, and—and you know, the kombuchas, and you know, most people who come to the histamine diet, the low histamine diet, or the antihistamine diet arrived there via GAPS.

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  Because of the—yeah, I see it time and time again and in fact, that’s how I worked out what was wrong with me in the end. Somebody served me Rejuvelac. I don’t know if you’re familiar with that beauty. But it’s a fermented drink made from barley I think it is.

Dr. Justin Marchegiani:  Okay, yup, yup.

Yasmina Ykelenstam:  But she had fermented it for a few weeks and I think she had combined it with kombucha and she swore up and down that it would heal me. This was a raw foodist.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  And—and I drank it all and I—I had—I basically had a seizure.

Dr. Justin Marchegiani:  Wow.

Yasmina Ykelenstam:  And—but it didn’t happen immediately and that’s the confusing thing as you know with histamine foods–

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  Because inflammation takes time to build up so especially if your bucket is already empty-

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  You can think that something’s not affecting you and also there’s, you know, the power of wishful thinking such as well, you know, a Snickers bar doesn’t trigger me but a tomato does.

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  Wow. Now, let’s really think about that.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  Let’s be honest with ourselves.

Dr. Justin Marchegiani:  Right, tomatoes obviously better for you than a Snickers bar, right?

Yasmina Ykelenstam:  Exactly and what are the odds really that the Snickers isn’t doing anything?

Dr. Justin Marchegiani:  Anything, exactly.

Yasmina Ykelenstam:  Or are you maybe just you know, kinda lying to yourself. But—but yeah, I know, absolutely it is. So it’s mostly the fermented foods and it’s a–

Dr. Justin Marchegiani:  So are you telling me I can’t have bone broth though?

Yasmina Ykelenstam:  There’s a lot of back and forth on that one.

Dr. Justin Marchegiani:  Yup, I see that.

Yasmina Ykelenstam:  I think it was the Paleo Mom, Sarah, who said that–

Dr. Justin Marchegiani:  Yeah, Sarah Ballantyne.

Yasmina Ykelenstam:  Yeah, Sarah Ballantyne and she—I—I think it was her who said that you know, technically because it’s—it’s boiling—as long as you keep it at a temperature where bacteria does not start to accumulate then it shouldn’t be an issue.

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  Now that kind of makes sense to me. But at the same time, you know, there’s—I mean there’s just a lot in bones. There’s—there’s a lot of different ‑amines that can cause–

Dr. Justin Marchegiani:   Yup.

Yasmina Ykelenstam:  Problems in people. Glutamine for example and I know this is—this is a struggle for a lot of people because they want to heal the gut so they want the glutamine and a lot of people take glutamine supplements and then–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  You know, they—they have some sort of major episode and you know, glutamine is an –amine.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  If you’re sensitive to histamine–

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  You are likely to be sensitive to other –amines–

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  And glutamine, you know, and so to these people, well there’s another interesting study conducted on animals–

Dr. Justin Marchegiani:  Let’s hear it.

Yasmina Ykelenstam:  Which was found that rat mast cells–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  If you expose them to an antigen for a—for a long period of time at very small doses that increase incrementally, the mast cells eventually stop reacting. So this is what I tell people. A couple of years ago, I couldn’t eat anything.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  I didn’t go out and heal my gut. I ate a sensible diet. I didn’t do any complicated protocols with bone broth or glutamine or whatever. I was—I wasn’t even taking quercetin at the time actually. I just started eating a very healthy diet and I started a process of incremental exposure to things that bothered me.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  Now I would not advise anybody at home to do this on their own. I literally couldn’t find anybody to work with me and I took a lot chances that could have ended very badly because I had had very serious reactions in the past. So in combination with stress relief and meditation because there’s no point in exposing yourself to something if you are so stressed out about it that you’re causing a reaction to begin with because then the brain begun—begins associating that food even more strongly with a negative—with a negative impact because you know, if you experience something negative, your body doesn’t want it to happen again so you start thinking about this thing and the body might start giving you the feeling of that reaction that you had that bothered you. So I—I’m not sure I explained that very well but that goes back to the amygdala as you know.

