Could Histamine Be Causing Your Symptoms?, with Dr. Meg Mill

A lot of the things that you do normally to heal your gut can be a problem for people that have histamine intolerance.

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Welcome back to the Feel Freaking Amazing podcast. I'm one of your hosts, Dr. Wendy Trubo. My co host, is not able to be here today and he's missing a really cool session. Our guest today is Dr. Meg Mill. She is a certified functional medicine practitioner. She's got over 20 years of experience. Sounds better than two decades, actually. She's also a best selling author, podcast host, summit host, and sought after corporate wellness speaker. She uses her Eat Eat method to uncover and resolve the underlying connections, whether it's gut dysfunction, hormone imbalances, or histamine intolerance. So, Meg, welcome. I'm so happy that you could be here today. Thanks for coming on.

Absolutely. Thank you so much for having me.

So what is histamine? And I know we have these receptors, but like, is it just setting off this cascade of domino effects that we then react to?

Yeah, so. And I think it's something a little bit like cortisol. It's one of those things that gets a bad rap. But there's reasons we have it. It's when it gets out of that, we have a problem. So when your immune system detects an allergen or an invader, histamine is actually released from your mast cells and your basophils. So its job is to actually like, increase the permeability of your blood cells and allow your immune cells to actually quickly reach the area. So think of it as a first line defender of immune defense. So we need it for immune defense. We need it for an inflammatory response. I mean, we do need inflammation in acute phases. It actually also helps regulate gastric acid secretion. It can act as a neurotransmitter. It helps with wound healing. We do need it to expel allergens. It even can constrict your lungs so that the histamine producing things, I mean, so that invaders can't get deep into the lungs. So it actually does bronchoconstriction too. So it has all of these functions and purposes that actually are good for your body in acute situations.

So when you say people are suffering with histamine intolerance, what are our listeners going to be experiencing? Like, how would they know to go, oh, I think this is a histamine issue?

Yeah. So I think a lot of us, when we think of histamine, we just think of allergies. So that's sort of what everybody thinks of. But we actually have four different types of histamine receptors in our body. So we can get neurological symptoms. We can get, you know, we're going to talk about estrogen, can increase histamine, which can increase estrogen. So you can see hormonal imbalances. You can. I see a lot of people that, that there are underlying. I still got issues. I see migraines, I see rashes, eczema, those kind of things. You know, when you start to react to all sorts of different food, when you feel hypersensitive to things, that's another thing. Like, okay, I don't like, you know, if I walk by perfume, I don't feel well. I'm not like, oh, I love that scent. It's like, oh, that scent bothers me and I have to walk away. So those kind of things can start to come out. So I think it's one. Sometimes when you have all of these different symptoms and then you're going to your doctor and they're telling you you're fine and you're not.

Drives me nuts.

Yes. So you're getting that you're fine, everything looks good and your numbers look great. You know, that's what I was told. So it drove me nuts, too, that you're thinking, okay, well, could this be something that's actually connected? And I'm really dealing with different things now. We're. It's not the only thing. It's not, you know, we. We are going to see other things that potentiate it and potentiate. You know, we see other imbalances, but it's. It's something that's worth investigating. And I see once people can identify this and really look at some of the things and investigate it, they can pull. They can pull some of these things out of their diet. We can do some gut healing and feel a lot better.

It's funny because I'm not an expert in histamines, but every once in a while, someone will just sort of cue me. And I said to this patient, God, it was like three years ago at this point. I think you have a histamine issue. Because every time she gets her period, she's thrown off the cliff. And you've talked so far about estrogen impacting histamine. I was like, I really think you have a histamine issue. So we put on a low histamine diet and she was like 80% better, which is just crazy to think of how powerful it is. So when you had referred to estrogen altering histamine, how does that work? What happens?

