CBS Mutation and Low Sulfur Diet. CBS Mutation and Low Sulfur Diet: As a clinician, I have learned that what is healthy for one individual can be poison for another. Unfortunately, some individuals have particular genetic mutations that do not allow them to effectively metabolize and eliminate ammonia. Ammonia Production: Ammonia is a normal product of protein metabolism in the body is generally excreted through our urine. When ammonia levels raise the body uses more glutamine in order to reduce the ammonia. Magnesium is also very important as it helps to stabilize the blood brain barrier. Histamine Intolerance: Another Great Pretender. Graphic from Healthy Pixels: The Many Faces of Histamine Intolerance. I have been preoccupied with this topic, and have since heard from many readers who recognize themselves in the widely inconsistent and variable symptom picture that can be associated with it. Please read my first post on the subject, as well as Freshness Counts, on the blog Diagnosis Diet, by my esteemed colleague, another Boston psychiatrist with a curiosity about the relationship between food and health, Georgia Ede, MD. This will provide a good background. Histamine Intolerance can be used as a frame work to understand the connection between many different symptoms, and to provide an understanding of the way that they are linked by a common underlying pathophysiology. For instance in my own case, “What is the relationship between depression and anxiety, insomnia, hypotension, constipation, tinnitus, easy bruising, and dry eyes?” Answer: They could all be manifestations of excess histamine in the body. Histamine intolerance flies beneath the radar of most doctors, and can easily result in a misguided treatment approach. Syphilis used to be called the Great Pretender because it could present with such variable and diverse symptoms, that doctors often missed the diagnosis. Histamine Intolerance is a modern day Great Pretender. Take my housekeeper Sandra. She had been suffering from a mysterious syndrome that had been getting worse. It began with migratory arthritis; first her elbow became massively swollen. After that resolved her knee was affected, then her wrist. Next it switched to migratory myositis, with bizarre . Then she began to be afflicted with hives, and other odd skin lesions. The final symptom was an agonizing muscle spasm of the side of her back that would come in waves like contractions of the uterus during birth.
She could not sleep and was completely debilitated. The doctors gave her pain medication, steroids, muscle relaxants, anti- convulsants, nothing helped. Are you in ketosis but still not losing weight? Calories do count on a keto diet! See the big picture: Ketosis itself will not guarantee weight loss. Suffering From Histamine Intolerance? As a clinician, it is imperative that I understand all different types of unique health problems and metabolic challenges. Health Issues Plan of Action for Amyloidosis. Vidt presents a plan to monitor Shar-Pei with the goal of uncovering renal amyloidosis as early as. She had been following a GAPS- like diet, which was my two cents, but with no relief. I continued to research on the internet, and came upon a site called The Reluctant Raw Foodist. Sandra began to follow a modified version of her protocol, and the terrible spasms which had been continuous for three weeks resolved in two days. No other symptoms have returned. This was 2 months ago. Prominent psychiatric symptoms can be the presenting complaint of a patient suffering from Histamine Intolerance, with anxiety, panic and insomnia. Unfortunately food sensitivities are still not part of the vocabulary of most psychiatrists. It is still the very unusual psychiatrist who asks a patient about diet, when trying to make sense of the current symptoms and history. The most common treatment modality offered by psychiatrists to the anxious patient who is not sleeping is medications. It is interesting to note that some anti- depressants and anti- psychotics have prominent anti- histaminic side effects, such as blurring of vision, dry mouth, sedation, headache, dizziness, increased appetite and weight gain, to name a few. When a patient tries to discontinue the drug, symptoms of histamine intolerance can manifest, such as profound insomnia and anxiety, and it can be difficult to come off the medications. Monica in her blog Beyond Meds writes in detail about her experience of the terrible aftermath of psychiatric polypharmacy in a valuable post entitled Multiple Drug Sensitivities. I would like my readers to understand that I also prescribe psychiatric medications to some of my patients, and believe that they can be very useful in certain situations. But if a patient has gut dysbiosis which has resulted in food intolerances and sensitivities that are expressed as anxiety, depression or insomnia, it may be that if they would modify their diet and supplement