Is It Really Histamine Intolerance? The Misdiagnosed Epidemic Explained | Jennifer Fugo

Jennifer Fugo: [00:00:00] Approximately three to 6% of the population that's struggling with some sort of histamine issue. But the reality is we need histamine. It is something crucial for us to stay awake. That's if you have the appropriate amount. I actually think that histamine intolerance is over-diagnosed. It's partly self over-diagnosed, but I also think in functional medicine, I think it's over-diagnosed because we're only looking at it from the enzyme perspective.

Dr. Brighten: When it comes to the histamine diet. We'll see people who say, you have to eat a low histamine diet for life. Do you agree or disagree? 

Jennifer Fugo: Jennifer Hugo 

Narrator: is a certified nutrition specialist dedicated to helping people who feel failed by conventional medicine finally find relief from chronic skin and gut issues.

Jennifer Fugo: Through her virtual practice, she works with clients worldwide to tackle conditions like eczema, psoriasis, rosacea, and hives. 

Narrator: Offering real solutions beyond just symptom management. 

Jennifer Fugo: As the founder of Quell Shop, a skincare and supplement line designed for chronic skin sufferers 

Narrator: and the [00:01:00] host of the Healthy Skin Show podcast with over 1.1 million downloads, 

Jennifer Fugo: Jennifer is on a mission to empower people with the 

Dr. Brighten: knowledge and tools to heal from the inside out.

Jennifer Fugo: So we actually have two enzymes in the body that break down histamine, DAO, and then HNMT. So, DAO is our primary histamine breakdown in terms of 

Dr. Brighten: it is very, very important. Whatever you put at the end of your fork is input to the body and is supporting those systems. What foods are most problematic for people who are struggling with histamine issues?

Jennifer Fugo: There are, uh, histamine foods that are considered low histamine. Either they have low histamine or they 

Dr. Brighten: welcome back to the Dr. Brighton Show. I'm your host, Dr. Jolene Brighton. I'm board certified in naturopathic endocrinology, a nutrition scientist, a certified sex counselor, and a certified menopause specialist.

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Chronic skin rashes, gut symptoms, migraines. These things might not be random, but maybe [00:03:00] linked to histamine. How many people are estimated to be struggling with histamine issues? It 

Jennifer Fugo: turns out that there is approximately three to 6% of the population that's struggling with some sort of histamine issue.

And I think it's really important to know that it's not an, like an on off type situation. Mm-hmm. You can have shades of gray. So some individuals might notice like, oh, I eat certain foods like, uh, fermented foods, for example, and all of a sudden I'm getting really stuffed up. I start getting a headache.

Maybe you're getting a little flushed. Whereas another individual might eat even a tiny, the tiniest amount, and all of a sudden their whole body is going into a whole type of really extreme reaction where their skin will get really red, they'll get very itchy, they might break out in hives. They could feel, um, like they're, you know, coming down with something, developing a headache, all these sorts of things.

Um, so again, it's a, it really is. This gray, [00:04:00] uh, scale where someone could fall. Mm-hmm. Um, and that's where I think this whole conversation is the most interesting because when we just think about it as like, do I have this or do I not have it? I mean, that's, that's nice. But when you understand the severity, that's where we can really get targeted in like how to help these particular individuals.

Dr. Brighten: Yeah. I'm gonna wanna get more into the fermented foods and different foods that can trigger this. But before we go there, I wanna get everyone on the same page. So let's just start with the basics. What is histamine? 

Jennifer Fugo: So histamine is a biogenic amine. It's basically a chemical in the body that is not inherently bad.

Mm-hmm. I love to get out of the, the black and whiteness of the wellness world. And I think this is one area where people are like, oh, histamine is bad. It's bad for you because it causes all of these reactions. But the reality is we need histamine. It is, I mean, I would describe it as something crucial for us to stay awake, to be alert to, [00:05:00] um, show up.

Now that's, that's if you have the appropriate amount, right. Too much could keep you up at night and cause insomnia. So, um, I think that's. A crucial piece. Our body makes it, there are foods and things in the environment that can either trigger the release of histamine or have high histamines in them.

Mm-hmm. So where it comes from can be from a variety of different aspects, but it is really important for us from a physiologic standpoint to be healthy. So it's not, it's not good. It's not bad, it's just, it just is what it is. 

Dr. Brighten: Yeah. I mean this is a lot like the conversation about hormones. Some people are like, estro estrogen's, the devil.

Estrogen's the best thing ever. I don't wanna be without it. And I think we see this conversation with inflammation a lot as well. We had, uh, Dr. Nabi that I know, you know mm-hmm. A link to him. We talked a lot about inflammation and that perspective on it. Mm-hmm. And histamine came up in that conversation.

That's why I was like, I need to bring you on. We need to just have that histamine [00:06:00] convo. You brought up hives. Mm-hmm. A lot of people think histamine. Allergies. Mm-hmm. Histamine, you are going to be, you know, having seasonal allergies or maybe you're even having severe allergic reaction. Mm-hmm. I think peanuts is one that a lot of people are familiar with.

So help us break down the nuance when people are talking about histamine intolerance, uh, mast cell activation syndrome versus allergies. What is, you know, if you could break that down so people understand the difference. 

Jennifer Fugo: I would say that there are different buckets. Mm-hmm. And again, it's about the gray, where do we fall?

And two things could be true. You could have histamine intolerance and have like an IgE allergy to peanuts, for example. Mm-hmm. So it's not like you have one or the other and that's it. It's little different with something like mast cell activation, where that's like, that's the super severe end of the spectrum and you could have allergies at the same time.

Yeah. But in general, [00:07:00] histamine intolerance is sort of where I would say this world and conversation really begin. Mm-hmm. Because at the end of the day, you are reacting to histamine in your body in a way that is not, I wanna say kind, it's not normal. 

Dr. Brighten: Yeah. 

Jennifer Fugo: Um, you're having experiences because of the environment.

And that environment can be external, it can be internal that. Create a scenario where your body is not happy and you know it, you know, these individuals who are experiencing this know it because of the variety of symptoms that they experience. So, like I said, that person who might eat some sauerkraut, they might go, oh, you know, I'm starting to get a headache.

I feel like I'm starting to get some heart palpitations. Mm-hmm. And I'm getting a little itchy in spots. Whereas someone with mast cell activation, anything could trigger it. It could just literally be going outside of the studio where there's a significant temperature change. It could be the waistband of your pants is too tight around your skin.

Yeah. And all of a sudden you're welting up. [00:08:00] Um, you are super hyper reactive to sometimes even the most minuscule and, um, nutritive things that most people wouldn't bat an eye at. Mm-hmm. Whereas an IgE allergy. Which is the people who don't know what IgE E means. So that I wanted to actually preface this conversation because a lot of people don't understand what intolerance means.

