September 18, 2025 • 48 mins
If you’ve been dealing with reflux, bloating, constipation, or even anxiety and can’t figure out why, histamines might be part of the picture. In this episode, I’m joined by Michelle Shapiro, RD, to break down the connection between histamine intolerance, MCAS, and gut symptoms and why so many people feel worse with standard gut protocols.
Michelle and I discuss:
- What histamine intolerance really is and how it overlaps with MCAS
- The wide range of symptoms histamine issues can cause (and why they’re often missed)
- How the gut, DAO enzyme, and microbiome influence histamine balance
- Why nervous system support is just as important as gut support
- Practical steps you can take if you suspect histamine intolerance
Michelle also shares her personal journey with histamines, mold exposure, and POTS and how slowing down and supporting safety in the body can be a turning point for healing.
Links Mentioned in the Episode:
- Gupta Program (free 28 day trial with this link)
- Michelle’s Histamine Essentials Webinar
- Michelle's Sept 28th Webinar
- Michelle’s Website
- Michelle’s Instagram
Stay Connected with Dr. Heather:
About Michelle: Michelle Shapiro, RD is a functional/ integrative Registered Dietitian who has helped over 3,000 clients transform their health over the past 11 years. As the founder of an NYC-based virtual private practice, Michelle leads a team of six expert nutritionists who specialize in complex cases including histamine issues, gut dysfunction, chronic anxiety, and weight concerns. She is the creator of the viral Histamine Essentials Webinar, which is available now on replay, and the host of the top-rated podcast Quiet the Diet, where she breaks down the science behind chronic illness in a way that actually makes sense and makes you feel seen. Michelle is the go-to expert for people who have tried everything and are ready for a real plan.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Heather Finley (00:03):
Welcome to the Love Your Gut Podcast.
I'm your host, Dr.
Heather Finley, registereddietitian and gut health
specialist.
I understand the frustration ofdealing with GI issues because
I've been there and I spent overtwo decades searching for
answers for my own gut issues ofconstipation, bloating, and
stomach pain.
I've dedicated my life tounderstanding and solving my own
(00:24):
gut issues.
And now I'm here to guide you.
On this podcast, I'll help youidentify the true root causes of
your discomfort.
So you can finally ditch yoursymptoms for good.
My goal is to empower you withthe knowledge and tools you need
so that you can love your gutand it will love you right back.
So if you're ready to learn alot, gain a deeper understanding
(00:46):
of your gut and find lastingrelief.
You are in the right place.
Welcome to the love your gutpodcast.
Welcome back to the next episodeof the Love Your Gut podcast.
I'm so excited to be here todaywith Michelle.
I feel like this has been a longtime coming.
We've been chatting for like 20minutes Off air should have just
pressed record.
(01:07):
But Michelle, welcome to thepodcast, Dr.
Heather.
I'm so excited to be here.
I'm really excited to be here.
Yes.
So you spoke in gutpractitioner, what was that like
a couple months ago and you werea hit, and ever since I'm like,
I have to have you on thepodcast because histamines and
MCAS and all the things issomething that I talk about, but
(01:27):
not too much.
So I figured why not have theactual expert come on here and
talk about it.
So why don't you just tell uswhy Histamines MCAS, why does
that matter?
You and then maybe like whatexactly are histamines and why
do they matter for gut health?
Just for someone listeningbecause they might not know.
Um, absolutely.
We'll kind of go back to thebasics.
(01:48):
Yeah.
So I live in what I've kind ofnamed a highly sensitive body,
and it took a long time for meto understand my highly
sensitive body.
And it took a lot of goingthrough what I would say is like
both conventional medical meansand functional medical means.
And no matter what I did.
Especially in the last fiveyears, it seemed like I was
(02:09):
getting sicker and sicker, andit didn't make sense.
I would go to the bestfunctional medicine doctors, the
best naturopathic physicians,and I would get something like
an iv, and then I would havewhat looked like a flu for a
week, or I would go get amassage or lymphatic drainage or
go to a sauna.
Again, violently ill, I mean,insomnia, tremors, dizziness,
um, nausea, gut issues, um, inyour domain.
(02:32):
Of course, many, many in yourdomain.
And really just could not putthe pieces together for myself.
And it really took, it wasafter, um, my first COVID
exposure that these symptomsseemed to really skyrocket.
I had both a COVID exposure.
And a mold exposure.
And as, as I was detoxing fromthe mold, I got much sicker and
(02:53):
I was like, wait a second.
This mold detox is supposed tomake me feel better, not worse.
And it really confused me.
And so it was my self-discoveryfrom basically being at a point
where I couldn't walk.
I was in a neck brace and a backbrace for over six months.
Um, I had to crawl a lot of thetime when I needed to do things.
Um, I had a chiropractic injury,this mold exposure.
Um, and this COVID exposure andthat together just created this
(03:16):
new level of illness that I hadnever experienced before.
And then I started to see thatclients were experiencing this
too.
So it was like many of uspractitioners, it was my
eagerness to figure out what theheck is going on in my own body,
and if I can figure this out formyself.
I hopefully can figure it outfor other people as well.
Um, so that's what brought meinto this specific sphere
(03:38):
because I had actually beenworking with different clients
and I still do.
Um, and my team still does formany years before.
And then I saw after COVID therewas this huge increase in this
kind of new type of feeling,terrible, um, that I desperately
sought answers to, um, for bothmyself and clients.
So interesting.
So it was really like, you canpinpoint it was COVID and then
(04:01):
mold kind of coupled togetherthat just made you feel so sick.
Did you, were you kind of a sickkid or do you feel like you were
highly sensitive as a, as a kidwith lots of reactions or
anything, or, no one's everasked me that on a podcast.
That's so interesting.
Oh, I'm a pretty atypical MCASperson.
I don't get any.
(04:21):
I don't sneeze, I don't get anyrashes.
I don't have any of what youwould think of as like typical
allergy symptoms.
I really get like nervous systemdriven symptoms in an extreme
way.
And gut driven symptoms I liketo say about mast cells.
And of course we're gonna definewhat mast cells are, but they
really show you your weak spots.
They really show you whateverthat symptom is that you don't
(04:43):
want is the exact symptom you'regonna get.
So for me, I hate feeling dizzy.
I hate feeling off kilter.
Um, that's the symptom thatcomes up for me.
So it really depends on theperson.
And because mast cells, whichare, are a type of immune cell,
they're a type of white bloodcell, uh, part of our immune
system.
They are literally in all of ourconnective tissue and in every
(05:05):
single part, connective tissuelines, our joints, our bones,
our blood vessels, and also mastcells line all of our organs as
well.
There's connective tissue in ourorgan, uh, tissue.
Uh, a layer of our organ tissue.
So you can really get symptomsfrom mast cells anywhere in the
body and depends on the person.
So the answer is actually, I wasa kid who like got strep once.
(05:25):
I think I was on antibioticslike once.
I was never sick.
I never had, um, like any sortof rashes, gut issues until I
started having reallydebilitating panic attacks and
anxiety, um, in college.
And then kind of started feelinglike a sick.
Person.
Um, I also had in high school,lost a hundred pounds going into
(05:48):
college.
I always occupied a larger bodywhen I was younger.
And rapidly lost weight to go toschool.
Um, I literally was like, oh,people aren't gonna like know me
when I go to college.
I have to like presentdifferently because I grew up in
Queens, New York.
It was no problem living in alarger body.
I had the most friends, greatgrades, like beautiful life, a
place where all types of bodydiversity and diversity in
(06:10):
general.
It was celebrated and I wasgoing to the University of
Delaware.
Um.
A much more homogenous place andI was like, I need to lose
weight.
And it really was the weightloss part that made me feel
sicker.
And that's that paradoxicalpiece of my body.
It's not the mold that made mefeel sick, it's the mold detox
that made me feel sick.
It's not carrying extra weight,it's losing weight rapidly.
(06:30):
So my body does not respond wellto any sort of strong changes.
Um, so I didn't really, again,assume that sickness identity
until after.
The weight loss and, uh, didn'texperience.
Yeah, no, not as a kid.
Uh, wasn't really sick ever.
So interesting.
It's so crazy how with histamineand MAs cell stuff, it can
(06:53):
present so differently.
And you kind of alluded to that.
So tell us, I guess we oftenhear histamine intolerance.
I feel like that's probably themost common phrase, at least
that I hear.
Histamine intolerance.
How is that different from mastcell activation and like what
are the types of symptoms thatsomebody might experience?
'cause.
As you know, and we know itcould literally be so many
(07:16):
different things.
Yeah.
Yes, absolutely.
So our mast cells are these typeof white blood cells.
And what happens is they have,they're, they're helpful to us
in many ways to help us respondto threat or perceived threat
inside of the body.
They will direct resources, theywill direct immune cells, they
will direct nutrients and bloodflow so that when there is some
(07:38):
sort of, again, perceived threator real threat.
We can help the body to recoverfrom it or defend against it.
So I think of our mast cells,um, as kind of like if there's
a, a watchtower, they're kind oflike the guards on the
watchtower and they're alwayslooking to see what's happened
here inside of our mast cells.
There are different types ofchemical messengers in kind of
like these.
(07:58):
Sacks and they will get releasedwhen they perceive that threat
or that threat is real.
So that's when the guards in thewatchtower are like, go, go, go.
And they start sendingeverything.
Um, in the case of mast cellactivation syndrome, those mast
cells are constantly, constantlybeing activated and then they're
sending out these 1200 pluschemical messengers.
(08:19):
One of those chemical messengersis histamine.
And we hear the most about itbecause I think it creates some
of the gnarliest symptoms,unfortunately.
Um, so the issue is not that ourmast cells are, it's not like
you have a, uh, hypoactiveimmune response.
It's not an autoimmune response.
It's a hyperimmune.
Response in a body that'shypervigilant, essentially.
(08:40):
So your body is constantly onand it's constantly sending
these signals.
So it's not bad that the bodydoes that.
The problem is that when youhave too many of these mediators
floating around, and some otherones that people may have heard
of, like cytokines,prostaglandins, interleukin six,
these are ones that we associatewith inflammation, uh,
generally.
Um, because being in mast cellactivation is a state of
(09:01):
inflammation.
It's chronic immune activation,which is inflammation.
Um.
They, it's that these messengerscreate new symptoms.
So you have a bunch of histaminefloating around in your
bloodstream and that causesthese new symptoms.
Um, so what happened also withthe COVID pandemic specifically,
was that COVID has this reallyspecial relationship with mast
(09:21):
cells.
Mast cells have a certainreceptor on the outside of them.
When something attaches to thereceptor, they release the
chemical messengers inside.
All these communicators andunfortunately, COVID attaches
and attacks the ACE two receptoron the outside of mast cells.
So that is why so many peoplehad what looked like long COVID
or was diagnosed as long COVID,um, I really think of as a
(09:43):
combination of MCAS and maybesome other, uh, pieces as well,
like pots and hypermobility.
But, um, that's what happened inthe past few years when we saw
the people.
Why are we all talking abouthistamines now?
It's because it caused thissurge in this histamine
response, uh, when thosereceptors were attached.
So histamine's goal in our bodyis to, again, respond to threat.
(10:05):
One of the things that it does,very importantly, is it causes
something called vasodilation,which is the opening and
widening of our blood vessels,so that it almost creates like a
slide in your body.
If your blood vessels are wideopen, you can just send anything
down really quickly, right?
If they're squeezed tight, youcan't.
Push anything through as quick.
So it's like kind of likeopening up those traffic lanes
in the body.
That can create a lot ofproblems if your blood vessels
(10:27):
are wide open because you don'tget that pumping mechanism that
would lead to good blood flow inthe brain and heart.
So one of the common symptoms wesee with histamine issues is.
Tech, fast, heart rate,dizziness, um, migraines can be
a, a cause, um, can be caused bylack of, uh, appropriate blood
flow, um, especially to yourbrain of course, and a, a lot of
(10:47):
body pain as an experience.
People have histamines.
Job is to kind of keep us alertand aroused and ready for any
threats.
So also people can experience anextreme amount of anxiety.
And I describe that anxiety asbeing tremendously physical,
almost like ants crawling underyour skin.
Um, you know, that's that heartpounding anxiety.
(11:08):
Um, of course that.
Thoughts can follow, but it's,it's very physical, this
feeling.
Um, I had tremors also thatwould last like all night.
Um, and insomnia is reallycommon with histamine issues as
well.
More common histamine symptomsthat we do know about, of
course, are what we would takeantihistamines for, right?
Like seasonal allergies, um,sinus issues.
(11:28):
Rashes, um, reactions to food.