with probiotics, that there would be no need for prescription medication. This is equally true for people who are carbohydrate intolerant. The average American eats between 3. A healthful amount would be around 6. Excess carbohydrate consumption can often result in decreased energy, depression and anxiety. When a patient is motivated to take on the hard work of dietary change, then that is clearly what is indicated, and not prescription medications. The general lack of awareness that psychiatrists have of the relationship between psychiatric symptoms and diet results in very poor care of patients and a great deal of harm. The cook book author and blogger at the Low Histamine Chef, Yasmina Ykelenstam. She is coming out with several new cookbooks, one with a Paleo perspective, which reflect this philosophy. Herbs such a thyme, holy basil and greens such as amaranth are just a few of the foods she highlights on her blog. Treating SIBO (Part 9): Elemental Diet. Small Intestine Bacterial Overgrowth syndrome (SIBO) is something that I personally have been battling with. The process has been incredibly frustrating, but it has also been enlightening and educational. One important step that I did to treat my severe case of SIBO was do an elemental diet. This article is part of a series about treating SIBO. If you missed the last parts of the series, catch up here: What is an Elemental Diet? An elemental diet, also often called a bowel reset diet, isn. It is a short- term protocol in which you eat nothing. The goal of elemental is to starve off the bacteria in your small intestine. To prevent your body from starving, you take a special liquid formula (formulated for tube feeding patients) which contains predigested nutrients. The nutrients are easily assimilated into the body so bacteria can. Elemental diets are also often used to treat Crohn. By taking the liquid Elemental Diet instead of eating, the gut is able to start healing. How Does an Elemental Diet Treat SIBO? Remember that bacteria are living things. Like all living things, bacteria have to eat something. When you eat these fermentable sugars, you aren. Bear in mind that some carbs are a lot worse than others, and there are a lot of reasons why you might have excess carbs in your small intestine. Instead, you take a liquid formula which contains predigested nutrients so they are absorbed into your bloodstream quickly and the bacteria can. So, the bacteria have nothing to feed off of and die off. Does it Work? An elemental diet definitely seems like a hardcore way to deal with SIBO . In one study, 9. 3 subjects with IBS and SIBO (diagnosed with a high lactulose breath test) were put on an elemental diet. After 1. 5 days, 8. According to RD Kelsey Marksteiner, elemental diet has a cure rate of 8. SIBO. 2 Compare this to the cure rate of antibiotics for SIBO (which is as low as 4. Because your gut is able to rest and heal itself while on the elemental diet, it might help cure some of the underlying causes of SIBO and thus reduce recurrence rate. However, this effectiveness comes with many drawbacks. The main one is that doing an elemental diet is NOT at all a pleasant experience! Elemental diets usually should last around 2 or 3 weeks to be effective, so you. Readymade elemental formulas for SIBO cost about $1. You can save money by making your own elemental formulas. However, even homemade elemental formulas are still going to be a bit pricy because you. Expect to pay about $3. Should You Do Elemental for SIBO? Even though the elemental diet has a higher cure rate than traditional antibiotics, it is understandable that most people wouldn. Doing elemental is not at all a pleasant experience, and you will have to make some serious lifestyle changes while doing it. I would recommend doing elemental for SIBO under these circumstances: Your SIBO case is severe (methane and/or hydrogen numbers over 8. You. I did both of these options (Vivonex the first round, and homemade the second). Overall, I like homemade better. It was easier to mix up than I anticipated and I just did it once a day and portioned out 3 jars in the fridge. Vivonex Plus: It is definitely pricy at about $1. This formula has also actually been studied and proven effective. You can easily buy Vivonex Plus online here. You will need to buy enough for about 6 packets per day. It is high carb/low fat, so it won. I could not get past 2- 3 sips of it without gagging. The only way I could get it down was by adding Crystal Light. Yes, I know the ingredients in Crystal Light are terrible (soy, dyes, artificial sweeteners, etc.), but it was the best solution I found and recommended by my doctor, and I had to prioritize starving the bacteria for this short treatment time. Homemade Elemental Formula: and consume ingredients that are slightly closer to real food, this is the way to go. Expect to pay about $3. The ingredients are a lot cleaner since you. Another