Thanks for joining us for episode 87 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are answering the following question from a listener:

“I have an anxiety disorder that was under control until I began to eat more high histamine and glutamate foods. While I was previously fine eating foods like canned sardines and salmon, avocados, strawberries, dark chocolate, fermented vegetables, and bone broth in moderation, the anxiety symptoms significantly increased after I made these foods staples in my diet. Similarly, daily B vitamins began to cause the increase in anxiety.

I have taken these foods out of my diet for months at a time. Trying to reintroduce them still causes symptoms. My doctor suggested it may be due to histamine intolerance, or impaired methylation from a MTHFR gene mutation which was confirmed by testing. Testing for gut dysbiosis has shown normal results.

I’m starting to prepare for pregnancy and would like to include these nutrient dense foods and B vitamins regularly into my diet. How can I increase my tolerance to these?”

When dealing with histamine intolerance, it seems like the only way to avoid the uncomfortable symptoms is to avoid higher histamine foods. The problem is that many foods that are high in histamine are also high in health promoting nutrients. But how is it possible to include foods like fish and fermented vegetables in your diet with histamine intolerance?

Listen today to learn the steps to take to gain control of histamine intolerance while feeding your body the foods it needs. We discuss potential causes of histamine intolerance and explain how to include nutrient dense higher histamine foods in your diet. We’ll also be sharing which nutrients and supplements may be helpful in lowering the amount of histamine in your body.

Here’s what Laura and Kelsey will be discussing in this episode:

• The effect of gut dysbiosis on histamine intolerance
• Why checking methylation status is key if you have an MTHFR gene mutation
• Types of B vitamins that may be better tolerated if you are over-methylating
• Supplements that can help to lower the amount of histamine in your body
• The role of calcium in histamine response
• The importance of considering dietary change when investigating contributors to the development of histamine intolerance symptoms
• Tips for choosing higher histamine foods that give you the most nutrient dense bang for your buck without overflowing your “histamine bucket”
• How those with histamine intolerance can better tolerate frozen fish instead of fresh or canned
• Supplements that may help reduce general anxiety levels

Links Discussed:

• This episode is sponsored by Pure Indian Foods
• “Regulatory Role of Calcium on Histamine Secretion“

TRANSCRIPT:

Laura: Hi everyone. Welcome to episode 87 of The Ancestral RDs podcast. I’m Laura Schoenfeld and with me as always is Kelsey Kinney.

Kelsey: Hey guys.

Laura: How have you been Kelsey?

Kelsey: Pretty good. I had a busy-ish weekend with lots of hanging out with friends and stuff which was great. It actually snowed here in New York for the first time this year. It wasn’t very long, but we had an hour of flurries which was kind of exciting. I always like that first snow of the year.

Yeah, pretty busy. I did a lot of stuff. I did some holiday stuff around the city which was fun. My birthday was on Thursday so I celebrated with friends and everything for that. Now I’m settling in for the week and hunkering down and trying to get a lot of work done before the holidays hit. How about you?

Laura: You share a birthday with my new nephew. My sister just had a baby last week which was really cool.

Kelsey: Yeah.

Laura: It’s the first child of my family, my parents are new grandparents. I’ve just been surrounded by babies. Oh, and actually that reminds me when I’m joking about being surrounded by babies, I kind of use that as like a little kick in the pants to get my baby launched. My new website is now available. Yeah, it was a pretty big week for me. I became an Aunt, launched a new brand.

I feel like our updates kind of come in cycles where it’s like we’ll go for some period of time and be like life is really boring, and nothing is changing, and I’m just elbow deep in wedding planning for the last three months.

Kelsey: Right.

Laura: Then all of a sudden there’s a bunch of things happening.

Kelsey: That’s awesome.

Laura: It’s exciting. The new website seems to be functioning pretty well and luckily all my old stuff from Ancestralize Me is all being I guess redirected to my new site. That was really important to me that all my old stuff didn’t get lost because I have a lot of links elsewhere on different websites, different locations where I don’t want to have people click a link from an old article and then go to a link on a dead page or just be like this site is no longer available. I was excited that everything seems to be working the way it’s supposed to and redirecting, so I’m confident that if people click on those old links, they’ll get to my new website.

But the cool thing is it’ll be like the same articles. For example, I have an article on how to eat liver that I’ve shared in other places. If you click that link that would have normally gone to The Ancestralize Me page, it’ll get sent to that same article on my new page which like I said was extremely important that that happened and didn’t just get sent to the homepage for my new website where people would be like well I thought I was going to read about liver not about this person that I don’t even know who she is.

Kelsey: Right.

Laura: That was really good and I’ve been getting some good feedback from some current clients and some friends and family saying that they like the design. My fiancé said that it’s very me. He said it definitely shows who I am, which I figured if anyone knows me, it’s my fiancé.