Yes, so there are actually estrogen receptors on your mast cells. And so estrogen can actually make our mast cells more reactive. So when we have more estrogen, it can trigger the release of histamine. And then estrogen also can inhibit the activity of our diamine oxidase enzyme. So we're looking at it happening in both ways. It also. There's three different things that start to happen too. Histamine can also influence the hypothalamus, which is a key region in the brain that regulates your hormone activity. So that can stimulate the hypothalamus to release the gonadotroping releasing hormone. And that can stimulate your pituitary gland then to secrete LH and fsh. So that can secrete more estrogen. So we kind of get these feedback loops that start to happen where we can see histamine releasing more estrogen, releasing more histamine. Then we're going to enter progesterone here on the other side. And progesterone actually will help promote the diamine oxidase enzyme, so that actually can upregulate it. So that's why a lot of people when they're pregnant can. If you get migraines all the time, sometimes your change in hormones can actually change your migraines because you're actually changing that. Those enzymes.

This is fascinating, Meg. Like, I never really thought about these pathways, so I love that you're talking about this. So, okay, I have a few questions. So if we give a woman. So from what I'm hearing, when a woman is in the first half of her cycle, and that ovulation would be the most vulnerable time, and the time if someone is sensitive to decrease their intake of histamine containing foods around ovulation, because there's the spike and then the hormones start to decrease for the next two weeks, Is that what you see clinically, that first half decreased histamine, second half, you might be able to tolerate more.

Exactly, yes. I would say ovulation. And then sometimes right before you get your period, if. Depending on if your progesterone's low. So. And that's why we start to see it happen more in perimenopause because we're getting the progesterone decrease and we're still. We're getting more estrogen dominance in a lot of women during that time of life. So you can see some of these histamine issues start to come out more in that phase of life. So when you think of histamine intolerance, that's like when it starts to build up. I like to give the analogy of a bathtub for this, because you want to think of you need water pouring into the bath and you need it draining at the same time to have this nice level. And what starts to happen is that we either have one of two things or both things start to happen. Often we either get the plugs clogged or we overfill the bathtub or both. And then we. And then we get all these. And that's when all those, you know, different symptoms that we're talking about, which are whole body symptoms, can start to happen. And so we need to make sure that we're effectively metabolizing the histamine. And we do that in two ways. We have diamine oxidase, that's in the gut, and then we have histamine and methyltransferase, and that we need methylation for. So that's. So we either need to methylate it or we need it to break down. And so when those get plugged, we can get this increase.

So wait, so if you're. If you just referenced that, you do methylate it to get rid of it. So if someone is positive for one or one or both of the MTHFR mutations, are they going to be impaired at methylating histamine?

They are likely going to be impaired. The MTHFR is a big, you know, a big factor. And it gets even more complicated because once you. You need the. The folate, the methylfolate, and you need to be able to have to have Sami and you need to methylate it, but then you also have, like, MAO is another genetic variant that can affect it. So sometimes we can increase methylation and then it can get clogged further down the pipe, too. So it's looking, you know, when we're looking at that whole pathway. But, you know, and that's a really great point to make because think of how many people have the MTHFR variant. So if you have that, you could be having histamine issues.

Okay? So there's a lot to unpack. And literally this tiny little sentence that you just said, okay, so if you have methylation issues, you're going to be in impaired at processing it. But if you're, and potentially right, 10% of people are over methylators. So if you're an over methylator, but then you're. You over methylate it and you, it then gets stuck and it doesn't go anywhere. So then you just build up unprocessed histamine. I think it's really important, Meg, to just take literally a side jaunt into the fact that so many people are on PPIs or other type of acid inhibitors. And if you don't have MTHFR mutation, but you do take something to decrease the acid in your stomach, you then don't start the process to process calcium, magnesium, B12, folate and iron into their active forms. So now you layer on, okay, like 40% of the population is MTHFR. And then I don't even know how many people are on PPIs or other acid inhibitors in the stomach. It's like 50% of adults. So how many people don't have one of those two things? Right. So we start with already we're kind of impaired. So that's a plug for. Get your MTHFR tested and know your status and try to get off your. Unless you have Barrett's esophagus, get off your PPIs and your acid inhibitors.

