The Root Cause of Histamine and Mast Cell Symptoms | Podcast #267

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Today’s focus is all on the root cause of histamine issues and mast cell symptoms. Find out more about its root cause, how we prevent it, and how we give solutions to it. Check out this podcast with Evan Brand!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

01:44 MCAS

06:36 Histamine on leftovers

11:18 Food Categories

15:50 Histamine vs. Food Allergies

27:32 Histamine Drugs

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Dr. Justin Marchegiani: And we are live. It's Dr. J here in the house. Evan, how are we doing today my man? 

Evan Brand: I'm doing really good. What's going on in your world?

Dr. Justin Marchegiani: Not too much, man. All is well excited to connect with some patients here today. I know we chatted kind of in the pre interview that we were going to focus on mast cell and histamine issues. So really excited to dive in on that topic today, man, what do you think?

Evan Brand: Yeah, this is getting more common, and I think it's due to more toxicity. I'm actually interviewing a lady named Beth today about mast cell issues which can happen usually due to some sort of toxin. So it's not that your mast cells part of your immune system, it's not that that just magically starts reacting to everything like foods and fragrances and chemicals. There's usually a trigger, so lime is a big trigger co infections like bartonella, or big trigger.

Dr. Justin Marchegiani: Correct.

Evan Brand:  You've got various pesticides and herbicides, just any toxin can basically damage this, we'll just call it a recognition system that the immune system has. And now you get to a point where your diet becomes an issue. And every time you eat you feel bad. And, you know, we've had so many clients and patients that begin to get fearful about food, and they're down to six or 10 or 12 different foods that they can eat because everything else causes them a worsening of symptoms. So we're going to kind of dive in today about what are the the safer, lower histamine things and what are even some of the foods that may help to reduce the histamines to where you can start to gradually go back to a normal diet not be so restrictive.

Dr. Justin Marchegiani: Exactly. Now, we have kind of the pathological form of histamine issues, which is MCAS- mass cell activation syndrome, and that's where you're going to have a lot more severe issues and our sensitivities in regards to hit To me, that could be headaches. That could be skin issues like the uterus area hives wheels on the skin. It could be brain fog is a big one, of course mood and energy issues. So there's a laundry list of different things. Now, the key thing it's gonna histamine issues is increased inflammation in the body in particularly the gut. And you mentioned earlier toxins can have a big one. So I know in your situation, mold exposure really increased your level of histamine symptoms. So of course mold could be a big one exogenous mold from water leak in the environment. Also endogenous toxins like lipopolysaccharides or endotoxins from bacterial infections, and or a parasitic infection. biotoxins or fungal mycotoxins from endogenous fungus in the body. That can also be a big one too. So a lot of people get myopically focused on the things you have to do to fix it, what foods to cut out all of that, which we'll talk about in a minute. But we also have to look deeper within and say, why is this now an issue where in the past, it wasn't? What stressors in my stress bucket accumulated over the last bit of time to allow me to get to this point where now I'm so sensitive. 

Evan Brand: Exactly. And the issue with the nutrition people, and you know, we talk about nutrition all the time, but the people who brand themselves as just straight nutrition, is they'll put people on these restrictive diets, and then that's it. And then here you are six months to a year later down the road. You haven't added any new foods back in or if you did, you had reactions. So then your nutritionist advise you to just pull those foods back out, oh, you can't do butter, pull it back out, oh, you can't do rice up, pull it back out. And then it's like, Okay, then what? So then you get stuck. And that's where we are now we're in that stuck phase. And now let's talk about Okay, what are you doing? What are the band aids to calm the system down from a diet perspective, while working on these root causes? 