Kelsey: Right.

Laura: The fact that he thinks it represents me well is a really good sign in my opinion.

Kelsey: Yeah. Well, it looks great.

Laura: Thanks. Yeah, I’m really excited. If anyone listening is unclear about what the website is, I just basically rebranded to my name as my brand instead of the old Ancestralize Me brand, which I liked, it just wasn’t really doing it for me anymore. I wasn’t excited by it anymore so I felt like I needed to make a change. If you go to LauraSchoenfeldRD.com you can see the new site.

It has this little about me page that talks about all my weird personality quirks and that kind of thing. If you want to get to know me better, that’s a fun little page that I added. Otherwise, I should be having articles come out on a semi-regular basis. I’ve been slacking on that like crazy lately, but I’m hoping to get some published on a biweekly or weekly basis in the future. I have a couple on backlog and ready to start publishing those hopefully in the next couple weeks. But for now just getting the website up there was the big push. I’m feeling pretty good about that.

Kelsey: Yeah, well congrats. It looks amazing. And congrats on that baby and your new nephew.

Laura: Yeah, it was funny, I made that joke sort of on Facebook about how everyone else is having babies and this is my baby. I was hoping that most people would think that was funny and not be offended as if I compare launching a website to childbirth and raising a child, which I obviously know it’s not the same. It’s just funny because sometimes I’ll make those kind of jokes, I’m like I wonder if all my friends with kids think I’m like horribly insensitive or completely oblivious to how hard it is to have a kid. I know that it’s very hard, I’m just not ready for it yet.

Kelsey: Yeah, fair enough.

Laura: This is the only baby I can handle, my business, and my fur baby. That’s about it.

Kelsey: Yeah. Well, that’s cool. I checked out your site and it looks awesome. I’m hoping to get myself in that position in the coming weeks, but I’ve had a little trouble getting everything settled and making sure all the redirections are happening. There’s just some tech issues that are happening which is annoying, but hopefully it will come out soon, guys, I promise.

Laura: You got to make an actual commitment.

Kelsey: I’m not ready yet, but soon, soon. That’s my commitment.

Laura: We’re just going to start pressuring you since we do call you Kelsey Kinney.

Kelsey: Right, exactly.

Laura: The process has started.

Kelsey: It has.

Laura: Hopefully it won’t take you almost a year like it took me.

Kelsey: Yeah.

Laura: Although I don’t know, maybe it has taken that long.

Kelsey: I feel like it almost has in its many iterations in changing what I wanted, so it’s getting there.

Laura: Just remember you can always put it out there and then make adjustments if necessary.

Kelsey: Very true. I think I’ll have to do that. That’s kind of what I’m planning. We’ll see. It’s coming soon, promise.

Laura: Well, I’m just going to tell everyone that’s listening to start harassing Kelsey and make sure she knows that you want to see her new site so she feels pressured into doing it.

Kelsey: Alright.

Laura: Peer pressure is a really effective way to get things done.

Kelsey: Oh yeah, for sure.

Laura: Well anyway, glad to hear that you’re hopefully in that direction as well and we’ll look forward to hearing about your launch hopefully soon, nudge, nudge. But let’s get into our conversation and health topic for today. But before we do, let’s hear a word from our sponsor:

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Laura: Okay. Our question today is this:

“I have an anxiety disorder that was under control until I began to eat more high histamine and glutamate foods. While I was previously was fine eating foods like canned sardines and salmon, avocados, strawberries, dark chocolate, fermented vegetables, and bone broth in moderation, the anxiety symptoms significantly increased after I made these foods staples in my diet. Similarly, daily B vitamins began to cause the increase in anxiety.

 

I have taken these foods out of my diet for months at a time. Trying to reintroduce them still causes symptoms. My doctor suggested it may be due to histamine intolerance or impaired methylation from a MTHFR gene mutation which was confirmed by testing. Testing for gut dysbiosis has shown normal results.

 

I’m starting to prepare for pregnancy and would like to include these nutrient dense foods and B vitamins regularly into my diet. How can I increase my tolerance to these?”
Kelsey: Alrighty. Good question. I think it probably makes sense to start with some of the things that she said she’s been tested for and that were either things that were confirmed by testing or showed normal results that normally would kind of have some influence on histamine intolerance.

At least for me, the first thing that comes to mind is that she’s saying she’s tested for gut dysbiosis and that’s shown normal results. Now I don’t know exactly what that means to her or her doctor, so potentially that could just mean doing a stool test and having that come back normal. The question in my mind regarding that is has she had SIBO testing done and was that normal? Because honestly that can have a really, really impact on histamine intolerance and I’ve defiantly found that some of my clients who present with histamine intolerance have SIBO and that getting rid of the SIBO significantly helps their histamine intolerance symptoms.

