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Have you ever wondered why some people react to certain food or environmental triggers differently? This episode seeks to demystify the enigma of histamine intolerance.

We are joined by the knowledgeable naturopath Carolyn Ledowsky, who shares her in-depth understanding of the role of genetics in histamine intolerance.

In this episode, we:

  • Explore the growing significance of histamine intolerance and mast cell activation in today’s health landscape and learn the reasons behind their increasing prevalence.
  • Discuss the prevalence of histamine intolerance and mast cell activation among your patient population and recognize the potential impact on their health.
  • Investigate the primary environmental factors that contribute to the development of histamine intolerance and mast cell activation.
  • Identify the crucial genetic single nucleotide polymorphisms (SNPs) that should be a focal point when assessing histamine intolerance.
  • Delve into the atypical symptoms associated with histamine intolerance and mast cell activation beyond the more common allergic reactions.
  • Discuss key solutions in managing these conditions, including antihistamines like quercetin and perilla, the role of probiotics, and the potential benefits of IGG immunoglobulins.

Get ready to dive into the intricacies of histamine intolerance and broaden your understanding.

About Carolyn

Carolyn Ledowsky is the founder of MTHFR Support Australia. She is currently undertaking her PhD at the University of Technology Sydney, where she is investigating methyl folate vs folic acid in women with recurrent miscarriage.

She is a Health Scientist, Researcher, naturopath, herbalist and nutritionist who has a Bachelor of Health Science (Naturopathy) Honours, Bachelor of Herbal Medicine, Bachelor of Naturopathy, Advanced Diploma of Naturopathy and Diploma of Nutrition and a Bachelor of Economics from Sydney University. She has also studied courses in genetics at Duke University (Genetics and Evolution) and The University of Maryland (Genes and the Human Condition – from Behaviour to Biotechnology) .

The secret to successfully unravelling chronic health conditions is the ability to understand a person’s genetic susceptibility and overlying environmental contributors that shift the biochemistry significantly away from the person’s ability to cope with an infection, exposure, bacteria or assault of some type.

Her practice specialises in genetic susceptibility and how this contributes to biochemical dysfunction and chronic health conditions.

Connect with Carolyn
 MTHFR Support Australia




Andrew: This is “Wellness by Designs,” and I’m your host, Andrew Whitfield-Cook. Joining us today is Carolyn Ledowsky, a naturopath who specializes in methylation and genetic issues. And today, we’ll be discussing histamine genetics and drivers. Welcome to “Wellness by Designs,” Carolyn. How are you?

Carolyn: I’m well, Andrew. Thanks very much for having me today.

Andrew: An absolute pleasure. I should say “again.” How many times have you been on? Three or something?

Carolyn: Yeah. Probably more than that now.

Andrew: Maybe more, and certainly on my channel as well, so… Carolyn, first of all, histamine intolerance. It seems to be becoming a bigger and bigger issue. Why? Why is that? What is it that we’re noticing now that we didn’t notice before?

Carolyn: Well, look, I have a few theories on it, and I think the number one is that we have just been inundated with wet and rain for the last three or four years. People have been flooded. Typically, the eastern seaboard of Australia is very much damp, wet. And even if we don’t have mold in our house, just having dust, and that damp condition, can easily cause mold. So, I think we’re exposed to a lot more of it. I also think that from a folic acid point of view, we have one of the highest rates of allergies in the world, and I think, if you look at how you break down histamine, you need methylation to work. And SAM-e is a cofactor to one of the key enzymes that degrade histamine. And so, if we’ve got too much folic acid in the system, or we’ve got a block in our methylation, our uptake of methyl folate, you’re going to have more histamine, and less being degraded. So, I think that’s probably one of the key triggers, is this whole folic acid thing, that is affecting, potentially, those people with blocks and exposure to mold, because they’re not actually getting methylfolate, to make SAM-e, to then degrade the histamine.

Andrew: Right. If we go right back though, take it right back to why is our immune system priming to IgE reactions? Is it because, you know, we’ve lost the old friends? We don’t, you know, helminths are… Everything, kill worms, and kill bugs, and kill parasites. Even blastocystis hominis, by many, is viewed as an obligate pathogen rather than a facultative pathogen. And so, rather than correcting the terrain, we kill the bug. So, “these bugs are bad,” you know? But is that, if we go back, is that the real reason that we’ve lost our breadth of triggers that balances out immune triggers, and so we, our immune system is tending to fire at will, if you like?

