I’ve had a breakthrough of sorts.
Remember back when I was doing my own version of The Plan? I started it in May 2016 and blogged every day while testing new foods for intolerance, as measured on the scale by water retention the following morning. Remember? Remember how frustrating it was for me because I was reacting to so many things that didn’t seem to have a relationship to each other? This cheese was fine, but not that one. Ibuprofen was fine, but not aspirin. Cooked vegetables and butter were fine, but not avocado. Pair that with the food intolerance testing I had done that showed only minor sensitivities to a couple of things (eggs, beef, whey and pumpkin), and I was left pretty confused and convinced the theory behind The Plan was bogus.
One month after starting that project I wrote this post. In it I said:
I seem to be reactive to an awful lot of things. I’m not sure why. Actually, that’s an understatement. I have no flippin clue why.
Through my meticulous testing I had identified the following “Friendly” foods: chicken, beef, unrefined coconut oil, butter, cooked vegetables (kale, carrots, onions, garlic, celery), fresh mozzarella cheese (without vinegar as an ingredient), dandelion tea, raw mixed greens, lemon juice, my prescription meds and supplements (multi, A, D, K, Pregnenolone, Licorice Root, DHEA, magnesium glycinate, probiotics, biotin), ibuprofen
…And the following reactive foods: ham, avocado, eggs, sauerkraut, coffee, red pepper flakes, aspirin, fresh mozzarella cheese (with vinegar as an ingredient)
I concluded the following: There is some correlation between eating foods that are less reactive and the following improvements:
- losing on the scale
- improved mood (less anxiety/depression)
- improved blood sugar numbers.
I just didn’t know how to identify which foods were likely to cause reactions without spending endless days of my life eating little other than kale soup and baked chicken.
Fast forward to now.
What I’ve recently learned is that the foods that I found to be reactive are foods that are high in histamine, block the enzymes that break down histamine, or cause a significant release of endogenous histamine from the body. The “friendly” foods I identified do not fall into this category.
I know, right?
A couple possible exceptions: coffee was determined to be reactive and lemon juice non-reactive…not everyone would have these experiences. It’s possible my study was flawed, or that these were idiosyncratic results.
When I started following a Peat-inspired diet at the end of 2013 I started drinking a lot of orange juice. That’s when the itching started. I didn’t think much of it at first, but it continued. It changed forms – internal itching, external itching. Itching in my throat, my ears, under my breasts, my girl parts. It wouldn’t go away completely for very long. It’s taken breaks, making it hard to pinpoint the cause. I thought it might be yeast – hence the antifungals. I thought it might be parasites – hence the antiparasitics.
Turns out that orange juice (all citrus, actually) is high in histamine.
Two weeks ago I started taking a new medication for my hypertension. Irbesartan. It’s in the same family of medications that I’ve previously had allergic reactions to, but I seem to react poorly to many medications, and my doctor was running out of ideas. I started taking it and within 24 hours I noticed a faint sore throat. I kept taking it because the sore throat would come and go – maybe it wasn’t related to the medication after all! My husband was sick – maybe I’m just getting sick. Since starting the Irbesartan I’ve completely avoiding all starches and foods containing a lot of fiber – the stuff that normally makes me depressed. And yet, I was depressed. Not only that, but I had 3 incidents of absolute rage. Rage like I’ve never seen in myself before. Screaming rage. Throwing rage. I thought, “Well, I must have some pent up anger” – and believe me, I have reasons right now to be angry. But this was an uncommon level of emotional expression.
And weirdly, I noticed the worse my mood got, the more my throat hurt. As my mood faded back to baseline, so did my sore throat.
I had learned at this point that medications can cause histamine reactions by blocking the body’s formation of DAO – the enzyme that breaks down histamine – or by increasing mast cell activity (the body’s histamine producers). So two weeks after starting the Irbesartan I stopped taking it. That was 3 days ago. Every day has gotten better since then. Perpetual sore throat – gone.
There are so many pieces to this puzzle, I’m afraid this post isn’t very cohesive. My main point is this: My body is clearly producing too much histamine or having trouble breaking down histamine. The consequences of this pattern are many. The mast cells – white blood cells that are part of the immune system – which produce histamine, also produce inflammatory cytokines, serotonin, and other substances to fight threats to the system. Hello, perpetually high inflammation. The itching, the flushing, the fatigue, the mood disturbance, the prickly heat, tachycardia, aches, difficulty exercising – all of these symptoms can be explained – at least in part – by high systemic histamine. Here is a list of symptoms associated with mast cell disorders. I have 7 out of the first 9, as well as many others.
Mast cell disorders can range from fairly mild to life threatening. I don’t have the life threatening version – Mastocytosis – which is rare and seems to be characterized by anaphylaxis and losing consciousness. The less severe forms of histamine issues – Mast Cell Activation Syndrome (MCAS) – sometimes called “histamine intolerance” are not recognized as “real” medical issues. Kind of like Leaky Gut. Probably real, but not to doctors. There are tests that can be done, but the easiest test is just to eat a low-histamine diet and see how you feel. You feel better? You probably have histamine issues. I think the times in the last few years that I was feeling best were times that I was accidentally eating a low-histamine diet.
No one knows exactly what causes this. There is some speculation that gut problems interfere with the production of DAO, that genetic predispositions can lead to compromised DAO production (I’m heterozygous for that gene, by the way), or that stress/trauma can lead to increased mast cell production (so, more histamine is released).
I noticed my histamine issues became noticeable when I stopped eating low-carb Paleo and turned to orange juice via Peat (as mentioned above). It got much worse when I started following the Gut Health Protocol and eating lots of sauerkraut – one of the most high-histamine foods on the planet. That’s when I started noticing hives and persistent skin itching, eye watering, and sometimes sneezing after eating.
I’ve found a couple of sources of information on histamine disorders that seem to be really helpful. One is Dr. Janice Joneja, who has a really comprehensive low-histamine/tyramine food guide, and the other is Yasmina Ykelenstam (the Low Histamine Chef) formerly here and now here.
So what is there to do about this? To start, I’m following a low-histamine diet now. I’ve eliminated smoked and cured meats, egg whites, aged cheese, chocolate, OJ…basically a lot of the things I was eating daily. I’m in the process of identifying which foods are triggers for my own symptoms. I have DAO supplements to take if I’m eating something I know is a potential trigger, like an avocado or tomato. For the most part, I’m trying to avoid triggers, but this leaves me with not much to choose from so that is my backup plan. At this point I’m not sure if I have a mast-cell sensitivity problem or a DAO-deficiency problem, so I’m just trying to eat whole fresh foods that don’t contain or cause histamine.
Given the physiological response I had to my previous “The Plan” elimination diet, I’m expecting to feel better as time goes on, and to see a drop in inflammation and probably body weight. I’ll probably update daily for a while.