The Hidden Roots of Histamine, POTS & Nervous System Dysregulation with Michelle Shapiro

We become like detectives. You and I are detectives going through people's lifestyle, their food, their supplements, what they're exposed to, their emotional beliefs, their thoughts, to really uncover what are the things that are causing imbalances. Would you agree?

Absolutely. I think functional medicine is not random supplements. It is pattern recognition. Every single person is so different. Like Mona, we could have two clients. One of my clients can have the exact same symptoms as another. One of them can have them from eating tomatoes because they have a histamine issue or while another person's because they're eating too much fiber. Like, there's literally no way that any one protocol would fit both people. And understanding anything about a person's body is so relevant to the treatment plan that there's just no way you could ever apply a functional. A true functional medicine or functional nutrition model without extreme detective work and kind of putting the puzzle together and the making those connections.

My dear friend, K.N. lifelong. Where have you been all my life, friend? Michelle Shapiro. Welcome to Rooted in Wellness. We have so much to talk about today, but let's just start out with the foundation of the podcast. So this podcast is really all about ancient wisdom in our modern world and how we can become more rooted in ourself and our health and our happiness. So let's start off the episode by talking about what are two or three things that help you feel really rooted in yourself and in your happiness and in your life?

I love that. So it's been almost corny. I've been talking so much about walking, and I'm like, why did I get this, like, huge degree and, like, practice for all these years if the whole thing is walking? So for myself, if I do not walk a certain amount, for me, it's like, really, 10,000 steps is kind of where I landed. I just don't feel like myself and I don't feel well. So walking is all that, so to speak. And for me, it really does make me feel rooted and grounded in wellness. The other thing I would say is that for me to feel like myself, I need to be what I call working the phones. So when I'm not with clients and talking to them, I'm with my friends and family on. You will find me on the phone with my friends and family. And that is, like, where I feel the most like myself is just listening and talking to the people who see me for who I am. And it makes me feel anything that makes me feel like myself, makes me feel grounded. So that's where I feel the most like myself and the healthiest you're the.

First person to give such a unique, authentic answer. Oh my gosh. On the phone with the people that you love, the people who see you for who you are. Like, talk about a brilliant way for you to just shine your light. Right? And that's exactly what you do online for so many people. You are so authentic in the way that you speak and it doesn't come off in an approach that is startling to people. It really does come from this heart centered approach. So that's a reflection of your community for sure. All right. So on the flip side, you and I have these insane healing journeys which I'm convinced is what keeps us aligned with our purpose. We'll get to that. So you must know in your life when you're drifting from that, then maybe when you're not talking to your tribe, when you're not walking, do you catch the symptoms or what are the things that cause you to feel more uprooted?

It's whenever I notice a symptom that I know that I'm past my baseline. So I will actually say, and I almost have a, a joke that goes on with my husband where I'll say, you know what? I haven't noticed digestive issues in so long. And by the time I say that is when the digestive issue is coming already. So that's when I know is when a symptom shows up. I have a very strong communication line between. And you do as well, Mona. Of course, between my mind and body. So I get those signals and I take them very seriously. So I'll start to notice when any of those symptoms come up. It's kind of a call to go back home. What? Nothing will disregulate me as much as sitting on my phone too much. Looking at it now, it's very different if I'm talking to people and if I'm looking at my screen scrolling on Instagram, I will face neck pain. I will. That will result in some sort of dysautonomic function which I know we're going to talk about. So for me, that's one of the most least grounding things in the world. And then I would say, you know, before I mentioned, what makes me feel grounded is feeling like myself if I'm doing things that are out of alignment with what I want to do consistently. It's so silly, Mona, but I hate sitting at dinners, so. So I, I need to like walk around and talk to people. I need to. It's the way I like to engage. So just sitting down in the same position for that long. If I have to do like three dinners in a row, I feel awful. So I just know my body and I know myself so I won't book them in a row. I'll do a brunch one day if I have to, I'll do a dinner and then I say I have to see you next weekend. So anytime I'm doing something that I know doesn't make me feel good repeatedly, even that being out of alignment, it really can create symptoms for me.

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You guys are hiking the Griffith Observatory? Are you kidding me? That's your lunch meeting. Yeah, I know. Not New York.

I love that you said that because, you know, for me as well, I feel like there's this resonance within the body that just knows. It's like our spidey senses going off, like, oh, there it is again. There's that feeling in your neck, there's that feeling in your gut. Or any digestive symptoms. Because I think as practitioners, we talk about symptoms all day long to the people that we work with. But I think for the most part of the population, because there's so much happening in our world, you know, we've become so desensitized to this communication system from our body, which is a freaking miracle. Let's just say, like our body's communicating with us all the time, but we've mastered kind of masking the, the symptoms, the emotions, the feelings that come up for what we think we should be doing instead of what our body's actually asking for. So that's probably a good segue. So you take on such a unique approach to nutrition, and I love that you, you really blend the world of functional nutrition and healing as well as our mindset and how that matters. But what led you into that work? And why is it so important to break away from this, like, tradition dietitian kind of mentality? I remember when I went to school for nutrition, it was like the nutritionist against the dietitians that, like, it's like, no, no, we can come together, but tell us about your story.