If this person has not tested for SIBO and ruled that out, I would really, really want them to do that. Then same way the other way around. If they ruled out SIBO but maybe they didn’t do a stool test, I would want them to do a stool test and see if there’s any parasites, pathogens, just general imbalance of gut bacteria going on that could be contributing to the histamine intolerance symptoms that she’s having.

She’s also mentioned that she’s had MTHFR gene mutation testing, which I think based on the way she’s phrased that here, I would assume that that means she’s had a test like 23andMe done where she can see that the MTHFR genes are mutated and that can cause methylation impairment I guess. But it’s a whole other ballgame to actually test your methylation status and see truly if you’re methylation is being affected by having the predisposition towards that because of that gene mutation.

Laura: Mm hmm.

Kelsey: I don’t do that kind of testing in my practice normally and I don’t think you do either, Laura.

Laura: Not the actual methylation function testing that’s available.

Kelsey: Right.

Laura: I feel like we might have talked about this before. I don’t even know if RDs are allowed to order that kind of test. Sometimes these tests that are brand new, they have a lot of restrictions on who they actually allow to order them.

Kelsey: Mm hmm.

Laura: That might be something that only doctors are available to order.

Kelsey: Right. It sounds like she’s working with a doctor who’s doing all this sort of testing which is great. But I do wonder just because sometimes the doctor may not be up to date on what’s available in terms of testing, they may do the MTHFR gene testing recommending things like 23ANdMe and then not going the step beyond that to actually test methylation status. If that’s the case for this woman, I would definitely recommend asking your doctor about that, of course if you haven’t done that already, to see if you can actually test your methylation. Because by supplementing those B vitamins, you may be over methylating and that may be why it’s causing anxiety for you, but we wouldn’t really know that until we looked at your actual methylation status.

Laura: Mm hmm. I’ve actually seen people get tests where they only had the MTHFR genes tested, like just the C677T and the A1998C.

Kelsey: You’re good.

Laura: That is like totally off the top of my head, so please forgive me if I’m wrong about that. Those are the mutations that are coming to mind though. That could be wrong, but you guys know what I’m talking about when I say C and A, and all that stuff.

Kelsey: Yeah.

Laura: But that’s something where I’ve seen that they just have those single genes in a test which it’s not like it’s bad information, it’s just is very incomplete. If you just have something saying that you have an MTHFR mutation, you’re not really necessarily getting enough information to make good supplement recommendations.

Kelsey: Mm hmm.

Laura: If that is the kind of test she got done, definitely getting at least the 23andMe test which can give a little bit more information. And then if possible getting the full methylation, like what actually is happening from a methylation perspective, that test is going to be really helpful as well.

Kelsey: Yeah, for sure. With the B vitamins, I think it does make sense also to think about the type of B vitamins you’re taking. If you are over-methylating because you’re taking methylated versions of the B vitamins, which can be very useful for some people with MTHFR gene mutations where they’re under- methylated and they need those methyl groups, but for somebody is who is potentially over-methylating and that’s causing this woman’s anxiety, you can try some non-methylated B12 or instead of folic acid, try folinic acid instead and see if that makes a difference for you.

Because I agree, those vitamins are going to be very important especially going to pregnancy and I do want to make sure that you have enough of those things around, but if it’s causing a significant increase in anxiety and obviously that’s problematic on its own, you do want to kind of experiment with different versions of these vitamins and see if not getting those methyl groups helps at all.

Laura: As far as the gut testing is concerned, you find that SIBO is a main contributing factor to histamine issues. Are there any other things that should be tested for specifically or do you just think it should be a general dysbosis test that would be done?

Kelsey: Yeah, I would say just a general dysbiosis. Dysbiosis, I mean that term can include something going wrong with the small intestine. That’s why I’m just a little confused as to what she’s referring to here. But I’d say if you are somebody with histamine intolerance with or without any digestive symptoms, you should rule out both SIBO and then dysbiosis of the large intestine. The two tests that you would use to do that are a SIBO breath test and a stool test.

As long as she’s done both of those and they’ve both come back normal, I would say that’s probably good enough to rule out anything coming from the gut that might be playing a really big role in why she’s having this increased anxiety and histamine intolerance. But if there’s anything that comes back as being wrong on either of those tests, for anybody out there that has a similar situation, you definitely want to deal with that because we’re kind of starting from the beginning here where we’re discussing the underlying root causes of what might contribute to developing histamine intolerance. Like we’ve taking about, that includes dysbiosis of the large intestine, it includes SIBO, it includes MTHFR defects. All of those things are going to play a significant if they’re there in developing histamine intolerance.

