Episode 348: The Link Between Histamine, Gut Health, and Immune System Dysregulation
Listen on Apple Podcasts | Listen on Spotify
Autoimmune conditions are on the rise, and more people are turning to functional medicine for answers. One emerging factor in immune dysregulation is histamine intolerance, which can manifest in a range of symptoms from digestive issues to chronic inflammation.
In this episode, we break down the connection between histamine, gut health, detoxification, and immune response. We also explore the impact of chronic stress, mold exposure, and complex treatment reactions—plus, a new training opportunity for practitioners looking to deepen their expertise.
In this episode:
Systems Biology & Histamines Overview [05:37]
Histamines and Immune Response [06:24]
Constipation and Detoxification Factors [12:48]
Navigating Root Cause Analysis Paths [17:59]
Chronic Stress Despite Resolution [20:28]
Addressing Challenges in Diagnosing Histamine Intolerance [23:45]
Reactions to Complex Treatment Protocols [27:02]
Beyond the Gut: Histamine Solutions [31:5]
Living with Mold: Challenges & Realities [37:10]
Coffee Enemas: Advanced Health Strategies [41:48]
Short-Term Low Histamine Diet Tip [44:06]
Resources mentioned:
Funk’tional Nutrition Academy™ (Next cohort starts in April of 2025)
Organifi supplement powder (save 20% on your order with code FUNK)
LMNT Electrolyte Replenishing powder (Use code FUNK get a free sample pack with any purchase!)
Qualia Senolytic (get up to 50% off and an extra 15% off your first purchase with link + code FUNKS)
Bon Charge (Use code FUNK to save 15%)
Kion Aminos (Get 20% off monthly orders and 10% off one time orders)
-
Erin Holt [00:00:02]:
I'm Erin Holt and this is the Functional Nutrition Podcast where we lean into intuitive functional medicine. We look at how diet, our environment, our emotions and our beliefs all affect our physical health. This podcast is your full bodied, well rounded resource. I've got over a decade of clinical experience and because of that, I've got a major bone to pick with diet, culture and the conventional healthcare model. They're both failing so many of us. But functional medicine isn't the fantasy that it's made out to be either. We've got some work to do, and that's why creating a new model is my life's work. I believe in the ripple effect, so I founded the Functional Nutrition Academy, a school in mentorship for practitioners who want to do the same.
Erin Holt [00:00:45]:
This show is for you. If you're looking for new ways of thinking about your health and you're ready to be an active participant in your own healing. Please keep in mind this podcast is created for educational purposes only and should never be used as a replacement for medical diagnosis or treatment. I would love for you to follow the show, rate, review and share because you never know whose life you might change and of course, keep coming back for more.
Erin Holt [00:01:11]:
Okay, so something that we're seeing a big uptick in clinically is histamine issues. So we're going to chat about what that looks like. How if you're a listener struggling with some of these symptoms, how you might know that you have histamine issues. And if you're a practitioner listening, kind of how we navigate this in practice. So, Rachel, when a client comes to you, at what point do you start thinking it might be a histamine issue? Like, what are they presenting with?
Rachel Mistry [00:01:40]:
So the classic symptoms are allergies, right? Runny nose, scratchy throat, watery eyes, maybe eczema and hives. Some of the less common symptoms that we can see are things like a really sensitive bladder, feeling like they have to pee all the time, or maybe irritation around the bladder. Diarrhea, nausea, acid reflux are some of those digestive symptoms that we can sometimes see. Honestly, a lot of our clients come to us with digestive issues, so I'm not always thinking histamine. And then insomnia is a less common symptom we can see associated with histamine issues. Just because histamines, they can stimulate the brain and then hormonal issues can also be really, really common. Like cyclical headaches, migraines, PMS symptoms, PMDD, estrogen dominance can all be associated with histamine issues. And this is because there's this chicken or the egg scenario that goes on with estrogen and histamines.
Rachel Mistry [00:02:36]:
Estrogen stimulates our mast cells to release histamines, and then histamines stimulate our ovaries to make more estrogen.
Erin Holt [00:02:44]:
So we've been talking about hormones on the podcast a lot lately, but one episode that Rachel and I recorded a while back was episode 1 91, where we get into a lot more detail about that histamine hormone link. And this is one of the reasons that we can see an uptick in histamine symptoms and histamine issues during big endocrine transitions like puberty, postpartum, perimenopause, menopause. It's due to those hormonal fluctuations. So estrogen is a big part of that. But I would also say that progesterone is a big part of that as well.
Rachel Mistry [00:03:15]:
Definitely. Progesterone can stabilize our mast cells. And I also like to say that progesterone helps to keep estrogen in check. It kind of controls it as well.
Erin Holt [00:03:25]:
So if somebody's coming to us with these symptoms, are they saying to you, like, hey, I have a histamine issue? Like, are people aware that they have this histamine response going on? Or are they like, I just have this, like, weird constellation of symptoms and I have no idea what the heck is going on.