Dr. Justin Marchegiani:  Uh-hmm. Uh-hmm.

Yasmina Ykelenstam:  And so the—the process of desensitization took many forms, you know. One was, you know, I called it a—what did I call it? Homebased immunotherapy–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Or something—

Dr. Justin Marchegiani:  Yup. Uh-hmm.

Yasmina Ykelenstam:  Low-dose immunotherapy. And so you know, it was first I would be in a room for one second with flowers, with a big vase of flowers. I’d walk into the room and walk straight out of the room–

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  Because I had really bad hay fever.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  You know, then I would spend a minute in the room and—my best friend walks in and I have 2 flowers shoved up each nostril.

Dr. Justin Marchegiani:  Huh.

Yasmina Ykelenstam:  She’s like, “What are you doing?” And I’m like, “Immunotherapy!”

Dr. Justin Marchegiani:  Love it. I love it.

Yasmina Ykelenstam:  But you know, and then I went out and walked through the park then I sat and meditated in the park, you know, and then it just kinda—kinda went from there.

Dr. Justin Marchegiani:  Yeah, it-it’s–

Yasmina Ykelenstam:  And the same with foods, you know.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  If—if something bothered me, I would—I would take the food and I would cook it for just a second in a bit of olive oil because–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  Olive oil boosted DAO in the—in the gut.

Dr. Justin Marchegiani:  Oh, great.

Yasmina Ykelenstam:  So that’s a great thing. And you know, I found that with many people, oil-based foods and supplements worked better for them when beginning to reintroduce and I don’t know if it’s just literally just shielding something from the gut lining where it’s inflamed and it’s—it’s kind of achy or if it’s, you know, the DAO boosting of—of the oils. But in any case, you know, just—I would just cook something for one second in the olive oil. I would take the food out and then I would cook the rest of my food in that olive oil. And the next time I’d cook it longer and longer and longer, and then I’d leave the food in there.

Dr. Justin Marchegiani:  Interesting. Very cool. Yeah, it’s like cooking a frog, right? You put a frog in the water, boiling water, it jumps out. You put it in low, you know, temperature water and you gradually heat it up and kinda get it desensitized to that change, you can eventually cook that frog.

Yasmina Ykelenstam:  That is absolutely what I tell people. I’m very amused to hear you say that.

Dr. Justin Marchegiani:  Nice. It’s a great analogy but I still don’t know anyone that cooks frogs though.

Yasmina Ykelenstam:  Well, I lived in France for a year, it’s–

Dr. Justin Marchegiani:  Oh, yeah. There you go. Yup, that’s good. But yeah, that’s the analogy I like it. So just kinda getting all the people that are listening here summarized all the—the brain candy that you’ve dropped here. So we have number one is kind of getting the inflammation down in general. Like figure out where those inflammation triggers are, whether it’s stress in your life emotionally, meditation, sleep, the gluten sensitivity—forget just being celiac but the non-celiac gluten sensitivity. We also talked about the desensitization you—you also touched upon. And I also want to go into a couple of other things. I know you have some really good videos online that have been viewed hundreds and thousands of times on supplements and histamines. I know just—you already touched about quercetin is one of them and you even mentioned the DAO enzymes. What else do you recommend supplementation-wise?

Yasmina Ykelenstam:  Mangosteen. Well, I’m not a doctor so I can’t recommend anything, but should people wish to discuss with their doctors–

Dr. Justin Marchegiani:  Yes. I would—I would just say–

Yasmina Ykelenstam:  The following–

Dr. Justin Marchegiani:  Let’s frame it like this, things that have worked for you and have worked for patients–

Yasmina Ykelenstam:  Yeah.

Dr. Justin Marchegiani:  Or people that have written to you–

Yasmina Ykelenstam:  Yeah.

Dr. Justin Marchegiani:  And shared them with you.

