Gut Health, Histamine Intolerance and What to do About It: 88

Hi everyone. Welcome back to the Heal, Nourish, Grow podcast. Today I am joined by Dr. Meg Mill, and she has been a guest on the show before, so I forgot to look up the episode, but that will be in the show notes. So if you're listening to this, it was another great episode with her before. Be sure you go check it out. But before we get started, we got a great new topic today, which I'm super excited about, and also a cool summit that Dr. Mill is running coming up. So more on that later. But first, Dr. Meg, if you could just share with everybody your background, your PharmD, you now do a functional medicine practice, so I'd love for you to just share how you got into all that for people that didn't listen to the interview yet, um, and then we'll start chatting about our new topic for the day.

Yes, yes. Well, so I, like you said, I graduated with a doctor of pharmacy, and then I actually went on to do a residency and was practicing as a clinical pharmacist. And I, I kind of have two reasons that I switched to functional medicine, and one was that I was— I knew all the protocols, I knew what, what to do, you know, we had what we should do, and people just weren't getting better. I'm like, okay, we're putting them on more medication, but we're not seeing them improve. It's just like, okay, we're sustaining this place. And then at the same time, I was having a lot of my own health issues. So I was having, you know, a lot of digestive issues. I was having anxiety. I actually started getting panic attacks, and that was when I was at the point where I have to change something. I remember sitting, like, my kids are playing on the beach, and I'm sitting there, and I'm like, okay, I'm here, but I'm in so much— like, my stomach's upset, I can't eat anything. I'm having all this anxiety. I need to make a change in my life. And, that's kind of when my journey shifted and I started to really look into more holistic ways of healing. And, that led me to find functional medicine for myself and finally get answers. I'd been to 5 different gastroenterologists. We moved a lot at the time, so I'd be like, "Oh, I'm going to get an answer now when we move to a new place." And, it was just everyone said, "You're fine. You look like the picture of health." So, Listeners, if you've been told that and you feel terrible, go with your instincts because that is not true. But when I finally found answers, I was like, I need to share this with others. So I opened my virtual practice in functional medicine and really it's been— I've been able to heal— help, not heal, really help other people heal so many different things and see these health transformations. It's been amazing. Yeah.

And that's— I'm sure a lot has happened over the last year since we last spoke. It might even have been longer than that at this point. So I think you, you mentioned, you know, you had some gut health issues before, before we move on to the new topic, you know, that's such a, a kind of a, it's really popular to chat about that right now. So I'm just curious, um, since we last spoke, is there maybe anything additional that you've learned in the last year or so, or new practices that you've put into place to really support your gut health? Because I do think that that is such a good foundation for a lot of the things, and probably we're gonna talk about that more in the upcoming topic, but I'd love to just hear if you have anything sort of new share or new thoughts on that since we last spoke?

Yeah, so I think a lot of it comes, you know what, we're gonna talk about some of this cuz one of the things that I am finding is that more and more people have histamine issues in our world. And when you're, when you have histamine issues, you actually have to look at gut health a little bit differently. So a lot of people are hearing from influencers and, you know, practitioners for good reason, fermented foods, bone broth, probiotics. But if you have histamine issues, those actually can make you feel worse. So some of the things that we're doing actually to help our gut can be making us feel worse or having flares and other things. You know, maybe you're getting more anxiety, maybe your hormones are out of balance. Maybe we're having some of these other things happen because of some of the things we're being told to do. Our gut health. And so, it's tricky. I think a lot of times, people just are out there saying things. You know, we're in that world of information, which is wonderful, but then we hear, "Oh, okay, I have to do this. Oh, I have to do this." You know, now the new thing is colostrum, and that's great. Colostrum can be good for a lot of people, but then someone, you know, that I was working with, we said, "Well, you know, colostrum's not what you need right now." And so, we took her off of it because she had just heard, you know, someone say, "Oh, everybody needs to have colostrum.", and she's like, oh my gosh, I feel so much better because it's not what she needed. So I think really my best advice is to, to get a stool test. I mean, stool tests give us so much information and we can look at your individual microbiome. We can, you know, really replete that bacteria that is low. We can, you know, get the invaders that we need. We can improve your digestive function. So it's more about personalizing it to what you need than maybe just following It's just a general protocol because that's what I see. Everybody's a little bit different and what their needs are a little bit different.

