Why a BAD REACTION to HISTAMINE Medication??

But most things in the body that you can think of have this dynamic balance of stimulation, release, binding, metabolism, and elimination. And you can imagine it's like a river flowing. If a lot of the river is coming in on the front with a reaction and I can't let it out, I dam it up, the river's going to back up. That's what happens with these inflammatory chemicals like histamine. Hey, it's Dr. Paul. Today I'm answering questions, and this one was a really great one. And it was, why, if I have histamine problems, would I react badly to something like an antihistamine or even a mast cell stabilizer? Great, great question. So we'll get into some of that right now. Thank you for listening, by the way. Medicine Health podcast. But we're gonna go and talk about a couple of questions that kind of overlapped a bit. First specific one was they take an antihistamine, so you think Benadryl or Claritin or something, and their symptoms get worse and they have histamine problems. Maybe they have mast cell activation or a little bit of everything. Well, we've done a bunch of these podcasts on histamine and mast cells, so I'm not going to go over a lot of ground. We've already tread there. But I talk about atypical or odd reactions with histamine specifically here. So the first thing to keep in mind is that histamine is. Is the chemical. It is a signaling molecule that goes out from your body. It's released under the behest of immunoglobulin E and your mast cells and other types of cells in your immune system. You can go in on the YouTube channel and check all that stuff out. But the bottom line is histamine is sort of one chemical, but it binds at different types of histamine receptors. And this is where a lot of the atypical reactions we get to histamine and histamine drugs and cell stabilizers come from. So we'll. We'll stick with histamine for the moment here. So you take a drug that is supposed to stop a histamine reaction, but you get worse histamine problems. Now, normally, the drugs that we take for histamine reactions are going to be H type 1 drugs, histamine receptor type 1, called histamine receptor type 1 because we discovered it first. Histamine receptor 1 is very important, and it's blocked by drugs such as Benad and Claritin and Zyrtec and stuff like that. All sorts of H1 blocking drugs. But guess what? We've got histamine receptor type 2, histamine receptor type 3, histamine receptor type 4. And they all do different things. Now, when we're starting to teach medical students in the pharmacology class, what we normally do is we talk about, well, histamine type 1 is, you know, the stuffy nose, dip, histamine, asthma, allergy, anaphylaxis, et cetera. Histamine type 2 became famous, gosh, probably 40 years ago when we developed the H2 types of drugs. And histamine type 2 was famous for manipulating the amount of hydrochloric acid that was made in the stomach and other stuff like that. So the H2 drugs were originally used a lot for, you know, gastritis and ulcer and that sort of thing. And then we discovered, well, there's H3 and H4 receptors. And we kind of said, well, those are brain receptors, really. Okay, now you need to understand that histamine not only study, but histamine biology and everything else has really undergone a lot of evolution in what we know about it. Because if you think about, like, brain histamine, it's not been that long ago that we had a real hard time sorting out brain histamine, because by the time we would, say, go to dissect, you know, an animal or do something, the histamine is gone. The receptors are hard to find. So it's really only in modern medical times that we see that and then these receptor classes we found out about. So I always tell students, you know, there's four main histamine receptors that we know about, and there's probably others that do some other cool things along the way. But if you imagine that you get one trigger going out called histamine, and then it can go to four different types of receptors that do all these different things. And then you go to the next step, past the. The first day of histamine training, say, in pharmacology, and you find out, well, histamine type 1 is not just about my stuffy nose or my anaphylactic reaction. Histamine type 2 is not just about my GI tract. Histamine 3 and 4 aren't just about my brain. That adds to the thickness of the soup, as it were, when it comes to histamine reactions in your body. We now know that we've got histamine type 3 receptors and possibly even 4 in our joint linings, synovial membranes. We've got histamine 1 and 2 in the brain as long as, as well as 3 and 4. So it's a real complex, complex system. So now imagine you've got some reason you're atopic, possibly where your body makes histamine because you get an allergy trigger or something, or you have an atopic situation and you have a mast cell activation problem which is going to crank up the amount of histamine and other inflammatory stuff. Guess what? That histamine comes out in higher amounts. And if I take a histamine type 1 blocker in many people, it will stop those symptoms of the histamine aggravating the body. But what am I missing? I'm not blocking H2, I'm certainly not blocking H3 and 4 very well with an H1 blocker. So a lot of times if you go for example to the emergency department, you've had an allergic reaction, they will give you an H1 blocker. But they may give you and send you home taking an H1 and H2 blocker together. Part of the reason for that is that there's this crossover where yes, the H2 drug will affect your gut more. But remember, histamine 1 and 2 are not just in, you know, respiratory mucosa and then the GI tract. Right. They're everywhere. And then you've got H3 and H4 also getting in the game and playing. So one way to help with histamine one drug sensitivity is to pair them with H1 and H2. Now what's the next level of complexity