WATCH THIS To Boost Your Immune System & Prevent LEAKY GUT! | Mark Hyman

I think most of us think we're sort of doomed to just have allergies. When I have patients who have allergies, when I fix everything else, their allergies get better or go away.

If somebody has a lot of histamine symptoms and are struggling, it's also worth a trial of a low histamine diet.

What we see often is this resignation that, oh, I've got allergies. It's just what I've got. And there's nothing I can do about it. So like Eeyore, right? I had to take these medications. and these nasal sprays. And the truth is, most of the allergy medicines are pretty benign, but the steroids are not. And they're often used pretty aggressively, like Flonase and NasalEx and all these inhaled steroids that may reduce symptoms but then cause osteoporosis and cause other immune suppressing issues. And people really suffer from these problems. And the question is, why are we so overreactive to things that are just part of our normal environment, right? I mean, that's the question nobody's really asking. It's like, well, allergies is something humans get.

Well, guess what?

Not necessarily. When you look at populations and indigenous cultures, when you look at even kids who grew up in America on farms.

And are in the dirt, I mean.

I thought, I don't have any allergies. And I'm like, why don't I have allergies?

And I realized, you know, when I.

Was a kid, Every summer, I went and lived on a ranch with 50 horses, shoveling horse manure and getting really dirty and sleeping in the dirt. I mean, who'd think, I don't even think I washed my hands all summer.

And I think there is a lot.

Of data on this and this science of why we have allergies.

So I'd like to kind of go.

Into that a little bit with you. Why are there prenatal reasons? Are there early childhood reasons that set people up for allergies? what are the things that kind of tend to predispose people? And how do we sort of begin to think about that? Because that's really about like a prevention strategy, right?

So that's a great question. I mean, our immune system is designed to be able to respond to things that it needs to respond to, but not react to airborne pollens or foods that we bring into our bodies. And it turns out that there may be early life influences that help educate or train that immune system to learn what warrants a reaction, like a parasite, for example, and what doesn't warrant a reaction, like the pollen's. So what's emerging is some of the factors that are making people more likely to develop allergies now could be related to more C-sections as opposed to vaginal deliveries, more antibiotic use in childhood, more frequent hand washing, being indoors, some of the things that you mentioned about your own life. that exposure to certain microbes early on that are friendly and beneficial help teach the immune system that that's what it's going to be quiet and react to, whereas it shouldn't be reacting to the things that we breathe in. There's even evidence before delivery that a mom who has allergies and asthma, so there's a genetic component, her diet in pregnancy may also impact her offspring's future risk of developing allergies and asthma. So there's evidence that we could put things in place that might lower somebody's risk in the first place with a healthy diet and pregnancy. Some women have to have a C-section. So I think what's really fascinating is research going on now that you've probably heard of vaginal seeding or bacterial baptism. It has a couple of different names to it. Don't do it at home.

That's where you take the vaginal fluids and you put it in the baby's mouth to inoculate the baby's gut tract.

Yes, yes. Because that vaginal delivery, it's swallowing all those lactobacilli and getting coated in the lactobacilli of the mom that helped train the really immature immune system that this is a healthy microbiome. Babies born by C-section, their first exposure to bacteria is going to be the deliver room nurse's skin flora, very different populations than what normally colonizes healthy gut. There is a higher prevalence of allergies and asthma in those kids. You mentioned growing up on a farm, having multiple siblings, playing in the dirt, having pets, paradoxically decrease the risk of allergies and asthma.

The dog licks you all over your.

Face and when cat sleeps in your face, you're less likely to have allergies, right?

Believe it or not, yes.

Let's go into your story because this is not just an abstract medical thing you're doing with your patients. This is something you've really suffered from. and you learned about and tell us about what happened to you and what you found, how you dealt with it and what changed.

Yeah, so we often use the term of peeling the onion, right? And Mark, it's interesting because I was born vaginally. My mom breastfed me, so she was kind of an outlier back in her generation. I grew up in South Carolina playing in the woods. I remember getting, okay, this is kind of gross, but we would get hookworm and pinworm. We certainly had some parasite exposure. played in the dirt, had pets, but I developed pretty significant dust allergy and cat allergy. So lived most of my adult life with chronic congestion, sneezing, itchy eyes, itchy nose, and I did the usual, I took loratadine and nasal sprays to kind of keep it at bay. And as you mentioned at the very beginning, I thought that was just my lot. Runs in my family, I've got allergies, right? I also noticed early on but didn't know what it meant, I never liked fermented foods. I didn't like pickles. I didn't like vinegar. I didn't like any of that food. I don't remember having a reaction. I just had an aversion to them, did not like them. That's a clue that we'll come back to in a moment. And over the years, as we looked at different types of testing, you know, sometimes at Canyon Ranch, we would vet a test before we brought it on and we would often do it on ourselves. The one thing that kept showing up for me with food sensitivities is lots of antibodies to dairy. Okay, I like my dairy. I'm not allergic to dairy, but I had IgG and IgA antibodies to dairy. So I did experiments off and on. I'd cut my dairy out, I'd put it back in, I'd cut it out, I'd put it back in. And the only symptom I really noticed was some joint aching. Long story short, I finally cut it out for other reasons, along with some other things. I don't have as many allergy symptoms anymore. my environmental allergies are quieted down. I'm not on medications. So it's really interesting how when we empty the bucket of triggers to histamine, it may make us less reactive to things that we have a true allergy to, if that makes sense.

Yeah, I think that's right.

I think there's an important concept that you're talking about, Cindy, is that, and I've seen this in my practice over and over, is that when I have patients who have allergies, when I fix everything else, their allergies get better or go away.

Right.

Right. And, and what I mean by fix everything else is getting their gut healthy, improving, making sure they don't have a leaky gut and fixing that and making sure their microbiome is optimized, making sure we get rid of all the bad bugs, put in the good bugs, give them prebiotics, help nourish the gut. And, and that really helps so many people. And of course.

Trying to minimize your.

Exposures if there's things like dust or cast. But even those things that are environmental allergies will go way down once you fix the food out. Often people will have corresponding food sensitivities. So they're not necessarily related to the environmental allergies, but when their immune system.

Is just pissed off about everything, it just reacts worse.

So they end up having, for example, and maybe food sensitivity dairy like you said, or gluten or something else. and they have environmental allergies, the environmental allergies will be a lot worse if you don't deal with those oral allergies that are really causing them also to suffer.

And then sometimes, you know, there's some.

Really amazing things you can do around histamine too, right? So you mentioned histamine and you've had a low enzyme DAO that is important in sort of neutralizing histamine, but you can't do that so well. So you have to actually potentially supplement with that.

Right. Right.

