Well with Arielle Lorre - 386: Is Histamine Causing Your Unexplained Symptoms? With Michelle Shapiro, RD

Episode Date: April 23, 2025

Michelle Shapiro is an Integrative/ Functional Registered Dietitian in NYC who has helped over 3000+ clients reverse their anxiety, heal long standing gut and immune issues (with a special focus on MCAS and POTS(m) and approach their weight in a loving way.She is the host of the Quiet the Diet Podcast, where she helps listeners bridge the gap between body positivity and functional nutrition. She is the founder of the Highly Sensitive Body Hub, an information center for MCAS, POTS, Long Covid and Hypermobility. She joins the show to discuss what mast cells are, how excess histamine (and other inflammatory issues) can wreak havoc on the body, the surprising connection between hormones, anxiety and histamine, how to know if histamines are causing your unexplained symptoms and more.This episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct, or indirect financial interest in products, or services referred to in this episode.Save 15% off my favorite red light face mask at boncharge.com and use code BLONDE.Go to ro.co/BLONDE to see if you qualify. Visit openphone.com/BLONDE for 20% off 6 months. Go to ZOE.com and use code WELL10 to get 10% off. Visit fatty15.com/WELL and use code WELL at checkout for 15% off their 90-day subscription Starter Kit. Produced by Dear MediaSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Auto-hue with Sunny Cars feels as if the children Not me's Beasel stramble Sandvorda Actisvercue Verdwine Vacantcy can chaotic

But who'sorgalose An auto-hurt Says No No Stress No own-vervict Novert to cost Always Follettive So footh urs

Sondergare Go to your Reisadviceor Orsoniccars. The following podcast is A Dear Media Production In a world of ever-changing wellness trends and information, what does it mean to truly be well? I'm Ariel Lurie and I'm going to explore this with you.

I am bringing you candid conversations that will equip you with everything you need to live your best life and look good doing it. Think of well as your go-to resource for all of the latest in wellness and me as your internet bestie. Well, let's get into it. Hi, everybody. Welcome to the show. have such a great episode today, one that has been highly requested from a lot of you guys. I am talking to Michelle Shapiro. Michelle is an integrative, functional registered dietitian in New York who has helped over 3,000 clients reverse their anxiety, heal longstanding gut and immune issues with a special

focus on MCAS and pots, and approach their weight in a loving way. She's also the host of the Quiet, the Diet podcast, and she's the founder of the highly sensitive body hub, which is an information center for MCAS, pots, long COVID, and hypermobility. And I really wanted to have her on because, as you guys know, I have recently made the connection between some of the issues that I was having post-Botox, and I was diagnosed with secondary MCAS from an immunologist at Cedars. This was a little bit of a tough one for me to put out because I'm hesitant to talk about health issues. You'll hear why in this episode, but I do receive a lot of judgment, especially as somebody being in the wellness space. But these issues and these diagnoses are becoming more and more prevalent and common. And we are seeing that especially women have such high rates of autoimmune. I had a guest on a couple weeks ago who explained why this is not a.

surprising thing because we are usually exposed to so many more toxins, chemicals, and our beauty and self-care products and stress and hormones come into play, all of these things. But anyway, I really wanted to talk to Michelle because, first of all, she is so knowledgeable, but she's also so fun. So this is not a heavy episode. We really brought a lot of levity to what could otherwise be kind of a downer conversation. And my hope is that with this episode, anybody who has been struggling for a long time might be able to connect the dots with their own health. This isn't meant to cause any kind of health anxiety, but it might really be the difference in starting to feel better. So we talk about, of course, MCAS, mass cell activation syndrome. We talk about what

exactly are mass cells and how do they then influence histamine and how does histamine cause a lot of unexplained symptoms? As I talk about in the episode, I made the connection to things that I had experienced my whole life that I didn't think twice about. So, you know, this really did kind of seem like the missing puzzle piece for me. And as I share here, I've had so much relief since going on the right medications with my doctor. So we talk about mass cells, histamine. We talk about histamine and its relationship with estrogen. So if you suffer from really bad PMS or PMDD, that might be something to look into. We talk about mass cell activation syndrome versus histamine intolerance. What's the difference there? We talk about pots. We talk hypermobility. We talk long COVID and the connection between all of this. We talk meds and supplements and so much more. So please enjoy Michelle Shapiro. Welcome. Yay. I'm so excited to be here. Really excited to talk to you. Ever since I've been sharing my story about my mast cell situation, a lot of people have come out and said that they've been dealing with similar symptoms or they're dealing with some level of histamine activity.

intolerance, and it's kind of crazy to me because before I experienced it myself, I always considered it kind of fringe wellness. I remember seeing low histamine diet. And I was like, that's pretty extreme, like who needs to do that? But now it seems like more and more people are either connecting the dots or more and more people are just experiencing these symptoms with their health. So we're going to be diving into all of that today. And a lot of people recommended having you specifically to talk about this. But why don't you just introduce yourself briefly to the listener? I'm extra excited to be here because this is something that's so near and dear to both of our personal lives and professional lives. So I'm really excited to talk about this. I'm Michelle Shapiro.

I'm a functional integrated registered dietitian from New York City. I historically have worked with clients on anxiety, gut issues, and losing weight in this kind of really loving way and bridging that world between body positivity and weight loss. And then I had kind of this second health crisis in myself that included mass cell activation syndrome, long COVID and mold exposure. And I just could not find information anywhere on it and was having such extreme symptoms. And that kind of prompted me into the next leg of my journey professionally and personally, which is this long COVID MCAS conversation. So I've been working with a lot of clients who have MCAS in the past.

Yeah. Do you think that more and more people have it now or more and more people are becoming aware of it and more people are acknowledging that it's a thing or a combination? of all of those things. I think it's a combination of all of those things. I think there's always been people who live in what I would call like highly sensitive bodies. I call them like HSBs. I'm definitely an HSB. Like I live in an HSB. And I think that those people may have been kind of sick before. But then honestly, with COVID, it just escalated people into this new level of sickness, which I know both you and I experienced different root causes that is like something

that people have never experienced before. So they may have been like, I feel off all the time. I'm kind of like this tired person. And then it turned into this like extreme symptom set. So I think COVID has a lot to do with it because I really consider long COVID to be very interconnected with MCAS. Yeah, I want to get to that. But I think a lot of people listening are probably feeling validated hearing that because I can relate to that experience of being in a highly sensitive body.

I've always been healthy. But I've always had little things here and there that happen that feel off. and I've always been more sensitive to any deviation from like my baseline of healthy. And I had somebody comment on my carousel that I posted the other day of the low histamine foods that I'm eating right now. I love that post, by the way. And thank you. And I knew that people were going to talk, but somebody was like, I think you have Munchausen's. Oh, my God.