Carolyn: Look, I think we can even go back further, and, you know, all these, the health of a child is determined by pre-conception. And I think there’s a lot in terms of the way that our children, and we now know it can be up to four generations, are affected by what people do pre-conceptually. So, I think there’s an element there, but I also think we’ve lost our biodiversity. We, a lot of all, the, you know, the processed foods that we’re having mean that we don’t have the leafy green veggies we need. We haven’t got an array of foods, and because it’s highly processed, what we’re eating is actually not helping our gut function. So, I think there’s a…and I think there’s also the slip, slop, slap. We’re not getting exposure to sunlight, hardly ever. That affects our immune system. I think there’s so many aspects of this. It’s not just one thing, but it’s a whole range of things. And I definitely think the gut, you know, diversity, and the array of foods we’re eating, the sort of foods we’re eating, the… You know, very few people are, you know, going back and cooking their own meals anymore. They just don’t have the time. And in so, it’s, they’re eating processed food, lots of folic acid, again. You know, when you look at the amount of foods that’s…the amount of folic acid that some people are getting, just by eating processed foods, it’s well, well, well above, I mean, thousands of milligrams, sometimes, above what we were initially supposed to get. So, I think you’ve got, an element of what you’re talking about is right. But I think there’s so much more to it. Our immune systems, don’t forget, rely on methylation as well.

Andrew: Right. Okay. So, genetic SNPs? Any relevant ones that we’re talking about here, with regards to histamine intolerance?

Carolyn: Oh, yes. It’s my favorite, actually. You have DAO, in the gut, diamine oxidase. And that, unfortunately, is reduced in inflammation. So, even if you don’t have a genetic polymorphism, I think there’s potential issues there, because you can down-regulate that enzyme just by having inflammatory…anything inflammatory, LPS, anything, yeast, will down-regulate it. You’ve also got the systemic breakdown of histamine, which relies on HNMT, histamine N-methyltransferase. And then you’ve got the monoamine oxidases, or the MAOs, A and B, that also degrade it further. So, if someone has a MAO-A TT polymorphism, where it’s slow, then your ability to break down histamine… And it’s really interesting when you dive into the genetics. Those people that you think, “Well, this is really weird. They don’t have exposure to mold, but why are they the ones that go out into the wind, in the, you know, this time of the year, and they’re absolutely blown away with allergies?” And if you look at their histamine genes, they almost always have a homozygous MAO-A or HNTM. And sometimes both.

And then you have the further aldehyde dehydrogenase genes, that get rid of the metabolite that MAO is meant to produce, which is that N methylimidazole acetaldehyde. So, it’s basically mopping up the aldehydes. And so, if you’ve got a yeast process going on, where there’s excess aldehydes, then you can be creating ancillary problems because that aldehyde dehydrogenase gene can really get affected, and gets over-saturated. And we see that a lot in the Asian population, because they have a very high predominance of this aldehyde dehydrogenase gene. That’s why they don’t deal with alcohol. And we were doing a case study just this week, actually, with a young kid who had all these histamine-based genes. And he had a yeast problem, and his practitioner asked his mother to do a breathalyzer test on him, and he blew over. And he, of course, doesn’t have any alcohol. So it was and so, what…

Andrew: So he had, what, auto-fermentation syndrome?

Carolyn: Yes, yes. And so, what we…we prescribed some dihydromyricetin, which is really good at mopping up those aldehydes and that yeast, that alcohol. They actually give that to people who have alcohol intoxication. But that, DHM is actually really good at mopping that up. And then you’ve obviously gotta deal with the histamine issue and the mold issue concurrently. So, it’ll be interesting to see, but how amazing that a kid can blow over the limit for the alcohol with no alcohol, just because of his histamine genes. And the yeast, obviously, the yeast exposure.

Andrew: All right. So, how big a problem is this now? Like, how many patients of yours, like, would present with histamine intolerance, as opposed to, say, other conditions that you see?

Carolyn: Eighty percent.

Andrew: Wow.

Carolyn: At the first, initial appointment, 80% of our patients will be put on a low-histamine diet. Now, it doesn’t mean that all of them have chronically bad histamine genes. It can often be environmental. As we said, the mold, the yeast, lime, so many other, can raise that histamine. Because, essentially, even COVID, because what we know is that if you’ve also got inflammatory cytokine genes that are upregulated, like your interleukin 6 TNF-alpha CRP, that will raise histamine levels. If you have excess estrogen levels in your body, that will raise histamine levels. Because histamine is triggered by estrogens. So, you’ve got many environmental factors that may be raising the histamine level, but then the people that really suffer are the people that have the degradation issues, because of their genetics. But that’s why so many people… Because we’ve got estrogen dominance in men and women. We’ve got the exposure to mold, and post-COVID, so many people have inflammation and elevated interleukin 6 levels. And what we’re now finding, in actual fact, is that the homozygous interleukin 6 almost always have a histamine problem. So, there’s a very high correlation between those two different genetic SNPs.