I think that's a major point. Yeah, I think you just made a major point. And it's an epidemic in some ways because we're all just given the, you know, it's candy in some ways that we're doing things that are actually reversing what we want. So sometimes.

And then, so one is, you mentioned two things that, that process the histamine. Where are they located? Are they both in the gut?

So that, so the, his. The methylation happens outside of the gut. So that's the, that's an overall body process. So then we have diamine oxidase. And these are things you can check. So if you do a genetic test, you can check your pathways and see, okay, how do you methylate? I do want to point out that, you know, when we're looking at the genetics, we're often set up to have these genetics, but it's usually there's something that potentiates us to get the symptoms. You're not usually born with all of these symptoms. It's okay. You talk a lot about toxins and other things and gut imbalances and things that build up that propensate you to be able to express this. So the other one is diamine oxidase and then that one is in our gut. So that's in the brush border of our gut. And that's what you, when you eat histamine containing foods, that's what helps break down the histamine from your food.

Okay. Do you eat leftovers?

Well, I have to be very careful with leftovers. It's kind of a battle in my house because my husband wants to keep leftovers. And then after a certain point I have like, really, you shouldn't eat them after 24 hours if you have histamine issues.

So can we sort of simplify this for someone who's listening, who doesn't know if they have a histamine issue? And let's just give that example. They eat two day old food, what happens to them? What do they notice that they would go, oh, that's histamine. Oh, okay, now I understand. I need to watch out for that. I might have an issue.

Yeah. So, and that's where it's a little bit tricky. So you can have anything. A lot of different symptoms come up. So you can even have like from the bloating. That can be a lot of different things. But that could also be a histamine issue if you're, you know, if you start to get like a red. I ate something, I'm so in tune. I had something that was fermented like a few weeks ago. And usually I can tolerate it, but right after dinner, like, my nose was bright red, it was hot. If you're, if you get flush, if you know any of those things that you think, oh, if your nose starts to run after you eat something, if you get a headache. My headaches and migraines are huge. And, and so that's a big, that's actually one of the, the first things that we can look at when we're looking at headaches and migraines are, okay, what are you drinking? You know, and I'm going to just actually go into a little bit of a side note. So let's use wine for an example. That is something, you know, that's high histamine. And so a lot of people, oh, well, I'll get a migraine or I'll get a reaction after I drink a glass of wine sometimes, but not other times. So I'm fine with it. And so we sometimes think, okay, we're fine with this because it doesn't happen every time we eat the food. But when we're looking at it, we're thinking of the overall load of what your body can process. So maybe you had wine with guacamole and there was avocado. And it's actually adding different things that are getting to that histamine load. Or we said, you know, we were getting into estrogen can actually perpetuate more histamine. So we can be at a time of month where maybe your estrogen's higher. And so at that time of the month. So it's, it's looking at all of these different factors. And that's why it's actually good to get some guidance and really become a detective. So it's really like, ideally you want to pinpoint when you have the reactions and then go back and sort of catalog. You don't have to write down everything you eat all the time, but it's, it is good to do a little bit of detective work.

I mean, are there categories of food, I'm assuming that are just sort of. You mentioned guacamole, like intrinsically high histamine foods that you can rattle off and go, okay, this is a high histamine category.

Yes. So there's different, there's different categories. So we have foods that are high in histamine. So those are aged cheeses, fermented foods, cured meat, and we talked about alcohol. And then we have histamine liberating foods. So those are things like strawberries, tomatoes, bananas. We have foods that inhibit diamine oxidase. So something like tea could an inhibitor, caffeine can also do it. So we're looking at different ways. And what's a little bit tricky is, as I'm saying, when we're looking at strawberries, bananas, avocados, those things are healthy. And so it's not. I do want to mention that low histamine diet is a great tool to investigate. It can make a big difference for you. But it's not the end all be all of long term treatment, because then you're just limited in your food. And then sometimes people become more reactive and we actually ultimately have to address what's going on to cause this histamine intolerance.

So I just heard you say three things. One, that there are foods that are high in histamine, One, that there are foods that cause histamine to be released, and another, that foods or drinks that cause histamine not to be processed and therefore to remain hanging around. So there's three potential categories people need to look out for.