Laura: Mm hmm. With the methylation issue because we don’t know what her actual genetics are, it’s hard to make recommendations. Even if you do know what the genetics are, a lot of times this is more of like an experimental adjustment to B vitamins. But I have had some clients with some MTHFR issues that had COMT mutations that made it hard for them to tolerate higher dosage of the methylated nutrients. For some of those people I’ve found that using either non methylated B 12 or folate options, so that’s either hydroxocobalamin, adenosylcobalamin, or I believe folinic acid is not a methyl donor. I’m not totally sure about that, but I have had some clients try out those other forms of the nutrients and do a lot better with them.

Kelsey: Mm hmm.

Laura: It’s something that you can experiment with. I would definitely have your doctor on board with the experimentation and make sure they know what you’re going to be doing or that they’re suggesting either products or dosages to try out. Not everybody needs B vitamins, but if you are dealing with some level of methylation issues, a lot of times you do need a little bit of extra compared to the average person. It just might be if you’re high dosages of the methylated ones, that you might be over-methylating and then causing some of those symptoms. It can be tricky to find a balance.

Again, we don’t suggest doing this on your own. But knowing that there’s other options for B12 and folate supplementation might make this person feel a little better because if she can find a dose and type that works better for her, she’ll be able to have that pregnancy prep that a lot of times people do recommend doing at least 400 to 800 micrograms of folate, and a little extra B12 doesn’t hurt either.

Kelsey: Right.

Laura: I would suggest looking into those different types. Also just checking on the dosage in general because I’ve seen some of these MTHFR support supplements that have just outrageous amounts of B vitamins in them.

Kelsey: That’s true.

Laura: They’ll have like 2,000% of your daily need of folate in a single product. I don’t know who that’s designed for necessarily. I’m sure there’s people out there that need 2,000% of their folate to get normal function, but I don’t think that’s typical. That’s possibly a root issue that this person is dealing with if they were taking a MTHFR support product that was just way too high of a dose, it could actually be causing these symptoms.

I’ve had some clients before where they were just taking all these supplements and they didn’t realize that one of the supplements was causing an issue. I just had a client recently tell me that she didn’t realize that her L-glutamine that she had been taking for years for leaky gut was actually causing these histamine or brain fog type symptoms. It’s just really important to reevaluate the supplements that you’re taking and make sure that there’s a good explanation for dosage, or frequency, or duration because a lot of these are not designed to just be taken indefinitely.

Kelsey: Yeah, absolutely. And then I guess from there once you’ve kind of ruled out those root causes that can be contributing to this, I’d say the next step if you know for example like this woman wants to prep for pregnancy and she knows that these nutrient dense foods and B vitamins of course are important in that preparation. If you want to include those kinds of things in your diet, I would say the next step after determining if there are any root causes contributing to it would be to just lower your overall histamine level as much as you can.

Histamine intolerance, I think most people generally describe it kind of as a bucket, like your histamine level in your body is a bucket basically. If you’re always at right before that bucket is about to overflow, any additional histamine coming in from the diet is going to overflow that bucket and that’s when you get those symptoms of histamine intolerance. For this woman it sounds like her general symptom of histamine intolerance is that increase in anxiety. What we’re trying to do by lowering the overall amount of histamine in the body is to maybe make that bucket half full so that even if she’s getting some histamine from her foods and everything that she’s doing in her life, that isn’t going to necessarily overflow her bucket every time she eats something high in histamine.

The way to do that generally without of course doing something like an antihistamine or anything like that is by adding some supplements that serve to just lower that amount of histamine. Those include things like vitamin C. There’s been research on that that shows that it significantly reduces the amount of histamine going around in your bloodstream. You can do pretty high doses of that depending on what else is going on in your health conditions. Especially if you have normal digestive function, which I think it sounds like I think sounds like this woman does, then you can probably do a couple grams of vitamin C without getting any loose stools or anything like that. I would try working your way up with your vitamin C dosage maybe to 4 or 5 grams if you can get there without getting looser stools. That should help to significantly reduce the amount of histamine that your body has around.

Then quercetin is another one. You probably heard that in relation to seasonal allergies. It’s often one that’s recommended for that kind of thing. That’s because what it does is it actually stabilizes your mast cells. Mast cells are the cells that are involved in allergic response. When they get destabilized or degranulated, basically they start to produce histamine and histamine is the chemical essentially that causes what we know as normal allergic response, so itchiness, watering eyes, runny nose, all that kind of stuff. But for some people that excess histamine can cause things like anxiety, or stomach upset, headaches, things like that. Generally with histamine intolerance you want to focus on stabilizing those mast cells so that they don’t produce quite as much histamine. Quercetin is really good thing to take to do that.