Rachel Mistry [00:03:44]:
Usually it's the people with the classic symptoms, allergies, the eczema, watery eyes, runny nose, rashes, who are aware that there is most likely a histamine issue. And then people aren't as aware that their acid reflux or their migraines or their PMS could be related to histamines. And that's where we can do some education, too.
Erin Holt [00:04:03]:
And that's kind of where you use your clinical clues to figure out, okay, this actually might be a histamine issue. And I just want to shout out that this is the work that we do with one on one clients in the functional care method. So if you're listening to this and you're like, oh, my gosh, I think this is me. This sounds like me. Definitely fill out an application to work with us. You can hop on a discovery call and we can let you know if we would be able to help. One thing that I think about when I'm thinking about histamine, it's like, these symptoms can be all over the map. Like you said, allergy symptoms.
Erin Holt [00:04:34]:
So, like flushing and hives. We can see asthma, coughing, a lot of GI symptoms. We can see joint pain, joint swelling, the headache, the migraines, the anxiety, sometimes issues with heart rate. The symptoms are, can be like anywhere from top to tail, which sort of reminds me of autoimmunity. With autoimmunity, we can see these symptoms all over the place as well. And so I'm curious, in your experience, do you feel that there's an overlap with histamine intolerance and autoimmunity or do you see them present together frequently?
Rachel Mistry [00:05:03]:
We can definitely see them presenting together. And one thing that I like to think about is both histamine intolerance and autoimmunity are driven by a really reactive immune system. So there's a lot of overlap between treating the two conditions. And you and I both say that we go inflammation hunting because we want to figure out what's putting so much demand on the immune system, on the mast cells in the first place. And really we do this work in our one to one work with clients using more of a systems biology approach, getting really holistic and looking at their lifestyle, their nutrition, their test results as a whole.
Erin Holt [00:05:37]:
Yeah, and for those who are not familiar with that term, systems biology just basically means like all the systems in the body communicate with each other and one will influence another, will influence another. Which is when we're talking about the immune system. We have to take that approach essentially because the immune system, you know, interfaces with every other system in the body. And we will be getting more into the systems biology approach in our upcoming four day practitioner training where we teach you how to take this intuitive functional medicine approach to autoimmunity. So stay tuned for that. We'll really unpack that in a lot of detail. Okay. But today we're going to continue to focus on histamines.
Erin Holt [00:06:13]:
And there's definitely a lot of different ways we could take this conversation, but I would. Let's start with the basics. Just tell us what are even histamines?
Rachel Mistry [00:06:24]:
So histamines, they are chemical messengers and they're essentially a compound found in, they're found in foods, living things, bacteria, plants. And when we think about histamine intolerance or even issues with our mast cells, we think about it's located inside of our immune cells, it's located in our basophils and our mast cells, and it's used to defend against invaders or a threat. It could be an allergen, a pathogen, bacterial overgrowth. And I do want to acknowledge that I think mast cells get a lot of shade nowadays. But mast cells are a really important part of our immune system. They help to protect us really they swing into action when a threat is detected, and they will release histamine along with a lot of other inflammatory mediators. And it's. Histamine is what will cause the allergy symptoms you experience.
Rachel Mistry [00:07:17]:
And kind of like we've spoken about it, can create a cascade of other symptoms as well.
Unknown [00:07:21]:
Yeah.
Erin Holt [00:07:21]:
And I think that's just because mast cells are found everywhere in the body. Skin, blood vessels, lymph vessels, nerves, lungs, intestines. So that's why symptoms can be so widespread. They can show up anywhere from tip to tail. But this is also presents a problem in terms of clinicians figuring out what the heck is going on. This is why so many practitioners are essentially like stym by these patients that come to them, and they're like, you know, I've got this and I've got this, and I've got this, and I've got this. And there isn't always an understanding of how all of these things are connected. And so these patients are just being dropped into this bucket of we're not really sure what to do with you.
Erin Holt [00:08:00]:
And a lot of the treatment becomes masking the symptoms or attempting to address the symptoms, which isn't a problem because these histamine reactions can be life altering. They can be pretty freaking gnarly. So it's not a problem to try to address the symptoms, but we also want to address the root of why this is happening in the first place. And this is really the approach that Rachel and our practitioners take when somebody's coming to us with histamine issues.
Rachel Mistry [00:08:28]:
And one thing that I like to share with people, too, is histamines themselves aren't the problem. It's an inability to break them down and clear them, or maybe the overabundance of them that really is.
Erin Holt [00:08:40]:
Yeah. And I want to talk a little bit more about that in terms of what histamine intolerance actually is, because we can potentially have an issue with too much histamine production. And we can also have an issue with the inability to clear these histamines out of the body. And sometimes it's both. So can you speak into that a little bit more? Yes.
Rachel Mistry [00:09:02]:
So histamine intolerance, it technically occurs when there's more histamine in your body than your system is able to break down. And oftentimes we'll refer to this as the. The bucket theory. So we want to think about what are the things that are filling your histamine bucket up, and then also what are the things like you mentioned, how do you clear histamine or how do we drain histamine from the body? How many little holes are in the bottom of that bucket? Because when the amount of histamine going into the bucket exceeds how well we're able to drain it, that's where we can see like an overflow of symptoms. And that's where people can notice an uptick as well.