Mm-hmm. We mix up allergies, intolerances, and sensitivities, and that's just something that has happened over, I would say the last 10 to 15 years. But there are different things. So an IgE allergy is on the spectrum where you are experiencing essentially like somebody could develop hives from. Like erythromycin, which is an antibiotic.

I used to get hives as a kid when I would take it. Other individuals who for example, have like a peanut allergy or a milk allergy could end up getting, um, really itchy. Could have their throat swell up, could have their tongue swell up, could die mm-hmm. Because of [00:09:00] anaphylaxis. So again, as a whole range of issues, some issues can be gi um, so in those instances, that's where you're like, I need medical attention for this.

You might need an EpiPen, you might have to go to the hospital. Mm-hmm. So an intolerance is different from that, as is a sensitivity. An intolerance implies that your body doesn't have this enzyme that's really crucial for a specific action. Most people understand lactose intolerance because they know if I drink milk, I'm gonna get like bloated, gassy, maybe have some diarrhea, whatever, and they can take a pill and all of a sudden, hey, you can eat, drink milk, eat cheese, what have you.

And that is similar to histamine intolerance because of the DAO enzyme, which I'm sure we'll, we'll probably talk a lot about that. We have to talk about it. We have to, we have to talk about it. And so basically there's either we don't have enough of that particular enzyme to break histamine down. Mm-hmm.

Or there is some sort of genetic snip that you [00:10:00] have that means that whatever copy of this enzyme that your body makes, it's just not as efficient. And so that can impact its ability to function correctly. Mm-hmm. So. That is different from a sensitivity where we could have, so for example, like with gluten sensitivity, you're having more like a IG response where we could have all of these symptoms that don't feel great, but you're never gonna get to anaphylaxis and it doesn't have anything to do with an enzyme.

We don't have enzymes to specifically break gluten down, for example. Um, so that's the difference. They're really different parts of the immune system and that's why I actually, I'm gonna say this now 'cause I think it's important for people to understand where I've come from. 'cause I've sat with this a lot.

I actually think that histamine intolerance is over-diagnosed. Mm-hmm. It's partly self over-diagnosed. But I also think in functional medicine, I think it's over-diagnosed because we're [00:11:00] only looking at it from the enzyme perspective. Mm-hmm. So that's kind of my 2 cents. 

Dr. Brighten: If you think histamine to intolerance is over-diagnosed, what do you think's actually going on that doctors are missing?

Jennifer Fugo: I think doctors are missing the fact that there is an a histamine overload situation. Okay. Which essentially means that you could have no snip in your DAO enzyme or your genetics that are causing an issue with the enzyme. 

Dr. Brighten: Mm-hmm. 

Jennifer Fugo: There's no issues with breaking histamine down. You just have too much.

Dr. Brighten: Mm-hmm. 

Jennifer Fugo: And it doesn't matter how much you supplement. You have too much and your body's like, oh my God. I think of like Lucy and Ethel at the Chocolate Factory. God, I love Lucy. Right. Like one my 

Dr. Brighten: favorite analogies for what happens in the body. I know, and it's 

Jennifer Fugo: like the, the conveyor belt starts going faster and faster, like shoving in their hats, and now their blouse is in and their mouth eating it.

I know. And that's part of what's happening. But if we don't look at why you're producing so much histamine or what's causing this [00:12:00] excess amount of histamine mm-hmm. Then all we're doing is managing symptoms with diet, with other supplements. I think those things are important and it's helpful to have bridges to help get you to a state where you're not suffering so much.

Mm-hmm. But you shouldn't have to do that for life. Yeah. I mean, that's not, I mean, I mean, you love to travel. I love to travel. If you had to do a low histamine diet and travel to different countries, different cities, that gets really tricky. It starts to cause your life to get smaller and smaller and smaller.

And to me, quality of life is just as important as all of this other stuff, because if we're not living, then what are we doing? Mm-hmm. 

Dr. Brighten: So when it comes to the histamine diet, we'll see people who say you have to eat a low histamine diet for life. Do you agree or disagree? I mean, I don't think 

Jennifer Fugo: you should have to.

Mm-hmm. That hasn't been my, my, um, experience clinically so. I had all these [00:13:00] clients come to me and, you know, I work in the space of like chronic skin problems and I was always so fascinated by hives, urticaria, angioedema, um, dermatographia, where like you could basically draw on yourself. Mm-hmm. I don't know if everybody knows what that is, but you could like, no, no.

Yeah. Draw with a pen cap or even your nails, you could draw an X or a star and your skin will basically kind of welt up. It'll look like that shape. Mm-hmm. Because it means skin writing and so, and angioedema for people who know where that is, it's like basically your skin swells up. Mm-hmm. So it's like you have welts and even they'll describe, um, hives as like wheels.

Mm-hmm. So you could have like little pinpoints. You could have huge big welts throughout, you know, your arms, your face, your head. And that can be. Really, really debilitating. Mm-hmm. And so I began to sit with this idea of why is it that we only have a diet management tool? Because it doesn't really change the end result.

Yes. There are some people who do a low [00:14:00] histamine diet for a while and they start to get better and that's great. I'm super happy for them. But I don't know about you. I think the low histamine diet is miserable. Mm-hmm. I'm just being honest. 'cause like I think, I don't think it's sustainable. No. I think 

Dr. Brighten: a lot of the functional medicine diets that are therapeutic in nature mm-hmm.

Should be temporary because you're treating something agreed. And that, I think often we saw this with a IP mm-hmm. Autoimmune paleo. We have seen this with, um, low fodmap. Mm-hmm. And now we're seeing it with the low histamine diet where people will clinging onto it as if it is the holy grail. And if you just do this thing, it will solve all your problems.

But I don't know, I mean, I would say you are gonna have to like, do a lot more to convince me to never eat an avocado again. 

Jennifer Fugo: I mean, strawberries, spinach. Yeah. Oh my gosh. And the salami and cheese. If you go to Italy, you're just not gonna ever have that. I mean, I, I don't know. I, that would be a tough, that would be a tough sell for me.

Mm-hmm. So, um, I, I [00:15:00] think as I sat with it, I thought. Well, why all of a sudden, because it's usually fairly sudden, and it might not be like an overnight switch turned on for some people it almost seems like it is, but it could be. Over the course of several months, you start to notice these weird changes that if you go to your doctor, like your GP might be like, I don't know what to tell you.