Dr. Justin Marchegiani: Yeah, and the foods may be an issue longer term right. There may be inflammatory component to the food, there may be an allergenic immune component to the food outside of just the histamine content, we don't know. But we kind of have a baseline way of making the food, the least amount of inflammatory, you know, making sure that food provides the least amount of inflammation on your body onto your stress bucket, so to speak, so you can adapt to it. And then also the foods providing you a lot of nutritional density as well, because we need nutrients to run our system, while at the same time we need to decrease the effect of inflammation that food will have. So it's kind of a balancing act, right? And we have to look within look deeper to make sure the root causes of that inflammation or to look at kind of our timeline history of how we got to this point, make sure the root cause is fully addressed. So if it's an emotional stress issue, they compromised our gut and our immune and our adrenal and our hormones and then we got exposed to an infection. And then now our digestion stinks. We have to cut all these foods out we have to make sure that we get that underlying stress handling system back up and running. We have to make sure that we address the infection and the immune response in the gut and then potentially down the road get some of these foods added back in doing a you know, elimination reintroduction diet and making sure we fix all the six hours right? So my six hours that everyone hears, like a broken record are going to be removing the bad foods with histamine that could be histamines, it could be autoimmune it could be low fodmaps it could be how we prepare and cook the foods to that's going to be dialed in per patient second hours and be replacing enzymes acid and or bile salts. Remember healthy food not digested properly is a stressor on the body. Third R is going to be repairing the gut lining and repairing the hormones. So we can deal with inflammation and stress and ever better immune response. fourth hour will be removing the infections and this is where parasites or H Pylori or it could be mold like the environment like an Evan situation mold could be an issue right? parasites, fungus h pylori, SIBO SIFO all those things can be an issue number five is repopulate repopulate good bacteria and this typically has to happen at Afterwards, some people do well adding in probiotics before things it can help with inflammation or, or digestion and motility. Some people feel worse, meaning their probiotic intolerant, the more worse you feel. Typically it means the more your gut has lots of bad bacterial issues. And it's like trying to throw a whole bunch of seeds into a garden full of weeds, or it's like throwing a whole bunch of wax on a dirty car, there's an order of operations. And when things are so bad, where the weeds are so bad, you just can't throw seeds in the garden. They're just going to be swallowed up by the weeds. And then the six hours retesting to ensure you've knocked out what your main focus was to begin with.

Evan Brand: Yep, well said. Let's get into the meat. So this is something interesting. You know, I had heard talks about histamine and leftovers and I was like, Oh, really come on, like leftover meat. histamine isn't really a big deal. But I started to notice especially if I was doing coconut aminos or something else that was fermented or higher in histamine and I would eat those leftover meats. I would notice some, some changes. In symptoms, whether it was something with like my daughter, she was kind of the canary, her skin would flare up a little bit, she'd get a rash on her cheeks. So we just stopped doing leftover meats. And now I only cook the meat fresh. And that alone, just ditching leftovers and only cooking meat fresh has been huge. Now there's also talk about buying frozen meat versus fresh meat. And that fresh meat that is at a refrigerator temperature is going to build histamine greater than frozen. So I've done this experiment of having this very interesting. Taking bacon, that's uncured you know, cured meats are always a no no on a histamine, anybody's histamine issue. They're going to know you got to stay away from cured meats. So we obviously do the uncured bacon but here's something interesting is we would take the bacon that was in the fridge, leave it in the fridge for a couple of days and then cook it and eat it. And then my daughter would get a rash versus if I took the bacon brought it home, frozen immediately did a quick thought on it, just run it under some water cook it immediately so frozen to table Basically, there was no rash at all. So I can't say with 100% confidence, but I'm pretty sure that was the secret is even if you can't buy your bacon frozen if you buy it refrigerated you then freeze it. To me, I think that is knocking down some of the histamine content.

Dr. Justin Marchegiani: Interesting. And again, people listening to this, if you're don't have a histamine issue, it may not be necessary. So don't freak out go to these extremes, I do think you should try to consume your meat within three to four days. So I'll try to I use the Instacart app or the Prime Now app and I'll go to Whole Foods and I'll have stuff ordered and dropped off twice a week to keep it fresher, you know, so if that's an option for you utilize it. If not, try not to buy all your meat I try to if I do a steak, I'm gonna buy my steak that day and do it fresh. I just feel like the taste and the flavor is just so much better. And I hate looking at steak that's oxidized where it's kind of loses that heem bright red color and it looks like brownish and dark and pale. I hate that. So I do my steaks fresher.

Evan Brand: I just want to restate your disclaimer because this is a special conversation this, this conversation does not apply to know a lot of people. So please don't become even more anal with your diet. This is for people that are struggling and having food reactions.