Exactly.

Okay, so then how does the gut health play into all of this? Because I know that if your gut's messed up and dysfunctional, then you're probably going to be more reactive to histamine issues. So how does gut health and histamine control play in the same sandbox?

So I think gut health is really the foundation of treating histamine tolerance long term. Because as we talked, the most common way that you're breaking down the histamine is diamine oxidase, and that's located in the brush border of your intestine. So any impairment of your intestine is going to result in the lack of that enzyme to break down the histamine. So once you start to get dysbiosis, then you start to have bacteria that can actually start to cause you to release extra histamine in your body too. So we know certain bacteria like Morganella klebsiella, we have certain microbes that can actually produce histamine too. So when we're looking at that, we want to. When we're doing, I do a gut, a stool test. And so I'm always looking at it from the fact of, okay, what are the histamine producing bacteria here. The other thing when we're just a side note when we talk a lot about gut health these days, and that's wonderful, but a lot of the things that you do normally to heal your gut can be a problem for people that have histamine intolerance. Because we talked about fermented foods, bone broth, probiotics.

I mean, think probiotics high enough, they set people off. Yep.

So we have to just. You're watching some of those things, you're doing it in a little bit of a different way, in a little bit of a different order. Then we also have to think of nutrient absorption. So you need to be able to digest and absorb your nutrients to actually produce the diamond oxidase. So nutrients like B vitamins, copper, vitamin C are vital for that function. And so we need to also make sure, going back to the basis and make sure we're digesting and absorbing. So we really want to be able to think about like emptying the bathtub, really get being able to. And then, you know, when you're thinking of infections, if we're going to look at the other end of it, when we have chronic infections, we're triggering our mast cells to, we're saying, hey, we have danger. You know, maybe you have a parasite, maybe have sibo, maybe of Candida, and you're telling your body there is something going on, hey, mast cells, come help us. And then that's gonna release more histamine too.

So you're on the rat wheel. And you can't get off the rat wheel because you're just running too fast. Is stomach acid helpful for people with histamine?

Yes. Yes, stomach acid is helpful for people, you know. You know, we're looking again at digesting and absorbing. So we want to make sure, you know, so you're looking even like at an H. Pylori. Is there something. Are you on a ppi? Is there something that's actually decreasing that stomach acid? So making sure we do a lot with digestion and then like, you know, all of these things are taking different steps. So then we can even take a step back. And we do a lot of nervous system work because we need to make sure that you have a regulated nervous system because you're, you know, you got brain connections. We work on vagal nerve toning and things like that so that we can actually decrease your nervous system response so we can calm down your mast cells, so we can, you know, about every activity, all of those things. So we're looking at all. And in parasympathetically, we digest better.

So what are you telling patients to do for vagal tone and quieting the system? Are we talking about meditation and heart math? Are we talking yoga? Are we talking biofeedback? Like, what's the. What do you recommend for people to do?

So I do. We do all of. I work, you know, alongside when I'm working with people with a lot of different modalities. So we do a lot. We do some exercising, we do some. We do some breath work. I do have them. Do I have a heart math that we. We do that. We do meditation, we do different breath work exercises. I've actually been training something called hypno breath work. So we do some hypnosis while we're doing breath work. And in some of those. And then I actually have a different. I have some fun new devices that I'm trying out that have recently, you know, there's all these different feedback devices.

I need that toy.

Yes. That are new. I can't comment yet because I haven't had them long enough. But I'm trying some different things out. There's a lot of new technology that, that are. People are having success with too.

That's awesome. So when someone comes to you and they're like, Dr. Mag, I think I have a histamine issue. Or they're like, I'm not right. Fix me. Do you. What are the tests that you're doing? What are. What you mentioned you do stool testing? What's your Favorite stool test and for specifically histamine?

