sydney naturopath histamine

Oestrogen & Histamine Intolerance – The Vicious Cycle

The vicious cycle that drives pre-menstrual anxiety, indigestion, headaches & more…


I am meeting more & more women at my private practice in Sydney who have un-diagnosed histamine intolerance. The key to understanding what drives histamine intolerance is to examine its relationship with the hormone oestrogen, and how the two feed each-other in a vicious cycle

The women I meet in my practice have typically done the rounds of conventional testing & treatments with their GP, but haven’t uncovered any significant reason to explain their intense symptoms such as anxiety, congestion, headaches, PMS, pain & indigestion that seem to be much worse right around ovulation and premenstrually

Supplements, herbs & pain medications may be helping to treat their symptoms, but they still don’t feel 100% and have become completely reliant on them to get through their cycle each month

If this sounds like you, histamine intolerance may be the missing link to uncovering the cause of your symptoms

What Is Histamine Intolerance?

Histamine Intolerance occurs when there is a build-up of histamine in the body due to an impaired ability of our body to handle, break-down and metabolise the histamine that we make in the body, and also the histamine that is in particular foods.  When levels of histamine in the body build because we aren’t breaking it down well enough, you may start to experience symptoms of histamine intolerance

A useful analogy for understanding this is the bucket – under optimal conditions our bodies should be able metabolise & break down the histamine we consume in foods and which we make, but if the bucket overflows because we’re not emptying it properly, we can start to experience symptoms of histamine intolerance

It is one of the many food chemical intolerances that many people experience, where their symptoms are all over the place and it seems impossible to figure out which foods they’re reacting to – this is because histamine is in so many foods, so it becomes almost impossible to avoid it completely

The classic symptoms of Histamine Intolerance:

  • GIT – Altered bowel function, abdominal pain, nausea, abdominal cramping, reflux
  • Headaches , Migraines
  • Heavy and/or painful periods
  • Joint pain
  • Tissue swelling
  • Hives, flushing, skin rashes
  • Brain Fog, Anxiety, Depression
  • Respiratory – congestion, runny nose, sneezing, difficulty breathing

What Does Oestrogen Have To Do With It?

The majority of people who develop histamine intolerance are women, and it appears this has to do with the hormone oestrogen

A big clue that you may have histamine intolerance is if you experience symptoms such as headache/migraine, anxiety, GIT issues that are worse right before ovulation & pre-menstrually

This is because oestrogen rises dramatically leading up to ovulation, and oestrogen is higher premenstrually relative to progesterone, which naturally declines (demonstrated in the graph below)

As women reach these parts of their menstrual cycle where oestrogen rises, this naturally drives up histamine levels because the two feed each other.

It is also common for women to suddenly start experiencing these symptoms during peri-menopause & menopause because although oestrogen levels eventually decline, it is the hormone progesterone that begins to decline initially. So relative to progesterone, higher oestrogen levels can drive histamine intolerance

Interestingly, histamine intolerance symptoms are relieved during pregnancy, due to the placenta increasing production of Diamine Oxidase (DAO) enzyme 500-fold. DAO is the enzyme responsible for breaking down histamine

Numerous studies have demonstrated that oestrogen, particularly the form ‘oestradiol’ (the not so great form), can elicit the activation of mast cells – the cells most known for their role in releasing histamine into the bloodstream when activated by the immune system

So it becomes a vicious cycle where oestrogen & histamine reinforce eachother

> Increase in oestrogen levels triggers histamine release

> histamine causes increases oestrogen production

> chronic symptoms continue in a vicious cycle …

As you can see in the picture, below, once histamine is released it has the potential to cause a large number of symptoms due to its effect on vasodilation, neurotransmitter release, mucous secretion, oestrogen production, smooth muscle contraction & gastric acid secretion

The Key To Overcoming Histamine Intolerance – Treating The Gut

The most commonly mentioned ’cause’ of histamine intolerance is a deficiency in diamine-oxidase (DAO), the enzyme responsible for breaking down histamine. Many people seek out DAO supplements as a way to treat histamine intolerance, but this is unfortunately an expensive band-aid approach that doesn’t address the true underlying cause

