Although histamine is most often associated with allergies and immune responses, it plays a much more multifaceted role in the body as a hormone, neurotransmitter, and immune system mediator.
In this episode, Bec is joined by chronic disease expert naturopath, Elizma Lambert to discuss the fascinating topics of mast cell activation syndrome, histamine, and their role in a leaky gut and leaky brain.
Tune in to learn about the connections between mast cell stabilisation, gut health, and neurotransmitter regulation and explore the interplay between histamine, and glutamate, and how they influence the way you think and feel.
Key Takeaways:
- Histamine acts as a multifunctional compound in the body, playing roles in neurotransmission, immune response, and hormonal regulation.
- Mast cell activation syndrome can result from dysregulated mast cells that release excessive histamine, leading to chronic inflammatory responses.
- Histamine's impact on the brain can contribute to neurological symptoms like anxiety, insomnia, and brain fog.
- Understanding the interplay between histamine, glutamate, and other neurotransmitters is crucial in addressing histamine-related issues.
- What are the natural support options for mast cell stabilisation, gut histamine, glutamate and mood?
Episode Timestamps:
[00:00] Welcoming Elizma Lambert
[01:53] Histamine's Multifaceted Role in Health and Disease
[11:49] Post Viral Fatigue and Long-Covid Symptoms
[13:16] Understanding Histamine's Role in Immune Response and Mast Cell Activation
[17:38] Histamine Pathways and Their Impact on Gut and Systemic Health
[26:04] Testing and Identifying Histamine Issues and Mast Cell Activation
[31:41] Histamine's Impact on Brain Receptors and Neurotransmitter Balance
[39:25] The Evolution of Information Access and AI in Healthcare
42:05 Managing Histamine Issues Through Gut Health and Nutrient Support
Episode Transcript:
0:00:00 - (Bec): My guest today is Elizma Lambert. Elizma is a talented and well-respected naturopathic practitioner, educator, and author with over 20 years of experience in functional medicine with special interests in functional diagnostics, nutrigenomics, and cellular dysfunction. She is internationally regarded as an expert in unravelling chronic illness. Her special interests are mitochondrial dysfunction, redox signalling, calcium signalling, neurotransmitters, dietary influences on our unique biochemistry, mould and biotoxin illness, and the gut microbiome.
She is perhaps best known as a leading authority in functional test analysis, particularly in interpreting organic acids, which has earned her the nickname the organic acid test whisperer or the O.A.T whisperer.
In addition to her busy clinical practice, she is also a sought-after speaker, educator and author, having co-authored books with other prominent international experts including Leaky gut, Leaky Cells and Leaky Brain with Doctor Jess Armine and The Dirty Genes, The Histamine Workbook with Doctor Ben Lynch and Angela Arthur. More exciting book projects on the horizon, I asked Elizma to join us today to share her expertise on the role of mast cell activation syndrome and histamine when it comes to a leaky gut and a leaky brain. Without further ado, I warmly welcome Elizma.
Elizma, thank you so much for joining me for this chat. I am really looking forward to learning more about these areas of expertise that you have in mast cell activation syndrome and histamine and the relationship with the leaky gut and the leaky brain because I think it's still kind of unknown. Would you agree?
0:01:53 - (Elizma): Yeah, I would agree. I mean, there's now a lot more talk about mast cell activation syndrome, but typically, you know, we think sort of like about histamine in terms of allergies, you know, sinus, hay fever. And now, we also know that histamine is involved in things like eczema, but I don't think a lot of people think of histamine in the context of brain and neurological function that much. More, really immune function. So, but more and more information sort of, like, is coming out. People are becoming a little bit more aware of. But I think that's kind of like, where we have to look at that. Histamine is so much more than just allergies and things like that. So, yeah, I definitely agree with you on that.
0:02:37 - (Bec): Yeah, absolutely. We put out some social media posts around the fact, did people know that histamine is, in fact, a neurotransmitter in and of itself? And I think it took a lot of people by surprise. But to set the scene, let's kind of go into a bit of a 101. What is mast cell activation syndrome and the role of histamine? Let's go and start there.
0:03:03 - (Elizma): Yeah, so I guess if we start to look at, well, what is histamine? I mean, histamine can be classified as a hormone, can also be classified as a neurotransmitter, and of course, also in terms of the immune system, like a signaling molecule and so forth. And it's quite interesting, like, in terms of, if you look at hormones, normally hormones are released by an endocrine gland right? Like the thyroid gland or the ovaries or what have you. When we look at histamine's sort of, like, role as a hormone, it has a very localised response. So it's very much where is it released and then what's the receptors that it binds to and how it will sort of, like, function there? The same pretty much in terms of being a neurotransmitter as well. But when we look at its immune function, it's a much more diffuse kind of function that histamine has. In that kind of, like, context. From a, you know, from an immune perspective, histamine is generally released by mast cells, but also basophils, and can also be released by other immune cells, for instance, in the brain, that can be released by microglial cells. And that's when it has more of an immune function. So that's when there is, like, an invader, pathogen, a toxin, or anything that their body deems should not be there. It would sort of like, release histamine from a mast cell or a dendritic cell. Typically, your mast cells are kind of like, they sort of like, sit around the border of mucous membranes. So that would be the lungs, the skin, the gut, and also in the brain. And they sort of, like there to detect anything that shouldn't be there, like the first line of defense, so to speak. And if they see there's anything there, it shouldn't be there, they will release histamine. Histamine is like their communication molecules. They also release more than just histamine, I should say. They also release a whole bunch of other interleukins and signaling molecules. But that's the purpose of these cells, is to tell all the other immune cells, hey, guys, there's something here. You guys need to…
0:05:01 - (Bec): We're under attack.