Dr. Justin Marchegiani: It's already pretty stressful. So what I tell patients who are, let's say, if you're in this category, you keep doing what you're doing, you know, have a good paleo template or customize it accordingly. Don't worry about it. take it with a grain of salt. Now, if you're very histamines sensitive, we talked about cooking methods. Well guess what a crock pot you know, the slower cooking is known to accumulate histamines, you have to be careful with that. So what's the solution there? Well, what I found the tends to be helpful is faster cook meals accumulate less histamine. So what's a great way to have the crock pot of vibe of a super stew and have all that broth is using Insta pot, it cooks it a lot faster. It's a pressure cook because the meals cooked within 30 minutes to an hour. It's an accumulated less histamine and it's also going to be broken down very well so it's gonna be easier on your tummy. So I would tell patients is just go out, get that cut of meat that you're going to have for the day throw it in the crock pot put your vegetables or your safe starch in there, add some water make it a you know a soup, a soup or a stew, right little more water becomes a little less becomes a stew and it's going to be pre digested and that's what you eat for the whole day and then every day you just do a new one. And because crockpots or because of Insta pots are so easy, which is basically a crockpot hybrid pressure cooker cooks at fast, you throw all your food and you're done for the day. So people complaining about all it takes so long, no, get your protein source, throw it in. If you need some carbs, cut up some carrots or squash or sweet potatoes, if you can tolerate it, peel them, get a couple of vegetables, you can always do some onions, or or celery or carrots, throw it in there done. That's it. That's what you have for the day. And then you can rotate your proteins each day. So you can do beef, one day, lamb one day, chicken one day pork one day and just kind of have a rotation opponent to at least the meats. That way you have different proteins coming into less chance of a food allergen.

Evan Brand: Yep. Do you want to go into specific foods now like do you want to talk about? I think it's important to mention some of the fruits. Like we've got some comparisons of like lower histamine versus higher histamine fruit. So something that I actually reacted to-

Dr. Justin Marchegiani: Just just to kind of highlight one thing, I think it's important to put foods in categories. So when we look at histamines, there are foods that are high in histamines, okay. Then there are foods that stimulate histamine release in the body when they may not have a lot of histamine in it, but and they stimulate internal release. And then there are foods that block the enzyme to metabolize histamine and there's kind of an overlap. So the enzyme to metabolize histamine is DAO- diamine oxidase. And so there are some foods that will block that and then there are also the histamine releasing foods. And then foods that are just naturally high in histamines. We can go over those three categories. People can wrap their heads around that.

Evan Brand: Yeah, so citrus was big and I didn't realize that avocado would be technically in the, in the, the fruit category. It's always like this debate of fruit vegetable, okay. Anyway, avocado caused me migraine headaches. And it took me a long time to figure this out because I would have certain meet certain veggies and all the sudden would throw a little slice of avocado on there and I'd get a headache and avocado is one of the highest in terms of fruits, it is one of the highest histamine and now I think it contains high histamine. I'm not sure if that's one that it contributes or messes with the enzyme. I don't know what all I know is that it's a common issue because so many people do avocado now they throw it in smoothies that throw it on top of your support labels and so I think avocado is becoming abused and paleo world which is okay, but for me it was an issue and I had to pull it out for about six weeks reintroduced and then I was fine.

Dr. Justin Marchegiani: Exactly. So I'll attach my link that I've made looking at a couple of histamine articles and kind of making a companion But you have your foods that are high in histamines which you already mentioned avocados are on that list so are a lot of your cured and lunch meats. So are a lot of your fermented foods right sour cream, sour milk, buttermilk, sourdough bread, you know, kimchi, sauerkraut, those kind of things, your fermented drinks, so that could be alcohol, champagne beer, kombucha would be on there too. A lot of your citrus fruits, ah, cheese, your knots would be on there. The big veggies that are going to be on they're going to be avocados, eggplants, spinach and tomatoes. smoked fish would be on there any of your turkeys Who's that are more preserved. So those are going to be your foods that are really high in histamine and then your histamine releasing foods are going to be alcohol will stimulate histamine release. And if you notice a lot of people that have Asian descent, it tend to get very red or flushed after alcohol and they take Pepcid AC, which is like an h2 blocker, histamine blocker to help prevent that. So people with Asian descent tend to have sensitivity with the histamine release from alcohol. Bed bananas and chocolate and cow's milk and then nuts as well which is a remember there's an overlap so some of these foods that are high in histamine can also stimulate histamine release, pineapple, your shellfish, strawberries, tomatoes, wheat germ. And then your enzyme blocking foods, your da o blocking foods are going to be alcohol, any of your energy drinks, your teas, your latte tea, your black tea, your green tea, so anything that's going to be more stimulating, or caffeine based drink is going to stimulate more of the DAO blocking so you won't be able to metabolize that histamine in your body as efficiently.