Andrew: Right. So, it certainly doesn’t trivialize histamine intolerance in and of itself, but it can mean, certainly, that it’s not the only thing that you should be directing therapy towards, that you should be looking for other causative agents. The antecedents.

Carolyn: Absolutely. And one of the major triggers is inflammation.

Andrew: Right. Okay.

Carolyn: So, we’ve really gotta be working on that, and finding out what’s driving that inflammation. And it could be gut.

Andrew: Yeah, right. So, here we go back again to the old naturopathic axiom about, you know, that the gut… I don’t necessarily agree to it being the cause of all illness, but certainly a part of the therapy. So, all right. So, do we have any…I mean, do I say the word questionnaires? That we could give practitioners, patients, to learn from, to say, “Look at these issues?”

Carolyn: Oh, yes. Yes. We do. We have a histamine questionnaire that we give our prac members to use in their clinic, to identify people that might be struggling with a histamine issue.

Andrew: Okay.

Carolyn: Yeah. Because it is varied. And if we look at those old charts, you know, that showed where and how histamine spikes, the knock-on effect is not only the direct histamine issues, which is the redness, swelling, and inflammation, really, of any smooth muscle in the body, but it’s, yes, it’s the sneezing, it’s the asthma, it’s the allergies. But it’s also the period pain. It’s the immune dysregulation. It’s the mast cell activation. It’s the neurological inflammation. And it’s not uncommon for us to pick up the histamine problem purely because a woman has, premenstrually, such significant anxiety, and as soon as you address the estrogen and the histamine, it goes. Goes, disappears, doesn’t come back. Even the premenstrual pain and inflammation, it shouldn’t be there.

Andrew: One of the interesting points I picked up from…his name is Professor Theo Theoharides. Interesting name. But I love the way that he methodically goes through and backtracks, and said, “No, what we’ve…before jumping ahead to this conclusion, we’ve gotta test that sort of thing.” It’s kind of like the unwind. But what I’m interested in is, with these people with histamine intolerance, do they always or significantly…are they always or significantly associated with allergic-type disorders, as well as the presenting symptoms? Like, for instance, neuroatypical kids?

Carolyn: No. No.

Andrew: No. So, this is what I find interesting. If it’s mast cell activation syndrome, why are we not getting that degranulation issue?

Carolyn: I think part of the problem is that because it’s such an integral trigger for anxiety and glutamate issues, a lot of the kids and the behavioral issues is because the histamine is triggering something else. And so, if you’re looking at these kids, it’s often… So, what often goes hand-in-hand with the histamine issues is the oxalate issues. Because if you’ve got a yeast or a mold problem, the very production of those yeasts, they’re producing oxalic acid. And oxalic acid, then, is, can often, with these kids with autism and ADD, ADHD, they cause a lot of pain. And a lot of the behavioral issues that you see, where it’s banging your head against the wall, and, you know, rubbing their tummies against tables, and, you know, sore ears and everything, is because these oxalate, oxalic acid crystals, are forming. And they can form in the ear, they form in the gut. They can form in the bladder. You get a lot of urinary irritation. And unfortunately, that comes hand-in-hand with the histamine inflammation, and the histamine response. Because they’re creating inflammation in itself.

Andrew: Yeah, right.

Carolyn: And because you’ve got the yeast and mold, you’ve got the immune response, the inflammatory response, the histamine response. But it can just be anxiety that we see with histamine. It doesn’t have to be allergy at all.

Andrew: Right. okay.

Carolyn: And then, often, you see these kids having really significant effects to Wi-Fi, because we find that a lot of these kids with mold exposure, inflammation, histamine, mast cell, reacts significantly to Wi-Fi. And I had a patient of mine who has had three little boys. And she said to me, “I just, there’s nothing we can do for these kids, and we’ve had to take them out of school. Their behavioral issues are just out of control. And I said, “I really think you’ve got a problem with mold, and histamine. Have you tried turning Wi-Fi off at night?” And she did. But she realized that they were within 500 meters of a… I said, “Are there any towers that you can see?” And there was a tower within 500 meters of the home. So, what she found is, if she…she shut her kids in her dressing room, and made them sleep there in the nighttime, on mattresses on the floor, completely surrounded and protected from the Wi-Fi, their behavior was brilliant. As soon as she took them out and exposed them to that 500-meter radius of that cell tower, their behavior went off the charts. So, I think, very much we’ve gotta consider that the behavioral side, we really do need…that’s an alarm bell, for me, for histamine, mold, and mast cell activation.

