Histamine is a naturally-occurring compound in your body. It is an essential part of your immune system, and is also a neurotransmitter and helps regulate your digestive system. One of the possible root causes of digestive challenges, such as diarrhea and nausea, along with a host of other symptoms, can be caused by histamine intolerance. In today’s post, I want to explain histamine intolerance, help you determine if histamine intolerance may be part of your symptom picture, and help you understand what to do about it.
Histamine Metabolism
Histamine is naturally produced in your digestive system, in brain synapses, and by immune lymphocytes called basophils as well as MAST cells. There are high concentrations of these types of cells in your tissues that are prone to exposure or injury, especially mucous membranes). When a basophil or MAST cell is exposed to the right type of antigen (allergen), the cell “degranulates” and releases histamine to try to destroy the invader.
Histamine also helps regulate your daily body clock, stomach acid secretion, blood vessel dilation, appetite, body temperature, endocrine balance, and itch perception.
So histamine is an important regulator and player in your body!
Excess histamine is broken down by two primary pathways in your body: with the DAO (Diamine oxidase) enzyme and the HNMT (Histamine n-methyltransferase) enzyme and is supported by the methylation process (see What the Heck is Methylation https://confluencenutrition.comwhat-the-heck-is-methylation/). DAO is responsible for breaking down excess histamine in your digestive tract, while HNMT degrades histamine in the nervous system.
Usually, these enzymes break down excess histamine, and you don’t even notice. But if one or both of these enzymes aren’t working properly, or the intake or creation of histamine overwhelms your ability to clear it, you can start to experience histamine intolerance symptoms.
Histamine Intolerance Symptoms
Excess circulating histamine can cause a wide range of symptoms. To complicate matters, the severity of the symptoms can vary widely, and reactions may be delayed making pinpointing the offender difficult.
The classic signs of histamine intolerance include flushing skin or rashes (including hives), itching, and headache, but may also include itchy throat or eyes, fatigue, anxiety or heart palpitations, eczema or rosacea, nasal congestion, dizziness, shortness of breath, and tinnitus or hearing problems.
As always, these symptoms can also indicate other issues as well, so it’s important to create a holistic picture of your case, and to place the symptoms in context to make sure that we are fully understanding what’s involved in your picture, and to make sure we are focusing on the correct things. (See the blog How to Use These 2 Functional Medicine Tools to Clarify Your Path to Healing.)
Histamine Intolerance Root Causes
There are multiple possible reasons that histamine intolerance could be an issue for you, and creating the appropriate solution requires getting clear on your unique root causes.
The first place to always begin is with the food you are putting in your mouth each day. Foods can contribute to the problem if they are high histamine foods, if they are histamine liberator foods, OR if they impede the function of the DAO enzyme.
Some of the most common histamine problem foods include: fermented foods or beverages (kombucha, kefir, sauerkraut, miso, tofu, tempeh, etc.), processed or cured meats (salami, prosciutto, bacon, bologna, ham, luncheon meat, etc.), bone broth, alcohol, vinegars, avocado, tomatoes, and really ripe or overripe fruits.
Another reason for histamine issues can be dysbiosis or gut damage. This impacts your gut’s ability to produce the DAO enzyme that breaks down histamine.
If you also happen to have high amounts of bacteria that produce histamine, you may have histamine flares when you eat foods that encourage these bacteria. Candida toxins may also flare histamine symptoms.
Additionally, if you have a leaky or permeable gut (See video on How to Fix a Leaky Gut below), immune triggers may be sneaking through your gut lining and triggering a histamine response.
Or the problem may be that you are deficient in some of the nutrients that support methylation, which helps break down your histamine. The most important co-factors, which I find many people are deficient in, include vitamin C, vitamins B6, B12, and folate, as well as magnesium.
Finally, some people may have genetics that reduce their efficiency at breaking down their excess histamine. This includes people with certain MTHFR mutations.
How to Tell if Histamine Intolerance is a Problem for You
If you suspect that histamine intolerance may be part of your symptom challenges, here is a step by step way to expand your awareness and build understanding of what your body is doing.
With these broad lists of foods high in one particular food element, the goal isn’t to remove ALL the foods. This isn’t possible, and generally isn’t advisable, because we want to keep you eating as wide a variety of foods as possible. The goal is to clearly identify YOUR unique symptoms triggers and to focus your attention there.
Take a look at the Histamine Handout and mark the histamine foods that you regularly eat (daily or very frequently). Using your Food-Symptom Diary to track your food for a few days, taking particular note of the histamine foods, and how your body responds (there are instructions for how to use the Food-Symptom Diary inside it).
Can you see any correlation between when you eat the histamine foods and your symptoms flares? Make sure to note any and all signs or symptoms in the Symptom column of your diary.
If you DO notice a correlation between eating the histamine foods and your symptoms, try reducing or removing that food for a short while, 1-2 weeks. Keep note of your symptoms, and see if they decrease.
After you’ve completed the elimination exercise, eat a trial serving of one of your suspected foods, and keep your eyes on your symptoms for a few days afterwards. Did your symptoms flare up again? If so, that food may need to come out of your diet for a period of time, or you can experiment with dosage or timing to see how you can tolerate it. For example, you may be able to eat tomatoes once a week, but more frequently causes a flare.
Other Steps to Support Histamine Intolerance Symptoms
The food changes are only one part of the process of resolving a histamine imbalance, and there is more you can do to resolve the root causes. Here are some other places you can focus your investigations to get to the bottom of your histamine issue.
Consider gut testing to see if SIBO or other gut infections are a factor, and address what you find. Sometimes these infections can really aggravate a histamine situation, particularly SIBO, candida, or other bacterial overgrowth. (See Gut Testing for IBS and SIBO for more info).
Add methylation support supplements. Because the methylation process helps break down excess histamine for eliminiation, supporting methylation can help. These nutrients include vitamin C, vitamin B6, B12, methylfolate, and magnesium.
Natural antihistamines can help with symptoms while you address underlying causes. Options include quercetin, vitamin C with bioflavinoids, and DAO enzyme.