Evan Brand: Here's the interesting thing with nuts, is depending on I mean, there's several different lists down there. Some lists are better than others, but one list that I have on on nuts, I tested it, and it was said that walnuts cashews were higher histamine and then almonds were considered lower histamine, but cons pistachios, pumpkin seeds macadamias these were all considered lower. So I tested it. And I noticed I was getting a headache if I did too many walnuts, so I do believe that some nuts could be okay. Like if I do almonds or almond butter, I'm fine. I have no issues at all. Whereas walnuts, even though I love them too many can be an issue. So I don't think all nuts are off the table. I think if we just pay attention to the big ones like, according to this list, I'm looking at walnuts and cashews were the biggest I've tested those and I could confirm, I did react to those the most. And it's mainly the problem is and this is why it's so hard to do a podcast like this because it's so dependent on the person. The dose that affects me may not affect you. And there may be a person listening where a small dose of a walnut one walnut could be enough to trigger somebody, whereas for you it may be a couple of walnuts before you have any issue.

Dr. Justin Marchegiani: Yeah, yeah, absolutely. But also a lot of people may be confusing histamine, which is generalized food allergen issues right. And it may not be necessarily a histamine issue. It could be There's a food allergen issue. And so how would you know it's histamine versus food allergy? Well, you're going to see those typical histamine symptoms with like any of the hives, you know, it's going to be histamine, right? If you notice, like headaches or brain fog right after a meal, that's tough because those symptoms correlate with food allergies, in general, how you would know is you just see a correlation with fermented foods or you see a correlation with citrus foods, or just those higher histamine foods. That'd be how we know because coming off the bat, when I'm working with patients, we're cutting out autoimmune foods A lot of times, and maybe lower fodmap foods depending on their gut health. And then from there, if we start seeing a correlation with histamine symptoms, especially the ones I mentioned, and or histamine foods, then that's how I'm going to know but off the bat, like we talked about before is lectins. And irritants in the food could easily be driving history. or other types of immune issues that don't involve histamine. So histamine, it's a neurotransmitter Actually, it's it's made from histidine. And it's being produced by the mast cells. And mass cells are a basal phills. Once they go outside of the blood into your tissues, they become mass cells. And so these immune responses stimulate histamine release. The problem is because it's an immune cell releasing that you can still have allergy to food. Let's say you have some gluten, right? And you can have an immune response that could create other T cell or antibodies as well as a mass cell release of histamine. So you can have a couple of things happening at the same time. And it's not going to be a linear Oh, this food causes only histamine, you may have an immune response that hits a couple of different cascades, histamine, various antibodies, T cell response, right. So there could be lots of different things happening. So it's really hard to say oh, this is Just histamine, this is just a food allergen, it's really hard. So you need a trained person that's kind of looking at it and trying to make, you know, use deductive reasoning to figure out what the issue is as well. 

Evan Brand: Very good point, because that's the hard part is then people try to make this black and white and kind of robotic in the sense that they'll say, Oh, we do think this is a histamine reaction. So you can either go to a lower histamine, vegetable or fruit. And then you can take some supplemental Diego, but that might not be the answer. You're saying because it could be a food allergy reaction. And it doesn't matter if you take things to lower or help digest histamine, better, the food allergy reactions still causing the symptom. Although the histamine component of that reaction may have been tuned down.

Dr. Justin Marchegiani: Yes, it's kind of like this to like, some people have a lot of SIBO small intestinal bacterial overgrowth, and that causes them to be very probiotic sensitive. So when they have probiotics, or even fermented foods, they have a reaction, but now they're like, wait a minute, but probiotics and fermented foods are on that histamine list. So is That a histamine issue or is it a SIBO issue? And it could be both it could be the SIBO is driving the histamine. So, we have to figure out what foods allow you to feel the strongest, right like if Superman or Superwoman is weaker when it gets when they get exposed to kryptonite. What's your kryptonite when it comes to your food. So that's going to allow us to heal faster if we can find out what our kryptonite is. But we have to be focused on the root cause is the root cause histamine are the root cause SIBO causing a secondary histamine issue. So there's primary and then there's secondary, and even tertiary things that we may be addressing. So it's important if something's tertiary, we're not going to treat it the same way is if it's the primary issue, so it's good to line those things up in your head. So you can prioritize things accordingly. And a lot of people they confuse the secondary and tertiary issue as the primary issue. So they get some results because they kind of, you know, broken clocks, right twice a day. So they eventually hit it, but they miss the root issue.