Maybe take some antihistamines and yeah, just go with that. And you might notice that they help other individuals don't. And so I had this one client who she had such severe angioedema hives, um, for about, I wanna say it was like six or seven months that they put her on Xolair, which is the biologic type drug.

It's sort of in that category, I guess, um, to try to help control. And on top of it, every day she was taking up to eight doses of antihistamines. Mm-hmm. With no improvement. She even tried doing a low histamine diet. With no changes whatsoever. She [00:16:00] still needed all of these antihistamines to help maintain barely assemblance of comfort in her daily life, which is horrible.

And she even said to me, I'm at a point where like, I don't know if I can keep on going because this is awful. This is like literally my worst nightmare and a living hell. And so with these individuals, what are you gonna tell them to do? Just keep taking more and more out of their diet. Yeah. The, the diet doesn't work for everyone and as you pointed out, it's not sustainable.

I mean, any diet book that you look at, there's several low histamine diets you can find online and mm-hmm. You know, we have colleagues, friends who've written low histamine diet books, and you look at that and you're like. That's, that's it. It's pretty, it's a full-time job. Yeah. It's a full, it's a full-time job to manage your diet and eat in that way.

And part of the reason is because the worse it gets, you can't eat leftovers. Mm-hmm. You can't eat processed foods. And processed foods can include things like protein powder or collagen. Yeah. And [00:17:00] so, um, that was where. I started to really go down a rabbit hole. Well, if it's not the food, right, if it's not just allergies, because there's also people who've had these huge skin prick panels with allergists who are experiencing these issues and have nothing come back wrong.

Mm-hmm. What do you tell that person at that point? Okay. You have no environmentally, you have no food allergies. The diet is not really helping. You're on tons of antihistamines, which, by the way, some of them have pretty significant long-term brain impacts. Yeah. They're associated 

Dr. Brighten: with cognitive decline.

Yeah. It's not a, a mess around kind of pharmaceutical. 

Jennifer Fugo: No. And so then what else is it Like, what else? Mm-hmm. I mean, there's just like, seems like there's no hope for these individuals other than, well, we hope that you'll just, like in maybe a couple years, your immune system will shift and mm-hmm. Maybe it'll go away.

We don't know, or we'll develop [00:18:00] some drug, like Xolair was like the thing that they thought would fix everyone. And it, it doesn't, yeah. It doesn't help everybody. So that's why I think we have to ask the question, what is filling this histamine cup? What is causing it to so easily overflow? Mm-hmm. And when you ask that question, you get vastly different answers that you can actually do something about.

And I recognize that in conventional medicine, it's not ex, I mean they, they're just like, meds, meds, meds. Okay. Maybe change your diet. Don't go outside, don't be exposed to allergens. But we're not sure what exactly it is. Don't get stressed out, I mean. That's not living. Mm-hmm. And so I think that's where this, this whole conversation gets really interesting.

Dr. Brighten: Absolutely. So you, the diet, yeah. It has the time and the place. It does, but it's not gonna help everybody and it's not sustainable long term. No, but you just mentioned that when we ask the question like, why do we have so much histamine? We get different answers. What are those different answers? One 

Jennifer Fugo: of the things that I realized is that, [00:19:00] so in the health space, for example, um, we have our liver, which is wildly important for so many different things.

Mm-hmm. Um, I think we as a whole do not fully understand what detoxification actually is. It's really the transformation of different molecules. One gets converted to another and there's different reasons for why that can happen. Some of those things are like vitamin D for example, estrogen gets, can get turned off.

So we can actually help shuttle it outta the system through bile and whatnot. Um. But if we don't have a healthy phase two liver detox functioning mm-hmm. That's where we have methylation, our glutathione pathways, our glycine pathways. And when these get overrun, it's all of a sudden, like we're really struggling to deal with this on, um, in a way that our body needs to, it has the capacity to do it, but we have to ask why.

And specifically, phase two liver detox is run on nutrients, many of which that our body may make. So when we [00:20:00] have issues with our phase two liver detox, it makes it very difficult for our body to handle. Transforming really important things and part of what goes through phase two liver detox are toxins.

Mm-hmm. And those toxins can come from the outside world, but many of them come from the GI track. And so we need nutrients in order to do this detoxification for, like I was saying, our glutathione pathway, our glycine pathway, uh, sulfation. I mean, we have many really incredible pathways there. And if you, you and your best intention are limiting your diet, all of a sudden we now are restricting the amount of nutrients coming in.

And maybe you're at a point where you're also really sensitive to supplements, so you can't even add it in through a supplemental form, and that's where your liver's like, whoa, I can't handle this part of things. Then on the flip side, what happens if you do have a few allergies and you're like, oh, I read online.

I should support my liver [00:21:00] detox and I'm allergic to ragweed. Do you know what's in most liver detox supplements? Milk thistle. Mm-hmm. That's a ragweed family thing. Uh, ragweed family plant. And so you could be, 

Dr. Brighten: I just wanna say you just highlighted, again, I want to underscore this for people. This is milk's thistle is awesome.

It is. And it, it actually helps with the cellular regeneration of the liver, but it's not for everyone. Right. And I feel like this is a theme that has come up a few times and I really want people to take that home, but I'm slowing your role. No, it's fine. On the liver detox. I do wanna say though, when you said the I Love Lucy and the Chocolate factory.

Yeah. That's what I think of when I think of phase one. Of phase two. Yeah. And whenever people are like, oh, I did a detox and I felt so bad, and I'm like, I would bet money you were pushing phase one. Mm-hmm. And there's Lucy unable to keep up in the phase two and the intermediates that go from the liver.

So for people who understand liver has phase one, the intermediates. Are actually very toxic oftentimes. Mm-hmm. [00:22:00] Because then it has to go through phase two. So what you're talking about isn't just the inability to clear things that have come in or the body's produced itself, but the inability to neutralize mm-hmm.

More toxic intermediates. Mm-hmm. So I'll let you keep going though with your liberal explanation what's going on with histamine. 

Jennifer Fugo: And I a hundred percent agree with you. I oftentimes, when I talk about this, I'm like, it's like Ethel and Lucy in the chocolate factory. It's like the best analogy. And so the other piece is that a lot of what comes from the GI tract, specifically benzoates, so if you look in the food supply, especially foods that are more processed, they'll say like potassium benzoate.

Yeah. And it's usually added to food as a food preservative. And there are benzoates naturally occurring in foods, but what is produced in your gut is massive. Mm-hmm. And that jumps, it jumps the line, it goes right to phase two. So if you're already handling a heavy load or you upregulate, or. Speed up or put the gas pedal on phase one and you don't have, I like [00:23:00] to call 'em the bonbon wrappers because it's like that's what the nutrients are.