Yeah. And that's such a great point because really things do need to be individualized. And so even if you've learned something new in the past year that worked for you or one of your patients regarding gut health, that doesn't mean it's gonna necessarily work for the next person. I guess that being said, we should just— you mentioned it, histamine. So let's talk about it. That's kind of your new passion at the moment. And I would love for you to first just maybe start for people, you know, they hear this word histamine and the first thing that probably comes to their mind, especially this time of year if you live in Cincinnati like I do, is antihistamine because the pollen is insane. But I, so I think people have kind of a sense that it's sort of like a reaction maybe in your body, histamine, but could you just kind of give a broad definition of it and then maybe go a little bit more detail into how it relates to your overall health?

Yes, yes, absolutely. So, you know, histamine we generally think of as allergies, like you're saying, but it's actually so much more. We're finding more and more research on how it's affecting so many different parts of our bodies because we actually have 4 different types of histamine receptors in our body. So it's actually an overall body issue, and we can get into that, but it's actually what we call a biogenic amine, which is the scientific term. But it actually— the purpose— so when the immune system detects an allergen or an invader, it's— histamine is released from our mast cells and our basophils, and it's actually part of our immune response. So it increases the permeability of our blood vessels, which allows our immune cells to reach the affected area more quickly. And it's kind of like cortisol, where I feel like it— there's purpose, but it gets a bad rap because there's so many negative symptoms. But we do need it for immune defense. It actually regulates our gastric acid secretion to help us break down foods. It can affect our neurotransmitter, so it can affect serotonin, norepinephrine. It's part of our body's response to repel allergens. It also can even cause bronchoconstriction in our lungs. So if you breathe something in, you— it prevents it from getting deep into your airways, and it actually creates an inflammatory response. And So in the purpose of an acute situation, this is important because we need to increase vascular permeability to allow the blood to flow to the area that needs help. But the problem is when we start to see this happen long-term and we're starting to get this long-term inflammation because it's not being turned off.

So it's similar to, and the same thing, like inflammation gets a bad rap. It's very important process in the body, but if it's a chronic long-term thing rather than acute, so just to remind people, acute sort of what happens in the moment, like like you get some pollen in your nose and you sneeze, that's an acute reaction because it's just like maybe a one-time thing. Whereas like if it's more of an extended period of time, your body can kind of almost go into overdrive. Is that how you would describe it? Um, when it's more like of a chronic condition that causes the issue?

Yes. So when we're— yes. So I like to think of it like a bucket. So I mean, it's just a good way to give an analogy. So think of your body like a bucket with holes in the bottom. And so as long as we're pouring things in and draining out, so you need to fill the bucket, drain it, fill it, drain it, as long as that's happening, your body's in balance and you don't really, you know, you're using histamine for the purposes that we need to, and you don't really feel the effects. But what starts to happen is if you either get holes in the bottom of the bucket or you get an overflow of things filling your bucket up, or both. And so when we're looking at the, the plugs, like if we're getting plugs in the bottom of that bucket, we're looking at a breakdown in the way we're processing histamine. So we process histamine in two ways out of our body. And the first one is diamine oxidase and the other one is histamine N-methyltransferase. So the diamine oxidase is in your, in your gut. And then the histamine N-methyltransferase is a process of methylation. So we need to be able to methylate to break down the histamine. And so what starts to happen is when we start to get different things happening in the gut, we can either have— well, we can either actually first have genetic factors that are variations in the way we produce the DAO enzyme, um, but then we also can have an imbalance where we start to get what we call dysbiosis, and we start to get this imbalance of this, this good and this bad bacteria, and it can create different problems. So the DAO lives in the mucosal layer of the gut lining. So if we have issues with that mucosa, we start to get a compromised DAO. And so we can't break down the histamine that we eat from our foods well. And then we can also start to get a leaky gut, which can also cause more inflammation, and it can actually cause more downregulation of the D— the DAO. So we need to have those good DAO enzymes in order to break down the histamine. We also can get nutritional deficiencies because DAO require certain nutrients. So like vitamin B6, copper, vitamin E, you need to be able to make sure you are actually digesting and absorbing those nutrients. And, and so we need to make sure all of these factors are happening in order to break down histamine in our food. So we have histamine in some foods and there we'll get into that. They're often healthy foods, but we need to make sure when we eat those foods that we're breaking it down. If that happens, you're not getting symptoms. If not, you start to get the symptoms.