It's like she was, she started by saying like, it seems like an eating disorder. And I was like, okay, well, here are the reasons why I'm doing this and like why it's not an eating disorder. and then she went to Munchausens. And I was like, I am going to try and not react. Just disengage. Yes. Disengage. But if I look back on my history, like, I could see how somebody not being in my body would

be like, oh, there's something that's always wrong. And I do also want to say that as somebody who lives my life online, like, I'm open about the good and the bad. And it probably seems like there's always something, even though there really hasn't been. It's really the last year and a half ever since the Botox incident that I just have not been able to get my health back. Before that, I was like, I had novarian cyst. I had like a gut thing in 2016, but like by and large, healthy. But I know that so many people, women especially, experience this. And we are brushed off and told that it's anxiety or that it's in our heads. And I think that we deal with health things and discomfort on a level that men don't, and especially

people who are considered highly sensitive, right? You're 100% right. The tricky part about MCAS is that it kind of hides itself as other conditions. And truly, the medical community is not caught up with MCAS yet. This huge, like, surgence of cases of symptoms. that people were exhibiting. It's so large and it was so fast compared to what people were experiencing before in the past call it five years. Doctors are not capable of it and they just don't have the information yet. So to someone who is on the outside looking at and saying like, why are your

symptoms so extreme? You have to be making them up. Certainly not. But it's it's really hard to get MCAS diagnosed. And the symptoms are so tricky because they look like they're almost like vital signs, right? There are reasons you'd go to the ER. It can affect your temperature. It can affect your heart rate. It can affect like rashes on your skin. It can affect your breathing, your respiratory rate. These are like call 911 kind of symptoms. And the problem is that when you go to the emergency room, they don't know what to do, right? If you have a heart rate issue, you're going to go to a cardiologist, but it's not a heart problem. It's a brain thing and an immune system problem. So that's the real issue is that you're kind of chasing these symptoms, but they don't align with the organs

that the symptoms you're experiencing, they're not connected to them. So it can definitely look like how on earth can one person experience so many symptoms? I can promise you as an outsider looking in, it's a lot easier than being the person experiencing them. So I think we also should have a lot of compassion. And no one with MCAS wants MCAS. That I can promise you. Yeah. We don't want it.

On that post, I was like, I don't want to be eating this way. It's like all the fun things. The worst diet ever. Yeah. It's like literally I think the hardest, most restrictive elimination diet in the world. And to comment on that, too, the eating disorder versus not piece, if the intention for someone eating a low histamine diet is, I don't want to eat a tomato because then I feel like I'm going to be hospitalized.

I think it's not a psychological thing. I think it's definitely a physiological thing. So I think we always see online people commenting and what other people are eating and saying it's disordered or not. The intention is what makes something disordered. If you're eating it out of an irrational fear of something, then it's disordered. If you're eating it out of a pretty rational fear, you might be saving yourself from going to the ER. Yeah.

For me, the anihistamines that I'm taking, which are plentiful and the low histamine diet, it's like it flipped the switch back off in a good way. And it's not my long-term solution. But, I mean, it was crazy how effective it was for me. And to your point about MCAS, like the symptoms are so tricky. It involves multiple organs, right? So traditionally our healthcare system. system has been such that you have an issue with your head. You go to see the head doctor, you know, neurologist, whatever. You have something with your heart. You go to the cardiologist.

Everything is very siloed. And I experienced that right after I got the Botox and had all the health issues subsequently. You know, it started very much neurological, vertigo, dizziness, brain fog, went to the neurologist. Then it went to, you know, another system. So I got sent to a different doctor. And the symptoms that I had were everything from rashes to, with the MCAS, rashes to headaches, to brain fog, to that like muscle twitching feeling, fatigue, debilitating anxiety. Like I cannot even explain the anxiety to people, except I saw somebody say it's like when you almost get in a car accident, but you don't. And you have that adrenaline and that panicky feeling, but 24-7. And then I have rash on my eyelids, puffy, eye.

swollen lip, things like that, all of it gone with the right medication and the low histamine diet. So the multi-organness of it all was completely alleviated with this treatment plan and also other things, severe PMDD gone. So I want to talk about that as well. And I'm in a good phase right now. It's been like a month and a half. So it's, you know, it hasn't been linear. But it's interesting how now I can go back through my life and see these little things that I always dealt with and just kind of endured as normal, like severe anxiety and insomnia before my period. It feels very similar to that anxiety that I get when I'm in a flare. Don't experience that anymore. Swelling of my top lip when I would eat certain things or take

a non-steroidal anti-inflammatory drug. Gone. These things that I just considered normal are now gone with treating this thing that I didn't even know what it was and that I was in denial about for the first year after the Botox thing, you know, that I really started looking out in the last six months. So it's pretty interesting. It's the most amazing thing in the world to hear your story. And I know you already inspire so many people. But for people who are in this moment, Ariel, where they are literally sleepless, having anxiety that feels like you said, like an electrical, you're plugged into an electrical current. Like ants crawling under your skin, zingy, tremor, it's very violent. Like the symptoms are very extreme. For someone to hear that you can feel like that

and then at some point not feel like that, it's really awesome. So this is what I will say about antihistamines is that if you have a histamine issue, you have to treat the histamine issue. So you can't, if you have anxiety that's caused by histamines, you can't take like an anti-exiety drug and it's going to fully resolve the issue. And I'll give you an example of a client that I had. She was on eight psychiatric medications for sleep. Like throughout, they trialed every. And everything they possibly could. Trazidone, Ambien, Xanax, like any kind of relief they could think of. And she was really sleeping like two hours a night for 21 days. And when we hit 21 days, we started working together. And this was a, I'd say four years ago. So this was a little bit before we knew

what we knew, but I had a little bit of like a download in my head about, I was like, I want to try an antihistamine with you. I just feel like let's try it. We started her on Pepsid, which you've talked about on your podcast, of course, is an H2 blocker. It's a type of antihistamine. It's not only an acid-blocking drug. And she slept that night and she has not had a problem sleeping since. So she was on all these psychiatric medications. The reason is if histamines, which are very arousing and arising, they want to make sure that you are awake and alert for anything that's coming your way. That's their goal, really, is to like perceive threats and be ready to receive and fight. And so because her brain wasn't getting the signal to tone down the histamine response,

it didn't matter because her brain could not be tricked. So if you have a histamine issue, you need to treat the histamines. It's just there's no other way. By now, everybody has heard the success stories with GLP-1s, and if you are wanting to try one, especially before the summer, Roe has got you. So Roe now offers FDA-approved weight loss vials for half the list price of auto-injector pens without applying insurance or saving cards and with results that you can see faster. So this formula from Eli Lilly hits not one, but two hormones to curb hunger and with less nausea. Your Roe-affiliated provider can help you understand if GLP-1s are right for you and your goals, but that's just the beginning. Roe members have support throughout the entire

process, which is huge. And you can sign up online from the comfort of your own home, which means no waiting for an in-person doctor's appointment, no commute to the doctor's office, and no waiting room. So it's faster weight loss, better confidence, and a cheaper price. You can join the over 385,000 people who have already chosen Roe to access GLP1s when you go to row.co slash blonde and see if you qualify. That's RO.com slash blonde. Again, row.com slash blonde. Go to row.com slash safety for boxed warning and full safety information about GLP1 medications. I'm turning 40 in a few months, which is absolutely crazy to me. So I am very serious about my skincare and my wellness. And one of my absolute non-negotiables is red light. Not only does red light help with things like wrinkles and fine lines, but since we're

talking about MCAS and histamine issues in this episode, I found that red light actually did help a lot with some of the rashes that I was experiencing as well. Red light can help with eczema. It can help with acne, wound healing, as well as things like relaxation, migraines. It has so many benefits. In fact, red light therapy has been reviewed in over 4,000 peer-reviewed studies with over 400 being double-blind placebo trials, which is the gold standard. And not only do these studies show amazing health benefits, but they've also shown zero negative side effects. I am using bond charge, which you probably know because I post about it over on Instagram. But the reason why I love Bon Charge is because it's very customizable. Whereas some other red light masks on the market

have a preset time, also a preset strength. With Bon Charge, you can adjust the intensity of the red light. It also has both near infrared and red light. So the near infrared is really good for that collagen and elastin production. And the red light is really great for surface level concerns. It's also super lightweight on the face. It doesn't get hot. It has zero EMF radiation, which is huge. They removed circadian and sleep disrupting blue and green light from their red light face masks, and it also has a one-year warranty. So go to bondcharge.com and use the coupon code blonde to save 15% off of your red light mask. That's B-O-N-C-H-A-R-G-E.com, and the code is blonde for 15% off.