Erin Holt [00:11:03]:
And so what would be. I know we're going to get into this in a little bit more detail, but just kind of like a little teaser. What would be some of the things why somebody would be over producing it. So we know that our immune system creates these histamines in response to stuff. But what are certain situations where you would see an overproduction of histamines?
Rachel Mistry [00:11:22]:
We can definitely see too many histamines when there's dysbiosis present in the gut. And this could be too much bad bacteria, not enough good bacteria. SIBO, Candida parasites, exposure to toxins. These could be environmental like mold or even in our drinking water for some individuals. And then stress as well, which I know is a. A loaded topic.
Erin Holt [00:11:42]:
Yeah. And it's not uncommon. I mean when we're working with people, one of the things we always ask about Is the timeline of events, like when all these symptoms started, what was happening before. And it's not uncommon, even with histamine, for somebody to say that they were under like, pretty extreme ongoing emotional stress or a physical stressor, like maybe they had surgery or some type of, like, injury in the body. And I think that just can't be overlooked. Yes, we have to look at the gut. Yes, we for sure have to look at hormones. Yes, we have to look at diet.
Erin Holt [00:12:10]:
But also this. These, like life stressors can tripwire these big reactions in the body. And it kind of is like the proverbial straw where people have a really hard time recalibrating after that. And so it's like that stressor, that life stressor, that traumatic event could be the thing to overflow the bucket, to.
Rachel Mistry [00:12:30]:
Stick with that analogy.
Erin Holt [00:12:32]:
So we might be making a lot of histamines all at once. And if the body has the ability to clear them out, not really a problem. We wouldn't see histamine intolerance necessarily with that. But if somebody can't clear it out, then. Then it becomes a problem. What would be reasons why somebody is not clearing it out effectively?
Rachel Mistry [00:12:48]:
Some of the most common things that I see in practice are constipation. Right? We're pooping and we're literally excreting waste from our body. So constipation plays a big role in this. Alongside that, we think about poor bile flow because bile is how we detoxify all of the things that our liver is processing. Really. This might seem overly simplified, but poor hydration, the more dehydrated you are, the more concentrated histamines are in the bloodstream. So drink your water. And then nutrient deficiencies can play a big role in order to perform the two phases that naturally occur in our liver that perform detoxification.
Rachel Mistry [00:13:24]:
It just requires a ton of nutrients. And so if you're eating a really processed food diet, not robust in antioxidants or protein, that could also be a big part of why you're having histamine related issues and genetics, the constipation thing.
Erin Holt [00:13:37]:
I was just thinking about this and this, like, can't be overlooked. Some. One of my friends sent me this morning routine of a health influencer and it was like, so nuts. And Rachel, let's be honest. You and I are people that probably invest more time, money, resources into our health and into like, gadgets than the average person, right? This is what we do for work. It's our passion, it's our hobby, it's also our livelihood. So Kind of makes sense. But this was like unhinged.
Erin Holt [00:14:02]:
This was so next level. I mean, it was like two hours. There was like red light there. I just, it went on and on and on and on. And I was like, all I do for my morning routine is just like make sure I poop, I like sit, I drink coffee and I poop. And I was like, felt like I wasn't doing enough. But I'm like, actually that poop is doing more than her whole morning routine combined. If we are clearing poop out of our bodies, we are doing like, like 90% of the work right there, I swear.
Erin Holt [00:14:30]:
So I just feel like we talk about constipation like every episode we record together, but it's like so pooping regularly is so, so crucial. I know you want to talk a little bit about this. There's also specific enzymes in our body that help us break down histamine. And so if there's issues with these enzymes, we're going to have issues breaking down and clearing histamines out. So talk about those for a little bit.
Rachel Mistry [00:14:51]:
So the biggest enzyme found in the gut that's associated with histamine issues, it's (DAO) diamine oxidase. And we see this a lot in our practice. Most people that come to us or many people have gut issues. And again, this can be from parasites, yeast, SIBO, leaky gut and DAO helps us degrade histamine, whereas you know, yeast parasite, SIBO leaky gut, they can interfere with your body's ability to produce that DAO enzyme. Something else that can really suppress DAO production as well as long term antihistamine use. And then it's kind of a double edged sword because you have all these people taking antihistamines to control their allergies and then they're also suppressing dao, just making that whole histamine intolerance cascade worse.
Rachel Mistry [00:16:56]:
Nutrient status is really, really important for DAO production as well. We need copper, vitamin C and B6 to produce healthy levels of DAO. And we're oftentimes assessing for deficiencies in these nutrients on lab testing, in practice.
Erin Holt [00:17:11]:
Yeah, I was just gonna ask that because this is something that you're doing regularly. How common would you say copper deficiency or vitamin C deficiency or B6 deficiency actually is?
