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Histamine Intolerance Gut Health and SIBO- Another Piece Of The Puzzle

Video transcript Histamine intolerance and gut health 2020

One of the root cause of histamine intolerance/MCAS can often be traced back to problems in the gut. These problems include SIBO, SIFO, gut dysbiosis, low Secretory IgA, a food sensitivity or intolerance or food allergies. Ignoring gut health when you have histamine intolerance/MCAS is a sure fire way of relapse.

Histamine Intolerance Explained

If you ever got a splinter stuck in your skin, or ever experienced the redness and swelling after a mosquito bite- then you are already familiar with histamine. Histamine is an immune chemical messenger and Histamine works by causing your blood vessels to swell, and dilate. This in turn allows your immune fighting white blood cells to quickly find and attack the infection or invader. Histamine intolerance is something very few doctors are talking about with their patients and yet it’s one more piece of the health puzzle for those struggling with symptoms of IBS and SIBO that I want you to be aware of.

Watch the video for additional health tips.

Todays Article

  1. 4 ways histamine intolerance develops when you have SIBO
  2. Some of the Things that might be causing your histamine intolerance and symptoms of histamine intolerance
  3. Why DAO enzyme activity is so important when you have Histamine intolerance 
  4. A step by step approach to addressing SIBO and histamine Intolerance
  5. Supplements that can help with SIBO and histamine intolerance

About a year ago, I started working with a patient who came to me looking for help with histamine intolerance. She had all your classic symptoms of histamine intolerance and She had seen 3 or 4 Naturopaths, worked with her allergist, she was working with a Functional Medicine doctor in NY, but no matter who she worked with she continued to suffer with symptoms.

She continued to experience allergies, headaches, itchy skin, asthma, she was experiencing headaches 3-4x per week, and anxiety that was getting worse and worse.

She was living on aspirin and Tylenol for headaches, she was on steroids for asthma, she was on steroid creams for her itchy skin and hives and she felt sleepy and drowsy most of the time.

Histamine Intolerance Gut Health and SIBO- Another Piece Of The Puzzle 1

When I read through her case review, I saw on her intake forms that she had mild to moderate GI problems that no one bothered to look at.

She had a history of H.pylori infection, she was bloated few times per week, her doctor recently put her on a drug called metformin for newly diagnosed diabetes.

So even though she was coming to me for the symptoms of histamine intolerance- itchy skin, hives, brain fog and headaches as her primary complaints, I had explained to her that we had to run testing to better understand the connection between this histamine intolerance and her gut. Every doctor she went to, continued to look and try to treat the histamine intolerance as the primary problem without success.

What no one bothered to do…… was investigate what was CAUSING the histamine intolerance in the first place. No one was treating the root cause!

They suspected histamine intolerance, they put her on antihistamines, they put her on topical steroids, but the investigation stopped there, and this is why she didn’t get better, no one bothered to look further and tie together some of the other piece of the puzzle together.

So, with the symptoms of IBS and bloating even though they were mild to moderate I felt that the direction I needed to investigate and further understand was the SIBO-gut-histamine intolerance connection and those things affecting her gut.

There were a few other clues to me with this patient that made me want to investigate this SIBO-Gut-Histamine connection. In her case history she had this long history of problems in the gut, she travelled to India on missionary trip, she had several bouts of food poisoning, she had been treated for H.pylor, she had cryptosporidium infection, she was on antibiotics 6 or 7x In her life and she was using aspirin for headaches a few times per week.

This became so important for a number of reasons.

Aspirin and Tylenol are not friendly to the gut lining. They cause leaky gut, they cause irritation. Tylenol also depletes glutathione levels in the body.

The history of infections told me she most likely had low Secretory IgA, Secretory IgA is a first line of defense in your mucosal pathways. Mucosal tissues are things like your respiratory tract, urinary tract, your gut.

So, I was already thinking that perhaps this low SIgA was one of the culprits behind the asthma and frequent infections she was having for which she received many antibiotics for.

The repeat infections with H.pylori was treated with antibiotics, so I suspected gut dysbiosis and fungal infection.