The other thing beyond those two which actually serve to lower the amount of histamine being produced and then hanging around in your bloodstream is to consider a DAO enzyme supplement. That would be something some of you may have heard of as a supplement in Histame. What that does is it actually breaks down histamine. Typically it’s used where you’re taking it when you’re eating a meal that might be higher in histamine. What it does is it actually breaks down histamine so that it doesn’t cause that bucket to overflow. That might be another good thing for her to try to add just to help her be able to tolerate some of those higher histamine foods that she wouldn’t otherwise be able to tolerate because it’s actually helping her to breakdown that histamine before it causes problems.

Laura: Now it’s interesting, I feel like I’ve had some clients that developed histamine intolerance and it’s interesting to try to figure out where that actually comes from because I feel like there’s not a lot of great research really showing a cause. I think the gut involvement is definitely a contributing factor. I also think that nutrient deficiencies or super restrictive diets can contribute to that as well. I don’t know exactly what the reason is. I don’t know if it’s because those diets tend to be low in micronutrients, or that it affects the gut health, or anything like that.

But the interesting thing is that I’ve actually seen…it’s weird, I’ve seen so many people that were pretty healthy, or generally healthy, and then they went on a very low carb Paleo diet for several months, years, a long time and they were feeling fine, and then all of a sudden they developed this histamine issue. I’ve been trying to figure out what the reason for that is. Again, my two hunches tend to go with either the gut health concern because obviously we know that very low carb diets can impact the gut flora and so it’s possible that there might be a big shift that happens there that isn’t necessarily appropriate. Then the other question is these micronutrient deficiencies. Ones that I would be a little bit concerned about in that kind of situation would mostly the minerals. Magnesium, I think everyone is potentially at risk for deficiency in just because of the way our food supply is.

One thing that I’ve been a little bit more curious about lately is calcium intake as being a potential contributor. I’ve done some research on the role of calcium in histamine response. I don’t necessarily have a strong hypothesis about that, but I think it’s definitely possible that the Paleo diets that a lot of people follow are quite calcium deficient. If you’re not eating dairy and you’re not eating lots of things like bone in fish or actually eating bones, not just drinking bone broth which isn’t really that high in calcium, it’s possible that you’re not getting enough and calcium deficiency could potentially contribute to histamine intolerance.

That’s one theory that I have either the overall mineral deficiency in the diet. There’s other minerals that are important like zinc, copper, molybdenum, manganese, those can all affect histamine sensitivity and metabolism as well. But I actually really feel like the calcium thing is a concern of mine. I think we had talked about calcium in the past. We might need to do another show on that in future, but I feel like a lot of the people I see on the lower carb Paleo, dairy free Paleo diets are probably not getting enough calcium. That’s something that could potentially be a supplement that’s necessary if they’re not able to get to at least 600-800 mg in the diet on a daily basis. Is that something you’ve seen at all?

Kelsey: Well, not really, but I will say that I don’t see histamine intolerance a ton in my practice actually. The people that I’ve had that have had histamine intolerance, like there was one woman that had it really badly and I actually ended up getting her diagnosed with mast cell activation disorder. That to me is a little bit different. Again, it’s one of things that we don’t really know what causes it, but it’s certainly something that’s being seen much more often now, or I guess maybe just being diagnosed much more often now.

But yeah, I don’t know. It’s at least not something that I’ve noticed or correlated with it. I was just going to ask you, I know you said you don’t really have a strong hypothesis here, but any reasons why you think that being calcium deficient would potentially cause something like histamine intolerance?

Laura: I’m going to have to look into it as far as what the research shows, but when I did some baseline research for a client in the recent past in the last couple of months, I did find some study showing that there’s a regulatory role of calcium on histamine secretion. This one study, and I can link to this in the show notes, but this one the abstract says, “Calcium seems to have two opposing effects on histamine secretion from mast cells, arises in the cytosol calcium concentration, initiates”…hold on, let me just see if there’s a little bit more helpful information. Okay, “On the other hand, calcium seems to have a regulatory role limiting the secretion of histamine.”

I feel like calcium balance is something that’s really important. I can imagine if somebody is getting a lot of calcium but not enough fat soluble vitamins to deal with that calcium appropriately, that could potentially be an issue.

Kelsey: Mm hmm.

Laura: Then if their calcium levels in their body are low, then that could potentially cause it as well. I don’t know if calcium is some magic bullet with histamine. I don’t think it is necessarily, but I do question if people are not getting enough calcium in the diet, and we know that calcium deficiency could enhance the histamine secretion, and that if there’s evidence that there’s an inhibitory effect of calcium on histamine secretion, I think it’s potentially relevant that if somebody’s diet is super low in calcium, that that could potentially be a nutrient of concern.

Kelsey: Mm hmm.

