Low Histamine and High Anxiety

I’ve decided to stop worrying about my white blood cell count.  One friend suggested that perhaps it’s just the immune system doing it’s job – actually clearing an infection – and that one high lab result doesn’t indicate a chronic problem.  So I’ll do follow up testing in a few months, and until then just let it go.

Updates on other issues:

I made a list of foods that are considered to be low-histamine by an app called All I Can Eat. This app is created by someone in Germany so there are foods listed in this app that I’ve never heard of (brill? chayote? gurnard? junket?), and there are some foods that met the criteria as low-histamine but that I’m not likely to eat or don’t really have access to (e.g., gooseberries, lychee, margarine).  So here’s the list that I came up with for myself – things I have actually heard of and have the means to include in my diet:

all i can

Keep in mind – this is one guy’s list.  Low-histamine lists vary depending on the source – for example, this list from the Mastocytosis Society of Canada says blueberries, potatoes and sour cream are off limits, among other things.  However, I don’t seem to have problems with any of those foods – so I’m giving the All I Can Eat app a try – it seems to be a little less restrictive and maybe more aligned with my current needs.  I’ve been gradually including more of these foods and reducing things that the list said were higher in histamine (e.g., chicken, grapes, spinach).  Diet change is tough – I’m trying to make small changes over time that will add up to big changes.  If I try to do too much I start avoiding the situation all together and eating leftover chocolate bunnies from Easter 2 months ago.

It’s been probably 4-5 weeks now that I’ve been eating more fat in my diet.  My weight is stable – no gain or loss during that time and my blood sugar is also stable – fasting blood glucose is in the mid-80s or low-90s with no evidence of change.

Still having hot flashes – haven’t committed fully yet to a low-histamine diet.

Mood isn’t as good as it used to be.  It’s still ok, and depression is still absent.  I have more anxiety recently though.  I’m preoccupied sometimes with worry about my daughter getting hurt somehow.  We just bought a house last week and will be moving in the next 2 weeks.  I’m having trouble enjoying the process because I’m afraid she’s going to get Lyme disease or get injured by a weed wacker.   I know moving and buying a house are stressful events – but it does feel like there’s a biological component to the anxiety.

About a month ago I started taking Thorne Vitamin C capsules with bioflavanoids, including Quercitin – a plant substance that can help reduce mast cell activation (a histamine-releasing event in the body).  Well, it’s been about that long since my anxiety increased.  I read somewhere (probably a Facebook group) that Quercitin can increase anxiety in people with certain genotypes (COMT+/+).  Now, I’m not homozygous for any of the COMT snps but I am heterozygous for a couple of them.  I know it’s a reach, but I’d like this anxiety to go away now, so I’ve stopped the Vitamin C capsules for now to evaluate.

Saw this the other day…there’s a ring of truth to it:

Image result for depression is not caring enough anxiety is caring too much

High Leukocytes and Histamine Reactions

Yesterday I posted some of my recent labwork.  I was a little upset to see my white blood cell (WBC) (aka leukocyte) count was high – I’ve never had that happen – and immediately I assumed I must have a horrible infection (at best) or leukemia (at worst).  I did some research on the causes of elevated WBCs and found that use of steroid medication can cause an increase in total WBCs.  However, the increase should be in the neutrophils, while the other types of white blood cells should actually decrease, according to this article:

Glucocorticoid treatment results in increased polymorphonuclear leukocytes in blood as a result of increased rate of entrance from marrow and a decreased rate of removal from the vascular compartment. In contrast, the lymphocytes, eosinophils, monocytes, and basophils decrease in number after administration of glucocorticoids. A single dose of cortisol results in a 70% decrease in lymphocytes and a 90% decrease in monocytes, occurring 4 to 6 h after treatment and persisting for about 24 h.

Well, I have high neutrophils, but also high lymphs and monocytes.  So maybe I do have an infection.  Or maybe the Lichen Sclerosus is causing this.  Sort of a chicken-and-egg situation.  Did the autoimmune condition cause the increased white blood cells?  Or did an infection of some kind cause both?  My doctor wants me to retest my CBC in 3 months.

In the meantime, I’m learning that eating a diet high in histamine (e.g., a standard American diet) makes everything worse – the Lichen Sclerosus gets worse, mood gets worse, fatigue gets worse, and I get all itchy.  Sometimes I wake up in the middle of the night itching everywhere – all over my torso.

I suspect I have Mast Cell Activation Disorder (MCAD), which could be causing these other problems.  I’ll be researching and sharing more about this in the near future.