The next thing I began thinking about was all the bloating and IBS symptoms she complained about especially after breakfast. Every morning she had oatmeal. Not only is Oatmeal high in fiber, but It is also high in resistant starches Two things that are notorious for giving people who have SIBO terrible symptoms.

While the symptom of bloating can have many causes, the SIBO-Histamine intolerance connection began to become more clear. Not only do people who have SIBO have low stomach acid but low stomach acid also causes an increase in more histamine.  In other words,  Histamine is also tied into stomach acid levels.

When you have low stomach acid, let’s say because of H.pylori, SIBO or some other cause, your gut releases more histamine.

Histamine in turn signals the acid producing cells to make more hydrochloric acid. This makes perfect sense when you have SIBO, you also almost always have low stomach acid.

  1. Symptoms of low Stomach acid
  2. Causes of low Stomach Acid
  3. 5 ways to naturally improve Low stomach Acid
  4. Tips to Improve Low stomach acid

The other thing I began thinking about was her symptom and complaints of feeling drowsy or sleepy all the time-this feeling of brain fog, is something so many patients who have SIBO complain about.

She was a person who had to take regular naps just to get through the day.

This really stood out to me because one of the things that histamine does is that it promotes wakefulness or feelings of being alert. Histamine- wakes up the brain.

So based on all these symptoms, bloodwork that I reviewed, her diet, past testing, and the symptoms she was experiencing, we began digging into the root cause of these symptoms and what we found was that she had low SIgA, she wasn’t digesting fat, she had Giardia, she tested positive for H.pylori again and she hydrogen breath test levels off the chart indicating she had a really bad case of SIBO.

So if you are someone who can relate to those symptoms that I mentioned, Brain fog, drowsiness, itchy skin, frequent infections, antibiotic use, even if you don’t have severe GI complaints, then I want you to consider not only histamine intolerance but I also want you to consider SIBO as a potential culprit or root cause behind the histamine intolerance.

Again, this patient didn’t have raging GI complaints, but the testing we ran clearly showed that her gut was the problem with her histamine intolerance. That was a good reminder for me as well- that symptoms don’t always correlate to the area of the body- where the problem is rooted.

Before I get into the step by step approach I did with this patient that helped her, there are a few more things I want you to know.

First off, I want you to know how you or someone you love develops histamine intolerance and you will appreciate this explanation.

Your body produces two major enzymes known as diamine oxidase (DAO) and HNMT- these enzymes keep your histamine levels in check.

If for some reason you don’t break down histamine properly, it begins to build up and you develop what we call histamine intolerance.

I like to use the bucket analogy. The more things that fill up your bucket, the more prone you are to suffer with the symptoms of histamine intolerance.

What fills up one person’s bucket may vary from the next person- but if you suspect histamine intolerance, SIBO may be one of the things that has not only filled up your bucket, it has also caused your bucket to overflow.

So keep this in mind…..- if you have histamine intolerance, you may have any number of things filling up your bucket and your functional medicine doctors job is to figure out what is filling that bucket up.

Other things that I think about are certain foods that are high in histamine. Many people who have gut issues are eating and drinking foods that are fermented. These fermented foods will filling up your bucket. I know your favorite podcaster or nutrionist is telling you to eat fermented foods and having wine now and then is ok, and you should make your own kombucha and bone broth. But I’m going to tell you to stop ALL of that if you have SIBO, IBD, Crohns.- If you have histamine intolerance, eating and drinking these foods will increase your histamine levels.

How To Start A Low Histamine Diet- Getting Started Part I 5

The other things filling up your bucket are medications and nutritional deficiencies.

In this particular woman’s case she was using aspirin a few times per week and she had just started taking metformin for her diabetes.

Guess what?…. This is a classic example that when you treat symptoms and not treat the root cause, you create more problems. The aspirin and the metformin are two medications among many that deplete the DAO and HNMT enzyme activity.

You may have mold exposure that is filling up your bucket, you may have a problem with DAO and HNMT enzymes that are not working properly causing histamine to overflow your bucket.