And then, um, other very commonsymptoms of histamine issues are
chronic, um, urination, feelingof fullness in the bladder, and
a, a sensation of inflammationin the bladder.
Um, waking up in the middle ofthe night to pee, uh, waking up
at all in the middle of thenight because of the insomnia
piece, and then a tremendousamount of gut issues.
(11:48):
Acid reflux is closely linked tohistamine issues as well as I
see both a combination ofconstipation or diarrhea,
depending on where you tend.
And then.
Um, depressive symptoms andanything that can come from, uh,
neurotransmitter issues ornervous system issues.
It's so interesting because, Imean, I think you kind of
already answered thisindirectly, but histamine issues
(12:10):
are so often missed ormisdiagnosed in traditional
medical settings.
In your experience and in youropinion, do you think it's just
because it could be, I mean,literally the symptoms could be
all across the board.
We just don't know.
Great question.
I mean, if you, Heather, if yourheart was pounding outta your
chest, where are you going?
(12:31):
Are you going to theimmunologist's office?
Are you going to the allergist?
Right?
No.
You're probably going to the ERcardiologist.
Exactly.
There is no world in which ifyour heart is pounding out of
your chest, you are going to besent to an allergist.
And that is the problem withhistamine symptoms.
They look nothing like what'sgoing on on the inside.
They don't look like immuneconditions.
They look like whatever thesymptoms are and a lot of
(12:54):
histamine issues'cause they cancause slight variations in in
body temperature, certainlyheart rate, blood pressure.
They look like emergencysymptoms.
They look like you need to go tothe er, right?
Those are all, they can changeyour respiratory rate.
They can change your O2saturation.
I mean, these are the exactreasons you would go to the er.
This is what any doctor wouldtell you.
Please go to the ER with, and bythe way, I invite people, please
go to the ER if you have anydrastic symptoms.
(13:15):
But they're not gonna be able toget to the root cause there,
because it's so, it's, it's, so,the way our medical system is
lined up is that each body part.
Is so fragmented and segmented.
You go to the heart doctor forthe heart stuff.
You go to the this, you know,you go to the neurologist for
the headaches.
It.
There's no one really to put thefull picture together, but I
think we're getting better atit.
(13:36):
But that's why I don't evenblame doctors.
'cause if I'm a cardiologist,I'm gonna run an EKG, an
echocardiogram.
I am not going to say, Hmm.
Is your heart pounding outtayour chest?
Because of a histamine issue.
Like they're gonna check alltheir boxes so that they're not
missing something major.
Yeah, totally.
They're gonna look at the organsand how they're functioning.
They're not gonna look at what'smaking those organs act in an
(13:58):
interesting or unique orunpleasant way, because it's not
what.
That their job is, to be honestwith you, and I don't blame them
for it, their job is to makesure there's nothing emergent
happening.
Um, and some cardiologists dotreat pots, which we're gonna
talk about I'm sure as well.
But yeah, that's really why,and, and what I'm more nervous
about, I would say, is thatit's, you know, back in the day
(14:22):
it used to be.
You go to a conventional medicaldoctor, conventional medicine
fails you.
Where do you go?
You go to a functional medicinedoctor and the promise of a
functional medicine doctor isthat they're going to be the
ones they're if, if all elsefails, you go to them.
They're the last stop on thetrain.
Most of my clients come fromfunctional medicine doctor's
offices.
Now, same.
They have been harmed, andcertainly for you for years,
(14:43):
this has been the case.
They have been harmed byfunctional medicine because a
lot of the interventions like,Ooh, let's do a gut detox.
Let's do a mold detox.
Those create very drastichistamine issues because
histamines will respond to thosechanges in the body, and our
mast cells are always on alert.
So if you create any largechange or you try to really dig
in.
The histamines, the mast cellsand histamines will be very
(15:04):
reactive.
So I'm seeing people get sickerin functional medicine doctor's
offices, which again, I don'tblame them for,'cause it's like
a to, it's like playing four Dchess sometimes with our immune
system.
Well, this is probably a rantfor another day.
But I often tell clients that,you know, I'm on calls with,
they're like, well, how is thisdifferent than the functional
medicine doctor that I saw?
(15:25):
And I asked them, you know, whatdid they recommend?
What did you do?
Honestly, what they've done isno different than conventional
medicine.
They were given like a bag ofsupplements and like probably
told to eliminate a.
A ton of foods and that's it.
And I'm like, that's apathicmedicine.
Thats allopathic medicine.
Yeah.
It's literally no different thanconventional medicine where
(15:45):
they're just stacking onmedications and like true
functional medicine is actuallylooking at like all the pieces
of the puzzle, lifestyle,nutrition, like all of it.
And yeah, so that's a bone thatI have to pick for another day.
But I mean, that's an, that's anepisode for us.
I'm telling you for sure.
Because I, I could cry, youknow.
When I first became like frombeing a conventional dietician
(16:07):
to a functional dietician, likethe hope of functional medicine
burned inside of me, I was like,this is it.
And I still do believe this isit, because functional medicine
is not a pill for every ill.
Functional medicine is thebelief that every single part of
our body is.
Interconnected that our body'slike a seesaw.
You push one thing down, theother thing pops up, right?
That is every single thing inour spirit, in our connections
(16:30):
with other people, everything ispart of this big picture, and
that's what the real heart offunctional medicine is.
And it's, and it still shouldbe.
And there's still many amazingpractitioners and it's really
hard.
When we've kind of gone intothis, again, it's, it's the sa
it's just a for-profit system,unfortunately, um, where we're
just, again, giving supplementsand if you give supplements to a
body that's on alert, um, itwill react to those supplements
(16:53):
and you can get a lot sicker.
Um, so a lot of functionalmedicine doctors are very into
IVs, detoxes, really aggressivemodalities.
And then they say to a clientwho's getting sicker, oh, you're
just having a herx reaction.
Mm-hmm.
It's just a detox reaction.
In the case of histamine issues,if you're getting sicker, you're
just getting sicker.
They're just get, you're justgetting worse and now you have a
(17:13):
new problem to deal withbasically.
So it's something really tonotice that if you are working
with a functional medicinedoctor, you're getting sicker.
You're just getting sicker.
Mm-hmm.
If it's eh, you feel a littleoff for a week or something,
it's very different than if thesymptoms are progressing.
Totally.
So kind of on that note, youknow, obviously this podcast is
about gut health and weobviously see a lot of things
(17:35):
outside of gut health, but ofcourse, what role does the gut
play in regulating histaminesrelated to like, of course, DAO
microbiome, gut permeability,all of those things?
Because to your point.
We have seen a lot of peoplesimilar where, oh, I did a SIBO
protocol, or I did thisprotocol, and I, I couldn't
(17:56):
tolerate it.
I felt horrible and they told meto just push through, or I
needed to take more binders or,you know, whatever the like
recommendation is.
But.
What role does the gut play?
And obviously we have to lookoutside of the gut and stabilize
things there as well.
But yeah, hundred percent givekind of some insight there.
Oh, there's a lot of areas wecan go into here for sure.
(18:17):
So one of the first things thatI am going to think about is
histamines and its relationshipto acid reflux.
Mm-hmm.
And the reason is they have adirect relationship.
So the more your body releaseshistamines, the more your body
will release acid.
The more your body releasesacid, the more your body
releases histamines.
In functional medicine, we knoweveryone talks about all acid
refluxes from too low of stomachacid.
(18:38):
Always Not in the case.
Histamines usually, and it's notalways exactly.
I know it could be 98% of thetime.
And either way, even if that waswhat's driving it, if they're
symptomatically having acidreflux issues, that then you
know you're releasing acidthat's creating a new state of
inflammation and then yourbody's going to respond by
releasing more histamines.
Mast cells do this reallyfrustrating thing.
(18:59):
They're more active duringinflammation, so it becomes this
kind of vicious cycle.
So that's one thing that Idefinitely wanna look out for
is, is someone experiencing acidreflux?
Very common with histamineissues with SIBO protocols.
E, whether it's an herbalprotocol or antibiotic protocol,
if you are going in and killinga bunch of bacteria.
(19:19):
And then your body can't get ridof the bacteria in ways of
drainage or detoxification.
You're basically gonnarecirculate those toxins.
And when you recirculate them,your immune system's gonna go,
what the heck is that?
Let me mount a response on that.
I don't like what that is.
And then when you have thatresponse mounted, you then have
new issues basically,'cause thatyou'll get symptoms.
(19:41):
From the response it's mountingas well.
So it's just really importantwith those protocols.
And Sibos very concurrent.
It happens a lot with histamineissues, um, because gut motility
can be affected becausehistamines and the nerve, your
immune system and nervous systemwork very closely together.
So, um, your basically the, the,just the actual action of.
(20:02):
Blood flow going towards thegut.
Muscle contraction can be, iscontrolled by the nervous
system.
So if your nervous system's onfire, you can have altered gut
motility, whether it be like.
Really aggressive diarrhea orconstipation.
And then as we know, and youdefinitely know Dr.
Heather for sure, um, foodsitting in our gut and
fermenting because we're notmoving it through our guts then
(20:25):
is going to create new histamineissues as well.
Um, so it's, it can be reallycyclical in that way.
And using really aggressiveprotocols when you don't have
the drainage or detox capacitycan lead to brand new issues
essentially.
So what would you say to someonewho's listening to this and
going, okay, yes, that's me.
I've attempted a SIBO protocolmultiple times and I always feel
(20:48):
worse.
Like where with.
Michelle, would you start, likewhat are you kind of looking at
as far as like, okay, let's takea step back and let's like
address these things, nervoussystem, et cetera.
Yeah, you basically said it, butyeah, that's the, the rule is if
we are addressing anything inthe body that's a root cause.
'cause SIBO can certainly be aroot cause.
It also cannot be root cause,uh, as we know.
(21:10):
But you can't address the rootcause and histamine issues until
you've stabilized.
Your immune system and youstabilize your nervous system
because if your immune systemand your nervous system are
firing, you know, very fast andand very aggressively, and that
threat response is high,anything you throw at it is
going to scare your body andcreate a new response.
(21:31):
So I just say it's reallyimportant to focus on
stabilizing histamines, and thatcould be, that could be
something as easy as eating alower histamine diet or
addressing stress.
Really complicated.
I know it's like so much easiersaid than done.
Um, and, and then it can besomething again, addressing the
nervous system as simple asbreathing or meditation or as
something like taking herbalsupplements that help support
(21:53):
the nervous system, whatever ittakes to get those two steps.
A approached first is essential.
And I would say if someone'sgoing to approach a root cause
protocol.
Even again, and I know the SIBOsymptoms can be so debilitating,
but at least taking a coupleweeks to try to calm the body
down first before, um, startingand initiating a protocol.
(22:14):
And then it's really hardbecause there's, there's rules
and therapeutic doses,especially with herbals and
sibo.
We have to go as slow as youcan.
Um, and then it's really sillyand really, um, it sounds very
corny, but it's very true thatwhen you're like taking these
supplements or medications youlike, have to work with and
communicate with your body andbe like, this is for us.
(22:35):
This is a nice thing that we'redoing.
I love you body.
This is to help you and like tryto create a landscape of healing
also, I think is really, reallyimportant.
We talk to our clients all, allthe time.
Neuroplasticity is one of thethings that we like really
emphasize because, and probablysimilar to your clients, so many
of our clients have had so manyattempts at feeling better and
(22:56):
they have this narrative of,, Ican't tolerate X, Y, and Z, or
I'll never be able to eat X, y,and z food.
And like changing thoseneuropathways can be so
important.
But like you said, it's sotricky because.
Oftentimes, I think the secondthat someone hears stress in
their nervous system is the rootcause.
They're like, forget it, youknow?
Like, I can't quit my job.
(23:17):
Totally.
I can't do this.
So what would you say, if that'skind of the mindset of, you
know, kind of the connectionbetween stress and the nervous
system and histamine and, andall of that, like Yeah.
How it doesn't actually have tobe.
Meditating on the beach for anhour a day in a fancy outfit.
Like, it's not, that's notreally what we're getting at.
Oh, I have to be, I'm, I'm aJewish New Yorker born and
(23:38):
raised.
That's not our style.
You know what I mean?
It wouldn't, there was not,there's nothing soothing about
what you just described to me.
I use the word safe, right?
We have to do whatever makes usfeel safe.
For me, it's like blasting emomusic.
That's what makes me feel safe.
It's like blasting rock and rollmusic.
So it has to be what makes youfeel familiar and safe.
To you.
So that's what it means.
(23:59):
And the other part of it is, youknow, there was a time.