0:05:02 - (Elizma): We're under attack. You need to come and help us, kind of thing. And so. But typically, that is what, when we talk about mast cell activation syndrome, it means that for whatever reason, for that person, their mast cells or their other histamine storage immune cells are releasing a lot of histamine or being activated, and they're on alert. The immune system is on alert.
Now, sometimes it's justified, right? Well, I should say most of the time it's justified. And so there is something there that the body is reacting to that shouldn't be there, and that's an appropriate response. Right. So the, if you think about histamine, you know, specifically, like, I guess when you have a mosquito bite or a bee sting, you get the redness, you get the swelling, you get the heat, and that's kind of like what histamine does. It creates the leakiness. That's how, you know, fluid sort of like, leaks out of the blood vessels and all of that. But that's kind of like what's supposed to happen. The whole point of the leakiness and the swelling is to get immune cells and fibroblasts and other cells into an area..
(Bec): Drawn there..
(Elizma): Yeah, fight a pathogen or repair the area. All of those things have, like, a purpose that's to get from one point to another point. The problem is when those cells are not switching off, you know, if it's sort of like an ongoing immune response. And typically, I guess, if you want to then put a label on it, that's where we have the label mast cell activation syndrome. Where this is, you know, uncontrolled, kind of like mast cell response. Like, I like to call them misbehaving mast cells. Right. So they're.. Yeah, they're not behaving as they supposed to. They kind of like going a little bit rogue, so to speak. Right.
(Bec): A bit rogue, yep, love that.
07:00 (Elizma): That's the immune aspect of histamine right? That’s the immune aspect of histamine and then, if we're talking about its role as a neurotransmitter, that's not histamine released from mast cells, that's histamine released from histamine neurons or histaminergic neurons. Neurons. And I think people, sometimes they get confused with each other. They think that histamine has this one response in the body. I think that's where maybe a little bit more education is needed. It's like, well, no, the histamine that's released by histaminergic neurons has got a different function than histamine released by immune cells like mast cells, which has a different function than histamine released by enterochromaffin-like cells in the gut. Right. They all have different functions. And then it also depends on the receptors that histamine binds to. That will depend, you know, what is it going to do. Is it going to amplify a response or is it going to diminish a response? So there's a lot of these intricacies that I think we're learning a lot more about or becoming more aware of, you know, as we sort of, like, look through. But certainly, yeah, from a brain perspective, histamine is like an excitatory neuron, and it also has a role in regulating other neurotransmitters as well. So like GABA and glutamate and dopamine and serotonin and all of those neurotransmitters.
So, you know, I think we briefly spoke about it last time, it's when it comes to the brain neurochemistry, nothing's black and white, it's all an orchestra. And yeah, and I think that's a challenge.
0:08:25 - (Bec): One of those instruments is out of tune and makes the harmony sound really off.
(Elizma): Absolutely right. And if you, if you sort of change one of them, you're going to have a flow on effect where it's going to change others around them as well. And which is what makes neurochemistry probably a lot more complex than what we would like it to be, but also very interesting as well, if you're interested in that kind of stuff.
0:08:50 - (Bec): Absolutely. What you've touched on there is something is we often will pigeonhole something as, oh, well, histamine's ‘bad’ because it causes all these problems, but we forget that, well we don't forget, maybe we aren't even aware that in biochemistry there's never black, white. There's these shades of gray. And for every action, there's an equal and opposite reaction, right? So histamine has as many positive qualities as it does negative. But for the purpose of today, I mean, we'll probably focus on the negative qualities because they do have a profound impact on the brain. So, you know, like, what makes it bad? In terms of affecting our brain health and initiating things like brain fog or, you know, problems with thinking, or problems with sleep.
0:09:38 - (Elizma): Yeah. So histamine's role in the brain, it's got many, many different kind of, like, roles, but a major one is like, it's the wakefulness neurotransmitter. Right?. It makes us awake and alert, which is a good thing during the day. You know, that's. You do want to be awake and alert. The problem comes, you know, if there is too much histamine in the brain, let's say at nighttime, because then that will kind of, like, interfere with sleep. Right. You. You just lie awake and you. Or you wake up very early in the morning and can't fall back to sleep again.
0:10:07 - (Bec): Right. So that could be histamine?
0:10:09 - (Elizma): That could be histamine, for sure. And then also because it's in. It's an excitatory neurotransmitter. It can also trigger anxiety or irritability, over-excitation. I guess, at the very extreme end, maybe seizure activity and things like that as well. I mean, there's lots of other excitatory neurotransmitters that can also be responsible, but certainly from a mast cell perspective in the brain, because there's mast cells in the brain as well, we see a lot of brain fog as it is a very, very common symptom. Vertigo, very common symptom as well. And I guess that kind of, like, comes into, like, if you look at, like, okay, well, what histamines functions? It does create leakiness. And when we talk about leakiness, we can say leaky leaky brain, leaky gut, leaky blood vessels. In a way that's kind of like, one of the purposes of histamine is to allow things to cross from one side to the other side because there's a threat.