Rachel Mistry [00:17:22]:
I see a lot of increased needs for vitamin B6 because B6 is really used for our adrenals. Use B6 a lot. Same thing with vitamin C. So I do see a lot of individuals needing to support B6 and vitamin C status. Copper. We assess for copper on the htma, the hair tissue mineral analysis, and I like to interpret that alongside blood work. And it's very common to see people with copper dysregulation issues, whether that's because they're not consuming enough vitamin C or not consuming enough retinol. These are nutrients really important for healthy copper status as well.
Erin Holt [00:17:59]:
And I just want to, like, give a head nod to the fact that when you choose to take a root cause approach, there's a lot of different paths to go down sometimes. This is where practitioners, I mean, we were talking about this last week in one of our meetings. Practitioners can just feel such a sense of overwhelm because it's like, where do I even start? And this is why we created fna. It's so you have like a foundational place to start. And then we teach you how to build on that too, and how to use your, like, investigative clues to figure out like your investigative hat to figure out the clues to be like, where should I even start with these particular patients? Because, you know, somebody comes to you with histamine issues, like, you have to figure out, like, why are they overproducing histamine or why Are they not clearing it and is it an issue with Dao? And if it is, then where is that issue coming from? You know, there's a lot, there's a lot to it for sure. There are other enzymes involved in the breakdown of histamines. Are you as concerned with those?
Rachel Mistry [00:18:58]:
I don't pay as much attention to this enzyme, but it's the HNMT. It degrades histamines in our central nervous system. So sometimes we might start to think about this if people are having a lot of sleep issues, fatigue, anxiety, and we suspect histamine related issues, but we're not seeing a resolution in their symptoms. Basically this enzyme, HMNT, it's involved in methylating our histamines. And so sometimes we can pick up context clues on like DUTCH testing and organic acids testing if someone might need a little bit of methylation support. And that's where that enzyme can come into play.
Erin Holt [00:19:34]:
Yeah, and in some of our meetings in the past maybe like year or so, there's been certain clients where like, things just weren't moving in the direction at the pace that you would expect to see them, or moving in the right direction at the pace you'd expect to see them. And by supporting methylation, that was like the thing that just like clicked on. I mean, it's not always that easy or like, you know, it's not always like, oh, this is the button that we have to press, like the easy button. But I just think that that's worth noting here because you've seen that clinically kind of pop up a few times over the past year.
Rachel Mistry [00:20:07]:
Definitely. And, and really, simply put, the way that I like to explain methylation issues is people with methylation issues, they have a hard time clearing things or pushing things out from their bodies. Whether that's neurotransmitters associated with stress, toxins, estrogens, people with methylation issues just like hold onto things a little bit longer. And that can include histamines and, and emotions and stress.
Erin Holt [00:20:28]:
Emotions and stress. That's like, that's how it shows up for me. Like sometimes I'll get stressed and like the thing that was stressing me out is gone. It's like, it's over, it's resolved, it's healed, it's done. But I will be like locked into a stress response where I like feel stress chemicals like pumping through my body and I'm like, none of my tools are too, like, like nothing is working. And that's like how methylation issues show up for me. That's when I Know, I'm like, okay, probably could use a little bit of methylation support. So that's one of the questions that I will ask somebody if I'm trying to, like, figure out if there's, like, clues of that on the DUTCH test, for example, like, do you ever feel like when you get stressed, like, those stress chemicals just stay in your body? Just a little clinical pearl to throw into the mix.
Erin Holt [00:21:08]:
All right. I also want to talk about mast cell activation, because this is something that I would say is becoming more and more common. Unfortunately, it's like, in the same constellation of just immune dysregulation. It's more common. Look at the environment. Look at the way we're living our lives. Like, we are going to see more of this. Practitioners get ready, like, be prepared for this.
Erin Holt [00:21:27]:
It's not slowing down. So I know for the sake of today's show, our focus is going to be more on histamine intolerance. But, like, let's at least give a little acknowledgement to MCAS and what you're seeing here. Clinically, the way that I think about.
Rachel Mistry [00:21:42]:
MCAS is just where our mast cells, they're really sensitive or they're really hyperreactive. And mast cells, right, they break down when they are exposed to a trigger, and they release those cytokines, they release those histamines. But with a lot of MCAS patients, their mast cells are breaking down, and they're really not protecting us from anything. It's not like there's a major allergen present. For instance, I have one really reactive patient, and if she smells anything, like a scented soap, for instance, or she walks by like, a bath and body works sometimes this can really trigger headaches for her, and she can just feel icky throughout the day. Basically, like I said, MCAS patients, they're really sensitive, they're really reactive, and MCAS is just making people feel really, really sick.
Erin Holt [00:22:27]:
If you're working with somebody in practice, is there a way for you to, like, kind of discern this might be more of a histamine intolerance issue versus MCAS. I mean, there is some overlap between the two, of course, because mast cells are the white blood cells that are producing histamine. But, like, if there's a severity scale, like, how do we assess for that?