Andrew: Okay. And what other environmental…

Carolyn: And they had no allergy symptoms at all.

Andrew: Right. Okay. What other environmental drivers are important to be aware of? So, like, for instance, forever chemicals. I love that, with the way that we call this now. “Forever chemicals.” It’s a lovely name.

Carolyn: Well. It is a lovely name, isn’t it? Well, part of the problem is that they deposit in fat tissue, and they’re gonna be there for years. And if you have, say, something that is affecting your methylation, it’s gonna then affect your detoxification capacity. And the less you detox these, the more you’re going to have liver issues, and the big thing about these molds, and the mold exposures, and some of these chemicals, and particularly that are eliminated through the glucuronidation pathway, that’s the pathway that the mold jams up. So, mold will jam up the glucuronidation pathway, because that’s the pathway that clears mold. So, what we often find is that you’ve got the double whammy, because they have all the endocrine-disrupting hormones, and chemicals, that have to be cleared through glucuronidation, but they can’t be, because the mold is jamming up the glucuronidation pathway. So, you actually find they get more toxic. So, these so-called forever chemicals, and all these things that are sitting in the body, they’re not being eliminated. Because in actual fact, the glucuronidation pathway is probably more important than the glutathionation pathway.

Andrew: Oh, really?

Carolyn: In terms of getting rid of everyday chemicals, yes.

Andrew: Oh, okay. I thought that, like, glucuronidation was the premium one, and then everything else flowed…

Carolyn: Well, we think that…

Andrew: …to a lesser degree after that. No?

Carolyn: …but in actual… Yeah, no. In actual fact, I mean, I’m not saying glutathionation isn’t important, but we’ve got, you know, when you look at phase two, and how you get rid of it, most of the chemicals are glucuronidation. Whereas, and you also have glycination, you’ve got taurine, you’ve got methylation. You got sulfation, and sulfation is hugely affected by a variety of different things, particularly oxalates, because as oxalates come in, sulfur goes out. And so, if you’ve got an oxalate problem, and a mold problem, you’ve got a sulfation problem.

Andrew: Right. So, okay. So, forgive me, Carolyn. I’m just trying to catch up here with my biochemistry, and so, with glucuronidation, we can support that pathway with calcium D-glucarate, right?

Carolyn: Yes.

Andrew: With sulfation, do you support that pathway with MSM? Do you support it with thiols, from garlic and things like that? NAC?

Carolyn: Yes.

Andrew: How?

Carolyn: Yes. So, I did a presentation on NAC at the end of last year, and it really opened my mind to the power of NAC for that whole sulfation. And what we found in clinic is that you’re actually better to start with NAC, I think, than you are to ever go in with glucuronidation.

Andrew: Right.

Carolyn: And everybody says, “Yeah, yeah, but you can’t do that, because it slows down SOD.” But…it does slow down SOD, but it does it for a reason, because it takes the pressure off glutathionation, by slowing the SOD down.

Andrew: Yeah, that’s…

Carolyn: You know? Because when you’ve got an, you know, an upregulated superoxide dismutase, when you do in inflammation, or LPS, or anything like that, you’re creating more hydrogen peroxide. And that is where the glutathione peroxidases have to get rid of it, and catalase. So, if you can’t do that, you’re putting a lot more pressure on your elimination pathway, and this is where NAC is so helpful. Because it’s the cystine that can then get diverted to support sulfation. It’s…

Andrew: Right.

Carolyn: …I think it’s really good, particularly with the sulfation, for our hormones, and our serotonin. It’s also really nice and calming the brain. So, N-acetylcysteine can be really good to reduce glutamate levels. It has so many ancillary things. So, we go in first with… We might use broccoli sprout powder, or, you know, sulforaphane, as you said. If there’s more of the estrogen-type issue, we find that that’s actually really good combo. But we tend to go in with the NAC, because it just has so many ancillary support mechanisms than straight glutathione.

Andrew: What about the facility of just having…. This is for very sick people, chronic fatigue sufferers, people who have got extremely bad histamine intolerance, but just using glycine? Have you ever used that, just to take the heat off for a while?