And it's interesting, Mark, that you say that because I only found that out this past year with one of the new genetic tests that I, both copies of my gene that codes for the DAO enzyme that breaks down histamine, it codes for a slow version of it. So even without allergies, I may be more prone to having histamine-like reactions. But some foods have histamine, those fermented foods, they tend to be really high in histamine. And in retrospect, The fact that I have difficulty genetically breaking them down might explain my body's own wisdom and not liking those foods. I mean, it's a story, but it makes sense. Makes a lot of sense to me.

Yeah, and I think it makes total sense. And then, we can treat people by one, moving the foods they're reacting to; two, by optimizing their gut and healing a leaky gut; by three, helping them support histamine breakdown with histamine breakdown enzymes. We can also give herbs and supplements that can help, like vitamin C and quercetin and other things. Quercetin can help a lot. So can you talk a little bit about the supplementation? There are all certain things that can help reduce allergies and allergy symptoms.

Sure. So you mentioned DAO. For people who are really symptomatic, that can make a big, big difference. We want to make sure if somebody has a lot of histamine symptoms and are struggling, it's also worth a trial of a low histamine diet, which is, interestingly, it's not just fermented foods. There are other foods that we tend to think of as being healthy foods that have high histamine, foods that I happen to love, things like avocados and spinach. Some people respond dramatically to a low histamine diet, and it's one of those dietary approaches that you really have to partner with a good dietitian because it's confused. This is a complicated approach. Histamines accumulate when foods sit. as leftovers. So even foods that have been in the refrigerator for three days might have more histamine buildup than not. And anytime you're thinking about cutting foods out, you need to make sure that you're putting enough things in that you feel nourished and satisfied and you're meeting all your needs for critical nutrients. So this is an important one to partner with a good dietitian. While we're emptying that histamine bucket. We know that some probiotic strains can also help reduce histamine. Some may actually make it worse. So it's also important to get some guidance about which probiotic might be the best for you if you're trying to improve your gut function and not cause harm, not cause things to get worse. For example, Lactobacillus casei is one of the ones that's been associated with possibly making histamine issues worse. So we need to kind of, and probiotics, you know, Mark, it's a dizzying array. People go stare at the supermarket and say, oh my gosh, there's so many, what do I take? You know, there's high quality ones that are specifically designed to only give you the strains that are gonna lower histamine, not increase it. But if you're just taking a random one off the shelf, you may not know, may thinking you're doing good and you're doing harm. You mentioned Quercetin, I think that's a great nutraceutical that's a natural histamine down regulator. Resveratrol may also lower histamine. Vitamin C, even food sources of vitamin C like red peppers and broccoli, those can all down regulate histamine. So there's a lot we can do. And you mentioned the gut. The other thing to keep in mind is those histamine releasing cells, those mast cells, they cluster behind every place that our body has a natural barrier to the outside world. So they predominate under the skin, they predominate in the lining of the respiratory tract, and they predominate in the wall of the gut. So we have to keep our skin barrier healthy, and resilient, no breaks in the skin and not dry. We want to keep our respiratory tract healthy, not smoking and vaping, that'd be the best way to do it. But air pollution can negatively impact it as well. And then keeping the health of the gut lining really, really in tip-top shape. And that also decreases the burden on those mast cells.

Yeah, and I think it's getting everything out, like you only fuels heavy metals and dealing with any nutritional deficiencies. And zinc is common to be low in people. And vitamin D is and so you basically just kind of stabilize the immune system by helping to optimize all the systems in the body. And the immune system is also influenced by our thoughts and feelings, right? There's a whole field of psycho-neuro immunology and we know that your immune system is listening to your thoughts and so stress can often inflame your emotions, inflame your immune system. And I think that's really underappreciated. Another doorway is through your autonomic nervous system. Can you talk a little bit about that?

Yeah, I think that's great, Mark. There was a study a few years ago in people with asthma, and they found that people who started journaling, so a way to kind of get some of their stresses out on paper and manage them, they had fewer asthma flares and less significant symptoms. Meditation, biofeedback, quieting down that sympathetic arousal, that upregulated nervous system can also quiet the immune system. Acupuncture, many people find that acupuncture is another way to help kind of quiet everything down and can make a big, big difference. So it's a critically important piece that often gets overlooked.

So important. And I think that the bottom line here, Cindy, is that, you know, we don't have to suffer like we thought we did from allergies with, you know, just constant seasonal allergies and struggling and having, you know, difficulty with, you know, just congestion and runny eyes and being a mess. And, and I can tell you just how shocking it is to me. Even people with very high levels of allergies, like IgE levels that are really high, which is the part of your immune system that fights sort of with the allergic response, they can get better that come down and you know, what's really striking is that it's really not something you get from your traditional allergist or your traditional doctor. You have to struggle. So this is a vexing problem that affects so many people. These over-the-counter drugs, people are buying like candy. And I think most of us think we're sort of doomed to just have allergies. We can get allergy shots, but the truth is there's so much that's driving this overactive immune response that we can modify. once we understand what's going on underneath. And I know you've had your own experiences with allergies, and I certainly have seen many, many patients who struggled and had just remarkable benefits by adjusting some of their lifestyle habits, the diet, and also improving their other factors, which we're going to talk about, like the gut, for example. So what are the symptoms that most people get? What causes it? and how does traditional medicine typically deal with this problem?

Well, allergies have been around for a long time, so it's not a new problem. It's when your immune system makes antibodies, usually called IgE antibodies, to something that you're breathing in or exposed to in the environment, like a dust allergy or a pollen allergy or grass allergy. When that happens, these mast cells that contain histamine dump their histamine and cause all the symptoms that we recognize as allergy symptoms. Congestion, sneezing, itchy nose, itchy eyes, watery eyes, sometimes wheezing tightness in the chest. It can contribute to asthma. And one of the things that sort of gets overlooked is just how exhausted people who have active allergies can feel. It's a really common contributor to just low-level lethargy and fatigue. So those are the classic symptoms. Even though it's not new, the prevalence is unfortunately increasing. There are a lot more people nowadays with allergies, actual allergies, than there were 50 years ago, 100 years ago. And we can talk about some of the reasons why that happens. And typically we're going to treat it or in traditional medicine you treat it with identifying the allergen, trying to remove it, treating the symptoms with antihistamines, maybe nasal steroids, maybe an inhaler for your lungs, or trying desensitization shots or drops to try to downregulate that response.

You know, it's interesting. I think there's a whole theory of these missing microbes. There's been a book called Missing Microbes written by a professor, I think he's a Columbia or Cornell, NYU. and Michael Gerson and talks about the fact that we have lost so many of these indigenous microbes that help us regulate our response to foreign substances.