May 2017 Labs

I had some labwork done in May – metabolic panel, lipid panel and CBC.  Here they are with current labs in RED:

Labs

CBC

A few notes off the bat – the glucose and lipid panel were NOT fasting.

White blood cells were high….hoping that’s a reflection of the Lichen Sclerosus and not something else I don’t know about.

I have no time to analyze right now…but feel free to take a look and let me know what you think.

 

Histamine and Hot Flashes

A general update – I’ve been taking an extended break from low-fat eating, mostly because my body told me to, through cravings and just feeling less great overall.  So the last couple of weeks my diet has been higher in fat and has also included things I normally like but wasn’t eating – different kinds of meat and cheese, chocolate, pizza…as I write this out it looks less like a break and more like a binge.  But it’s been spread out over weeks!  So not bingey – just breaky.

Anyway, during this last couple of weeks my hot flashes went from mild to wild.  Lasting longer, causing sweating instead of just warmth, causing itching all over my skin at the same time. It’s really unpleasant.  Particularly bad on hot days, but also bad on cool days so I know it’s not just my perception that has shifted.

I wrote on here in January that after I started watching my histamine and taking a histamine-degrading probiotic my hot flashes disappeared.  This was the timeline (relevant items in bold):

12/29/16 – Started a low histamine diet

1/3/17 – Started taking Culturelle (histamine degrading) probiotics

1/5/17 – Mood significantly improved

1/6/17 – Hot flashes gone (after having them almost daily for years)

1/12/17 – Started Verapamil for Hypertension

1/14/17 – Started eating starches

1/28/17 – Started Weight Watchers (low fat diet)

2/6/17 – Hot flashes back again.  I wrote at that time:

I don’t really follow a low-histamine diet anymore, and my hot flashes have come back.  They’re not as bad – no sweating, pretty short in duration, and less frequent- but back.  Right now I’m ok with it. At some point I’ll eliminate whatever is causing them.

My interpretation of the above timeline:  I stopped eating foods with a lot of histamine and started taking a probiotic that degrades histamine in the gut, and my hot flashes went away.   So maybe hot flashes are caused by histamine in the system (including mast cell activation) which can also release lots of other inflammatory compounds into the blood stream.  I started Verapamil, which may have some effect on histamine release (marking this page of pubmed for followup on this), and then when I started eating low-fat I stopped focusing on histamine.  I was feeling so much better overall I figured I could deal with a few hot flashes, and that was better than restricting my diet further.

Well, that time has come to revisit this because I’m not ok with the hot flashes anymore.  They are absolutely worse when I eat foods that are high in histamines – in fact, I’ll often get one during or right after a meal containing high-histamine foods.

I really love the approach taken by Yasmina Ykelenstam, the Low Histamine Chef.  In her book, she talks about how at one point she was down to 5 safe foods, and things weren’t really getting better.  This, of course, reminds me of myself and the numerous times I’ve talked on here about having only a few foods I could safely eat.  She says that rather than focusing on removing histamine-containing foods (though that may be necessary too in the beginning) she recommends increasing nutrition – specifically increasing foods that are naturally anti-histamine and anti-inflammatory.  Her book contains a list of such foods, as well as recipes for using them.  I hope to go in this direction more – adding rather than subtracting.

I also found a really nice app called All I Can Eat, which lets you pick your food intolerance from a list of 6, including histamine, gluten, lactose, fructose, sorbitol, and salicylic acid (sort of an odd list, of all the foods to be intolerant to…).   Anyway, you can check the boxes of your personal food intolerances and then view the food list, which color codes foods based on your intolerances – green is good, red is bad, with several shades in between.  I’m going to start moving towards the green foods and away from the orange and red ones I have been eating.

I predict I’ll be hot-flash free again within 2 weeks.

 

Comments

My commenters have saved my life.  The advice I’ve received and the personal stories that have been shared with me have very literally changed the trajectory of my life, and of the lives of the people that I spend the most time with.  Because of you guys my daughter has a mom who is not crying and yelling all the time.  My husband has a partner who can make rational decisions.  I have dreams now that I am certain will come true, whereas a few years ago I had none.  It may not seem like much, leaving a comment here in my little corner of the web to say, “I had that too! Here’s what worked for me,” or “Here’s the science that shows why that isn’t working,” or “I know it’s hard, but keep going.”  To me, these comments are everything.