Yasmina Ykelenstam:  Right, okay. So mangosteen–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Supplements which are made from the—the skin of the mangosteen, not the actual fruit itself. So drinking the juice is not the same thing.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  Mangosteen supplements work as a mast cell stabilizers, preventing it—preventing them from releasing inflammation along with–

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  Along with histamine into the body, unnecessary inflammation. It might also be beneficial for hair loss that is associated with histamine issues and mast cell activation which is driven by prostaglandin D2. There is also—hang on, let me look over a little bit—holy basil.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  You can buy this–

Dr. Justin Marchegiani:  Adaptogen.

Yasmina Ykelenstam:  Also known as tulsi. Exactly.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  It’s absolutely wonderful and if you have low cortisol, it might not be great for you. It acts as a mast stabilizer and antihistamine, highly inflammatory. It’s been one of the most healing things I’ve discovered. You can get it as a tea or as a supplement.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  There is also—it’s important to have—to make sure that you are not lacking in nutrients.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  I’m finding more and more people and you know, I’ve—I’ve been saying this for years, but people restrict themselves so much that they lack vital nutrients that will help fight the inflammation. So on the one hand, you’re restricting foods because the symptoms go away, but that’s the short-term achievement, because long-term as you deplete your nutrients, you become incapable of fighting inflammation in—in the future. There—probiotics are a really difficult one because on the one hand obviously it’s—it’s a problem with the fermentation and you know, some people if they’re lactose-based but Seeking Health make a–

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  Histamine-safe probiotic, which is basically they are strains that raise histamine and trigger inflammation but this—and here’s again where it gets confusing but in many cases, this might not be a bad thing in the long-term because they have other positive effects on other types, on other aspects of inflammation. But for our particular needs, they may not be appropriate because in the short-term they trigger this histamine release. So the Seeking Health ProBiota—ProBiota Bifido is what it’s called–

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  Has the histamine neutral and histamine lowering strains in it; otherwise for people who are unable to tolerate probiotics, a prebiotic foods are a good options. Things like chicory, dandelion, you know, those—those high fiber–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Food—plant. Things like that. And magnesium—a lot of people find beneficial simply because it calms the nerves and it’s necessary for proper manufacture of the DAO enzyme. We have DAO pills—diamine oxidase pills made from—from pork extract.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  And those you know, mixed reports on that. They really work for some people. They don’t work for other people. They initially worked for me then did not, and then I just didn’t like the fillers in them but you know, people were talking about a plant-based one, you know, different companies issued patents for them. I also trolled the patents to see what’s—what’s new and what’s coming out.

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  But something interesting that I’m waiting to see more on but haven’t heard anything about it for a while was a handheld device that could measure histamine tent of foods for the consumer. And–

Dr. Justin Marchegiani:  Oh, wow.

Yasmina Ykelenstam:  Because a concern to me, although I am not concerned when I eat foods anymore, and you know, although I’m careful about what I eat, I will eat what I want, you know, I will have a baguette. You know, a nice piece of crusty French bread when I’m—when I’m–

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  In France, you know, I will have—well, no, ice cream. I just don’t like dairy, that’s the thing. But you know, I will eat what I want within reason because I just don’t deal with any of this on a regular basis anymore. But—oh, no, and I forgot where I was going with this—that’s terrible.

Dr. Justin Marchegiani:  So, you were saying that you were able to do it. You are eating the bread and such because you are able to tolerate it more frequently?

Yasmina Ykelenstam:  Yes, and I was making a point with that, I’m sorry, and I don’t know where I was going. Never mind. But–

Dr. Justin Marchegiani:  It’s okay. It’ll come back to you. It’ll come back.

Yasmina Ykelenstam:  It will come back, but so you know–don’t know where I was though

Dr. Justin Marchegiani:  We were still talking about the supplements. We were hitting—hit the mangosteen.

Yasmina Ykelenstam:  Yup.