Evan Brand: Yeah. How many times do you think that's happening? I mean, make up a percentage, like how many times do we We think people are going down this histamine rabbit hole thinking its primary, but it's not?

Dr. Justin Marchegiani: Frequently so I mean, if you're like the big foods are going to be like, people feel worse with avocados, right? Well, that's a really good kind of Paleo Food. All right, that's interesting, or citrus, fruit, those kind of things. I'm like, All right, let's, or if I'm really having like some tea and I'm really having, okay, so kind of like these foods that like the Paleo community or the natural health community think like, they should be relatively healthy, healthy foods, and you kind of have an issue, that's a good sign as a histamine overlap. And it's never like we're going down one track, like, oh, we're down the histamine track. We're down the auto autoimmune track, we're kind of doing a hybrid of different tracks at the same time. And it that's hard for people to wrap their heads around, and they get very overwhelmed. And when people start heading down a track, they're like, I'm heading down here for life. And it's not like a season for a reason. Right? There's it's kind of like the mindset is, this is forever and that's it's important. To work with someone that can get your mindset, right, because that mindset sabotage is people. Because forever is a long time. And they're like, I rather just be sick, whatever. So you have to have the right mindset when you're going down a path. So you understand what that timetable is and what the progression is to open new foods up.

Evan Brand: Yeah, for me, I could have thought avocado was the primary bad guy, you know, that was what was causing me the headaches, it almost felt like a migraine, it was just this head pressure. But that was at the same time that I had gut issues. And so I was working on my gut, I was using antifungal antimicrobial herbs. And by the time I was done with the six or eight week protocol for the gut, and I added avocado back in I was perfectly fine. So you made a great point, which is that if you're able to tolerate these things before, which I was, and then all the sudden I couldn't, what changed, and I had extra gut symptoms. I had extra skin symptoms, extra mood symptoms, so it was kind of this. I guess using the histamine template or the lower histamine approach was The the band aid or maybe like the neutral in the gears, it's kind of like, okay, we're not going to be sticking with this die forever. But let's try to get it into a state, you know, a stable place to where we can work on other things. Peel back the gut layer through the stuff back in, I was fine.

Dr. Justin Marchegiani: 100% and I tell my patients all the time, you have the right to have more than one issue going on at the same time. So if you think you have a histamine issue, you're probably have a bunch of other issues happening at the same time. But just remember that more than one thing happens. It's like you know that like one of those Venn diagrams, it's like a circle and the other circle overlaps. There's another circle that overlaps, and then there's the three circles in the middle that have an overlapping feature for everything. It's kind of like that. We have that Venn diagram effect. With histamine. I think that's important. It's an easy kind of illustration that allows people to wrap their heads around what's going on. Now, what else can we do to see if histamines an issue? Well, let's look at some natural de granulating, histamine supplements. So B vitamins B6 is a really important B vitamin for brain health. It also can help with histamine. Things like stinging nettle, right? sip, sip on some stinging nettle tea, how do you feel? Let's maybe add in some broma lean, right or some extra potassium. Let's maybe add in some and acetylcysteine and I have a product called allerclear that has a lot of those things in it, which works great. put a link below. higher dose vitamin C can be helpful. We may even do just a really good kidney glandular kidney tissue has the enzyme da o in it, and that enzyme breaks down histamine. So let's maybe throw in a couple of natural histamine granules, maybe one supplement, maybe we'll get some kidney tissue, throw it in, does that help that make you feel better? Let's get some steam that'll t How do you feel? If that starts to make you feel a little better than histamine could be part of the puzzle. We just have to make sure we segregate in our brain, palliative relief and root cause solution. Right. And a lot of times some doctors are root cause solution. The problem is there's no palliative release so the patient kind of suffers so we kind of want to Do a hybrid of the two. So we feel better faster. That keeps our faith in the practitioner and in the process high. We feel better we perform better while we get to the root cause and we kind of have to have that approach. Or we're just on this journey of suffering, suffering, suffering, hoping one day will heal.