Yeah, I, I have lovingly called myself the anti dietitian dietitian A little bit. I definitely believe that every single one of us has a seat at the table and we are in such desperate need of healers and people who want to help others. So for one, someone else, and this kind of like credentialism obsessed world we live in, I think is completely ridiculous. And I think that we should all be so grateful that there are people who want to take their time to help others and we should welcome help from every single person. So that's just something I had to say about that because I'm really, really passionate about it. Yeah. So I went to. I, I grew up in Queens, New York. I'll kind of weave my personal and health story together. I grew up in Queens, one of the most diverse, amazing places in the entire world. And I always lived in a larger body. When I was younger, when I was going off to college, I kind of realized that as I'm going to college, it's not going to be as like it's going to be much more homogenous place. And in Queens, people are really valued for their uniqueness. Like, it was like cool to be different in New York City growing up, you know, so for myself, like, you know, gender identity, racial identity, body size, there was so, there was 5,000 kids in my high school. So it's like there's so many different types of everyone that whatever made you stand out was actually, you know, an advantage. But I realized I was going to school at the University of Delta Delaware, which is a much more homogeneous place. And I realized, like, if I don't lose weight before I go to school, I will not be socially accepted. Like, people don't know that I'm Michelle Shapiro, class clown. Like, they don't know these things about me. It didn't inhibit me in my younger life, but it did inhibit me going, you know, when I was going to school. So I lost. And this is like a trigger warning. I would never recommend this, but I lost close to £100 before I went away to school. And it was probably in like a year's time frame through disordered eating and starvation the entire time I was at college. Mona I was sick. I had hypothyroidism, acid reflux, severe gut issues, severe panic attacks that would happen several times a day with vomiting, like severe symptoms. And every doctor I went to was like, why don't you lose those last five? And really what it was is my body was so dysregulated from that extreme stress and that extreme weight loss that it led me into basically being chronically ill the rest of my adult life. And I, I couldn't understand it until I sought the help of a naturopathic physician, Dr. Robert Kochko, who became one of my besties by force. I was in that session with him and I was like, we're done now. I was like, we are best friends for life now. You're not just my doctor. But it was when he kind of sat, we went, we did a Dutch test and we kind of looked at everything. It was a 90 minute initial session that I think we went over into the two hour range. And I was like, oh, this is what I'm actually supposed to be doing. Because traditional dietetic schooling didn't sit well with me and I often complained. I worked in nursing homes and the last straw for me of why I left conventional dietetics was I would not give ensure to long term care patients. I just felt like it was very counter to what the work that I wanted to do. And then I. I left to pursue functional health as I had my own healing journey. I then wanted to help people in the same way. I had kind of a second health crisis a couple years ago. We'll talk about two related to histamines and long Covid. But that was the. What led me initially into functional dietetics versus that conventional dietetics degree which I.

Have, but so important. And I think that says just a lot about you because often we go into these big school Systems and there's a 1 cookie cut, you know, cookie cutter approach to how we're approaching healing and well being. But that's the exact approach that got me s thinking that I had to do something in a certain way to heal. And a lot of like the research, I don't know about you, but the textbooks that we had, they're like so antiquated, right? So I love that you said that. This idea of conformity and you as a kid, how that has also now bled into how you lead as a leader and a healer in this world. And I think that says a lot because when people look at, you know, practitioners like you and I, I think the misconception is that we've arrived. Here's pillar health. This is what it is. But I swear I got like every weird genetic thing that came up. Like I'm this highly sensitive person, which we'll talk about, and like, I'm just affected by the weird stuff, but I'm kind of changing the lens in which I look at that one to not conform to the other healers that are out there. I think you and I are here for a reason, to kind of deliver a message based on our healing and the fact that we're on this path because it keeps us students, it keeps us in practice for all of those things. So I love that you have that approach especially. So let's flash forward then. You know, you and I share the story of COVID Covid was. I thought it was fine. Covid felt fine. For me, my body was strong and resilient to fortunately not have the same symptoms as a lot of other people did. But I didn't realize that I went into long haulers Covid and that long haulers Covid. That ended up. I think I was just way more. My immune system was just so compromised that I became predisposed to mold. I had full mold exposure in my apartment. So this is over two years. Covid, long haulers, mold exposure. And I've shared this on the podcast before. Getting over mold, doing all the hardcore protocols, the Exact same thing that got me sick. Hardcore protocols now depleting even more. I stripped my system. I probably gutted my all the amazing microbes in my gut microbiome with all these binders and modalities and stuff like that in order to heal. And now it's been a process of rebuilding. So share your story from that because the timing of you kind of gaining so much traction online was with the rise of understanding long callers. Covid but also histamine response.

Thank you for saying everything you just said. First of all I'm. I'm literally actively nodding so hard and closing my mouth cause I'm like oh my God, Mona, I want to. What you just said is so beautiful. First of all, the conformist thing that you picked up on that I'm very, very non conformist. So yes, if you're telling me to fit into a box and not listen to myself or not listen to the people in my life, it will never work. So that is hard for me about the conventional education system. Absolutely. I had lovingly as you kind of just put together the same mold vid puzzle which is I had a mold exposure. I had exposure to Covid and I really think of and I want to do a couple like defining terms to help us here, but I really think of long covet as a combination of a different syndromes. One of them is Mast cell activation syndrome. I'm sure everyone's seen it online. Mcas. Mcas we call it pots pal Orthostatic tachycardia syndrome which is what we'll talk about. And then hypermobility. So that's kind of and exacerbation of hypermobility symptoms. This long haul Covid as a. It's kind of a cluster of these different syndromes. Some people have one a little more than the other, but they deeply connect and relate. So I had this mold exposure. I was going to the best functional medicine doctors, best naturopathic physicians and just absolutely destroy. Like you said, destroying myself with mold protocols, detoxes, binders, everything. I got sicker and sicker. The more I went to functional medicine doctors the sicker I got. And really when I'm talking about these people in highly sensitive bodies Mona like us a long time ago, we used to always say about functional medicine we're the last stop when conventional medicine has failed you. Well now the clients I'm seeing have been harmed by functional medicine. So it's like they did conventional, they did functional and now they're sicker than they were before. And can you imagine Paying thousands of dollars for these advanced tests to then get sicker. I mean, imagine the heartbreak and the fear in that. If you're going to the practitioners who people say, this is the last stop on the train. So that's really where I've been. And you said something so beautifully, which is that it was the protocols themselves that actually made me sicker. It wasn't even mold. It was when I tried to kill the mold that I got sicker. And I can say why that happens, too. So Covid, as a virus, attacks our immune system, as we know, and the organs of our body. But there was something really weird that happened after Covid, which is that people stayed fatigued, Their hearts were racing hives for months after, and we just really couldn't understand. There was one study in 2022 where they did statewide surveys, and they found that up to 30% of people in each state who had Covid were experiencing long Covid. 30% of people. That's. That could be 100 million Americans who are experiencing it. So as a definition, our mast cells are a type of immune cell. They're a type of a white blood cell that is. Are really involved in connecting our body with the resources that it needs in times of threat. It's a. It's an immune response. Basically, the way our mast cells work is they're kind of like the guards on the watchtower of our bodies. So if there's a battle like Covid, let's say, mast cells are going to see that they're going to, you know, deliver resources to the body where they need it. And I'll say how they do that. And then after mast cells are really interesting because they stay kind of on guard. They're, like, very hypervigilant, and they connect to both our immune system and our nervous system. So if they sense a threat is coming, they're going to fire out everything they've got. From an immune perspective, the way mast cells work is there's receptors on the outside, and then they have these sacs on the inside which have all these different chemical messengers inside of them. Histamine is one of those chemical messengers. So they will have something attached to the outside and as a result, mount an immune response. Covid and mast cells share a commonality in that one of the receptors on mast cells are this ACE2 receptor, which Covid attacks and attaches to. So long Covid happened is because normally we have an immune response, and then our immune system's like, okay, that's done. But now we have an immune Response and a nervous system response that cycles and perpetually keeps going. And the problem is that histamines, and Those are only one of about 1200 messengers that mass cells send out. Histamines, particularly when there's too much floating in our bloodstream, can create extreme symptoms in people.