DAO is produced by the lining of your intestine, which is an obvious sign that damage to the lining of the gut wall is an underlying cause of histamine intolerance. This is an indirect consequence of underlying gut dysbiosis (microbial imbalance)

Gut dysbiosis is also responsible for directly increasing histamine levels due to imbalances of gut bacteria being responsible for over-activation of the immune system

To to treat over-activation of the immune system, you must address gut dysbiosis. Another clear link here is that altered histamine receptor expression is seen in people with Irritable Bowel Syndrome (IBS), where dysbiosis is a key underlying driver

A downstream of effect chronic dysbiosis I see in many clients is Small Intestinal Bacterial Overgrowth (SIBO), which is very common in people with histamine intolerance. Depending on your symptoms, you may need to rule out & address SIBO if necessary

What To Do If You Think You May Have Histamine Intolerance

  • Track your menstrual cycle – Because histamine rises & falls with oestrogen, track your cycle to see if there is a pattern of symptoms intensifying pre-ovulation & premenstrually
  • Trial a lower histamine diet (see the list below) – Histamine is in most foods to some degree, so it’s more a matter of reducing your total load of histamine containing foods. If you are histamine intolerant, you should notice a level of improvement in your symptoms within 2-3 weeks
  • Rule out underlying conditions – Ensure you rule out other underlying causes of your symptoms such as Coeliacs disease, Inflammatory Bowel Disease (IBD), Lactose Intolerance, Small Intestinal Bacterial Overgrowth (SIBO). Histamine intolerance is ultimately an underlying symptom of a deeper issue, related to the gut
  • Check your medications – antidepressant, antipsychotics, blood pressure medications, antibiotics, diuretics, muscle relaxants & malaria drugs are examples of medications that interfere with adequate DAO enzyme production. Do not stop your medications – discuss with your medical doctor and health-care team

Low-Histamine Diet Guide

A great place to start is to experiment with a low-histamine diet. If you have true histamine intolerance, the relief you experience will be rapid and obvious, even if is just slight

There are a large amount of foods that naturally contain histamine, and there are other foods that directly block the DAO enzyme

High-Histamine Foods To Avoid Include

  • Fruits – citrus, bananas, papaya, pineapple, strawberries, dried fruits (apricots, prunes, dates, figs, raisins)
  • Vegetables – avocados, eggplant, spinach, tomatoes, sauerkraut & other fermented vegetables
  • Nuts all nuts & peanuts
  • Dairyall dairy products including fermented dairy such as yoghurt & kefir
  • Dairy Alternatives – coconut yoghurt & other fermented products
  • Protein – cured meats such as bacon, salamin, pepperoni, luncheon meats & hot dogs, shellfish, mackerel, tuna, smoked fish, anchovies, sardines
  • Starches – Soured breads, wheat germ
  • Seasonings & Other Ingredients – Pickles, olives, vinegars, miso, soy sauce & tamari, mayonnaise, artificial preservatives & dyes
  • Drinks & Alcohol – Wine, champagne, beer (alcohol in general), kombucha, energy drinks, black & green tea, yerba mate
  • Chocolate – sorry!

Histamine “Safe” Foods to Stick To On A Short-Term Low-Histamine Diet

  • Fruits – All Fresh fruits except citrus, banana, papaya, pineapple, strawberries
    Vegetables – All fresh vegetables except avocados, eggplant, spinach, tomatoes
  • Dairy Alternatives – coconut milk, rice milk, hemp milk, almond mild
  • Protein – Freshly*** cooked meat, poultry (frozen or fresh), freshly caught fish, eggs
  • Fats – Coconut oil, olive oil
  • Seasonings & Other Ingredients – leafy herbs
  • Drinks & Alcohol – Herbal teas, no green or black tea; no alcohol

*** Freshness is very important in the foods you eat – notice that many of the foods to avoid are aged or fermented

Avoid eating leftover meats & fish, and strictly avoid any canned fish, as they will be higher in histamine. Frozen fish is fine

Take Action Now

Start tracking your menstrual cycle, trial a low-histamine diet & seek the appropriate help to heal underlying gut dysbiosis & intestinal permeability so that histamine intolerance no longer leaves you struggling with unmanageable & constant symptoms

sydney naturopath pyroluria

Treating Pyroluria (Pyrroles Disorder) In Sydney | A Wholistic Approach

Anxiety - Why It's Not Always In Your Head & How To Treat The Root Cause

Anxiety – Why It’s Not Always In Your Head & How To Treat The Root Cause

I regularly see clients at my practise in Sydney seeking help with chronic anxiety symptoms.