Laura: Again, it’s kind of just like a real loose theory of mine, but the reason that I’ve come up with some of these theories is because I just think that the number of people I’ve seen that were perfectly healthy that developed these histamine intolerances on a low carb Paleo diet is a little concerning to me.

Kelsey: Yeah.

Laura: In those situations, I’m kind of….I know you work similarly where you feel like you’re a bit of a detective with people in more complicated health conditions. When I have a client who like I said is in this situation where everything was find and then all of a sudden they developed this severe histamine issue, my question is, okay, what causes that?  Because even if it’s genetic, there was some kind of environmental trigger because they didn’t have it their whole life, it just developed recently. My thought is okay, if you made these big changes in your diet, what might be missing? Is it that your carbs are too low and then that’s affecting your gut bacteria? Or are you not getting enough minerals? Or are you overeating protein? Just different things that were the big changes and trying to figure out what could potentially be contributing.

Like I said, it think the calcium thing is defiantly a theory and I don’t want people to go out there and just start downing calcium supplements if they have a histamine issue. But it is something I think doesn’t get enough attention in the Paleo world. I think people tend to say there’s plenty of calcium on a Paleo diet. I think there can be, but it’s similar to a lot of other nutrients where unless you’re paying attention, it’s easy to be low.

Kelsey: Right.

Laura: I did just see a talk by Chris Masterjohn at the Weston Price Conference talking about calcium balance, and fat soluble vitamins, and all that stuff. He actually suggests that people be getting closer to 1,000 mg a day, which is actually what the USDA recommendations are. But I think there’s been this push in the Paleo community that suggests that lower levels like 400-600 mg per day is fine. I don’t know, I question whether that’s accurate. Anyway, I just took that on a crazy tangent.

Kelsey: We should do a show about calcium because I was just going to say I think in our old show about calcium intake, I think we were recommending like 600 mg as being kind of a bare minimum I guess. But yeah, we should do a show on that because it’s an interesting topic and that’s really cool. I’ve never kind of made that connection between histamine intolerance and potentially not getting enough calcium. Especially with that article that you mentioned, I can see that at least being a contributor cause.

Let’s add that to our list of potential contributing causes that we have going here, first of which is any sort of gut dysbiosis. That’s going to be either SIBO or some sort of large intestine dysbiosis like potential pathogens, parasites, or just general imbalance going on in the large intestine. Then we also talked about methylation status. That includes having gene mutations in the MTHFR genes and then also testing your actual methylation status to see if those gene mutations are actually impacting how you are methylating. Then of course we just were talking about different minerals in terms of their role in creating or contributing to histamine intolerance as well. Anything else that you would add to that list of root causes to look out for before we move on?

Laura: Well, I kind of touched on this little bit. She mentions that she began to eat more high histamine and glutamate containing foods so it sounds like more protein and fat containing foods, maybe some more fermented foods. I feel like whenever you increase something, something else may have decreased. My question would be, is she on a low carb diet right now? Is she on a ketogenic? Is she is on a moderate carb diet? I think it’s hard to tell. Yeah, strawberries and dark chocolate are not low carb, but you have to eat a lot of strawberries to really not be on a low carb diet at that point. I would want to know what her carb intake is because again I’ve seen some people who like I said developed these issues going low carb.

Just a caveat, I am not against low carb diets. I don’t think that everyone should completely avoid them. I don’t think they’re dangerous per se. I just have been quite surprised by how many people I’ve worked with, and it’s possibly because of my writings on that one article that I wrote for Chris Kresser that was like “Is A Low Carb Diet Ruining Your Health?” I swear is probably where I get all these people from.

Kelsey: Yeah.

Laura: But it is kind of crazy to see how many have developed these kind of issues, and they were fine before, and it was before they went low carb. I’m not saying that I’m 100% confident that the carbs are a contributing factor, but I think it’s definitely worth looking at if she suddenly went to a lower carb, higher protein, Paleo type diet and these issues came up, she made need to think about what her overall macronutrient balance is.

Kelsey: Mm hmm. Alright. We’ll add that too.

Laura: Carbs, carbs, carbs, that’s all I ever talk about.

Kelsey: Carbs, carbs, carbs, yeah. Fourth on our list is carbs, carbs, carbs as something to look at. Okay, cool.

I guess now that we’ve gotten some of the underlying causes that can contribute this, let’s go back a little bit to what I started talking about before which was just the next step would be if you still have histamine intolerance, because again, we don’t know everything about why this condition develops and so we may not have all the answers to heal you perfectly from your histamine intolerance now or before you wanted to get pregnant. Let’s say you’re going into pregnancy prep, you’re still histamine intolerant, but you want to include some of these foods that are really good for you and good for your developing baby potentially while you are still histamine intolerant. The first step in doing that would be to add some of those supplements that I just talked about before that help to lower your overall histamine level, stabilize those mast cells so you’re not producing so much histamine, and then taking something like Histame to help breakdown the histamine that you are getting from your food.