I also get some really mean comments on here, wishing me death or mocking my writing style.  Those comments don’t get approved so they don’t show up among the published comments. I sometimes wonder if I should publish them and make this place more entertaining – add a dash of drama – but then, I don’t want to give trolls the attention they’re seeking.  Unfortunately, there’s a shock-factor to meanness that makes it memorable to me, and I’ve let some of these comments reduce my self-expression. Today I became aware of the fact that I’m writing less now, avoiding posting on here unless I have something important to say, so I don’t have to hear mean stuff about the irrelevance of my blog.

I also became aware of how stupid that is.  This is my life.  I get to write on here whatever I want. Nobody has to like it, and I guess people are free to be mean if they don’t like it.  But to the mean commenters, I ask you:  Is your life better after you’ve been mean to well-intentioned people on the internet?

On Sean Croxton’s Quote of the Day podcast (which is changing my life, by the way) Brene Brown says,

“It is not about winning. It’s not about losing. It’s about showing up and being seen.”

I’m going to write more from now on.  And a lot of it won’t be perfect.  The purpose of this blog was to raise awareness in the world that if you’re tired of being sick, there are options for you outside of mainstream medicine.  It was also to be a journal for myself – a way to track my own progress over time, so I could look back when I needed to see what I was doing a year ago, or two years ago.  Mean people can keep being mean – I’m not going to let them stop me anymore.  To my friends in health, I honor you and am eternally grateful for your insight, intelligence, and support.

HbA1C and Prolactin

I had some lab work done – still waiting for some of it, but here’s what I have so far:

HbA1C Feb 2015 Dec 2015 May 2017
6.7 6.4 5.9

In February 2015 I had a routine HbA1C test done – essentially a summary of my blood sugar over the previous 3 months.  With a result of 6.7, that test earned me a diagnosis of Type 2 diabetes, and the doctor prescribed me Metformin.  I took it for like a week, didn’t like the side effects, and stopped taking it, determined to control my blood sugar with diet instead.  And I did for a while there, with low carb.  However, as soon as I stopped low-carbing my blood sugar shot back up again (and I had to stop low-carbing because I started feeling like crap eating that way long term).  Over the last 4 months I’ve been eating high carb, low fat.   My blood sugar has been well-controlled on this plan, and my fasting blood glucose is routinely in the 80s now.  Here’s a graph of my fasting blood sugar since January:

fbg

For a minute there I thought the steroid I was taking for Lichen Sclerosus was helping my blood sugar somehow, but it was already trending down before I started that.

Anyway, good news – my A1C is below the diabetic range now (which is generally considered a A1C of 6.5 or higher), and I’m firmly in the PRE diabetic range.  I expect that to be a thing of the past too, the next time I test.

So isn’t this interesting?  It’s almost as if carbohydrates don’t actually cause diabetes.  Poor carbs…always getting blamed for everything these days.

Here’s what I’ve learned about myself – I can eat high carb/low fat and my blood sugar will be well-controlled.  I can low carb/high fat and my blood sugar will be well controlled.  What I CAN’T do is eat high carb/high fat.  When I do that my blood sugar trends up and suddenly I’m diabetic again.

Ray Peat talks about the Randle Cycle, and I’ve referenced it in this blog before.  Here it is again:

The antagonism between fat and sugar that Randle described can involve the suppression of sugar oxidation when the concentration of fats in the bloodstream is increased by eating fatty food, or by releasing fats from the tissues by lipolysis, but it can also involve the suppression of fat oxidation by inhibiting the release of fatty acids from the tissues, when a sufficient amount of sugar is eaten.

Readers Digest version: Sugar and fat compete.  Choose one and go with it.

I choose sugar.

So…is my improvement in blood glucose due to eating low fat?  or is it due to improving my gut microbiome with Culturelle Probiotics?  I changed both variables in January….so it’s hard to say.

Last thing – I tested my prolactin, to evaluate whether or not that may have increased since starting Verapamil for high blood pressure, and if so, whether that may be contributing to autoimmunity, as I described here.

Prolactin in March 2014 – 5.4 (range 4.8-23.3)

Prolactin in May 2017 – 5.9 (range 4.8-23.3)

So not much change there.  Can’t really blame prolactin for tipping me over into autoimmunity.

Tomorrow:  A snapshot of exactly what I’m eating these days.

Weight Loss and Autoimmune Update

I got down to 187 about a week ago…a 25 pound loss from my top weight of 212 in January.  Then I started having a lot of cravings. One thing I’ve learned about myself is that I have a strong backbone when it comes to sticking with a diet or plan that is working for me.  I can refuse my favorite foods every single day for months and months at a time, knowing they’re not currently aligned with my commitment to myself to be healthy.  Maybe that sounds extreme – but to me, it’s focused.  SO…..when I have cravings and can’t stop thinking about food and I’m not hungry, I know it’s not a character issue.  I know something biological is causing it.