(Bec): Yep.
0:11:15 - (Elizma): And so it can sort of cause leakiness, and then that in itself can have other repercussions. Things can get into the brain that shouldn't get into the brain and so forth and so forth.
But, yeah, typical neurological symptoms. It is the anxiety, the wakefulness, and a lot of those symptoms that we sometimes also apply to CIRS or chronic inflammatory response syndrome, that some people may be aware of that's commonly associated with mould biotoxin issues, Lyme disease, and so forth. But, you know, we're also seeing it now a lot with, I guess, long COVID symptoms. Right. And what I would sort of like, maybe call more like post viral, post-viral fatigue issues and things like that.
0:12:02 - (Bec): Yep, because that wouldn't be just isolated to Covid, I'm guessing, like, chronic fatigue is something that viral infections have been initiating for years.
0:12:11 - (Elizma): Absolutely. Ross River fever, Epsom Barr virus. It's interesting. Like, you know, I remember, you know, when a few years ago, when COVID was quite big, there was all this talk about long COVID syndrome and all of that. And I was just thinking to myself, well, it's no different to other post-viral kind of, like, symptomatology and recently may have been like a month ago or so. I think I read an article where I believe it's the Australian Medical Association, or at least some doctors were sort of like, saying, they don't actually want or like the use of the term long COVID because it's.. they now just see it as post-viral, you know, symptomatology, the same as all other viruses. And so. And the reason for that is because, again, these are viruses, infections that trigger an immune response. Right. So anything that triggers an immune response will involve histamine, whether it's bacterial, parasitic, viral, or any of those kinds of... Yeah.
0:13:16 - (Bec): Exposures, pollens, food allergens.
0:13:19 - (Elizma): That's right. That's right.
0:13:21 - (Bec): So what is it then that goes from this appropriate immune response that we want from histamine? Like, where do things go wrong that it doesn't get shut off or that it's constantly being triggered? What do you find are the common reasons there?
0:13:38 - (Elizma): So there can be a few different reasons. So it could just be that you know, the body doesn't get the message that the threat is over and, you know, it can now calm down. So sometimes it just, I guess, gets stuck in that inflammatory response. A lot of times it's to do with the mast cells being unstable themselves. So you have to kind of like, imagine mast cells are a little bit like, imagine they're like balloons, right? And inside these balloons, you have all of this histamine and other kind of like cytokines. And so sometimes the balloon, I guess, is quite robust. And so, you know, when you play with it outside and it bounces on the grass, it's fine, it doesn't pop. And then other times it's super, super sensitive and anything, just the slightest touch just makes it explode. So in that aspect, we're talking about, I guess, membrane stability, but also, I guess, how healthy the membranes are. And so for some people, the mast cell membranes are, I guess, quite thin or not very healthy or very reactive. And there's various reasons why that can happen as well. I mean, you know, I don't want to go down too many rabbit holes, but hormones could play a role there, right? So progesterone for females, progesterone is a mast cell stabiliser. Estrogen makes mast cells more trigger-happy, you know? Which could probably be a reason why, for women who have mast cell issues and they're still in their reproductive years, they may find that during their cycle, their allergies get worse or their histamine symptoms get worse. Right?
(Bec): Right.
0:15:15 - (Elizma): I mean, that's one example. Stress is another really common trigger for mast cell activation syndrome or cortisol. Toxins are a big one, you know, and certainly with foods, you know, If the body thinks that if food is foreign, then we can start getting the food kind of like sensitivities. I mean, that in itself is a really interesting aspect of, well, why do the body, why do the mast cells in the gut, you know, if you eat, like, a food, like, I don't know, I'm just gonna, you know, let's say gluten. Why is does the body think, oh, this is foreign, I should react to it. Right. And that can involve a whole bunch of other biochemical compounds, which can get quite complex. But there are.. there are often reasons why histamine or mast cells don't shut off. And sometimes it could also be. Often it has to do with the receptors, how well the histamine receptors work. So, for example, there's four histamine receptors. And histamine, the H3 histamine receptor is what we call actually an autoreceptor. So if histamine binds to that receptor, it actually signals for histamine cells to produce less histamine. So that's the way of controlling how much histamine gets released, or, you know, to always kind of, like, keep it in balance. So those autoreceptors aren't working very well. Well, then the cells don't get the signal to release or produce their less histamine. So that would be one aspect.
And generally, if it binds to H1, H2, or H4 histamine receptors, depending on where these receptors are, they will tend to amplify the response. So sometimes it's the receptors that don't work well, there could be genetic components as well. There are some genes that are very specific. But I'd probably say the most common reason would be that the body is not breaking down histamine sufficiently. That's probably one of the biggest reasons. If we just move a little bit away from mast cell activation syndrome as a condition, but we just look at why do people have histamine symptoms? In my opinion, the most common reason is that histamine is not being broken down adequately or not quickly enough. And so that just means at any one point in time, there's more histamine floating around than there should be.
0:17:38 - (Bec): So how or what is needed to help the body along with histamine breakdown, I'm assuming that's enzymes?