This is Amanda Hirsch from the Not Skinny but Not Fat podcast. You might know me from Not Skinny but on Instagram, where I spend my time talking about reality TV. celebrities, everything happening, and pop culture every Tuesday. Okay. I also talk to some of our favorite celebs and reality TV stars. We talk about what's going on. Tune in every Tuesday and just feel like you're talking to with your best friends in your living room. I'd love to kind of rewind because we dove right into everything. So let's talk a little bit more about histamine and what its role is in the body and what can happen when it goes awry. Because I think when people think histamine, we think seasonal allergies, anihistamines like Zyrtec, Claritin, Benadryl, things like that. I know that Pepsid

is surprising to a lot of people that that actually has an antihistamine. And I'm curious with that patient, you didn't do H1 and H2, you just did H2. I know. It's so interesting. I promise you will walk it back and I'll tell you why. So at the time I was looking at studies for, because this was, it might have been 2021, call it four years ago. I was looking at studies for long COVID unrelated. And every study that I saw for long COVID, they were using Pepsid. And I was like, why would you use Pepsid? An acid blocking drug?

And that's when I started to understand. My guess is, and I noticed this, is that when people take Pepsid versus taking Zyrtec, because it's working on the gut, I think it affects your vagus nerve. So I notice for like the zingy feeling or the insomnia feeling, usually Pepsid works better. And I think it has to be that gut brain connection. And then in like Eastern medicine way, Pepsid's very like dry and bitter. so it helps like with dampness. I think that could be why as well.

But that's my explanations on both ends of what I think. But I just find personally, and I took a Pepsid right before this interview, we're not selling Pepsie, but like we're not not selling PEPA. But I think it just takes that like, I don't know, it takes that edge of it's weird. For acid reflux, I would almost more so use the H-1s. And then for anxiety and sleep, I usually use Pepsid with clients. And the H-1s for people listening are more of those like traditional over-the-counter. Zyrteclaritin.

And I can walk us back to even further than what is histamine, what are mass cells as well. So our mast cells, M-A-S-T cells, are a type of white blood cell, part of our immune system. And they really stand as like the guards for our system. So they really want to perceive threats and they want to respond by if something attaches to the outside of them, their receptors. They then do something called degranulate. They send out little granules of all these different chemical messengers. There's over 1,200 chemical messengers they send out.

histamine is one of them, but we talk about it the most because it seems to wreak the most havoc in ways of symptoms for most people. There's other people who have like cytokines, interleukins, like ones that you would, you have heard of and being involved in inflammation and definitely involved in long COVID, but for the purpose of our conversation, we'll probably talk the most about histamines. And just something interesting to note about mass cells is that COVID and mass cells have a very close relationship because mass cells have a receptor on the outside of them called the ACE2 receptor and COVID attaches to and attacks it directly. So that's why we got this kind of MCAS storm from COVID is that normally the flu does not attach to mass

cells directly. And that's that relationship. So something will attach to the outside of the mass cell, say, please send some immune support for the rest of the body. The body will send histamines out. And in the case of something like COVID or a huge, you know, something like Botox, a huge chemical response. The mass cells are not only trying to help in the moment. They are so smart that they are thinking ahead. I never want this to happen again. So if we think of mass cells as being like the guards on the top of a watch tower, they might look at a war. Like let's say there was like a battle of some kind. And they are not only saying we need to send out some chemicals to fix up and clean up all of the debris. They're then thinking, how do I stay on guard basically permanently to make sure this never happens again?

on. So histamines and other chemical messengers, they kind of act like neurotransmitter, some of them, constantly getting released. And then the functions of histamines are really protective for us, but when we have too many of them, it can wreak a little bit of havoc. And do you want me to go into their functions a little bit? So one of the main functions of histamines is they help with immune modulation. So they will help to send a robust immune response. They will do that by opening up our blood vessels to get immune cells and nutrients to a site of injury. So they do something called vasodilation. And it's so important for so many of the symptoms that we experience. Vasodilation is the widening of our blood vessels. So I want you to think of someone who's like,

that person, and it's probably you, Ariel, because it's me, who's taking a shower, suddenly in the middle of the shower, they feel really dizzy. And they look down and like their legs are red. And they're like, oh my gosh, what just happened in the shower? And before they know what their heart's pounding. So what happens in heat, which is also a vasodilator, is that basically your blood drops down because your blood vessels are open. And then if your blood drops down, it's not able to get back up to your heart. So your heart freaks out and starts pounding really fast. So with histamine issues, we see a lot of heart issues, and that's because of this blood flow piece. Because there's too much wide open blood vessels, and we don't have that pump to get the constriction to get the blood back up.

So there is another condition called POTS, which I'm sure we'll talk about at some point, and posture or theratatacicardia syndrome, which is this exact thing. You change your position and then your heart rate goes crazy. And it's because there's not an appropriate blood flow going to the right places. Vasodilation comes into play with histamines as well because like we get rashes on our skin. That's literally blood pooling. Like opening up the blood vessels, you see the redness in your skin. So that's what you would see in like seasonal allergies.

So that's one of the main ways that histamine acts. and then also it does create an inflammatory response intentionally to help, again, bring those correct blood cells to the right areas and the correct nutrients to the right areas. So we talked a little bit about MCAS. I want to dive into it a little bit more like what are typical symptoms. There's such a spectrum. Some people have it kind of mildly. Some people are in the middle and some people have to, you know, carry an epipen if they walk outside.

So there's a range. And I fully from the beginning, I've thought of this as temporary and that I'm healing from it. And I don't pay a lot of attention to it, despite what people might think. Because I share about what I'm going through online, except for when I'm in a flare, which we'll talk about. But for the most part, you know, I live my life. I don't live in a bubble. And I'm like, this is temporary and I'll get better.

And that's what I choose to believe and how I've, you know, approached it, the thing you this entire time. So we talked about that it's a multi-organ syndrome, right? It can affect everything from your brain to your gut, to your skin, to what else? Tell us. I mean, literally mass cells line your cancer. connective tissue and your connective tissue lines your blood vessels, joints, bones, organs. I mean, there is connective tissue in every, they call it every hollow space in your body

is where mass cells live. Like they are in every single part of any communication with your entire body. So the symptoms that people can have, they can cluster or people can get different symptoms at different times. Like what you said, it's very common for people to have that seasonal allergy, sinus congestion. Migraines are very common. because of congestion and basodilation, which we can talk about too, when it comes to cycle changes.

And I know, again, we're going to dive into that as well. But people notice that they might feel worse towards the tail end of their period. And then about a week before their next cycle starts, like days 5 to 11 and then day like 19 to 21, usually, because estrogen and histamine have a direct relationship. People can notice, I see a lot of people who have like frequent urination, especially in the middle of the night. like we talked about before, extreme insomnia, anxiety, depressive symptoms and what they look like with histamines is people describe, they almost feel like there's a black cloud over their head. And it's just like, there's nothing that can like penetrate it basically, which is like really scary, huge symptoms.