Evan Brand: Yep, very, very well said and how you're implementing these is typically before the meal so like you're mentioning the stinging nettle tea or the kidney glandular, it's going to be best. What would you say maybe half an hour before you're going to eat these? Potentially, let's say avocado, you're going to sit down, have a meal of avocado, you may want to do your stinging nettle tea, your DAO, your-

Dr. Justin Marchegiani: You could try it before I mean, the food is going to interact with all the the histamines and happened when the food goes in your body. So as long as it's in the same time, I think that's going to be fine. But I would experiment doing it ahead of time. So you have that kind of already gone. Yeah.

Evan Brand: Yeah. And and then regarding the there's always this question, I want to get your thoughts the argument of potential down regulation like if you're doing the Diego supplement you have any issue or any concern with people doing these Diego supplements around the meals every time they got a pop this pop that pop these capsules and then all of a sudden they want to try to get off of it. Have you seen any issue or any need to like wean off of those.

Dr. Justin Marchegiani: It just depends, right? As long as you're getting to the root cause there's more than likely not going to be a problem. So with enzymes or any digestive support, I just don't see that being a problem with disrupting the feedback loop. It's a positive feedback loop. It's not a negative feedback loop, right negative feedback loop is you shoot up some testosterone, your testicles shrink, that's a negative feedback loop, right? more testosterone comes into your system and Hibbing goes back to the brain. More inhibited means less Lh less Lh means less testosterone, therefore the gland shrinks. That's like a negative feedback loop. A positive feedback loop is, you know, hey more enzymes, more acid. Oh, that actually stimulates more gastrin and more stimulation for more production of That. So it's a positive feedback loop. Typically, you're not going to have atrophy per se. But more importantly, think of it as like a crutch. It's just taking pressure off your systems so that you can heal. So you wouldn't be like, well, I'm gonna get dependent upon this crutch. I'm gonna just walk around on my broken ankle Well, no, because you won't heal. So of course, at some point we can try cutting off is we feel better as we know we're infection free, we can start coming off some of the digestive support, maybe find our healthier meals are cleaner meals when we're eating, and it's very stress free. Let's just try maybe one meal a day without that. And then we can just kind of go from there and see how we do and gently come off. I think that's a good way to approach it.

Evan Brand: Yeah, good advice. And we've done podcast before on restoring acid and enzymes. And we've talked a lot about Dr. Jonathan Wright's book on HCl and how you make it less HCl as you age. And as you add more to the fire, you're not subtracting from the original fire, you're just building more logs onto your little fire. So I'm just wanted to cover that again, because I know people have that in their head if they're on the supplements now. They're always saying well how do I get off? How do I get off? And I think the answer is you will assuming that you're fixing everything that led to this dysfunction in the first place unless you're like 80 years old and that case maybe you do need some supplemental you know Diego or enzymes you know because you're just making hardly anything at that age and you really want to get back to eating your orange or whatever maybe you can't do it if your age at I mean we do have some clients that are that are that are you know up there in age and we often just give them a small dose of acid and enzymes just for good health insurance.

Dr. Justin Marchegiani: And there's a lot of histamine drugs that are out there. I'm I may mess them up but you can go to to confirm, but you have like your Xur Take Pepcid AC is one that works on histamine as well. You're going to have some of your allergy ones are a lot of times are going to be histamine based. I think Singulair, maybe a corticosteroid one usually your allergies come in two categories, right? It's either going to be histamine, like a leg or I'm pretty sure and then you have your corticosteroid wants Think Singulair is a corticosteroid one. So it's going to be either a histamine or corticosteroid. And so people that are really histamine sensitive and they do better cutting the histamine down or they feel better with a histamine drug and it helps those allergy symptoms that's good. But now let's try working on the diet also clean air if you have mold or environmental stuff that's stimulating histamine get your air clean you know we have will use the air doctor or the Austin air or some of the advanced air filters we'll put links down below Evan has some links as well. So if you guys want to get a good air filter air can be a big stimulator of histamine if it's cedar like an Austin- See, there's a big deal, right, especially this time of year, that can be really helpful internally inside the house. And then we may throw in some of these natural histamine things as well. The side effects of the histamine drugs is they can make you groggy and tired. They may work a little bit with the symptoms of histamine but they can make you tired and fatigued on the backside. So you kind of just have to balance that out. If there's a natural solution. Obviously and or root cause solution that's always better to do first. 