During the worst moments of myhealth where I literally, and I
always look, I had a computerchair.
I was, I would sit on, I havelike a day bed in my office
that's like, kind of a couch,kind of a daybed.
I would sit there, I would liftmyself onto the computer chair.
'cause if my feet touch thefloor, my heart would start
pounding and I would wheelmyself to the bathroom.
(24:20):
And then I would have to crawlbasically to get to the
bathroom.
'cause I, if, if my feet touchedthe floor.
I was so dizzy.
I would be dizzy for days.
At that time, I had torecondition so, so
substantially, and I rememberstanding in front of the mirror
for a minute.
And I was just like so dizzy.
And I just said to myself like,I just don't think you're gonna
like make it out of this.
I just don't.
I don't, I'm not seeing it.
(24:41):
And then some other likeanimalistic part of me was like,
don't ever say that again.
Do not ever say that again.
So it doesn't come down to, oh,I have to sit on a beach and
meditate or do these things thatare like cooling, calming.
It's just about finding thatpart of you that may seem
irrational, but believes thatthere's some chance you can
heal.
And the reason is with these.
(25:03):
Syndromes and conditionsparticularly, they're extremely
nervous system driven and thesymptoms come from being in that
nervous system state.
So I have a lot of my clients,as much as we can to be
non-reactive to symptoms.
And it's so hard.
I mean, who is gonna havediarrhea 15 times a day and
excruciating pain and be like,this is fine.
You know, but that's really whatwe have to get to.
(25:25):
'cause the second you go, oh myGod, this isn't fine, you're
actually getting new symptoms.
So it really becomes cyclicaland then your body anticipates.
The discomfort and then releaseshistamines on top of that.
So it's this very weird thingwhere you have to like believe
blindly that you are going toget better, visualize it, and
anyone can do that.
You don't need time.
You just have to be a littlesilly about it, I think.
(25:47):
Mm-hmm.
It's like that's not, stressreduction to me isn't like
putting ice on your neck, eventhough it can be really helpful
and, and cooling and nice, butit's about finding a way to find
that part of you that believesin an irrational sense that
you're going to heal.
And then finding little pocketsof safety wherever it is,
whatever that is.
I don't care if you're watchingtv, you know, I know people are
so weird about the, not weird,about like rationally, but so
(26:09):
strong about like no blue lightat night.
Like if you need to watch likeold seasons of Sex in the City
or something.
To like soothe'cause it'sfamiliar and it's, your brain
can calm down whatever thatthing is for you get and, and
find that identity of the personthat once wasn't sick.
And I think that's reallyimportant too.
I love that.
I think that's such a good wayof looking at it.
(26:29):
And honestly, I mean, if someoneis reaching out to you or me, or
even listening to this podcast,there obviously is some piece of
them that believes they can getbetter.
Oh yeah.
You know?
So like, you're already there.
Lean into that piece.
Yes.
Oh yeah, absolutely.
You're already there.
I wanna circle back to pots,because you mentioned POTS
earlier and we see a little bitof pots.
Um, I would say when I wasseeing a lot more eating
(26:52):
disorders, I saw even more pots.
Oh yeah.
Um, mm-hmm.
And you know, now we still seeclients with disordered eating,
I would say not like activeeating disorders, but.
You know, the standard treatmentfor POTS is like, we'll just
have three to five grams ofsodium a day.
Well, it's actually 10 grams,which is, is it 10 now?
Okay, 10.
Yeah.
So, you know, you'll go to yourdoctor, you'll get like a
(27:13):
massive recommendation for salt.
And although that can help, likeyou and I both know, there's a
lot more to the story hundredpercent when it comes to
histamine and, and all thesethings.
So kind of walk us through that.
For anybody listening.
So we'll walk back even to thepoint of defining pots.
Pots is postural orthostatictachycardia syndrome.
So that means you make apostural change and your heart
(27:33):
starts pounding.
Okay.
I wanna give the example ofsomeone who, and if a client is
listening to this or you know,they might identify with this,
you're in the shower, you out ofnowhere, look down and your legs
are really red and you feelreally dizzy, and you're like.
What's going on a second later,your heart starts pounding
really fast.
So when histamines are an issue,they cause what we talked about
(27:54):
before, vasodilation, thewidening of the blood vessels.
So what happens is your blooddrops down to your feet, and in
the case of pots, it may not,your heart may not react to pump
the blood back up.
The reason you see the rednessin your legs is there's.
Blood pooling, literally bloodthat's pooling in your legs, and
then your heart and your brainare going, hello, we need the
blood flow up here.
So your heart starts poundingreally fast.
(28:16):
So the heart fast, the the fastand hard.
Pounding you feel is to getblood flow back up.
So often the, and, and often therecommendation for POTS is, is
like we said, 10 grams of salt,which you have to picture those
little element T like elementsodium, that's they're one gram
each, so that's 10 elementpackets a day.
This is an extreme amount ofsalt, which most people don't
(28:36):
need that much or can meet thatneed, but some, some do.
So the goal for.
That type of approach is thatthere's different types of pots.
One of them is something calledhypovolemic pots, and the the
deal is your blood volume is toolow, that it doesn't have enough
to pump and bring the blood flowback up.
That's the goal.
Now, this is the mostinteresting thing in the world,
(28:57):
and I'm obsessed with this,okay?
Pots.
Is a form of would, if we weregonna categorize it, we would
say, oh, it's probably acardiac, this has to be a
cardiac condition.
It's actually a form ofdysautonomia.
Mm-hmm.
It's a form of dysfunction ofour autonomic nervous system.
It is a nervous system disorder,which makes no sense to people
because how could that be?
Your nervous system will tellyour brain, send blood.
(29:20):
Contract this muscle, so it'scoming from your brain.
So the treatment for POTS that'sconventional is, well, let's
just add a bunch of salt, makethe blood volume bigger so that
the blood pumps.
More efficiently, or I say it'skinda like making your body like
a Go-Gurt tube.
You like wear compression socks,you wear an abdominal binder and
you squeeze the body.
So the pressure goes up.
(29:40):
Basically if you think aboutlike squeezing the middle of
that Go-Gurt tube and the bloodflow will go up, right?
Mm-hmm.
So that's the goal.
Or you lay with your legs on awall.
Basically just anything to helpthe body's mechanism.
Put the blood up please.
'cause the body's doing it foryou and compensating.
But the real ultimate treatmentfor POTS is you have to address
the nervous system, right?
Because if the nervous system isin the right, not constantly
(30:04):
sympathetic state, and you getin the parasympathetic state,
then it'll say, oh.
You're supposed to send bloodflow here it, this is the muscle
that's supposed to contract, andthat is the core and crux of it.
So a lot of the treatmentprograms for MCAS and POTS are
actually limbic systemretraining programs like the
Gupta program, primal Trusts,because we know these are
brain-based conditions, which isfascinating.
(30:25):
Of course, the immune systeminvolved, of course the cardiac
system becomes involved, but theroot cause of them is a nervous
system.
Um.
You know, condition, which is,I, I, I've always thought
fascinating and I think therelationship between MCAS and
POTS is in this vasodilationpiece is a huge component.
It's so interesting.
You know, going back to like2020, I, I think I was like
(30:46):
patient X for COVID.
I think I had it like rightbefore, like the world shut
down.
I was sicker than I've everbeen.
March, 2020.
You were, that was it.
No, it was like February.
Like I, it was like beforeeverything.
I like swear that I was one ofthe first people that had it.
I, I could be totally wrong, butI was so sick for like two
weeks.
I, I've never been sicker in mylife.
(31:06):
I'm so sorry.
It was crazy because severalmonths after that I started
having POTS related symptoms,and at the time I was developing
the Gut Together program.
Mm-hmm.
And the Gupta program is like abig recommendation that we give
to our clients and somethingthat I did.
Symptoms gone, so I know.
It's so cool.
Yeah, I, first of all, he's socool.
(31:26):
The creator, Ash Gupta had himon my podcast.
He was like, so cool.
Love that.
And the program's incredible.
I have a little bit of apreference because I've been
through it, but I've only seenparts of Primal Trust, um, and
DNRS.
I've only seen parts, but yeah,it's.
It's really incredible and theidea that you're treating this
immune condition that shows uplike a heart condition by
treating the brain.
It's so fascinating.
(31:46):
And, and then once you get it,you get it.
And it wasn't until that allthose symptoms I was describing
were really pot symptoms, right.
When I, when I would stand upmm-hmm.
The blood changes and thedizziness, they only got better
when I started working with mylimbic and nervous system.
It's so true.
I mean, my husband was, wouldget so worried because I'd stand
up and I'd be like, so dizzy,blacking out, like holding onto
(32:07):
something so I didn't fall over.
And he's like, you need to go toa cardiologist.
Like I'm really worried.
Hundred percent.
And I mean, I was so close tobeing like, is there a problem?
And then it just.
Like slowly started gettingbetter and I'm like, that's the
only thing that was different.
It's wild to me.
And then when I dealt with mold,same thing.
Like the limbic system is such abig piece.
So Yeah.
(32:27):
And our limbic system that Iknow we've mentioned, and I'll
walk back to is three brainstructures, our amygdala, our
hippocampus, and ourhypothalamus.
And they will process threat,same thing.
And they will also prepare yourbody using memory.
If this happens, we don't wantit to happen again.
Let's prepare.
Your limbic system communicatesdirectly with your nervous
system and your immune system.
(32:48):
Um, histamines can also bereleased from and created in
your hypothalamus.
Um, so that is why you get thatextra alertness anxiety that can
happen.
Uh, this link between youhaving.
A COVID virus and that turninginto this pots, you don't know
how long it took all of us tofigure this all out because it
was so, it so doesn't makesense.
(33:08):
'cause it didn't happen withother viruses.
It never'cause the, the fludoesn't attach to mast cells,
you know, and in the same way,like the seasonal flu, right.
I'm sure it does in somecapacity, but certainly not to
this level.
So.
For me, it was like figuringout, I literally would just type
into, I would just type intolike Google, like pre pre-chat
GPT.
I was like, why dizzy on daynine cycle?
(33:31):
Like I just, and what's theanswer you get from that?
Right?
Like, I had to go on Reddit andbe like, what the heck is going
on it?
It really was when I saw astudy.
About long COVID patients, andthe study was studying 16 long
COVID patients and they hadsevere fatigue symptoms and they
gave them 80 milligrams ofFamotidine, Pepcid.
And I was like, and then 80% oftheir symptoms resolved.
(33:53):
And I was like, what?
I was like, why is this acidblocking drug helping with
fatigue symptoms?
And then I.
Oh wait, Pepcid also anantihistamine.
Wait, wait, wait.
I didn't even realize that atthe time.
No one would realize that, ofcourse, at the time.
And it took me like, I was like,oh, there's a thread and the
thread is histamines and, and ittook me tying so many different
things together and really a lotof self-discovery because how do
(34:16):
you get from point A to point B,right?
It's like impossible.
And I don't blame even again,practitioners for not getting
there.
But now, after five years ofCOVID, I we're starting to see
these predictable patterns, andI've really never seen someone
with p.
Who do not have M Cs.
It's very rare.
There's a couple like people whowere maybe had a history of
eating disorders and werechildhood athletes who I've seen
(34:38):
with POTS that don't really havehistamine issues.
But in the COVID context, I'venever seen someone with POTS who
doesn't have histamine issues.
And again, if you went to aneurologist for pots, they're
still not gonna look athistamines because of the
fragmentation of our healthcaresystem.
So you bring up two points andthings that I wanted to mention.
Histamines and hormones.
You mentioned day nine, and thenalso Pepcid and antihistamines,
(35:03):
Zyrtec, et cetera.
So when you spoke in gutpractitioner, you talked about
kind of like this, like trialyou could have clients do, like
try Pepcid for, I think yousaid, three days or something,
and see if your symptomsresolve.
Um.
Talk us through that.
And then also maybe we can bringin like the hormone connection
as well.
Yes.
And something I have to mentionis, of course, this is not
(35:23):
medical advice.
This is not medicalrecommendations.
Yes.
In any capacity.
And everyone will have adifferent reaction to every
single over the countermedication, every single
supplement, especially in thispopulation.
So know that you can get theseover the counter.
It does not mean that you willreact the same way as anyone
else.
And that's just something I haveto mention.
Um, so.
Again, why did I become afunctional dietician so I could
(35:43):
be talking about over thecounter medications?
No way.
I never thought I would betalking about over the counter
medications, you know?
Um.
It's really interesting.
I have a friend who a lot ofpeople know on Instagram is
organic, Olivia, but she mm-hmm.