But beyond that, in terms of the foods that are high in histamine that you are eating, I would recommend picking and choosing what is going to give you the most bang for your buck when it comes to nutrient density. To me those things would include things like liver, things like fish. And you can do things to those kinds of foods to help make them lower in histamine. For example, I’ve had a lot of clients with histamine intolerance that do pretty well with frozen fish if they can get it because it tends to be flash frozen almost as soon as it’s caught typically. That’s not the case for all brands or even within the same brand all batches of fish, but in general I’d that say clients with histamine sensitivity are going to do better with frozen fish than fresh fish unless you can of course catch the fish yourself and you eat it right away, or you just live in a town….

Laura: Like Gollum from Lord of the Rings style, just straight out of the river.

Kelsey: Yeah. But if you live in an ocean town and you can just get fish that’s been freshly caught, hasn’t been sitting around for a while, that’s a different situation. But I’d say for most people, if they don’t have access to super fresh fish like that, then getting it frozen is going is going to be a better bet. That’s a way that you can still consume fish which has a lot of really great things in it for you and your baby but without getting a super high amount of histamine coming in from your diet.

Same thing goes for liver. If you can get it frozen from your farmer, again, typically it’s going to be flash frozen as soon as it was butchered, not going to be sitting around as long as it would if you bought it fresh because it could be sitting there for a day or two just being refrigerated in which case the histamine is still building up. Just in general, any meat product that you can get frozen is generally going to be a better bet for you. I haven’t seen that across the board necessarily for people with histamine intolerance, but I will say for the clients I have worked with histamine intolerance in general they tend to be better with the frozen stuff than the fresh stuff. Have you seen the same thing, Laura?

Laura: Yeah. I mean I think depends on how quickly this stuff is eaten. I feel like with fresh fish, if you’re getting that at a grocery store it’s usually pretty fresh. It’s not going to be sitting out for days or weeks or something. But the frozen stuff definitely even reduces the histamine production over fresh in general.

Kelsey: Mm hmm.

Laura: And certainly over canned. I mean canned is going to be probably the most histamine containing fish option.

Kelsey: Yeah.

Laura: The closer it is to freshly caught, which when they have it frozen, it’s basically frozen right after they catch it. The same goes for like you said the liver and meat in general. It can be a little hard because a lot of times you get fresh meat and maybe finding good frozen stuff might not be as easy at a grocery store. But as far as my experience is concerned, a lot of these local farms sell this stuff frozen.

Kelsey: Yeah, same.

Laura: It’s not hard to find frozen stuff and then just thaw and cook pretty quickly after thawing.

Kelsey: Yeah. The other thing to think about too with the foods that you might be eating that are higher in histamine is that you can potentially get a lot of the good stuff out of those via supplementation and sometimes that actually can be less histamine containing or just less aggravating to somebody with histamine intolerance. For example, we’re talking about fish. Let’s say you really just have a tough time doing fish but you could potentially try something like an unfermented cod liver oil like Rosita’s Cod Liver Oil if you can’t eat fish. You may be able to tolerate that cod liver oil because it’s not fermented, it’s not sitting around a lot. You hopefully can just keep it in the refrigerator or even in the freezer to help prevent histamine accumulation overtime. Some people can do quite well with unfermented fish oil like that. That’s a potential thing to try.

Then fermented foods for example, instead of doing those, you can do a low histamine probiotic. Something like Klaire Factor 6 or Seeking Health Pro-Biota Bifido or ProBiota Infant, those could be good options to help you lower your overall histamine amount in your body because they don’t contain histamine producing strands of bacteria. Fermented foods, they’re really great for you because not only do they give you probiotics, but also you’re getting fiber and different antioxidants from eating the vegetables that they’re made from, but in the case of somebody who’s got fairly severe histamine intolerance, I’d say that’s one of the things that may not be as much of a bang for your buck type food than something liver or fish could be. I’d rather see somebody eat liver or fish and take out the fermented foods and maybe swap that for probiotic so that they’re able to tolerate liver and fish on occasion.

Because again, think about it as this bucket idea. You might be able to tolerate a little bit of extra histamine from your diet. Let’s say one day you want to eat some liver, but maybe you can’t eat liver and fermented foods in the same day, or in the same week, or whatever depending on how severe or just depending on your level of histamine intolerance. I think it makes sense to think about which foods are going to be the most nutrient dense and give you like I said, that most bang for your buck when it comes to histamine rich foods and nutrient dense rich foods. Think about that.