It's also a learned stress response from the body. Right. If the body adapts to constantly defending itself, it's going to get stuck there because it's keeping, it's keeping itself alive. Right. So people started understanding this concept of mast cells, the concept of a cytokine storm within their body. So they're gradually starting to understand this, but they're not recognizing like just the impact of the smallest things that they could be doing every single day. And when we think about that concept of a mast cell, people always talk about your body defending itself or attacking itself. I think it's the most brilliant, like what a gift, you know, magnificent ability for your body. It's trying to keep you healthy and safe. It's trying to re regulate and move back to resilience. Right. So I'm curious from your perspective in understanding, let's start with, let's start with MCAs, would you say kind of as you start to describe it a little bit, maybe give our listeners some understanding of how they can check themselves for this. Is this a modern day problem? Like did our ancestors have to deal with this?

So the discovery of mast cells at all happened in like 1890s. The, the cells, mast cells at all. The, our understanding when we started publishing like papers on mast cells and like huge practice papers was like 2012, 2015, 2016. So our understanding of it is definitely in its infancy, but it's really good because we have a lot of really juicy information coming out that's really helpful. Do I think that people experience what is probably like mast cell activation disorder, mcad maybe what I think I view MCAS from a spiritual perspective as humans becoming incongruent with their environment. So we're incongruent with the amount of stress in our lives, with the extreme amount of like toxins, perfumes, even like artificial light and all these things. And it's, it's. Our body is not able to accommodate those changes. So I do view MCAS as like a lifestyle and environmental mismatch from how we're supposed to be living. So more and more people have it. And you know, when I first started practicing 11 years ago, you know, I think about clients back then and I'm like maybe one in a hundred of those clients were like what I would call a histamine type of client. And it's not just because I'm talking about it now, but all of my practitioner friends who don't work with MCAs at all are like, are all of my clients have histamine issues now? So I think that we already were on a slope of environmental mismatch, and I think Covid kind of blew us out of the water. So I would say yes, more people have it now. And the types of stress we have on our physical selves and emotional selves is probably more as time goes on.

I would say, which kind of makes sense, right? You know, from an ayurvedic standpoint, we always talk about these imbalances or dis ease within the body as a process of accumulation. Accumulation. And we've been accumulating our entire lives since we're in utero. And now we're learning, even through our mothers and fathers genetics. Right? And when we think about our modern world, like, there's so many assaults that we are confronted with every single day. When I got. When I was at my sickest God, I was slathering my body in perfumes every single day. I was hardcore dieting every single day. I was wearing perfumes. There were so many exterior influences. And, you know, I think something that's so relevant for your practice and for mine is that ultimately we become like detectives. You and I are detectives going through people's lifestyle, their food, their supplements, what they're exposed to, their emotional beliefs, their thoughts, to really uncover what are the things that are causing imbalances. Would you agree?

Oh, absolutely. I think functional medicine is not random supplements. It is pattern recognition. Right. Every single person is so different. Like, Mona, we could have two clients. One of my clients can have the exact same symptoms as. As another. Let's say it's like loose stools. Every single day. I feel like I'm like, can we talk about diarrhea on podcast?

Like, every.

It's not what you and I don't talk about every day anyway. But let's say one person's having loose stools. Another person is. One of them can have them from eating tomatoes because they have a histamine issue, while another person's because they're eating too much fiber. Like, there's literally no way that any one protocol would fit both people. And understanding anything about a person's body is so relevant to the treatment plan that there's just no way you could ever apply a functional. A true functional medicine or functional nutrition model without extreme Detective work and kind of putting the puzzle together and the making those connections.

I want to take a quick break from today's episode. To tell you the truth, healing is so much more than just food and supplements. It's about community, connection and accountability. My name is Mona Sharma, celebrity nutritionist. And that's why I built the rooted community. A space where we can learn, grow and support each other on this wellness journey. Inside, you'll get access to exclusive content, Q&As, deep dive discussions and real connections with like minded people. If you're tired of going at it all alone and want a space where wellness finally makes sense, join today@monasharma.com which kind of sheds light on the word syndrome. Right? So mast cell activation syndrome. From my experience, syndrome is another word for doctors saying I don't really know what's happening, but it probably has something to do with this. It can't be an official diagnosis because one, one person's symptoms can manifest very differently from the others. So you do this so well. You talk about the different symptoms that people might be experiencing. So can you talk about what are the biggest ones that you see in your practice, your, your patients?