Evan Brand: Yeah Benadryl's one too. 

Dr. Justin Marchegiani: Benadryl another one.

Evan Brand: Yeah. And those are those are now the drugs are negative feedback loops. We were kind of talking about this idea of negative and positive feedback loops. The drugs are they do have some sort of crutch effect where when you try to get off you do have an issue. I'm not sure the mechanism right away but I've looked at a few papers on like Benadryl for example. And some of these prescription anti histamines and what they do I believe they actually deplete DAO is what they're doing. I think that's the mechanism.

Dr. Justin Marchegiani: Yeah, it can absolutely. So your big ones are going to be Allegro like I said before, Claritin, like I said, you're going to have Zyrtec. So good. I was on I was on track. I know my medications enough because every time patients come in, I have to go look them up and look at the mechanism. But when you understand the mechanism, how a drug works, drugs typically work by blocking or inhibiting various enzymatic pathways. So drugs don't ever uplift or enhance physiology. Functional Medicine does the things that we do uplift Enhance physiology while we work on taking stressors off the system. So drugs don't do that they block and inhibit enzymatic pathway. So it's nice to know because if, hey, if this drug works over here, oh, what pathway? Oh, it's a beta blocker. Oh, okay. Well, you have blood pressure and anxiety issues. Well, beta blockers work by blocking the receptor on the heart say most the heartbeat but so does magnesium too. So maybe let's add some magnesium in and get your cortisol under control up magically, your blood pressure comes under control, right? So there's a lot of things we can look at. And we can trace back the drug trace back the mechanism of action, while we get to the root cause and use natural things to help with the symptoms positively.

Evan Brand: Yeah, well said. Yeah. When people come in with Alyssa drugs, it's a very good, I would say it's almost a good tour guide of the body, wouldn't you it can kind of lead you into I mean, obviously we're going to do a good clinical assessment workup to figure out what labs to use, but we can use like the anxiety example okay? She's having anxiety and heart palpitations. Okay, where's that, leading us to? or depression. Okay, why she haven't depression? You know, let's go look at the gut. So I think it's a good tour guide to see the list of drugs to correlate to the symptoms to then correlate to the body system and how those dysfunction.

Dr. Justin Marchegiani: Exactly. And what are the big cyst? What are the big side effects of anti histamine it's important to know dry mouth, drowsiness, dizziness, nausea, vomiting, kind of being restless or moody. difficulty urinating blurred vision and confusion. So if you are on histamines or need to be on histamines and you have the side effects, well, you really want to start looking at getting to the root cause because the medications may be causing more problems than not but you know, make sure you see your conventional doctor on that. Let them know kind of what you're doing. So you don't just jump off things fast. You want to be responsible and how we adjust our doses if we do.

Evan Brand: Yep, yep, well said- 

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

Evan Brand: Well, of course, you've got the risk of like severe severe, you know, and if lactic reactions obviously that's going to be an extremely small percentage of the population. But if you're somebody who has been on these drugs, you're working with a practitioner, you're trying to go from conventional drugs to natural remedies and such, you still may need to have if you've had a history of issues like this before, you know the tongue swelling, throat closing, you may need to have your epi pen on hand or possibly a junior epi pin on hand, if you've got kids that have these type of issues you're trying to resolve because you don't want to try to be a tough guy, oh, I'm getting off the drugs, I'm going natural, and then something bad happens. So obviously we're talking like 0.1% of the population, but it just needs to be said.

Dr. Justin Marchegiani: 100%. And just anyone listening here, just try to in your mind have two tracks, right? What's root cause? What's palliative right? If you have those, your set? And then also what can I do to create a better environment if histamines may be an environmental issue, like I gave you with the analogy with an Austin and with the cedar, keep that in the back of your head right or an Evan situation with mold in your home. Keep that in the back of your head. So we kind of have to have an algorithm where we look at you know, the environmental things outside of our body to to make sure those are stressor. 