0:17:48 - (Elizma): Yeah. So there's, if you look at sort of like histamine breakdown, there's three pathways that histamine can be broken down. The very small pathway is the NAT2 pathway, which is a very minor pathway. It's really just a little backup pathway in case the other two pathways don't work well. So we don't really look at that pathway too much. Then there's the.. one of the big pathways is the.. what we call the DAO pathway, and that's essentially gut histamine. Right? So histamine is a component of a lot of foods, you know, typically aged foods. So aged foods, you know, that'll be like leftovers, foods that have been cooked for a long time, fermented foods, cheese, you know, so overripe fruits. So rule of thumb, aged foods would.
0:18:36 - (Bec): Be they accumulate histamine in the life cycle of the food, Yeah?
0:18:40 - (Elizma): Yeah, that's right. So they become higher and higher histamine. The older, the more it ages. Right? Yeah. Um, but then there's also certain bacteria that produce histamine as well. Um, and certainly if certain bacteria become pathogenic, then that can also trigger more mast cell activation. And so in the gut, you need DAO enzymes to break down histamine. And those DAO enzymes, they sit sort of like in the cells in the small intestine. And, um, some of. Some of the DAO enzymes are sitting on the outside surface of the enterocytes. So the small intestinal cells and some of the DAO enzymes are inside the enterocytes, but they sort of like control gut histamine.
Now, if there's anything going on in the gut, like SIBO, which is small intestinal bacterial overgrowth, or there's damage to the intestinal lining (intestinal permeability), which then would mean that there's not that much DAO enzymes there to do their job, then you can end up with too much gut histamine. Right? And then that in itself, because histamine creates leakiness, will then create leaky gut, or contribute to the creation of leaky gut,
(Bec): Creating a cycle.
0:19:46 - (Elizma): That's right. And now that histamine crosses into the bloodstream, now when histamine crosses into the bloodstream, then we sort of like get more into the HNMT histamine route, which is governed by methylation, and we won't get too much into methylation..
(Bec): Massive topic!
(Elizma):, That’s a whole other topic. So where DAO is more in the gut, in the system, or in the bloodstream, it's more really regulated by HNMT, which is a different route. Now, it's not 100% true. I mean, DAO is also found in the uterus and all of that. But just for simplicity purposes, DAO is gut. And in the system it's HNMT. And so now you need a whole bunch of different nutrients and enzymes to kind of like, break down histamine once it's in the system. And so that's why for some people you know, they can have the systematic histamine symptoms, like the eczema and the allergies and the hay fever and the runny eyes and all of those kinds of things. But they don't really have, let's say, many gut histamine symptoms or vice versa. But typically, if we look at how it progresses, it pretty much always starts from the gut. Like the gut histamine issues start first, and then later on you get the eczema or the asthma or whatever systemic kind of like issues that you end up with.
(Bec): Yep.
(Elizma): But you do kind of like, I want to say you treat them slightly differently. You have to kind of like, understand that they're connected somehow. But you may use different nutrients for gut histamine than you would use for, let's say, systemic histamine. And certainly in the brain, the only way that we can break down histamine in a healthy way in the brain is through that HNMT route.
0:21:34 - (Bec): So supporting methylation is really important in that regard.
0:21:39 - (Elizma): Absolutely. You know, and then, and it kind of like, makes sense if you think about, you know, B12 and the B vitamins being so important for brain health and all of that. I mean, there is backup systems. I mean, the body always has backup systems, but it's always at the expense of something else. If there really, really is like a lack of methylation in the brain, it can sort of like, be broken down directly by MAO-A a MAO-B enzymes in the brain. But that's not ideal. It sort of like, forms these other byproducts that can. That's not that great, you know, in the brain kind of thing. So. But, yeah, the body will always find ways to do things, I guess, if there's really something lacking there.
0:22:23 - (Bec): So it kind of makes sense, I guess, that we're seeing these surges in these histamine issues when we consider how just how many people, people have really poor gut health or are eating, living, or even being prescribed things that have an impact upon gut health and a worsening of it over time. And then on top of that, not only do you have poor gut health, so you're poorly absorbing a lot of your nutrients, which will include a lot of those important methylation nutrients. It's kind of almost like this cycle of being undernourished and lacking the resources to just deal with what's being thrown at you.
0:22:59 - (Elizma): Yeah, absolutely. You know, and it's. And it is. It's like, I'm glad you did.. you mentioned that. It's like, yeah, it may start in the gut, but as we know, that's where nutrient absorption takes place. Right? And if we're now not digesting our food properly, not absorbing nutrients properly, then we start getting deficiencies in nutrients for these other histamine pathways. But not just histamine. We now also have issues with other neurotransmitters. Right? Even if you go back to histamine's function in the gut, one of its main functions, functions is for gastrin release, right? Stomach acid production and stomach acid release through the enterochromaffin-like cells in the stomach. So whilst we're talking about too much histamine and its symptoms, if there's not enough histamine released, let's say, in the gut, by these specialised stomach cells, then we're not going to get the stomach acid release, we're not going to digest our proteins very well. We know that we need proteins to be digested for amino acids, which are the substrates for all our neurotransmitters. Right?
(Bec): Yep, building blocks.
(Elizma): Everything. Right.
(Bec): Yeah.
(Elizma): And so one of the interesting things that I often see when we do testing, is people who have had long-term mast cell activation, they've had all these allergies and this immune kind of like release of histamine. So they end up with the brain fog and all of the eczema and all of those kinds of things. Because you need the amino acid, L-histidine, to make histamine, I've often seen people kind of like, end up with very low levels of L-histidine because it's. Their mast cells are just pumping out all of this histamine. Right?