Absolutely. So I'll talk about the histamine client because I think it's really interesting also. Or a histamine like client. You know Mona, like when my symptoms were happening with, when I was having histamine issues because I have mcas, mine looks like rapid heart rate, mine looked like extreme insomnia, mine looked like tremors. So it's really interesting because what I did was I, I actually had a chiropractic injury mixed up in all this as well. I left a chiropractor's office, they had been adjusting my neck but I didn't know that I had upper cervical instability and I'm hypermobile. Did not know yet. And they kind of like sub laxated or dislocated joints in my neck by really aggressively with this like tool. They're like, wow, you have the tightest neck I've ever felt. And they did not do a hypermobility assessment which I don't want anyone to get. Cervical assessment, like cervical work done like ever. But especially if you're hypermobile, never let anyone touch your neck. I left that appointment and my heart rate was 180 and I was not moving, sitting. And then I went to standing, it would jump up even higher. I walked straight to the er. I don't know, I crawled to the er. Let me be clear about that because I had to get down on the floor, at different points on the cement and like shuffled my butt there. And when I go there, what, what are they going to say if my heart rate's 180? Mona? They're going to say go to a cardiologist. Here's the really weird thing, it's not a heart condition. So the trouble with these symptoms when it comes to histamines and you can have histamine symptoms that look like basically anything because our mast cells lie line all of our connective tissue which is on our joints, blood vessels, bones, and basically every organ in our body has connective tissue lining it. So you could have symptoms in any organ. So the problem is you have rapid heart rate. Where do you go? You go to a cardiologist, they're not going to really be able to do anything because the reason that you're having that reaction is from either a neurochemical reaction or a neurological or nervous system place. So we kind of need like a nervous system doctor in that situation. And yes, neurologists exist, but not in the treatment of, you know, this, these set of symptoms generally. So it's really hard because the symptoms don't match up with what's going on inside and it doesn't match up with the type of doctor you go to, which makes it really challenging to, to treat. And with histamine issues, I've seen urinary frequency. Yes, of course, I've seen the classic, you know, like when we think of cold with seasonal allergies, right. We think of like cold symptoms. I've seen of course, rashes, urinary frequency, extreme diarrhea, vomiting and a lot of anxiety and this very physical ants crawling under your skin, zinginess and a lot of insomnia. That's what I see in a lot of my clients. And again, these symptoms can look like where are these coming from? It doesn't even make sense in our brains. Yeah.

And there's so many different system symptoms. So last year I had a client who, she was getting up to pee about ten times a night. Getting up, pee, go back to bed, get up, pee, go back to bed non stop. She didn't really necessarily have a lot of other symptoms. Like there was no rashes on her skin, she didn't feel any bloating or anything after specific foods. But then it also came out like, you know, with the hypermobility in her neck also like there were so many different factors. Her hair was falling out also. But she also had major heartburn during the day, which I know is another symptom.

Yeah, I definitely want to talk about that, too. Heartburn's a big histamine symptom because histamines and acid reflux have a direct relationship. The more your stomach acid goes up, the more your histamines go up. Something else has a direct relationship with histamines is estrogen. So this is really interesting, Mona. So I have clients. This is how I pick up. This is a little sneaky detective work that I do. And if someone's listening to this, I want them to hear this. You know, oftentimes we hear women having PMS symptoms, and that's the time in their cycle, their luteal phase, and especially pms, where they'll have symptoms. Those with histamine issues will actually get symptoms, like the day their period ends. So it's like day six of their cycle. And that's because estrogen starts to rise again. The second rise in estrogen is in the mid luteal phase. So around day 20 of their cycle, whenever estrogen starts rising, that output creates an output of histamine. So it's really interesting because it's so unexpected. And I'll have clients be like, michelle, why are you even asking me? Like, what day of my cycle? I feel anxious. What is the. It's not pms. Don't worry about it. And I'm like, no, I'm actually not looking at pms. I'm looking at those changes in hormones. So when we start to understand again, what is the relationship between histamine and the body systems, we can do that Pattern recognition. That helps so much.

Okay, so woman then moving to. My mind is just a little bit blown here.

I'm dying right now. That's so funny.

Oh, my God.

Exactly.

I just love it when I learn something new. So what's incredible about that, because somebody who may have experienced MCAs growing up didn't have a practitioner who could help them diagnose. Now they might be moving through perimenopause or even menopause, and symptoms are going to completely shift again. And doctors are now throwing hormones at the situation, saying that they're premenopausal. When it's like now, it's the foundational issue of the body that needs support. And that goes back to what we were saying about just throwing so many things at the wall, hoping for them to stick, instead of addressing the actual resiliency of the body. So, all right, we've listed these symptoms then for listeners, you know, they might not be able to go to a nutritionist, a dietitian, or their family doctor and say, hey, let's look into histamine tolerance and mcas and pots. What is the test that they can run? How are you assessing this in your clinic?

Sure. So there, there are some diagnostic parameters. If you do have a doctor that you trust and can bring this to them. So you can measure histamine through urine serum, and you can measure the other mediators that come out. Right. So like you said, cytokines, you can measure things like. And you can't really measure for cytokines that well, but you can measure for Tryptase and you can measure for. In urine is usually the way that they do it. There's a couple other mediators you can measure for. The problem is that, like, histamines don't live in your bloodstream that long, so it's not like a perfect measure. The kind of gold standard is to do a biopsy either in your gut or of your skin and see the mast cell activity from that. So if someone's. If you're already getting an endoscopy or colonoscopy because you're having gut symptoms, just ask the doctor while you're in there, do you mind biopsying for MCAS as well? So that's a, that's a really good trick that people can. And it's actually a much. It's a much more accurate test.

Yeah.

So in my practice, if it's histamine issues, and we're kind of. Because sometimes you have to go off of suspicion also, and you have to test and trial things. You know, it's funny. I, I, One of my dear friends is Olivia, who's organic Olivia, and she. We've made a joke because back in the day, she had this article before she knew she had histamine issues. She made that, she wrote this article about herself. And they asked, what's the one thing that you will, like, never trav without? And she said, Benadryl. And I was like, so I just want you to know that, like, people who don't have histamine issues don't need to bring Benadryl with them. Places like, it doesn't help them. She's like, it just seems to cure everything. I'm like, it only cures everything if it's a histamine issue. And, you know, I'll give you another example of where this kind of applies and how I've kind of, like, done kind of, like, deduced histamine issues. I had this client who is a very special person to me, and she had untreatable insomnia. And what I mean by that is she literally went 21 days only sleeping like one hour a night at most. She was in a state of basically like paranoia and hallucination at that point. And an otherwise like gorgeous, like full of life, beautiful human being. She was on eight psychiatric medications to try to get her to sleep, including Ambien, Trazodone, Xanax, these ones. Nothing would knock her out. I had a little bit of like a download about her because this was many years ago, before I even we really knew anything about Long Covid. And I said, I think this is a histamine issue. So I gave her Pepcid, which a lot of people do not realize is actually an antihistamine. Pepcid. Most people think of Pepsi as an acid blocking drug. Mona, she slept that night. She's never had a sleep issue since. So the deal with histamine issues is if you try everything else for them, but it's a histamine issue, it will not move the needle. So when I see someone starting to move the needle and we could try, you could do a lot of natural. You don't only have to use over the counter medications, of course, they're just sometimes are very necessary. But that's a little bit of a gold standard in my practice too, is that if I can see those distinct patterns where it's like, okay, you ate tomatoes and you were violently ill for a week. Great. And kind of draw those patterns and conclusions and make those connections again. How someone feels during different parts of their cycle, how someone's digestion is affected by heat, stress and things like that, I can kind of draw that picture together. Is this like a biochemical issue, like a histamine issue? Is this a blood flow issue? And we can kind of like pull that together. And I'm sure a language, by the way, that is a very rudimentary version of Ayurveda. Like I love Ayurveda by the way, but I would never claim to be an Ayurvedic professional, but it's, it's a very, there's, there's matters of heat, there's matters of blood flow, there's matters of life force and, and these things, I think those, that pattern recognition becomes clearer and clearer in clients. Sorry for the long answer.