Reduce or eliminate alcohol: Alcohol is a histamine double-whammy because it is very high in histamine, but also reduces the effectiveness of your available DAO enzyme.
Should you feel that you’re on the right track, but the details are confusing, or you need some more help getting gut testing, or interpreting your Food-Symptom Diary, please schedule a free 30-minute assessment session with me, to find out how I can help you work through this process.
This week is Endometriosis Awareness Week, and as I had my own journey with Endometriosis (see my latest YouTube video where I talk about it HERE), I wanted to share what I learned about eating a proper endometriosis diet with you.
Endometriosis is a complex condition that is largely misunderstood. But like every complex health challenge, diet and lifestyle factors are significant contributors to your ability to manage and cope. In today’s blog, I’d like to share what I’ve learned about how to eat an endometriosis diet to minimize symptoms.
Endometriosis 101: What Is It?
Endometriosis is an inflammatory, possibly autoimmune disease, where tissue like the inner lining of your uterus, or endometrium, is found outside your uterus. The misplaced endometrial tissue responds to your monthly hormone cycle just like your uterus lining, and this causes inflammation, swelling, scar tissue build up, pain, and adhesions.
The most root-cause resolution approach for treating endometriosis is wide-excision surgery, which removes all of the visible endometriosis tissue with a wide margin of healthy looking tissue. Though there is some recurrence rate, it is much lower than more conventional laproscopic cauterization surgery, and is certainly far more effective than hormonal or other pharmaceutical treatments.
However, these treatments are only one side of the coin. Endometriosis, especially long-term endo, often causes secondary problems, which need to be addressed in addition to surgery for best long term success. Many of these secondary problems are manageable with diet and lifestyle. These include things like: IBS, SIBO, generalized gut dysbiois and leaky gut and the downstream nutrient deficiencies this can lead to, adrenal fatigue, underlying hormone imbalances, food sensitivities, interstitial cystitis or other bladder problems, and internal structural problems due to scar tissue.
Though it can be tempting to try to “attack” all these issues aggressively, the most real, lasting effects are gained by drawing your attention back to the basics, and to create a nourishing, supportive environment, where your body’s cells fundamentally get what they need.
What to Eat and What Not to Eat on an Endometriosis Diet
As with most other inflammatory conditions, an endometriosis diet template reduces or removes inflammatory foods like gluten, rancid vegetable oils, dairy, sugar, and processed foods as a starting place for eating. But here are few specific considerations that may help you find your way to the least symptom-tiggering endometriosis diet.
WHAT TO AVOID on your Endometriosis Diet
Dairy products
No matter whether your sensitivity or dairy source, all dairy products come from a lactating or pregnant cows, and therefore all contain hormones. Because endometriosis is generally hormonally mediated, naturally-occurring hormones from dairy can aggravate the mixed up hormonal messages your body is already experiencing or sending. Avoid dairy products or evaluate each type to see if they affect your symptoms.
Industrial Seed Oils and Trans-Fats
As Americans, we generally over consume industrial seed oils like canola, safflower, sunflower, soy, and cottonseed oils. These oils are easily oxidized, or turn rancid, and this rancidity causes inflammation in your body, especially when not balanced by an abundance of omega-3 fatty acids, like those from fish and seafood.
Reduce or eliminate these seed oils, and replace with olive, coconut, or avocado oil for cooking, and sesame or flax oils for cold uses. You can also increase your consumption of fatty fish or consume a fish oil supplement.
Red meat and Farm-Raised Fish
Many women with endometriosis find that red meat or farmed fish aggravates their endometriosis. For some people, red meat consumption increases inflammatory cytokines, which leads to more pain. Meanwhile, farm-raised fish is raised in toxic, chemical-laden ponds, and is often given antibiotics.
If you can, purchase organic, grass-fed or pasture-raised meat, and wild-caught seafood. Avoid seafood that accumulates toxins like mercury, such as mackerel, merlin, shark, tuna, bluefin, and orange roughy. Commonly farmed fish include tilapia, catfish, and salmon. Choose short-lived fish and seafood species such as wild-caught salmon, cod, shrimp, and pollock.
Oxalate Foods
Oxalic acids naturally occurs in some foods. With certain gut conditions, oxalic acid can deposit into any body tissues and form sharp, jagged crystals. Oxalate crystals are the most frequent cause of kidney stones, and can often be involved with body pain.
Some common foods high in oxalates include spinach, chard, sweet potatoes, chocolate, almonds, peanuts, wheat, chia, and rhubarb. But before you run out and remove all foods these foods (please don’t do this!) you need to know that if you suspect oxalates to be a contributor to your pain, you must slowly reduce the oxalate content of your diet over a period of weeks. This prevents an episode of oxalate dumping, which can lead to a major pain flare. If this is you, I suggest working closely with someone who can guide you through this process. You can start by downloading my Food-Symptom Diary and doing a little tracking to see if you notice a correlation between your symptoms and oxalate foods.
Caffeine and Alcohol
Both caffeine and alcohol can increase the severity and incidence of endometriosis pain, and they can also affect your estrogen metabolism, which is also involved with endometriosis. Reduce or eliminate these from your diet, except for an occasional treat. Green tea is a wonderful substitute for caffeine, and is generally anti-inflammatory.
Sugar
Sugar is generally an inflammatory food, and depletes your body of important nutrients, including magnesium, vitamin D, calcium, chromium (which helps your sugar metabolism), and vitamin C. Since several of these nutrients support your immune function, sugar reduces your healthy immune response. Eliminating sugar can make a significant difference in your level of endometriosis pain, and your body’s ability to manage the inflammation and swelling.
WHAT TO INCLUDE on your Endometriosis Diet
Though it’s easy to say what you should avoid, I also want to take a moment to share a few foods that may be helpful for you to include to modulate your endometriosis. These foods help balance hormones, support proper hormone detoxification, keep your balanced blood sugar, and reduce inflammation.
Green Tea
Green tea contains powerful antioxidants that help clean up inflammatory damage in your body. A cup or two of green tea per day, or using supplemental ECGC can help.