They're studying Pepsid in clients with suicidal ideations, by the way. There's now like studies coming out. I know Pepsid's. Oh my God. I'm sorry. Pepsid is that girl. It is. It's that girl. It really is.

People can notice, again, there can be two different symptom sets, a lot of. lot of digestive issues. Acid reflux is extremely common. Vacilating between constipation and diarrhea. I do see a lot more diarrhea with histamine issues. And anything that would look like an allergy symptoms. So unfortunately, like you said, anaphylaxis can happen. Changes in breathing. A lot of like overheating feelings, heat intolerance. And you kind of talked about in the beginning, Ariel, that feeling like just something's off all the time and you just can't put your finger on it, but you're like, I'm not adjusted to this environment. Like, there's something off between me and the environment that's often a histamine issue. Yeah, I would describe it as like on any given day,

I wouldn't know how I was going to feel when I woke up. And I couldn't ever connect the dot. Was it something I ate? Was it something I did? Was it my sleep quality? All of these things. And it could be any of them. That's a problem. Right. Yeah. It's so, it's so tricky. I want to talk about the diagnosis part of it because that's a lot of people's other main question, especially because a lot of doctors don't really recognize it, and it can be really hard to test for. There are some things that they look for, TripTase being one of them, and I can talk about my experience, but a lot of times, really the best diagnosis is if you try the kind of frontline medications and see if you get better, right? Exactly. I've joked with Olivia Amatrano, who's organic Olivia, because she had written this journal

for magazine. She did this little journal about her, and they said, what's like the number one thing you can't travel without? And she said, Benadryl. And she didn't know she had MCAS at the time. And so it was years and years ago, and I was teasing her, like, Benadryl helps no one unless you have MCAS. Did you realize that you felt so much better when you were taking, you know, Benadryl? And we were joking about it. But absolutely. So the reason it's so tricky to diagnose is, yes, you can measure for serum triptase. You can measure for some serum histamine.

It won't show up in a lot of people. You can measure for the same metabolite versions in urine. So you can see if there's any that you're excluding. The problem is histamines don't live in the bloodstream or the serum. So you can't really catch them. Triptases, that's not where they live. They're delivered to the tissues, right? They're from the mass cells delivered to the tissues. So it's not like they're in that bloodstream for so long. A gold standard way that is actually effective is biopsying the skin or like if you happen to get an endoscopy or colonoscopy, I always say, just ask them if they can biopsy for MCAS and you can see mass cell activity on that. So that's a little bit better. And that's, I guess, closer to the gold standard. But it's pretty hard to come by and like to people necessarily want to like take. parts of their skin, I don't know. You know, it's like if you're in there already, but it's it's not as easy and there's not a lot of doctors who are willing to do that. I think in 2010, the prevalent, this is when we first started learning about mass cell disorders, the prevalence

of MCAS was estimated to be like 10%, but now we're seeing that in some states there's up to 30% prevalence of long COVID. Wow. So I think those numbers are probably a lot higher than we think. And I'm hoping the diagnostic community will catch up with us a little bit, but until then, If you feel like a million bucks, if you take, you know, a Zyrtec, like there's no other reason you'd feel good from taking a ZERT. Yeah, yeah, yeah. Yeah. You know, it's very controversial in the MCAS and long COVID community, too, because I think

there are people who maybe had less severe cases of COVID because they got the vaccine, or some people were injured from the vaccine and it maybe was just an MCAS response. So either way, any strong immune response, if you have, like, environmental toxicants, if you have mold, anything too strong you're doing with your body, can lead you down that path. And something that I've seen so much of Ariel that I would be remiss if I didn't mention is the clients who come to me and myself,

I wasn't actually sick from mold. I was sick from trying to get mold out of my body. So a lot of people get sick not only from the thing itself, the parasites, whatever it is, they're sick from the protocols that they get in functional medicine doctor's offices. So I love functional medicine.

I'm a functional dietitian. But the problem is that I used to when I first came into this career, I would see people who, like, conventional medicine failed them. And they were like, you know, that was our thing with functional medicine. It was always like, you went to a million doctors, now you come to us. Now I'm mostly seeing clients who are injured from functional medicine doctors, which is very devastating because they're putting people on these parasite cleanses, mold detoxes, these intense IVs, biohacking, all this stuff. And their bodies can't handle it. And then they just get sicker. And their doctors say, you're supposed to,

it's a Herc's reaction. You're supposed to get sicker. No. you're not supposed to get sicker. And if you're getting sicker and sicker, the more you do with a doctor, you need to consider that there might be a histamine issue. Interesting. In today's fast moving world, your team needs to stay connected to your customers without missed messages, communication, silos, or slow phone systems. A flexible and efficient business phone system isn't just nice to have. It is essential to succeed. So enter open phone. Open phone is the number one business phone system that streamlines and scales your customer communications. It works through an app on your phone or computer, so no more carrying multiple phones or even worse, using a landline. So with open phone, your team can

share one number and collaborate on customer calls and texts like a shared inbox. That way, any teammate can pick up right where the last person left off, keeping response times faster than ever. Plus, with AI-powered call transcripts and summaries, you will be able to automate follow-ups ensuring you'll never miss a customer interaction again. So whether you are a one-person operation, drowning in calls and texts, or you have a large team that needs better collaboration tools, Open Phone is a no-brainer. See why over 50,000 businesses trust OpenFone to manage their businesses, calls, and texts. OpenFone is offering my listeners 20% off your first six months at openphone.com slash blonde. That's O-P-E-H-O-N-P-H-O-N-E dot com slash blonde. And if you have

existing numbers with another service. Open phone will port them over at no extra charge. Open phone, no missed calls, no missed customers. Unfortunately today, there is so much misleading health advice everywhere and much of what we're told about food is wrong. It can be really confusing. And this is where Zoe comes in. So Zoe has this amazing app. They use at home tests to create a tailored program based on your unique results, guiding you step by step with recipes, meal plans, and food scores to help you make consistent progress. We all know that gut health is the key to overall well-being, and Zoe are really the experts in gut health. So one of Zoe's at-home tests is a gut health test. Their scientists have identified 50 gut microbes associated with positive health outcomes and 50 linked

to negative ones. Zoe provides you with detailed results so you can understand exactly what is happening in your gut. And in fact, clinical trials have shown that Zoe's personalized nutrition program works. So you will be eating the right foods for your body, feeling healthier in weeks, and building better habits for life. And you can also experience continuous improvements. So with regular testing, Zoe helps you track your gut health and ensures your advice stays up to date. Nutrition and gut health are not universal. They're not one size fits all. So it's really helpful to be able to take a peek under the hood and see what's going on with your own body and then tailor your nutrition for that. So as a Zoe member, you will get an at-home test kit and personalized nutrition program to help you make smarter food choices that support your gut.