Okay. And I, I definitely have some follow-up questions on what you just described, but before we do that, I think what you just mentioned is, you know, you're getting some histamine from foods. Are foods the only source? Are there, you know, some foods that more commonly cause this issue than others, or where else might you find histamine? Because I think, again, going back to the pollen analogy, every— or example, everybody knows about pollen, but I think fewer people know What are histamine-causing foods, or are there other things outside of food that can cause this histamine response?

Yeah, that's a great question. So, you know, even, even things like stress, actually. So stress affects everything. So stress can actually stimulate the mast cells. So it can lead to a release in histamine. So that's one thing. It also can modulate the immune system and lead to an imbalance in the Th1 and Th2 immune response. So That's something that we're not even maybe thinking is bothering us. We have the histamine-rich foods, and which we can get more in depth, but I'll just go through some of these other things and then we can talk more about the foods. But there's also environmental. So look, think of your allergens or seasonal allergies. They can cause the release of histamines because our immune system has tagged those as invaders, even though they're not something that's dangerous to us. So that's a, that's an important point here. To make is that what can start to happen, and we see this, so one of the things that can cause a big factor for causing histamine intolerance. So right now we're kind of switching gears and we're talking about what fills the bucket up and we're looking at these things. And one of the things that can be a big factor is mast cell activation syndrome. And so what, what starts to happen is you get this immune dysregulation, you can get some nervous system dysregulation, immune hypersensitivity. And we start to see the mast cells release histamine from everyday things. So you may just start to react to so many more things than you should be. You know, we, we see this, it depends on the person, but we can see it really vary and your body starts to react to everything. And so some of the things that can start to cause that are toxins, mold, we can have environmental fa— other environmental factors. And then we can even have illnesses like a virus and like EBV. We have like tick-borne illnesses. We see, we're seeing this more and more in COVID. And so we're starting to see our immune system have to deal with other assaults that are going on, which is causing it— basically think of it getting angry. So it's like, okay, I'm dealing with this, I'm dealing with this, this, and the imbalance gets off and it starts to just overreact. And so once it starts to overreact to things, then it's releasing more histamine and then you're getting more of these histamine symptoms. Okay.

And before we move on to the food there, there is another thing that you mentioned maybe a minute or two ago that I kind of wanted to bring up for people. You said something about methylation. So for example, now these genetic tests are a little bit more common that people will take and they learn maybe that they're poor methylator, for example, me. So if— is that the same sort of pathway that has to do with maybe being more sensitive to histamines. And so can supporting your methylation pathways with things like methylated B vitamins or other things, can that actually help you become more resilient in this histamine process? Or is it like a totally separate process altogether? It is. Nope, you are correct.

So there, it's a little bit, it's a little bit more complicated than that because it, but that's the first step. So we need histamine and methyltransferase is active in the breakdown of histamine within ourselves of the body. So it works by methylating histamine and forming it into N-methylhistamine, which then is excreted in the kidneys. And so we do need the methylated folate and the methyl— the methyl B's in order to methylate well if you have that MTHFR. So we're hearing a lot of, okay, I have MTHFR. Now I do think it's interesting because I feel like people are now taking MTHFR. It's like, I have MTHFR, like it's something that is like terrible that we have. And, and really it's just a variant. So what we're looking at is how can we overcome that variant in your body? And so what we're doing is, you know, we're giving you methylated B vitamins, methylfolate, in order to overcome that. So you want to be careful if you have this to have regular folic acid, but as long as you're taking the methylated folate, we're upregulating that. Now, when it comes to the breakdown of histamine, we have to be careful. Because N-methylhistamine can be more active. There's different forms of histamine that are more active. And so we want to make sure that the whole pathway is actually ability— you're able to excrete it out, the whole pathway. So sometimes if you're upregulating that and you're taking, let's say, a methylated B complex and you're, you're upregulating methylation, but down further you have like a monoamine oxidase variation, you may actually be blocking it further down the pathway. And so sometimes we have to look at that full pathway and make sure that, you know, things like, like B2, like riboflavin, can help open up some of the parts on the lower part of that pathway. So we have to make sure that that whole pathway is open. It's a little bit complicated to get into, like, eat that— people probably don't want to hear like each piece of it, but you have to just really— the gist is if you take the, the B complex that's methylated and you're like, okay, I feel more anxious, I feel like my symptoms are getting worse, then maybe you have a block further down in that pathway.