Red Veggies and Fruits
These contain lycopene, another naturally-occuring antioxidant, which may reduce adhesion formation.
Cruciferous veggies contain a relatively high amount of sulfur compounds, which aid your liver in detoxing estrogens and other compounds.
Flaxseed
Flax has a reputation for being estrogenic, but it actually helps bind up the “bad” estrogens and eliminate them. Daily ground flax seeds are helpful to keep estrogen in check.
Fermented Foods
Sauerkraut, pickles, kombucha, and more are a wonderful source of beneficial and diverse good bacteria. Keep in mind that if you already struggle with IBS or SIBO, probiotic or fermented foods may not be the right thing until you handle this because increasing your intake of these foods may exacerbate your bloating or belly pain.
Evening Primrose Oil
This supplement may help with estrogen metabolism and to reduce pain.
Water
Drink plenty of clean, filtered water.
Conclusion
Changing your diet and taking a few supplements won’t likely make your endo go away, but it can make your symptoms largely manageable, and make your other treatments or pain management more effective. And these same dietary changes can help you manage the conditions downstream of your endo as well. By working methodically to shift your life terrain, you can expect to find your cycles less painful, as well as improved pain management, sleep, moods, and immune function.
If you are feeling confused about how to navigate all these choices to manage your endometriosis, I encourage you to reach out to me and schedule a free 30-minute assessment session. I can help you set a course for success.
If you’re not ready for that yet, I invite you to download my free guide, Roadmap to Recovery, where I share the how you can make sense of what your body is telling you so you can experience relief from your most pressing symptoms.
If you struggle with IBS or IBS-like symptoms, you may have found your way to the low FODMAP diet or another therapeutic diet. In this blog post, I will help you understand how the low FODMAP diet fits into the context of your full IBS diet plan.
Making sure your IBS diet is low on aggravating foods is a key part of healing, and will dramatically improve your quality of life. But dietary intervention is rarely enough to help you resolve your IBS from the root cause level.
Because IBS is so frequently caused by dysbiosis, what you are really aiming to do with all of your interventions, is to support your body in shifting its gut microbiome.
So if you’re trying to resolve your IBS or IBS-like symptoms at their roots, what does this plan look like? And where does your IBS diet plan fit in?
Getting to the Right IBS Diet Plan
The first step in any plan is doing a proper assessment and finding which areas are ripe for easy action. These areas usually fall into a few different categories:
choosing the right diet for your unique body.
creating a foundation of health practices that supports you (sleep, stress management, exercise, balancing blood sugar, hydration, and supportive community).
recharging nutrient deficiencies with proper food and supplementation.
So many people think that the diet part is all they need to do. But this is only one small piece of the journey.
Though tempting to skip these steps, finding your way to the right combination for you can often remove some of the root causes that are contributing to your current health challenges. This makes your bigger healing project easier and more efficient and effective.
By cleaning up these foundational pieces, you set yourself up for much greater success.
How to Create the Wrong IBS Diet Plan: Potential Pitfalls
I made a lot of mistakes using therapeutic diets before I was trained as nutrition coach, and I’ve seen countless others make the same mistakes.
Here is how my story went:
Like many of you, I had intermittent, but challenging digestive symptoms. They at times, but not always, had me staying close to a toilet, and feeling very puzzled. Sometimes my symptoms struck in the morning, sometimes it was the middle of the night. Either way, it was always unwelcome.
I have been a DIY health person since I was in college, when I succeeded in curing my recurrent bladder infections using herbs and homeopathy. So I started researching.
I learned about therapeutic and elimination diets, and tried them out. I stared with simple gluten, dairy, and sugar free. This one actually made a lot of difference, but I didn’t know I should stay on it for a while. I gradually slipped off after the initial month.
A few years later, still struggling, I learned about the ketogenic diet, and based on the testimonials of people who had been wildly successful with it, I dove in whole hog.
I felt a little better, but didn’t seem to access the profound energy that many keto advocates describe. Then, after several months, my digestion, hormone, and skin issues all started to get WAY worse.
I shifted back toward a more paleo template, and added more carbs back in, but cut dairy out. This helped, but by now, the issue had exploded, and was bothering me more days per month than not.
When adopting a diet template for digestive problems, I was missing a few very key pieces of information:
Your Diet Highly Contributes to Your Microbiome: Extremely low carb diets like keto can dramatically shift the composition of the microbiome, and this isn’t always a positive thing. Our good bacteria survive by consuming the natural fiber in plant based foods, such as fruits, vegetables, whole grains, legumes, nuts, and seeds.
In my case, the keto diet removed most fruit, some high fiber vegetables such as beets, carrots, potatoes, and winter squash due to their carb content, legumes, and whole grains. Essentially, I starved my beneficial bacteria, which contributed to a lot of worsening mood and hormone symptoms. When choosing a therapeutic diet, it’s important to be mindful of the varied effects it is likely to have on your microbiome, and to be sure to support it.
Diet Templates Must Be Customized: Any diet template, for any health condition, needs to be customized to you to minimize the potential negative affects that widespread eliminations can produce. You want to remove the foods that are causing a lot of inflammation or other problems, but minimize the number of removals so you don’t destabilize the microbiome, create nutrient deficiencies, and minimize the disruption your experience of eating.
In my case, eating a much higher fat and lower carb diet overburdened my already struggling digestion and elimination, and contributed to increased acne, anxiety, diarrhea, constipation, and hormone havoc. Had I been paying closer attention with diet tracking, I would have noticed that these changes were worsening my symptoms.
Diet is ONLY ONE piece of a complex puzzle that may require multiple steps. I feel the diet shift is beneficial to do at first, to focus on providing symptomatic relief, as well as underlying inflammatory relief. Once you have diet sorted out, then and only THEN should you focus in on resolving the other pieces of your puzzle, such as nutrient deficiencies, detox support, and hidden infections or pathology.
I think a lot of experts and authors sell a lot of people short here. Many people promote their therapeutic diet as the magic bullet or likely cure for an illness. For some people this is the case, but I believe it is the slim minority. Most people require not only diet changes, but also habit realignment, customized supplementation, and sometimes, more significant protocols to shift the microbiome or even prescription medications. It’s a great disservice to tell people that diet will fix them when it’s not really the case.