Right.

So we should not be having an overreactive response to things that normally shouldn't bother us. We should be tolerating them. They shouldn't be affecting us. And, and we've seen, you know, a lot of other books like the epidemic of abscess. And this goes for allergy, for autoimmunity and more. And I, I think one of the the most striking things that I've seen is this study years ago was way back when we were just starting doing this work in Canyon Ranch. There was a paper published that showed if you gave pregnant women lactobacillus while they were pregnant, and then you gave the babies lactobacillus after they were born, or even if you didn't, the babies would have far less eczema and asthma and allergies just by virtue of that. It turns out that there's a bacteria that's so important for helping regulate immune function and reduce inflammation and help with the development we call oral tolerance, which is when you eat, you know, why don't you, when you eat a chicken, you don't become a chicken or you don't react. It's because your body knows what to do. There's a company called Invivio that's created a bacteria strain that's called Bifidobacterium infantis. And this is infant, it means infant, right? So this is a very important bacteria that should be in every baby's gut. And it's also in, should be in every mom's system. And the problem is that one, our overuse of antibiotics during pregnancy, during delivery, and even before. I mean, there isn't probably a woman on the planet pretty much who hasn't had an antibiotic sometime in her life. And, and these bacteria are super sensitive to antibiotics, and you will literally wipe them out. And so there's a whole generation of kids being born with increased allergy and autoimmunity and inflammation and asthma. And it may be in part due to this sort of widespread genocide of this particular bacteria that now you can take as a supplement and they're giving it to pregnant women, they're giving it to babies in the first 100 days. What they're seeing is dramatic reductions in the consequences that we typically see in these kids such as allergies and autoimmunity.

So I think this whole field of.

How do we sort of reset the gut how do we reset the immune system? How do we sort of calm things down? So, so important.

Yeah, there's another piece related to that, Mark, and that's what's been fairly recently recognized that another advantage of breastfeeding your baby is breast milk is rich in prebiotics that actually allow a bloom of beneficial bacteria in the baby's gut. So, if they're being bottle-fed, they're missing another opportunity to help develop a resilience ecosystem in their gut.

Yeah, absolutely. I think that's so important. But the problem with it, the breast milk is that not everybody gets it. And we need to think about how do we put the oligosaccharides, these non-digestible starches or in breast milk into formula if kids are drinking formula. And what's interesting in terms of this bifidobacterium infantis is that it really loves this particular food. It loves the oligosaccharides that's in breast milk and it feeds on it. But the problem is, if the babies or the mother doesn't have it, even if they get the oligosaccharides, it won't feed it because it's just not there. It's just not there. Yeah.

Yeah.

So it's really important. And the other thing that is kind of an interesting therapy that, you know, was written about in a book called the Epidemic of Absence, Epidemic of Absence or Missing Microbes is the other book. But they're all the basically the same idea that we've messed up our gut flora, that we are not exposed to the same things we're exposed to. And we often their immune systems don't know what to do. So they create autoimmunity or they create allergy. So autoimmunity is you're overreacting to something inside yourself. An allergy is you're overreacting to something outside yourself. And what they found was that there, there's cultures, like I mentioned earlier, where they don't have these problems, but they also have other issues. They have gut issues such as parasites and worms, things. And it turns out that these worms and parasites were keeping our immune system busy.

And when those go away, because we've.

Been so hygienic that our immune system is looking for something to do and they get busy doing autoimmunity or allergy. And there's actually some studies looking at worms for the treatment of allergy. And I particularly personally use some of these. One product is called HDCs, which is a rat tape worm. And as our friend Sid Baker calls them little dudes, and they, and, and it sounds really weird and a little crazy, but there is a lot of scientific data about this and evidence that, that it could be helpful and, and it's very harmless. They don't take up residence in there. And I actually treated a number of patients who've had, like, ig levels of a thousand. Normally it should be like a hundred. And I've seen levels come down to normal and allergies should basically go away.

So I don't start with that treatment. It was often these other things we.

Have to do anyway first to stabilize and improve the overall health of the patient.

But if people get stuck, there's a.

Lot of cool tricks we functional medicine family can do.

Yeah.

So I don't know how that would work.

No, it's great.

I learned it from Sid Baker. It's very impressive.

And it's shocking when you see like an IG level go from a thousand to like a hundred. That's shocking. And you go, okay, well there's something there. And it makes, it makes sense that there's a biological plausibility to it. It's inexpensive. It's safe. Uh, there's, you know, there's, there's, there's evidence that it works.

And so it's sometimes these things are.

Worth trying even though they're not mainstream.

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Cindy, what other wisdom do you have about people suffering allergies?

Because you're in it with them, right? I'm in it with them. Well, I wish the pinworms and hookworms.

Had served me a little bit better.

They did not when I was a kid.

Did you try? Oh, you didn't take, but you haven't taken them. I was exposed to them. I was exposed to them. I grew up playing in the dirt in South Carolina.

Yeah.

You know, it's interesting. I loved this study. It's a very small proof of concept study that came out last year in Finland. We're talking about prevention, right? They, in half of the daycare's playgrounds, they created a mimicking of the forest floor, the kind of things that would grow in the forest floor in Finland, and the other was just a regular daycare, and they let the kids just do their normal playing in the playground. And after two months, the kids who were using the playground that mimicked the forest floor, they had a more resilient, diverse skin microbiome and gut microbiome, and their inflammatory markers were down regulated. So that, to me, is yet more evidence that, man, we are healthier when we're outside in the woods and playing in the dirt. That I think it had even, even after the fact, there's a rebound or improvement in our skin and gut microflora.

Yeah.

It's all about getting the bugs balanced, right?

Getting the bugs balanced. Yes, absolutely.

Well, Cindy has been such a great conversation about a very vexing problem for so many millions of people. But have hope by using a functional medicine approach, by getting your gut healthy, by dealing with the root causes, by addressing things like histamine, addressing underlying heavy metal toxins and other factors, you can restabilize your immune system and calm down the allergic responses and maybe even get rid of your allergies. I've seen it in a number of patients. And maybe, who knows, maybe worms will help you.

So I know it sounds crazy, but you definitely look it up. It's. It's a thing. Hey, YouTube, if you like this video, you're gonna love the next one. Okay. Histamine. What the heck is histamine? Why should we care?

And. And tell us. Tell us why it's so important and why it contributes to so many people's unnecessary suffering. So histamine is. Is found naturally in the body. The body makes histamine. We also consume histamine. and the interesting thing about histamine is it is also part, it's released by mast cells as part of our first response to offending organisms like viruses.

So mast cells are like a white blood cell.