No, that's the whole intention of this podcast though. Like it's the integration of everything that you're talking about. There's a time and a place for prescription drugs and prescription meds and my God, if they help you Then that's it. And continue to get to the root cause. So, you know, I would say over the past six months, it's become trendy for me to get a lot of questions about, hey, I started a histamine diet and this is what I'm doing. I don't feel a lot of differences, a lot of changes. Just because something is trending online doesn't mean that it's the thing for you. So key foods that you would tell people to opt out of. So a lot of vitamin C rich foods, lemon cheeses, fermented foods, green sauerkraut, spinach. Yeah. Any, any other triggers where you're like.

You know, this is the hard part about a low histamine diet is that by nature it's a very restrictive and unhealthy diet because you're cutting out some of the healthiest foods in the entire world. And these are the foods. This is a big hint, Mona, for people listening too. If you do the things that are objectively healthy, but you feel sicker, you probably have a histamine issue. So that means you're going to saunas, you're going to do your exercise, you're doing detoxes, you're eating fermented foods, you're eating vinegar, citrus, spinach, tomato, gorgeously healthy stuff, and you feel sicker. It probably means there's a histamine issue at play. So while I don't love people being on a long term, low histamine diet, if someone, and I mean I literally have clients who can eat one bite of a tomato and they are bedbound for a week in those cases, it is worth it to kind of explore again, really like the heaviest hitters, fermented foods, kimchi, and that means kombucha too. Anything fermented pickles, things that are in vinegar as well. Like vinegar's top, top, top. Citrus, avocado, spinach, tomato, those would be the ones that. And bananas are like very high for people. But I also would say cutting everything out of your diet immediately is also not effective. And again, you're missing out on a lot of beautiful foods then. And it will make it impossible to ever eat in a restaurant because they will use lemon and vinegar in every single food, essentially.

You got it. And I think any restrictive diet, long term, you're also going to impact your immune system and your gut microbiome for everything that we're learning about the diversity that's needed there. Also, the client that I was referencing, she literally would have like a teaspoon of lemon juice. Or a bite of an orange and she would be just sitting on a toilet forever.

Oh, yeah, the. And the cramping that comes from histamines is like a different level. I cannot explain. Like, it's like. And like the loose stools and cramping, it's very frightening for people because it can cause like muscle contractions too. So it's really. Yeah, it can be really severe. There are things we can do like taking like a DOW supplement, which is an enzyme that helps to break down histamines. And I'm sure Dao. I'm sure you guys have seen a lot about this before eating a higher histamine meal. And then I will say this. You know, our mast cells are not only responsible responsive to food, they're responsive to our nervous system. They're responsive to changes in our environment. So they're responsive to exercise. So anything that is a perceived stressor on the body can trigger that histamine response. So that can be literal trauma and stress, or it can be something again like. Or medic stress and healthy stress like exercise. It can be doing something that promotes detox, like taking a B vitamin or something that's objectively. Again, these are objectively healthy things. But if your body is not able to receive and communicate that message properly and communicate back with you properly, you will end up with symptoms. So it's really about with everything with histamines is going slow, slow, slow, slow, and listening into your body. Because sometimes you can think, maybe this was a food reaction. In reality, it was actually stress or something like that.

I cannot stress enough the people that I work with who are doing all the things and all the supplements and the diet. Like, there's so many things that they're incorporating because they hear that it's something that could be good for them, should be good for them, them. Just because it's good for one person doesn't mean that it's good for everyone. So I think that is such a good point. Less is often so much better. And I often. I just look at the relationship between us and nature. You know, we just. We don't transition from, you know, spring to summer overnight. It takes time. It's gradual. And our bodies are. It's the same way. Like if we don't see and feel results in the moment, we often walk away from something instead of. Of giving it the time to work and our bodies the time to heal. Do you find that rebuilding stomach acid in other ways can often reduce symptoms?

I would say it would increase symptoms, unfortunately. The problem is that because of this acid and histamine relationship. Like, someone taking betaine, hcl or taking digestive bitters or doing, like, lemon water can actually increase histamine. So the way I view histamines kind of is you have to take the heat down before you bring the heat back up. So you have to address the nervous system and histamines. It's kind of like, cool the body off, tell the immune system it's okay, we don't have to react, and then you can bring that digestive fire back because you need that agni. You need that digestive fire. It is so essential. But I think it's. It's different than. Again, most functional medicine doctors want to jump into bringing the fire up first, but you have to cool the body off before you do that, which is challenging because from a TCM perspective or ayurvedic perspective, I think of these conditions as definitely being conditions of dampness. So they definitely have that piece to them. And so you want to add fire, but the body's already kind of on fire, so you have to, like, cool it before you bring it back up, which is really complicated. But it's doable. It's doable. It is.

But the way that I see that, if you want to bring down the fire, I associate heat to electricity. When we think about nervous system dysregulation, like, you literally are plugged into high voltage, and. Let's park that for a second. I really want to talk about the connection to nervous system dysregulation, but we said that we would talk about pots. So tell us about where we bring.

