Last Updated on December 4, 2025
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Do you feel like you get crazy histamine intolerance symptoms as your body reacts to everything — certain foods, smells, stress, or even the weather? Maybe you’ve got itchy skin, random rashes, headaches, or bloating that flares out of nowhere. If that sounds familiar, histamine intolerance might be a significant problem.
Before you start a low-histamine diet, there are two really crucial things you need to know.
First, it’s highly likely that you don’t have histamine intolerance despite having symptoms of histamine intolerance. (I promise I’ll explain more.)
Second, having histamine intolerance symptoms doesn’t mean you should blame food. Especially if you’ve already tried cutting out histamine-rich foods or loading up on DAO supplements and haven’t seen results, there’s more going on under the surface.
Yes, histamine intolerance is real.
BUT it’s way overblown in the integrative and functional medicine world.
Today I’m sharing an interview I did with Alyssa Simpson, RD on the Gut Health Dialogues podcast, diving into all of this. After working with over 1,000 clients, I’m going to share what histamine intolerance really is, how it differs from mast cell activation syndrome (MCAS), and why your skin and gut symptoms of histamine intolerance signal that something deeper is out of balance.
We’re diving into how infections, mold exposure, poor liver detox, and even hormone imbalances can quietly trigger a cascade of histamine intolerance symptoms that can drastically wreck your quality of life.
And if you want more help with this, download my free Skin Rash Root Cause Finder!
So let’s dive in!
Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android
In This Episode:
- What do histamine intolerance symptoms really mean?
- Why DAO supplements aren’t working
- Difference between histamine intolerance, MCAS, and mastocytosis
- What does it mean to have histamine overload?
- List of histamine-producing gut bacteria
- Two significant factors that drive histamine intolerance symptoms
- Histamine, estrogen, and liver detox: What’s the link?
- Why most itching is not histamine-related
- Where to get started figuring out your histamine intolerance triggers
Quotes
“Most itch is not histamine driven…Skin infections can cause itch [as can a] thyroid problem.”
“It's not just the mast cells that are the problem within the body. You can be a literal walking histamine production factory and not even realize it.”
Links
Check out my FREE Root Cause Finder
Healthy Skin Show ep. 270: Low Histamine Diet: Is It Good Or Bad For Skin Rashes?
Healthy Skin Show ep. 257: Itchiness + Histamine Intolerance – Why Am I Itchy?
406: Histamine Intolerance Symptoms: Everything You Know Is Wrong (And Why A Low Histamine Diet Won’t Stop Chronic Hives) {FULL TRANSCRIPT}
Alyssa Simpson (00:00)
Hi everyone, we're diving into the complex and often misunderstood world of histamine intolerance and how it connects to both gut health and chronic skin conditions. I know a lot of you listening are dealing with food sensitivities, skin flare-ups, and feeling like your body is reacting to everything. And this conversation is going to unpack what might really be going on beneath the surface. And I'm excited and honored to introduce today's guest because not only is she incredibly knowledgeable, but she brings a powerful mix of clinical expertise and personal insight that makes her work so impactful. Welcome, Jennifer.
Jennifer Fugo (01:42)
Thank you for having me.
Alyssa Simpson (01:45)
So you didn't start out in this world as a practitioner. You were actually a patient. Right. So can you tell us about your story and how you got into this?
Jennifer (01:55)
Yeah, well, I will say one thing that I think people really appreciate that I can really empathize with where they're at because when I started, and actually it was during grad school, I developed a form of eczema on my hands called dyshidrotic eczema. I did not have any histamine intolerance issues, but just the eczema journey alone, which was extremely frustrating. You don't realize how many things that you need your hands for, like simple things become unattainable and life and quality of life gets smaller and less colorful. There's less options and you just feel like shirking away from life entirely. And so that was really what drew me into this space. Space. Ironically, I originally I would see a lot of clients that were just like primarily gut-focused.
Jennifer (02:51)
But then I started to get clients where every single one of them had some type of chronic skin condition. It just seemed like they wanted to, like, oh, well, but I have gut issues. I want to focus on that. And so it was a journey to really learn so much about how skin is impacted. Within the functional medicine paradigm, it's different than just gut issues. It's a longer, more complex journey. And specifically around histamine intolerance and histamine intolerance symptoms, really thinking about it in a way that I never learned about it. So, like, the way that I was taught about histamine issues is not really how I practice, because I had to start thinking outside of the box in order to help people get lasting results so that they didn't need to stay on their antihistamines or even, like Xolair, for example.
Jennifer (03:49)
So that's how I got into this.