Exactly, yes. Type of white blood cells. Type of white blood cells, yeah. And the also interesting thing is that histamine actually works as a neurotransmitter. And when you think about this, this is really an interesting thing. And as as I was preparing for this, I sort of stumbled upon some things which I thought was really quite fascinating, is that when you take antihistamine.

What happens to you?

You get drowsy. Exactly. So, histamine, when it's at high enough levels, it stimulates the brain. Histamine is actually involved in the sleep-wake cycle.

Well, I mean, you know, Tylenol PM or Advil PM, it's Tylenol Advil plus.

Benadryl, which is an antihistamine. Right. So, it's a balance. Like, you know, too much histamine is bad, too little histamine is is also bad. So when you actually totally block histamine, you actually get sleepy. It actually involved with the sleep-wake cycle. And, modafinil, which is the drug that people take, that actually works on histamine. It's part of- Provigil. Provigil, exactly. Actually part of that works on the histamine.

So it keeps the histamine levels higher, so it keeps your brain sort of awake, if you will. Incredible. So most people, you know, are familiar with certain histamine conditions, right? If you get hives, if you have a peanut allergy.

Yeah.

If you have this condition we call dermatographia, which it sounds weird, but essentially, it's if you scratch your fingernail on your skin, it'll create a red welt.

Yes.

Yes. That's a, that's a, you literally write.

Your name on your back and it'll kind of have raised, like, letters. And that's, that's actually a poor man's way. I oftentimes will use that with patients to determine how much histamine they're, but they're, they're having in the connective tissue because the mast cells are in, are the type of white blood cells that are in the connective tissue of the body. And when they have excess amounts of histamine in them or they release histamine too easily, you will get this thing called dermatographism, where you can take your finger and stroke on the skin and you will form a red line and it'll stay there. And sometimes it'll get really welty and raised, and that will tell you that there is a problem with excess amounts.

Of histamine in the body. Yeah. And it's something that, you know, we've all experienced. You know, when you get a bee sting or something like that, you'll see this raised welt. but what happens for some people, they don't necessarily get the hives and they don't get these raised welts on their skin, but they do suffer a whole range of symptoms. So when someone walks in your office, what are the clues that alert you to the fact that they might have a histamine problem? Because by the way, most traditional doctors don't even know anything about this syndrome. Yeah, if you have allergies, take an antihistamine, but that's about it. But there's a whole host of problems that people suffer from that are mostly misdiagnosed, poorly treated and create so much suffering which is unnecessary. Yeah, and there's a term out now.

Which when I was in medical school, we didn't even have it. It's now called MCAS, Mast Cell Activation Syndrome. Like it's a real medical diagnosis. It's a real medical diagnosis. I mean, we're seeing a lot of it now and the question is, why are we seeing so much mast cell activation? It's a really, and I've been puzzling on this myself.

Yeah, I never took that class in med school.

I never, right, exactly. But it's true, it's a big thing now. We're seeing a lot of it. And it's not like there's one cause for mast cell activation. There are multiple causes. And I actually even, and I deep dived into the literature. One of the things that I stumbled upon was the effects of EMF on mast cells.

EMF is.

EMF is electromagnetic frequency. Like your cell phone, background cell towers, Wi-Fi. Absolutely, absolutely. And there's some work by a woman Johansson out of, I think it's Sweden, who's done some work on the effects of EMFs on mast cell degranulation. And there's some good studies showing that EMFs are one of the things in susceptible individuals that cause their mast cells to release more histamine that drives this allergic inflammatory response.

So that's fascinating. And so what are the sort of symptoms that you see people coming in with?

Well, they oftentimes will react to every food. They're sort of the people who they can't. They, they, they have a, a more and more restricted diet because the more foods that they, they eat, it'll trigger because lots of foods contain histamine or will get broken down. Histidine is an amino acid. And that when you, when you consume foods that are high in histidine, things like meats, I have a lot of histidine. Your body will actually break it down into histamine. and normally the body can process that, but when you have problems with either too much ingestion or too much production of histamine or not enough breakdown of the histamine, then you'll have problems with histamine intolerance. And these are, you know, typically a lot of people who have food allergies. And, Mark, I think you've done this yourself.

Yeah.

This is really interesting is the old, old way of treating food allergies was what? Chromal and sodium.

Yeah.

Right. Remember using that?

Yeah.

And that, it's actually quite, it's actually a pretty good treatment for people who are really, really reactive to foods and the way that chromosomal, because chromosomal is.

Actually used for patients with asthma.

Yeah, you inhale. It's an inhaler. It's an inhaler. Exactly. And it's a, it's a very effective drug for really bad cases. Chromosomal can be very, very helpful for.

Patients who have severe histamine responses to foods. And it's true. And people can come in with all sorts of weird symptoms that just are misdiagnosing. They have headaches, they can have migraines, nasal congestion, sinus issues, fatigue, brain fog. brain fog, digestive problems, menstrual cycle problems, nausea, vomiting. And if it's really severe, you can get really bad cramping, you can get edema, tons of fluid retention, palpitations, anxiety, your temperature regulation is off, dizziness. So a lot of people come in with all these weird symptoms.

I don't know what's wrong.

Taking antidepressant. Yeah, exactly. So, but there is a way to diagnose this. And so if you're suffering from any of these issues, it may be that that there may be a chance that it could be a histamine issue.

Yeah.

And, you know, when you have someone who comes in with all these symptoms, and by the way, a lot of people have edema and food retention. You can just stick your finger in their body and their tissue. You can feel it's puffy and swollen. You can get edema in the legs. You can see just people carrying a lot of extra weight and fluid. Yep. There's often some type of histamine activation there.

Well, sure, because, well, the mast cells, which are the one, the cells that contain histamine, they're actually found in the spaces, the interstitial spaces in the connective tissue of the body. So that's why they get puffy because those are where those cells that are.

High in histamine reside. And it can really be something that leads to chronic fatigue syndrome, this mast cell activation issue. It's a big deal and most of the time it's just completely missed. I mean, if you ask the average doctor, say, Doc, I think I have mast cell activation syndrome, can you please get me the test and diagnose me? They're gonna go, I don't know. Let me check your histamine levels. so when you have a patient with this, how do you begin to think about diagnosing this? Because it can be a big deal for people. And I want to share a case later. You're going to share some cases of some patients who suffered for decades, decades, and finally get better when we treat them.

Yeah. Well, again, we talked on the last podcast about the role of leaky gut in the microbiome. Interestingly, when you have dysbiosis, some of the bacteria will actually cause more of your body to produce excess amounts of histamine. so that's another thing where when the histamine is in excess in the digestive tract, that can be related to food consumption, which are high foods in histamine, or the bacteria are actually causing the breakdown of histidine as an amino acid to go into histamine. So dysbiosis is one of the things that can trigger excess.