Yeah, my favorite stool test for this is the GI map, actually. So I've had a lot of success with that. And, and that's just the one that I've gravitated. There's a lot of. There's a. I wouldn't say a lot. There's a few good stool tests out there, but that's the one that I use the most. And they. It's. It's been. We get great data. We, you know, do that. That's one of the testing. It's a little bit hard. That's a good question. Because it's clear, you know, we can draw a histamine level in the blood, but that's not giving you the whole picture. So we're really looking at this. You know, we're looking at the stool test, we're looking at. We can look at the genetic tests. We can, you know, we can even do maybe a homocysteine to see how well you're, you know, methylating along with the genetics. We can, we can look at, like, at histamine levels in your blood. But that's not, it's not as simple as just going to your doctor and saying, hey, check my histamine to be able to get the answer. So it's really kind of doing a whole panel and then going into some of the root causes. I know with a lot of the work you do and looking at what is triggering some of this relief, like, what does your environment look like? What are you exposed to? What toxin overload do you have in really peeling some of that back to.

What, other than MTHFR you mentioned, are you also doing genetics for mao? And if so, what other genetics are you looking at?

So when. If I, you know, people can go often to just get 23andMe and then put that in a database and you can get some great information. I know a lot of people have that. So when I run a genetic test, I'll just run a full genetic panel and, and look at, you know, the different pathway. You know, we'll work sort of more in depth in different pathways, just as a kind of a full approach. But if you're. If you want to know some of these things, I know a lot of people have done that, and there's. There are some good databases even to check.

Okay. And I am always interested. I always feel like 80% of agency is in people's hands, and then 20% is what you need to work with an expert like you for. So if we suss it out and go, okay, obviously someone who's been working at this for a while and doesn't have improvement needs to come see you. But then what's the 80% that people can do on their own to help? And then if it doesn't work, then they come see you. Can you give the listeners some tips that what are they going to do?

Yeah, so the first thing that I would do is start a low histamine diet. So I would just. And I would use that as a clue. So do that. You want to do it, I think with any investigative diet, you want to do it for about three to four weeks. I think that's one of the backfalls, is that people say, oh, I tried it, and it, it's not, you know, that didn't make a difference. And it may just be a week or two, so give it a little bit of time to be able to see. And I think, like I said, writing down when you have reactions. So if you notice, like some you're having symptoms, write down what you ate in the last 24 hours and see. Okay, what are those common threads? And I will share. I have a free guide. I think a lot of the low histamine diets are confusing. They're not all accurate. So I do have a history, a free guide with histamine about histamine tolerance. So I'd be happy to share that. And then you can look at more of a complex list of these foods and be able to identify, okay, is there any patterns for me and do I see that? So I think that's where I would start, you know, making sure and doing the basics. You know, really, we, we're to do all of those basic things to improve health, like bring out processed foods, make sure you're hydrated, make sure you're sleeping, working on the stress response, all the things you probably have heard over and over again. But we, we always want to do those things.

Well, these are foundational though, right? You can, you crawl, walk, run. You can't, you can't get to the good stuff until you've dealt with the foundations. And, you know, I say to, I said to someone yesterday, we have the best supplements in the world in our store, but you abuse yourself. And my supplements are not going to help you if you keep abusing yourself. So, and I don't mean that she's like taking a hammer to her hand. I'm like, she doesn't sleep enough. She doesn't move her body. The food she eats isn't the right quality for her, you know, she's just not optimized. I'm like, it can't help you until you get the. We need to focus on foundational things, and then we can get cooler stuff. So that makes sense to me. Okay.

Yes. Yes. So do the foundations. You can take it up a notch. Try the low histamine diet. See if that makes any difference for you in your life. And, you know, if that helps with some of your symptoms, that's a clue that you have some histamine issues.

Now, I know this is personal for you, but do you. Do you have any patient stories that you could share? The, you know, the before and after transformation that occurred for people and what difference it made for them?