The liver, the fish like I said, those are going to be two great options that I would recommend. If you can include them, definitely do that. They’re going to give you a lot more than even something like fermented veggies, but definitely things like strawberries, or avocado, or dark chocolate is going to give you. I’d rather see you take those things out so you can include things like liver and fish.

I’d also include bone broth there. I’m not quite as adamant about the bone broth as I am the liver and the fish, but it certainly something that if you can include at least on occasion would be great to have. I’ve had some clients that have been able to include bone broth if they cook it in a pressure cooker. Honestly, I don’t know the mechanism as to why that would necessarily be true because it is cooked for less time, but in theory I guess I would image that actually the histamine level would be at least somewhat similar because it’s breaking everything down in the same way that it would if you cooked over a really long period of time. But I’m no expert on exactly what happens in a pressure cooker and how that affects histamine, but I’ve defianatly seen that my clients do generally better with pressure cooked bone broth rather than cooking it in let’s say a slow cooker for like 12 hours.

Laura: Yeah, I have no idea why that would be the case, but it’s defianately an anecdotal recommendation or observation. I feel like at the end of the day, if you’ve see something that works for a lot of people, it’s always worth a shot even if we don’t have a randomized controlled trial showing two different groups of histamine intolerant people using slow cooker bone broth versus pressure cooker bone broth.

Kelsey: Right.

Laura: We don’t have any evidence or we don’t have an exact mechanism to explain why that works, but yeah, I’ve definitely seen it too.

Kelsey: Like we said, first take out those root causes if they’re there, then lower your overall histamine level, then choose the most nutrient dense foods that may be high in histamine to include while taking out some other high histamine foods that aren’t as nutrient dense. Like I said, that could be things like strawberries, avocados, dark chocolate, those are the ones that she mentioned that I would say.

Laura: Dark chocolate? No! Just kidding.

Kelsey: I know, I know. But those are the ones that if you’re going to get histamine from your diet, let’s get the histamine from stuff that’s like really going to make a difference in your nutrient levels. Pick and choose with nutrient foods which nutrient foods you want to include that also happen to be high in histamine. Then from there, obviously we can then focus on the anxiety that’s there and try to reduce the amount of anxiety that she might get from eating too much histamine or just the general level of anxiety that she might have. Any things that you would recommend there, Laura?

Laura: Not that we didn’t already cover. I mean I really feel like on my end other than just the typical histamine treatment type support that you’re going to see, so vitamin C, quercetin, DAO enzymes, just trying to figure out what the potential root cause is, and what changed, and what were you doing before this issue started? What was different about the diet at that point that might be missing in this new diet approach that she’s taking?

Kelsey: Yeah. I guess when it comes to the anxiety itself, of course that could be potentially started from the histamine intolerance, but for a lot of people they kind of have that that tendency toward anxiety in the first place too. If that’s you, you could certainly try, and Laura remind me if you already mentioned this, but things like Lavender oil, taking that internally, or L-theanine. Those are things that they have been shown to be helpful for people with anxiety of any cause. Taking those things as some additional supplements just to help lower your overall anxiety levels might make you less prone to the anxiety that you would get when you overeat histamine.

Laura: Yeah, I mean it’s again one of those things you really want to run by your doctor especially if you’re on sort of medication for anxiety.

Kelsey: Yeah.

Laura: But I find that L-theanine especially is pretty effective for people in improving just general low level anxiety symptoms from any kind of contributing cause.

Kelsey: Yeah.

Laura: Cool. I think that covers it. That was a bit of a longer episode than I expected.

Kelsey: I know.

Laura: But hopefully that’s helpful and if you guys have any other follow up questions about histamine intolerance, or we’ll try to talk about calcium down the road, maybe do some research on that and get you guys some information. Because again, I feel like sometimes these theories that I develop, I don’t always flesh them out entirely. I see research and I see some kind of diet holes that are potentially an issue and I think there’s a lot of different things that can contribute to these issues. But like I said, I just see way too many people coming to me from like a low carb Paleo history that develop those issues because of that diet.

Kelsey: Mm hmm.

Laura: I just tend to think about what were they getting in their diet before that they’re not getting now that could have contributed to that. It might be a genetic tendency, but I don’t think you can totally blame genetics for all of it.

Kelsey: Yeah, I agree.

Laura: Well, if you guys have any other questions feel free to go to TheAncestralRDs.com to our contact and submit a question or a recommendation for a podcast guest. Hopefully we’ll be getting you more of those and get a nice I guess editorial calendar for 2017. We have a couple of guests coming up in the next couple weeks that we’re excited about. But we want to hear from you so please go to our website and submit your question there. Otherwise, we will see you here next week. Thanks for joining us.

Kelsey: Alright. Take care, Laura.

Laura: Alright. You too, Kelsey.