there? Let's say that doesn't work. It maybe helps, but it doesn't work as well. Well then you can do what we talked about in the cell activation series, which is to go and to either forcibly like acutely stop mast cells from releasing histamine and serotonin, all the other inflammatory stuff they release. So you could give somebody steroids, which is a good acute drug treatment, but it's, it's a tough long term treatment because we get steroid side effects in the rest of the body. But if you're going to die from a histamine, you know, reaction, the steroids are actually quite useful in keeping you here with us. So you could do that now if you have time and you can take it chronically, you could do a mast cell stabilizing drug or natural supplement. Now again, you can go back, go on the YouTube channel, in the playlist on mast cell histamine, tons of stuff there on that. But to shorten it up, I'll just talk about two. One is a drug and the other is a supplement. They're both the same category of chemical. They're called flavonoids. Some people say bioflavonoid. So chromolin sodium is a highly purified bioflavonoid or flavonoid that is highly absorbable for a flavonoid and it actually its parent molecule comes from a particular type of a flower. Okay. Bioflavonoids tend to come from either the flowering part of a plant or the rind of a fruit or other stuff like that. A real common supplement is quercete. Kind of does the same thing. But I've had people, especially mast cell activation patients, where we give them chromolyn and it should be sett everything down. And again, remember, H1 blocking drugs usually don't have these atypical reactions, but they do happen. And that's why the person asked the question mast cell stabilizers. So if it's not a steroid and we're going to use a bioflavonoid, which doesn't have a steroid effect, so it's slower and lower, why would I have a aggravation of my mast cell symptoms if the mast cell stabilizer is going to do that? It's terribly frustrating for your doctor. It's frustrating for you. Everybody's upset when that happens. Well, it's kind of the same thing, but it's at a different end of the problem, which I'll get to in a second. Now, the next thing is, I do want to say, although we're not really sure of the incidence of this going on, but we do know it happens in certain people. There are genetic differences in us humans in the way that we either form histamine or metabolize histamine or even in the way that we maybe have sensitivity or histamine receptors. So on top of these receptor category balance things and mast cell stabilization gone wrong and all that, you can also have genetic reasons that can get epigenetically turned on because of stress. And mast cell activation disorder is a big stress and chronic infections and toxicity, all that stuff. So what can happen is your genetics can kind of work against you here too. Another probably big reason for some of these atypical reactions. So I said that I would explain maybe a little bit more in context. How can a mast cell stabilizer not seemingly stabilize? How could I take chromolin or quercetin and be worse? Well, it's a little different than the histamine blocking drug story with mast cells. And you might remember if you go into the, if you hunt the graphic that I held up a couple of times, this weird, you know, sort of target graphic I have with different. There's at the very base of mast cell activation, there's a collusion of four forces, primary and then there's others. There's the immunoglobulin E, which is associated with allergy atopic problems. There are eosinophils and basophils, which are types of white blood cells. And then there's the mast cells and they have slightly different activities, have different triggers and then they all collude together and they all create a mast cell like reaction. So the mast cells get blamed for it. But really there's a bunch of other players in the game too. So let's say I give you a mast cell stabilizer. It really should stabilize everybody. But again, you've got four forces coming in with a lot of different chemistry. And if the mast cell stabilizer stables maybe one or two portions of those four, then the energy from the trigger of your mast cell reaction, your allergic reaction, whatever, all goes into the other one or two or three places that the mast cell stabilizer isn't working on. And so a lot of the problem when we have problems, especially with a stabilizing either drug or supplement or whatever, is that the, the trigger is still coming down. And you think about, I've got 100 units of trigger and let's say it's going to go 25 units per each of these four areas, one of which is your mast cells and let stabilize your mast cells and a little bit of your eosinophils and basophils, but not completely. And your IGE response is still touchy. And what that means is that Instead of going 25 units of stimulation across all four, now I've got the, let's say, you know, I've got 50% blocked with a mast cell stabilizer that might be stabilizing a few of those few of those cells. Well, Now I've got 100 units of stimulation going to just 50% of the area. So I'm doubling up on the stimulation of your inflammatory allergic anaphylactic system. So those are reasons why a mast cell stabilizer can do that. Then you think, well, why would the steroids work so well? And then these mast cell stabilizers like Cromolyn or Questin or whatever, I switch over from steroids to that and then I've got all these problems. Well, reason is that the steroids don't just stabilize the release of mast cells and degranulation of these other cells and stuff. The steroids also go and they calm everything else down. So you kind of. You're. You may be having the chemistry of the reaction, but you can't actually achieve the reaction. That's why we like steroids in emergency situations for the most part, because they go and they do other things for