You know, I'll, I'll, of courseI'll call her Olivia.
Olivia wrote an article a longtime for her company, and they
said in the article like, well,what is your ultimate travel
emergency, you know, pack?
(36:04):
And she said, I always haveBenadryl in there because
Benadryl helps with everything.
I said, Olivia, the fact thatyou didn't know you had a
histamine issue.
When you wrote this article, Iwas like, Benadryl doesn't help
anyone with anything unless youhave a histamine issue.
Like, she's like, this is thething that will cure every
ailment in my body.
I'm like, yeah,'cause your, ifyour ailment iss a histamine
issue, it'll, it'll help.
So if you have a histamine issueand you respond really well to
antihistamines.
(36:25):
You know, you'll, you'll get anunderstanding that potentially
this is what's going on, and I'mgetting some relief from this.
A lot of clients are veryhesitant to take over the
counter medications, especiallyif they've been in like the
natural world, the holisticworld, the functional world for
a long time.
Um, but I've seen that somepeople really do.
Need them.
Um, and from a hormoneperspective, and I'm doing a
(36:47):
histamine hormone webinar at, onSeptember 28th.
Okay.
I'll put the, I'll put the linkin the show notes.
Yes.
With Amanda Montalvo, who peopleknow on Instagram is the Hormone
healing Rd.
It's gonna be nuts.
I'll be there.
Yeah, exactly.
Yeah.
It's gonna be a little nuts.
I have to be honest, like thisis, this is like heavy hitters.
I'm very, very excited.
She's the most brilliant personI know, so I'm so excited.
Um, for me, again, I was lookinglike.
(37:08):
Why do I feel so bad the day mybleeding stops?
Like normally people, if youlook online, what do they say?
The luteal phase.
Everything's the luteal phase.
You feel so bad during, I waslike, I feel amazing during the
luteal phase.
It's the follicular phase I feelterrible in.
And that's because estrogen andhistamine also have a direct
relationship.
So as your body starts torelease estrogen in, uh,
preparation for ovulation, whereit will peak in estrogen, of
(37:30):
course that's when people startto notice symptoms.
And that'll start usually bythe, you know, days.
Seven or eight in a 28 daycycle.
Um, some people a littleearlier, and that's where those
histamine symptoms start comingup.
So if clients have any kind ofhistamine driven symptoms,
that's where they can trial.
Oh, this three day period is themost symptomatic for me.
This is where I might wannatrial either natural
(37:52):
antihistamines or over thecounter antihistamines, whatever
that looks like for them.
But the most important thing youcan ever do when it comes to
histamines is track.
Especially as a woman, trackingyour cycle.
'cause then you can see, oh, day10 every month to not feel
crazy.
When I would I, I just, it mademe feel so sane when I would
look at my calendar and be like.
(38:13):
Day 20.
I got a headache last threemonths in a row.
Okay, day 20 is a headache day.
I need to understand and preparefor that.
Okay, day nine's a dizzy day.
I need to prepare for that.
So just understanding andtracking your cycle is
important.
And I know we can sometimes gethypervigilant about it and I
wouldn't recommend that as muchwe can avoid, but the validation
of like, I know my body and Iknow what to expect is so
(38:34):
helpful.
And then you can say, oh, I needto up antihistamines, whatever
form again.
Natural or not.
Um, and then, or I need to, youknow, take it easier these days,
or I need to drink extra waterif it's gonna be a headache day,
whatever it is.
What about pregnancy?
So we've had clients who feel alot better during pregnancy and
(38:55):
then we have some, you know,maybe no change or maybe feel a
little bit worse.
Yeah.
So walk us through how pregnancywould affect histamines.
Absolutely.
So the first cool thing aboutpregnancy is you do produce more
Dao, which does help break downhistamine in the gut, which is
the placenta actually producesmore Dao, which is DAO Oh,
diamine.
Oxidate.
So cool to me.
Like how it's just so cool.
Yeah, it's, yeah, it'simmaculate.
(39:17):
I had this brilliantnaturopathic physician who I was
working with, and she alsodescribed that like when your
immune system is so busy, likebuilding new life and like
creating an immune system andusing your own, it kind of like
diverts its efforts into growingthe child as opposed to.
Being hyperactive to all thesymptoms and things around you.
(39:39):
So it can happen where MCASsometimes it can be worse in
pregnancy just because yourestrogen's really high in
pregnancy too.
So it's not stabilizing.
Progesterone is supposed to bemast cell stabilizing.
The other problem is, I mean,the other reason why pregnancy
may be positive, there's otherpeople who have more problems
with it, and I'll talk aboutthat, but is because your blood
(39:59):
volume increases by 50%.
So that's really nice for pots.
If you have hypovolemic pots.
That's really, really nice sopeople can feel a lot better.
So I notice pot symptoms get.
Often a lot better.
Um, but then you're alsogenerally people are a lot more
inactive and that can lead todeconditioning and that can, it
really depends.
Um, also you can become very,your blood sugar's much more
(40:20):
erratic.
Um, oftentimes it can be inpregnancy and actually in the
first trimester, your, yourinsulin's more sensitive.
If you already tend towards lowblood sugar, that can create
more low blood sugar episodes.
So I've seen people with MCAShave worse acid reflux, worse
morning sickness as well.
Um, but I've also seen like thecrazier huge MCAS symptoms get
(40:41):
better, like we said, becauseyour immune system has a new job
to do as opposed to just beingdramatic like my immune system
is, you know?
Yeah.
Mine's pretty dramatic too, so Iget it.
I think the best people's are.
Yeah, I think that's the truth.
there was this joke growing up,like my family would always joke
that like, I could look atsomething and get a rash, and
I'm like, I mean, it's funny,but like, it's also true.
(41:01):
So, you know, I think that's mewith like, um, empathy, physical
pain.
Like, I, I can't, I couldn't,that was the truth.
I may not have been by a lotlike a hype hypersensitive from
a body perspective, but I washighly sensitive as a person and
everything.
Everything mattered to me at alltimes in my life.
Everything was so important.
(41:21):
Everyone else, everyone else wasfeeling I needed like a shield.
Even as a kid it was like Icouldn't even like go on the
soccer field.
My dad had to hold my hand,which is so funny'cause I am
very extroverted and like lovepublic speaking in front of
thousands of people and have noproblem with it.
But my dad had like hold my handon the soccer field.
'cause I was like, I don't knowwhat the other kids are thinking
or feeling.
And he's like, okay, that's not,you have to just kick the ball.
(41:41):
We're here to play soccer ball.
Yeah, exactly.
Just take the ball around.
Oh, I get it.
It's so hard.
So we've talked about a lot ofthings and someone might be
thinking, well, would like a lowhistamine diet just fix all
these problems?
Walk us through that.
They already, they already know.
No, by the way, if they're here,they already know the, they've
already tried that.
Yeah.
However, I will say this, themore high histamine foods we
(42:04):
eat, the more our body produceshistamines.
It's a very backwards, sillything about our body, by the
way.
I'm like.
No, you have enough.
You don't need to make more.
But our body does this veryfrustrating thing.
So there are clients I have whocould eat a tomato and end up in
the hospital.
There are clients I have whocould eat two bites of vinegar
and they're stomach sick forthree weeks.
It is often necessary to trial alower histamine diet for some
(42:26):
period of time, but.
Highest mean foods are thehealthiest foods that we know
of, right?
If you went to a gut healthdoctor or you went to Dr.
Heather 10 years ago, youwould've been like, have some
fermented foods, have citrusfruits?
Mm-hmm.
Have like nato, Tempe, miso,bone broth, right?
Vinegar, like they are all thethings, some of the healthiest
(42:47):
foods.
Tomatoes, avocados, bananas,spinach, you could not create
healthier foods than the highhistamine foods.
So it's just that it's causingthis kind of sideways, odd
reaction.
But they're not actuallyunhealthy in any capacity.
These foods, they just createunhealthy symptoms within us.
So it's often necessary forpeople to, yes, sometimes trial,
(43:07):
low histamine diet.
But if that's not your rootcause, I have some clients who
are huge histamine clients andthey can crush vinegar and
there's no problem with it.
I have some clients though, whogo into a room and has a
chemical smell.
They're sick for weeks.
Mm-hmm.
So you, you really have to knowyour own triggers.
But often in the beginning whenthe body's hyperreactive, it's
going to be hyperreactive tofoods as well.
(43:28):
And the goal is to just lowerthe bucket, all of the histamine
load, lower it as much as youpossibly can for in the
beginning.
So on that note, if someone islistening and they suspect
histamine intolerance or MaMCAS, or maybe they already know
they have that, what would yousuggest as like a first kind of
practical step to start feelingbetter?
(43:48):
Yeah, the first thing I would dois get to know your symptoms.
So track them, notice them.
When I eat this, I notice I feelthis way and it's not gonna be
the same every time.
So don't expect the pattern'sgonna be perfect if you are a
woman.
What's going on with your cycle?
What are you noticing?
The first thing is getting toknow your symptoms and getting
to know where maybe there's apattern you could recognize.
It's not about one-timereactions, but where we can pick
(44:10):
up on patterns.
That would be the first thing.
The next is I would just startto assess.
What makes me feel safe, whatmakes me feel unsafe, and start
to understand again, what areyour personal triggers, whether
it's food, whether it's stress,whatever those things are.
You don't have to do anythingabout them, but just inventory
those things in your life.
(44:30):
That act of getting to knowyourself is extremely soothing
to your nervous system becausewhen we can understand we can
calm.
Mm-hmm.
It's when we don't understandwhat's going on in our bodies
and we say, oh my God, my heartis pounding and it's so freaking
scary.
That is when we start to freakout and that's when the symptoms
get much grander, which is sonormal and human of course, to
feel that way.
But when we understandourselves, we start to heal.
(44:53):
So the first step is understandyourself and understand.
Start to get to know yourtriggers.
Then you can trial at home alittle bit of a lower histamine
diet if you wanted to.
It's safe to do, but not in thelong term.
Um, so just trialing.
Do I feel a little bit better?
It will take more than a coupledays for you to, to notice that.
And then again, anything thatdrives safety, anything at all
(45:13):
that drives safety for you.
I would also probablydiscontinue all supplements, you
know, for the time being,especially if your reactions are
really great.
And if you are trialing newsupplements, you do one or one
eighth of one for a week, andthen you add in another one.
Mm-hmm.
Okay.
Very, very slow.
Yes.
Slow is.
Is the key for all of this.
(45:33):
It it really is, yes.
Slowness in every way.
Slowness in how you live,slowness in how you approach
things.
It is MCAS makes us feel likewe're on fire and we need to do
everything we can to slow.
Yes.
So what gives you hope inworking with clients who
struggle with histamines mastcell?
What gives you hope?
(45:54):
Oh, I've ne I've never felt morehopeful.
Than I do now, which is the bestfeeling ever.
Um, watching myself, watchingall of our clients getting
better.
Um, I've, I've seen people healfrom just attending a freaking
pod, watching let's do a podcastor watching a webinar.
I think the really excitingthing is we really get it now,
like we're really starting tounderstand how, what's this
(46:16):
landscape of our immune systemand our nervous system, and I
just have so much faith in thehuman spirit, and I have so much
faith in our ability to heal andthat our bodies want to heal and
they don't.
They don't want to stay sick.
And I just have so much faith inus, and I've seen what looks
like miracles every single day.
But it's not miracles.
It's because we get it now, andthat's the truth.
So the more and more informationwe have, the more we can empower
(46:39):
ourselves and the more successthat we see other people
experiencing, I think thebetter.
Um, I, I just, I've never feltmore hopeful.
I'm like, we so got this.
I mean, there's really no levelof sick someone can come to with
me and I'm like, we're good.
We'll, we'll figure it out nomatter what.
I love that.
Yeah.
Okay.
Well this has been amazing andso much good information.
(46:59):
So tell everybody where they canfind you, work with you,
podcasts, like all the things.
Absolutely.
Um, it was my joy and I'm soglad that we got to hang out
before too, by the way.
Um, so you can listen to olderepisodes of Quiet The Diet,
which is my podcast.
I haven't recorded in a bitbecause I've been working on
these, the, a lot of thehistamine webinars and
everything like that.
Um.
I'm on.
It's really easy to find meeverywhere.
(47:20):
I'm on Instagram, MichelleShapiro Rd.
My website Michelle Shapiro Rd.
Um, we have an upcoming, um,histamine webinar with Amanda
Montalvo, the Hormone Healingrd.
Oh my God, I'm so excited.
We're gonna do P-M-S-P-M-D-D,endometriosis, PCOS,
pre-pregnancy, during pregnancy,post-pregnancy, perimenopause
and menopause.