Alyssa (03:53)
Wow, that's so much to unpack right there. Because I think probably the listeners are thinking, okay, are we talking about skin? Are we talking about histamine? Are we talking about the gut? Well, we're talking about all of it because it's really hard to separate these issues, isn't it?
Jennifer Fugo (04:09)
It is. It's very difficult because they are so interconnected. And I think one of the biggest mistakes that I have seen clients consistently make is that they are looking for the one thing. They're like, what's the one thing I can do that's going to make all this go away? And while I would love to be like, oh, okay, it's this or it's that or try this supplement or take this out of your diet or start a histamine intolerance diet, the problem is that histamine intolerance, when once it gets to a where it's now showing up and manifesting on the skin, so it's not just like. So first of all, I should put out there that eczema specifically, and this is one of the biggest points of confusion, is that most people assume that if you have eczema, you have a histamine intolerance symptoms problem. And that is completely wrong.
It's actually less so that you have a histamine intolerance if you have eczema. So it's more common that it's not a histamine intolerance issue than it would be. Histamine intolerance and histamine intolerance symptoms for sure look like chronic hives, urticaria, and even the autoimmune type. Or they will tell you, oh, we don't know why you have urticaria. Can be triggered by pressure to the skin, exposure to the sun, heat changes, that kind of thing. Dermatographia so if you draw on the skin and that it's like, that's what it is. It's literally skin drawing. So you could, like, scrape your skin and it'll welt up in that exact pattern. Angioedema where there's swelling. Those are really significant histamine intolerance issues, more so than it's just impacting your digestive system.
Jennifer (05:56)
And it's not quite to the point where we would say you have mast cell activation syndrome or MCAS. That's a more significant, more serious, complex problem. And then mastocytosis would be on that in those two instances. I kind of feel like you might do better with a physician, like an MD or a DO, as opposed to trying to sort it out yourself, because a lot of times you need medications at that point that, like mast cell stabilizing medications. But when it comes to histamine intolerance symptoms, gosh, there's so much to this because there are areas that can be impacted. Like you mentioned the gut, but also a lot of people don't realize that it's impacted by what's happening within liver detox as well. So there's a lot of different areas that we want to start to look at and hone in on.
Jennifer (06:48)
And oftentimes it's not just one thing that's going wrong, because sometimes people will have, for example, a particular infection, or they could have a really messed up dysbiotic gut microbiome, for example. And there's different things that can actually drive histamine tolerance within the GI tract. Recently, actually, this was aired already on YouTube. So I'm not saying anything that hasn't been aired yet. But on my podcast, I interviewed Dr. Mariana Castells. She's a mastocytosis expert, I think, at the women's. It's in Boston. She's at a hospital. They have a whole mastocytosis center. And what she's interestingly shared on the show was that the amount of histamine produced in the body (when somebody actually has a real true histamine intolerance issue) is like 1,000 times more histamine than what you get from food.
Jennifer Fugo (07:45)
And yet we fixate on food and we're like, let me cut everything out and that'll make it go away. And then you don't get any better. And you're like, now what? And it's because the amount of histamine that we're getting from food, it's not that you know, histamine is bad. We need it. It helps us stay awake. But we also have to put it into context. If it's not just the food, if there's other things. And we need to start looking at the histamine bucket, the other triggers that are potentially causing not only histamine release, but also producing histamine within the body itself.
Alyssa (08:20)
Yes. I like that you said the bucket, because that's how we like to think of it. Right. It's not that it's bad. It's not. It's a natural part. So histamine is a natural part of your body. It serves a function. It's in foods. It's produced by the immune system. But when our bucket overflows, we get too much. That's when we have issues. And that can be caused by not being able to degrade it. Right. Either in our gut or in our cells, or overproducing it. Right. So we're talking. And so the way I think of it is there's histamine intolerance, I think about not being able degrade it more so. And then mast cell activation, where there's overproduction. Is that. And then you mentioned mastocytosis. So is that how you think of it? Can you clarify that a little bit?
Jennifer (09:12)
Yeah, absolutely. I love that question, actually. So thank you for asking, because it's. It's like, I love. I'm just a curious person, so I'm like, let's talk about this. Let's understand complex.
Alyssa (09:23)
I have to, like, categorize it in my life somehow, because everything's so circular. It can get out of control.
Jennifer (09:31)
It can be really overwhelming. So if someone is listening to this and they're like, oh, my gosh, this is so much bigger of a puzzle than I even realized. I feel you. I'm a visual learner, so that's one of the reasons, like in my episodes on the Healthy Skin Show where I talk about histamine intolerance, or specifically, I actually call it histamine overload. I've made all these graphics because that's how my brain works, and I feel like that's helpful for. Do find this confusing. And a lot of people do. And I'm not saying I know everything. I certainly don't. I learn things every single day, which I love, so I think of it more. So, yes, we have the enzymes that break histamine down. So there's an enzyme within the GI tract called diamine oxidase, or DAO.