I love 

Dr. Brighten: your delicious analogies. 

Jennifer Fugo: I just wanna say that chocolate factories, bonbon wrappers for it all, but like if you don't have enough of them. Your body's not just gonna find it someplace else. Mm-hmm. Our liver's not a fish filter. I, that is one of the biggest grievances I have with how things are described online.

Your liver's not a fish filter. It doesn't just suck things up and mm-hmm. Filter it out for you. It actually does a lot of things. It has some amazing capacities, but it requires nutrients in order to do it. And like the glycine pathway, for example, is one that does require nutrients. And yes, glycine is readily available in a ton of foods.

However, and I don't know why this is, I don't have any data to back this up, but I tested this out repeatedly with clients. It did not matter how much we increased glycine consumption in food. So we would say, Hey, um, just increase your collagen, uh, intake. Right. That seemed to like [00:24:00] the math. Math, except it didn't seem to make any difference.

Mm-hmm. And so then I was like, okay, let's just try supplemental glycine, like focusing on these more therapeutic dosing, which starts at around three grams a day and can go all the way up to like 10 grams a day, depending on severity. And we noticed that that for some reason seems to get better results.

Mm-hmm. I don't know why. I don't know if it's that the body's like, oh, the glycerin collagen, we know what to do with it. We're gonna put it in these other spots. Because there's no guarantee when you take something, it's gonna go where you want it to go. When you say better results, like what kinds of things do you observe?

So we notice that people tend to be, like, for example, less reactive to salicylates, which is a totally other type of mm-hmm. Uh, food. It's a really, it's a phytochemical that, um, some individuals become reactive to, and a lot of times it's also described as salicylate sensitivity or an intolerance, but it's actually not, most people think it's a gut intolerance, but it's a [00:25:00] liver detox issue because if you're, you're sensitive to salicylic, salicylic acid is processed down the glycine pathway.

Mm-hmm. And so you need more glycine in order to. Yeah, you need the bomb bond wrappers, right? Yeah. To wrap it up, process it, and get it out without having reactions. So people will notice an improvement in their skin, they'll notice an improvement, and this includes eczema, psoriasis, even urticaria and hives and dermatographia.

They'll notice that in general, they seem to just feel better. 

Dr. Brighten: Mm-hmm. 

Jennifer Fugo: Um, they're, they're less reactive to things. Their skin clears up faster. Obviously, that's kind of the wheelhouse that I work in. Um, but they do notice that their rashes will be less red. Some individuals, I'm not gonna say it's magical because nothing is magical.

Sometimes that crucial first step, you're not gonna notice a drastic improvement because you've got so many other layers of things to address, like in this histamine intolerance or histamine overload situation. Usually there's a lot more that we need to do. Um, but this is a [00:26:00] crucial first step. 

Dr. Brighten: Mm-hmm.

Jennifer Fugo: The next thing is, I mentioned the gut. The gut. There's a huge gut impact. Wait, before 

Dr. Brighten: we move on in the gut, I wanna ask you a question. 

Jennifer Fugo: Oh, please. 

Dr. Brighten: You are a licensed nutrition professional. Yeah. What do you say to providers who say your liver has the capacity to detox, therefore there is nothing you need to do to support your detox pathways?

It just happens on its own. I mean, 

Jennifer Fugo: the problem is it is in every single, uh, you could look in any textbook, you could look on PubMed. It's very easy to find that these pathways specifically in phase two, require nutrients. Okay. And so that's great. Yes, they do have the capacity to do that, and they need the nutrients to do that.

So who's to say that the nutrients that you should get from the foods you eat is even being absorbed? Mm-hmm. There's, there can be issues, uh, for example, with digestive fun dysfunction where you might eat meat, for example, which does have usually a good amount [00:27:00] of glycine in it. But what if you don't have enough stomach acid?

Mm-hmm. You don't break the proteins down into amino acids. What if then you're, you have celiac disease that's undiagnosed, or you just ha your gut is. Super, super unhappy because of overgrowth issues and whatnot. And now you're not absorbing things the way that you're supposed to. So we can't assume that what we eat, unfortunately, is actually making its way in.

Mm-hmm. And if there are nutrient wells that are really dry. You, you can't expect the normal amount of nutrients that a person who is healthy, who is in a robust state that that's gonna fix the problem because we have a well to fill up. So I understand and hear them. I'm not saying that the liver doesn't have the capacity to do it, I'm just saying the liver needs some support.

Absolutely. 

Dr. Brighten: And I think that it is actually a very dangerous statement to make blatantly, like when you consider the standard American [00:28:00] diet mm-hmm. And how nutrient devoid it is, and how many people are consuming processed foods. Mm-hmm. Then aren't even getting things like cruciferous vegetables, which we know are essential to liver detoxification.

Maybe they're not eating, maybe they're vegan and they're not getting the right array of amino acids. And so to be so flippant of like. Your body has detox pathways? Well, it's like I always think, well, yes, your kidneys can detox, but if you don't drink water, no, they actually won't. So there's inputs that have to happen.

Mm-hmm. And I think for people listening, it is very, very important. Whatever you put at the end of your fork is input to the body. Mm-hmm. And is supporting those systems. Okay. So we covered liver detoxification issues can be one cause of this histamine overload. You were moving onto the gut. 

Jennifer Fugo: Ooh. The gut.

There's the gut. Actually, I, I think I would love to talk a little bit about environmental issues first. Yeah. Because obviously that impacts, obviously impacts our liver, but it also can impact our mast cells. Mm-hmm. And we can breathe in things like chemicals, [00:29:00] allergens, I mean, especially for those who are high, like you've got really bad, uh, hay fever.

Yeah. And allergies. Obviously that's gonna impact things as well. Um, as I had mentioned, if you have specific allergies, you should be aware that there's that possibility of cross reactivity. That's why I mentioned we, we talked about the milk, the milk, ra meat. I love that for people. Yeah. So just be aware of that.

That unfortunately might not be something that you can do. And that's where we wanna look more towards just general nutrients mm-hmm. To help support the liver instead. So, um, so we have environmental allergies, mold can be a factor. Mm-hmm. And I, I'm not going to sit here and fear monger about mold because I think the way we have conversations about it is really like, to me it's, it's sad because your system is already overwhelmed and now you're throwing on top of somebody, oh my gosh, you might have mold in your house.

You need to move, you need to burn all your things. And it's like. [00:30:00] I just wanna feel safe. 

Dr. Brighten: I will also say that I think people who have legitimately had mold in their home, it is so traumatic, and I don't hear use that percent word lightly. It is so traumatic. Like there's, you know, women who have had multiple miscarriages.