And it's all gonna be, it'sgonna be like eight hours long.
(47:43):
The last one was three and itwas just me.
So I am concerned.
Yes, I am.
Yes.
It's scary.
It's scary.
I can't wait.
What we're gonna do.
Exactly.
Yeah.
It's gonna be really fun.
It's gonna be really fun.
Um, and the last one wasliterally just a histamine
essentials webinar.
People can buy the replay of ifthey want to.
That was an almost three hourwebinar and it was, it was so
much fun and it was so muchinformation.
And I have a team of, now thereare seven of us, um,
(48:04):
practitioners, if people wannawork with people one-on-one.
Okay, so amazing.
I'll put all those links in theshow notes.
I'm definitely planning to be atthe webinar.
Can't wait.
And thanks so much for joiningtoday.
Thank you so much.
Welcome to the Love Your Gut Podcast.
I'm your host, Dr.
Heather Finley, registereddietitian and gut health
specialist.
I understand the frustration ofdealing with GI issues because
I've been there and I spent overtwo decades searching for
answers for my own gut issues ofconstipation, bloating, and
stomach pain.
I've dedicated my life tounderstanding and solving my own
(00:24):
gut issues.
And now I'm here to guide you.
On this podcast, I'll help youidentify the true root causes of
your discomfort.
So you can finally ditch yoursymptoms for good.
My goal is to empower you withthe knowledge and tools you need
so that you can love your gutand it will love you right back.
So if you're ready to learn alot, gain a deeper understanding
(00:46):
of your gut and find lastingrelief.
You are in the right place.
Welcome to the love your gutpodcast.
Welcome back to the next episodeof the Love Your Gut podcast.
I'm so excited to be here todaywith Michelle.
I feel like this has been a longtime coming.
We've been chatting for like 20minutes Off air should have just
pressed record.
(01:07):
But Michelle, welcome to thepodcast, Dr.
Heather.
I'm so excited to be here.
I'm really excited to be here.
Yes.
So you spoke in gutpractitioner, what was that like
a couple months ago and you werea hit, and ever since I'm like,
I have to have you on thepodcast because histamines and
MCAS and all the things issomething that I talk about, but
(01:27):
not too much.
So I figured why not have theactual expert come on here and
talk about it.
So why don't you just tell uswhy Histamines MCAS, why does
that matter?
You and then maybe like whatexactly are histamines and why
do they matter for gut health?
Just for someone listeningbecause they might not know.
Um, absolutely.
We'll kind of go back to thebasics.
(01:48):
Yeah.
So I live in what I've kind ofnamed a highly sensitive body,
and it took a long time for meto understand my highly
sensitive body.
And it took a lot of goingthrough what I would say is like
both conventional medical meansand functional medical means.
And no matter what I did.
Especially in the last fiveyears, it seemed like I was
(02:09):
getting sicker and sicker, andit didn't make sense.
I would go to the bestfunctional medicine doctors, the
best naturopathic physicians,and I would get something like
an iv, and then I would havewhat looked like a flu for a
week, or I would go get amassage or lymphatic drainage or
go to a sauna.
Again, violently ill, I mean,insomnia, tremors, dizziness,
um, nausea, gut issues, um, inyour domain.
(02:32):
Of course, many, many in yourdomain.
And really just could not putthe pieces together for myself.
And it really took, it wasafter, um, my first COVID
exposure that these symptomsseemed to really skyrocket.
I had both a COVID exposure.
And a mold exposure.
And as, as I was detoxing fromthe mold, I got much sicker and
(02:53):
I was like, wait a second.
This mold detox is supposed tomake me feel better, not worse.
And it really confused me.
And so it was my self-discoveryfrom basically being at a point
where I couldn't walk.
I was in a neck brace and a backbrace for over six months.
Um, I had to crawl a lot of thetime when I needed to do things.
Um, I had a chiropractic injury,this mold exposure.
Um, and this COVID exposure andthat together just created this
(03:16):
new level of illness that I hadnever experienced before.
And then I started to see thatclients were experiencing this
too.
So it was like many of uspractitioners, it was my
eagerness to figure out what theheck is going on in my own body,
and if I can figure this out formyself.
I hopefully can figure it outfor other people as well.
Um, so that's what brought meinto this specific sphere
(03:38):
because I had actually beenworking with different clients
and I still do.
Um, and my team still does formany years before.
And then I saw after COVID therewas this huge increase in this
kind of new type of feeling,terrible, um, that I desperately
sought answers to, um, for bothmyself and clients.
So interesting.
So it was really like, you canpinpoint it was COVID and then
(04:01):
mold kind of coupled togetherthat just made you feel so sick.
Did you, were you kind of a sickkid or do you feel like you were
highly sensitive as a, as a kidwith lots of reactions or
anything, or, no one's everasked me that on a podcast.
That's so interesting.
Oh, I'm a pretty atypical MCASperson.
I don't get any.
(04:21):
I don't sneeze, I don't get anyrashes.
I don't have any of what youwould think of as like typical
allergy symptoms.
I really get like nervous systemdriven symptoms in an extreme
way.
And gut driven symptoms I liketo say about mast cells.
And of course we're gonna definewhat mast cells are, but they
really show you your weak spots.
They really show you whateverthat symptom is that you don't
(04:43):
want is the exact symptom you'regonna get.
So for me, I hate feeling dizzy.
I hate feeling off kilter.
Um, that's the symptom thatcomes up for me.
So it really depends on theperson.
And because mast cells, whichare, are a type of immune cell,
they're a type of white bloodcell, uh, part of our immune
system.
They are literally in all of ourconnective tissue and in every
(05:05):
single part, connective tissuelines, our joints, our bones,
our blood vessels, and also mastcells line all of our organs as
well.
There's connective tissue in ourorgan, uh, tissue.
Uh, a layer of our organ tissue.
So you can really get symptomsfrom mast cells anywhere in the
body and depends on the person.
So the answer is actually, I wasa kid who like got strep once.
(05:25):
I think I was on antibioticslike once.
I was never sick.
I never had, um, like any sortof rashes, gut issues until I
started having reallydebilitating panic attacks and
anxiety, um, in college.
And then kind of started feelinglike a sick.
Person.
Um, I also had in high school,lost a hundred pounds going into
(05:48):
college.
I always occupied a larger bodywhen I was younger.
And rapidly lost weight to go toschool.
Um, I literally was like, oh,people aren't gonna like know me
when I go to college.
I have to like presentdifferently because I grew up in
Queens, New York.
It was no problem living in alarger body.
I had the most friends, greatgrades, like beautiful life, a
place where all types of bodydiversity and diversity in
(06:10):
general.
It was celebrated and I wasgoing to the University of
Delaware.
Um.
A much more homogenous place andI was like, I need to lose
weight.
And it really was the weightloss part that made me feel
sicker.
And that's that paradoxicalpiece of my body.
It's not the mold that made mefeel sick, it's the mold detox
that made me feel sick.
It's not carrying extra weight,it's losing weight rapidly.
(06:30):
So my body does not respond wellto any sort of strong changes.
Um, so I didn't really, again,assume that sickness identity
until after.
The weight loss and, uh, didn'texperience.
Yeah, no, not as a kid.
Uh, wasn't really sick ever.
So interesting.
It's so crazy how with histamineand MAs cell stuff, it can
(06:53):
present so differently.
And you kind of alluded to that.
So tell us, I guess we oftenhear histamine intolerance.
I feel like that's probably themost common phrase, at least
that I hear.
Histamine intolerance.
How is that different from mastcell activation and like what
are the types of symptoms thatsomebody might experience?
'cause.
As you know, and we know itcould literally be so many
(07:16):
different things.
Yeah.
Yes, absolutely.
So our mast cells are these typeof white blood cells.
And what happens is they have,they're, they're helpful to us
in many ways to help us respondto threat or perceived threat
inside of the body.
They will direct resources, theywill direct immune cells, they
will direct nutrients and bloodflow so that when there is some
(07:38):
sort of, again, perceived threator real threat.
We can help the body to recoverfrom it or defend against it.
So I think of our mast cells,um, as kind of like if there's
a, a watchtower, they're kind oflike the guards on the
watchtower and they're alwayslooking to see what's happened
here inside of our mast cells.
There are different types ofchemical messengers in kind of
like these.
(07:58):
Sacks and they will get releasedwhen they perceive that threat
or that threat is real.
So that's when the guards in thewatchtower are like, go, go, go.
And they start sendingeverything.
Um, in the case of mast cellactivation syndrome, those mast
cells are constantly, constantlybeing activated and then they're
sending out these 1200 pluschemical messengers.
(08:19):
One of those chemical messengersis histamine.
And we hear the most about itbecause I think it creates some
of the gnarliest symptoms,unfortunately.
Um, so the issue is not that ourmast cells are, it's not like
you have a, uh, hypoactiveimmune response.
It's not an autoimmune response.
It's a hyperimmune.
Response in a body that'shypervigilant, essentially.
(08:40):
So your body is constantly onand it's constantly sending
these signals.
So it's not bad that the bodydoes that.
The problem is that when youhave too many of these mediators
floating around, and some otherones that people may have heard
of, like cytokines,prostaglandins, interleukin six,
these are ones that we associatewith inflammation, uh,
generally.
Um, because being in mast cellactivation is a state of
(09:01):
inflammation.
It's chronic immune activation,which is inflammation.
Um.
They, it's that these messengerscreate new symptoms.
So you have a bunch of histaminefloating around in your
bloodstream and that causesthese new symptoms.
Um, so what happened also withthe COVID pandemic specifically,
was that COVID has this reallyspecial relationship with mast
(09:21):
cells.
Mast cells have a certainreceptor on the outside of them.
When something attaches to thereceptor, they release the
chemical messengers inside.
All these communicators andunfortunately, COVID attaches
and attacks the ACE two receptoron the outside of mast cells.
So that is why so many peoplehad what looked like long COVID
or was diagnosed as long COVID,um, I really think of as a
(09:43):
combination of MCAS and maybesome other, uh, pieces as well,
like pots and hypermobility.
But, um, that's what happened inthe past few years when we saw
the people.
Why are we all talking abouthistamines now?
It's because it caused thissurge in this histamine
response, uh, when thosereceptors were attached.
So histamine's goal in our bodyis to, again, respond to threat.
(10:05):
One of the things that it does,very importantly, is it causes
something called vasodilation,which is the opening and
widening of our blood vessels,so that it almost creates like a
slide in your body.
If your blood vessels are wideopen, you can just send anything
down really quickly, right?
If they're squeezed tight, youcan't.
Push anything through as quick.
So it's like kind of likeopening up those traffic lanes
in the body.
That can create a lot ofproblems if your blood vessels
(10:27):
are wide open because you don'tget that pumping mechanism that
would lead to good blood flow inthe brain and heart.
So one of the common symptoms wesee with histamine issues is.
Tech, fast, heart rate,dizziness, um, migraines can be
a, a cause, um, can be caused bylack of, uh, appropriate blood
flow, um, especially to yourbrain of course, and a, a lot of
(10:47):
body pain as an experience.
People have histamines.
Job is to kind of keep us alertand aroused and ready for any
threats.
So also people can experience anextreme amount of anxiety.
And I describe that anxiety asbeing tremendously physical,
almost like ants crawling underyour skin.
Um, you know, that's that heartpounding anxiety.
(11:08):
Um, of course that.
Thoughts can follow, but it's,it's very physical, this
feeling.
Um, I had tremors also thatwould last like all night.
Um, and insomnia is reallycommon with histamine issues as
well.
More common histamine symptomsthat we do know about, of
course, are what we would takeantihistamines for, right?
Like seasonal allergies, um,sinus issues.
(11:28):
Rashes, um, reactions to food.
And then, um, other very commonsymptoms of histamine issues are
chronic, um, urination, feelingof fullness in the bladder, and
a, a sensation of inflammationin the bladder.
Um, waking up in the middle ofthe night to pee, uh, waking up
at all in the middle of thenight because of the insomnia
piece, and then a tremendousamount of gut issues.
(11:48):
Acid reflux is closely linked tohistamine issues as well as I
see both a combination ofconstipation or diarrhea,
depending on where you tend.
And then.
Um, depressive symptoms andanything that can come from, uh,
neurotransmitter issues ornervous system issues.
It's so interesting because, Imean, I think you kind of
already answered thisindirectly, but histamine issues
(12:10):
are so often missed ormisdiagnosed in traditional
medical settings.
In your experience and in youropinion, do you think it's just
because it could be, I mean,literally the symptoms could be
all across the board.