Your IBS Diet Plan: Customized and In Context
The Low FODMAP diet is currently the only peer-reviewed diet proven to support IBS. The Specific Carbohydrate Diet is similar, but has not yet been proven scientifically to be effective. But since diet templates are simply a place to begin, this doesn’t really matter. You start where you need to start, and work from there.
In the basic FODMAP diet, you focus on removing high FODMAP foods, which are foods high in certain fermentable carbohydrates. These carbs and fibers feed bacteria in the gut and can contribute to gas and bloating, as well as the diarrhea or constipation that are hallmarks of IBS.
But the high FODMAPS list is really broad. It includes a lot of generally healthy foods, including (this list is not complete):
asparagus
artichokes
garlic, onions, and leeks
apples
cherries
figs
mango
agave
high fructose corn syrup
honey
peas
soybeans, black, fava, kidney, navy beans
dates
persimmon
plums
cauliflower
mushrooms
apricots
blackberries
carob
chicory
and more…
But here’s what you need to know about this list: it would be difficult to remove ALL those foods entirely, and you don’t need to. You likely have sensitivity to one or two TYPES of FODMAPS, but not necessarily ALL of them.
You might mostly have a problem with Fructo-saccharides, or fructose. By using detailed FODMAP lists of foods (check this really detailed one out) along with your Food-Symptom Diary (you can download yours here) properly to assess this, you may find that you don’t need to eliminate the segments of the list that pertain to other types of sugars.
And even within one sub-segment of the FODMAP list, you may find that some of the foods on that list bother you, while others are just fine and don’t contribute to your symptoms.
So while anyone can read a list, and decide to remove everything on it, the true benefit of the list is to use it as a tool to know WHERE TO LOOK for your unique sensitivities. Then you do the elimination work to discover what specifically is true for you.
Once you have THAT information, you can move ahead with confidence, knowing that you won’t be triggering your symptoms while you address whatever other underlying causes are contributing. Ideally, you’ll be able to discover the specific dysbiosis or other mechanisms that are creating the conditions that make your IBS happen, and you can work through the process of resolving them. (To read more about how to use Gut Microbiome Testing to resolve IBS, read Gut Microbiome Testing for IBS).
Conclusion
Healing from a chronic illness like IBS is really a transformative experience, and requires context. Transforming your practices and habits sets you up for a lifetime of not only improved health, but the ability to deal with and successfully face any future health challenge that comes our way because you will have learned how to work WITH your body. What you learn about your body never deserts you. It becomes something you build on as you move forward.
Now you know how to use the Low FODMAP Diet in the proper context to create your IBS diet plan, but what about the other steps along your Roadmap to Recovery? Grab your free copy here.
And if you’re feeling confused about how to wade through all those FODMAP food lists, and you’re ready for some support with diet and supplement customization in your pursuit of your personal remission, schedule a free 30 minute Assessment session with me right here.
If you’ve been diagnosed with IBS, or another digestive illness, you may have been told there’s not much you can do, other than change your diet. And while diet changes are foundational for success with your IBS, there is a lot of useful information to be gained by gut microbiome testing using functional labs.
As many as 80% of IBS sufferers may in fact have SIBO, or Small Intestinal Bacterial Overgrowth as a primary cause of their symptoms. And other types of gut dysbiosis has been shown to be associated with IBS as well.
To create a meaningful strategy for healing from IBS and other digestive challenges, it’s important to do gut microbiome testing because choosing the right strategy requires knowing which types of organisms are overgrown.
Read on for a gut microbiome testing overview, and to learn which specific labs I use with my clients.
What is Gut Microbiome Testing?
With the recent evolution of DNA-PCR technology, it’s become easier and more affordable than ever to do DNA gut microbiome testing. Several labs have developed technology to identify the presence or absence of particular microorganisms in a sample of stool.
We all have a prolific community of miocroorganisms in and on our bodies, including bacteria, yeasts, parasites, and viruses. Some writers and researchers have said that our communities of microorganisms outnumber our individual cells! These communities are an integral part of maintaining our digestive function.
Gut microbiome testing uses DNA analysis to find out whether there are known pathogenic, or infectious, microorganisms in our digestive system. Some gut bugs are normal residents, but can cause problems if there are too many of them, while others are non-normal residents and can cause symptoms and illness.
Before DNA testing was available, most gut microbiome testing was done by culturing a stool sample for bacteria and yeast, and physically looking for evidence of parasites, such as eggs or parasite bodies, with a microscope. The huge advantage of using DNA testing is that it can detect much smaller quantities of organisms than can be visually seen. Labs claim that they can detect down to 3-5 cells worth of an organism by identifying its DNA fingerprint.
Gut Microbiome Testing for IBS and Other Digestive Problems
Because an irregular microbiome is a hallmark of chronic digestive problems, using gut microbiome testing can provide you with important direction when planning your individualized plan for healing.
The symptoms of IBS, IBD, Crohn’s Disease, SIBO, Celiac disease, and other digestive related disorders are similar, but the approach to helping you reach remission will be unique and individual to you. Likewise, symptoms of infection with parasites, bacteria, or yeasts are similar, but the best approach for each situation is different.
It’s always best to test, not guess to move forward with the most accurate and specific information possible, so you can create the most personalized plan.
Gut Microbiome Test #1: Diagnostic Solutions Laboratory GI-MAP
The GI-MAP is a stool test. Using the scoop in a little test vial with preservative solution in it, you collect stool at home, and ship it back to the lab for testing.
The GI-MAP test is my go-to gut microbiome test for these reasons:
Thorough testing for the best normal and worst pathogenic players, including H. pylori, C. difficile, Giardia, Enterotoxigenic E. coli, Klebsiella pneumoniae, Bifidobacteria spp., Lactobacillus spp., Blastocystis hominis, Dientameoba fragilis, Candida albicans, and parasitic worms.
Includes markers for gut health, including Secretory IgA, Anti-gliadin IgA, elastase, calprotectin, and more.