In the nervous system dysregulation. Anyway. Yes, I want to, too. I'm so excited. We're gonna have one of my favorite words in this conversation, which is vasodilation. And we're going to talk about vasodilation. So when I think of POTS and, like, what a symptom set would look like with pots, it's like someone goes into their shower, and a lot of our clients will have experienced this. The shower's hot. The hotter the shower, the more this might happen. They look. They feel really scary, dizzy. They leave the shower, they look down, they see their legs are red bed. So this is. And then their heart starts pounding after that. And what this. What is happening inside of the body potentially, and this is something that would be very common in someone with pots, is that we're standing in the shower. Histamines. Something that I want us to keep in mind. Histamines cause something called vasodilation which is the widening of our blood vessels. So if we're standing up and our blood vessels are wide open, blood's going to be like on a slide, right? Whoop. Drop down to our feet. If we have autonomic dysfunction and our brain doesn't know, where do I send blood flow? How do I get blood back up here? Should the blood go to the heart? It's almost like gravity takes the blood for us, and we don't have that pump to get blood back up. So what happens is you look down at your feet because there's blood pooling. That's what that redness is, actually blood pooling happening in your feet. Sometimes I have clients whose feet turn purple after a shower. And then what happens? Your brain is dizzy because it doesn't have blood flow, and your heart goes, what the heck? Neck, Give me some blood up here. Starts pumping. So the way that POTS this. And literally, it's postural orthostatic tachycardia syndrome, which literally means you make a postural change, you go from sitting to standing, and your heart starts pounding really fast. Tachycardia, right. The way that MCAs and pots are related is through histamines, because histamines cause this vasodilation. So if your blood vessels are wide open, and the reason why histamines want your blood vessels to be wide open is so that they can send immune cells, nutrients, and everything. It makes it really quick for blood to move throughout the body and nutrients and immune cells to move throughout the body. So the more that we have that constant vasodilation, gravity works against us. So a lot of the treatments for POTs in the conventional world are how do we kind of. I. I joke, and I say it's like, how do you make your body a go gurt tube? Like you. You wear an abdominal binder and compression socks and squeeze the blood flow up. You kind of like, that's exactly just like squeezing blood. That's like kind of the goal with compression. And then also, the recommendation is to increase your blood volume. And the recommendation for pots. And people are going to freak when I say this is 10 grams of salt per day, which is sodium per day, which is 10 element packets. Element packets. So, yes. So that is. And people complain about one element being too salty. Right. Even though I. I do like them, but think about that. So that's really to increase blood volume. Again, the goal is to increase blood volume. Now, POTS is not a cardiac condition. There is one type of POTS that might have. There might be some blood vessel Damage called neuropathic pots but generally in hypo hyper adrenergic POTS and in the POTS that we know which is hypovolemic pots, it, it really comes down to it's a form of dysautonomia. POTS is a form of dysautonomia which means it is a nervous system condition and is not a cardiac condition. So let people sit with that for one second. So the reason the heart is not pumping is because the brain is not telling the rest of the body where to send blood flow. It is not because the heart is damaged. So this is why it's so tricky because again people will want to go to cardiologists. But for us to understand the nervous system, we think of the nervous system as being like this, I don't know, like you know this like oh I, I, my nervous system's over activated, I need to meditate or something. It's like no, the autonomic nervous system is like in control of like our temperature regulation, fluid regulation, heart rate, like the most like what I call like the vital sign functions, the ones that will really scare the crap out of you and make you go to the er. That's what your autonomic nervous system's in control of. So it's, you do have to work with the nervous system first in these conditions. But that's where again it's much more about the nervous system telling the blood and the muscles which to contract, where the blood to go than the actual pumping of the blood being the problem. Problem.

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I was doing when you were talking before, I'm like.

So if you were with me, God, I wish you were with me. When I had my first heart surgery, the doctors were asking me, mona, why are you crying? Why are you crying? As you're awake, looking at my screen on my heart on this massive screen? And I said to them, my palpitations are not going to happen unless I'm up and moving my body. Get me to bend down to pick up a pair of socks and my heart palpitations will start. And they thought that I was crazy because they thought that it was an issue with my heart.

With your heart.

In retrospect, it had nothing to do with my heart. When I went away to the ashram, it wasn't the food that got me healthy again. It wasn't any of those. I didn't do anything differently except I shifted the state of my body. Okay. And look for listeners. I know a lot of people reach out to me daily. Pretty much like I have heart palpitations. What did you do? What is it that worked? Every heart is different. But tachycardia, you've gotta do your investigation to understand the sources of what are causing you issues. So for me, what's interesting is that my symptoms would dissipate if I was on a very hardcore restrictive diet. Hello. Potentially histamine.

You probably cut out some histamine foods too.

Yeah, definitely. I definitely was consuming a little bit more salt. I remember this was a time when my mom was giving me electrolytes and stuff like that. Like, there's so many things that came into play. But when we think about then for the listeners, how are we testing for this? How do we go to our doctors and help them understand? I. There was one doctor I remember, she was a naturopath. And I do this with some of my clients. I get them to do a lying down to standing test to see if they experience the same symptoms. Don't do this alone. If you're somebody who does have this, make sure someone's with you. But how do you talk about this with your clients? And how do you assess it?

100. So we might notice some heart rate changes. I will always recommend going to an interventional cardiologist for actual diagnosis. So that's who diagnose this diagnosis. Pots. They will do something called a tilt table test. Just like you're saying. They lay you down, take you back up, see if you make these postural changes, what's going to happen with your heart rate? Absolutely. So that is possible. However, if you have a different type of pot, something called hyper adrenergic pots, which is basically that you have an adrenaline response from your nervous system and that. And that response causes changes in your heart rate because adrenaline cause makes your heart pound, right? So it is. If you have that type of pots, you actually might not respond to that postural test. But there are diagnostic measures. And I will say this. If your heart is pounding, there's Mona, and I want you to see a cardiologist first. You have to rule everything out first in a medical doctor's office with, I want you to get an echocardiogram, I want you to get everything. This is when it's. When it's ruled out from a really good cardiologist, then I would start exploring things, you know, in other areas and arenas for sure. So there is diagnostic capacity for that in. And some neurologists do as well, but some cardiologists. So once. Usually my clients do have a diagnosis by the time they're coming to me or they don't. And then we can work on. Like you said, I'd like to know exactly when the flares happen, because it's weird. Like you can have a POTS flare and an MCAS flare because they usually travel together, but they're like totally different symptoms for people. So I'm like, oh, this is a histamine day, or this is a POTSY kind of day. And. And we kind of like play with that. But it's really about. And we talked about this before that pattern recognition. And if it is happening during postural changes, do you need to stabilize? The one thing I wanted to mention before, in the context of pots, as we were talking about when I had this chiropractic injury that kind of of set me over the edge with all of this. I have hypermobility, which I have Ehlers Danlos syndrome. If so this is really why everything went so crazy with me, heart rate wise. What do we talk about all the time in functional medicine? The vagus nerve, right? So if you have nerves in your neck and they're not protected because you have an inability to create connective tissue, or your blood vessels are leaky or looser, which can happen if you are making, you know, pressure on the nerves, if you are basically attacking those nerves, those are the nerves that control your heart rate. Right? We know this. We talk about the vagus nerve and the heart rate all the time, but those are in your neck. So the nerves in your neck also are related to and involved in controlling your heart rate. So it's really important also that we acknowledge the. The physical form part of this as well. And that's where POTS and hypermobility tie in. And a lot of people with upper cervical instability will. A lot of people with POTS will have some upper cervical instability in the neck area.