Rachel Mistry [00:22:47]:
I. Not to oversimplify things, but I feel like histamine intolerance is usually triggered by high histamine foods. Root causes are usually due to reduced enzyme activity in the gut, low DAO caused by gut imbalances, maybe nutrient deficiencies MCAS can be triggered by more things, including toxins, infections, food, alcohol, and more. But I do want to clarify that. I. I think that histamine intolerance in MCAS kind of exists on a sliding scale because I am working with a handful of clients where they do have digestive issues, and as we treat their gut, their histamine issues reduce. But then they're also experiencing things like insomnia, which might fit more in the MCAS category than the histamine intolerance category, and they do better with some histamine support, methylation support as well. So I.
Rachel Mistry [00:23:39]:
I don't feel like everyone fits perfectly into the histamine intolerance category or the really reactive MCAS category.
Erin Holt [00:23:45]:
And I think it's fair to say that, like, some of us as practitioners out here in these streets are just, like, figuring shit out in real time. Because to be clear, there's no, like, one test you can do to be like, oh, this is histamine intolerance. This is MCAS that doesn't really exist. There's different types of testing that we can do. They're not always super accurate. We're just kind of, like, cobbling things together, trying to do the best that we can with the information that we have to support our clients in the best way that we can. Even to, like, test histamine levels in the blood isn't, like, really going to tell us a ton because those histamine levels fluctuate. It's kind of like trying to test cortisol levels in the blood.
Erin Holt [00:24:24]:
Like, those levels fluctuate throughout the course of the day. So we're not necessarily going to be like, oh, this is a high histamine picture. So we might see normal levels of histamine in serum, but that doesn't mean that somebody doesn't have a histamine issue. I know one thing that you have you're really conscientious about with some of our more reactive clients is going very, very slow with treatment. So can you speak into that a little bit?
Rachel Mistry [00:24:51]:
Definitely. What I have found for some of our more sensitive reactive patients is if, for instance, we're treating the gut before we might bring in treatment for bacterial overgrowth or pathogenic overgrowth. We might want to spend some time supporting their liver, supporting their gallbladder, maybe supporting their digestive immune system before we would enter, like, a kill or a removal phase. These patients. I'm not bringing in three to four supplements at one time. I'm typically like, let's start with this one product. Maybe for three days, maybe for seven days and see how your body responds. What I've also seen for these individuals is if we're bringing in, there's certain supplements that are blends.
Rachel Mistry [00:25:32]:
They're a blend of three to five products. Histamine reactive patients typically don't do as well with the blends. It's good to give them a single ingredient.
Rachel Mistry [00:26:54]:
For instance, like a glutamine instead of one of those like GI-Resolve or GI-Mend products for these really reactive patients, just so that we know.
Erin Holt [00:27:02]:
What's going on and like what they're reacting to. Because it's really hard to figure out if you're taking a blend with like six different things, what in the blend am I actually reacting to? So that's a pro tip for practitioners, especially if you are entering the realm of working with really complex cases. But also if you are listening to the show and you are a complex case, that's just like a pro tip. And just be mindful of like, we've talked about the medical gaslighting in conventional medicine. Unfortunately, we see some of that in functional medicine too, where these sensitive patients are put on really, really, really complex treatment protocols and they have a big reaction and sometimes they're told like, oh, that's just like a Herxheimer reaction. Or like, that's the natural part of healing. And it's like, it might not be. It might just be so overwhelming to your system that it's like actually like reinforcing some of the symptoms that you're already having.
Erin Holt [00:27:51]:
And so we just want to Be super mindful. And that's not everybody at all. Some people just have a sturdier constitution. And you can throw like 26 supplements and FM, that's me. Like, give me all the supplements. I'm fine. I'm not going to react to anything.
Erin Holt [00:28:04]:
But a lot of people, we have to, like, tiptoe our way in. Okay, so let's talk a little bit more about that bucket analogy. Specifically, what fills the bucket. So you've talked about some things that can increase the histamine production in the body, but let's get into the nitty gritty of like, what you're seeing in practice and what you're actually doing for these clients in practice too.
Rachel Mistry [00:28:24]:
So something that fills the bucket, I like to call it, or I see it a lot in practice, is this deficiency dysbiosis. Our good bacteria. They actually help us degrade histamines and break them down. And this is just low levels of your good bacteria. And we actually test for this on the GI-MAP a lot in practice.
Erin Holt [00:28:39]:
Yeah, I just interviewed Tom Fabian, as you know, and he was. He said that this is. I mean, we can see this in practice. Like, this is the most common pattern that we see on a GI-MAPwhen we're running gut panels. Is this just low levels of good bacteria? And I've talked about this a lot, but it's like when we're running a GI-MAP, we put our practitioner cap on. We're like, let's go find the problem. Let's go find the pathogen or the thing to kill. And oftentimes there isn't a huge glaring pathogen problem.
Erin Holt [00:29:05]:
It's more like you just don't have enough good bacteria. And if those good bacteria are breaking down the histamines, then like, Houston, we have a problem.