Its cost is reasonable compared to other similar tests.
It is fairly often covered by insurance.
It’s easy to collect your sample, doesn’t require complicated preparation like some other stool tests, and the sample doesn’t need to be mailed immediately.
Understanding particularly which types of organisms are likely contributing to your problem is essential to creating your healing strategy. For example, if parasites are present, it’s important to address them first, before working on bacteria or yeast. Or, if yeast overgrowth is the only thing that shows up, then the appropriate strategy would be different.
Gut Microbiome Test #2: SIBO 3-Hour Lactulose Breath Test by BioHealth Labs
It’s estimated that a high number of IBS patients actually have SIBO (Small Intestinal Bacterial Overgrowth), which is an overgrowth of normal bacteria that has migrated from the large intestine to the small intestine.
To take the Biohealth Labs SIBO test, you prepare a day ahead of time with a special diet, and then drink a lactulose solution. You then collect breath samples into glass tubes every 20 minutes (materials are all included in the test kit) for 3 hours. You mail these back to the lab for analysis.
If you have a bacterial overgrowth in your small intestine, levels of hydrogen and methane gas will spike during the 3-hour period.
SIBO is notoriously difficult to resolve, but knowing which type you have is critical for reaching resolution, because the healing approach for each type is different.
Gut Microbiome Test #3: Intestinal Permeability (IP) Testing by Genova Labs
The Intestinal Permeability test by Genova Diagnostics is not a specific gut microbiome test, but it can show you how leaky your gut is. When your gut is permeable, proteins that shouldn’t be able to cross into the bloodstream are able to do so. This is an acknowledged autoimmune trigger, and also can leave your gut vulnerable to infection with pathogens.
This test doesn’t have a whole lot of clinical value, because we can assume a leaky gut if certain symptoms, such as multiple food sensitivities are present, but some people want to know for certain if their gut is leaky or not. This test answers that question.
Gut Microbiome Test #4: Mediator Release Test Food Sensitivity Testing by Oxford Biomedical OR IgG Food Sensitivity Testing by US Biotek or Genova Labs
Again, food sensitivity testing is not specifically Gut Microbiome testing, but food sensitivities are often a side effect of underlying infections or gut dysbiosis. I generally recommend my clients first use Food-Symptom Diary tracking to get clear on their own particular and unique triggers. (You can download your copy of my Food-Symptom Diary with instructions on how to use it here.) But sometimes, the situation is really confusing, or people are unable or unwilling to complete the full elimination diet process.
How to Get Gut Microbiome Testing for IBS or Other Gut Challenges
While there are some gut microbiome testing services that are available to the public, the tests I have mentioned here require working with a practitioner who has an account. Though more and more traditional doctors are becoming aware of the value of gut microbiome testing for their patients, many are still not using it. Functional medicine doctors and practitioners are generally using these tests and principles in practice, as well as many nutrition practitioners as well.
Check out the following referral links to find a practitioner near you, or one who works online or long distance:
Now that you know how important gut microbiome testing can be to finding your pathway to healing your gut or allergy symptoms, go get tested! I can provide access to all these tests I mention, in addition to others, as they may fit with your situation.
Not sure whether testing is right for you, or whether something else might be better first? I invite you to schedule a 30-minute Assessment Session with me to find whether testing is the next best step for you. I hope to meet you there.
During my late teens and early 20s, mental and gut health challenges slowly became daily burdens in my life. The first time I experienced anxiety, I startled awake in my dorm room with my heart racing in the middle of the night, wondering if I was having a heart attack. Other times, I would sometimes experience a deep sense of foreboding, like something really bad was about to happen, and I would frantically ask my friends or partner to change plans.
By my 30s, I had frequent diarrhea and cramping attacks, which were inconvenient when I wasn’t near a bathroom. I would go through periods where I was nauseated a lot. And I couldn’t sort out why it was happening. And my worry compounded my digestive symptoms. I could see some overlap between my mental and gut health symptoms, but I didn’t really realize until later how my mental and gut health were deeply connected.
As I studied functional nutrition, it suddenly all fell into place: the health of our gut is totally connected to our mental health status.
Here are some aspects of the mental and gut health connection you may not know about that may help you understand what you are up against, and to create a plan.
1. The Gut and Mental Health -Microbiome Connection
Your gut is home to a community ecosystem of microorganisms, made up of bacteria, yeasts, and even some types of parasites. When in balance, this ecosystem helps you maintain your digestive function, create and absorb nutrients, and maintain an effective barrier against pathogens, or bad guys. These microorganisms communicate by chemical signaling messages, which can be actually transmitted from gut to brain. In this way, your gut tells your brain if you’re feeling well, or if you’re feeling stressed. This is the source of a “gut feeling”.
Healthy microbiome residents, like certain kinds of Bacillus bacteria, are responsible for creating certain essential nutrients via fermentation in the colon, such as B vitamins, vitamin K2, vitamin A, and antioxidants. Some of these nutrients help maintain good gut barrier function, and prevent toxins from unwelcome microorganisms from getting to and affecting your brain.
If you have populations of unwelcome, pathogenic bacteria, their chemical messages and waste exhaust communicate with your brain via the vagus nerve and can contribute to anxiety and depression symptoms. Collections of digestive symptoms are often a sign that gut infections may be present. Because the gut microbiome is so important to brain health, it’s important to address any hidden infections as a part of your plan to resolve your mental health challenges at its roots.
2. Regular Bowel Movements are Essential to Gut and Mental Health
If you aren’t pooping regularly, toxins and exhaust from bacteria can increase and affect your mood and mental health. For example, elevated methane gas from bacterial overgrowth in the small intestine can create severe brain fog, anxiety, depression, headaches, irritability, and fatigue. Moving the bowels if constipated may help reduce mental health symptoms. (See 9 Ways to Get to the Bottom of Chronic Constipation for additional help and resources).
3. The Thyroid- Gut and Mental Health Connection
Thyroid imbalances are closely related to your gut health and mental health. A majority of T4 hormone (made in the thyroid gland) is converted to T3 (the usable hormone) in the gut. In this way, emergent thyroid problems may be a digestive disturbance at the root, and can often be cleaned up with an elimination diet and adrenal support.