plus of going with the homemade route is that you will be able to adjust the amount of carbs and fats a bit to your needs. Bear in mind that you will have to buy each ingredient separately and mix them together each day. Siebecker’s website siboinfo. You can also use cod liver oil or macadamia oil. I think this is because I found it obnoxiously sweet from the dextrose and the vanilla seemed to accentuate that. With Vivonex Plus, you use 6 packets per day (you can double them up and take 2 packets, 3 times a day or take the 6 packets separately, as you wish), which comes out to 1. With the homemade elemental, the dosage is 3x per day, which comes out to about 2. Keep in mind you don. You really have a lot of flexibility with how you take it. For example, while doing the Vivonex elemental formula, there were days when I just laid around in bed and rested. Consult with your doc to see what is best for you! Retesting After Elemental Diet. After completing the Elemental Diet, you need to wait at least 4 days before retesting. This gives things time to settle down . On my second round, I did it at 2 weeks after because it also coincided with the retesting schedule of the herbal antibiotics I took simultaneously with elemental. There are now SIBO breath tests that you can order directly without a doctor! Excited at the thought that this would be the quickest way to get results (it was). The results from my next breath test were better, but I still had work to do. I also took herbal antibiotics and a prokinetic while doing the second round of elemental.? But, for me, it was actually days 8- 1. During those days, I had diarrhea and terrible bloating and cramping. I relied on detox protocols during this time (especially Epsom salt baths and castor oil packs) to help me through. Symptoms throughout: I had headaches which started pretty much on day 1. It might not have been related to SIBO but to the corn and soy ingredients which I don. I also often felt itchy and had lots of phlegm. Again, it could have been the ingredients. The bloating was so bad that I looked like was 6- 8 months pregnant, depending on the time of day. It was interesting to see this after 1. Clearly, the party in my gut was starting to get disrupted. It could have been the bacterial die- off, but I think inadvertently I wasn. If I had to do Vivonex Plus again, I. My writing looks dyslexic. Simple math in my head seems impossible. And finding words is very difficult. This is most likely because I had made a ton of progress on the first round so there was less die- off and thus fewer symptoms. However, it was still emotionally tough to feel deprived of food. I noticed that, while again I didn. It was like the healing was still happening even though I wasn. Sort of like when you step off a treadmill and your heart is still pounding and sweating for quite a bit longer. Results. Yes, it made me feel deprived at times. An interesting thing though is that I found Elemental easier than those weight loss diets I used to do. For some reason, it was easier to swear off all food completely than the superhuman willpower it takes to have. As a mom and business owner, I don. It was great to be able to ask my husband and older daughter to pick up some of the slack for a couple of weeks so I could focus on resting. Plus, I hired a housekeeper to help out as well. Again, stress is the biggest cause of SIBO! My Advice for Elemental Diet: 1. Get Support! Without the help that I had during both rounds of element, I guarantee I wouldn. I also mean emotional support. The toughest times for me were evenings and weekends, during my family. Get Time Off Work. Ideally take 2 weeks off and make it your full time job to get well. Clothing. Do yourself a favor and forget jeans or anything restrictive in the waist. Go Easy with Food when Coming Off Elemental. Your body will be in a for a big shock when you suddenly start eating again, so take it easy on the food front. Stick to small portions of well- cooked, simple food for the first few days. Managing Symptoms and Food Cravings. Diffuse peppermint essential oil in the room; it helps with gas (don. A hot water bottle on your belly (bonus points for castor oil pack) helps reduce nausea and belly pains, as does ginger tea. Use visceral manipulation (just massage your abdomen, even if you don. The Gross Film on Your Teeth. The elemental diet (especially Vivonex Plus) leaves this weird gross film on your teeth. Also, try oil pulling for the teeth pain. Get your copy of The SIBO Solution: Your Comprehensive Guide to Eliminating Small Intestinal Bacterial Overgrowth by clicking HERE. You’ll also receive a BONUS SIBO Detox Support Guide mini ebook with your purchase. Are You Suffering From Histamine Intolerance? Suffering From Histamine Intolerance? As a clinician, it is imperative that I understand all different types of unique health problems and metabolic challenges. On a biochemical