Super interesting. I've never heard that part of it before because all I've heard is, um, for example, I had this advanced test that I actually did a full podcast on one time, and that's when I learned that I, I was a poor methylator and I should be taking the methylate, which I haven't actually started on yet. Bad. Bad, bad practitioner here. Um, but it was because my, uh, oh, I'm going to forget the thing. Uh, you know, it's very related to cardiac health. This number was a little bit elevated and he thought it was because of my— yes, thank you. Yes. My homocysteine was a little methylated. So he thought that, that, um, that taking those Bs might help, but that's a good— all that's to say that that's why it's kind of important if you know you have something like that to work with a practitioner, because for example, if I go on this which I should try this, go on the methylated bees, then I should notice, are, are any symptoms getting worse or better related to that? And then if I'm working with a practitioner like yourself, you would know that, okay, maybe that MAO pathway is not totally open, so let's maybe like tweak something or do something with that. So I just think that's like a good point for people. Like once you know these things, definitely work with somebody so that the things that you try, you don't end up making things worse.

Because it's like you're he— again, we're hearing a lot of information and it's like, okay, I need to do this. And then. We do it. And is that right for you right now? And I think that's what you always want to ask. Like, is that right for me? And is that right for me right now? And what I'm doing, like, if you're taking something and you're reacting to it, then you should question like, okay, should I actually be taking this? It doesn't make me feel better. Does it make me feel worse? And maybe getting it, some of that intuitive body feelings to see what, how things are actually affecting you.

Yeah. And actually that's another great point that you said about, is it right for you right now? Because I'm noticing that for many years I had really bad seasonal allergies and then somehow over the years they just got a whole lot better and really hadn't bothered me for years until this year, which I had been away, uh, living in another state for a while. And so maybe my body got a little used to a different set of allergens and then coming back here, my body's like, whoa, wait a minute. But you know, so, so if your system is activated in some way, or you're feeling different, adding some of these additional things on right now might not be the right moment to attack that. So I think that's just a great point. And again, another reason to work with a practitioner so you have somebody to bounce these ideas off of, um, you know, when you're dealing with health issues. But anyway, I would love to go back to, um, you mentioned some of the environmental factors, other things. I think, you know, one really obvious thing is if you have if you know you react to histamines, one of the easiest to avoid maybe are certain foods. So I'd love it if you'd share a little bit about what you found to be the most activating foods for people with this issue. And how would somebody know that they're reacting to histamines? Like, what kind of symptoms would they be experiencing after eating a histamine food, for example? Yeah, so it—