If your body notices too little thyroid hormone, your brain and thyroid gland may try to make up the difference by releasing more Thyroid Stimulating Hormone (TSH), leading to too much hormone. Too much thyroid hormone, and you may experience anxiety. Too little thyroid hormone, or low levels of T3 and T4, and you will likely feel depressed. Supporting your thyroid function by supporting your gut function can be a really important part of balancing any mental health concerns.
4. The Gluten- Gut and Mental Health Connection
Many authors have noted the presence of mental health symptoms with the consumption of gluten. Grain Brain by Dr. David Perlmutter, Why Isn’t My Brain Working by Dr. Datis Kharrazian, The Autoimmune Fix by Dr. Tom O’Bryan, The Paleo Diet Cure by Chris Kresser, L.Ac., Healthy Gut, Healthy You by Dr. Michael Ruscio, and many more explain how consuming gluten foods breaks down gut barrier function which allows toxins to reach your brain and affect your moods and mental well-being.
As partially digested gluten (and other) proteins make it to the brain through a leaky gut, they can cause inflammation in the brain and contribute to mental health symptoms, including anxiety, depression, brain fog, poor memory, and even schizophrenic episodes. There was some very interesting research done in state hospitals in the 1960s removing gluten from the diets of schizophrenics. The patients experienced noticeably improved symptoms, and symptoms got worse with the reintroduction of gluten. If you are experiencing gut and mental health challenges, you might consider a gluten elimination diet. You can read more in 6 Reasons to Quit Gluten If You Have a Chronic Illness.
5. The Importance of Good Digestive Function for Gut and Mental Health
Many of our mood-supporting and regulating amino acids and neurotransmitters, like GABA or 5-HTP, or serotonin are in part made from protein foods in our diet. For your body to have access to the amino acids that build neurotransmitters, they must be chemically broken down from protein with hydrochloric acid in your stomach. If your body is low on stomach acid, then you can become deficient in aminos important for your mood regulation. Further, even if you can break down the proteins, if your gut function is compromised by bacterial overgrowth, yeasts or parasites, you may not be adequately absorbing the aminos you need either. Supporting your belly for robust digestive function is important for your mental health. You can read more in Have You Skipped These 9 Digestion Tips in Your Quest to Heal?
6. The Stress- Gut and Mental Health Connection
I hope by now you can begin to understand how important good digestive function is to support gut and mental health. High stress levels work against this process, and not only decrease our mood, but deplete our ability to maintain a positive mood. Stress also decreases our digestive efficiency, by slowing down digestion. To make matters worse, staying stressed out burns through large quantities of amino acids, which can further deplete your stores. Coupled with a compromised digestive system, you can see a self-reinforcing feedback loop worsening your mental health state. To make sure your stress isn’t wrecking your gut and mental health, it’s imperative to focus on effective stress relief practices, such as breathing, yoga, meditation, or simply doing something you love.
7. The Importance of Fat for Gut and Mental Health
In a world that has mistakenly villianized dietary fat, our mental health has suffered. Not only does too much carbohydrate-rich food feed the bacteria and other microorganisms that can destabilize your gut and therefore your mood, your body need fats to make your hormones. Your hormones help keep your moods in check, help you feel motivated, confident, and relaxed. As women begin to experience perimenopause, for example, levels of progesterone decrease, which can increase feelings of anxiety and stress. This process often collides with increased family and career demands, leading to a confluence of events that can precipitate a mental health crisis. If this woman also happens to be eating a low-fat diet, she will feel far worse than a woman who is consuming healthy fats. Make sure that you are including healthy fats (olive, avocado, coconut, ghee, or butter) and are avoiding industrial seed oils (cottonseed, soy, canola, safflower oils) in your diet, and are supporting healthy fat digestion with stomach acid and enzyme support.
Conclusion: What does all this amount to?
To work on resolving anxiety or depression at its root cause, it’s important to consider what exactly is going on in the gut, the interface between your gut and your food, and to work to balance and correct it. In most cases, the gut is a significant contributor to mental health symptoms, and must be balanced. This work is done by managing stress, adjusting the diet to reduce inflammation, removing infections, and repairing the gut barrier function and leaky gut. It can take some time, but the mental health improvements, without medication, are worth the effort for those that want to avoid medication.
If you are experiencing gut and mental health symptoms, know that you are not alone and that there is a lot you can do to heal yourself from the inside out! When you’re ready for a some support and action in crafting a plan to investigate your root causes and heal, schedule a free 30-minute phone call with me here. Together, we’ll assess where you are, and what your next best steps would be. I look forward to talking with you.
Having an IBS (Irritable Bowel Syndrome) flare is no fun.
To illustrate, imagine this scenario:
I live a 90-minute drive over remote mountain roads from the nearest city, and I make the trip once a week, to resupply my groceries and other necessities. It’s an all-day affair. I leave after I drop my kids off at school, and I return around 5:30 pm. It’s challenging on the best of days, but even more so on one of the days when I used to have an IBS flare.
One January day, I found myself pulled over on the side of the road in the pouring rain, frantically digging a hole, trying to keep out of sight, while my belly cramped. I knew I was in for a crappy day when that happened (pun intended!).
Later that day, I had trouble finding a decent public restroom. Belly rebelling, I managed to make it into a not-so-clean bathroom in a local grocery store.
On this day, I felt not only crampy in my belly, but exhausted, stressed, and fed up with this process! Unfairly, my IBS flare days often seemed to happen on my town days. I was pretty motivated to figure out not only how I could prevent these flare days, but also how to stop them from ever happening! Because, you know, life happens, and I had things I wanted to get done!
So to help you have less frequent and less severe IBS flares, I want to share how IBS patients and practitioners work through an IBS flare, and some bigger picture strategies for unraveling their root causes.
What is an IBS flare?