level what may be a superfood for one individual may be poison to another. Histamine intolerance is an area where this is the case. People who are unable to effectively metabolize histamines must restrict their consumption of many foods that I typically recommend on a regular basis. If you have a histamine intolerance consuming histamine rich foods can lead to chronic health issues such as allergies, asthma, sinus problems, eczema, chronic pain, menstrual problems and much more (1). The Unique Nature of a Histamine Intolerance. I always wondered about what was happening with individuals who told me they were “allergic to the sun.” Interesting research is indicating this is a histamine response as UV light can trigger histamine release (2). Other research is indicating that those susceptible may have problems with high- intensity exercise, especially done in a warm environment (3). Individuals with periods of high estrogen may have higher than normal histamine responses and high stress increases histamine levels and decreases the bodies ability to metabolize the histamine (4, 5). What is Histamine? Histamine is an in important neurotransmitter and immune messenger molecule. It is involved in processes involving hydrochloric acid secretion for digestion, triaging water reserves to key areas of the body and the inflammatory response. Histamine receptors are located all over the body and have many important functions including: Histamine H1 receptors: Smooth muscle and endothelial cells affecting skin; blood vessels (Benadryl and Claritin block activity of these receptors)Histamine H2 receptors: Cells in the intestines control acid secretion, abdominal pain, and nausea; heart rate. Histamine H3 receptors: Central nervous system controlling nerves, sleep, appetite and behavior. Histamine H4 receptors: Thymus, small intestine, spleen, colon, bone marrow and white blood cells; inflammatory response. One of the major effects of histamine is causing the blood vessels to swell and dilate. When the body senses that it is threatened it will secrete higher amounts of histamine. This allows the white blood cells to quickly move through the blood stream and find the potential threat or infection. This is an important component to a healthy immune response. When Does Histamine Become a Problem? Histamine only becomes a problem when we have metabolic disturbances that do not allow us to effectively metabolize histamine properly. When histamine is formed it is broken down by specific enzymes. In the central nervous system it is metabolized by hitamine N- methyltransferase (HMT), while in the digestive tract it is broken down by diamine oxidase (DAO). The experts state that DAO is the major enzyme involved in histamine metabolism (6). The enzyme converts the histamine into imidazole acetaldehyde which does not trigger any sort of reaction in the body. DAO is responsible for ensuring a steady histamine level required for the balance of numerous chemical reactions taking place in the body. Altered DAO Enzyme Production: Some individuals have altered DAO production due to a number of different factors including (7): Small Intestinal Bacterial Overgrowth (SIBO) – some gut microbes produce high amounts of histamines as a byproduct of their metabolism. Copper, Vit C & B6 Deficiency: Copper and Vit C are crucial components of the DAO enzyme and B6 is a key cofactor that enables DAO to degrade histamine. Leaky Gut Syndrome: Intestinal permeability creates major inflammatory stress in the body which can contribute to poor DAO function. Genetic Polymorphisms in DAO enzyme – this can be seen on the 2. SNP’s. A homozygous DAO would make someone more susceptible to developing a histamine intolerance. Use of Certain Medications: Non- steroidal anti- inflammatory drugs (ibuprofen, aspirin)Antidepressants (Cymbalta, Effexor, Prozac, Zoloft)Immune modulators (Humira, Enbrel, Plaquenil)Antiarrhythmics (propanolol, metaprolol, Cardizem, Norvasc)Antihistamines (Allegra, Zyrtec, Benadryl)Histamine (H2) blockers (Tagamet, Pepcid, Zantac)According to expert Dr. Amy Myers MD, “histamine blockers, a class of acid- reducing drugs, seem like they would help prevent histamine intolerance, these medications can actually deplete DAO levels in your body” (8). According to Chris Kresser L. AC, “Histamine is different than typical food sensitivities or allergens in that it is a cumulative problem” (9). So we begin to have symptoms when we either take in too many histamine molecules or we reduce the DAO enzyme to the point where the histamines overload the system. These symptoms will last until the body metabolizes the histamines and removes them from the system. Who Has Histamine Intolerance: According to available research, histamine intolerance manifests in approximately 3% of the population (9). In up to 2. 0% of these cases the symptoms occur mostly when histamine containing foods are used in combination with DAO inhibitors such as alcohol. Approximately 8. 