and it can— that's where it's like a little bit tricky here because it can vary. So you can have the out— like you could find that you have a runny nose, you could have itchy skin, your face could turn red, you could have flushing, but then you could also have things like a rash come out. You could feel more anxious, you know, maybe a day within that day of eating, you could get a headache. So migraines can be a big trigger. You might have IBS symptoms. You might like one more. And I think that's where we're like, we think of, okay, just that allergy type reaction, but a lot of these can be overall body reactions that you might not be associating with food. And so That's where actually one of the things that I have people do is print out a blank calendar. When we're using the low histamine diet, I like to use it as an investigation tool, not a long-term strategy. And I think a lot of people can get hung up on this diet as like, okay, I have to follow this. I have, you know, it's a complicated diet. I follow it exactly. And it's really, it's a good starting place to see if these foods are bothering you. And if they are, we can see which ones, why., and it can give us a lot of clues and we can pull them out for symptom relief, but we're ultimately looking at why is your bucket filling up? Why are your, you know, why are the drains clogged? And that's what we need to do long-term in order to reverse this. But what, when we're looking, it's a really great investigation tool. So when we're seeing, um, there's different categories, so we can see high histamine foods. So high histamine foods are fermented foods, we have aged cheese, we have cured meats, alcohol is another one. And then we have histamine liberating foods. So these are, these are foods that are going to like liberate histamine from your body. So we see strawberries, tomato, banana. Then we also have foods that can inhibit DAO. And so those can be actually something like tea, like black tea. We also— caffeine can block DAO. So we're looking at these different categories. And as you've noticed, some of the foods that I said are healthy foods. And so it can be surprising, even avocados are another one. So things that we're eating maybe on purpose for different reasons that are valuable might be actually bothering you. Another thing you have to be very careful that makes histamine tolerance tricky with the low histamine diet is that freshness counts. So we need to make sure that you're— you're— it's not necessarily a great idea to meal prep unless you're gonna flash freeze, because once you cook meat and, and different foods, then histamine can actually grow in the food. So sometimes actually avoiding leftovers over 24 hours can be a really good thing if we're exploring this diet. So I think that's something that, that's kind of— you're not thinking about how long your food has been out, and even restaurants, because you never know when they cooked it. So like, it's another thing people say, well, I actually got food out and I reacted to maybe something that's not typically high histamine, but it might have to do with the freshness.

Interesting. Yeah. My husband would be very happy to hear that because he's not a big gluten person. So I don't think he reacts to it. He just never thinks to use them.

But that's just an aside. Like, no, I can't, I'm not going to eat. Like, I'm like, will you be eating that? Because I won't be eating after 24. I mean, I do have histamine issues. I'm genetic, like I have some of the genetic variants. I, you know, I have, but, but I guess that being said, all the symptoms that I have are under control. So I'm not really having issues, but I also, I'm just careful, you know, careful about the basics. I don't have to really avoid the foods at this point. Um, because I have worked on gut health for so long, I've worked on so many of these things, but I still do. Maybe I'm just, you know, I still do watch leftovers too long.

Yes. So meal preppers out there, sorry about that. If you happen to have histamine issues.

Well, if it's in your schedule, then just put it in the freezer until you're ready and then— Got it. So all that.

So I think, you know, you probably, you mentioned that you were having this issue yourself, which is often how we all get into these paths of, uh, these little health rabbit holes we go down. Uh, and you started a summit this year, and I think probably partially in relation to exploring some of these new things. Can you share with the audience a little bit about what the summit's gonna be about, what kinds of things you'll be sharing, and you know, how they can listen in and learn even more great health tips from you and your guests?

Yes. Yeah. So it's called Reversing Mast Cell Activation Syndrome and Histamine Intolerance summit, and we are going to be talking about both. So we're going to be talking all about histamine, how it affects your body, and then we're even going to get into mast cell activation and how you know if you have it, how it's diagnosed, and how this is affecting more and more of the population. I think one of the things that I just kept seeing is I've had the history, but I've been seeing more and more people come to me with histamine issues. And it's like all of these, like we're talking about, unrelated symptoms that once we look at it through this histamine lens, we put these pieces together and it's sort of like everything starts to clear up. So I have interviewed 50 experts in this field. Um, we have some, some top names in the, the functional space that are going to give us great information. It is June 18th through the 24th and it's a free event. So come listen, learn. There's, there's going to be so much— you're going to have more information than, than you can even absorb because we have a lot of great speakers and a lot of great information.

So just so when people hear this, um, I can create a special link to it. And so let's say it's gonna be healnourishgrow.com/histaminesummit, and that will be where you can go and register to join for free. And you said you have 50 guests. Are you allowed to kind of like preview or give a little share of, um, you know, some people that you have talking and the kind of topics they'll be covering?