Go to Zoe.com and use the exclusive code, Blonde 10 to get 10% off membership. That's ZOE.com. The code is Blonde 10 for 10% off your membership. Let's talk about aging. So we all know the various symptoms that come along with typical aging. We think of what it looks like. but we might not be thinking about what is happening on a cellular level. A key nutrient when it comes to strengthening our cells and enhancing longevity is C-15. There is a deficiency or a syndrome called

cellular fragility syndrome. It's the first new nutritional deficiency in 75 years and it's caused by a lack of the essential fatty acid C-15. So to help fix this syndrome and further extend our health and longevity, a team of doctors spent over a decade to develop the pure, optimized, and bioavailable C-15 ingredient in Faddy 15. Faddy 15 helps to repair age-related damage to cells, protects them from future breakdown, and activates pathways in the body that help regulate our sleep, mood, and natural repair mechanisms that support our overall health. 72% of Fadi 15 customers report seeing or feeling benefits within 16 weeks, including improved metabolic, liver and heart health, smoother functioning joints, deeper sleep, or healthier

hair, skin, and nails. It is science-backed. It's award-winning. It's vegan, patented, and 100% pure C-15. And it actually has three times more cellular benefits than omega-3 or fish oil. Faddy15 is on a mission to optimize your C-15 levels to help you live healthier and longer. You can get an additional 15% off their 90-day subscription starter kit by going to fatty15.com slash well. and using the code well at checkout. I want to differentiate between Mcast and histamine intolerance, right? Because there are people who are sensitive to histamines, and they can probably follow a lower histamine diet and move on with their lives, right?

So where does it cross over into MCAS from histamine intolerance? So histamine intolerance is that you can have histamines in your bloodstream. Either you have too many, but mostly it's that you just don't feel good when they're there. You're intolerant to them being there, essentially. M-CAST, the differentiator in my world is that you probably have other mediators active, and it's the whole mass cell that's active, not consistently activating and degranulating, not just you don't feel good from histamines and you're sensitive to histamines. However, I have to be honest, I think we'll evolve on these definitions as time goes on

because there might be hidden MCAS issues and people who have histamine intolerance, and then some people who have MCAS might only be reactive to histamines. So there is a decent amount of crossover. I think those with histamine intolerance, like you said, would do really well with like a low histamine diet. But the full-blown inflammatory response that's seen in MCAS, they might not have that. Yeah, I feel like for me, at least when I was really in it, eating things with histamine just sent me over the edge.

And I always knew that it wasn't the cause and it wasn't the cure long term, like eating low histamine. But that it felt like my body was so in high alert and so sensitive that the littlest thing would just push me over the edge. So I have, you know, tomato sauce and it's like, forget it. I still haven't had tomato sauce. It's been three years for me and I still haven't. Yeah. That's the only, that and pickles, which is like very hurtful as a New York do to not be able to have pickles. It's very hurtful. You know, it's like they could have picked some other foods, right? The histamine. Healthiest, most delicious foods. That's the, you know, now I'm going to hyperfixate

on this comment that you got, by the way, because I'm like, if I was going to pick the foods, I wouldn't pick the healthiest foods in the entire world. Thank you. Highestamine foods are the We're talking citrus, fermented foods. Yeah. We're talking like literally kombucha, sourcrow. If you went to a gut doctor, they would be like, here's the 10 foods you should eat. Like tomatoes, spinach, avocados. These are the gut healthiest, healthiest foods you could ever eat.

And that's really the tricky part of it is that healthy for someone with MCAS doesn't mean healthy in general. Yeah. It's so, so difficult to navigate. When I was trying to figure out my triggers in the beginning, I was like, okay, well, I know that I'm fine with oats and rice so I can have rice. and potatoes and freeze-dried potatoes. And I was eating copious amounts. I still eat so many potatoes. And like brown rice pasta. Like it was carb only diet in the beginning. And it was like, I had to take a step back. And I'm putting olive oil on them and salt. And I'm like, am I trying to gain 50 pounds? Because this is what I would be doing if I wanted to be putting weight on. It was the opposite of

disorder. You were like, I'm literally just trying to eat anything safe. And those foods are not particularly making me feel amazing. I just, that's the only thing I can eat. Yeah. And I understand like orthorexia and I know that people can get really obsessive and health anxiety and all of these things. But again, it's kind of back to what we said in the beginning. If it's alleviating symptoms, then it's something, especially when you feel so miserable, something that you're going to continue doing. So we talked about the anihistamines. I've been doing H1 and H2 morning and night, which is not my long term plan. But again, it's like got to put the fire out enough that I can try and navigate. and, you know, figure out how I can move forward without having to be on the meds all the time.

They dry the fuck out of my skin. They're very drying. So I'm like, this is not a long-term thing. We need to have the dewy, plump, glowy skin. You're the skin queen. I mean, you need your skin. And I'm on like three, four, five antihistamines a day. So what do you got?

Tell us your stack of antihistamines. All right. Let's get into it. I've always been a little bit hesitant just because I'm like, this is not medical advice. But you can find this information anywhere. And also do not take anything without your doctor or dietitian, like recommending. Yeah. Please.

Don't do what I'm doing. For me, it was trial and error. So I wanted to do like the most benign. So at first I was only doing Claritin. And I was like a Claritin or two a day, not having any relief. Then I was really hesitant to add Pepsid because I'm like, I don't know, at lower stomach acid. Like I don't want to mess up my microbiome. But I was miserable.

So then I added Pepsid and I was like, huh. That's interesting. I feel 90% better. And like my digestion is amazing. And like, what's happening? But still was not good. Had a lot of joint pain. At this time, I was also navigating some prescription mass cell stabilizers.

The Claritin was not really. And I told a doctor, not my doctor, but somebody who I was talking to who did their residency, I think, in allergy, immunology. And he's like, clareton is not going to do shit. He's like, two Zyrtec a day. And I was like, all right, Zyrtec. So then I started with the Zyrtec, but it made me so exhausted during the day that I was like, I need Diet Coke.

I never drink Diet Coke. I was exhausted. Here she has eating potatoes and drinking diet called The New Diet. So that was not good. So then I did Allegra. Allegra has been that girl for me. Allegra's, I think, the strongest of the three. I think that's the order, by the way.

But I do Zyrtec at night because then I'm sleeping. So I do Allegra and Pepsid in the morning. Zirtec, Pepsid, sometimes Benadryl at night, really loading myself. And that's been where I have found normalcy. 100%. So your doctor mentioned something that a lot of doctors do know when they treat MCAS, which is that there's kind of a number, and it's usually two H1 drugs and one H2. You can't hit it without the two pepsid, basically.

The way that the histamine load works, and, you know, I'm glad we're having this conversation because I want to desigmatize antihistamines because I'm so fed up with people on Instagram being like, you know, antihistamines cause all these damages. I'm like, all right, why don't you come and sit with my client when they were awake for 48 hours in a row and in the hospital because they ate a tomato? And then come tell me about them not taking antihistamines. Like, please, come experience what it's like and then let them know. You have to do like a cost-benefit analysis here. So Benadryl every day is something that we know in the long term is not safe. We do know that. But my question is for people like that, too, what's the deal with if you let your inflammation and your histamines run wild for 20 years? That's the studies they're looking at for these antihistamines. What's the consequence of that, by the way, too? There's huge consequences either way. The way that histamines work and mass cells work is that, your body will stay at the level that it thinks is needed for safety.

So if your body's like, all right, Ariel, I need to stay at a 10 for us to be safe, it's not going to come down from the 10, like maybe time, but you have to like, I call it, you have to slam it down usually. Like that's what it actually takes. So I'm a functional dietitian. I'd like to do things as holistically as possible. You're very holistic. But if it creates such a balance and quality of life, I just really do want to destigmatize

antihistamines. I never thought I'd be taking them either. And I'm excited to tell you that also I've been off of them for close to a year. So I just took one pet. I'll take Pepsi at like once a month. Now like just before our interview, I want to be in the zone. Yeah, exactly. You know, just having a little fun, you know.

