The Dr. Hyman Show - Exclusive Dr. Hyman+ Ask Mark Anything: Histamine Intolerance And Adrenal Fatigue

Episode Date: May 4, 2021

My team and I are excited to introduce our revolutionary new platform, Dr. Hyman+, which offers premium content, perks, and information available exclusively for Dr. Hyman+ members.  In this teaser episode you’ll hear a preview of our monthly Dr. Hyman+ AMA. To gain access to the full episode, head over to https://drhyman.com/plus/. With your yearly membership to Dr. Hyman+, you’ll gain access to: Ad-Free Doctor’s Farmacy Podcast episodes Access to all my docu-series, including Broken Brain 1, Broken Brain 2, Longevity Roadmap + bonus material Exclusive monthly Functional Medicine Deep Dives Monthly Ask Mark Anything by you and only for you

Hey, podcast community. It's Dr. Mark here, and I'm so excited to introduce a revolutionary new platform my team and I've been working on. It's called Dr. Hyman Plus, and it's a premium membership exclusive for my community. With Dr. Hyman Plus, you get a ton of private content and special access that nobody else gets. Now, the yearly membership gives you exclusive access to ad-free Doctors Pharmacy podcast episodes, access to all of my docuseries, including the Longevity Roadmap and Broken Brain 1 and 2, plus all the bonus content. You get monthly functional medicine deep dives where one of our doctors goes deep into a health topic to tell you everything you need to know. You also get access to my monthly Ask Mark Anything Q&A where I answer the Dr. Hyman Plus community's biggest health and wellness questions. And this Q&A is only accessible with a membership.

Because I'm so excited to share this platform with you, I'm releasing a teaser of my brand new Ask Dr. Mark Anything episode. And I hope you enjoy it. And I hope you head over to drhyman.com forward slash plus that's drhyman.com slash PLUS for more information. Okay, here we go. Hey, everyone, and thank you so much for tuning in to the newest episode of Dr. Hyman Plus exclusive Ask Mark Anything. My name is Darcy and I'm one of the producers of the Longevity Roadmap docuseries, and I'm joined by the one and only our Dr. Hyman Plus community manager, Herschel Perwitt. This is an episode where we collect all of your questions to be answered by our resident expert, Dr. Mark Hyman,

and is only available exclusively to you, our Dr. Hyman Plus community. We've collected some of your top questions for Dr. Hyman in this month's Ask Mark Anything, and we're excited to get the answers from the expert himself. So let's go ahead and get started with that first question. And I'm just going to hop right into it. Dr. Hyman, this is actually one of the questions that I've been really curious about myself personally. And it's all about histamine sensitivity, or even histamine intolerance. So the question from our community member, she wants to know if somebody has a problem, they know that they have a problem breaking down histamine, can they ever reverse that completely? And of course, if you could maybe elaborate for our community, what histamine intolerance is, where, yeah, all, everything about histamine. Well, it's going to go on for a couple hours.

Hey, everybody, it's great to see you all. And I'm excited to share a little bit of what I know about a lot of the amazing questions we have today for Ask Me Anything community. The histamine issue is quite a big one. It's really mostly undiagnosed. It causes a whole host of miserable symptoms for people that seem related to other things. And doctors often confuse for other diseases, but actually are driven off of histamine. And I'll just tell you a quick story of a patient patient and then I'll sort of dive into what it is. But histamine essentially is this molecule that's in food that is in our bodies and that's released by our white blood cells and so forth. It's necessary for regulating

our immune system and inflammation and so forth. And we know if we, for example, get a bee sting or a peanut allergy, that's a histamine response to the extreme where the body releases huge amounts of histamine. It leads to food retention and can ultimately lead to anaphylaxis and death. And it's pretty uncommon to have those level of reactions. But that doesn't mean that histamine, if it's in a level that's sort of overcomes people's natural ability to break it down in the body, that it doesn't cause a lot of symptoms. And it really does. This one guy had been sick for years and years. His immune system was not working.

He was always about 30, 40 pounds overweight. It was almost all fluid. He had all these weird sores and rashes all over his body. And it was just a lot of vague symptoms. And we put him on a histamine-free diet and a number of other supplements and things that help regulate histamine. And he was able to completely drop the weight and reduce all these chronic infections to feel better and really, really recover. So it's something that takes a lot of work and detective work, but it's really important for people to understand that if they've got weird,

vague symptoms, they might want to think about it. So first of all, what is histamine intolerance? Well, it's basically a buildup of histamine in the body because of medications, various medical conditions, nutritional deficiencies, environmental toxins, our diet, all these can lead to a dysregulation of our ability to break down histamine. And so what you see is the decrease in function or effectiveness of a particular enzyme in the gut called DAO or diamine oxidase, which is the enzyme that breaks down the histamine that's in your food, because there's naturally occurring histamine in food. And there's another enzyme called the HNMT also that's involved. And really severe reactions are pretty rare, like probably 1%, as I mentioned,