(Bec): Right.
(Elizma): And so eventually you run out of, you run out of the ingredients to bake the cake, so to speak.
(Bec): Yep.
(Elizma): And so that can often have a detrimental effect on the neurotransmitter, the functional histamine. So now there's less histamine for digestion, there's less histamine in the brain for neurological function. And so in a weird way, some people can end up with both high and low histamine symptoms. Right.
(Bec): Right. It's pretty tricky.
(Elizma): Yeah, they end up with a high immune histamine symptoms with the inflammation, but they can end up with a lower neurological and gut histamine, which is, like, needed for digestion. So.. which is why it's sometimes quite tricky, because we tend to think of things as just, well, either we have high levels of this or low levels of that, and it's like, well, no, it actually can sometimes not always work.
0:25:36 - (Bec): Yes, our organ systems don't work independently. They're also an orchestra of instruments that need to create their harmony, right? And so you mentioned just before, you know, when you do testing to unravel this, I would imagine just because of, well, obviously you would have people sitting across from you describing all the things they're going through and you’re formulating a picture in your mind of what kinds of things they're experiencing, and then you're going to verify it with testing. So what and how do you decide what to test, and what does it tell you?
0:26:09 - (Elizma): So if you want to sort of like test more for, let's say, more towards mast-cell activation syndrome or if there's mast cell issues, like, very common tests we will do is this is just blood tests, so serum tests that can be done by, you know, your general practitioner, is we look at things like TGF beta one, which can be a really good marker. Tryptase is another good marker. C4A is another really good marker. So they can sort of like, tell us whether there's excessive immune activation. Because typically if there's a high histamine, these markers will be high. Some of those markers will be high because they, they’re released in an attempt to sort of like, reduce histamine. And so if you sort of, like, see those markers high, then you know that, yeah, this person probably has some kind of like mast cell activation going on. I mean, IgE, another common one.
0:27:05 - (Bec): Yep.
0:27:05 - (Elizma): I can also indicate histamine. Now, you can measure, we talked a little bit about the DAO enzyme. You can measure serum DAO levels and also serum histamine. Now, in my experience, I have not found serum histamine to be very useful. There might be other people out there who disagree with me, but I see a lot of normal serum histamine levels in people with very clear histamine symptoms.
(Bec): Yep.
(Elizma): And I think the reason why I don't find that a very reliable marker is because serum histamine, it doesn't have a very long half-life in the blood.I believe it could be 60 seconds or 80 seconds or something like that.
0:27:51 - (Bec): Right. So it's really just a small snapshot in time, isn't it?
0:27:55 - (Elizma): It is. It's a really small snapshot in time. So if, you know, if you did want to sort of like measure histamine, the urinary N-methyl histamine is probably more accurate if you, if you, if you want to do that. But at the end of the day, you know, Bec, I would also say, I'm a big believer in signs and symptoms. You know, sometimes, you know, it's very obvious that someone's got histamine issues, and it's not always… even if tests sometimes come back normal, I wouldn't disregard that there is a histamine thing going on there. Right?
(Bec): Yeah.
(Elizma): So sometimes, you know, you've got to sort of, like, go by the science and the symptoms as well. But those are very common markers that one can sort of like, test for. They're more the direct markers. Then you can obviously get what I call indirect markers. So, for instance, if someone has SIBO, which is a breath test, it's very likely they're going to have some kind of histamine symptoms. They'll have other issues as well, because their whole digestion mechanism would be affected right? So histamine is not going to be the only thing. But, you know, I'd be surprised if someone didn't have some kind of, like, histamine issue who had SIBO.
(Bec): Yep.
(Elizma): So when you're talking about indirect markers, you're now really more measuring for things that could be causing the histamine issue or, you know, the, the mast cell issue or what have you. So that's more like testing for infections, testing for toxins, checking hormone levels, you know, estrogen and cortisol and progesterone and all of those things, and seeing if, if there's anything there that could be making mast cells more trigger happy and that sort of, like, produce symptoms.
A very easy, very easy test to do is that I sometimes get my clients to do, and I don't suggest this as a treatment, so I don't want people to go out there and say, oh, well, I'll just take an antihistamine. And that solves all my problems. But it sometimes can be a good sort of like, little test if you, if you want to see, well, is this a rabbit hole I should go down? And so what I sometimes get people to do, especially if they've got brain histamine symptoms like the brain fog, irritability, anxiety, sleeping issues, is I'll get them to take something like an over-the-counter, first generation antihistamine. So benadryl or something like that, and then I'll get them to just take it for a couple of nights. Right? Two nights, three nights, and just see what happens. And if histamine is a really, really, really big issue of your neurological symptoms, generally what will happen is, is within that short space of time, you'd find there's some improvement in your brain symptoms. And that just kind of gives us an idea of, like, okay, is histamine involved in your brain symptoms? And if so, how much is it playing a role in terms of sort of like, brain histamine symptoms and things like that? So that can sometimes be like a quick little experiment to just see if that's an area to kind of like.
0:30:48 - (Bec): Look at some of those medications, though, if you, if they're confirming or they have an improvement on symptoms. I guess the, the side note on that is, though, though, if you go down the path of going, oh, well, that, that's fixed. Fixed my symptoms, it can also worsen them over time. Right?