Evan Brand: Yeah, it gets it gets left to the wayside. Often people often bring the the exterior of your home, your air quality like these are the missing pieces of the puzzle. Maybe an allergist, would pick up, pick up on that. But allergist are so myopic with their focus that they often miss all these other pieces that we're looking at gut.

Dr. Justin Marchegiani: Yeah exactly. But then they're also practitioners that are out there. And it gets scary with patients that don't know what to look for, where someone comes out, and they're just like, they're a certain mold practitioner, I won't say who their certain kind of mold practitioner and then they're all about mold, and they're only focused on mold. And then they don't know how to remediate their mold right in their home. And then they want to spend $100,000 and getting the more media and then they're doing all these protocols to get the mold under control where there may be some foodstuff there may be some gut stuff. So you can't just be myopically focused on one thing. So if someone's only focused on one track, and they you're working with them, that should be a warning sign unless they thoroughly ruled out other tracks. are already supporting those tracks. If someone gets myopically focused on one thing and ignores lots of other things and can't give you a good rationale why that's a warning sign everyone listening.

Evan Brand: Yeah. And it's very sexy, right from a book perspective, a podcast, a website perspective, a branding perspective to label yourself as the blank guy or the blank girl in terms of your quote, specialty. But those specialties have led to many, many hundreds of thousands of dollars and failed protocols. And then we have to be the cleanup crew because we kind of market ourselves as functional medicine, but that is, that is general, but yet we dive into the specifics and you have to be able to zoom and zoom out. You can't just zoom in because you'll miss some really low hanging stuff that gets people better.

Dr. Justin Marchegiani: I've seen a couple of practitioners out there, I won't name who the person is, but this person markets themselves as a gut person. All they do is gut gut, gut gut and I've seen a lot of their patients. And guess what that person has A thyroid issue or an anemia issue or a hormone issue, and they were just totally ignored. So it's okay to market to a specialty. As long as when you're addressing that issue, you're still looking at other systems. So just be careful with someone marketing one thing. But then when they go to treat that, they're only treating that one thing, make sure they're if they're marketing something, and they're treating that make sure they're also assessing everything around it, because that can be a warning sign. So keep that in the back of your head. And then also, one thing because it's very daunting, when you find out you have mold in your home, it's like an absolute punch in the gut. So if you think you have mold, or you're not sure about how to address mold, take a look at my podcast with JW and Jeff Bookout will put links down below. They've done some great I've done a two podcasts with them. They really talk about how to remediate, test, assess and treat mold in your home in a very, very cost effective way. It's not going to, you know, be as stressful as the conventional ways years ago that were just really daunting at 100,000 dollars or $50,000 to get your home fixed?

Evan Brand: Yeah, we'll save it for another day. But just quickly, I before I became friends with Jeff and JW got to interview them, I had spent $10,000 out of my pocket on an enzyme based solution. And guess what, it didn't work nearly as well as the solution that costs like 1000 bucks. So I spent 10 times more and got less benefits. So yeah-

Dr. Justin Marchegiani: Probably better than the conventional [inaudible] or some of the more toxic stuff. All the better than that, though, at least.

Evan Brand: Yeah, it was. It was from a toxicity perspective. It felt fresh, it felt clean. It was kind of a clove, clove and enzyme type blend. But still, I mean, it was 10 grand and then and then the petri dishes still showed as an issue and more colonies were growing then then what was safe. So yeah, I mean, we could go on and on a rant about that, but let's wrap it up. So if you do want to reach out clinically, we would love to help you. We love the opportunity. We love serving I mean, this is just our passion and our calling, you can reach out to Dr. J, Dr. Justin that is at My website is And we have the ability to schedule intro calls as well. So 15, 20 minutes you can chat about your symptoms and goals and see if you're a good fit for care. You know, let us let us listen to some of the things you've already tried. What have you done this work? What have you done the hasn't worked, what practitioners have led you down good paths, bad paths, we want to hear about it. So don't hesitate to reach out and we'll be back soon.

Dr. Justin Marchegiani: Thank you, Evan. Appreciate it. anyone listening to this content and enjoying it giving give us a share Sharing is caring thumbs up. Make sure you subscribe as well for that YouTube algorithm and appreciate you guys joining in. Everyone. Have a phenomenal day. We'll be in touch.

Evan Brand: Take care. 

Dr. Justin Marchegiani: Take care of Bye now. 

Evan Brand: Bye bye.


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