Jennifer (10:17)
You can obviously buy supplements of DAO as a supplemental replacement. There's that. And then within the cells, we have the HMNT enzyme that breaks down histamine within the cell, but what's produced and what's available, kind of histamine-wise, within the GI tract, the only thing that's breaking that down is DAO. Now, I don't know what your experience has been, but most of my clients who have these issues find the DAO supplements to be completely not helpful. And so I started to think about that because I'm always curious, like, why isn't something working? It's great when, like, you go on all these, like, naturopathic and functional medicine websites and they're like, oh, take this. And I'm like, yeah, but that doesn't work. Like, why doesn't it work? I want to know. I'm not just going to, like, take it at face value.
Jennifer (11:05)
And so what I realized was that it's not just the mast cells that are the problem within the body. You can actually be a literal walking histamine production factory and not even realize it. And that was where that was why. So I started to ask this question about DAO. I'm like, well, why does DAO not work? Because all these functional doctors at the time, so this was back in like, let's say 2018, 2017, 2018, were still like, oh, we should test for a genetic SNP of the DAO enzyme. And I'm like, but why, like, just supplement? Like, I don't know. I don't like to waste people's money, right? Let's go the simplest route. And testing for a DAO SNP is expensive. So I tested this out and a lot of people didn't respond.
Jennifer (11:54)
They noticed no improvement whatsoever and didn't feel any better. So. And I'm thinking to myself, like, well, maybe there's like, is it possible that there's so much histamine that even the supplemental DAO isn't actually helpful? Because that could be possible, right? If it exceeds the threshold, even with supplemental DAO, the answer is not, well, let's just throw in more DAO, right? So that could be a solution, but to me, I want to know, well, then what's causing that? And that was where I started to look at organisms that either could destabilize mast cells, thus causing these mast cells that have. I think of them as like little histamine warehouses. Like, they dump their histamine, right? Like an Amazon warehouse, and all the packages spill out all over the floor.
Jennifer (12:44)
At the same time, there are organisms that produce histamine, and that's a bigger problem. That's something we can't account for. And it's often totally ignored. I'm sure you find this, that in conventional medicine, it is ignored to look at what organisms could be causing this sort of histamine response. There are some organisms that drive up our more allergic side of the immune system that will elevate, for example, your eosinophils. They'll elevate your total IgE, which most people would go, oh, that's an allergy marker. No, there are organisms crawling around and squirming around in your body that will also do that same exact thing because they play on that side of the immune system. And so that was where I started to really get curious about this whole microbiome component.
Jennifer (13:42)
And yes, then we have obviously allergies in our environment. Another factor, I don't know. You know, a lot of your listeners might not realize this is if you have certain allergies to, for example, ragweed. What most people don't realize is they'll go, oh, I'm. I have a ragweed allergy. Like a significant one, that if they walk out during ragweed allergy season, they need like a Zyrtec or they're like, they're not in good shape. Right. It's a rough day. They're taking liver detox supplements. Except the liver detox supplement contains milk thistle, for example. Milk thistle’s in the ragweed family.
Alyssa (14:21)
Or artichoke, too. Right?
Jennifer (14:24)
I don't know about artichoke, but stevia is also in the ragweed family. So dandelion root.
Alyssa (14:33)
Dandelion.
Jennifer (14:34)
Dandelion. Dandelion and milk thistle are both in the ragweed family. So if you have a ragweed allergy, those can be causing you to actually feel worse. And so there's that. Plus you can have oral allergy syndrome, which I know they renamed it, but basically, like, if you eat cherries and your mouth feels all funny and you're like, oh, I feel like my lips are starting to swell a little bit. That can because you have. Oh, goodness, that's the stone fruit. I think that's birch. Exactly. It's a cross reaction. So we have those factors. We have mold exposure. Right. Because mold can also do some of this fungal overgrowth.
So there can be a lot of things that can contribute to this where, you know, even estrogen, if you have estrogen dominance, that can make your cells way more sensitive to whatever histamine is produced in your body. And thus, because the cells are more sensitive to it, you feel worse. So even your hormones can cause an issue. So it's not to say that somebody has all of these things, and I don't want anyone to go, my gosh, I have, like, everything. I am a mess. Like, how would you even start with this? But it's crucial to really get clear on what exactly is going on, because then you, as I'm sure you do for your clients, you can create an action plan that helps unwind this mess in a way that is efficient.