We just don't know.
Great question.
I mean, if you, Heather, if yourheart was pounding outta your
chest, where are you going?
(12:31):
Are you going to theimmunologist's office?
Are you going to the allergist?
Right?
No.
You're probably going to the ERcardiologist.
Exactly.
There is no world in which ifyour heart is pounding out of
your chest, you are going to besent to an allergist.
And that is the problem withhistamine symptoms.
They look nothing like what'sgoing on on the inside.
They don't look like immuneconditions.
They look like whatever thesymptoms are and a lot of
(12:54):
histamine issues'cause they cancause slight variations in in
body temperature, certainlyheart rate, blood pressure.
They look like emergencysymptoms.
They look like you need to go tothe er, right?
Those are all, they can changeyour respiratory rate.
They can change your O2saturation.
I mean, these are the exactreasons you would go to the er.
This is what any doctor wouldtell you.
Please go to the ER with, and bythe way, I invite people, please
go to the ER if you have anydrastic symptoms.
(13:15):
But they're not gonna be able toget to the root cause there,
because it's so, it's, it's, so,the way our medical system is
lined up is that each body part.
Is so fragmented and segmented.
You go to the heart doctor forthe heart stuff.
You go to the this, you know,you go to the neurologist for
the headaches.
It.
There's no one really to put thefull picture together, but I
think we're getting better atit.
(13:36):
But that's why I don't evenblame doctors.
'cause if I'm a cardiologist,I'm gonna run an EKG, an
echocardiogram.
I am not going to say, Hmm.
Is your heart pounding outtayour chest?
Because of a histamine issue.
Like they're gonna check alltheir boxes so that they're not
missing something major.
Yeah, totally.
They're gonna look at the organsand how they're functioning.
They're not gonna look at what'smaking those organs act in an
(13:58):
interesting or unique orunpleasant way, because it's not
what.
That their job is, to be honestwith you, and I don't blame them
for it, their job is to makesure there's nothing emergent
happening.
Um, and some cardiologists dotreat pots, which we're gonna
talk about I'm sure as well.
But yeah, that's really why,and, and what I'm more nervous
about, I would say, is thatit's, you know, back in the day
(14:22):
it used to be.
You go to a conventional medicaldoctor, conventional medicine
fails you.
Where do you go?
You go to a functional medicinedoctor and the promise of a
functional medicine doctor isthat they're going to be the
ones they're if, if all elsefails, you go to them.
They're the last stop on thetrain.
Most of my clients come fromfunctional medicine doctor's
offices.
Now, same.
They have been harmed, andcertainly for you for years,
(14:43):
this has been the case.
They have been harmed byfunctional medicine because a
lot of the interventions like,Ooh, let's do a gut detox.
Let's do a mold detox.
Those create very drastichistamine issues because
histamines will respond to thosechanges in the body, and our
mast cells are always on alert.
So if you create any largechange or you try to really dig
in.
The histamines, the mast cellsand histamines will be very
(15:04):
reactive.
So I'm seeing people get sickerin functional medicine doctor's
offices, which again, I don'tblame them for,'cause it's like
a to, it's like playing four Dchess sometimes with our immune
system.
Well, this is probably a rantfor another day.
But I often tell clients that,you know, I'm on calls with,
they're like, well, how is thisdifferent than the functional
medicine doctor that I saw?
(15:25):
And I asked them, you know, whatdid they recommend?
What did you do?
Honestly, what they've done isno different than conventional
medicine.
They were given like a bag ofsupplements and like probably
told to eliminate a.
A ton of foods and that's it.
And I'm like, that's apathicmedicine.
Thats allopathic medicine.
Yeah.
It's literally no different thanconventional medicine where
(15:45):
they're just stacking onmedications and like true
functional medicine is actuallylooking at like all the pieces
of the puzzle, lifestyle,nutrition, like all of it.
And yeah, so that's a bone thatI have to pick for another day.
But I mean, that's an, that's anepisode for us.
I'm telling you for sure.
Because I, I could cry, youknow.
When I first became like frombeing a conventional dietician
(16:07):
to a functional dietician, likethe hope of functional medicine
burned inside of me, I was like,this is it.
And I still do believe this isit, because functional medicine
is not a pill for every ill.
Functional medicine is thebelief that every single part of
our body is.
Interconnected that our body'slike a seesaw.
You push one thing down, theother thing pops up, right?
That is every single thing inour spirit, in our connections
(16:30):
with other people, everything ispart of this big picture, and
that's what the real heart offunctional medicine is.
And it's, and it still shouldbe.
And there's still many amazingpractitioners and it's really
hard.
When we've kind of gone intothis, again, it's, it's the sa
it's just a for-profit system,unfortunately, um, where we're
just, again, giving supplementsand if you give supplements to a
body that's on alert, um, itwill react to those supplements
(16:53):
and you can get a lot sicker.
Um, so a lot of functionalmedicine doctors are very into
IVs, detoxes, really aggressivemodalities.
And then they say to a clientwho's getting sicker, oh, you're
just having a herx reaction.
Mm-hmm.
It's just a detox reaction.
In the case of histamine issues,if you're getting sicker, you're
just getting sicker.
They're just get, you're justgetting worse and now you have a
(17:13):
new problem to deal withbasically.
So it's something really tonotice that if you are working
with a functional medicinedoctor, you're getting sicker.
You're just getting sicker.
Mm-hmm.
If it's eh, you feel a littleoff for a week or something,
it's very different than if thesymptoms are progressing.
Totally.
So kind of on that note, youknow, obviously this podcast is
about gut health and weobviously see a lot of things
(17:35):
outside of gut health, but ofcourse, what role does the gut
play in regulating histaminesrelated to like, of course, DAO
microbiome, gut permeability,all of those things?
Because to your point.
We have seen a lot of peoplesimilar where, oh, I did a SIBO
protocol, or I did thisprotocol, and I, I couldn't
(17:56):
tolerate it.
I felt horrible and they told meto just push through, or I
needed to take more binders or,you know, whatever the like
recommendation is.
But.
What role does the gut play?
And obviously we have to lookoutside of the gut and stabilize
things there as well.
But yeah, hundred percent givekind of some insight there.
Oh, there's a lot of areas wecan go into here for sure.
(18:17):
So one of the first things thatI am going to think about is
histamines and its relationshipto acid reflux.
Mm-hmm.
And the reason is they have adirect relationship.
So the more your body releaseshistamines, the more your body
will release acid.
The more your body releasesacid, the more your body
releases histamines.
In functional medicine, we knoweveryone talks about all acid
refluxes from too low of stomachacid.
(18:38):
Always Not in the case.
Histamines usually, and it's notalways exactly.
I know it could be 98% of thetime.
And either way, even if that waswhat's driving it, if they're
symptomatically having acidreflux issues, that then you
know you're releasing acidthat's creating a new state of
inflammation and then yourbody's going to respond by
releasing more histamines.
Mast cells do this reallyfrustrating thing.
(18:59):
They're more active duringinflammation, so it becomes this
kind of vicious cycle.
So that's one thing that Idefinitely wanna look out for
is, is someone experiencing acidreflux?
Very common with histamineissues with SIBO protocols.
E, whether it's an herbalprotocol or antibiotic protocol,
if you are going in and killinga bunch of bacteria.
(19:19):
And then your body can't get ridof the bacteria in ways of
drainage or detoxification.
You're basically gonnarecirculate those toxins.
And when you recirculate them,your immune system's gonna go,
what the heck is that?
Let me mount a response on that.
I don't like what that is.
And then when you have thatresponse mounted, you then have
new issues basically,'cause thatyou'll get symptoms.
(19:41):
From the response it's mountingas well.
So it's just really importantwith those protocols.
And Sibos very concurrent.
It happens a lot with histamineissues, um, because gut motility
can be affected becausehistamines and the nerve, your
immune system and nervous systemwork very closely together.
So, um, your basically the, the,just the actual action of.
(20:02):
Blood flow going towards thegut.
Muscle contraction can be, iscontrolled by the nervous
system.
So if your nervous system's onfire, you can have altered gut
motility, whether it be like.
Really aggressive diarrhea orconstipation.
And then as we know, and youdefinitely know Dr.
Heather for sure, um, foodsitting in our gut and
fermenting because we're notmoving it through our guts then
(20:25):
is going to create new histamineissues as well.
Um, so it's, it can be reallycyclical in that way.
And using really aggressiveprotocols when you don't have
the drainage or detox capacitycan lead to brand new issues
essentially.
So what would you say to someonewho's listening to this and
going, okay, yes, that's me.
I've attempted a SIBO protocolmultiple times and I always feel
(20:48):
worse.
Like where with.
Michelle, would you start, likewhat are you kind of looking at
as far as like, okay, let's takea step back and let's like
address these things, nervoussystem, et cetera.
Yeah, you basically said it, butyeah, that's the, the rule is if
we are addressing anything inthe body that's a root cause.
'cause SIBO can certainly be aroot cause.
It also cannot be root cause,uh, as we know.
(21:10):
But you can't address the rootcause and histamine issues until
you've stabilized.
Your immune system and youstabilize your nervous system
because if your immune systemand your nervous system are
firing, you know, very fast andand very aggressively, and that
threat response is high,anything you throw at it is
going to scare your body andcreate a new response.
(21:31):
So I just say it's reallyimportant to focus on
stabilizing histamines, and thatcould be, that could be
something as easy as eating alower histamine diet or
addressing stress.
Really complicated.
I know it's like so much easiersaid than done.
Um, and, and then it can besomething again, addressing the
nervous system as simple asbreathing or meditation or as
something like taking herbalsupplements that help support
(21:53):
the nervous system, whatever ittakes to get those two steps.
A approached first is essential.
And I would say if someone'sgoing to approach a root cause
protocol.
Even again, and I know the SIBOsymptoms can be so debilitating,
but at least taking a coupleweeks to try to calm the body
down first before, um, startingand initiating a protocol.
(22:14):
And then it's really hardbecause there's, there's rules
and therapeutic doses,especially with herbals and
sibo.
We have to go as slow as youcan.
Um, and then it's really sillyand really, um, it sounds very
corny, but it's very true thatwhen you're like taking these
supplements or medications youlike, have to work with and
communicate with your body andbe like, this is for us.
(22:35):
This is a nice thing that we'redoing.
I love you body.
This is to help you and like tryto create a landscape of healing
also, I think is really, reallyimportant.
We talk to our clients all, allthe time.
Neuroplasticity is one of thethings that we like really
emphasize because, and probablysimilar to your clients, so many
of our clients have had so manyattempts at feeling better and
(22:56):
they have this narrative of,, Ican't tolerate X, Y, and Z, or
I'll never be able to eat X, y,and z food.
And like changing thoseneuropathways can be so
important.
But like you said, it's sotricky because.
Oftentimes, I think the secondthat someone hears stress in
their nervous system is the rootcause.
They're like, forget it, youknow?
Like, I can't quit my job.
(23:17):
Totally.
I can't do this.
So what would you say, if that'skind of the mindset of, you
know, kind of the connectionbetween stress and the nervous
system and histamine and, andall of that, like Yeah.
How it doesn't actually have tobe.
Meditating on the beach for anhour a day in a fancy outfit.
Like, it's not, that's notreally what we're getting at.
Oh, I have to be, I'm, I'm aJewish New Yorker born and
(23:38):
raised.
That's not our style.
You know what I mean?
It wouldn't, there was not,there's nothing soothing about
what you just described to me.
I use the word safe, right?
We have to do whatever makes usfeel safe.
For me, it's like blasting emomusic.
That's what makes me feel safe.
It's like blasting rock and rollmusic.
So it has to be what makes youfeel familiar and safe.
To you.
So that's what it means.
(23:59):
And the other part of it is, youknow, there was a time.
During the worst moments of myhealth where I literally, and I
always look, I had a computerchair.
I was, I would sit on, I havelike a day bed in my office
that's like, kind of a couch,kind of a daybed.
I would sit there, I would liftmyself onto the computer chair.
'cause if my feet touch thefloor, my heart would start
pounding and I would wheelmyself to the bathroom.
(24:20):
And then I would have to crawlbasically to get to the
bathroom.
'cause I, if, if my feet touchedthe floor.
I was so dizzy.
I would be dizzy for days.
At that time, I had torecondition so, so
substantially, and I rememberstanding in front of the mirror
for a minute.
And I was just like so dizzy.
And I just said to myself like,I just don't think you're gonna
like make it out of this.
I just don't.
I don't, I'm not seeing it.
(24:41):
And then some other likeanimalistic part of me was like,
don't ever say that again.
Do not ever say that again.