Did you have a chiropractor who decided to take an X ray of your neck? Did they manually assess it to get.

To understand that I had upper cervical instability, yeah. So I've got a bunch of X rays, and you have to get one in motion also, like, you have to go like this and then like this because otherwise you can't see instability. It was, like, hard. I got MRIs. I got everything to make sure there wasn't other things going on. Because my primary symptom in all of this. This was unrelenting dizziness. I was dizzy 24 hours a day for years. And the heart rate stuff was newer, but the dizziness was so perpetual and really scary. Dizziness is scary. It's really uncomfortable.

Absolutely. It's dangerous, too. I can't exactly. What a story. What a journey. I'm looking at this through the lens of our listeners who, you know, I'm sure you do as well, hear from so many women who just feel like. Like crap. Like they're just doing all the things. And to talk about hypermobility, when I think about a stress response and our spinal column. Right. Everything is connected. You talked about the vagus nerve, our digestive system, if you're not digesting food properly, could be related to your nervous system. And now with your neck, also your posture over time, since the time that you were a little kid, the way that your body metabolizes stress, if it's altering the state of your posture over and over and over again, your posture will become adjusted to live in a dysregulated state also, which impacts every nerve in the spine, which branches out to every single system and organ in the body. So are you seeing a practitioner consistently?

Yes. So I'm. So it's really interesting. What is one of the best things we can do for hypermobility is since we basically. Hypermobility can be a genetic condition where you can't grow connective tissue properly. And again, connective tissue stabilizes our entire body. Again, it's part of our joints, bones, blood vessels. It's very structural for our body. So, you know, we kind of end up being like bobbleheads if you are hypermobile. So really the best thing is building muscle because muscle holds you together. If your body can't hold itself together through those bones and joints. You need something to stabilize you. It's almost like putting bricks in there, right? To help keep the columns standing up. If the columns were kind of like Lucy. So I work with a virtual hypermobility. She's actually a chiropractor by trade. Her name is Taylor Goldberg. She's the freaking best. She was one of the first people who, like, saw me and she's the hyper mobile Cairo on Instagram. But we. I do training and I. I was at the point, and this is kind of the part of the story where I want to get, like, so real. I left that er. They gave me like, propranolol, they gave me a beta blocker and I said, see you later, your heart rate's high. I went home and I had to basically, to get from my office, from my bed to my office, I had to lift myself onto a computer chair using my arms that my legs didn't detect a postural change, essentially, and then wheel myself to the bathroom. And it was months, Mona. I was wearing a neck brace with clients. I said, I love you guys. I couldn't hold my body up because my nervous system was not like, I. I had no stability in my body. And so I would just take t see clients, you know, with my neck brace on. I'm like, you got to take me like this or leave me. And I will tell you, Mona, that in the. There was a moment, I remember it like yesterday, I looked at myself in the mirror and I was like, you're just not going to make it through this. I just. I just don't know how. And then I. I heard another part of me that was like, don't ever say that again. You will never say that again. Here's the tricky part of these conditions being nervous system conditions. If you believe you're not going to heal, you will not. And that is freaking scary. And I hate to put that burden on someone who's already sick. You have to be like, toxic positivity with these conditions because they hear you. So your body will respond exactly in that way. And since you have these extremely frightening symptoms, if we react to those frightening symptoms with fear, the body goes, oh, I was right. It was really bad. Let me do it again. So. So it's. There's something very sinister about these, like, kind of long Covid symptoms and why you have to be so on your game. And listen, I'm a Jewish New Yorker. We are not by trade, very positive people, okay? It's actually by trade. We're very Negative people. That's kind of like the, that's why we're funny, right? That's just how we are. But I had to like change the way that my brain was operating. And there's actually like four pots and MCAs. There's actually like brain based programs called Limbic system retraining programs like the Gupta program, DNRs, Primal Trust, because all of them start in the brain. So if you hear yourself saying, oh, you know Mona, like your clients, I'm never going to get better. Like we ought to cut it out immediately. And I know it's counter to what we're actually feeling, but you need to go against that instinct and just say, I'm gonna fight and I will figure this out and I will get better. It literally starts the healing journey. I've never seen someone heal from these conditions without that mindset change. Never.

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Oh, my gosh.

So when we think about all the nerve endings in your spine, right, that goes up to your brain. That affects your amygdala. Your amygdala is associated with anxiety, and.

It'S a part of your limbic system, which we mentioned before. This is really important, especially in these chronic conditions. So we have parts of our brain that are responsible for sending the signal to our nervous system, to our nerves, to tell our body what to do. In the rest of our body, there's a. A compilation of brain structures. Our amygdala, hippocampus and hypothalamus that comprise what's called our limbic system. And our limbic system assesses for threats using memory. So here's the problem. Our nervous system and our limbic system only learn by example. So they are so smart that they don't believe what you tell them. They believe what they see. So the problem is that if you chronically have symptoms and then you chronically react to them, the limbic system's like, oh, my gosh, I never want that to happen again. Let's be very scared of that thing happening. Let's be very scared of tomatoes. Let's be very scared of. Of these things. So you have to actively go against what those brain structures are telling you. But the. This nervous system, limbic system, and postural piece are intricately related. You are so. I. I just emphatically agree with everything you just said. Absolutely.

Yeah. And I think it's such a big takeaway for people, so. Especially when we're talking about histamine intolerance and it's a food issue. And I can't have this. This really recognizing is my nervous system trying to communicate with me that it's stuck in survival mode. Right. And this could also manifest as anxiety, as brain fog, as chronic stress, postural stress that are kind of in disguise. Right.