Whilst occasional worry and situational anxiety is a normal human experience, chronic anxiety can be debilitating as it becomes distressing and uncontrollable.

Physically it may manifest for you as sleep disturbance and insomnia, a constant feeling of tight pressure in the chest and throat, heart palpitations, tension headaches, ‘wired and tired,’ irritability and concentration problems…

Emotionally it can be incredibly draining, as if you are constantly on guard and fearful of something completely random and ‘normal,’ with a desire to numb yourself in whatever way possible as a means to relax, feel safe and get through the day (or the night).

You may dread socialising due to the chance of an embarrassing or stressful interactions with others…I have been here and used to feel guilty and ashamed of my thoughts and behaviours, not realising that there may in fact be organic underlying reasons as to why I was feeling so anxious. It is such a relief and incredibly empowering when you can find out what specifically may be causing anxiety in you.

However you experience anxiety, there are 4 key areas to address and investigate to find out what may be driving your anxiety:

1. Heavy Metals

The brain is highly susceptible to a variety of toxic metals, and due to its high fat content it can store toxic metals over long periods of time, causing neurotoxicity. I observe high levels of copper in many of my clients, which can be a huge driver of anxiety and ‘adrenal fatigue’ (HPA Axis dysfunction).

For this reason I routinely order Hair Tissue Mineral Analysis (HTMA) to assess levels of heavy metals stored in the body, as well as a blood test for zinc, copper & caeruloplasmin (a ‘transport’ protein), so that we can uncover if heavy metals are an issue. If they are, we are able to fine tune treatments to safely get these levels down.

Understanding the impact of heavy metals is important because you can take supplements and herbal medicine for symptom relief and have talk-therapy but if you don’t address one of the underlying causes in the body – the anxiety will continue to resurface

2. Nutrient Deficiencies

There are a handful of foundational vitamins and minerals which are typically deficient:

  • Magnesium has an important role in neurological activity, is needed for energy production, a healthy stress response, balanced blood sugar levels, hormone balance…it is super important, and usually deficient in anxious individuals because it is rapidly depleted through chronic stress
  • Zinc is a mineral that is required as a pre-cursor to every neurotransmitter & hormone in the body. A deficiency is usually seen alongside high copper levels, as the two are meant to be in a delicate balance. Most people are zinc deficient (and most people with anxiety have high copper levels). Zinc is an important antioxidant with profound effects on our immune, digestive and neurological symptoms. The most accurate way to test for zinc relative to copper levels is through blood pathology and HTMA testing
  • B Complex Vitamins are involved in a range of biochemical pathways that influence neurotransmitter production, nerve cell synthesis and DNA repair. B6, Folate (B9), & B12 are especially important for a process known as methylation – a biochemical process involved with neurotransmitter synthesis, heavy metal detoxification and DNA repair. Some people feel immediately better on B-Complex Vitamins, whilst others who are sensitive experience a worsening of anxiety related symptoms. For this reason I recommend these clients have an MTHFR Gene Test to rule out the potential genetic susceptibility of having methylation issues (this can be a game-changer for people)
  • EPA/DHA (Omega-3) Fats are crucial for the healthy functioning of our central nervous system and deficiency can result in low mood, neuro-inflammation (and systemic inflammation), and cognitive decline. Download & Refer to my free E-Book The Mind-Body Blueprint for a more detailed run-down on how and where to obtain EPA/DHA to reduce inflammation, and other dietary tips.