Rachel Mistry [00:29:12]:
Definitely. And it's specifically those Lactobacillus and Bacillus species they produce. Dao. Again, that's the histamine degrading enzyme. We can see this a lot because of antibiotic use. We can see this because of poor diet. Or what I see a lot for my clients is they eat a really anti inflammatory, nutrient dense diet, but they're eating the same things all the time. And I love a meal prep.
Rachel Mistry [00:29:33]:
Like I just meal prep today. So I'm probably gonna eat the same thing for the next three days. But each week making an effort to eat different plant foods, different colors, different fibers can really, really support beneficial bacteria. So again, I'm seeing that a lot in practice. People eat healthy, but they're eating the same foods. I currently Have a client. She. We ran a GI-MAP on her, and this was, we ran this GI-MAP on her maybe six to eight months after she had a more major surgery.
Rachel Mistry [00:30:01]:
When she was in the hospital, she was on IV antibiotics for four or five days, and then she was discharged on oral antibiotics. And so I think it was about one to two months after her procedure, she started to develop histamine issues. She wasn't even able to spend much time outside in the sun. That would trigger more of a histamine itchy response for her. We ran a GI, curious if we were going to see any pathogens, any dysbiosis we needed to treat, and it was squeaky clean. There was not any bad bacteria present. Her organic acids test showed that she was negative for Candida as well. She just had a major deficiency dysbiosis.
Rachel Mistry [00:30:38]:
And so we really spent a decent amount of time repairing, healing, seeding, and feeding her gut. And she's doing a lot better, actually.
Erin Holt [00:30:46]:
Would you say so if, if these beneficial bacteria are helping us break down histamines, would you say that taking a probiotic is enough to help people reduce their histamine issues?
Rachel Mistry [00:30:58]:
It depends on, on the case and what else they have going on. Because if it's just deficiency dysbiosis, maybe you will see some resolution and some improvement. But if you're not pooping, if your liver detoxification pathways aren't optimized, if you're not hydrated, you may not see all the resolution that you're looking for.
Erin Holt [00:31:15]:
Okay, so first thing, like, we're looking at the gut, and if there's dysbiosis deficiency, so not enough good bacteria, we can think that, okay, that could be contributing to this. What about overgrowths of opportunists?
Rachel Mistry [00:31:26]:
So we also see this on a GI-MAPand opportunistic bacteria or problematic bacteria, they produce histamines. And the most common ones that I see on GI-MAP in practice are Morganella, klebsiella and pseudomonas. I see this a lot on stool testing. When those are elevated, we definitely start to think more along the lines of histamine issues. And sometimes you see both. You see a lot of histamine producing bacteria overgrown and then a deficiency dysbiosis. And typically those patients are more symptomatic.
Erin Holt [00:31:56]:
And we're always trying to, like, figure out, like, why is this happening in the first place and solve for those things too. I will say, is that, like, just knocking back certain overgrowths isn't always enough to resolve the histamine. Issues. I mean, Rachel just alluded to this like it's art of the puzzle, but we're trying to take When I'm thinking about autoimmunity or immune dysregulation in general, we have to acknowledge that the gut plays a huge part. But I think where we have perhaps done ourselves not a great service in functional medicine is being like all roads lead back to the gut. And solving immune dysregulation is as simple as solving a GI-MAP stool test. It's a huge critical part of that puzzle, but it's not the whole puzzle. And so talk to me about other things that we should be thinking about and looking at with these histamine issues.
Erin Holt [00:32:49]:
You mentioned Candida earlier, so that is kind of an up gut overgrowth. But of course we can see fungal overgrowths in other parts of the body as well.
Rachel Mistry [00:34:08]:
So Candida stimulates our mast cells to release more histamines as well. And my favorite way or the gold standard way to assess for Candida would be in organic acids test because this is looking at urinary metabolites of yeast or fungal overgrowth in the urine. There's over a month of curriculum that reviews this in FNA as well. So Candida is definitely one factor and then estrogen dominance like we hinted to, is very common with histamine related issues. We like to assess for this and test for this on the DUTCH test as well.
Erin Holt [00:34:38]:
Are there certain patterns that you see on a DUTCH test that make you think hmm. This could be contributing to your histamine issues.
Rachel Mistry [00:34:45]:
Definitely. Primarily high estrogen levels, but sometimes low progesterone can be a contributing factor as well. I see a lot where women will have normal estrogen, but low progesterone. And progesterone keeps estrogen in check. It stabilizes our mast cells. So sometimes if progesterone is absent or low, it can also feel like estrogen excess. High histamine issues. We can also sometimes see high cortisol levels.
Rachel Mistry [00:35:10]:
We know that cortisol can also stimulate and degranulate our mast cells.
Erin Holt [00:35:16]:
Yeah, and it's just like, with wonky cortisol, it goes hand in hand with, like, wonky inflammatory response. And I like, we talk about inflammation like it's a bad thing. It's not. When it just goes on and on and on and on and it's left unchecked, it becomes problematic. But inflammation is part of our immune system's response. Like, if we didn't have the ability to mount an inflammatory response, like, we would be dead. So it's like, really, really important. But if we have dysregulation with inflammation, that's a problem too.