Sort of like if you had this, like, tree of options, I think of, like, those buckets, and you fill up one bucket and it feeds the other buckets so that everything that you do is sequentially more. More effective. Instead of starting at the bottom and having to fill each rung, how do we efficiently get from top to bottom in a way that actually, like, is helpful?
Alyssa (16:35)
So, yeah, absolutely. I talk about this all the time with patients because they'll ask, like, you know, like, someone will take a gut healing supplement and I mean, they'll do all the right things, right? They could be taking all the right supplements. They could be taking the good brand of probiotic, the good brand of gut healing supplements, plenty of glutamine, all this stuff, and they'll wonder why they're still not better. And it's because you have to do the right things that are targeted to what you actually have going on, which could cause a lot of similar symptoms from different causes in the right order.
Because if you're just throwing a gut healing supplement, say, but you have, like, a raging case of Candida, you know, you have a lot of inflammation that's continuing to be driven. The glutamine can't even help your gut lining to heal when that inflammation is still there. So it's really what you're describing. I love that visual. It's like, take it one step at a time. Only when we clear the overgrowth can the gut lining even be allowed to heal. So don't bother with these supplements here until you're further down the line.
Jennifer (17:48)
And I will. I'll just share, too. Like, I had one client who had really severe hives. And so I just want to say for anyone who is really struggling with this, where, like, your quality of life has significantly been compromised. So this one client, she had such severe hives and dermatographia everywhere. Like, I just remember one of our calls, and she was like, I feel like I'm like, almost at the end. Like, I don't know how I can continue like this because I can't sleep, I can't function, I can't work, I can't do anything. I can't even put on certain clothes because if the clothes press in the wrong way, I explode with hives. And I'm so itchy that I can't be in my body anymore, and I don't know what to do.
Jennifer (18:41)
So this individual, she was on somewhere between six to eight doses of antihistamines every day and on Xolair. And she was, I wouldn't have even known. She, like, literally was pulling down her shirt and just showing me how welted up she was. And so one of the things we realized, I mean, I really love digging through a case because it's not just what happened in the last six months. It's not what happened the, even the year before the symptoms started. I want to know what your life looked like when you were born and moving forward because, you know, look, I'm sure you had the same experience. I went to college. I lived in an old dorm. I'm sure it was moldy, and, you know, those moldy exposures can influence your microbiome.
But for her, we did a stool testing and looking over her case, I believe she had H. Pylori, which is an infection of the stomach. It's fairly common. I think 50 to 60% of the world's population has H. Pylori. And you can also, it's very common to have like a silent infection where you don't even have the classic, like, heartburn symptoms and whatnot, but know you. She had, so this was one of the most interesting things, and I've only seen this twice, but she had a Yersinia infection in her gut in addition to fungal overgrowth. So she had a candida overgrowth issue and she had parasites, but she had yersinia get flagged on the test. And I've only had one other case of an individual with urticaria who also had Yersinia. And Yersinia can cause a huge amount of histamine to be produced.
And so when the doctor treated her for the Yersinia, because I am not at all against medication. I think there's a time and a place for it and we have to consider the well-being and the suffering that person is like, she could work, she could function. Like what kind of quality of life is that? Right. So in that instance, let's utilize conventional medicine as best we can. And in treating, I think she got antibiotics for the Yersinia and she was then treat with antifungals and she had a huge improvement in things. And then we did some more work with herbs and whatnot to work on some of the other things. And within, let me think, we started in January.
By the time she got to June or July of that year, she was off all of her antihistamines and she was slowly titrating off of Xolair. She's now off Xolair and doesn't have any issues anymore. And she's not like a rogue loan case because we work with a ton of people who have urticaria, hives, dermatographia, etc, and so it's important to consider all of the things around you that could be potentially causing this. And of course like you can have. It's weird to have a histamine overload issue with like psoriasis, but it does occasionally happen. You could have a histamine component if you have rosacea, that is possible. But not all rosacea, just like not all eczema, is a histamine issue. But I just, I find it fascinating to like dig.
Alyssa (22:08)
Yeah. And that was. That story you just told is such a great explanation and example to frame why you order that DAO supplement off of Amazon. And it doesn't do anything because it's a drop it. Not that it's not breaking down the histamine in foods, but those are, that is just such a small piece of the bigger picture of the problem. And so understanding what are your underlying causes? And so people listening to this are probably thinking, okay, that clicks. That's why the one supplement I bought didn't work. Or that's why I went on the low histamine diet. And I'm still, it's helping, but I'm having all these problems still. So. And then the other problem with histamine and even yeast and mold, it's tricky to test for these things. It can, we can have some indicators.