3. HPA Axis Dysfunction (“Adrenal Fatigue”)

When you are feeling extremely anxious or having panic attack, you are constantly sending a signal to your brain that you are under threat (even if it is only imagined). The brain responds by flooding the body with stress hormones so that you can flee from danger.

After hours, days, months and even years of this stress response being over-activated, this system becomes dysregulated and results in feeling ‘wired and tired’ (anxious yet fatigued), sleep disturbance and insomnia, erratic energy peaks and slumps (e.g. mid-afternoon crash with a surge of energy late at night time!), appetite suppression and digestive symptoms.

Restoring the HPA Axis is targeted with a combination of adaptogenic and adrenal tonic herbal medicines (e.g. Withania somnifera, Rhodiola rosea, Rehmannia glutinosa), nutrients (e.g. Vitamin C, B-Complex Vitamins, Zinc) & effective stress reduction techniques such as a breathwork practise or meditation.

For clients who have not responded at all to previous foundational treatments, a salivary cortisol test is useful for evaluating levels of the stress hormones and how they are fluctuating, so that treatment can be more specific.

4. Gut Health

“Fire in the gut – fire in the brain,” i.e. if you have inflammation, parasites, small intestinal bacterial overgrowth (SIBO), fungal overgrowth, stealth infections (e.g. Lymes disease) or dysbiosis in the gut, then that is going to produce an inflammatory response that affects the brain and can cause inflammation. This is another example similar to not addressing heavy metals – you can take supplements for digestive system relief, but if you don’t address what’s causing it, they will continue to surface.

The fact that there is 400x more serotonin produced in the gut than in the brain and that researchers now talk about our gut being the ‘second brain,’ is just scratching the surface of why it’s important to address our gut microbiome health. even if we don’t have ‘typical’ symptoms such as cramping, bloating, alternating bowels and indigestion, there may be some level of gut flora imbalance causing psychological symptoms.

The gut is an organ that is a branch of our nervous system – think of it as a large bag of giant muscle, a big bundle of nerves that responds to our nervous system activity. The gut, our nervous system and the stress response are intricately linked, and we now know that anxiety and the stress response disrupts our gut microflora and gut-wall integrity.

I unfortunately meet many clients who have never experienced anxiety until they have had a course of strong antibiotics, due to their effect on our gut microbiome. Antibiotics can be the underlying cause of a lifetime of physical and psychological problems.

If this sounds like you, focusing on restoring your gut microbiome would be a key treatment strategy.

A Holistic & Functional Approach To Anxiety

Anxiety is experienced by everyone differently. It is not the same for everyone. Treatment must be holistic if we are to truly uncover the root cause.

The conventional medical approach to understanding anxiety is that it’s caused by an imbalance of neurotransmitters in the brain (due to an ‘unknown’ cause), which are then treated with medications that increase the availability of these neurotransmitters in the brain. The issue with this approach is that, while it may appear offer effective symptom relief in the short-term and extremely necessary for a small group of people, they are not meant to be long-term prescriptions.

They should be used if necessary, whilst trying to uncover the underlying causes. It is a very reductionist approach to just hand someone a medication without any further investigation other than a short conversation. It’s like having a rock in your shoe that’s causing inflammation and pain, so you take panadol for pain relief, but haven’t addressed the rock in your shoe. As a functional naturopathic practitioner I am interested in addressing the rock in your shoe and getting it out, so you don’t have to take unnecessary medications.

Whilst brain chemistry is important, these are so many other factors to consider – as I have already mentioned we must consider heavy metals, nutrient deficiencies, HPA axis dysfunction and gut health. I am also interested in your environment, work/life balance, stress tolerance, emotional and/or spiritual health, and past traumas or significant events. All of these things are involved with having anxiety.

Sometimes we just need to be heard in a safe space so we can explore and process our emotions without judgement. This is why I don’t look at anxiety as a ‘problem’ or a ‘condition’ – it is a signal from the body that something is wrong. The body is incredibly smart. We shouldn’t be trying to ‘suppress’ anxiety to deal with it, we should be asking why it is there. Anxiety is part of our primitive, emotional brain that protects us from danger. By taking a holistic and functional approach to anxiety, we can find out what is causing it.