Mm-hmm. There's people that, you know, they became very chronically ill, people lost their job. And then on top of that, then they have to remediate their house. They have to lose their stuff. And so, um, for anybody listening, if you see somebody that it feels like they're fear-mongering with mold, I don't want you to go hate on them.

I want you to have compassion for the fact that like, that was incredibly traumatic. And I think they very much want to warn everybody. So it, because if they had known and they could have prevented it, that's what they would've wanted. A hundred percent. But I think you're right that there are other people who, it wasn't necessarily their experience, but they're selling great programs for mold.

Mm-hmm. There's their, they've got an affiliate for testing your house and they're literally telling everybody. Everyone has a mold issue, which we know is not true. 

Jennifer Fugo: No. And some individuals [00:31:00] are more re I, I hate to say it, but the cards we got dealt with do matter. Mm-hmm. So you might have some genetic snips that make it more difficult for your body to clear mycotoxins.

Whereas somebody else, I mean, I work with families where the wife is really super sensitive to even the most minute amount of old mold. Mm-hmm. And sometimes there also can be mold allergies on top of that. So those are two separate things that can co-occur, but the rest of the families. Basically, okay.

Mm-hmm. They're able to handle whatever that exposure is. And it may just be that maybe there's a little bit of a leak under the one toilet and it hasn't gotten too bad. Where it's a challenge is where we're dealing with super, like a ton of black mold. Mm-hmm. You know, like if, God forbid you broke down the wall, I couldn't imagine in ear and like you're like, oh my gosh, it's concrete.

There's no mold. No mold. No mold. I've in concrete houses. But like you were sharing with me about how you went on your honeymoon and stripped the bed. Yeah. And the whole bottom side of the mattress [00:32:00] was covered in mold in a tropical area. Mm-hmm. And so we. We forget that yes, we can live in a place where there might be a small amount of mold and depending on your unique cards that you got dealt, you might be able to handle it.

You might wanna clean it up, but is it a five alarm? I think that's the always, the question is, is it really a five alarm fire? And that's where I get worried even in this conversation, that everyone wants it to be a five alarm fire in order for it to be motivating. But the reality is nobody makes the best decisions when they're constantly in that fear state.

Totally true. Because we're missing the other data points. We're missing some, I mean, you could have mold in your car. Mm-hmm. It might not be your house. Literally. You could have mold under the rugs in the car and in the ventilation system. It could be your work, it could be your gym. So should you freak out and think, oh my gosh, I.

Clearly of all these symptoms of mold illness, it must be my home. Mm-hmm. It might be someplace else. So [00:33:00] again, having this mindful approach to it. So mold can be a factor because it can destabilize mast cells. Mm-hmm. Obviously it, it's just mold is its own, its own beast. I'm not an expert in mold by any stretch of the imagination, but I do think that's a factor.

Um, and then also too, in terms of like the gut. We have bacteria that can produce histamine. Mm-hmm. There are obviously parasitic issues, both protozoa and worms or helmets that can cause, um, that the more allergic side of the immune system to be become elevated. Like our eosinophils, which are one of the white blood cells or our total IgE marker, can get elevated as a result of them and kind of get confused with allergies.

Um, also fungal overgrowth or candida overgrowth can also cause issues having sibo. So small intestine bacterial overgrowth can be a factor. Having an h pylori or helicobacter pylori infection in the stomach can be a factor. Mm-hmm. So many [00:34:00] of these things play a role in this histamine bucket and the overload that happens.

There's no amount of moving. Right. If it's not, let's just pretend you're like, okay, it could be mold in my house. What happens with everything that's going on internally? You can't walk away from that. 

Dr. Brighten: Mm-hmm. 

Jennifer Fugo: You're living in it. So that's where I started to think, well, what happens if we seek out the organisms that could be contributing to mast cells and basophils degranulating and releasing their, their histamine into the body?

What could we do if we were to help sh reshift the microbiome so that your body could handle those things? Mm-hmm. And you could regain tolerance again. And that was where. Like, that's where I really find it fun and fascinating and interesting. I love being that sort of like, uh, uh, detective for clients because there's, they're so exhausted.

Dr. Brighten: Yeah. 

Jennifer Fugo: And, [00:35:00] um, I just want people to know that there's hope. You don't have to be stuck that way. Like the client that I mentioned earlier who had angioedema and chronic hives from months and months on end, eight antihistamine doses a day, plus Xolair, she's on none of that now. Mm-hmm. She has no outbreaks.

So it is possible to roll it all back. It's just, you have to understand what the causes are. 

Dr. Brighten: I think people listening are gonna be curious if there's other environmental inputs they should be aware of. So we talked about mold. Are there other issues that could be contributing to MAs cell? So everybody knows mast cells, they're, they basically have little pockets of histamine on them.

And so when they become disabled, I think always think about this. Cell, like freaking out. But it's like throwing confetti everywhere, but it's like histamine and it's just like, I don't know, maybe the Oprah, like, you get histamine and you get histamine going on. But uh, you know, so in the mold context, you know, we, I think that's like a really big extreme that people can, you know, grasp.

But are there things day to day that they might be coming into, [00:36:00] you know, encountering that's causing this? 

Jennifer Fugo: So an interesting part of this could even be something as simple as temperature changes. Mm-hmm. Could be sunlight exposure, like all the good things that you would think like, oh, let's go, we're like, do, we're like beta mean be out in the sun.

We should get our, our, our daily sun. And for some people that triggers a histamine reaction. Yeah. Um, even wearing something tight. Mm-hmm. So it could be like, the straps of your shirt, could be your waistband, could be anything elastic, anything tight around your feet or your, your neck, whatever. Mm-hmm. It doesn't matter.

That can cause your mast cells to de granulate. And I love that analogy. I think of it like, uh, kind of like the fulfillment houses that have all the packages and they're floating around the body and all of a sudden something just like causes them to just. Dump all their packages everywhere that like 

Dr. Brighten: UPS during Christmas.

I know. Forget it. I'm done. I'm 

Jennifer Fugo: going home. So I, I I know it's like, I, I [00:37:00] think having some great analogies helps us to better understand this. Mm-hmm. And, and in some regards to kind of laugh at times, which we do need to laugh. We do need to find joy. 'cause it can be really heavy. And I get that. I don't want to feel, I don't want anyone to feel like I'm minimizing their experience because like I said, I've worked with people that are literally at their wits end.

Mm-hmm. Like if this cannot stop, they're not sure how much longer they can go on. Yeah. Because it's that bad. 