So let's talk about that next. How does somebody evaluate this? I think this is shedding light on how Important it is to work with a clinician who understands these issues. Right. Because the primary doctor doesn't.
Jennifer (23:19)
No, I think one of the problems is that doctors are looking for infections and these are not necessarily infections, right? Candida, and again, I think it's worthwhile to mention that not all fungal overgrowth is necessarily Candida overgrowth because there's other types of fungal organisms like Rhodotorula and Geotrichum. So you could have different organisms or even different types of Candida species that have overgrown. So I think that's important to consider. The big thing that I've, and I've talked about this on my podcast quite extensively, that all stool testing, including. So first of all, if you're getting stool testing through like Quest or LabCorp, there's a high likelihood it's going to look fine and it's not. So you can't necessarily go by that. I hate to break the news to you.
Second of all, even if you get like a GI map, GI360, a GI Effects, it's probably going to come back and look fine and it's not. So you have to know what things to look for. Like I was just saying, how would you know to go all the way back to, say, college or childhood and consider what was going on in your house? What if you lived in a basement apartment for most of your life that was super moldy? Are you telling me that magically because you're 25 or you're 35 or 48, that because you were there for 15 years, it didn't have an impact on where you are now? Of course it did. Everything affects everything else. And when we're in a moldy fungly environment, that's going to influence not only our exposure to mycotoxins, which hopefully you've cleared after all that time.
Hopefully. But it's going to influence your gut microbiome. And then we factor in what your diet look like, what you then what happened in college, because I made pizza and beer and all sorts of stuff, you know, and who knows what your diet looked like, you know, in your 20s and 30s and 40s or even presently. And antibiotic exposure, birth control, pill exposure, all sorts of things. So stool testing is not perfect when it comes to both candida and fungal organisms, as well as parasites. There's a lot of times it'll show false negatives or even if it shows up positive and it's not high, it's just like normal, it's within range. You shouldn't see them at all. So realistically, you want to address that because fungal overgrowth occurs, it originates up in the small intestine.
That's where fungal organisms live. We can't test the small intestine, unfortunately, for the fungal population. So if it's grown far enough down to show itself on a stool test, you have a small intestine problem for sure. And you pop, you have a large intestine impro problem as well. And I know somebody will go, but I had an organic acid test run. The problem is that not all fungal organisms that overgrow produce the organic acids that show up on those tests. And I will also say that I realized quite quickly because I used to run the organic acid panel from Genova like, really frequently when I first started practicing. And I realized that even though I know everybody looks for highs on that, but I realized that if you were above the like.
So it's for anyone who's had this test runner, if you've seen it as a practitioner, you know that it's the, they have, this is a little bar that's in quintile, right? It's broken into five. And so if you get into the fifth quintile or high, then you have a problem. But I realized if anyone was above the third quintile, so in the fourth and even in the fifth and it wasn't high, you had a problem. And so you only know that from working with clients and seeing patterns repeatedly and then starting to ask questions. And so I find that microscopic stool tests of looking for fungal overgrowth and parasites tend to better. But even that sometimes is not perfect due to biofilm formation within the GI tract, where they kind of build like these force fields.
So fungal organisms build force fields that like, kind of hide them. They mask themselves against the wall of the GI tract. And unfortunately, what can also hide behind those biofilms are worms or helmet infections, bacteria, some, not all, can also produce biofilms. And what will hide behind those biofilms? Films include protozoa. So sometimes you might also like at your first GI map or GI effects or whatever. And you've never done any herbs or anything that could have dissolved the biofilms. It might only show up as, oh, you've got some bacterial problems. The problem is A) we already know it's bad at picking up fungal and parasites. So we need to look, go through the case to understand that. We need to look at symptoms. We need to look at your blood labs and understand the context in which these results are framed.
And on top of it is, as you start working on things, sometimes testing will look worse after a while because now all of a sudden, you're, like, peeling back the layers and finding more things that you didn't even know were there. And sometimes I'll be talking to a client and I'm like, I can't tell you that you have a parasite because I have no proof of it. But you have all of these signs, and I feel like we have to put, like, a question mark next to parasites or fungal organisms and, like, kind of keep a side eye on it, because I have a feeling that's possibly the case. A recent case of mine, this was really fascinating. I get weird cases. I work with a lot of, like, doctors and surgeons and nurses. And I got this one weird case.
This kid ended up with really bad urticaria after getting braces put on, and nobody could figure out why. And I was like, well, I went through the case and I'm like, I think he has, like, a parasitic issue. I think he has a fungal issue. But nothing showed up on stool testing. I think I forget, like, which order we did things. So I apologize about that because we've been working together for, like, I think about eight months now. And we've really made a lot of great headway. But it turned out that we did a lot of work. And also using some herbs that sometimes can dissolve biofilms in a gentle fashion. And now he had a stool test come back that said that he had, I think, fungal organisms. And. Oh, gosh, was it blasto? No, he had helminth infection, so worms.