0:31:07 - (Elizma): Absolutely. Because it's like, you know, because all you're doing, you're, you're not, you're just stopping histamine from binding to the receptor. You're not reducing the histamine. The histamine is still floating around. Yeah.
0:31:20 - (Bec): It's kind of a band aid over a bullet hole, kind of.
0:31:23 - (Elizma): That's right. And you could you, you run the risk of also making the, of desensitising the receptors. I mean, it happens with everything, you know, whether we're talking dopamine receptors or insulin receptors. If there's a whole bunch of things floating around and you're sort of like, blocking those receptors, you can end up just making those receptors more desensitised over time.
0:31:41 - (Bec): Can we improve that? Like, I know we say insulin receptors in the case of insulin resistance, like, it can be really hard to wind that back. So is that something that's treatable, that you can make improvements on, the receptors, or kind of, once you've worn them out, that's it. They're kind of a little bit cooked.
0:32:00 - (Elizma): I like to think that there's always something we can do. Right. And so, and certainly with recept, I mean, think about if we, you know, get a little bit off histamine if you think about addictions, right. So whenever, whether we talk about nicotine addiction or alcohol addiction or what have you, that's all to do with the receptor desensitisation. So can you get over addictions? Sure you can. Is it easy? No, it's not. Right. It's, it's. Some things are easier than others.So certainly you can, you can retrain those receptors. How long that'll take, I think it's going to be very individual from one person to the other, that it might, there may be genetic components there, people who are very, I guess, what I would call slow receptors will maybe find it a little bit harder than people with oversensitive receptors. But, yeah, you could certainly retrain the body and get it to become sensitised again. But anyone who's ever tried to give up very strong addictions, trying to give up benzodiazepines, know that sometimes it can… it's very.. a very difficult road to go down.
0:33:02 - (Bec): Usually challenging, but does tend to respond well to many of the same kind of nutrients and herbs that support brain chemistry, but are also really strongly antioxidant and antihistamine in nature. An interesting parallel there.
0:33:18 - (Elizma): Absolutely.
0:33:19 - (Bec): So one of the things I wanted to get into is this concept of the leaky brain barrier. And I think when we talked offline, we were talking a little bit about the relationship with histamine and glutamate and sort of how that unravels things. So do you want to go into that a little bit.
0:33:40 - (Elizma): Yeah. So, again, when we look sort of like, in the brain, one of the cells that's kind of, like, responsible for the brain barrier is the astrocytes. And so astrocytes are kind of, like, they're a type of brain cell that's often called the ‘housekeepers’ of the brain. So they kind of, like, do cleanup duty kind of thing, but they also are involved in maintaining a really healthy blood-brain barrier. I'm trying to remember what the mechanism of it is, but I believe astrocytes releases a compound… it's some. It's a compound that's similar to brain-derived neurotrophic factor, but it's… But it's not. But it's something similar, and that's kind of, like, helps to repair and keeps the blood brain barrier really healthy. Right.
0:34:26 - (Bec): Okay.
0:34:28 - (Elizma): But one of the things that astrocytes can also do, they don't produce histamine, but they do respond to histamine. So if there's a lot of histamine being released by either mast cells in the brain or microglial cells in the brain, which is kind of like the immune cells of the brain, then that histamine can go and bind to H1 histamine receptors on astrocytes, and if it binds to those astrocytes and astrocytes will release glutamate and glutamate, whilst it's the…I believe it's the major neurotransmitter in the brain, and we need it for memory and learning. And again, cell signalling and all kinds of things. If there's too much glutamate being produced, then that in itself can become an excitotoxin. It can also start to damage neurological structures, over excitation of the brain. And so often you can get sort of like this double whammy with high histamine is you get, with a high histamine comes the high glutamate.
(Bec): Right.
(Elizma): And there's a lot of overlap between high glutamate and high histamine symptoms. You know, it's the wakefulness, not being able to sleep, the anxiety, irritability, brain fog and all of those kinds of things. And if we then sort of like, relate it back to the gut, it's also why a lot of people, they start getting these food intolerances and they're not sure what it is they're intolerant to. They're reacting to histamine foods, but then it also seems they're reacting to glutamate foods. But often it's because there's some kind of a link between them. Where one thing causes another thing, and then before you know it, you have all these food reactions and you don't know exactly what it is you're reacting to. It's a bit of a mixed bag. But that's kind of like, you know, that plays a fairly big role in the brain. It's that balance between… the histamine balance does play a really, really important role also with other neurotransmitters.
And I guess whilst we're on that, if we look at sort of because this also, you know, we talk about histamine receptors on histamine brain cells. We talk about histamine receptors on, you know, mast cells and things like that. But there's also histamine receptors on what we call non-histamine cells. So because there's a lot of different brain cells, right. Some of the neurons will release histamine, some neurons will release GABA, some neurons will release dopamine. So there's actually histamine receptors on these dopaminergic neurons and gabonergic neurons and serotonergic neurons, right?
(Bec): So, it could block them?
