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:
11:15 Testing histamine
19:00 Histamine symptoms
32:03 Histamine categories
36:33 Histamine offenders
43:20 Summary and recommendations
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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