Being heard, and allowing our past wounds, stresses and traumas to surface is just as important as investigating the potential physical drivers. It goes both ways. If we can consider everything together and customise treatment plans to the individual, you can say goodbye to chronic anxiety.

Please download my free E-Book The Mind-Body Blueprint which goes into much more extensive detail about the foundations of mental health, and feel free to get in touch if you would like to dig a bit deeper and work together to achieve optimal health. Naturopathic medicine can do marvellous things for mental health & wellbeing.

Yours In Health,
Steven Judge

Sydney Naturopath

Wholistic Medical Centre (Surry Hills)
(02) 9211-3811
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Sydney Naturopath Anxiety Depression

Training Your Brain For Gut Health – Is The Vagus Nerve The Missing Link In Resolving Chronic Digestive Disorders, Mental Health & Autoimmunity?

If you suffer from

  • Mental health conditions (Anxiety, Depression, Behavioural disorders such as ADHD)
  • Digestive disorders (Chronic Constipation, Irritable Bowel Syndrome, Small Intestinal Bacterial Overgrowth, Inflammatory Bowel Disease)
  • Autoimmune Diseases (Hashimotos Thyroiditis, Rheumatoid Arthritis, Multiple Sclerosis)

OR a combination of these…

It can be frustrating to feel like you are doing all of the ‘right’ things – you might be following a gluten free + dairy free/paleo/gluten-free/anti-inflammatory diet of sorts, ruled out or are treating IBS/infections/parasites, you’re taking probiotics, prebiotics, l-glutamine, digestive enzymes, bone broth, gut-healing powders and specific gut- nutrients (e.g zinc)…But you are STILL frustratingly suffering from gut symptoms and related conditions, and haven’t noticed a drastic improvement in your mental health and overall well-being.

Or you may feel much better taking these things but once you take them away you are immediately unwell. If this sounds like you, we may need to dive a bit deeper into the role of the gut-brain axis and in particular THE VAGUS NERVE, incorporating specific techniques to get your gut functioning strong and bowel movements happy, which in turn will drastically improve your mental health and help to dampen the inflammatory cascade of autoimmunity.

What Is the Brain-Gut Axis?

It is a pathway of communication that occurs via the vagus nerve and our gut microbiome.

Whilst we know much about the importance of our microbiome, aka our ‘beneficial gut flora,'(check out my blog article on prebiotics + sleep for more info) much less consideration is generally given to the other direction of this axis working ‘brain-down’, which is via the vagus nerve. Dr. Datis Kharrazian, who was awarded Researcher Of The Year in 2017 by the International Association of Functional Neurology, explains that “One of the most neglected things that I think most practitioner’s don’t understand, whether they’re conventional or alternative, is that there’s this brain-to-gut axis,”… and basically that what we may think of traditionally as gut-disorders are in fact neuro-degenerative diseases that start in the gut. The vagus nerve connects the brain with every other organ in the body, allowing the brain and the gut talk to each-other (they have quite an intimate relationship!)

This communication is “bi-directional,” meaning that communcation travels in both directions – the vagus nerve also carries information from the body back to the brain. Why is this so important for our digestion and overall health? Basically, the brain plays a crucial role in gut function as it controls gut motility (the movement of food through the intestines). When gut motility is impaired this means that your food is not moving and being broken down, nor can you make your own digestive enzymes, which will eventually result in fermentation and bacterial or yeast overgrowth.