but a lot of food and drinks have histamine, and a lot of factors can interfere with this enzyme DAO or HNMT, which means you build up a lot of extra histamine. And there are a lot of medications, for example, airway medications, like theophylline, heart medications, antibiotics, antidepressants, antipsychotic medications, muscle relaxants, pain meds, GI meds, nausea meds. Even over-the-counter drugs like, you know, like Advil, like aspirin and indomethacin and Voltaren and naproxen, all these things you can get over-the-counter. And then, of course, other things that are part of our life, like alcohol, intestinal problems that may affect the gut. So having gut issues, which is a big factor of functional medicine, various liver problems, B vitamin deficiency, like B6, copper, zinc, vitamin C, stress, trauma, injury, various temperature extremes, all these things can

screw up your ability to break down histamine. And then you get this hypersensitivity and you get all kinds of symptoms that make it really hard to figure out and it can be really weird stuff like digestive stuff like diarrhea flushing you get dermatographia where you scratch on your skin and you'll see a little welts uh you literally write your name on your chest flushing headaches congestion red itchy eyes and we know you know when you get allergies that's a typical histamine reaction that's why we take antihistamines like Benadryl, right? Or Zyrtec or Claritin. These are antihistamines that block some of these histamine reactions that come from environmental factors.

But it can also be other things that you can get from this. A lot of skin issues, itchy skin, hives, burning bumps, weird things. You can get cramps in the stomach anxiety constipation nausea vomiting gas bloating a lot of digestive stuff fatigue patchy dry skin like eczema really regular heartbeats menstrual cramps that are pretty bad so all these things can happen you can even worse symptoms so diet plays a big role and there's a lot of foods that have a high level of histamine. So if you have those symptoms, you know, sometimes being a histamine-free or a low histamine diet can really help.

Most foods contain some level of histamine. And the more aged food is, the more sort of fermented food is, you know, the more likely it is to be a problem. So like blue cheese or moldy stuff, you know, those are probably not great. The most sort of rich foods in histamine are things like alcohol, cheeses, which are kind of aged, canned, pickled, fermented foods, smoked products like sausage or bacon, sorry. Certain beans like soybeans, chickpeas, lentils, vinegar, lots of prepared food, yogurt, salty snacks, sweets with preservatives, chocolate, sorry, green tea, pineapple, canned fish, peanuts, spinach, tomatoes, eggplant, all these things really have problems and things that often can increase the release of histamine. So even if there, for example, isn't in the food, you might, if you eat citrus food or chocolate or tomatoes or various beans or nuts,

these can cause the body to release histamine, even though they may not have histamine in them. And then there are a lot of foods that interfere with this enzyme, DAO, like alcohol, energy drinks, green tea, black tea, mate, egg whites, yogurts, depending on the bacteria, and that can interfere with that enzyme. So this causes a lot of problems.

So what you need to do is sort of eat a low histamine diet. And what does that look like? Well, getting rid of some of the histamine foods. So chicken, but no skin, fresh, everything has to be fresh, right? No, nothing, no leftovers, basically fresh food. Egg yolks are fine uh frozen mean fish is fine most vegetables except tomatoes and eggplants are fine most fruits fine and berries are fine except citrus strawberries and cherries um most whole dairy products are okay if they're

fresh uh uh certain you know things like coconut rice milk are okay. Butter's okay. Certain teas are okay that are herbal that are not green, black or mate. Leafy greens are okay, except spinach. Most oils are okay. So you can construct a diet. It's a little bit restricted, but sometimes it's worth it for two or three weeks to see if you can get into trouble. So a lot of vitamins can be helpful. B6, it helps break down histamine, which helps that enzyme DAO break down histamine. Vitamin C lowers histamine levels and helps DAO break down the histamine. Copper also can help raise the levels of this DAO and breaks down histamine. Magnesium can reduce allergic responses. Manganese can also help zinc, calcium B1, 12, and folic acid. These are all really important.

And of course, sometimes we'll use medications. If we do eliminate the sources of it and we optimize people's nutrition, try to get the enzymes working, we get rid of alcohol and all that, we might need to give them antihistamines. It could be things like Zantac or Zyrtec. Zantac is an antihistamine, even though it's a gut drug. There are DAO enzyme supplements that we prescribe. Get off the medications.

It could be a problem. And avoid using sort of the anti-inflammatory medications like Advil and pain drugs, unfortunately. So that can really, really help if you focus on it. Now, testing for it is tricky. You know, you kind of have to rule out other causes. You might, you know, really look at other factors that could be driving it. But keeping a food diary and serum really works. Skin prick tests can be helpful, but not really, really that reliable. You can measure histamine levels as well. So, I mean, histamine intolerance is a real thing. And if you have weird symptoms that aren't being explained by other factors, it's something to think about.