Dr. Justin Marchegiani:  We talked about the diamine oxidase. Is there any other supplements you wanna add to that list?

Yasmina Ykelenstam:  Some people—those are the primary ones that work for most people. Vitamin C.

Dr. Justin Marchegiani:  Oh, yes, yes. Oh, perfect.

Yasmina Ykelenstam:  Vitamin C is—yeah. Vitamin C is a mast cell stabilizer–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  And also an antihistamine. It’s actually really, really, really powerful and it is even prescribed by the world’s leading mast cell activation experts.

Dr. Justin Marchegiani:  Mmm.

Yasmina Ykelenstam:  In the field and the one caveat to make sure it’s not–

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  Corn-based and you know, for obvious reasons, but it’s also it gets worse than that. It’s not just corn but it’s fermented corn.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Which is not great.

Dr. Justin Marchegiani:  You–

Yasmina Ykelenstam:  And something to watch out for is–

Dr. Justin Marchegiani:  Go ahead.

Yasmina Ykelenstam:  Citric acid–

Dr. Justin Marchegiani:  Mmm.

Yasmina Ykelenstam:  Just so people know. They’re often derived from mold.

Dr. Justin Marchegiani:  Ahh.

Yasmina Ykelenstam:  And that’s something we obviously need to avoid.

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  You know, people make the assumption that it’s derived from—from lemons. But no.

Dr. Justin Marchegiani:  Right. And also you mentioned before that you like a lot of Vitamin C that comes from palm, is that true?

Yasmina Ykelenstam:  Yeah, that’s the one I’ve been using.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  Simply because it came packaged with quercetin, but that one is now not—no longer being manufactured.

Dr. Justin Marchegiani:  Was that the one by–

Yasmina Ykelenstam:  Which is very upsetting.

Dr. Justin Marchegiani:  Was that the one by Between Balance?

Yasmina Ykelenstam:  My—Twin Lab, exactly.

Dr. Justin Marchegiani:  Twin Labs, yes.

Yasmina Ykelenstam:  Yeah and it—it’s just out of stock, and people write to me every day about it. But sadly, it’s out of stock.

Dr. Justin Marchegiani:  Got it.

Yasmina Ykelenstam:  My usual preference is for a Whole Food supplement. So something like camu-camu.

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  But a lot of people are reactive because it’s a berry–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  And some of the berries are problematic for us. Acerola cherry Vitamin C.

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  Some people do well with and you know, I generally get a lot of vitamin C from my diet already but you know, if—if you’re traveling, if you eat something that, you know, didn’t agree with you, vitamin C can sometimes help.

Dr. Justin Marchegiani:  Got it. And then you mentioned I think in your story. I’m not sure if you said it today or if I saw it in one of your videos or blog post, you mentioned you lost over a third of your hair on your head. Is that—is that true?

Yasmina Ykelenstam:  Oh, that was—that was awful. That was so awful.

Dr. Justin Marchegiani:  I know, it does sound terrible. I see lots of patients that have that though and I’m just curious, just on a personal note, do you see a connection between hypothyroid? Because hair loss is a common hypothyroid symptom. Do you see the connection with thyroid issues and histamine issues, too?

Yasmina Ykelenstam:  For a lot of people that is the case.

Dr. Justin Marchegiani:  Yeah.

Yasmina Ykelenstam:  And I, you know, I would encourage people to make sure they have enough iodine in their diet–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Or iodine-containing foods–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Which is a huge problem nowadays.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  But that in my case, my thyroid was although I was at one point told I might be hypothyroid.

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  I mean, I was still well within range and I was prescribed the—the thyroxine which–

Dr. Justin Marchegiani:  Yup.

Yasmina Ykelenstam:  Made me feel awful.

Dr. Justin Marchegiani:  Synthroid.

Yasmina Ykelenstam:  For a month. Yeah, exactly. And I came off it. For most people-not for most people. For people dealing with mast cell activation or histamine issues, it is very likely that it is either a thyroid issue because we’re already dealing with an—with an immune system breakdown.