Erin Holt [00:35:44]:
And so we can see that kind of go hand in hand with, like, wonky cortisol patterns. I mean, I always refer to you as the moldy girl, which is like, I mean it as a compliment, but it doesn't sound like, like a compliment. So talk to us about mold. I just feel that Rachel has found molds in a lot of our people. She doesn't go looking for it, but, like, when somebody just hits a crossroads and they're like, we're not making progress. Rachel has sniffed out the mold in situations. So are you seeing this with histamine issues?
Rachel Mistry [00:36:13]:
Definitely. Mold is a trigger to our mast cells. And again, mast cells protect our body from harm. So when they're triggered, they're going to release these inflammatory mediators. So when you have mycotoxins entering the body, that's a trigger to our immune system, a trigger to our mast cells. And really the problem is not like, I walked through a moldy department store and I left it in five minutes. More of the problem is chronic exposure in your home media, in a workplace as well. I have a client who I'm working with right now, and she has a lot of histamine related issues.
Rachel Mistry [00:36:45]:
And she noticed a worsening of her histamine issues when she moved into her current home. So at baseline, she had some gut issues going on, some autoimmunity going on, moved in her current place. And she was like, oh, yeah, my period problems got worse, my rashes got worse. And we recently found mold in her master bath, which is attached to her bedroom that she's sleeping in every night. So currently remediations in progress.
Erin Holt [00:37:10]:
And I think that's a good point that you brought up, maybe inadvertently, that there are some people that live in mold. I mean, we are always going to be exposed to mold. There's mold in our environment, like literally outside. There's mold in our environment everywhere. And so it doesn't always cause a ruckus in all of the people all of the time. We've actually recorded a whole episode on mold, so we'll make sure we link that up in the show notes. But it can be a really overwhelming concept. I have a good friend of mine who recently just found molds in her house and doesn't have the financial needs means to do anything about it right now in this moment.
Erin Holt [00:37:42]:
And so ideally, we're removing the person from the mold. But also, like, working on your health foundations is going to go a long way in preventing you from having these bombastic reactions to mold in the environment. And so I just, you know, I want to say that keep working on your health house, everybody, because it's going to protect you from a lot of these issues that we're talking about. Usually by the time somebody gets to us, they've already, like, dealt with all of these issues or they're experiencing these issues. And so a lot of the podcast content we create is in response to those complex issues. But if you don't have them, let this be a warning. Just start working on your health house now. Get yourself in robust enough health that these things don't become a problem for you.
Rachel Mistry [00:38:23]:
And I will say mold is really common. It's not everyone's root cause, exactly. Like you mentioned, maybe I'm seeing mold as the histamine culprit and root cause 15 to 20% of the time. And we'll a little bit later, we'll chat about some detox and drainage strategies you can use to support yourself. But, yeah, it's not everyone's root cause. I just want to emphasize that and throw that out there because I think it's the scapegoat for a lot of people. And in some cases it really is, but not always.
Erin Holt [00:38:49]:
Okay, so let's just do like a brief rundown of labs. If somebody comes to you with histamine issues, some of the labs that you are running. And we, you know, to be clear, we're Running more of a bespoke practice. So meaning that not every single person that comes to us gets the same set of labs. It's really in response to the individual. So obviously this all is with the caveat of it. It depends. It depends on the person, it depends on their budget, it depends on their symptoms.
Erin Holt [00:39:13]:
But just so somebody can have an understanding of what you would be looking for on labs for root cause, I.
Rachel Mistry [00:39:20]:
Always like to start with the gut, and I love to give some, like, gentle liver support. And that could be focusing on a nutrient dense diet. It could be focusing on, like, integrating more protein into their diet. It could be really foundational. But as far as labs are concerned, GI-MAP's, stool testing would be my go to number one priority to start with, with histamine issues. And then maybe depending on their history, depending on our initial conversation, their lived experience, their health history, we might be considering an organic acids test to take a look at candida nutrient deficiencies, mitochondrial dysfunction. Sometimes we can stop there. Sometimes people get major resolution by addressing just the GI-MAP.
Rachel Mistry [00:40:01]:
Some people feel really good with, you know, looking at an oat and a GI-MAP. You know, there's a lot of tests that we could run, including a Dutch test, to look at those hormone issues. We could look at an HTMA to look at copper issues for DAO production. We could look at mold testing as well. And to clarify, we're not running all of these tests on our clients at the start of their care. It's very personalized. It's very individualized.
Erin Holt [00:40:25]:
Okay, that's helpful. And then let's talk about strategies that you're using with clients to help them empty their bucket.
Rachel Mistry [00:40:33]:
So this is customized, and it's unique for each person. Like I've alluded to this whole episode, most individuals need some type of detox and drainage support. And then this is really personalized based on their lab results. So we might bring in some strategic supplementation. I'm not a big advocate of bringing in supplements at the start of someone's care unless I'm 100% confident it would help them.