And even seeing someone who can help evaluate histamine sensitivity. Hopefully that answers your question. It's kind of a long answer. Yeah, for sure. Well, I actually have one follow-up question about that. So a lot of the foods that you just listed that are really high in histamine levels are also healthy foods. So why is it that some people can have this reaction to high histamine foods and that others just aren't affected by histamines like that? Well, I think that's sort of, I mentioned to you,

and as I was going through it all, there are certain factors that actually drive histamine intolerance. And those are the medications that I talked about. They're the, the nutritional deficiencies I talked about, alcohol, chronic stress, trauma, temperature extremes. These all can kind of set people up to be in trouble. And also I find often it goes along with leaky gut and other things. these all can kind of set people up to be in trouble and also i find often it goes along with leaky gut and other things so it's kind of often associated with a lot of other other problems as well yeah yeah that makes sense i feel like somebody's explained it once to me that it's kind of like a cup where you kind of you can fill it up with some histamine and it's okay but once you fill it up with too much and it kind of spills over, it can cause like

some of these issues. Exactly. Okay, great. Well, thank you so much for that answer. I think that's really helps to summarize histamine. That's something that a lot of people aren't particularly familiar with. And so I'll hand it off to Herschel for our next question. Hi.

So the next topic is something that's I think ignored in conventional medicine and it's sort of a driver of chronic disease. And it's something that comes up, especially right now during the pandemic, when everybody's sort of stressed out and busy and that's adrenal fatigue. So can you talk a little bit about adrenal fatigue, what causes it and why it's not something that's usually brought up in your regular doctor's office? Well, you know, I joke and I would say to people, you know, listen, if you go to the doctor and you're having all these weird symptoms and they do all the tests and they examine you and they say, well, your exam's fine, your tests are fine, everything's fine. And then probably your next sentence is you probably are depressed

and need Prozac. But what usually is the case is, you know, either the doctor is missing something or you're crazy. And I don't usually assume my patients are crazy. And if they're complaining, there's usually something going on. And just because traditional approaches don't think about it or can't find it doesn't mean it's not real. And we often in medicine think about things as on or off. You either have it or you don't. Right. You're alive or you're dead. You're diabetic or you're not.. You either have it or you don't, right? You're alive or you're dead.

You're diabetic or you're not. You have high blood pressure or you don't, right? This is nonsense. The body is sort of an ecosystem and there's imbalances that occur all the way from sort of mild changes to very severe changes. So in adrenal issues, we think, oh, you either have Cushing's disease, which is where you have a tumor that makes too much cortisol, or you have Addison's disease, which is where you have an autoimmune disease that nukes your adrenal glands. So you can't make all the adrenal hormones. So you get

adrenal exhaustion. And aside from that, everything's fine, but it's just not the case. And we know from work with Bruce Lipton and others, when you look at the pattern of chronic stress, like we're really, we burn out over time. And there's a great book by Robert Sapolsky called Why Zebras Don't Get Ulcers, which basically explains the fact that zebras are out there chewing their grass and hanging around. And then the lion comes along and they all chase and they all run like crazy. It catches one of them. And then the rest of them just go back to eating their lunch while the lion's having his lunch just right next door. And nobody's upset or stressed.

The problem with Western societies, we're just chronically stressed. We don't have the acute stress where we run like crazy, burn off the stress hormones, and then we're back to doing our normal thing. We're chronically stressed. And what initially happens is you get a cortisol response, which is a stress hormone. You'll get this high spiking cortisol, which makes you feel a little revved up. And it's a good thing in response to stress. You don't want to be struggling with not being able to respond to a very powerful stressor. So it's a good thing. But then when you have this chronic stress, the cortisol will cause ongoing damage. It'll cause muscle loss, because you'll be hypertensive, diabetic.

It'll cause you to be hungry, crave sugar, carbs, be depressed. I mean, it just increases, you know, damage to your skin and all kinds of things. It dissolves your bones. You just don't want that. And the truth is that when you stay in that state for a while, your body can kind of compensate. And then what happens, you start to decrease the function. So you're just like beating a dead horse. Your pancreas, I mean, your adrenal glands can't keep up anymore, producing the adrenal hormones that you need in order to respond to stress. So then you get a burnout phase. So you go from like high cortisol and you're sort of the normal stress response to basically

this flattened response until like it's a flat line. Well, I hope you enjoyed that teaser of exclusive content that you get every single month with Dr. Hyman Plus. If you want to listen to the full episode and get access to ad-free podcast episodes, plus all the content from my docuseries, and of course, any future ones we're going to release, plus monthly Ask Mark Anything episodes, plus, that's what we call a plus, right?

Plus monthly functional medicine deep dive episodes. I guess, right, that's why we call it Dr. Hyman Plus. Head over to drhyman.com forward slash plus, that's drhyman.com slash P-L-U-S to learn more. I'll see you there. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical

professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database It's important that you have someone in your corner who's trained who's a licensed health care practitioner and can help you make changes Especially when it comes to your health