IBS, or Irritable Bowel Syndrome is a broad, non-specific digestive disorder. IBS typically waxes and wanes, much to the chagrin of sufferers. Sometimes it’s quiet, and not causing much trouble. But other times, it decides to rear its ugly head. In general, IBS symptoms may include:
Bloating
Gas
Constipation OR Diarrhea
Alternating Bouts of Constipation and Diarrhea
Urgent need to use the bathroom, or stool is difficult to pass
Clear, white mucous in the stool
The specifics can look different for each of us, but an IBS flare is an increase in the frequency or intensity of the symptoms. For me, this looked like frequent stool (up to 5-6 times in a day, though it might be even more for you), cramping, pain or soreness, along with fatigue, dehydration, and general malaise. As a practitioner, I have found that a food allergy flare looks quite similar, which suggests to me that IBS symptoms are likely to be connected with food sensitivities or allergies (more on that in a minute).
What Causes IBS?
If you’ve been given a diagnosis of IBS, it’s likely you have these symptoms. But this doesn’t mean that you or your doctor know what’s causing them. The IBS diagnosis is usually given when other digestive pathology, like Crohn’s, Colitis, or other diseases are ruled out.
But from a Functional Medicine or Nutrition perspective, there are a lot of possible causes, and you owe it to yourself to try to uncover them.
One of the main causes of IBS that is well within your control is food allergies or sensitivities. Many of you with IBS are already aware that certain foods flare your symptoms and you avoid them like the plague. But clearly identifying all of those trigger foods can be a game changer. (To read more about how to figure out your particular food triggers, check out Food Intolerance Primer: What I Wish I Had Known here.) Another commonly overlooked cause of IBS is Small Intestinal Bacterial Overgrowth, or SIBO. Some studies suggest that as many as 85% of IBS cases are actually caused by SIBO. In SIBO, bacterial overgrowth in the small intestine can cause malabsorption issues, diarrhea OR constipation, bloating, gas, and many other symptoms. (Sounds like IBS, right?) In addition to SIBO, other potential root causes of IBS are underlying, previously hidden infections, including parasites, fungus, bacteria in the large intestine, or things like Lyme disease. Other potential players or contributors include mold, stress, environmental toxins, or poor water quality in your home.
How to Repair IBS and Restore Normal Gut Function
As tempting as it is to want a quick, easy fix for a problem like IBS, restoring normal gut function is more of a long-game. But even in the worst cases, there is hope for a more normal life. The first step to repairing your gut function isn’t to dive into every possible solution you can think of. Instead, you want to zoom out, and really understand what you’re seeing in context. Gathering information about your story, family history, the triggering events that may have started your problem, your collection of test results, understanding when, where, and how often your symptoms occur, and your current diet and stool habits can really help in creating the right solution. Once you have this information, you can begin to adjust your current diet and habits that are likely to lead to a change in your symptoms. This can often mean adding digestive supports like stomach acid, enzymes, or probiotics, removing foods that may be aggravating your gut lining, adding in nutrients that appear to be deficient, or even focusing on stress management. After you have adjusted these parts of your life, if you still have symptoms, now is the time to consider testing for deeper dysfunction, like infections or SIBO. (If you’d like to see all this mapped out, with some suggested action steps you can take on your own, I invite you to download your free copy of Roadmap to Recovery. I go into a bit more detail about what this looks like in real life, and provide you with some things you can do right now to get started.)
What to Do When You Have An IBS Flare
Even when you are diligent, and work really hard to avoid an IBS flare, they sometimes happen anyway (Damn it!). So what then? In a lot of ways, living with IBS or other bowel disorders is about learning how to minimize your flares. You may never be able to completely eliminate your symptoms, but you CAN certainly minimize them and live well in spite of them. I do want to make sure to say that not ALL of these tips is likely to help you. Choose two or three to test next time you have a flare, and see how you respond. If your body doesn’t like what you’ve chosen, now you know to move on to something else. You can keep a running list that details what works for your body and what doesn’t. This list is GOLD, because you now have a personalized tip sheet to turn to when symptoms get out of hand. If you have already created a Functional Nutrition Matrix, you can note these details in the “Mediators” section. These are important clues that help detail what your body is doing and why. This is at the heart of the Functional method of practice. I asked around my community of chronic illness bloggers and Functional Nutrition professionals to find out what they do themselves, or what they recommend to their clients when they experience an IBS flare.
Here is the list of tips they shared to quickly work through an IBS flare:
#1: Simplify Your Diet and go back to your known safe foods:
I find my flares often happen when I decided to get a little more adventurous on purpose. The first thing I do in response is to try to identify what the food trigger may have been, and return to foods I absolutely know to be safe. And I add a “note to self” to continue avoiding that trigger food while I work on my gut repair.
Here are some other SIMPLIFY tips from IBS patients and practitioners:
Jessica Donces, FDN, Owner Optimize to Thrive: “I suggest basic, easy-to-digest animal proteins. They are broken down and digested earlier on compared to veggies, therefore “easier” on the gut in terms of symptoms one may be experiencing with IBS. Also, elemental diets can be a great tool, there are several different types.”
Amber Blackburn, IBS patient: “My biggest tip when I have a bad flare up is I start eating basically only from the BRAT (Bananas, Rice, Apples and Toast) diet. And I do that for a few days at least until my gut feels better.”
Marya Mesa, IBD patient, blogger atChronic Mom Life: “I had IBS for years and now IBD – ulcerative colitis. When I flare I keep it very simple… stock, yogurt, smoothies, eggs, bananas, avocados.”
Candace Mantle, IBS patient: “I’ve also got Crohn’s disease. When I flare I just eat chicken, white rice and mashed potatoes. This allows my digestive system to rest.”
Collin Wong, IBD patient, blogger atCollin’s IBD Chronicles: “When I have a flare with IBD, I just avoid fried foods and spicy foods and keep it to steamed foods, and soluble fibers.”
Nicole NIckley, FDN Practitioner with The Health Mission: “Fasting with bone broth, chamomile tea, homeopathy (Ignatia Amara, or Nux Vomica remedies), and digestive essential oils blends, topically.”