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  Or just general, you know, body breakdown. But also it’s important to bear in mind that one of the most common side effects of inflammation is hair loss, and generally and you can pin it down to interleukins and prostaglandins. And if there is an excess of either of those, then it’s likely that they are contributing to hair loss. So it’s something that should be looked at also. I don’t feel that people who are within the normal range for their thyroid technically what’s considered technically than normal range–

Dr. Justin Marchegiani:  Right.

Yasmina Ykelenstam:  That the first approach should be to prescribe thyroid, you know, the—the Armour or whatever.

Dr. Justin Marchegiani:  Yeah, Synthroid, right.

Yasmina Ykelenstam:  To people just on the basis of hair loss, I think that further testing for inflammatory molecules should be done and that’s as I said, the interleukins and the prostaglandins, and this is something for people out there who do decide to pursue testing of—of their mast cells for example, it’s important to have a physician who will run a full panel–

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  Rather than just one or two.

Dr. Justin Marchegiani:  Yes.

Yasmina Ykelenstam:  And you know, as you know, there’s many different tests. There’s the 24-hour and methyl-histamine test which is urine test which is a test for metabolite of histamine which is much more accurate than the histamine plasma test, but there are others and most doctors will only do one. But the thing is you can test negative for excess histamine in your urine. But if you have a high prostaglandin level, or interleukins, heparin–

Dr. Justin Marchegiani:  Uh-hmm.

Yasmina Ykelenstam:  Or whatever, than can intensity the effects of histamine in the body by up to according to one medical study, up to a thousand times.

Dr. Justin Marchegiani:  Ah, okay. So that’s big.

Yasmina Ykelenstam:  So if one of–

Dr. Justin Marchegiani:  Because prostaglandins, go ahead, yup.

Yasmina Ykelenstam:  Yeah, so—so exactly. So one of your—if one of your levels is off or two of your levels are slightly off, this all compounds and can indicate that you have massive inflammation because they build on each other and they cause the bucket to spill over. Sorry, go ahead.

Dr. Justin Marchegiani:  No, that was perfect because the prostaglandin E2, the one you mentioned and eicosanoid 2, that’s really—goes high in inflammation. So kinda everything I think you’re really driving the point home on is it all comes back to inflammation. The more inflamed you are, the more that histamine’s gonna have a, you know, a more virulent effect in your body. Is that correct?

Yasmina Ykelenstam:  Absolutely.

Dr. Justin Marchegiani:  Great, awesome. Yasmina Ykelenstam:  It’s so nice to be interviewed by a doctor.

Dr. Justin Marchegiani:  Well, thanks. You’ve really brought some awesome knowledge bombs today. I mean, seriously you got all the research going. You got a lot of experience with different people that are writing to you. I mean, I have a lot of my patients that are very familiar with your work and I use a lot of your blogs as references clinically. So I appreciate all the great work that you’re doing, too, and getting the word out there.

Yasmina Ykelenstam:  Thank you for having me. It’s been an absolute pleasure being interviewed by somebody who knows the subject so well and has helped so many people. You asked all wonderful questions and I’m really excited to get the information out there.

Dr. Justin Marchegiani:  Thank you so much. Her name is Yasmina Ykelenstam. You can find her at thelowhistaminechef.com. Subscribe to the Facebook there and also she’s got some really good cookbooks, as she mentioned there are 25-page eBook all on histamine on her site, so go over there, check it out, lots of good recipes. Last question, Yasmina, you’re stuck on a desert island. You only can bring one supplement. What do you bring?

Yasmina Ykelenstam:  That would be quercetin. That would be the Dr Theoharides NeuroProtek, which is quercetin and luteolin.

Dr. Justin Marchegiani:  Love it. Alright, everyone go out there and get that. Well, thank you so much, Yasmina. We will post this up and feel free and share it with your peeps at your site, too, to help get this information out there. Thanks so much.

Yasmina Ykelenstam:  Wonderful, thank you.

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