But it's totally possible to use them short term and then get off of them. And when my clients who are having these huge histamine issues finally feel better and then they see those podcasts where it's like or like those little snarky posts that are like, there's a study about antihistamines. I'm like, just be sensitive to what people's experiences. So I'm really glad we're destigmatizing it because they can be, I mean, the word that I would use is life-changing medications for people. Yeah. And I don't think people understand, like, you mentioned the depression before. I have never experienced depression in my life. But that feeling of just being, like,

trapped. I felt trapped in my body. And there was no way to get out. And there was no end in sight. And it was like really, really debilitating and really bleak for a while. So yeah, the anihistamines were a total lifesaver and my doctor had the analogy of like, let's win the race and then learn how to run the race. So first let's win that race, you know, get the right cocktail of meds and get you asymptomatic. And then we can start to try and do the work and figure out like, okay, what are my triggers? What are, you know, and then try to peel back some of those layers. And then you can go for the root causes. Yes. That's the other thing too with a lot of clients who come with MCAS are like, I went to this like famous functional medicine doctor and he put me on a gut protocol for MCAS because he said the

root cause of my MCAS was parasites. And I'm like, you have to, exactly like you said, cool the fire first. If you have a histamine issue, your only priority is deal with the histamines, and then you can see what's underneath. I phase out my client. So we'll have like phase one is like, cool the fire, cool the nervous system, because it's both the histamines and the nervous system that have to be worked on. And then it's like, all right, then we can have fun. Then we can start replenishing nutrients. Then we can see if there's any vitamin deficiencies. Then we can start having glutathione and all the fun stuff, you know, the detox phases and everything like that. that. But first, you just have to tell the body, please do not fire at the rate that you're firing.

I do not need you to be so on guard. Cool it off. And then you can start, like you said, then you can see the landscape of your body and what you need to work on. But if you try to start even a B vitamin could send someone to the hospital if you have MCAS. Any supplement can like literally make you ill. Yeah. So you really have to do nothing besides laser focus on the nervous system in histamines. I tried so many supplements before I was doing the in histamines, and it was horrible because I was so sensitive, you know, and there's additives and fillers and what's in the capsule, like things that I would never typically think about, and I would just get so sick. So let's talk a little more about the nervous system component, because that is such a big part of it. Fortunately,

unfortunately, there's no pill for that, really. And then let's talk a little more about the supplements that can be helpful when somebody is at that place. 100%. Yeah. When I had this chiropractic injury, I could not stand up without my heart rate, like my pulse jumping up to like 180. It was, it was extreme. Like I ended up in the ER, I literally walked out of a chiropractic appointment where they adjusted my neck. I have upper cervical instability in my neck. I wasn't aware of. And they kind of like loosen the joints in my neck and all my nerves were affected in my neck. And your nerves and your neck control your heart rate. So just something to mention too when it comes to all of this is that your brain is the command center for all of this. So it's not like,

again, your heart doesn't only control your heart rate. Your brain tells your nerves, oh, pump that, send some blood here, do that. So it really starts in the brain, but, and it's nerve base. So I went to the ER. I could not walk. It took me months to start really walking on. I was still seeing clients at this time. And my clients will tell you, I was in a neck brace. I would prop myself up against the wall. I couldn't hold myself up. And I was like, you got to take me like this or no way. And they're like, it's fine. Like, I'd rather keep the session if we can. I'm like, it's fine. I'll just prop myself up against the wall. But there was one. One time I literally was, this is like how I am and it's not a good way to be, but it's how I am.

But I remember I had to lift myself onto a computer chair because anytime my feet touched the floor, my heart went crazy and that feeling is so scary. You're dizzy. It would take me hours to recover. So what I would do is just push myself around on my computer chair to go to the bathroom. And I remember standing in the mirror for one second and I was just my whole face lost blood. And I was like, you know what, Michelle, I just don't think you're going to make it through this.

And then like another animal part of me was like, don't ever. say that again, Michelle Shapiro, don't ever say that again. That is the part about MCAS. You have to not be the way that I've been trained as, again, a Jewish native New Yorker to be like a negative Nancy because your mass cells are listening to at all time. So you almost have to be like abundantly, toxically positive. And you have to be like, I'm just going to make it through this. I don't know how I'm going to, but I'm going to make it through this. And it was that moment for myself where I was like, you'll never say that again. Because if you say that, the game is over because when it comes comes to MCAS, it's so corny and it sucks, but like you have to save yourself and you have to find

safety within yourself. And the whole goal of it is to stop the cycle of reactivity because what happens with MCAS is you have this initial symptom and then you have this reaction to the symptom that happens subconsciously where you're like, oh my God, why did that just happen? This is so scary. My heart's pounding out of my chest. I'm dizzy and feel like I'm going to faint or I might actually faint. These symptoms are so extreme that then we have a nervous system response. And then our mass cells go, what was that? Oh, that was bad. I don't want that to happen again. So they start firing even more. And it's this wonky system of this constant nervous system activation. These parts of our brain called our limbic system are Magdalal hippocampus and hypothalamus that communicate for threat and memory.

And they start firing off and they remember. And then you get into the cycle. M-Cats is the cycle. It's not just a one-time chemical exposure. It's that then your brain goes, oh my God, that was so awful. I never want this to happen again. And then you start to. cycling. So if you can crack into the cycle from a histamine perspective, or you can cool the fire from a nervous system perspective. So Ariel, I was just like, you know what? My legs are violently shaking and I can't sleep. Whatever. Like, I'm like, this sogs and whatever. And that's kind of how you have to be. And I would just say, how can I feel one percent better today? How can I be compassionate with myself? And then you will get there. It is a syndrome. Remember, it's not, you know, it's not MCAD.

It's M-CAST. It's a syndrome. So it is totally possible to move out of it and to heal from it. And I see clients doing that every day. But it has to start in your mind. And I can promise for you the same as it was for me, the moment that changed for both of us was when we changed our mind. You can never talk to someone who's healing from MCAS and they will not tell you the same thing. It is kind of corny, but I feel like your body is always listening. And I think that thoughts do become things in a way. And I feel like, you know, in the same way that you can spiral out with anxiety, you can also heal if that makes sense.

I don't know. I feel like psychosomatic things can become very real. because you can actually experience them even though it starts in your mind. Right? You're 100% right. And I think that you can heal that way as well. You know, the most common treatment methods for MCAS is like getting mass cell stabilizing drugs, antihistamines, all these things.

But there's a second thing that's the most common for treating MCAS, which is something called brain retraining programs. So like the Gupta program, these are limbic system retraining programs because we know with chronic fatigue syndrome, pots and MCAS, these are brain things. These are not just immune system. These are immune system and nervous system disorders and where the nervous system and immune system meets. So the treatment for MCAS could actually be brain retraining. And the brain retraining is literally like you receive a threat response and what do you do with that from basically a cellular level?