So it doesn't come down to, oh,I have to sit on a beach and
meditate or do these things thatare like cooling, calming.
It's just about finding thatpart of you that may seem
irrational, but believes thatthere's some chance you can
heal.
And the reason is with these.
(25:03):
Syndromes and conditionsparticularly, they're extremely
nervous system driven and thesymptoms come from being in that
nervous system state.
So I have a lot of my clients,as much as we can to be
non-reactive to symptoms.
And it's so hard.
I mean, who is gonna havediarrhea 15 times a day and
excruciating pain and be like,this is fine.
You know, but that's really whatwe have to get to.
(25:25):
'cause the second you go, oh myGod, this isn't fine, you're
actually getting new symptoms.
So it really becomes cyclicaland then your body anticipates.
The discomfort and then releaseshistamines on top of that.
So it's this very weird thingwhere you have to like believe
blindly that you are going toget better, visualize it, and
anyone can do that.
You don't need time.
You just have to be a littlesilly about it, I think.
(25:47):
Mm-hmm.
It's like that's not, stressreduction to me isn't like
putting ice on your neck, eventhough it can be really helpful
and, and cooling and nice, butit's about finding a way to find
that part of you that believesin an irrational sense that
you're going to heal.
And then finding little pocketsof safety wherever it is,
whatever that is.
I don't care if you're watchingtv, you know, I know people are
so weird about the, not weird,about like rationally, but so
(26:09):
strong about like no blue lightat night.
Like if you need to watch likeold seasons of Sex in the City
or something.
To like soothe'cause it'sfamiliar and it's, your brain
can calm down whatever thatthing is for you get and, and
find that identity of the personthat once wasn't sick.
And I think that's reallyimportant too.
I love that.
I think that's such a good wayof looking at it.
(26:29):
And honestly, I mean, if someoneis reaching out to you or me, or
even listening to this podcast,there obviously is some piece of
them that believes they can getbetter.
Oh yeah.
You know?
So like, you're already there.
Lean into that piece.
Yes.
Oh yeah, absolutely.
You're already there.
I wanna circle back to pots,because you mentioned POTS
earlier and we see a little bitof pots.
Um, I would say when I wasseeing a lot more eating
(26:52):
disorders, I saw even more pots.
Oh yeah.
Um, mm-hmm.
And you know, now we still seeclients with disordered eating,
I would say not like activeeating disorders, but.
You know, the standard treatmentfor POTS is like, we'll just
have three to five grams ofsodium a day.
Well, it's actually 10 grams,which is, is it 10 now?
Okay, 10.
Yeah.
So, you know, you'll go to yourdoctor, you'll get like a
(27:13):
massive recommendation for salt.
And although that can help, likeyou and I both know, there's a
lot more to the story hundredpercent when it comes to
histamine and, and all thesethings.
So kind of walk us through that.
For anybody listening.
So we'll walk back even to thepoint of defining pots.
Pots is postural orthostatictachycardia syndrome.
So that means you make apostural change and your heart
(27:33):
starts pounding.
Okay.
I wanna give the example ofsomeone who, and if a client is
listening to this or you know,they might identify with this,
you're in the shower, you out ofnowhere, look down and your legs
are really red and you feelreally dizzy, and you're like.
What's going on a second later,your heart starts pounding
really fast.
So when histamines are an issue,they cause what we talked about
(27:54):
before, vasodilation, thewidening of the blood vessels.
So what happens is your blooddrops down to your feet, and in
the case of pots, it may not,your heart may not react to pump
the blood back up.
The reason you see the rednessin your legs is there's.
Blood pooling, literally bloodthat's pooling in your legs, and
then your heart and your brainare going, hello, we need the
blood flow up here.
So your heart starts poundingreally fast.
(28:16):
So the heart fast, the the fastand hard.
Pounding you feel is to getblood flow back up.
So often the, and, and often therecommendation for POTS is, is
like we said, 10 grams of salt,which you have to picture those
little element T like elementsodium, that's they're one gram
each, so that's 10 elementpackets a day.
This is an extreme amount ofsalt, which most people don't
(28:36):
need that much or can meet thatneed, but some, some do.
So the goal for.
That type of approach is thatthere's different types of pots.
One of them is something calledhypovolemic pots, and the the
deal is your blood volume is toolow, that it doesn't have enough
to pump and bring the blood flowback up.
That's the goal.
Now, this is the mostinteresting thing in the world,
(28:57):
and I'm obsessed with this,okay?
Pots.
Is a form of would, if we weregonna categorize it, we would
say, oh, it's probably acardiac, this has to be a
cardiac condition.
It's actually a form ofdysautonomia.
Mm-hmm.
It's a form of dysfunction ofour autonomic nervous system.
It is a nervous system disorder,which makes no sense to people
because how could that be?
Your nervous system will tellyour brain, send blood.
(29:20):
Contract this muscle, so it'scoming from your brain.
So the treatment for POTS that'sconventional is, well, let's
just add a bunch of salt, makethe blood volume bigger so that
the blood pumps.
More efficiently, or I say it'skinda like making your body like
a Go-Gurt tube.
You like wear compression socks,you wear an abdominal binder and
you squeeze the body.
So the pressure goes up.
(29:40):
Basically if you think aboutlike squeezing the middle of
that Go-Gurt tube and the bloodflow will go up, right?
Mm-hmm.
So that's the goal.
Or you lay with your legs on awall.
Basically just anything to helpthe body's mechanism.
Put the blood up please.
'cause the body's doing it foryou and compensating.
But the real ultimate treatmentfor POTS is you have to address
the nervous system, right?
Because if the nervous system isin the right, not constantly
(30:04):
sympathetic state, and you getin the parasympathetic state,
then it'll say, oh.
You're supposed to send bloodflow here it, this is the muscle
that's supposed to contract, andthat is the core and crux of it.
So a lot of the treatmentprograms for MCAS and POTS are
actually limbic systemretraining programs like the
Gupta program, primal Trusts,because we know these are
brain-based conditions, which isfascinating.
(30:25):
Of course, the immune systeminvolved, of course the cardiac
system becomes involved, but theroot cause of them is a nervous
system.
Um.
You know, condition, which is,I, I, I've always thought
fascinating and I think therelationship between MCAS and
POTS is in this vasodilationpiece is a huge component.
It's so interesting.
You know, going back to like2020, I, I think I was like
(30:46):
patient X for COVID.
I think I had it like rightbefore, like the world shut
down.
I was sicker than I've everbeen.
March, 2020.
You were, that was it.
No, it was like February.
Like I, it was like beforeeverything.
I like swear that I was one ofthe first people that had it.
I, I could be totally wrong, butI was so sick for like two
weeks.
I, I've never been sicker in mylife.
(31:06):
I'm so sorry.
It was crazy because severalmonths after that I started
having POTS related symptoms,and at the time I was developing
the Gut Together program.
Mm-hmm.
And the Gupta program is like abig recommendation that we give
to our clients and somethingthat I did.
Symptoms gone, so I know.
It's so cool.
Yeah, I, first of all, he's socool.
(31:26):
The creator, Ash Gupta had himon my podcast.
He was like, so cool.
Love that.
And the program's incredible.
I have a little bit of apreference because I've been
through it, but I've only seenparts of Primal Trust, um, and
DNRS.
I've only seen parts, but yeah,it's.
It's really incredible and theidea that you're treating this
immune condition that shows uplike a heart condition by
treating the brain.
It's so fascinating.
(31:46):
And, and then once you get it,you get it.
And it wasn't until that allthose symptoms I was describing
were really pot symptoms, right.
When I, when I would stand upmm-hmm.
The blood changes and thedizziness, they only got better
when I started working with mylimbic and nervous system.
It's so true.
I mean, my husband was, wouldget so worried because I'd stand
up and I'd be like, so dizzy,blacking out, like holding onto
(32:07):
something so I didn't fall over.
And he's like, you need to go toa cardiologist.
Like I'm really worried.
Hundred percent.
And I mean, I was so close tobeing like, is there a problem?
And then it just.
Like slowly started gettingbetter and I'm like, that's the
only thing that was different.
It's wild to me.
And then when I dealt with mold,same thing.
Like the limbic system is such abig piece.
So Yeah.
(32:27):
And our limbic system that Iknow we've mentioned, and I'll
walk back to is three brainstructures, our amygdala, our
hippocampus, and ourhypothalamus.
And they will process threat,same thing.
And they will also prepare yourbody using memory.
If this happens, we don't wantit to happen again.
Let's prepare.
Your limbic system communicatesdirectly with your nervous
system and your immune system.
(32:48):
Um, histamines can also bereleased from and created in
your hypothalamus.
Um, so that is why you get thatextra alertness anxiety that can
happen.
Uh, this link between youhaving.
A COVID virus and that turninginto this pots, you don't know
how long it took all of us tofigure this all out because it
was so, it so doesn't makesense.
(33:08):
'cause it didn't happen withother viruses.
It never'cause the, the fludoesn't attach to mast cells,
you know, and in the same way,like the seasonal flu, right.
I'm sure it does in somecapacity, but certainly not to
this level.
So.
For me, it was like figuringout, I literally would just type
into, I would just type intolike Google, like pre pre-chat
GPT.
I was like, why dizzy on daynine cycle?
(33:31):
Like I just, and what's theanswer you get from that?
Right?
Like, I had to go on Reddit andbe like, what the heck is going
on it?
It really was when I saw astudy.
About long COVID patients, andthe study was studying 16 long
COVID patients and they hadsevere fatigue symptoms and they
gave them 80 milligrams ofFamotidine, Pepcid.
And I was like, and then 80% oftheir symptoms resolved.
(33:53):
And I was like, what?
I was like, why is this acidblocking drug helping with
fatigue symptoms?
And then I.
Oh wait, Pepcid also anantihistamine.
Wait, wait, wait.
I didn't even realize that atthe time.
No one would realize that, ofcourse, at the time.
And it took me like, I was like,oh, there's a thread and the
thread is histamines and, and ittook me tying so many different
things together and really a lotof self-discovery because how do
(34:16):
you get from point A to point B,right?
It's like impossible.
And I don't blame even again,practitioners for not getting
there.
But now, after five years ofCOVID, I we're starting to see
these predictable patterns, andI've really never seen someone
with p.
Who do not have M Cs.
It's very rare.
There's a couple like people whowere maybe had a history of
eating disorders and werechildhood athletes who I've seen
(34:38):
with POTS that don't really havehistamine issues.
But in the COVID context, I'venever seen someone with POTS who
doesn't have histamine issues.
And again, if you went to aneurologist for pots, they're
still not gonna look athistamines because of the
fragmentation of our healthcaresystem.
So you bring up two points andthings that I wanted to mention.
Histamines and hormones.
You mentioned day nine, and thenalso Pepcid and antihistamines,
(35:03):
Zyrtec, et cetera.
So when you spoke in gutpractitioner, you talked about
kind of like this, like trialyou could have clients do, like
try Pepcid for, I think yousaid, three days or something,
and see if your symptomsresolve.
Um.
Talk us through that.
And then also maybe we can bringin like the hormone connection
as well.
Yes.
And something I have to mentionis, of course, this is not
(35:23):
medical advice.
This is not medicalrecommendations.
Yes.
In any capacity.
And everyone will have adifferent reaction to every
single over the countermedication, every single
supplement, especially in thispopulation.
So know that you can get theseover the counter.
It does not mean that you willreact the same way as anyone
else.
And that's just something I haveto mention.
Um, so.
Again, why did I become afunctional dietician so I could
(35:43):
be talking about over thecounter medications?
No way.
I never thought I would betalking about over the counter
medications, you know?
Um.
It's really interesting.
I have a friend who a lot ofpeople know on Instagram is
organic, Olivia, but she mm-hmm.
You know, I'll, I'll, of courseI'll call her Olivia.
Olivia wrote an article a longtime for her company, and they
said in the article like, well,what is your ultimate travel
emergency, you know, pack?
(36:04):
And she said, I always haveBenadryl in there because
Benadryl helps with everything.
I said, Olivia, the fact thatyou didn't know you had a
histamine issue.
When you wrote this article, Iwas like, Benadryl doesn't help
anyone with anything unless youhave a histamine issue.
Like, she's like, this is thething that will cure every
ailment in my body.
I'm like, yeah,'cause your, ifyour ailment iss a histamine
issue, it'll, it'll help.
So if you have a histamine issueand you respond really well to
antihistamines.
(36:25):
You know, you'll, you'll get anunderstanding that potentially
this is what's going on, and I'mgetting some relief from this.