you. Okay, so that's another reason. Now, if we go back and again, go over the YouTube channel, I got a bunch of things in the playlist on, you know, mast cell and histamine and stuff. But just keep in mind, we've got. We've got a trigger and the triggers are numerous. Okay. We just dropped a video about, you know, six common triggers, which goes through, you know, hormones and infections and. And all these other things. Right. So all the triggers in the world, the triggers create a release of things like histamine and other inflammatory things. And there's a bunch of other chemicals that kind of come before that happens. So the release process is what you're trying to stabilize with a mast cell stabilizer. And the steroids, like I say, do it best and. But let's say put in chromoly interquestin. The release is going to slow down, not stop. It's going to slow down, but then the release of all those chemicals. And we were talking about histamine today. Go over. It binds to histamine receptors. Remember, that can be 1, 2, 3, or 4, or maybe some of the other ones that we don't know as much about yet. And then you get an output which is generally inflammatory. So you can think of the classic allergic reaction, Atopic dermatitis, itchy skin, hay fever, anaphylaxis, you know, all of these big bad things. Well, that's the downstream output effect. And then you get to the part of getting rid of all these chemicals, especially like the histamine. Well, when it comes to getting rid of histamine, I've done a couple of videos on this. There's three pathways to get this to me. Now, a problem is in a lot of people, they may be slowing down the mast cell release, but there's still stuff going out. Remember, you got 100 units of trigger and it's all going to the stuff that isn't slowed down, so it's still coming out the other end. And you're binding histamine and other receptors, but then you got to get rid of the histamine. What happens if the histamine is slow leaving your body? You can metabolize it to intermediates that are worse for you and all manner of things. So you can go check that other video out, too. We'll put the link down below in the description. But metabolism elimination is very helpful, too. And a lot of times people that may take a histamine blocker and have a reaction, or people that might do a mast cell stabilizer have a reaction, the other piece of the puzzle is they're still creating the inflammatory chemistry and they can't get it out of the body. And again, I will leave the the other videos and the other podcasts on histamine elimination to themselves because the explanation gets a little bit deep there. But most things in the body that you can think of have this dynamic balance of stimulation, release, binding, metabolism, and elimination. And you can imagine it's like a river flowing. If a lot of the river is coming in on the front with a reaction and I can't let it out, I dam it up, the river's going to back up. That's what happens with these inflammatory chemicals like histamine. The other thing that can happen, if you're one of those sensitive people where it crosses over and you're taking an H1 blocking drug like Benadryl, and then your H2, 3 and 4 receptors are still getting all whipped up from all this histamine. Imagine if the histamine levels rise because I'm not eliminating it, then I'm going to have an even worse reaction. So those are the main reasons that we have atypical reactions. So from a drug point of view, what we often try and do is do a balance of H1 and H2 blocking drugs together in those sensitive people. Nowadays we can do genomic assessments of your single nucleotide polymorphism and see, you know, do you have some of these, you know, genetic problems with either, you know, over producing histamine, overbinding histamine, or maybe you got horrible elimination genetics for histamine. All of that can come into play as well, and kind of the same with mast cell stabilization. I've had a number of people, you know, the majority of people, you give them a mast cell stabilizer, chromalin or quercetin, whatever, and eventually it will help. Does it, does it cure their problem? No, you're just sort of slowing the problem down while you work on all that other stuff that's wrong. But usually it helps. But then you get people where they do their first dose of quercetin or chromalin and they're like, blows them out of the water, they're all inflamed their symptoms worse, etc. And that can be, as I said, because I've stabilized a piece of the inflammatory puzzle. But the mast cell stabilizer does not stabilize some of the other trigger areas, which is a little bit more of a tall order. So that's when you get into comorbid other disorders that go into it again. Look at the YouTube channel for the, you know, mast cell histamine. And we've got things about what other causes would cause these triggers. So hope that answers a question. I'm Dr. Paul Andersen with Medicine Health with Dr. Paul Anderson, and it's been my pleasure to answer your question today about histamine aggravation. Mast cell aggravations. Check out everything. Easiest way to find all of the channels, whether it's you're trying to get to the pod burner or YouTube or my newsletters or whatever, is to go over to dranow.com d r a n o w.com that's my hub website. You can find all that stuff there. If you haven't been over the YouTube channel, please check it out. I'd love you to join the community there. We're growing that. And please like share, subscribe, do subscribe, do the comments, you know, do notifications. This all helps us. It helps push us up in the algorithm so the education gets out there and then share it with a friend if you have somebody looking. And like I say, the YouTube channel is really great because, you know, sometimes there's graphic stuff and also there's the playlists are all sort of coalesce there as well. 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