Dr. Brighten: Okay. So we've talked about. What, you know, you've covered the symptoms. I feel like maybe we should do a roundup of symptoms. Actually, before I ask my next question, because I feel like, you know, you've said things from hives to migraines to insomnia, but maybe like a head to toe, like mm-hmm.

Somebody taking an assessment of themselves, might I have a histamine issue? Mm-hmm. Let's do that and then, and then I've got some more questions for you. 

Jennifer Fugo: One thing that I will tell you flat out in my clinical view, if you have hives or urticaria, any type, it doesn't even matter if it's the autoimmune type.

If [00:38:00] you have dermatographia or angioedema, you have a histamine problem. Mm-hmm. Period. Like you don't need to look at the other symptoms and to figure out. Do I have this? No, you do. Now it's just, we wanna know the severity. Yeah. So those for sure, those skin symptoms for sure are a problem. I will say this about itchiness.

You can get itchy in having a histamine reaction, but not all itch is driven by histamine. Mm-hmm. And so you cannot use that as a reason why you think you have a histamine problem. And most. Itch that occurs in eczema is not histamine driven. I actually interviewed Dr. Sean Quatra on my podcast. Mm-hmm.

All about this. He's like the worldwide expert in itch and he, um, works at the University of Maryland in an itch lab. And so they discovered that most itch is not actually histamine driven. Hmm. But one factor to note that is helpful is if an antihistamine [00:39:00] does help, that obviously is a good telltale sign that we have a problem.

Um, for example, if you were to eat something and you notice that you're starting to have, like your throat gets itchy and your mouth feels itchy, um, you might get some GI symptoms. You could have maybe even like a little bit of heartburn. You start to feel like your heart is racing. Mm-hmm. You start to get a headache or even to a migraine.

Um, you have issues sleeping, maybe full-blown insomnia. Um, you can also have other issues like POTS type symptoms like autonomic issues. Um, and then also those who have like ERs, Danlos, where you are hyper flexible mm-hmm. Can be a factor in, um, histamine issues. Um, I've also had clients where they just generally don't feel well.

They start to turn red, um, they get really flushed and they feel like they're getting sick. 

Dr. Brighten: Mm-hmm. 

Jennifer Fugo: So those would be some things that I would categorize as like, [00:40:00] definitely something's going on, but like I said, where I get worried is when someone, like, they'll say, Hey, um, I can't even handle like a little bit of zinc in a supplement.

I can't take, uh, things that are nutritive where you become super hyper reactive to it. Yeah. That's where you're sort of like headed towards mast cell issues. Mm-hmm. 

Dr. Brighten: And 

Jennifer Fugo: that's where I think at that point you should be really working with a doctor because you might need medications and whatnot to help stabilize some of those symptoms.

Dr. Brighten: Mm-hmm. And from the hormonal perspective for people listening mm-hmm. If. Five, seven days, maybe even closer to just one to two days before your period. You're like, I'm getting sick. I feel like I'm getting the flu. I'm achy, I'm feverish. That could be a sign that you're having issues with your histamine.

If you've been diagnosed with P-M-D-D-A-D-H, ADHD, endometriosis, we know there's certain conditions where histamine issues can ride along with them, and it's because you inherently have immune system dysfunction as it is, and so mast cells being [00:41:00] part of the immune system, it's, you know, not shocking.

Although some people are like, you know, really dismissive that this could even happen. Or patients who are like, no, but I take an antihistamine and I don't feel suicidal before my period. Yes, because histamine is also a neurotransmitter. Mm-hmm. It is not just affecting your, your gut and your skin and a lot of these obvious symptoms.

It can be affecting your mood, but for people who are struggling with skin symptoms mm-hmm. We kind of pulled the, the hope away that like the diet's gonna cure everything for everyone. Right. What can they do topically to maybe get some relief if they're itchy, if they have eczema and they're like, yes, antihistamines do help, but like, I've got a family history of dementia.

I don't wanna mess around with these things long term. Are there topical things that in the short run they can use to kind of get some relief? And then I want to start getting into like what you can do big picture. Yeah. 

Jennifer Fugo: I think it's tricky because there's some more natural things you can do and then mm-hmm.

You're sort of at this point where you do need medication. So zinc can be really helpful. Topically [00:42:00] it's in calamine lotion. Yeah. For those of us that, remember when we used to get mosquito bites and poison oak poison, like I 

Dr. Brighten: was pink like all 

Jennifer Fugo: summer. Exactly. So that has zinc in it, so it can be helpful in that instance.

So, uh, you could try like an organic diaper cream, if you don't mind being like. Spotted white. It is, it is. It will make you look pretty pasty. Um, or those butt paste. Yes, I'm a fan. Um, there are some other formulas that have less amount of zinc in it that can possibly be helpful, but that's one thing, you know, when you, I also like, which Hazel?

Um, which Hazel hydrosol. Mm-hmm. It can be nice to just help kind of like break up the itch as can anything cold. So ice packs, uh, even like you, if you have like, uh, issues with your face, for example, you can get those frozen metal rollers that you can keep in either the freezer or the refrigerator and roll over your face if you feel like you're having an issue.

Mm-hmm. And that can kind of calm [00:43:00] things down, break the itch cycle to hopefully give you a little bit of relief. Um, I generally would not recommend getting in as sauna or a hot shower. That seems to make things worse. Mm-hmm. Um, and from there, most doctors that are looking at like steroid creams and other things to pry.

To try and calm things down. 

Dr. Brighten: Mm-hmm. 

Jennifer Fugo: So those are like the most kind of like natural, this is a really hard, I, that's why I said I have great empathy for folks who are dealing with this. 'cause this is tricky. There's not a lot on the natural side that is just gonna like, jump in and save the day. Mm-hmm.

There are things that can make it better, but at the end of the day you are, you are probably gonna have to lean on some type of meds to some degree. Mm-hmm. And, and I just wanna normalize that because there's a time and a place for medication. I know in the wellness world where there's a lot of people that screaming and, and cry out against medications.

But that's nice when you're not [00:44:00] in that boat, when you are struggling. And that medication means that you can get through your day with some semblance of normalcy. I, I'm really hard pressed to, to understand why we would make someone feel ashamed for choosing a medication to help them, especially when it gives them more runway to be able to be the mom that they wanna be, to go to work to see their friends and family.

I mean, even just to get outside to go for a walk. 

Dr. Brighten: Mm-hmm. 

Jennifer Fugo: So that, those to me are the big things. And I also wanted to just like mention progesterone can be a potential trigger. Yes, it can. I, you were talking about hormones and I was like, hold on. I need to mention progesterone dermatitis is real. Yes, it is.