My old nasty gut thing again, we're always talking about the gut here on the Doctors Pharmacy podcast. and especially on our house call episodes because it's such a fundamental thing and it's connected to everything. And the microbiome is so critical in so many aspects of our health. And I remember when we started doing this, Todd, decades ago, and we'd say, oh, people have a leaky gut or there's problems with their gut floor. They have dysbiosis. They would just laugh at us. They literally would just, doctors would just laugh at us and think we were completely crazy. And yet, it is now one of the most important areas of research in medicine is the microbiome and understanding leaky gut. and you see all kinds of papers and scientific literature using the term leaky gut.

Wow.

Yeah.

I literally remember sitting, it was in 1997 and I was at Canyon Ranch and I was having dinner with some guests and there was some doctors in the crowd and we were having nice dinner and we were talking about leaky gut and this one was an allergist. So her specialty was allergy and things like histamine. And she looked at me and she says, you,'re just completely nuts. There's no such thing as leaky gut. You know, this is just a bunch you know what? And I just looked at her like, oh boy, you know, and it's now, you know, 25 years later.

Yeah.

And medicine's really come along. It takes a long time, but people are still struggling, you know, and I think the obvious, you know, the obvious, the worst sort of case scenario of a histamine reaction is obviously anaphylaxis. Yeah, but that doesn't have to be that. So talk about how we begin to diagnose it. We look at what tests besides a SIBO test.

Well, you can measure histamine in the blood. You can also measure tryptase, which is another marker for mast cell activation. You can also measure, there's another test.

Which.

In my preparation for this, I've not measured, I haven't found the lab that does it, but it can be measured as n-methylhistamine, which is a breakdown product of histamine. That is another one that can be done. And then again, I think one of the tests for me is dermatographism. I find that a very helpful clinical test to determine if a person's mast cells in interstitial spaces are overly reactive and releasing lots of histamine.

Yeah.

And we also do a test for DAO deficiency.

Yes.

Yeah.

So talk about what that is. DAO is an enzyme, right?

Yes. So DAO is a diamine oxidase. So this is an enzyme that our body has, and it helps to break down histamine. So histamine has to be, you know, consumed, it's used, and then it has to be detoxified. And if this enzyme is lacking in a person, for whatever reasons, the enzyme may be turned off. you will have problems with detoxifying histamine, especially in the gut. So, and there are enzyme products that you can use, DAO enzymes that you can use that patients respond very, very well to. Yeah, we do that here at the UlchroWana Center.

We give people hist DAO and enzyme support. And it's interesting, there's a lot of things we do every day that block the AO production.

Absolutely.

Alcohol, black tea, green tea, which is a good thing, mate, energy drinks. These all block DAO production, so it's going to increase your histamine intolerance.

Yeah, exactly.

Yeah.

And then, you know, you can, you can use his antihistamines. And the other thing, we had another podcast earlier on migraines. And this is, I found this also very interesting is one of the things that is a histamine blocker is butterbur. And butterbur is used in migraines. And the reason why butterbur works in migraines is it actually is working on an antihistamine level because you can get a, an allergic brain. if you will. You know, we know about that where you get fuzzy in the head and you can get headaches and things like that. So, excess amounts of histamine has an impact on the brain. Yeah.

And so, when you see these patients, you can do some of the genetic testing, look for these DAO deficiency issues. You can look at histamine levels, you can look at some of these byproducts, you can do tests for DAO deficiency. You can look at some of the other factors that might be causing it, like leaky gut, food sensitivities, all that is really part of what we do here at the UltraWellness Center when we check these patients history and we look at their lab tests. And then, you know, so when they come in and you sort of, you'd have this sort of suspicion, because sometimes it's hard to diagnose, you have a suspicion, like it's pretty easy to sort of test and, and, and, and try different approaches that allow people to see if it's an issue. So what are the dietary things that we'd start with? Because a lot of histamine triggers are in the diet.

Yeah.

Right.

And so we can have a low histamine diet. so what's a low histamine diet? Well, foods or what actually are, well, put this way, what are the foods that have the highest histamine that we should be avoiding?

Yeah, so basically the way to think about it is bacteria produce histamine. So if you have food that's old, if you have food that's sitting in the refrigerator for a couple of days, guess what happens? The bacteria actually break down histidine, the amino acid, into histamine.

So no leftovers.

Leftovers, exactly. Leftovers, exactly.

I mean, it's like the next day.

And then fermented foods, fermented foods are fermented by bacteria. So anytime we have food that's old or fermented, things like Parmesan cheese, aged meats, cured meats, et cetera, they have high histamine and that's part of the fermentation process.

And yeah, we talk about fermented foods being so good for you, like sauerkraut and kimchi and natto and miso and- Exactly.

And this is where this is where these really good foods in someone who has histamine intolerance is like putting gasoline on a fire. And they'll be like, well, I'm getting worse. It's like, well, no, you should be getting worse.

These are good foods for you. No, you have histamine problems. What is that saying? Was good for the gooses and good for the gander, right?

I think this is so critical what.

We'Re talking about here, Todd, because functional medicine is personalized medicine. Absolutely, yeah. It's precision medicine. And it's not only medicine, it's precision nutrition. So, it's really important to understand that.

Even though this way of eating may.

Be great for some people with fermented foods and eating avocados and having delicious shellfish.

Bone broth. That's another one.

Right, we think all these are great foods, but you might be killing yourself. Of course, alcohol and beer and all that is a problem, wine.

But.

We'Re really here focused on what is right for you. And I think dietary dogma really interrupts personalization and approach to nutrition. Some people do great on vegan diets. Some people do terribly. Some people do great on keto and some people do terribly. So there's no one size fits all approach. And what really frustrates me, Todd, and probably I imagine you too, is that there's all these people out there on the web and internet and promoting this and that approach and this and that diet, and they're not seeing patients. And the thing about seeing patients is it's incredibly humbling. If you've seen tens of thousands of patients, you can't be dogmatic. you- can't say this is the way. You have to be vegan or you have to eat meat or you have to eat fermented foods. It's like you go, wait a minute, everybody's different. And what works for one may not work for another.

Yeah, one man's food is another man's poison.

That'S right. And even good quote, good foods. We're talking about good foods. And so I think this is a really important point, particularly people who have histamine issues, which is a lot of people at some level or another, they should consider trying a histamine free diet and also other foods that we think are also great, maybe triggering histamine like papayas, and chocolate, oh my God, chocolate, which I love, would be terrible to get this condition. Dried fruit, certain nuts, food dyes, additives, weight germ, weight germ is supposed to be healthy food, right? Tomatoes, bananas, all these things may really cause increased histamine production. And sadly, in order to get this under control, sometimes you need to be restricting some of these foods for a while for your body to heal.