Carolyn: I tend not to, because glycine, if they’ve got oxalate issues, it can actually be converted to oxalates.

Andrew: Right. Right. Okay.

Carolyn: And it can also affect people who have glutamate issues. So, as a general rule, I don’t use glycine. And that’s one of the reasons why we tend to, in a, with people with histamine issues, we don’t use a magnesium glycinate. We use a citrate.

Andrew: Gotcha.

Carolyn: Because we’ve found that, particularly if you’ve got a histamine issues, most people do have an elevation in oxalates, and therefore, if we use glycine with the elevation in oxalates, we risk pushing it down that pathway.

Andrew: Right. Gotcha. Okay. So, environmental issues. We’ve got… Well, you mentioned hormonal aberration. So, things like, you know, anything from menopause, endometriosis, polycystic ovarian disease. Just so that you know, they are looking at renaming it. So, finally. How long’s that taken? But where you’ve got these… I don’t like the word “estrogen dominance,” but estrogen-driven conditions.

Carolyn: Well, I… Do you know what? I actually do think it’s fair to say estrogen dominance, because, when you’re looking at why and how these people have the issues in the first place, it is because, normally, they have an upregulated CYP1B1, and they have a COMT homozygous. And so, their ability to detoxify estrogens is compromised. So, they’re pushing estrogens more to the 4-hydroxy. And because of methylation, that becomes dangerous, and they’re not converting that to the methoxy. So, I do think it is estrogen dominance, because what you typically see is excess estrogens not being cleared because of these deficient pathways. And so, as a result, you will get that surge in histamine, premenstrually, and mid-cycle. Because…and what you see in blood ratios… So, if you did a 4 to 16 conversion, and/or looked at their DUTCH test, you’ll see that those ratios are out. But if you actually did blood levels of estrogen, you would see that the estrogen is above reference range. But as soon as you start clearing the estrogen, and making it more methylated, less going down that 4-hydroxy, and you improve the, you know, getting rid of the quinones and everything else, you actually see that estrogen level in the blood come to better within the reference range.

Andrew: Yeah, yeah. Cool.

Carolyn: And when you see that elevation, it is shifting your hormones. So, you’re potentially getting less progesterone, and less testosterone, because of that estrogen not being, not going down the right pathways.

Andrew: Gotcha.

Carolyn: And if your sulfation is affected, then you’re going to shunt more down your testosterone pathway than you are the estrogenic pathway as well. So, that can really influence the PCOS side of it. Most of them do have sulfation issues, but you’ve got to ask, where’s the sulfation coming from? Where’s the sulfation issue? Is it an oxalate issue, which is pushing the sulfur out? Is it because they’ve got pathway issues with sulfation itself? Because, don’t forget, PAPS, which is our universal sulfur donor, like SAM-e is our universal methyl donor, PAPS is our universal sulfur donor. And we make PAPS through our CBS, or cystathione beta-synthase pathway. And that’s where we need our cysteine. So, the cysteine comes out, with the help of B6, and you convert it, and make sure that you then take your sulfites to sulfate, and that’s how you make PAPS. And that’s your real sulfation support. So, I always think, I look at that distinction between the DHEA and the DHEA-S, and if you’ve got a lower S, we know that we’ve really gotta work on that sulfation pathway. If you’ve got a deficient CBS, or you’re deficient in B6 because you’ve got an oxalate problem, then you’re gonna have less sulfation. So, you know, it is all tied in, and you’re quite rightly asking the difficult questions, but it is…there’s so many elements…

Andrew: Oh, yeah.

Carolyn: …that need to be considered when you’re looking at all of these, you know, the hormones, and the effects of these pathways, because they’re all influenced, A, by genetics, or B, by environmental influences. Or both.

Andrew: You can see, everyone, why you need to do Carolyn’s course, so that you understand all of this

Carolyn: Yes.

Andrew: Carolyn, can we get more into therapy? So, for instance, things like proteolytic enzymes, bromelains, quercetin, things like that? There’s a herb that, it just seems to have fallen out of favor. I don’t know. And yet, it’s an actually, it tastes incredibly beautiful. Perilla. Perilla

Carolyn: Oh, we use it a lot.

Andrew: Right. We don’t hear about it anymore.