Just taking digestive enzymes and gut-healing nutrients will not resolve the spectrum of underlying causes unless you address the brain-gut dysfunction – THE BRAIN is what makes us produce digestive enzymes in the first place and directs blood flow to the gut. One of the key things that would highlight an issue with the functioning of your vagus nerve is if you have issues with gut MOTILITY – i.e. if you have constipation, have to drink coffee to have a bowel movement, rely on magnesium or laxatives for bowel movements, if you have chronic & unresolved bloating…

If there is no gut motility or production of digestive enzymes due to dysfunction in the brain, this is what will will cause intestinal hyperpermeability (“leaky gut”) and then a range of downstream effects that drive chronic inflammation and an overactive immune system that can develop into an autoimmune condition – when they body starts to attack itself….so we may need to take a step back and approach chronic gut conditions from the brain down! This can not be done with a supplement – sure, they may help relieve symptoms, but it will not ultimately treat the underlying cause. In this case, we must develop plasticity and new neural connections so that:

-> Neurons fire into eachother -> Brain fires to the vagus nerve -> Vagus nerve fires into the gut nervous system -> migrating motor complex functions properly (which means gut motility will be functioning optimally)

Correcting an impairment in the brain-gut axis is so important, as many neuro-degenerative diseases such as Parkinsons & Alzheimer’s Disease have been linked to alterations in our gut microbiome and gut-brain axis.

One of the most common neuro-degenerative diseases, Parkinsons Disease, is referred to as an “alpha-synucleinopathy” – where a protein called alpha-synuclein builds up in between nerves which then can not communicate, and they begin degenerating off. The build-up of this protein leads to degenration which begins in two places:

1. The gut – people start to get gut degeneration

2. The olfactory bulb – people start losing their sense of smell.

The brain starts to degenerate, and since the majority of the brain’s output is at the pontine area where the vagus nerve lives, there is inevitably failure in the brain-gut axis at some point! Harnessing the vagus nerve should be a key treatment strategy for anyone predisposed or with an early diagnosis of any kind of neuro-degenerative diseases (including dementia). Alas, let’s get down to some of the key tools for firing up your vagus nerve and working from the brain down to ensure we are preventing and properly treating gut, mental health, autoimmune and neuro-degeneration!

GUIDE TO HARNESSING YOUR VAGUS NERVE:Dr. Kharrazian Has 3 Key Recommendations

1. Gargling – Take water, put it into the back of your throat and gargle to the point of tearing up. You must really work it out and gargle aggressively enough so that it makes your eyes tear, since the vagus is right next to an area called the superior salivatory nucleus, which causes you to tear. If this area of the brain isn’t functioning well you may have a hard time gargling, only being able to gargle for 3 or 4 second before having to spit it out. Build it up over time until you can do it for several minutes and you’re tearing consistently. This is how you activate it! Make this a daily routine. Gargling has been utilised in functional neurology for many years, e.g. people with head injuries.

2. Inducing Your Gag Reflex – Buy a box of tongue blades (can purchase online, e.g. through amazon), and use these to push down on the back of your tongue until you gag, which will make your eyes start to tear. Doing this activates the pathway, developing neural connections and getting plasticity going. Be careful not to push it on the back of your throat which could cause injury.

3. Coffee Enemas – NOT for ‘detox’ reasons, this tool is useful due to the caffeine which stimulates gastrointestinal nicotinic cholinergic receptors, which makes the gut move along. The key here is to get enough coffee so that you have to force yourself to SUPPRESS the urge to have a bowel movement – lay on your side and do the enema, and when you have an urge to have a bowel movement hang out there as long as you can, suppressing the urge. This fires the frontopontine vagal enteric axis.

Continually doing this builds endurance and starts to retrain the brain-gut axis. You want to ensure you are consuming a well-rounded, anti-inflammatory diet and taking digestive enzymes as well, as to not neglect the gut-brain pathway, whilst using the right techniques to training the brain-gut pathways. Singing is another fantastic remedy, which activates the vagal muscles in the back of your throat (you’ve got to sing loudly!)

And finally you must focus on utilising a range of lifestyle techniques, incorporating them into your schedule as they suit you, to ensure you are promoting your parasympathetic, “rest & digest” nervous system, to ensure optimal digestion & adequate blood flow to your digestive organs:

It might not seem like a typical ‘prescription,’ but please focus on incorporating these vagus nerve stimulating techniques if you have unresolved gut, autoimmune and mental health conditions (which may be overlapping), to ensure the brain-gut axis is working both ways!

Yours In Health

Steven Judge
Sydney Naturopath & Nutritionist
(02) 9211-3811
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