Natalie Gardner, IBD patient and blogger atThe Spoonie Mummy: “I have IBD (Crohns) and an Ileostomy. One of the first things I turn to when I feel like I’m starting to flare is the Low Residue diet (also known as a low fiber diet).
#2: Add binders
Binders, such as activated charcoal, bentonite clay, or citrus pectin, can bind up toxins or inflammation in your gut.
Nicole Nickley, FDN Practitioner at The Health Mission: “I had a flare up from my Thanksgiving feast and took GI Detox (you can get it here) and that took care of symptoms.”
I do want to add the caveat about binders: If you already trend toward constipation, you may want to skip these, or try them carefully and assess your reaction. Binders may cause or increase constipation. Here are a few specific products to explore (you can access most of these inside my online supplement dispensary at FullScript):
In addition to these shared tips, here are a few more than I have used myself for my flares, and might suggest for you if you are experiencing a flare.
#3: Plain water enemas, or coffee enemas, 1-2 x per day
I’ve found this practice greatly reduces the length of my IBS flares, especially since I generally trend toward constipation. Plus it allows my body to detox a little bit more thoroughly. I only recommend this frequency of enemas for a short period of time, maybe 1-2 days. To do enemas more frequently may lead to nutritional deficiencies and dehydration. Here are instructions on how to perform an enema. Here is the enema kit I prefer.
#4: Return to your tried and true stress-reduction techniques
Stress has a huge impact on the digestive system. Any kind of stress can slow down (or speed up!) your digestion and appetite. If stress is part of your symptom flare, be sure to think about stress-relief techniques as part of your solution. For me, this includes:
You can also use any other stress relief methods you have found work. This might include yoga, or walks outdoors, dancing, a hobby you enjoy, singing, time with people you love. Whatever feeds you and helps you feel happy is stress relief!
Rachel Romaine, FDN Practitioner with Present Day Wellness, recommends belly massage and a hot water bottle to relieve belly stress and pain. If you’re not too sore, massage in slow, small circles, moving always in a clockwise direction.
If I missed any stress relief techniques you like, please add yours in the comment.
#5: Include soothing, demulcent, or carminative supplements or essential oils:
This is a very bioindividual recommendation, because while some of these may help soothe your gut, some could irritate your gut. But many people find relief using herbs or botanicals orally, such as:
Kara Louise, Certified Integrative Health Coach, Holistic Health Practitioner, and Functional Medicine Practitioner, and owner ofLife Hub Center says:
“There are several essential oils that can help keep the digestive system in a state of relative calm. These are my favorites:
DiGize (Young Living brand) is an essential oil blend that includes Fennel, Tarragon, Ginger, Peppermint, Juniper, Lemongrass, Anise, and Patchouli. DiGize can be used internally (either via a couple drops in a capsule), rubbed on the lower belly, or via under the tongue. DiGize also helps relieve digestive problems like indigestion, heartburn, gas, and bloating to name a few. It is also known to help fight off candida and intestinal parasites making it an all-in-one essential oil blend that’s a must-have for every at-home medicine cabinet.
Marjoram, Basil and Peppermint are three single essential oils that when added to Epsom salt baths (3 drops each to a cup or more of Epsom salts) help relieve the cramping that is associated with irritable bowel. (Peppermint happens to be a great oil to keep with you at all time to help relieve stomach upset and nausea. It’s also great on the roof of your mouth to relieve headaches.)
Oregano is a “hot” oil that has strong anti-bacterial qualities. Many individuals have found it to be beneficial as part of their anti-candida therapy and to balance their microbiome. It’s best to work with a health coach trained in essential oil usage when it comes to using oregano.
Essential oils are powerful, strong and therapeutic. My two tips when it comes to essential oil usage are: (1) find the right company who can track your oil from Seed to Seal to be the best quality; (2) work with someone who is trained on aromatic medicine and can help you with an individualized approach to using essential oils as part of your healing journey.”
For some people, especially if SIBO is an issue, probiotics may aggravate symptoms. Back off on probiotics for a few days while you restore balance and calm inflammation.
#7: Increase antioxidants
Vitamins A, C, & E, CoQ10, or glutathione will help repair the inflammatory damage in your guts, whatever the cause. Give your cells the nutrients they need to do repair work! One simple way you can do this is by eating a rainbow of foods, if you can tolerate them, or by using herbal teas, which contain plant phenols which are natural antioxidants. While a nutrient-dense diet is always the preferred way to get these nutrients into your body, you can also include nutritional supplements to meet your needs.
#8 : Hydration
The body needs adequate hydration to do all it’s tasks. If you’ve had diarrhea as part of your flare, you may also be dehydrated. Be sure to drink plenty of fresh, clean water.
#9: L-glutamine
L-glutamine is an amino acid that your gut cells use to do repair work. Taking L-glutamine (1-5 or more grams per day) may help repair your gut lining during a flare. L-glutamine is generally well tolerated, but it’s always a good policy to start at a low dose and slowly increase to your tolerance to avoid any negative reactions.
Conclusion
You don’t have to simply wait out your IBS flare. With some attention and care, you can reduce the length and severity of a flare by trying out some of the methods shown here. If your IBS flares and attacks are an ongoing, regular occurrence, it may be time to get serious about investigating your root causes. When a client comes to me with symptoms resembling IBS, I always do a full case history, to try and identify when and why the symptoms first started. I help them do some dietary clean up and support their digestion first. If we’re not able to resolve symptoms that way, I suggest running a stool or breath test, to find out whether infections are involved. I’ve used this approach with myself as well as my clients. I’ve done so well with my IBS approach that I can’t remember the last time I had an IBS flare, let alone on my town trip day. What a relief! And though I do occasionally have a flare, they are no longer anywhere near as bad as they once were, and I’m able to resolve them quickly with a minimum of disruption of my life. My kids and my family need me, and I’d rather spend my time with them than be on my toilet. Wouldn’t you?
Let’s get you free from symptom flares, and back to comfortable belly function! When you’re ready to dig into your underlying reasons for your IBS flares, and are ready to see the length of time between your flares increase, grab your free copy of Roadmap to Recovery, and get started right away with some easy, accessible tasks.