Remember what I said just a moment ago? If you don’t break down histamine properly, it begins to build up and this is what we call histamine intolerance.

So, when this histamine builds up and spills over (think bucket analogy) it travels throughout your bloodstream, where histamine then affects your skin, lungs, brain, heart and your gut.

Let’s talk about SIBO and its connection to Histamine Intolerance for just a minute.

Histamine Intolerance 2

First and foremost, SIBO is a motility disorder and what’s so important to remember is that it can be caused by overgrowth of bad bacteria BUT it can also be caused by overgrowth of GOOD bacteria. This will be important to remember in just a moment.

(sign up for my 10 part SIBO video Series here)

Over the years one thing I have seen time and time again, is the connection between SIBO and histamine intolerance.

Once you understand WHY histamine intolerance occurs frequently in people with SIBO, it will make sense to you why most SIBO treatments fail.

Always keep in mind that SIBO/IBS is multifactorial disease. There is no one cause behind SIBO, there is no one cause of histamine intolerance but rather a bucket of things. So don’t beat yourself up if you are not getting better- your probably not doing anything wrong, you and your doctors are most likely just missing something in the bucket. Let me give you a few ways SIBO and Histamine are interconnected.

#1 Stress the overproduction of Histamine by Mast Cells

Mast cells are one type of cell in the human body that produces histamine and stress, mast cells, and SIBO are all connected- Heres how.

Chronic stress put an enormous strain on your adrenal glands. Your adrenal glands produce cortisol and adrenalin. When someone suffers with Prolonged stress this will exacerbate SIBO in a number of ways. Stress shuts down the migrating motor complex, decreasing vagus nerve tone because during stress we get locked in that fight or flight mode. This fight or flight mode affects Brain – gut connection, altering the gut microbiome, slowing down GI motility, and finally it over stimulates histamine producing mast cells. That’s right stress alone can set off a chain reaction causing all of these things and causes excess histamine production.

For these reasons, If you suspect histamine intolerance, in addition to fixing your gut, you’ll need to take the necessary steps of curbing your cortisol and stress hormone levels. You have to balance out your stress hormones, you have to support your HPA axis, you need to get out of the fight or flight mode! and into a parasympathetic state! I have several articles and videos on this topic. 

So, this is the first way we see SIBO and motility disorders creating histamine Intolerance.

The 2nd way we see SIBO contributing to Histamine intolerance has to do with two very important enzymes, namely DAO and HNMT and their level of activity.

#2 SIBO decreases DAO Enzymes Activity- Strains Methylation and causes Nutrient deficiencies.

Medications, foods sensitivities, fermented foods, SIBO, Candida, gut infections, Intestinal inflammation, nutritional deficiencies can all lead to a decrease in DAO enzyme activity. This in turn causes the bucket of histamine to overflow. In particular SIBO causes nutritional deficiencies.

Take a look at this picture and what you will notice is that there are key nutrients requires to activate the DAO and HNMT enzymes.

Histamine Intolerance and SIBO- Putting The Puzzle Together

You see that we have Vitamin C, Copper, Iron, B6, B12 as well as your methyl donor SAMe. Medications, poor diet, infections, inflammation, poor digestion, poor methylation can all cause nutritional deficiencies in these enzyme activators- the end result is a slowing down or decreasing DAO enzyme activity

The 3rd way we see SIBO creating histamine Intolerance stems from your probiotics. You simply have too much histamine producing bacteria.

#3 Histamine-Producing Bacteria

Earlier I said that SIBO can be caused by not only an overgrowth of bad bacteria but also by the overgrowth of GOOD bacteria, strains such as lactobacillus can cause SIBO if in excess. Are you taking probiotics with these strains and wondering why you are not getting better? It’s not that your probiotics are not working, they are not the right kind for YOU at this time!

Adverse reactions to probiotics commonly regarded as beneficial can be a likely signal of histamine imbalance or gut bacteria dysbiosis.

One of the reasons, I so strongly believe in stool testing is that if you have high level of these bacteria strains, you are potentially increase histamine production in your gut- you are just feeding the fire.