But they can only see that they're, like, in the baby form, so larval nematodes. And the mom was like, well, what does this mean? Like, is he. And I'm like, no, we just. We've been working on the gut. We've been dissolving, unfortunately, biofilms. And, like, you kind of. Actually, you should kind of celebrate and be like, ding, ding. We unlocked a new level. We're gonna get rid of this stuff. And hopefully he will get to a point where he does not need to use Benadryl. He does not have a problem going outside. He does not have any. He's so much better now because he used to need, like, two Benadryl a night, and now he's maybe. Maybe needs to take a Benadryl maybe. And sometimes it will go away on its own. So he's in a way better spot.
They actually took the braces off because they weren't sure. Was he allergic to the metal? Was he allergic to the cement? And pressure. Right. Think about that. All that pressure on the teeth that in that area caused this huge explosion of hives.
Alyssa (31:04)
So do you think he had. His oral microbiome was already out of balance? He had something going on in his mouth?
Jennifer (31:11)
Not necessarily. I think he already had fungal overgrowth. And so I kind of look at it similarly like a bucket. Like your body has the. The body is amazing. I think that we can never state that enough. The human body is absolutely amazing and works in ways that we still to this day don't understand. And so how I look at things now has really changed over the years. I kind of look at why something happens suddenly is it may have been present, the issues may have been lingering for a really long time. And for whatever reason, your body could handle it. And then there was usually, it's like one thing that might seem insignificant to other people. Sometimes it's not.
Sometimes it could be a severe infection or really bad Covid, or you were in a car accident or you ate some like, really bad sushi and got really sick six hours later. Right. So like, we can like, pinpoint things and sometimes we can't. But there's something that caused your body to be like, I can't juggle all these plates anymore. I can't keep whatever is happening in check. And sometimes that can be a depletion of nutrients, like so many things. And so in this particular instance, I think the pressure on the teeth, that's my theory, this is my working theory, that the pressure on his teeth caused his body to freak out and could no longer contain what was already kind of. It was like teetering on the edge and it couldn't quite bear it any longer.
The pressure, that extreme pressure of the braces caused everything to go awry. And there he ended up with hives.
Alyssa (32:55)
Yeah.
Jennifer (32:55)
So.
Alyssa (32:56)
Yeah, that's amazing. And so, you know, people listening to this, there is no test for histamine intolerance (histamine intolerance testing). Right. It's looking so much deeper. And it can be very complex. You did mention earlier and let's clarify this because I didn't realize this. As a skin specialist. You said eczema is not histamine. So how does eczema present differently from the histamine skin reactions?
Jennifer (33:28)
So eczema can be histamine driven, but most of it's not. The reason I say thism, this is not my idea. I had the pleasure of meeting and then interviewing my colleague, Dr. Shawn Kwatra. So he was on the Healthy Skin Show, and he ran, kid you not, the itch lab at Johns Hopkins University, and he's now at the University of Maryland. He moved. So I think he's the director of their dermatology department. I don't quite remember the specifics, but it's something like that. And anyway, he was the one. I had suspected this for a long time because people would go, I have histamine intolerance symptoms. I have eczema. And I'm like, do you? Because you don't really check any of the other boxes that would, like, warrant you to be on a low-histamine diet.
You also don't find that actually it helps anything or it's like, kind of helps, but not really. Like, I would imagine it would be a more sizable improvement, but they just don't check those boxes. Histamine intolerance is, like, way different than just having a skin rash. Right? The other conditions I talked about, they're very clear. Those are histamine-driven. They take antihistamines, and most likely they're going to feel, depending on how severe it is, some level of relief. But there are a lot of people, if you ask them, if you take Zyrtec, if you take Benadryl, if you take something and you're itchy, does it make any improvement? And they're like, no, it's because you don't have a histamine problem. And antihistamine is a super. A, they're over the counter.
B, most derms will probably suggest it if you're super itchy, if it does not help the itch, it's not that. That's where I started to realize that there was more nuance here. And so I think the mistake that we assume is that itch is a sign of histamine intolerance symptoms, and it's not. I met him at the Eczema Expo that was hosted by the National Eczema Association the first year I went. And he's like, most itch is not histamine driven. There are so many other things that can cause itch. And if you think that this is just all a histamine issue. How many people here have been told to take antihistamines and you get no relief.