It is a serious 

Dr. Brighten: problem. I think we actually did an episode on your podcast mm-hmm. The Healthy Skin Show Yes. Where I talked all about that. Yep. So we'll link to that. Yes. 

Jennifer Fugo: So that can be a factor as well. And it's considered rare, so a lot of, mm-hmm. A lot of doctors don't even look for it and [00:45:00] many have never even seen it, so they don't know what they're even gonna look for.

Yeah. 

Dr. Brighten: And 

Jennifer Fugo: for 

Dr. Brighten: people. Who are like, well, why wouldn't my doctor look for this? The most case studies and most, most studies in general, it's IVF treatments that we see it. Mm Uh and so it's when you're using high dose and you're using vaginal suppositories, maybe you're doing IM injections or subq injections of progesterone, and you're getting those levels up.

That seems to be the time that like tips the scales. For some people it's also, you know, during fertility treatments, there's a lot going on with immune system regulation that, um, you know, for whatever reason, even just being put on oral steroids, there might be something coming into play there. So. But if you are somebody who's like, oh, you know, when I, um, you know, before my period, I start to know this is that I get hives and things like that.

And it's not actually usually just before your period. It's usually five to say seven days after you ovulate when progesterone peaks. Um, but when we most commonly see it is [00:46:00] when we are high dosing with fertility treatments, which by the way, for everybody listening, we don't use those high of doses when we're doing hormone replacement therapy.

So everyone perimenopause, we are not hitting you with 600 milligrams a day. It's like one to 200 and sometimes even less than that. But I appreciate you bringing that up because that isn't, there's a big interface between estrogen and progesterone. Mm-hmm. And what is happening in the immune system in general.

But we know estrogen's involvement and I'm actually gonna be on your show again, so you guys have to call her. And I'm gonna talk all about estrogen's involvement with histamine because I think it's so important for people to understand. So, and the other thing I wanna say, just to your point about medication, I really appreciate it because I'm a fan of the tool.

Any tool for the right job, right. Whatever the tool is that we need. I don't wanna screwdriver when I need a hammer. Mm-hmm. Often when I see people who are like natural is better at any cost and shame people about pharmaceuticals, they do not have a license to prescribe pharmaceuticals. And so they don't, they're not actually trained to understand pharmaceuticals, they're not trained to understand [00:47:00] how to actually go through the risk versus benefit.

Give a true informed consent on that. And I think it creates a bias. Mm-hmm. Uh, it even helping happens with healthcare practitioners who don't have a license to prescribe. They'll steer everyone away from medications because they have their own bias. And I think. We all have a bias, it's inherent, but we have to be willing to recognize that and to always step away from the bias to say, is this actually what's best for the patient, or is this just me having a bias around this?

Mm-hmm. Now as you bring this all up, I think people are gonna have question. I think the big question is gonna be, is this a lifelong thing? Is there no getting rid of histamine issues? Am I just stuck with it? 

Jennifer Fugo: I don't believe you should be stuck with it. Mm-hmm. I think mast cell activation may be a much longer road.

Mm-hmm. And again, I don't work with that. 'cause at that point, I feel like you're going to need medication and a significant amount of medications. So having a physician on board that is very knowledgeable [00:48:00] about mast cell issues is gonna be really crucial. 

Dr. Brighten: Mm-hmm. 

Jennifer Fugo: That being said, if you're in that sort of histamine overload bucket, and that could include histamine intolerance.

Yeah. I do think that you can reverse it, you could minimize it. Maybe you might have some lingering issues. But I do tend to find, uh, with clients that we've worked with, people who've gone through even my group programs, they're doing this on their own just with guidance that they are able to reintroduce high histamine foods without any reaction.

Mm-hmm. They're able to go about. Their life again, which is like, to me, that brings me so much joy because I know, I mean, when you can't do basic things Yeah. That is, you know, it's not like you're going, I need a billion dollars. No, you're, you just wanna go outside, you wanna go exercise, you wanna go to your kids' soccer game and sit on the bleachers and cheer them on without feeling sick.

Mm-hmm. You want quality of life. And to me, when we can get that back, that [00:49:00] is like amazing. And I mean, if you wanna go like to Italy and eat some salami and some Parmesan cheese and have some fermented foods and whatnot, and you're just able to relish in all these amazing flavors and eat strawberries, you know, like just simple things.

Yeah. That to me is. That brings me a lot of joy. So, speaking of salami 

Dr. Brighten: and strawberries, what foods are most problematic for people who are struggling with histamine issues? 

Jennifer Fugo: Well, I again wanna clarify, there is a range. Mm-hmm. Um, so there are low, there are, uh, histamine foods that are considered low histamine.

Either they have low histamine or are they. They don't cause a whole lot of histamine release within the body. We then have more moderate foods. That's probably more so where things like strawberries, um, asparagus, uh, no, sorry, I misspoke there. Not asparagus, uh, strawberries, avocado, chocolate, all those different foods kind of light where we get, get all the awesome [00:50:00] food.

I know, I know. Again, 

Dr. Brighten: I brought up, uh, avocados, but you guys, I would be a liar. It's chocolate chocolate's. The deal breaker for me. 

Jennifer Fugo: No chocolate. I love chocolate. But where we get into the high histamine bucket and then there's kind of like the beyond. So I'll, I'll, I'll start with highest mean bucket is our fermented foods.

Alcohol, uh, aged and cured foods. Um, things that are molded. So like blue cheese for example has mold in it. Mm-hmm. Um, and that's where you have to be careful. Some berries, for example, are low histamine foods like blueberries. But if they're moldy, yeah. Then 

Dr. Brighten: no. So do you recommend people wash their, their produce with like apple cider vinegar diluted in water or, I think, I 

Jennifer Fugo: think those are great things to do.

Okay. Just in general. Um, I mean, there's a lot of, who knows what ends up on our food by the time it gets to us at the grocery store. Mm-hmm. So anything that we can do, I always just think about 

Dr. Brighten: whose hands ended 

Jennifer Fugo: up on my food and did they wash 

Dr. Brighten: them? Are they singing happy birthday? I don't [00:51:00] know. Mm-hmm.

Jennifer Fugo: Who knows? But anything that we can do, I think is helpful. You know, so any little, little bit of extra care and step is, is important. Um, you know. Uh, so anyway, those are a lot of the big ones. Um, we mentioned fermented foods, pickled foods. Mm-hmm. Vinegars, um, things like that can be a really big challenge.

The bigger issue, so kind of like the upper end of the range would be protein powders, collagen, um, gelatin. Mm-hmm. So bone broth. Yeah. I mean, we talk a lot about how healing 

Dr. Brighten: bone broth is, and this is everything you're talking about right. Now. All these foods could be considered superfood Yes. In some capacity.