It's not forever. That's the thing, I think you're absolutely right, like an elimination a low-carb diet is not something that you do forever. And, a low histamine diet is also something that you don't necessarily have to do forever. And, I think that the key thing is really working with a really good, well-trained, experienced functional medicine nutritionist who can help you navigate all of the nuances of what to eat, what to avoid.

What to take in terms of supplements can be very, very helpful. Absolutely. You know, the things that we want to focus on if you have histamine intolerance are foods that are low in histamine, like fresh, really fresh food is the Not old fruit like you said, fresh meat, freshly caught fish, not fish that's been sitting around for a while or canned fish is not as very good. Fruit that's not citrus fruits, eggs are great, not gluten grains, get away from the gluten but quinoa and black rice, not dairy. Avoid dairy but you can have coconut milk or almond milk, lots of veggies but no tomatoes, avocado, spinach or eggplant, right? So, you've got to be smart about this and it's a little complicated and often you need help with the nutritionist. all the good oils and fats that we like. Those are all great. So, you know, it's pretty much how I eat. I mean, I do eat avocados and certain things, but I really pretty much eat protein, vegetables, and it works so well for these patients. Hey, everybody, it's Dr. Hyman. Thanks for tuning into the Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introduce to you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you have to do is go to drhyman.com/picks to sign up. That's drhyman.com/picks, P-I-C-K-S. and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Now back to this week's episode. So Todd, when you see a patient like this, tell me about a case that you might have had where it sort of kind of got you thinking about this and allowed you to really drive down into really the diagnosis and the treatment.

Well, you bring up an interesting thing because as I have seen more and more patients and I think we are seeing more patients who have histamine intolerance, call it mast cell activation syndrome to what degree, is there are certain individuals who can be a little bit more predisposed towards this. So people who have Ehlers-Danlos syndrome, the hypermobile people can actually have, for whatever reasons, will have a higher incidence of histamine intolerance. The other thing in the case I recently had was a patient who came in to me with severe mast cell activation syndrome. It was on a whole bunch of different medicines, including chromium, which we talked about earlier to decrease food reactions to histamine. And I saw the patient and he gave a very interesting history. He had this skin lesion which sort of like morphed into this almost like.

A.

Scarring type ulcerated lesion on his back area. He saw multiple dermatologists, had a biopsy, had part of the area removed, and was ultimately diagnosed with a, some type of form of a scleroderma, sort of like a malignant scleroderma, which is sort of interesting. And like, oh, what's, what's that related to? But he was also having all of these, these histamine type reactions. And then when I asked him a bunch of questions, you know, I started thinking about, well, guess what? Lyme disease is also associated with histamine intolerance because Lyme bacteria resides in the connective tissues in the body, sort of hides there. And that in turn can actually activate those mast cells, which mast cells are the first line defense or one of the first lines of defense against infectious agents. And when I asked him, because he had a lot of fatigue and brain fog type symptoms too, but maybe that was related to something else, so I asked him about potential exposure. So lo and behold, he ended up having a low CD57 count. which is oftentimes a marker. It's not diagnostic of Lyme, but it tells you that the immune system is not working so well. And when I did Advanced testing on him, he had actually had conventional lab testing. I think we talked about that in another podcast, how regular conventional lab testing for Lyme disease is not that helpful. But I did a specialized T-cell Eli spot test on him, and his, uh, Lyme, uh, Eli spot test lit up like a Christmas tree.

Wow.

Right.

So, he had Lyme disease.

He had Lyme disease, which was actually triggering a lot of his mast cell activation type symptoms. So, I've been working with him for a while and he did very well. I put him on a supplement which is a combination of quercetin, which can.

Help with-- It's like a natural antihistamine.

Natural antihistamine.

Turns out it's really good for COVID, too.

Yeah, exactly. Very powerful phytochemical. And I, he did very well by adding nettles along with quercetin as a supplement form. He also worked with the nutritionist, got on a low histamine diet, dramatically made a huge, huge Improvement. His brain was working better and his energy was better, but he still wasn't 100 better. So that's where I went, went to the next level. And, uh, he's, you know, currently actually being treated for Lyme. and it's in the medical literature. And I sort of stumbled upon this because I had this patient come into me and she had the same thing. She was, had severe mast cell activation. She was on Zoloft.

She was on injections for, like, 20 grand a year.

Yeah, yeah, exactly. Yeah, 20 grand a year. 20 grand a year.

Control the histamine, which could be controlled by diet and these other things.

Exactly. And, and her condition actually turned out to be the same thing. It was actually undiagnosed Lyme disease. and this is, I think, you know, one of those things where you have to think about it, not that Lyme disease causes everything, but Lyme disease is such a tricky condition that you've got to be thinking about it.

Anybody who comes.

The great masquerader. It's like syphilis. Exactly. It's like the great masquerader. And people can come in. I've seen people with Parkinson's symptoms. I've seen people with brain fog.

I've seen people with rheumatoid, you know, seronegative rheumatoid arthritis.

Chris Christopherson at Alzheimer's quote Alzheimer's. Exactly. Lyme disease. Exactly. I had one patient with fibromyalgia who is, you know, quote unquote fibromyalgia, whatever that means. It means you hurt all over. And so Lyme can actually mimic fibromyalgia.

Yeah.

So you really got to think about it and it doesn't present as one, you know, neatly neat little boxed diagnosis.

It's really, you got to really, I think, well, that sort of speaks to the, one of the foundational concepts of functional medicine is that one disease can have many causes.

Yeah.

Right, like histamine intolerance could have many causes. And one cause like Lyme disease can create many diseases. Lyme disease can cause neurologic issues and joint issues and skin issues and chronic fatigue and Alzheimer's and mast cell activation syndrome and pots and all these weird diagnoses that doctors treat as if they're the thing but actually it's something else.

Right.