So those programs are amazing. And I think that usually makes the biggest difference for clients. But it is so hard to go against your biology because your brain's like, please freak out. Every cell in your body is telling you, please freak out. have to go against it. And it's the hardest thing in the world. But if you can do that, the healing skyrockets. Like, it's so much faster. I've been thinking about doing one of those programs. So you're selling me on it. Yeah, that's the one I love it. Yeah, it's amazing. And then what about supplements? So everybody probably hears quercetin. What are the other ones, B vitamins,

vitamin C. Dow is very common, right? Like histamine digest, you know, there's a lot of good seeking health. There's like histoX and terabytes. So there's a lot of different histamine supplements. I would phase them, right? So the first step is, how do we? How do we? we prevent histamines from happening and inflammation from happening. That's part A. And then how do we get them out of our body when we need to? So there's things that can like gently support the enzymes that your liver needs to break down histamine. One of the most important enzyme processes is the Dow, the Dow enzyme, diamine oxidase. So you can just literally take that before a meal and it helps you to break down histamine from the meal. I find that that's incredible, especially if you like

get histamined by accident by a restaurant because remembering... I have it in my bag, by the way. Exactly. Love. I do use my chitaphs. You know that little, the seeking health, I think. Yeah, yeah, exactly. That's his brand. Yeah, exactly. It really was life changing for me too because two of the kind of sneakiest high histamine foods are lemon and vinegar. And that's what makes food taste good in a restaurant. It's in everything. It's in everything. Yeah. So just taking like one or two dow before meal. Quercetin works for a lot of people. It's, it's antihistamine and anti-inflammatory, which is really, really helpful. vitamin C also helps with the breakdown of histamines, but the problem is that it's also an antioxidant.

So again, you don't want to create a detox response in the body at all because if you create a detox response and then your body can't drain what that is, guess what your body's mounting an immune response to all that leftover gunk that you left. So we really don't want to create too much detox in a very activated histamine body. And then I like ginger a lot. Parilla extract. People can take before meals. that helps with both inflammation and histamines as well. So it's either you're trying to reroute the inflammatory and immune response or you're trying to literally break down histamines. But B vitamins, which are amazing for liver detox, are so challenging in those with histamine issues.

Most people with MCATs probably have B vitamin deficiencies. So it's this weird thing because it's like, body, take this thing that I need because you are deficient. But the problem is your mass cells get to it first. And it's like, what is that? we're detoxing? What's going on? Oh, that's a little foreign. Anything that feels unsafe can trigger a mass cell response. So B vitamins, what I do with clients, and this is like a trade secret, I guess, is we literally go one B vitamin at a time, B1, then B2, then B3, because B vitamins can compete with each other a bit and also they can trigger such huge responses. Vitamin B1 specifically in the form,

it's thiamen, but in the form of Benfo thiamen is amazing for like nerve conduction. It's actually independently works for people with pots. So B vitamins are great. but you have to wait on it. In my phase one with clients, just bring the histamines down, bring the inflammation down as much as possible. And then also using nerve supportive supplements, things that just make the body feel calmer. Like I love the herbs, like passion flour. I put some glycine powder into that, like Gabba and Altheonine, which is in like every

my favorite. Yeah, magical for very, very supportive for people. Some people can tolerate magnesium, some can't. But anything that calms your nervous system will help you as well. So anything that makes you feel calm from a spiritual level, a physiological level will help. You mentioned pots a few times. We don't have too much time to totally get into it. But there are a lot of co-occurring things, right? With MCAS. So you mentioned connective tissue disorders. Pots. Let's get into those really quickly. Absolutely. Yeah. So this postural orthostatic tachycardia syndrome literally means you move your position and your heart rate goes up.

So the treatment for pots generally is I call it like make your body a go-gurt tube. So you like you don't get blood flow to your heart. you squeeze by putting on compression socks, squeeze your legs, get the blood flow up. Or like you wear an abdominal binder, you just squeeze to get the blood flow up. Or you drink a lot of electrolytes because it could be a blood volume issue. So people are recommended to have 10 grams of sodium per day. For reference, an element like LMNT electrolytes has a thousand milligrams. So it would be 10 elements a day. So it's really, exactly.

So the recommendations are extreme. Pots is a form of dysartanomia, dysfunction. of your autonomic nervous system. It's generally not a heart issue and very small cases it is, but it's a brain issue. And histamines and pots and connective tissue disorders like hypermobility Ellers-Danlo's syndrome are all related because of connective tissue, because of vasodilation, and because of your nervous system. So all of them are intricately related. It's like, where does the body send what it needs, send blood flow, send nutrients? And it's kind of this, like, big picture of our body and our communication system. And that's why we're,

why these conditions often travel together. Can you have pots without the dizziness when you're standing up and without the heart beat? So it would be characteristic from diagnosed from the heart rate issues. Generally, it's like they'll do something called a tilt table test. So they'll lay you down and then flip you and see. I have seen people with pots who present with other symptoms. But generally, the heart rate has to be there. And then I do see like dizziness, a lot of joint pain and this very specific thing called coat hanger pain, which is basically like almost in the back. of your neck like a triangle back there and it feels like it's like almost like you're being pulled down and it's often because the nerves and your neck control your heart rate too got it and then with

the connective tissue ellor dan lath's syndrome how do people test for that no one does generally by the that's the problem which is why when I went to that chiropractor and they started digging into my neck and I'm really hypermobile that would have been how do you know you're hypermobile so I found out this thing that test? It can be, yes. So that's one way to, that's like for generalized joint hypermobility, there's genetic testing for Ellers-Danlo syndrome. There's many different types of Ellers-Danlo's syndrome. You can learn about mixed connective tissue disorders, again, mostly from genetic testing, or I work with like an amazing chiropractor, Taylor Goldberg, who's a hypermobile chiropractor, and she will do testing, like exactly like you're saying, like based on actual joint hypermobility.

But the deal is that connective tissue lines your joints, your bones, and your blood vessels. So it can create issues, again, with your blood vessels, your blood pumping. It's all tied in. And mass cells live. This is like a quiz from the beginning. Where do they live in our connective tissue from the beginning of the conversation? So that's why mass cell activation syndrome and hypermobility, all these things are related. I noticed with my mass cell, my joint pain, I was like tilted over.

I couldn't hold my body up. Yeah. And my hypermobility was a lot worse as a result. So they all signal together. Interesting. Yeah. Okay. I'm like racking my brain. Yeah, I got really bad joint pain in my hands. That was the only thing. That was the only place that I had joint pain.

Was in your hands. It's been painful. Yeah, very painful. But all of my inflammation markers were like down. I mean. I have to be honest, with MCAS, I never see a high CRP or anything. It's just like not that kind of inflammation. It just doesn't show up there. My CRP is zero. Like I've never, ever had that. Same. I've had like blazing high serum histamine on antihistamines, mind you. Like really, really high markers. But. Now, what I see a lot, and this is like a, again, just a trend I see. I see a lot of people with hypothyroidism who have MCAS and a lot of people with the cycle issues and progesterone and estrogen issues, which I know we think of talk about. Yeah, let's talk about it now because we have a few minutes. So we can kind of tie it all up with a bow here because, yeah, I mentioned in the beginning like PMDD and period issues. And that has largely been alleviated with my current protocol. So you mentioned that histamine and estrogen are very closely related, but let's dive into that a little bit more. Histamine and estrogen have a direct relationship. As histamine goes up, estrogen goes up. As estrogen goes up, as estrogen goes up. So people who live in not highly sensitive bodies or don't have histamine issues, they feel like really sick maybe like the day before their period comes. People with histamine issues may feel sick when their period ends, and they may feel sick a week before their period. And histamines also deal with our perception of pain and our pain tolerance.

as well, by the way, so that could be related. But that's the two times in our cycle when estrogen starts rising. So when you have that rise in estrogen, you also can have the rise in histamines. So I would be fine my entire menstrual cycle and the days leading up. It was like these weird points in the middle of my cycle surrounding ovulation that I would notice anxiety increases, like really dizziness, really weird symptoms, insomnia and things like that. So oftentimes working with histamines can help people with those higher estrogen times in the month. And it's not that the estrogen is bad. It's just that if you already have too many histamines, it can cause that problem.