Yeah. So I know I have so many. It's hard to. There's hard. It's hard to pick. And. But, you know, I think just. I know that, you know, there's one. There's actually many people, but one person I know in particular that I'm just thinking of right now that came to me, and she could only eat about five foods. I mean, she was down to reacting to everything. And she had been to an allergist, you know, a pulmonologist, like all sorts of different specialists, because she was just trying to get answers, and no one was able to give her the answers. And she was able to, you know, we did the gut healing. We did, you know, so many things. And it. It sometimes for some people can happen in a rather quick way. So there are times where there's a lot of layers and we have to be patient, and it is a journey. But then there's some things that just happen so quickly. And in this case, it was sort of. Once we just did some of the. That. That it was. She was able to eat a lot, you know, pretty quickly, and it made such a big difference in her life because it's. You're able to go out, you're able to enjoy food, you're able to celebrate with your family. I have another one. This is an interesting. Like, I know that I could go on all day, but this is another interesting one. I had a man I was working with that for 20 years. He had had full body itching, so he was having to take hydroxyzine, which you. And I know is, you know, makes you so drowsy. It's a prescription drug. And so the itchiness would come, like, as soon as that drug would start wearing off. Full body itching. And they were giving him shots. Nothing was working. And he had no gastrointestinal Symptoms at all. So he came to me and he said, I'm coming, but you're never gonna help me. And he's like, I'm just gonna come anyway. I've had this for 20 years. And so he remembers the day it started. And because of that, because I'm remembering 20 years ago, the exact date started. And at first, I did clue into mold. So I was like, okay, was he. Was there mold exposure, maybe at that time, we did mold testing, came back, and I said, we're going to work on your gut. And he was like, yeah, but I don't have any gut symptoms. He had high levels of that bacteria that I was telling you about that were histamine producing. Within three to four weeks of working on a gut protocol, he had no more itching. And I mean, and that's like the power of some of the stuff that we do. I mean, it's one of those things. He's like, I can't even believe it. I've spent all these years and the itching was just gone. And it was. It was a very simple solution in that case, but no one looked for it. And I think that's the message I want to get out to everyone, is that you just have to look for it. You have to be patient, you have to find the right people, you have to investigate, and you can find that connection that can be life changing.

Wow, that's an amazing story, meg. You know, four weeks later, that's it after 20 years. It's amazing. In your bio, you talked about the EAT method. What's the EAT method?

Yeah, so the E method, sort of a general method. But what we do is we first enlighten. So we're looking at enlightening ourselves of all the different triggers that we have. So we're trying to figure that out. And then we work on aligning. So we align your body. We work on hormones, we work on balance, we work nervous system balance. All the alignment that we need to do to get things. Things balanced in your body, and then the last part of it is thrive. So we're setting you up, you know, nutritionally, supportively to go on and thrive. And I think, I mean, that's what I. My goal is always to empower people to be able to take their health into their own hands.

That's great. Where can they learn more about you?

Yes, yes. So I have a podcast actually, called A Little Bit Healthier. And so you can go over there and listen. We talk about things you can do every day to be healthier. I Also am on instagram@doctor megmill and my website is megmill.com.

That'S great. We'll put everything in the show notes and then is there anything. I didn't ask you that. You're like, oh, I have to tell you this before we sign off.

Yeah. So actually I'm hosting a summit with a company called doctor Talks. And we're going to be talking, it's actually called Reversing Mast Cell Activation Syndrome and Histamine Intolerance. So we have 50 experts, including yourself, on this, on this summit. And so if you're interested, come join us. That's a, it's a great place to learn more, learn from so many experts. We have great information there.

Yeah, it's, it's, I mean, it's, it's fascinating to watch the impact that it has. Once you pull the right lever, people, they unravel, but in a good way. Right? You unravel their problems. So that's fantastic. So, and I mean, speaking as, as a human who reacts to everything, it's fixable, you know. So cool. I'm so happy that you shared this with us. So for anyone listening, this is Dr. Meg Mill and she, she will put all of the contact information in the show notes and you should definitely check out her summit. We will also put the link to that in the show notes and then we'll also put it out on our newsletter. And thank you for listening to another episode of Feel Freaking Amazing podcast. And Meg, thanks for joining us today.

Thank you so much for having me.

My pleasure.

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