You know, it's also interesting about histamine is that there are processes in our body, you mentioned this DAO enzyme that breaks down histamine. And a lot of things interfere with it. You talked about some of the foods that interfere with it, but there are also a lot of drugs that interfere with histamine breakdown through this DAO enzyme. Antibiotics, antidepressants, antipsychotic medications, diuretics, even things like muscle relaxants, pain meds, GI meds, meds for reflux like the acid blockers, TB meds, and even over-the-counter stuff we use all the time like aspirin and Naproxen, like Aleve, Voltaren, anti-inflammatories, all can be really driving this inhibition of this enzyme that breaks on histamine. So you might be taking all these drugs, you might be eating all these foods, you might be nutritionally deficient, all these things can really be driving this histamine intolerance. And what's interesting is that in order to actually have the ability to break down histamine using DAO, you need certain nutrients. There are certain nutrients that really play a role like vitamin B6, vitamin C, copper, magnesium, manganese, zinc, calcium, B1, B12, folic acid, all these are critical nutrients and many of us are deficient. If you look at the nutritional testing we do here at the UltraWellness Center, I don't know about you Todd, people say, oh, you don't need vitamins and oh, people are eating a healthy diet, they're fine. Nonsense. I mean, we don't guess, we test. And we look and see the amount of nutritional deficiencies exist are just massive. Even in our population, which is a relatively affluent, well-educated population, imagine how bad it is. And I've seen what I call virgin patients. People have really never seen a functional medicine doctor who have lower socioeconomic status, underserved patients, and they have massive deficiencies. And I think we really can take out the bad stuff, whether it's foods or drugs, and we can add in the good stuff, which is the right foods and the right nutrients. And that's really what's so powerful about functional medicine. So I just recall a case, I'm going to share a little bit of this guy who just was the most complicated patient he, for years and years, had tremendous swelling everywhere. He'd get these lesions all over his body and he would have skin breakdown, he had fluid retention, no matter what he ate, he couldn't lose weight. And he was always puffy and swollen. And it turned out he had this histamine intolerance syndrome. And we diagnosed him and we put him on a low histamine diet. We gave him the chromaline, which chromaline is a mast cell inhibitor. So it basically blocks the release of histamine from these white blood cells and you can take it before you eat. And it's very safe.

Yeah.

It's very, it's very water medication, very effective. It's prescribed for food allergies, but it's incredibly effective for this. I, I give them, he, he was also really severe. So we gave him and I met other medications, Xantac, which is a histamine blocker. It's another histamine drug, even though it's for acid stomach. And we gave him other, other, other supplements like quercetin.

We gave him the histdio.

We sort of piled a lot of stuff on in order to help him for severe cases. You got to do that. And he was so severe and it was amazing what happened to him. After 35 years of misdiagnosis and suffering and struggling, he was seeing the best doctors. He lost 35 pounds without really trying. All the fluid went out of his system. It was all fluid.

Fluid, yeah. It was interstitial fluid.

Fluid, yeah. It was like the Michelin Man. And he's got healed. He felt better. It was just really quite an amazing case. I think it was one of the more extreme cases of histamine intolerance I've ever seen. And he had to be very extreme. But there's middle ground depending on where you're at and what you need to do. So if you think you're suffering from any of this stuff, then it's really important to get properly assessed and treated. And people go from doctor to doctor to doctor and they don't get an answer. And if you're really struggling, it could.

Be this phenomena of histamine intolerance. Yeah, absolutely. I think it's a spectrum illness and you can have mild, moderate and severe forms of it.

It.

And, there's a whole variety of different things that are involved. And, you sort of have to treat each person individually looking at their unique situation, their history, their genetics, their gut microbiome. Yeah, absolutely.

I mean, this guy had Babesia as well. We had to treat him. He had really bad infections.

Yeah.

Did he actually have Lyme or did he just have Babesia?

He had Babesia. And, he also had bacterial overgrowth in his gut. so people have leaky gut, people have irritable bowel, people have inflammatory bowel disease, they tend to get more of this histamine problem too. So you just got to look for all the clues and it's really, really powerful when you see patients like this and they recover simply by understanding how their system is out of whack and it's really about getting them back in balance and often over time by healing the leaky gut by providing the nutrients they need by sort of reducing the trigger foods by adding in the foods that are beneficial. These patients do get better.

Yeah, and I'm sure, Mark, that was a very rewarding case because there's nothing I think that drives doctors is helping to alleviate suffering. When you see somebody who's suffering mentally, physically for years and they're not getting answers and they're saying, oh, it's in your head, here take an antidepressant, that's bad medicine.

Yeah.

Well, I hate to vilify doctors too because this, you know, we just, we just don't learn about this stuff, right?

Yeah.

It's like, you know, you expect a doctor to speak Chinese, but they never were taught Chinese.

Yeah.

Well, you know, I was, but I.

You know, I, I, one of my, one of my sayings that I say to my patients is, you know, I went from being a medical student to a student medicine. I mean, unless you're a physician and you're constantly learning, you know, the stuff that you learned in, you know, the, the old joke was, you know, whatever.

You learn in medical, half of it was wrong, but we don't know what half of it is wrong. That's right. The dean of our medical school got out the first day of medical school. So, well, I have good news and bad news. Half of what we're going to teach you in five years is going to be wrong. And the bad news is we can't tell you which half.

Exactly, right. Exactly, yeah.

But we're really at this, I think this extraordinary beginning of a new era of medicine. I think we are emerging from the dark ages of medicine.

Oh, yeah.

And I say that in all seriousness because traditional healthcare, traditional medicine is focused on a paradigm that's based on diagnosing diseases by symptoms and by geography. Where is in your body and what is the symptom? And then we group people into categories according to symptoms. You have depression, you have rheumatoid arthritis, you have dementia, you have diabetes. But there can be many, many causes for each of those diseases and yet they all get treated uniformly.

Right.

And doctors don't understand how to navigate the paradigm shift of systems biology, which is explaining how everything is connected. You know, I remember this patient who said, I have a doctor for every inch of me. You know? Yeah, all the ologists.

All the ologists, right?

And it's no fault of their own. It's what we learned in med school, what you and I learned in medical school. And it took us having some breakthrough to say, wait a minute, this doesn't make sense anymore.

The body is a system, it's an ecosystem, everything's connected. and I would venture to say, Mark, you actually bring up a really good point because I've seen all those patients who have, they have a cardiologist, they have a gastroenterologist, they have a dermatologist, they have an immunologist, they have a neurologist.