Rachel Mistry [00:40:56]:
But I usually will say, let's wait.
Rachel Mistry [00:40:58]:
Until we have test results back. Some clients will come to me at their first call and they will have test results, and then I'll maybe get them started on treatment sooner. But I'm like, let's personalize as we progress more than anything. So first and foremost, we empty the bucket through drainage pathways. Drainage pathways are basically how we get things out of the body. You and I have spoken about pooping. We need to Be pooping regularly. The liver filters toxins, sticks them in our bile, and bile is released in the gut.
Rachel Mistry [00:41:27]:
So coffee enemas can be really therapeutic for supporting our bile flow and bowel movements supporting the vagus nerve can be really helpful in promoting regularity. And then if people have are coming to us and they're like, I'm meditating. I'm doing coffee enemas. Like, the needle's not moving. That's where we might think about, okay, do we need to run a GI-MAP, or do we need to run a SIBO test?
Erin Holt [00:41:48]:
I feel like the amount of times we talk about coffee enemas, it's like, nobody's going to ever want to work with us because they're like, if I work with those two, like, they're going to make me put coffee up my butt. We are talking about kind of advanced strategies. So Rachel's working with people on their diet to add bitters to help stimulate, like, there's a lot of things that we're doing for today's show. We're kind of getting into, like, you know, some advanced strategies. But just suffice it to say, not everybody has to do a coffee enema, but we're just both big fans because we've seen them work really well, but we don't force our clients to do it.
Rachel Mistry [00:42:23]:
I've actually never done one myself, and I like, tell patients that I'm like, full transparency. I've never done this. You've recorded a podcast episode on it, so I'll refer them to that. And I always tell people it's, like, completely optional. I'm not casually recommending that people do coffee enemas, so don't let that scare you. But pooping is really important. You need to be pooping regularly. Along with peeing, hydration is essential.
Rachel Mistry [00:42:45]:
Sometimes with toxicity, people can just have this issue where water flows through them. They feel like they're peeing all the time. Sometimes the kidneys need tlc. Sometimes the minerals need tlc. I don't always treat this. And sweating. Sauna, hot yoga, again, we, like, detoxify so much through our sweat. So that can be really, really therapeutic as well.
Erin Holt [00:43:04]:
And then the, like, liver bile support. I feel like we always end up back here for, like, every time we talk about anything. So just kind of give us a rundown on certain strategies that could be helpful and why they would be helpful with histamine.
Rachel Mistry [00:43:19]:
So lymph work keeps our metabolic waste products and toxins and antigens moving, including our histamines rebounding dry Brushing castor oil pack or like topical castor oil can be really therapeutic for just stimulating lymphatic flow. Liver and bile support as well, like I've mentioned so many times, is so, so therapeutic because it just kind of helps us like clear and evacuate toxins and histamines from the body as well.
Erin Holt [00:43:45]:
We're like emptying the bucket. So a lot of these are strategies that are essentially working on root cause. So, like, why somebody would be having histamines to begin with? Is there any way that you can support them while you're working on the root cause? Because that's like what we do. That's like our whole function here to help them support the actual symptoms in real time.
Rachel Mistry [00:44:06]:
So a low histamine diet, it's not taking a root cause approach, but it can be really therapeutic short term. And it can be a great way to test like, hey, are my symptoms histamine related? Maybe try a low histamine diet and see how your body responds. This primarily involves avoiding fermented foods, aged foods, things like alcohol, vinegars, salamis, cheeses, aged cheeses, and even things like avocados and spinach. That is very short term. If someone's really symptomatic, we might consider a short term low histamine diet just to get them some relief. But then I also love to recommend supplemental quercetin or vitamin C. These can really help to degrade histamines and stabilize our mast cells. Metal infusions can be really therapeutic as well.
Erin Holt [00:44:51]:
Okay, so you're like working on the root cause and then you're also like trying to support the symptoms in real time just to stop somebody from suffering essentially.
Rachel Mistry [00:44:59]:
Definitely. And what we do see a lot for people is that mindfulness and mind body practices can really move the needle too. It obviously they help to reduce levels of those stress related hormones and then inflammatory cytokines. So breathwork, meditation, journaling, you name it. That's something people are really missing a lot of.
Erin Holt [00:45:18]:
Yeah. And it, like, no matter what you're dealing with, whether it's histamine issues or something else, mindfulness practices just help everything. So strong recommend. All right, well, Rachel, thank you so much for coming on the show and clearing up some of these histamine questions for us. Like I said at the top of this show, if you are struggling with any of these things yourself, definitely come work with us one on one. We can help you. We can do this root cause investigative work and get you feeling better soon.
Rachel Mistry [00:45:44]:
Yeah, I can't wait.
Erin Holt [00:45:50]:
Thanks for joining me for this episode of the Functional Nutrition Podcast. If you got something from today's show, don't forget to subscribe. Leave a review, share with a friend and keep coming back for more. Take care of you.