In the last week I’ve been having cravings for high-fat food.  When I started my weight loss journey I was eating 2 eggs every day and low-fat cottage cheese in the afternoons.  Since I got diagnosed with Lichen Sclerosus I’ve been trying to follow something closer to the Autoimmune Protocol by removing eggs and dairy from my diet.  This has left me with very very little dietary fat – probably around 10-15g a day.  I guess that’s just too damn low and my body is needing more.  I notice my hair, which I used to have to wash daily due to oiliness, now takes much longer to get oily, and I can now go 2-3 days without washing it.  Anyway, the food cravings have been a bit of a problem so in the last few days I’ve been adding eggs back in (which went fine) and I’ll be adding the cottage cheese back in – I could be missing the nutrients in those foods too.

So for the moment, my weight is back up to 190 – on the upswing because I have been eating things not supportive of my weight loss goals.

Had a doctor’s appointment with my functional med doc a few days ago. He didn’t want to test for Lyme, given the poor reliability of testing (regardless of lab, he says) and the extreme nature of treatment if I do get a positive.  He said that unless I was really feeling terrible it wouldn’t be worth it.  I can’t disagree with that.  He also said that lots of things cause autoimmunity – not just Lyme, and that Lyme isn’t even the most likely culprit.

When I got home from that appointment I saw this article in my Facebook feed: Trigger for Autoimmune Disease Identified, which references this study that was published a couple of months ago.  The basic idea is this:

B cells expressing the transcription factor T-bet promote the rapid appearance of autoantibodies and germinal centers in spontaneous murine models of systemic lupus erythematosus (SLE). Conditional deletion of T-bet from B cells impaired the formation of germinal centers and mitigated the development of kidney damage and rapid mortality in SLE mice.

So the B cells – I guess this is a kind of white blood cell – may or may not be expressing transcription factor T-bet.  The mice that were expressing T-bet and who were genetically susceptible to autoimmunity, had a high rate of autoimmunity.  The susceptible mice who had T-bet deleted from their B cells stayed healthy.

So what causes T-bet expression?

Check this out (h/t to Ruth in my Ray Peat Facebook group): “Prolactin (PRL) exposure stimulates expression of T-bet, an immunoregulatory transcription factor for Th1 development, and alters secreted cytokine profile in peripheral blood mononuclear cells (PBMC)”.

Prolactin = bad.  Just like Ray Peat sez!

Before I go on…a bit of background about prolactin from Self Hacked:

Prolactin is a peptide hormone made by the pituitary gland and various other parts of the body. It is also referred to as the luteotropic hormone (luteotropin) and PRL. Prolactin is encoded by the PRL gene (R).

Primarily, prolactin is responsible for the stimulation of milk production in women (lactogenesis) (R).

When a woman is pregnant, prolactin levels increase by up to 10-20 times the  normal amount.  The levels return to normal within a few weeks after the mother stops breastfeeding.

Despite what its name suggests, prolactin does much more than only promote lactation. It is found in men as well and is influential in over 300 separate processes.  It is recognized as a multipurpose hormone with one of the widest ranges of physiological actions of any hormone (R).

Here are more studies that discuss prolactin’s negative effects on the immune systems (specifically B cells):

Prolactin Alters the Mechanisms of B Cell Tolerance Induction

Prolactin Levels Correlate with Abnormal B Cell Maturation in MRL and MRL/lpr Mouse Models of Systemic Lupus Erythematosus-Like Disease

Prolactin modulates the naive B cell repertoire

Prolactin Rescues Immature B-Cells from Apoptosis Induced by B-Cell Receptor Cross-Linking

What’s interesting to me is that this hormonal connection between Prolactin and autoimmunity may help explain why far more women than men have autoimmune conditions.

So then I googled “What causes high prolactin?”  I know I could burrow through articles at raypeat.com and find this answer but I’m short on time these days.  The Pituitary Society seemed as good a source as any….oh hey look!  The medication I take for hypertension actually INCREASES prolactin!  Awesome…so Verapamil increases histamine release (and thus sustains my hot flashes) and also increases prolactin, perhaps causing and/or sustaining my autoimmune condition.

AWESOME!!!!

Ok, I seriously have to get my blood pressure down.  Immediately.  I need to get off this big pharma rollercoaster.

Fortunately, I have a baseline prolactin level from testing I did 2 years ago, long before starting this medication.  I’m going to get it tested again today to compare.