And the more ologist that you have, the more dangerous it is. Well, then you get more piles of pills. Yeah. And there's a pill for every yelp. But, you know, the thing is that, and they don't talk to each other. If you, if you have a migraine and joint pain and you have eczema and you have irritable bowel, and you have a little pre-diabetes they all get treated differently by different doctors. I mean, they get treated by separate doctors and every doctor really does the same thing. So we talk about second opinions. There really is no second opinions in traditional medicine. There may be nuances on how people do stuff, but it's the same old, same old. And functional medicine really is a true second opinion. It's a true approach that digs down into the biology, the underlying biology, and that doesn't get hooked on the diagnosis. Exactly. And, you know, the teacher we both had, Sid Baker, one of the greatest thinkers in medicine, I think, in the 20 and 21st century, you know, he said we do this phenomena called naming and blaming. We name the disease, and then we blame the name for the problem, and then we tame it with a drug. So, you come in, you're sad, you're hopeless and helpless, and you have no interest in life and you can't sleep and you're not eating and you don't want to have sex anymore. The guys, I know what's wrong with you. You're depressed. That's what's causing your symptoms. It's not the cause of your symptoms. It's the name of your symptoms. They go, I know how to fix it. Take an antidepressant. But depression is not a Prozac deficiency. It could be a million things. It could be the changes in your microbiome or a vitamin D deficiency or Omega-3 deficiency or mercury poisoning or maybe you took too much acid blockers and you have B12 deficiency or maybe your thyroid's not working. I mean, I could give you a million different reasons. and we have no road map in traditional medicine to get there from here. And that's what functional medicine really does. It helps us navigate this complex territory of disease. And Sid Baker goes, we were given the wrong map for the territory of illness. And we were given a map of these labels. So it's like if you're going to New Delhi and you get a map.

Of New York City, it's not going to help you.

So, they get you into trouble. So we got to come up with a new map. map. And that's what functional medicine is, folks. It's really a new map for navigating the territory, the landscape of disease.

Yeah.

And, and it is so gratifying after doing this for so many decades. That's why you and I both work so hard at it, because it's really not getting out there to enough people.

And, and a lot of this you can do on your own. A lot of this is really doesn't need a doctor.

Yeah.

And the fun part of this is, too, is, you know, I, I'm old enough to remember when there was no internet. You know, we used to have to, you know, we wanted to look something up. We'd have to go to the medical library to do that. And I can remember as a, as a physician, I a primary care doctor in Stockbridge, the local town doctor.

Oh my God.

And when the internet first came out and I could go on to the National Library of the PubMed, and I could do it through an old program called Lonesome Doc.

I remember that.

I remember that.

And I said, oh my God, this is a game changer. Now it's like, I have the library on my laptop.

Yeah, you let me say, I want to know about histamine. So you go to the librarian and say, you can pull all the articles that might be relevant on histamine or you look them up in a journal and you write them down and your level of ability to learn and process information. And that's really how I've learned so much is just digging into the original research.

Yeah, exactly. And the ability to access that information now, like I do so much my research, thank God I have a laptop and an internet connection. you can find amazing stuff. And, you know, just give me a good cup of coffee and some time and I can research amazing amounts of stuff. And one thing, maybe a little histamine.

To wake you up.

A little histamine to wake me up. And one thing will lead to the other. And yeah, it's like a rabbit hole. You go, oh, you follow this trail and that trail. Because it is all connected. It actually is all connected. And sometimes, you know, chance favors the prepared mind. When you're looking for certain things, certain things will start popping up and you.

Start, oh yeah, that's a connection.

There.

Oh, I see, I see that.

How that's related to that. I think that's right, Todd. I think what, you know, what you're describing in your understanding and processing of all this data is, is a different set of filters that is much broader than a traditional doctor. So a typical neurologist or cardiologist or gastrologist, they'll read deep into their silo.

Yeah.

They'll look at all the papers in their framework, but they don't look across disciplines.

Yeah.

And what's so fascinating is when you look at across all these different diseases, they all have the same common root issues. And we talk about the matrix in functional medicine, which is this framework for looking at the body that is based on understanding that health or disease is either balance or imbalance in these basic functional biological networks in the body. And so across the spectrum of diseases, these same networks are getting out of whack. So if you're a neurologist, you could have leaky you could have mitochondrial issues, you could have inflammation, you could have nutritional deficiencies, you can have hormonal disruptions. Same thing with diabetes, same thing with rheumatoid arthritis. And so you go, well, these diseases are actually all the same. They're just manifested differently depending on that person's unique genetics and predispositions and where the target goes. And so we get so hooked up on the diagnosis, whether it's histamine or migraines or depression, the diagnosis is just the first step in the process of unraveling what's going on. Yeah, exactly.

And what was the Holy Grail?

When I was in med school, the Holy Grail is, and you got brownie points for being able to make the diagnosis. It's called the differential diagnosis. So you could look at the symptoms, the physical exam, the lab tests, and the guy who wins the prize is the guy who can name that disease, like Jeopardy. Exactly. And you name that disease and you win. Gold star. You get your gold star. And then afterwards, words. It's just cookbook. Yeah. It's total cookbook. Paint by numbers. It's, it's, it's sad to say. I hate to break it to y'all people, but, you know, doctors, once, once, there's a bit of an art to it in which you do. But, you know, if you have a diagnosis, here's the standard of care. Here's the drugs you use. Here's the surgeries. Here's, here's the steps you take. And it's, it's not that complicated. So it's kind of boring. It's formulaic. It's very formulaic. I mean, I used to practice emergency room medicine. You did, too. and you think it's exciting and thrilling, it's actually boring because the kidney stone gets these three drugs, the heart attack gets these four drugs, the asthma patient gets this protocol, the migraine patient gets this cocktail, and it's like after you learn it, it's kind of boring. The key is making the diagnosis, but in functional medicine, the diagnosis is just the first step in understanding the complexity of what's going on. Then you go, okay, well why? Not what disease do we have, but why is this going on?

Absolutely. Yeah, you also, you made me think of a great book and I oftentimes recommend this to my patients, written by our friend Jeff Blan, a fantastic book and I highly recommend reading it. It's called the Disease Delusion.

Yes.

Fantastic. We are deluded by the how we think of disease. Exactly. And when you look at it from a systems biology and a broad approach, he does a very great job of articulating exactly what you're saying. And this is why it's such an.

Exciting time in medicine because all these silos are breaking down. We can't deny it anymore. The microbiome is blowing apart everybody's conception of disease. I said, you know, when your theory doesn't match the facts anymore, you got to change your theory. And I think that's what's happening in.

Medicine now and it's really, really exciting. It's a very exciting time. I think, you know, the knowledge is exploding and now that we computers and bioinformatics and even artificial intelligence, we're only going to get able to do better analysis of things and really dial in the personalization of medicine.

Absolutely. And we're talking about a real personalization around using much less invasive toxic interventions, because even this histamine thing we're talking about, you know, it's pretty straightforward when you, when you look at it, it's just getting rid of the bad stuff that triggers it, adding the good foods that help you heal, fixing your leaky gut, taking a few nutrients, maybe taking a few very low toxicity drugs that can help. And, and, and just people get so much better. Functional medicine is about getting rid of the things that impair health and putting in the things that help the body Thrive, and then the body can take over and with its amazing intelligence can repair and heal from all sorts of things.

Oh, totally.

Yeah. And that's what we do. So, one of the, you know, one of the complaints we see a lot is fatigue. Everybody's tired, right?