(Elizma): Well, that's, that's what can happen, right? So if there's a lot of histamine in the brain and it binds to these receptors, to a lot of the receptors on these other neurons, it will decrease the release of GABA, decrease the release of serotonin, decrease the release of dopamine. I mean, I'm oversimplifying it. It probably doesn't work exactly like that. You know, there'd be so many other nuances there, too. But the point I'm trying to make is that histamine can actually cause dysregulation of other neurotransmitters as well. So you may start off with a high histamine symptomatology, but then eventually end up with low GABA symptomatology, low serotonin symptomatology, which is kind of like the low mood. And it just amplifies the anxiety aspect and then not being able to sleep aspect.
0:37:44 - (Bec): That could certainly explain why you can get such swings of variance with both natural and pharmaceutical things that are designed to influence dopamine and serotonin. But if you've got this aberrant kind of histamine glutamate problem, like that kind of makes sense that people can get weird or not a no outcome, it would be the least problematic. But, you know, sometimes people get these crazy swings and…
0:38:09 - (Elizma): Yeah, I think that's. And that's one of the challenges, you know, that we do face when we're looking at mental health, and we try and treat mental health symptoms with, whether it's natural or pharmaceutical, I don't think it really matters because a lot of the times, and you know it's… No one's to blame. It is unfortunate that it's such a complex system, but often when we try and compartmentalise, someone say, oh, okay, you've got no serotonin. Let's boost your serotonin. And sometimes that's the right approach, but sometimes it can backfire, because by raising the serotonin, you've now kind of, like, trickled off a domino effect somewhere else that you may not have been aware of. And now you're creating issues somewhere else, which is often, you know, and it's kind of, like, frustrating to see. But sometimes you have people who are on five different types of, you know, I don't want to say antipsychotics, but five different medications working on different brain neurotransmitters.
(Bec): Yep.
(Elizma): If you work it back, you can see. Well, yeah, you know, this one is to deal with the side effects of this one, which is to do with side effects of this one, because we're not really looking at them all together as a whole.
0:39:25 - (Bec): Very true.
0:39:26 - (Elizma): Yeah. Which, you know, I'd say the way we're moving with AI and all of that kind of stuff, one day I'm sure we'll just be able to put symptoms in, press a button, and we'll have the perfect answer, and we don't have to work out ourselves, you know, which is just difficult to do.
0:39:45 - (Bec): Yeah, so we don't end up with people who have to be wound back from polypharmacy, you know, where they're taking all these different kinds of medications, it's often very huge cost as well, both financially but also with their wellbeing. Yeah, the AI may help to simplify it. I've been watching that closely. I think that's super interesting. And what a great side benefit of AI. Accuracy is mind blowing, isn't it?
0:40:11 - (Elizma): Yeah, it's, I mean it's, it still has its challenges at the moment. But, you know, I don't know, in our lifetime we've seen so many changes in technology. It's just incredible how fast things are changing. And so who knows where we will be in five years time, you know?
0:40:31 - (Bec): It's so true. Back when we were studying, students of today will have no idea, but like, there was not really the internet and the way we have it now and there was no TikTok and there was no social media. So your access to information was like the library, or if you were lucky enough to own your own set of encyclopedias, like way to make me feel old.
0:40:49 - (Elizma): Sure being at uni and like, yeah, we still had to go to the. Spend the afternoons in the library going through encyclopedias.
0:40:57 - (Bec): I can remember sitting on the library floor with boxes of the different, you know, like now you can just look it up on PubMed, but you actually had to flick through the physical pages of all the studies of all the issues. You forget now when you reference them, it's like issue five of, you know, autumn edition of this journal. But you actually used to physically look them up.
0:41:18 - (Elizma): That's right, yeah. We've probably given our age away. Europe. It is. It's just amazing how things have changed. And so it will definitely be different in five years time.
0:41:29 - (Bec): Absolutely. So sort of a final roundabout and I know that this is, you're going to laugh at me because there's so many hallways to run down with this one, but, you know, generally speaking, if someone is having a histamine problem or mast cell activation, you know, it sounds first and foremost like, absolutely, we have to work on the gut, which, no shock there, you know, the old naturopathic… Hippocrates, all diseases begin in the gut. And I think if science is proving anything, is that he was completely right. But, you know, like gut, obviously gut plays a massive role. But, you know, what are the things that we regularly reach for in natural medicine to help support people through this?
0:42:14 - (Elizma): Well, typical things, if you just sort of like want to, want to work on the, on the histamine itself, very common things would be mast cell stabilising nutrients. So that could be bioflavonoids, vitamin C, antioxidants, vitamin E, you know, they all can be very useful in sort of like stabilising mast cells and making them less trigger happy.
(Bec): Yep.
(Elizma): Other aspects would be to make mast cell membranes healthy. And that'll be like your omega-3’s and your omega-6’s and your phosphotidylcholine, all those fats and things just make them healthy. But then also in terms of gut histamine, DAO enzymes can sometimes be very useful to try and kind of like, reduce some of that gut histamine. And, you know, on that line with gut histamine, because I can, like, refer to gut histamine, creating leaky gut. And so sometimes it's also about whilst you're working on what's creating the, you know, what's creating the histamine issue, whether it be SIBO or, or what have you. It is can sometimes be very useful to reduce the histamine in the meantime, to just stop that leakiness, you know, kind of thing to give the gut the food.
0:43:26 - (Bec): You mean foods and triggers?