A lot of clients are veryhesitant to take over the
counter medications, especiallyif they've been in like the
natural world, the holisticworld, the functional world for
a long time.
Um, but I've seen that somepeople really do.
Need them.
Um, and from a hormoneperspective, and I'm doing a
(36:47):
histamine hormone webinar at, onSeptember 28th.
Okay.
I'll put the, I'll put the linkin the show notes.
Yes.
With Amanda Montalvo, who peopleknow on Instagram is the Hormone
healing Rd.
It's gonna be nuts.
I'll be there.
Yeah, exactly.
Yeah.
It's gonna be a little nuts.
I have to be honest, like thisis, this is like heavy hitters.
I'm very, very excited.
She's the most brilliant personI know, so I'm so excited.
Um, for me, again, I was lookinglike.
(37:08):
Why do I feel so bad the day mybleeding stops?
Like normally people, if youlook online, what do they say?
The luteal phase.
Everything's the luteal phase.
You feel so bad during, I waslike, I feel amazing during the
luteal phase.
It's the follicular phase I feelterrible in.
And that's because estrogen andhistamine also have a direct
relationship.
So as your body starts torelease estrogen in, uh,
preparation for ovulation, whereit will peak in estrogen, of
(37:30):
course that's when people startto notice symptoms.
And that'll start usually bythe, you know, days.
Seven or eight in a 28 daycycle.
Um, some people a littleearlier, and that's where those
histamine symptoms start comingup.
So if clients have any kind ofhistamine driven symptoms,
that's where they can trial.
Oh, this three day period is themost symptomatic for me.
This is where I might wannatrial either natural
(37:52):
antihistamines or over thecounter antihistamines, whatever
that looks like for them.
But the most important thing youcan ever do when it comes to
histamines is track.
Especially as a woman, trackingyour cycle.
'cause then you can see, oh, day10 every month to not feel
crazy.
When I would I, I just, it mademe feel so sane when I would
look at my calendar and be like.
(38:13):
Day 20.
I got a headache last threemonths in a row.
Okay, day 20 is a headache day.
I need to understand and preparefor that.
Okay, day nine's a dizzy day.
I need to prepare for that.
So just understanding andtracking your cycle is
important.
And I know we can sometimes gethypervigilant about it and I
wouldn't recommend that as muchwe can avoid, but the validation
of like, I know my body and Iknow what to expect is so
(38:34):
helpful.
And then you can say, oh, I needto up antihistamines, whatever
form again.
Natural or not.
Um, and then, or I need to, youknow, take it easier these days,
or I need to drink extra waterif it's gonna be a headache day,
whatever it is.
What about pregnancy?
So we've had clients who feel alot better during pregnancy and
(38:55):
then we have some, you know,maybe no change or maybe feel a
little bit worse.
Yeah.
So walk us through how pregnancywould affect histamines.
Absolutely.
So the first cool thing aboutpregnancy is you do produce more
Dao, which does help break downhistamine in the gut, which is
the placenta actually producesmore Dao, which is DAO Oh,
diamine.
Oxidate.
So cool to me.
Like how it's just so cool.
Yeah, it's, yeah, it'simmaculate.
(39:17):
I had this brilliantnaturopathic physician who I was
working with, and she alsodescribed that like when your
immune system is so busy, likebuilding new life and like
creating an immune system andusing your own, it kind of like
diverts its efforts into growingthe child as opposed to.
Being hyperactive to all thesymptoms and things around you.
(39:39):
So it can happen where MCASsometimes it can be worse in
pregnancy just because yourestrogen's really high in
pregnancy too.
So it's not stabilizing.
Progesterone is supposed to bemast cell stabilizing.
The other problem is, I mean,the other reason why pregnancy
may be positive, there's otherpeople who have more problems
with it, and I'll talk aboutthat, but is because your blood
(39:59):
volume increases by 50%.
So that's really nice for pots.
If you have hypovolemic pots.
That's really, really nice sopeople can feel a lot better.
So I notice pot symptoms get.
Often a lot better.
Um, but then you're alsogenerally people are a lot more
inactive and that can lead todeconditioning and that can, it
really depends.
Um, also you can become very,your blood sugar's much more
(40:20):
erratic.
Um, oftentimes it can be inpregnancy and actually in the
first trimester, your, yourinsulin's more sensitive.
If you already tend towards lowblood sugar, that can create
more low blood sugar episodes.
So I've seen people with MCAShave worse acid reflux, worse
morning sickness as well.
Um, but I've also seen like thecrazier huge MCAS symptoms get
(40:41):
better, like we said, becauseyour immune system has a new job
to do as opposed to just beingdramatic like my immune system
is, you know?
Yeah.
Mine's pretty dramatic too, so Iget it.
I think the best people's are.
Yeah, I think that's the truth.
there was this joke growing up,like my family would always joke
that like, I could look atsomething and get a rash, and
I'm like, I mean, it's funny,but like, it's also true.
(41:01):
So, you know, I think that's mewith like, um, empathy, physical
pain.
Like, I, I can't, I couldn't,that was the truth.
I may not have been by a lotlike a hype hypersensitive from
a body perspective, but I washighly sensitive as a person and
everything.
Everything mattered to me at alltimes in my life.
Everything was so important.
(41:21):
Everyone else, everyone else wasfeeling I needed like a shield.
Even as a kid it was like Icouldn't even like go on the
soccer field.
My dad had to hold my hand,which is so funny'cause I am
very extroverted and like lovepublic speaking in front of
thousands of people and have noproblem with it.
But my dad had like hold my handon the soccer field.
'cause I was like, I don't knowwhat the other kids are thinking
or feeling.
And he's like, okay, that's not,you have to just kick the ball.
(41:41):
We're here to play soccer ball.
Yeah, exactly.
Just take the ball around.
Oh, I get it.
It's so hard.
So we've talked about a lot ofthings and someone might be
thinking, well, would like a lowhistamine diet just fix all
these problems?
Walk us through that.
They already, they already know.
No, by the way, if they're here,they already know the, they've
already tried that.
Yeah.
However, I will say this, themore high histamine foods we
(42:04):
eat, the more our body produceshistamines.
It's a very backwards, sillything about our body, by the
way.
I'm like.
No, you have enough.
You don't need to make more.
But our body does this veryfrustrating thing.
So there are clients I have whocould eat a tomato and end up in
the hospital.
There are clients I have whocould eat two bites of vinegar
and they're stomach sick forthree weeks.
It is often necessary to trial alower histamine diet for some
(42:26):
period of time, but.
Highest mean foods are thehealthiest foods that we know
of, right?
If you went to a gut healthdoctor or you went to Dr.
Heather 10 years ago, youwould've been like, have some
fermented foods, have citrusfruits?
Mm-hmm.
Have like nato, Tempe, miso,bone broth, right?
Vinegar, like they are all thethings, some of the healthiest
(42:47):
foods.
Tomatoes, avocados, bananas,spinach, you could not create
healthier foods than the highhistamine foods.
So it's just that it's causingthis kind of sideways, odd
reaction.
But they're not actuallyunhealthy in any capacity.
These foods, they just createunhealthy symptoms within us.
So it's often necessary forpeople to, yes, sometimes trial,
(43:07):
low histamine diet.
But if that's not your rootcause, I have some clients who
are huge histamine clients andthey can crush vinegar and
there's no problem with it.
I have some clients though, whogo into a room and has a
chemical smell.
They're sick for weeks.
Mm-hmm.
So you, you really have to knowyour own triggers.
But often in the beginning whenthe body's hyperreactive, it's
going to be hyperreactive tofoods as well.
(43:28):
And the goal is to just lowerthe bucket, all of the histamine
load, lower it as much as youpossibly can for in the
beginning.
So on that note, if someone islistening and they suspect
histamine intolerance or MaMCAS, or maybe they already know
they have that, what would yousuggest as like a first kind of
practical step to start feelingbetter?
(43:48):
Yeah, the first thing I would dois get to know your symptoms.
So track them, notice them.
When I eat this, I notice I feelthis way and it's not gonna be
the same every time.
So don't expect the pattern'sgonna be perfect if you are a
woman.
What's going on with your cycle?
What are you noticing?
The first thing is getting toknow your symptoms and getting
to know where maybe there's apattern you could recognize.
It's not about one-timereactions, but where we can pick
(44:10):
up on patterns.
That would be the first thing.
The next is I would just startto assess.
What makes me feel safe, whatmakes me feel unsafe, and start
to understand again, what areyour personal triggers, whether
it's food, whether it's stress,whatever those things are.
You don't have to do anythingabout them, but just inventory
those things in your life.
(44:30):
That act of getting to knowyourself is extremely soothing
to your nervous system becausewhen we can understand we can
calm.
Mm-hmm.
It's when we don't understandwhat's going on in our bodies
and we say, oh my God, my heartis pounding and it's so freaking
scary.
That is when we start to freakout and that's when the symptoms
get much grander, which is sonormal and human of course, to
feel that way.
But when we understandourselves, we start to heal.
(44:53):
So the first step is understandyourself and understand.
Start to get to know yourtriggers.
Then you can trial at home alittle bit of a lower histamine
diet if you wanted to.
It's safe to do, but not in thelong term.
Um, so just trialing.
Do I feel a little bit better?
It will take more than a coupledays for you to, to notice that.
And then again, anything thatdrives safety, anything at all
(45:13):
that drives safety for you.
I would also probablydiscontinue all supplements, you
know, for the time being,especially if your reactions are
really great.
And if you are trialing newsupplements, you do one or one
eighth of one for a week, andthen you add in another one.
Mm-hmm.
Okay.
Very, very slow.
Yes.
Slow is.
Is the key for all of this.
(45:33):
It it really is, yes.
Slowness in every way.
Slowness in how you live,slowness in how you approach
things.
It is MCAS makes us feel likewe're on fire and we need to do
everything we can to slow.
Yes.
So what gives you hope inworking with clients who
struggle with histamines mastcell?
What gives you hope?
(45:54):
Oh, I've ne I've never felt morehopeful.
Than I do now, which is the bestfeeling ever.
Um, watching myself, watchingall of our clients getting
better.
Um, I've, I've seen people healfrom just attending a freaking
pod, watching let's do a podcastor watching a webinar.
I think the really excitingthing is we really get it now,
like we're really starting tounderstand how, what's this
(46:16):
landscape of our immune systemand our nervous system, and I
just have so much faith in thehuman spirit, and I have so much
faith in our ability to heal andthat our bodies want to heal and
they don't.
They don't want to stay sick.
And I just have so much faith inus, and I've seen what looks
like miracles every single day.
But it's not miracles.
It's because we get it now, andthat's the truth.
So the more and more informationwe have, the more we can empower
(46:39):
ourselves and the more successthat we see other people
experiencing, I think thebetter.
Um, I, I just, I've never feltmore hopeful.
I'm like, we so got this.
I mean, there's really no levelof sick someone can come to with
me and I'm like, we're good.
We'll, we'll figure it out nomatter what.
I love that.
Yeah.
Okay.
Well this has been amazing andso much good information.
(46:59):
So tell everybody where they canfind you, work with you,
podcasts, like all the things.
Absolutely.
Um, it was my joy and I'm soglad that we got to hang out
before too, by the way.
Um, so you can listen to olderepisodes of Quiet The Diet,
which is my podcast.
I haven't recorded in a bitbecause I've been working on
these, the, a lot of thehistamine webinars and
everything like that.
Um.
I'm on.
It's really easy to find meeverywhere.
(47:20):
I'm on Instagram, MichelleShapiro Rd.
My website Michelle Shapiro Rd.
Um, we have an upcoming, um,histamine webinar with Amanda
Montalvo, the Hormone Healingrd.
Oh my God, I'm so excited.
We're gonna do P-M-S-P-M-D-D,endometriosis, PCOS,
pre-pregnancy, during pregnancy,post-pregnancy, perimenopause
and menopause.
And it's all gonna be, it'sgonna be like eight hours long.
(47:43):
The last one was three and itwas just me.
So I am concerned.
Yes, I am.
Yes.
It's scary.
It's scary.
I can't wait.
What we're gonna do.
Exactly.
Yeah.
It's gonna be really fun.
It's gonna be really fun.
Um, and the last one wasliterally just a histamine
essentials webinar.
People can buy the replay of ifthey want to.
That was an almost three hourwebinar and it was, it was so
much fun and it was so muchinformation.
And I have a team of, now thereare seven of us, um,
(48:04):
practitioners, if people wannawork with people one-on-one.
Okay, so amazing.
I'll put all those links in theshow notes.
I'm definitely planning to be atthe webinar.
Can't wait.
And thanks so much for joiningtoday.
Thank you so much.
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