Yeah, so we're going to talk with— so Neil Nathan is big. He wrote the book Toxic, and he is big in this space of— because mold can play a role. We didn't even get into that, but sometimes mold can play a role in really how to look into that. We have Carrie Jones, who is the hormone expert. So hormones are a big deal, and that's even why you sometimes will have histamine issues at certain times of the month and not other times because we're more likely to have histamine issues when we have higher levels of estrogen. Estrogen can be histamine promoting and DAO enzyme inhibiting. So we look at the hormonal balance. We're going to talk about fasting with Cynthia Thurlow and Jay Ben Moore on there talking about even how Lyme can impact this. And there's just so many, so many great experts that, that really are sharing such different insights. We're coming at it from a lot of different angles to give you things about what we can do about it, how we can get this figured out, and then also how you can really manage it in your life. Becky Campbell's another one who is a big in, in the histamine and the cell space. Yeah.

Before we wrap this, I just wanna, again, for people, so they might be hearing this and they're thinking, well, I don't think I have a histamine problem, so I don't need to listen to this. But number one, just because you don't have it today doesn't mean you might never have it. I mean, we hope you never have it, but it could happen in the future, or it doesn't mean that people that you know and love and care for might not have it. So just to kind of wrap it up again, what are some of the top things that people could be looking for in their experience, in their life, in their health, the way they're feeling, that might indicate that this is something for them to maybe go to the summit, hear it, learn a little more about it so they can see if it's something that, you know, might apply to them, what would you be looking for?

So you're looking at like nasal congestion, sneezing, asthma, difficulty breathing. Those are kind of the ones you typically think of. But then headaches and migraines. I see it in so many of the people I work with, with headaches and migraines have underlying histamine issues, fatigue. So even if you're having unexplained fatigue, heart palpitations, dizziness, anxiety, difficulty concentrating, PMS, irregular periods, flushing, joint pain, sleep disturbances, high or low blood pressure, hives, and vertigo. So you're— as you're seeing, anxiety, depression, those are other ones. So as you're seeing, it's, it's a lot of different issues. And, and that's where I think I'm trying to bring more awareness that, okay, if you're having some of these symptoms, especially if you're having more than one of those things, you want to look at it from a different lens and see, okay, can histamine be playing a role in what I'm feeling? Because when we look at it this lens, we can do the right things in the right order to really get a lot of different things to clear up at the same time.

Yeah, and you just listed a list there, but the one that stuck out to me was fatigue. So basically, pretty much anybody listening to this right now should go to the summit and learn more about this and see if this is something that could help you. Because, and you're saying a lot of this, I mean, you named off a whole bunch of things that, um, you know, like for example, I could do that I could look at and be like, okay, maybe this is really what it's been all along. So that's, that's really great. So again, for Listeners, be sure to go to healnourishgrow.com/histaminesummit and you can register for free and then you can learn more about this and hopefully get yourself feeling better. I know after listening to this, I'm going to be going, not that I wouldn't have before because I'm a geek and I love learning about all this stuff, but some of the symptoms I've had lately, I think I should definitely go listen to this. Dr. Meg, any final thoughts or can you first tell everybody where they can follow you, where they can contact you, learn more about your work, all that good stuff, and any final thoughts that you want to leave people with? Yes.

So I have— my website is megmill.com, just M-E-G-M-I-L-L.com. And I actually offer free discovery calls. So if you have any questions, if you're curious, like, okay, does this apply to me? Reach out and I'd love to talk with you. I'm over on Instagram at Dr. Meg Mill. I also have a podcast called A Little Bit Healthier, and we talk about all sorts of different health issues over there. And yeah, I just— I would love to see you at the summit. I can also share and give you the link to— I have a free guide on histamine intolerance, and that gives more complete food list because a lot of the low histamine diets aren't accurate or confusing. And so, um, I took a lot of time creating this guide, so I can also link that too. And that's some— a resource that I'd love to share with everyone.

Okay, amazing. Definitely, I'll add that to the show notes. Dr. Meg, always such a pleasure to talk to you and see you on camera and learn about what you're doing. I just love your work. So thanks again for joining us today. And I will be listening over at the summit.

Thank you so much for having me.