So, again this is one example of why I believe it is so important to test and not guess. Without proper testing even if your doctor’s intentions are good, you could be fueling the fire.

If you are interested, you can read over transcript or watch a video I did on the best probiotic to take if you have SIBO and why I recommend certain ones at the various stages of SIBO treatment. And finally, the last way we see SIBO creating Histamine intolerance is Low Secretory IgA.

#4 Low SIgA and Histamine intolerance-

For many people who have SIBO they have low SIgA. Remember in the beginning of today’s video, I said that SIgA is the first line of defense in the mucosal pathways.

Many people also have an underlying fungal infection or underlying bacterial/parasitic infection- and most of the time, its been going on for a long time.

When these levels are low, you are prone to infections, you are prone to reinfections, you never quite get rid of SIBO or Candida/fungal overgrowth.

Very often people focus so much on killing and eradicating the SIBO overgrowth, that they never put as much energy and focus on supporting and rebuilding the microbiome. That’s the most important part- and its normally never done correctly.

This ongoing infection/overgrowth in the gut continues to drive gut inflammation, continues to suppress vagus nerve tone, it continues to weaken the migrating motor complex, continues to cause a breakdown in the brain gut connection and continues to cause low levels of stomach acid in the gut. AND IT CONTINUES TO CAUSE HISTAMINE INTOLERANCE!

If you are interested in learning why most people never overcome SIBO, I encourage you to watch BOTH part 1 and part II of my SIBO video, Why most SIBO treatment methods fail.

Part I

Part II

You and your doctor may be missing some of these key factors that I discuss in those videos…..So go back and watch them! It could be the difference between success or failure for you- If you don’t have a doctor you are working with and you need help then reach out to my office.

Step by Step approach to Treating Histamine Intolerance When You Have SIBO

  1. We removed all traced of foods that contain histamine
  2. We had her stop all fermented foods (no reheating foods, no Kombucha, no bone broth)
  3. We tested and treated her for SIBO using natural antimicrobials/natural antifungals
  4. We treated and tested her for low Secretory IgA– we used a combination of S.boulardi, Proline Rich Poly Peptides, ashwagandha, beta glucans and medicinal mushrooms.
  5. We put her on a special enzyme (HistDAO) that was designed to provide breaking down foods that are high in histamine and stabilize the histamine producing mast cells.
  6. We used Butyrate and several other short chain fatty acids to address the inflammation in the gut
  7. We worked on balancing her blood sugar because she was diabetic. For this we used a low glycemic, high protein, high fat diet, gymnema extractes, bitter melon and after almost 5 months we were able to get her off the metformin.
  8. Lifestyle and Stress modification, we supported the adrenals with glandulars and other tonifying apoptogenic herbs.
  9. We put her on a soil based probiotic, and then 8 weeks into care we layered in Mast Cell stabilizers. Things like powdered vitamin C, stinging nettle leaf, NAC and Quercetin and Bromelain- All of these have been shown to clinically help stabilize the cells that make histamine- we used Natural D-Hist to accomplish this

Now she wasn’t taking this all at once, it was broken up into stages, but this entire process took about 10 or 11 months but that’s what we did, and now we are at the point of retesting to see if we have to go back and tweak a few things before moving over to a maintenance program.

So there you go! Hope you liked todays video and hope you learned a few things!

If you or someone you know is struggling with SIBO histamine intolerance or any other chronic gut problem and they are having a hard time putting together all the pieces of puzzle…. reach out to my office.

How To Start A Low Histamine Diet- Part I 1

My nutritionists can help you with implementing a low histamine or Low FODMAP diet, meal planning, we can help assess your case, determine testing you need or we can help develop a comprehensive treatment plan that really addresses the BIG picture

Lastly, if you found todays information helpful. Don’t forget to subscribe to my channel and hit the notification button, I have an entire video series that will cover many other aspects of histamine intolerance.

Need Help Putting This All Together?

If you need help trying to figure out the different Histamine/MCAS puzzle pieces in your particular case lets talk! You can schedule a Free 15 minute phone consult after you complete a short health questionnaire. This Health questionnaire will help me understand more about your concerns and how we can best help you.

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