And almost, I think, two-thirds of the room raised their hands, and he's like, it's because you don't have a histamine problem. So what. What I have kind of seen is that itchiness is more a sign of. So, number one, we want to rule out a skin infection. That's a big thing, especially for eczema. You can have dysbiosis of the skin microbiome. A lot of times we think of staph aureus, but you can also have other skin infections, like a strep infection, a pseudomonas infection. I had one client who had a klebsiella infection, which I like. She was the only one I've ever seen that culture come back with that. So skin infections can cause itch. Other things that cause itch are the amount of moisture that your skin has. So the drier it is, the more likely you'll be itchy.
If you have a thyroid problem, that can cause itch, because hypothyroidism, one of the symptoms is itchy, dry skin. So you want to make sure that your thyroid is, you know, at least somewhere close to an optimal range. Right. That's important. But also the gut microbiome, I really do truly believe, can contribute to this. So one interesting thing that Dr. Kwatra shared with me is we have to consider the interconnections within the body. And so I'm sure, you know, we have this really interesting nerve called the vagus nerve that connects your brain all the way down throughout your GI tract. It's, like, literally plugged in all throughout the gut.
And so your brain, when you're like, I really feel like this is a thing, or I feel like something bad's gonna happen, it's possible you might actually be like, you know, I have a gut feeling. You might actually have a legitimate gut feeling, because it is literally your second brain for this reason. And so when we have these imbalances within our GI tract, you have to consider not only are these organisms inflammatory, but their waste products are also inflammatory. So when you have a very unhappy gut, but those signals are sensed by the vagus nerve in the GI tract and then sent up to your brain. And what he had shared is he thinks that the brain is misinterpreting the inflammation and pain and discomfort and everything else as itch. And that's how we feel.
Now, I will also say, and this is purely what I've seen in clients, so I can't say that I have any, like, proof about this, but I find that when people get really itchy at night. So, like in the evening when they're about to go to bed or they're in bed and all of a sudden they're starting to get itchy. I would say a couple of things. Number one, you always want to think about your air quality. If you have vents blowing on you, could be mold. So get your vents checked. Could be mold in the AC unit that's in the window. So again, that's one thing to consider. Consider dust mites or any allergy to the sheets now and to whatever the laundry soap is. Most people have already done some of that.
However, fungal organisms and parasites are also more active at night. And so I tend to find that people who have overgrowth of either of these or both of these organisms tend to be itchier at night. And sometimes, yeah, sometimes liver detox, like, we're really not able to provide enough nutrients into our phase two liver detox as well. Like, liver are sort of like from the Chinese clock, right? The Chinese medicine clock is that liver time is at night, and that’s when we're supposed to be, like, cleaning things up and doing all sorts of. Well, you can't sleep, you feel itchy, you're awful. You know, you're like, oh, my gosh, this is awful. I can't do it. We need to take a look at what's happening also with liver detoxification as well, but not phase one. Phase one's not the problem.
It's phase two, because that's nutrient-driven, and that's the one that we can really act the most on. Phase three is more. It's excretion. But most of that is looking at gut function. And I would hope by now, like, we've already kind of, like, worked, sorted itself out. And I'll also add, if you are constipated or you become constipated, most people will actually notice. This is purely, you know, something that they'll reflect me. Literally had a client say it this morning. She's started to get constipated, and all of a sudden she's super itchy. So it's not uncommon to notice. Like, we don't. A lot of times we think these things happen. Like, oh, but I'm. I'm constipated. What does that have to do with me being itchy? Or what does that have to do with my flares?
But you're sitting in waste for a longer period of time. You should be having a bowel movement, I would say ideally two to three times a day, a healthy bowel movement. A lot of people are struggling to just have one. Some people only have one a week, which is, like, to me, really shocking. But that's why eczema cannot be considered a histamine intolerance condition, because a lot of times we're blaming the itch on histamine, and that is not accurate.
Alyssa (41:14)
It's more than that. And I'm so glad you brought up the vagus nerve and the gut-brain connection, because I was going to ask about head symptoms, because I see this a lot too, with patients. The brain or just, either, just the typical brain fog, fatigue. But even weird head symptoms like dizziness or head rushes is. They'll explain really alarming things and like, so strange that they're often, like the doctors bewildered. They're like, have you ever heard of this before? That sort of thing comes up a lot with history, doesn't it?
Jennifer (41:51)
And also, too, it's not uncommon to feel anxiety, depression. I mean, these are very hard conditions to live through. I know that we've spent, I think, a lot of the 2010s talking about autoimmune disease, right? Everything was about autoimmune disease and gut problems. And I think while there's still a lot of that there, I think people who don't truly understand what it's like to live with a chronic skin condition, like, they're like, oh, but, you know, I'm, I have Hashimoto's thyroiditis, and no one can see it. It's an invisible disease, right? Except these are conditions that a lot of people can see that can produce. It's not even just that you have the fatigue or maybe even some of these brain symptoms. You mentioned burning skin, itchy skin.