0:43:28 - (Elizma): Well, it can be foods, um, but it. So it can be reducing, like, high histamine foods, taking DAO enzymes, anything that can sort of like just take pressure off, I guess, um, histamine in the gut, and then that can allow the gut to heal. Because sometimes, you know, if there's a lot of histamine stuff going on and you're giving someone, you know, all of these gut nutrients and, you know, glutamine and all of this kind of like, stuff. Sometimes it doesn't work because you. It's like throwing water in a bucket with a hole in it kind of thing. So sometimes it can be very beneficial to, to reduce the histamine in the gut, just to give you a bit of chance to sort of, like, deal with the real issues. And that could be, like I said, reducing histamine foods and taking DAO enzymes.
What I will say in terms of reducing histamine foods, a lot of healthy foods have got histamine in them. And so anything, anytime when we sort of like, looking at, I guess, you know, elimination diets or restricting foods, we do generally like to think of that as a temporary thing just to sort of like, buy us time to fix things. But then there are also foods that probably we shouldn't be having anyway, like alcohol, which is very, very high histamine. Right. So I guess in that respect, you're probably trying to definitely avoid the high histamine foods that doesn't really have any health benefits. But then the aim would be to sort of like get, get foods back in that may be high histamine but do have health benefits kind of like over time.
0:44:59 - (Bec): It raises a really important point because we, we said it earlier about that cascade of you've got a gut problem which is decreasing your absorption and which is then having a flow on effect in your nutrient status and blah, blah, blah. So if we go and really restrictive diets sometimes, you know, whilst that is like a great short term fix to stop or take the pressure off is the great way you've explained that. But otherwise, if it, if it's prolonged, it, it adds to the problem because it adds to nutrient deficiency. If we're not eating a nutrient dense diet and we're not absorbing. Because we're not just what we eat but what we absorb.
0:45:40 - (Elizma): Absolutely. Yeah. Because it is you start getting B vitamin deficiencies and mineral deficiencies and all kinds of stuff. And that's kind of like what a lot of us are seeing in practice. You know, initially eliminating whatever food is that that's triggering your symptoms, it makes you feel good, but the longer that goes on, you sort of like start ending up with deficiencies and not feeling so good. Right. So, yeah. And that's, you know, it can sometimes be a little bit challenging, especially for people who have, who are very sensitive, you know, and they're even sensitive to supplements and things like that, which is why, you know, these days, we don't really see the easy kind of like cases anymore. Like, I think things have definitely become a bit more. A lot more complex than what it was ten years ago in terms of, you know, where people are with their health, unfortunately.
0:46:34 - (Bec): And also, yeah, I mean, just in gut health alone, I'm. I often am thinking about years ago when I was studying naturopathy, you know, IBS was a fairly new term, but we, we'd never even heard of SIBO, we’d never heard of mast cell activation syndrome. Histamine was still just an allergy chemical.
0:46:53 - (Elizma): Right. And all you had to do was give them zinc, B6 and magnesium and they'll be fine, it doesn’t work like that anymore.
0:47:03 - (Bec): Yeah, I know. And also, obviously, you know, not to, not to get too doom and gloom, but just the level of things we're exposed to on a daily basis from personal care products to our water supply to our food security. Like, it's a lot of things and toxins and chemicals that we come into contact with every day that our detoxification systems and our gut have to deal with. So it's any wonder that most of us find ourselves. I think it's like, what’s the statistic now? I think it’s like one in three or one in six people has a chronic illness.
0:47:37 - (Elizma): That's. Yeah, wow. I mean, I remember, you know, not that this is really about autism, but I remember, I mean, the statistics was 1.1 in a million, and then it became, I don't know, this like 20 years ago. I think it was already one in 60. I don't even know what it is now. But it's just like we're just seeing things that we never saw before. And, I mean, there's plenty of theories on a lot of these things, but I think one of the things, one of the major things was probably the industrial revolution in that our genetics have always been able to adjust or sort of like keep up with changes in our environment. And a lot of genetic polymorphisms actually occurred, you know, for evolutionary reasons as kind of like a protective mechanism. But because we've been exposed to so much, you know, chemicals and toxins in a very short, like a short space in time, like with 100 years, 150 years, our bodies just haven't had time catch up, right? So it's like our bodies are just reacting to the environment kind of like, around us.
0:48:48 - (Bec): See, and now that is a discussion we can have on another day is genes and polymorphisms and the neurobiochemistry around those, because that, well, that's actually multiple topics, really. That's, probably like four or five chats. But, you know, I know that's something you have an extraordinary amount of expertise in. So that's definitely something we'll have to chat about in the future. But for anyone who's listening, you know, obviously you deal with a lot of chronic illness. Like, it's your strength, it's your special skill, your zone of genius. You unravel people's very complicated health issues. So where can people find you?
0:49:28 - (Bec): Online and elsewhere. So that if they want to access your advice, they can.
0:49:33 - (Elizma): Well, they can go to my website, which is elizmalambert.com. they can also contact us at office@elizmalambert.com and that's pretty much where they can find me. I'm not big on social media yet. Maybe one day I'll see. But certainly, they can access and get in contact, and we can certainly see if we can help them.
0:50:03 - (Bec): Yeah, perfect. Well, thank you so much for joining me for this chat. We did manage to keep it to under an hour, which is unusual for us, so, but, yeah, I can't thank you again enough and I look forward to speaking with you again on more stuff.
0:50:17 - (Elizma): You too Bec. No, this is great. Thank you for inviting me.