Carolyn: So, well, we use it in our clinic every single day. And the distinction, for us, between perilla and quercetin…and I say quercetin now, because I have so many American followers, and they say quercetin, so I apologize. But we, if you are COMT plus plus, we prefer to use perilla. Because perilla has no effect on the COMT enzyme, whereas quercetin slows it. And so, if you’ve got someone who is slow COMT, you’ve gotta be very careful with your dose of quercetin, because it will cause anxiety. So, we prefer…we use a combo, but we, it really does depend on their genetics. And we find that a low-dose, you know, quercetin is good for those with the COMPT plus plus, so we might, when I say “low dose,” it might be one twice a day. But we would go to two, three times a day if someone has a, say, a slow COMT, or they’re COMT heterozygous with a significant histamine issue. Outside that, we use perilla, for all those COMT plus plus, we go hard on the perilla, and we love it. We get capsules of it, and we’ve also got it in a liquid. But then you have the problem with your liquids.

Andrew: I know we’re not… Yeah. Well, I wanted to discuss that in a tick, but yeah.

Carolyn: The problems with the…

Andrew: So…

Carolyn: …the liquid is the alcohol.

Andrew: Yes. So, before we go on to that, just other herbs. I know these are sort of termed as “anti-allergic herbs,” in quotation marks, but things like Baikal skullcap, Albizia lebbeck. Do we… Sorry. Scutellaria baicalensis and Albizia lebbeck, I should say. So, do we use those in histamine intolerance, or is that more for…

Carolyn: Yes.

Andrew: …Franck IgE reactions? You do. Okay.

Carolyn: We do. And Scutellaria baicalensis is probably my favorite herb of all time. And I say that because…

Andrew: Wow.

Carolyn: …it has the antihistamine, but it is also obviously calming for the nervous system. It can reduce the glutamate, but it actually has an epigenetic effect on a lot of these enzymes. And I pretty well never leave Scutellaria baicalensis out. It is just such an amazing herb. And every pathway can benefit from Scutellaria baicalensis. It is, honestly, my favorite go-to herb. Albizia I would use if I had that, you know, someone with that sort of allergic asthmary-type effect, but…and it, but, as a general rule, our go-to is perilla, quercetin, Baikal skullcap. They’re our three absolute favorites.

Andrew: Yeah. Gotcha.

Carolyn: And then we go with, we also use DAO enzyme. We use histamine-based, antihistamine-based probiotics…

Andrew: Probiotics, yeah.

Carolyn: …and we use IgGs.

Andrew: Right, okay. So, I don’t want to jump the gun, because I definitely wanna look in… Oh, hell, let’s go with alcohol. Fluid…

Carolyn: Okay.

Andrew: …alcoholic fluid extracts. Now, I discussed this with another practitioner who’s right into this, Rebecca Hughes, and she was saying that, you know, these great herbs that we have at our disposals, it’s sometimes not the herb that’s the problem, but the actual extract that we’re delivering them in. So, take us through what the issues are, and how we overcome those.

Carolyn: Well, as we’ve been talking about it, alcohol, it raises histamine. It’s one of the, the number one, outside, say, tomatoes and chocolate, it’s probably one area where most people will react if they’ve got a histamine problem. So, the alcohol-based herbs are definitely a problem. We now use a lot of glyci tracts for those patients. And we’ll do a glyci tract formula that is low-alcohol, which is low-histamine. We tend to use buckets and buckets of perilla, and quercetin, as a capsule. And then we use homeopathic antihistamines as well.

Andrew: Okay. And, so, to…

Carolyn: You have to do everything… When someone’s in this really allergic response, you’ve gotta throw everything at them. And when you put them on a low-histamine diet, really, within three weeks, if you go hard, you’ve really seen huge improvement.

Andrew: Right. Let’s now talk about probiotics, because this is an area that a lot of praccies get confused about. Take us through some of the good species. And I don’t know whether we wanted to go strain-level, but take us through some of the good species, and some of the species of concern with histamine

Carolyn: Excuse me. Yes. Now, there’s a product that we use overseas, and the problem is that we can’t get some of the strains that we really like. I’m just bringing up my list for you, because I’ve done a fair bit of research on this. The gut, in the gut, the one…the histamine-producing bacteria that we see have the biggest effect are the Morganella, Klebsiella, Citrobacter, Enterobacter, and some of the Lactobacillus species. So, whenever we see Morganella, we know that we’ve got a histamine problem. Pretty well, 100%, if you see Morganella, you know there’s a histamine problem, because it just produces so much histamine. But the ones that we really like are the Bifido infantus, the Lactobacillus gasseri, plantarum, rhamnosus, and salivarius. They’re pretty well the best ones, and we find that the spore probiotics, we’re using more and more now, because it really helps reduce the endotoxins by about 42%. So, we use…

Andrew: This is the sporogenes you’re talking about? The, sorry, what’s it called now? Coagulant.