0% of individuals with histamine intolerance are women and most of them are over 4. The three biggest factors involved with histamine intolerance include leaky gut syndrome or related disorders such as Crohn’s disease, Irritable bowel, celiac, gluten sensitivity, etc (1. The second factor is a genetic polymorphism with the DAO enzyme. Heavy alcohol and/or medication usage is another strong risk factor. Diagnosing Histamine Intolerance: This is a challenging condition to diagnose for a number of reasons. The first is that there are so many popular foods, many of which are considered health foods that are high in histamines. Also, some individuals have a unique gut flora that is producing high histamine levels. Most doctors are not familiar with histamine intolerance and never consider this as a contributing factor in the individual’s health challenges. In fact, many physicians including myself, typically recommend a diet high in histamine containing foods. This includes fermented foods which have incredible health benefits for those with adequate histamine metabolism. Research has shown that people react quite differently to elevated histamine making it that much harder to pinpoint (1. As a clinician, I have learned that when individuals react very poorly to fermented foods it is a sign of histamine intolerance. Most people respond very well to small amounts and gradually increasing levels of fermented foods. Individuals with histamine intolerances often break out with hives, eczema, rashes, puffy eyes, headaches, etc. Common Symptoms of Histamine Intolerance. Headaches/Migraines. Difficulty falling asleep, easily arousal. Hypertension. Vertigo or Dizziness. Arrhythmia, or accelerated heart rate. Difficulty regulating body temperature. Anxiety. Nausea, Vomiting. Abdominal cramps. Flushing. Nasal Congestion, Sneezing, Difficulty Breathing. Abnormal Menstrual Cycle. Hives. Fatigue. Tissue swelling. Histamines travel throughout the bloodstream and therefore can effect the gut, lungs, skin, brain and entire cardiovascular system. This is why there are such a wide array of health problems associated with it and it is quite challenging to pinpoint and diagnose if you are not aware of the condition (1. Testing For Histamine Intolerance: The 2. DAO enzyme production. When an individual has a homozygous mutation they will most likely struggle with histamine metabolism. This may not occur until after a stressful season of their life when their gut barrier breaks down and their adrenal glands are unable to keep up with the demands placed upon them. This creates a vicious cycle of chronic inflammation and inflammatory stress that depletes the body of vital reserves and exposes the genetic weaknesses of the individual. There are lab tests that can be done that analyze the ratio of histamine/DAO enzymes. A high histamine/DAO ratio indicates that one is ingesting too much histamine and is not producing enough DAO to effectively metabolize it. Without getting the blood test you could do a histamine challenge by consuming a number of different fermented foods and high histamine foods and see if this aggravates your symptoms. If so, try a low- histamine diet for a week and if you notice significant improvements you most likely have histamine intolerance. To improve your tolerance to histamine, it is critical to heal the gut and address the dysbiotic issues that are at the root of the problem. I would recommend working with a qualified health practitioner to assess and create a specific plan to address the bacterial imbalance. Foods High in Histamines (1. Some foods naturally have more histamine content while others accumulate histamines while they age. Fermented and dried foods typically have the highest levels of histamines. A low histamine diet must be focused around getting foods at their peak level of freshness. Here is a list of high histamine foods: Fermented alcoholic beverages, especially wine, champagne and beer. Fermented foods: sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha, etc. Vinegar- containing foods: pickles, mayonnaise, olives. Cured meats: bacon, salami, pepperoni, luncheon meats and hot dogs. Soured foods: sour cream, sour milk, buttermilk, soured bread, etc. Dried fruit: apricots, prunes, dates, figs, raisins. Most citrus fruits. Aged cheese including goat cheese. Nuts: walnuts, cashews, and peanuts. Vegetables: avocados, eggplant, spinach, and tomatoes. Smoked fish and certain species of fish: mackerel, mahi- mahi, tuna, anchovies, sardines. Processed foods of all types – Preservatives are high in histamines. Histamine- Releasing Foods (1. These foods do not necessarily contain histamine but they block the action of DOA and therefore they potentiate the effects of elevated histamines. Alcohol. Bananas. Chocolate. Cow’s Milk. Nuts. Papaya. Pineapple.
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