But for some individuals, they are covered head to toe or the rashes are in areas they can't cover. They could be on your face, on your neck, or they could be intimate areas that really impair your ability to have a relationship with somebody or be intimate with someone and make it hard. They really impact your quality of life. And so I'm not saying I would rather have one over the other, but I think that I didn't have the appreciation for skin problems until I had eczema so bad that I couldn't even turn the doorknob on my office door because just the act of, like, gripping, you know, to do this, all my skin would crack open and then I'd be left with like a thousand paper cuts. So I didn't truly appreciate the level of suffering that people experience until I was in it.
And so I just want people to know that I don't believe. And you know, everybody has their own beliefs. But I do operate and truly believe that these skin conditions are a mirror of other things happening not only under the surface, but out in their environment. Environment. And when we can identify what those things are and work on them. And that may take time. I'll also say this gut issues. If you just have a gut problem, that's way easier to fix. Now if you have like inflammatory bowel disease, it's a whole other matter. But I tend to find that people are like, oh, I have chronic diarrhea or chronic constipation. You can address that a lot faster. Skin issues take time.
And so if you're looking at somebody who's like, oh, I did this cleanse and in 30 days my skin was healed, like really are you doing, are you using steroids? Like also there's consequences to using the skin medications because like topical steroids is manmade cortisol and that you can become actually addicted to and that can cause a secondary disease called topical steroid withdrawal syndrome. That is a whole other monster that looks like severe eczema but is not. And it's on top of whatever the original condition you had. You know, there are certain issues biologic drugs. I think the beauty is to know that you can do both if you need them. You can utilize conventional and the more like integrative stuff together, which is what I love to do and figure out what the fastest way forward is and what you're comfortable doing.
And there's hope. I always operate from that place of, I really truly believe that, you know, that ideally I want to see somebody get their life back. Because truthfully, nobody wants to think about their skin. Think about it even if you have clear skin. Like, I don't want to think about like how my skin is aging or the lines on my face. Like I don't have any eczema or anything. So like just a regular person doesn't want to think about the texture of their skin and their wrinkles and all that stuff. We don't want to think about it. A person who has rashes doesn't want to think about that either.
In fact, they would love a break so that days could go by and they would never have to think or worry about those skin issues because that would be the freedom that they're looking for because they would rather focus on their kids soccer game or their husband's, you know, promotion or just doing something that they love and they can't. So I just want everybody to know that there is hope. You don't have to be stuck like this. And that's what I believe what I've seen to be true. And I just think it bears, you know, saying it.
Alyssa (46:23)
And I totally agree with you. And I think that's such a great note to end on. Can you tell the audience what, you know, what work do you do, what does it look like? And how can they find you to get more help with some of these things?
Jennifer (46:37)
Absolutely. So I. So first of all, I have the Healthy Skin Show, which if you want to dive into, like all things skin, there's a lot. There's a lot of episodes, and many about histamine intolerance symptoms. We're close to 400 episodes. So there's a lot to learn in this department. So there's that. That's available everywhere on YouTube and all the podcast platforms. And then also we have a virtual actual clinic. So we work with clients and consultant cases all over the world. It's myself and my team of clinical nutritionists and we support clients on the integrative front. But again, taking into account, like, are the herbs best, are the supplements best, or this the diet best, or is the medication the best? And let's see what we can figure out. That's going to be the fastest way forward.
So we really try to address the person in front of us, and we do it from a root cause approach. And so we have that. And that is also another option in case somebody's like, I need help. And then you can find me on Instagram as well. And I also have a really great guide. This is sort of the matrix that I put all my skin clients through. So if they're interested in like, just like, what are my root causes? Because it's not usually one. It's a combination of three to six issues. But you got to figure out what that is. Is. I have a skin rash root cause finder guide and you can go through. It's like there's 16 different categories and you go through and you check the boxes.
There's like a little short instructions of like, how to use it, how to like, is this, did this happen now? Did this happen in the past? And then you score yourself and it'll help you figure out what that root cause combo is. That helps explain why the stuff you tried that everybody's talking about in a Facebook group that really helped them. Them is not helping you or it's making you worse. It's because your root causes are different than theirs. So that's that free guide is also available, which I'm sure you can share in the show notes as well.
Alyssa (48:35)
Yeah, we absolutely will. That sounds like an amazing resource. Well, thank you so much for offering such insights and such hope to our audience. This has been an amazing conversation.