Carolyn: The spore. The spore probiotic. Yeah.

Andrew: Yeah.

Carolyn: And, you know, the… Are we allowed to say product name?

Andrew: No.

Carolyn: No. Yeah. I only know the product name. I can’t tell you what strain it is, but it’s a spore probiotic. And so, what we’ve found is, we use now a combination of a lot of probiotics with these people. So, we could…

Andrew: I think I know which… Oh, sorry to cut in, Carolyn.

Carolyn: No.

Andrew: I think I know which one you’re talking about. It used to be called Lactobacillus sporogenes in the old days. Now it’s called Bacillus coagulans.

Carolyn: Yes. Yes.

Andrew: Yeah. Forgive me. Continue.

Carolyn: Yes. And, no, that’s fine. And what we’re finding is that it’s really, we use, say, we might use an SB probiotic, with a histamine-reducing probiotic and a spore probiotic, all on the same day.

Andrew: Well, okay.

Carolyn: So, we might use one at breakfast, one at lunch, and one at dinner. And we’re finding that, really, using those high-dose probiotics are amazing. Because it just helpens to dampen down, and we’ll use a binder. Often we go in quite low, with, you know, say a charcoal, something really simple to start, once a day, and then as they progress, we’ll go to the stronger binders, because the problem is, you go in with a really strong binder up front, you’re pulling out a lot of stuff, and a lot of these people, particularly with the mold, their detox pathways are jammed. So, and they can’t detox, so you don’t want a detox. We have a pre-tox program, where we get the bile moving. You know, we make sure that we’re sort of addressing things really simply, making sure that they’re going to the toilet every day, putting the probiotics in, helping them with the DAO enzyme. All of these things are super helpful, with the diet, to dampen down that histamine response very quickly.

My favorite anti-inflammatory at the moment, for a variety of different reasons, is resveratrol. And I use that because it’s a great neurological antioxidant. It helps upregulate catalase, which is one of those enzymes that’s helping rid the hydrogen peroxide, and helping recycle, with that glutathione peroxidase. It’s just a brilliant anti-inflammatory. It’s safe to use in preconception. It’s safe to use in pregnancy. And so, we’re actually finding a lot of research studies that are saying, even through pregnancy, it’s really helping with the anti-inflammatory effect, and helping the placenta, and the health of the placenta. And so, a lot of women have histamine problems in pregnancy, and so we use that as one of our strategies, with the other things as well.

Andrew: Gotcha. Is this, can I ask, all trans-resveratrol? What dose do we use? Have we got any data?

Carolyn: We use a 99% trans-resveratrol, at 500 milligrams, once, sometimes twice or even three times a day.

Andrew: Whoa. Okay. That’s decent.

Carolyn: Yeah. Well, you’ve…

Andrew: Now, those…

Carolyn: …got to. You gotta go quite hard to get the reaction that you need, because, remember, epigenetically, when we want a nutrient, or a vitamin, or a mineral to have an effect on an enzyme, you have to sometimes use really big doses to have that effect.

Andrew: Okay.

Carolyn: Because we’re really trying to either upregulate or downregulate something, and you’ve got to use quite high doses. So we go back to the research, and we say, what does the research say that the optimal dose is to have an effect on this enzyme?

Andrew: Gotcha.

Carolyn: So, we don’t use little doses. We use what the research tells us is an efficacious dose to get the effect we want.

Andrew: Yeah. Yeah. You mentioned something else that greatly interests me, and that was IgG. Take us through that, because it’s now available in Australia, and, like, I am a, still am, a big proponent of colostrum. This is just taking it to a next level, and I’m just so excited about this.

Carolyn: I…do you know, I’ve never been a fave, a fan of colostrum, because every patient I ever gave it to reacted.

Andrew: Really?

Carolyn: And that’s what led me to this. And I thought, “I really wanna try this on my high-histamine patients.” And we’ve been using it for years. And it’s one of my favorite go-tos when someone has this histamine response. And our, my little prescription for them at bedtime is the IgG, with the probiotic, and some magnesium, and go to bed. And we step up the dose of the immunoglobulins, because what we’re finding is that it not only helps digestion and the mucosal system, but it has an amazing effect at reducing inflammatory cytokines. And that’s what we want. We cannot reduce histamine unless we’re reducing the inflammation. Because the inflammation is always, always going to drive histamine.

Andrew: Yeah, right. Right.

Carolyn: And so, we’ve been getting…

Andrew: What about…

Carolyn: …really good effect.