Yeah. I. I also want to say that the nervous system conversation online upsets me a lot of the time because it's so not about the core of what the nervous system dysregulation is. For me, the word that comes up around the nervous system is safety. Like, you have to find a way to feel safer, and that looks different for every person. It's not like putting ice on your face. Right. Like, that's not nervous system regulation. That's not. It's. It's nice. Like, I like. I like the fun tools, too. I think there's, like, great tool humming. Like, there's a lot of beautiful tools. But the core of nervous system regulation is finding safety inside of the body that you're living in and finding safety outside of your body. So whatever that looks like, whatever you need to do to get that, and I think living authentically also really helps with that. But you. You have to find your safety. And I. And again, I almost say it in, like, a demanding tone because you can do all of that fun stuff, but if it's not literally making you feel like you're connected to your body and safe, it doesn't do anything. There's no point in any of it.

Do you know that there's some of my clients that I won't even recommend meditation to, and I'm a meditation teacher. And the reason why is because the analogy I give, it's like telling somebody who's obese, just go eat salad. Just eat the salad. It's going to make you lose all the weight. That's not the problem. They're not sick or ill or dysregulated for. Because they're not meditating every day. Right. And I think for safety. I. I've shared this a few times on the podcast where for so many years, I wouldn't give myself permission to talk about the things that were upsetting me. My mom is somebody who had all of this trauma in her childhood and growing up that led to an autoimmune disease. And I would often think, like, in just looking at world events today, right. We're so blessed. Like, I'm so blessed in this life. How can I not feel safe in my body? How can I complain about the issues that I'm having when there's so many people out there who are suffering? But a nervous system that feels unsafe for whatever reason, no matter what happened to you, if it was a learned response, that's all your nervous system knows.

That's all it knows.

Exactly. Yeah. And like words like trauma, and they're just words to describe the same state within our body or what's the other word that everyone's using? Inflamed. I'm inflamed. I'm inflamed.

Now you're triggering me. Okay, now you're just triggering me.

Yeah, yeah. And so it's such a buzzword these days, but people are ignoring, well, what else is causing you to feel inflamed? And the digging is really, really necessary there. So let's talk about that feeling of safety then, when you're working with your clients rather than feeling overwhelmed at all the things that are triggering them, that are causing them imbalance, how do you help them navigate wellness without falling into so many extremes?

Yeah, I am a big. And you picked up on this before. I'm a big non conformist, big rock and roll girl, for sure. And you have to, like, know what your voice responds to. So a lot of safety comes from accessing and listening to your internal voice. And you know, Mona, like, this is a sensitive thing to talk about, but a lot of my clients who have MCAs end up in, like, coercive relationships where they are people who are actually very type A perfectionist, really, like overachievers. But they end up in relationships with people who have like, coercive control over them, emotional, abusive relationships. And I've watched so many clients, like when I ask them, like, what is your body communicating with you and what does your internal voice sound like? They have no idea what that voice sounds like because someone else's voice is in the way. It could be a parent, it could be a partner or something like that. But building that self trust with yourself is safety. And finding your voice or really accessing it because we all have, you know, that internal voice. And that internal voice that serves our greatest good, I think is the first step. So I will have people just literally like tap their heart and say, what do I need? What do I need? What do I need? Until something comes up. But I agree that like, something like meditation can be too harsh for people because you have to sit. Meditation is not designed to be pleasant. It's designed to be tolerating discomfort. And sometimes the discomfort is so extreme to begin with that it, it makes people feel more unsafe. So I think just anything that eases you into accessing your voice and harnessing your voice and listening to it strengthens you in every single way. So that's, I think safety comes from self, self knowing. There's like, you know, the movie Les Mis, like, and the, the play Les Mis in, in Les Mis, they, they. There's a line at the end of it like to, to love another person is to see the face of God. And I always feel like it's to know, you know, my interpretation of that also is like to know someone or to know yourself is like the greatest act of love and healing that can happen. And that is like, that's the nervous system safety, right? Is to listen to yourself, to be able to block out everyone else. Else and listen to your own internal cues. Do you, can you imagine that validation, that trust from self? If we can hear ourselves like for the first time, like, that is the path forward. Is that self reflection and, and communication being built?

Oh, that was beautiful. So beautiful. Yeah. The analogy that I was thinking of listening to you is, you know, we live in a world where we're so focused on doing right and getting ahead and accolades and constantly thinking about the future, which is this stress response in and of itself that so many people, when you're talking about this idea of embodiment, not going to deal with that now. I'll deal with that later. I'm too busy. I'm using my hands to shove emotions down into my body. Not going to deal with that stress now, not going to deal with that trauma now. I'm too busy. And so we've given so much control to our intellectual body, right? We're in our mind all the time. And posturally, too. What are we doing when we're so focused on the future? Our chin is moving forward. Right. We can see that. That in people in their posture today. So I think that when we speak about rebuilding trust in our body, it's simply learning how to come back into your body. And that could be something like a gratitude practice. I love that. Tapping over your heart. First thing in the morning when I wake up, I just, like, put my hand over my heart to feel my heartbeat. That gets you in your body or gratitude practices are really important. But I'm saying this for people who are listening, who might be at a point where you brought up a great point of whatever programs that you have, just kind of. Maybe it's time to question, like, what are the beliefs that I have that might not be true anymore? Maybe I've been living my way, my life, a certain way that might not be working for me anymore? Or maybe, you know, something that was instilled upon me as a little kid that I thought I needed to be successful, happy, or loved that might not be working for me anymore. Just taking that ownership 100%.

And again, you know, if I had an internal voice, Mona, that was like, you. You're Michelle, you're the. You're wonderful, and everything's okay. I would be like, shut up. Like, that's so. You know, don't talk to me like that. Your voice has to be real you. It has to be the you that makes sense, the language that makes sense. And it has. You'll know because you'll be like, oh, I recognize that person. So it's important also when you're bridging that communication that you are talking to the most youish you that there is. And, like, I wouldn't. Wouldn't. I wouldn't listen to. I'm. I'll always bring up rock and roll music. And every. I listen to emo and rock and roll music. It's like the only music I listen to. But if, like, I knew also in that day when I had that where I looked in the mirror and said, you're never gonna make it through this, I was like, all right, we're listening to Tom Petty. I won't back down. We're listening to, like, those things that stoke the fire of rebellion in me because that's what gives me life force. Like, rebellion gives me life force, it's true. But for other people, hope gives them, you know, life force and love.