So having funky times where you feel like, why at this point in my cycle, do I feel so weird every month can really lead you in that direction. And I think cycle tracking is essential for that too. You had a post that showed a graph and it changed my life. Because I was like, why do I feel so bad after my period? This is supposed to be when I feel the best, not necessarily, maybe a little bit further along into my cycle. But I was like, the period's over. Why do I feel so anxious? That was my main thing.

And you showed the graph of, you know, the histamine. The estrogen is rising, right? So this is probably a whole other thing. But I feel like when my progesterone is the highest, which I can always tell, because I'm, like, way relaxed. I feel like I took nature Xanax. Progesterone's a mass cell stabilizer, by the way. Yeah, I can eat whatever I want, usually. So it's like bioidentical progesterone.

Is that ever an option for people with mass cell? issues that helps them to feel better? It's an amazing question. Yeah. So especially after giving birth when mass cell issues can increase just so the immune change is so extreme, definitely. And then if you, this is so interesting that I'm working with a client who just started keto typhin and her progesterone started coming up also when she was seeing that because basically your body needs to shunt progesterone into like the inflammatory process if your mass cells are constantly activated. So kind of steals progesterone from you. So I see people with low progesterone a lot with MCAS. And yes, I have seen progesterone help with those issues. But I've also seen it with people

in highly sensitive bodies. I've seen people feel so exhausted from it that that triggers anxiety because they're like, why do I feel so low? So it's like you have to be really sensitive with it. But yes, I have definitely seen that. And certainly in like women who are starting hormone replacement therapy, striking that balance between estrogen and progesterone is even more important because people with MCAS probably feel better when they're in perimenopause at times, not fully. There's a lot of other things that they feel that's negative, I'm sure, but they start to feel less mass activity because the estrogen's coming down, but you still need the estrogen. So it's tricky. And yes, I have seen people get supplemental progesterone to help stabilize mass

cells. Interesting. Yeah. I mean, there are so many avenues that we could keep going and we could talk about this forever. But, you know, at the end of the day, it just sounds like everybody is so bio-individual and what we respond to and what we are triggered by and all of that is so different for each person. Case in point, my post about the low histamine stuff, people were like, frozen blueberries are high in histamine, and I can't, and I'm like, okay. They're literally not, by the way. No, one of the lowest histamine foods ever, just so for people to know. They said anything frozen. No, they're frozen at peak freshness. Yeah. No, frozen foods are not high in histamines because they're frozen and they stop in time histamine-wise. If you have leftover foods, no, they're so low-ness.

I was eating leftovers. My favorite thing in the world is leftovers. And I was eating like daily. I would make this ground turkey bowl. Sounds good. Yeah. And make like a taco bowl situation. So like avocado salsa, ground turkey. And then I would put it in the fridge and then I would take it out.

And I'm like, oh, and I would make like a vegan sour cream like ranch with pickled jalapenios. Of course. Yeah. And then I would eat the leftovers. And I was like, I'm hospitalized hearing this. I just want to eat. I have to go to the hospital now because I just heard this. Yeah, same. And then I was like, okay, maybe I shouldn't be doing that, but I was still doing like the ground meats and then putting it in the fridge and then having leftovers the next day. And I would instantly get the joint pain and then like be off into a flare. Since then, I had to stop doing ground foods for now. But my leftovers, I freeze right away and I have no issue. So for people who think that that's like. And you will get more and more 100%. That's why the symptom tracking and the pattern tracking is so important. It's hard to know because sometimes the reaction.

happen three hours, six hours, 12 hours later. So it's really just about learning your body, noticing your patterns, not being afraid of those things, but just saying, you know what, for right now, like, no, I cannot have the avocado salsa, ground turkey bowl. By the way, it sounds amazing. And it does scare me. I'll tell you that. Exactly. Yeah, exactly. No wonder. And that could count us out for a week. Yeah. Oh, my God. I know. I went to lunch today because I had a meeting and it was a vegan restaurant, very good. The old by Chloe. Now it's Chloe on Bleeker. Oh, cool. Yeah. I've only been when I was by Chloe. Everything was avocado, everything was tomato, everything. Vegan's not a friendly place for his. No, no. It's tricky. We kind of need like a steakhouse. You kind of just need like fresh meat and a potato. Yeah, but then it's like aged. It's so hard. It's so, so so hard. People are listening and they're like, I don't get what it is. Like I'm doing smoothies and bone broth all the time and I'm having my like spinach and my fermented foods and I just feel like shit all the time. Like it might be worth looking into histamine issues. If you are at,

exercising more and eating healthier and feeling worse, it's probably a histamine issue. That's how I know. Like, people like, I went on this diet and I feel a hundred times worse. I start a new workout regimen and I feel a hundred times worse because exercise itself can be stressful and inflammatory to the body and can create a histamine response as well. So it's like, everything with histamines is just go slow and listen to your body and notice. Don't be hypervigilant about tracking patterns, but just take inventory of your body. I noticed like after the initial Botox thing kind of subsided after like maybe five or six months. And I was feeling pretty normal. And I didn't have to be eating like a special diet or anything. Every time I would try to work out. And every time I would get a massage. I used to get a two hour massage every week. The next day I'm like, I'm like, I'm back in the hospital. Every time the next day, I would be back at day one. Like so symptomatic. It was so crazy. And I was like, oh, I guess the toxin is just still in my body. That was my explanation of it. Like, oh, it's in my lymph system or something. I didn't. I didn't. know. And now I know that exercise intolerance is a huge thing. Also with massage, right? And massage.

Huge triggers. Which is horrible because that's my favorite thing in the world. We're just, we're just kind of stripping you from any fun you could possibly have. I'm like no Botox, no massages. It's destined to make you not as attractive or something. It's literally impossible with you. But like I know, I'm Cass is it takes all the fun out of things. I know. I want to go into an infrared sauna for an hour and then go into like a weird cold plunge and then drink like a lemonade. or something. One day. Exactly.

100%. And you know what? That's really the message because I'm telling you, I don't need antihistamines anymore. I can eat most foods. There's like, again, my two left are tomato sauce and pickles. I can have any, I eat chocolate every day now. Like any, I don't. That was hurtful.

And that was cruel, what I said. Exactly. But there's so much hope. And I've seen people go from not being able to leave their houses to flying across the world to go on vacation. You can make your world so much bigger. It might have to start by being smaller. but the goal is to just keep getting your world to expand and expand. It's not to be on a low

histamine diet. That's not the fun. We don't want to. It's horrible. But the goal is to stabilize so much that your body builds that resilience. And then you can do everything you want to do. Amazing. Well, thank you so much. This was so fun. We'll have to do part two and three and four. Tell everybody where they can find you. Absolutely. So I'm Michelle ShapiroRD on Instagram. My website. I also created a resource center called the highly sensitive body hub, which is just literally information about MCS POTs, hypermobility, and long COVID, because when I was the sickest I ever was, I was looking on Reddit for information. I was like, why dizzy day seven period? Like, where are you going to get that information from? It didn't make any sense. So I just created this resource center with 14 other practitioners. It's just as much information as we could pull together. Amazing. Thank you so much. I hope you enjoyed that episode. If you liked the episode, and if you like the show in general, please take a second to rate, review, and subscribe. It goes. goes such a long way in supporting the show. Follow the show over on Instagram at well.pod. You can also follow my personal Instagram at Ariel Laurie. I'm always sharing great clips from the episodes.

And we also have full episodes on YouTube as well if you want to watch in entirety. Thanks for listening. Please note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.