Andrew: What about other things, like these really innocuous herbs, slippery elm, apple pectin? And I’m quizzical about glutamine. Are you worried about a glutamate issue there?

Carolyn: Ah.

Andrew: Tell me.

Carolyn: Yes, I am. And I don’t often use glutamine until I know I’ve got glutamate under control. If I can see that there’s problems in glutamate or B6, I won’t use glutamine. Not that I don’t think it’s fabulous for gut, but there’s too many ancillary, you know, neurological issues that happen with the glutamine being converted. And if they’ve got problems with GABA, chances are you’re going to be shunting that glutamine into glutamate, and we don’t want that. So, I tend not to use that. I tend not to use a lot of apple pectin, unless we’ve got Helicobacter pylori, and I’m going in with a definitive, you know, protocol. But as a general rule, no. We dampen down the gut with the probiotics and the immunoglobulins. We get histamine out of the diet. We use the quercetin and the resveratrol to dampen down the inflammation. And that’s really our go-to protocol, really. And as I said, it’s really important we do a pre-tox if they’ve got detox issues. So, that will often be the way that we approach it.

Andrew: Yeah. I gotta say, Carolyn, every time I chat with you, before I chat with you, I feel like, “Yeah, I’ve got a handle on things. I’ve had some experience.” And then after I chat with you, I feel like an infant. I wanna go back and learn it all again.

Carolyn: No, it’s not that.

Andrew: Thank you so much.

Carolyn: It’s just… It’s not that. You’re not like that at all. Don’t feel like that. It’s just that it’s new concepts, and it’s things that, we’re just expanding our horizons, and we’re just learning more and more. And my, I guess my message to all the praccies listening to this, they go, “Oh my god. That’s so complicated.” Don’t think of it like that. You know, just pick your little…pick your area of expertise, where do you feel most comfortable, and just delve into the genetics of your field. You know, what is it that you really love to look at? And then just explore. And, you know, we’ve got a lot of resources on our website. Just play with it. And if you feel like, we’ve got a lot of practitioner programs that can help people, to sort of… It is a bit of a minefield when you start, but it makes so much sense. And what really spurred me on in the very beginning is that a doctor, a reporter told me that MTHFR was just a fad. And I said, “It’s a biochemical pathway. How can it possibly be a fad?”

Andrew: Yeah.

Carolyn: You know, yes, I think we’ve got a lot more environmental things that are affecting it, but genetics can’t be a fad. You know, you either have a genetic predisposition to something… And we don’t look at genetics that cause disease states. We’re looking at metabolic genetics. How do you make your B12? How do you make your folate? Can you use it? What’s your detox pathway like? These things help people, every day, sort of, run the gauntlet of diseases, and it makes a difference how they bounce back versus how they don’t. And this is where we see the benefit.

Andrew: Absolutely. Yeah, absolutely. Like, even in just clinical orthodoxy, forget integrative medicine, just orthodox medicine, how can you bypass the import of looking at single nucleotide polymorphisms in those people that are on triple therapy for Helicobacter pylori, when you know that there’s a significant portion of patients that aren’t going to get efficacious eradication of that organism, and therefore, they’re gonna have to go on to quadruple therapy, or rescue therapy later on, because their compliance is crap. What if you could improve that compliance? That’s genes. There are some people who need double the dose of omeprazole. We know this. This isn’t a fad. This is medicine.

Carolyn: Yeah. Yeah.

Andrew: Like, this is crazy.

Carolyn: And the exciting thing is that the research is evolving every day, and they’re looking at combinations of genes. I mean, that’s what people are really interested in. Because if you’ve… And we’ve seen it with some of our patients. You know, you can pick up a few key SNPs that can be absolutely life-changing, if you metabolically fix the issue. And it means that they go forward, and they don’t…they might, yes, they might get a little bit sick here and there, but they never fall in this, the hole that they have been in before, and that’s where it’s really powerful.

Andrew: Carolyn, I love your heart. I love your dedication. Not just to patients, but for furthering the science for practitioners to be able to grasp ahold of things later on in their career. So, thank you so much for your work, and thank you for joining us on “Wellness by Designs” today.

Carolyn: Thank you so much for having me. I really enjoy these conversations. We have to do another one.

Andrew: It is my absolute delight, as always. And thank you, everyone, for joining us today. Remember, you can catch up on whatever we can put up on the website. It’s gonna be huge. And also, of course, the other podcasts on the Designs for Health website. I’m Andrew Whitfield-Cook. This is “Wellness by Designs.”

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