And so Absolutely. This is really the nuance of like, what is actually true for you. Mm-hmm. And how your body responds 

Jennifer Fugo: and when it gets really bad is where you cannot consume. Anything that's a leftover. Mm-hmm. And that is where most people feel like the wheels are flying off the car and they can handle [00:52:00] it for a certain point until they can't.

Because it's basically like if you were to cook hamburgers for example, and you ate it right away, probably not an issue if you let it sit in the refrigerator. And you tried to eat it tomorrow or even later in the day, no, bueno not gonna work. Mm-hmm. Because as food sits, the amount of histamine increases in the food.

Canned foods are another problem. So you can see like, how do you travel like that? That's what I was saying. Yeah. How do you take a trip? What do you bring with you? You can't bring meat sticks. You can't, most berries you're not gonna be able to travel with. You could do some apples and, but that's not very filling.

Mm-hmm. So anything that's canned, anything that's pre-prepared is pretty much off the table unless it was frozen. Mm-hmm. And airplane food is not gonna cut it. No. 

Dr. Brighten: That's gonna be off the table too. No. So you're 

Jennifer Fugo: gonna be walking around the airport going, what do I eat? Yeah. And it's, you're gonna be really hard pressed to find something.

So, um, the [00:53:00] leftovers are where it's usually like, I need to, I need to make a change. Mm-hmm. I need to do something. I, I really would prefer people don't get to that point. But yeah, we all, we all reach out for help and start looking when we're ready for it. On the flip side, what foods can help. If you're struggling with histamine, there are actually some foods that you can add to your diet that can help.

Uh, so things that are high in Quercetin, for example. Mm-hmm. Which is a bio flavonoid in, um, things like. And they're kind of reddish. So apples, you could do red apples, but you could also do granny smith apples. Um, but we have things like, uh, currents, uh, cranberries, blueberry. I know blueberries aren't exactly red, but they're kind of reddish.

They're purpleish. Um, we could do like purple plums, red lettuce, uh, romaine lettuce. We can do dark leafy greens, um, asparagus. And one really interesting thing that has actually a plant-based source of DAO is [00:54:00] pea shoot sprouts. Mm-hmm. And so you could make like pea shoot pesto. Again, you'd wanna probably wanna make it fresh.

Um, and you could add that to your food. And that might be helpful in improving the digestibility from a histamine standpoint of your food. But adding pea shoots, I mean, sprouts in general are really helpful, but pea shoots specifically are mm-hmm. Like. They are a prime source of naturally occurring DAO.

Dr. Brighten: Yeah. And this is something that you can actually sprout in a paper towel, like a wet paper towel on your window sill. Um, I always share that with people because like we've all been to college and we know what living in a dorm is like and like, even in these situations. 'cause I think sometimes people, you know, you'll say things like pea shoots and people because they've never seen them before, they think like this is completely, you know, something that no one can access.

And so I want people to understand, actually you can DIY this at home pretty easily. You brought up alcohol. That's a huge controversial one I feel like in 2025 because. [00:55:00] Of the, you know, the acknowledgement of what we all knew of like, if you're drinking alcohol in excess, you are, you're playing the Russian roulette of cancer basically.

Um, what is alcohol doing though with histamine, and why are people getting flush when they drink it? 

Jennifer Fugo: So from what I understand with, from research is that it increases ex and our endogenous production or release of histamine. Mm-hmm. But it also is fermented. So it in and of itself is high in histamine.

So it has this dual effect. And then some individuals also may not have, it's called an enzyme that's alcohol dehydrogenase. Mm-hmm. So they may have an even further difficult time breaking histamine down or alcohol down. And then the other factor is like, what happens if your gut's really messed up? Yeah.

What if you have fungal overgrowth? And there are organisms that. Produce alcohol in the GI tract and now you're adding alcohol into it again. It just mm-hmm. Tips you right over into that bucket where you're like, I can't do this. [00:56:00] So alcohol is something that when you're in a histamine overload situation, I'm like, listen, I'm really sorry.

I like maybe once a month having a little bit of red wine with dinner, but like it's kind of off the table. Mm-hmm. For a while. You've gotta get things under control before you can add it back in if you wanna indulge periodically. 

Dr. Brighten: Mm-hmm. You brought up the DIO enzyme. Mm-hmm. Let's explain what that is to people and is it worth supplementing with it?

Hmm. 

Jennifer Fugo: So the DAO enzyme is diamine oxidase. It is our only histamine breakdown enzyme within the GI tract. So we actually have two enzymes in the body that break down histamine, DAO, and then HNMT, uh, that is our intracellular enzyme. So it's inside every cell. Mm-hmm. And it breaks down histamine inside the cells.

So DAO is our primary histamine breakdown in terms of like what we're consuming, what is being produced within the GI tract. And it [00:57:00] also requires copper in order to operate correctly. So if your diet is devoid of copper, you're taking a ton of zinc without balancing it, that can be a factor. And as I said, we can have snips, genetic snips that cause the DAO enzyme to not.

You know, work as well as it should. And some research looked at how many SNPs there are. It could be up to like 50. Mm-hmm. So, you know, and, and, and look, could we have SNPs that maybe make it more potent? I don't know. It's possible. Who knows? But the reality is the DAO is crucial. This is where, you know, this is where it's like in theory, okay, you have too much histamine.

What if I just supplement with more DAO to break it down? Wouldn't that math make sense? I wish it did. But what I found clinically is that most people don't find that additional DAO from supplemental form is helpful. Mm-hmm. The, the one challenge, there are maybe one or [00:58:00] two supplements on the market that might be plant-based, but most of it comes from pork.

So if you have an allergy to mammalian protein Yeah. Um, or you have, uh, an allergy to pigs, obviously that's gonna be, or your kosher. Or your kosher, that's gonna be a problem. Um, I usually recommend that clients try it for about two to four weeks, and you have to be really honest with yourself if you see an improvement and if so, to what degree?

Mm-hmm. If it's like a little bit or you didn't really notice a difference, supplementing is probably not going to help and it's expensive. And generally you're supposed to take those supplements about 10 minutes before every meal, which most people have a hard time remembering to take digestive enzymes to begin with.

Yeah. So to have to time, that is tricky. And again, it's an expense that if it's not necessary, I don't generally recommend. 

Dr. Brighten: Are there supplements that 

Jennifer Fugo: can help? So there are, um, you can supplement with quercetin. 

Dr. Brighten: Mm-hmm. 

Jennifer Fugo: I will just say [00:59:00] this about quercetin. I love it at the same time, if you take it for too long, so I would probably say too long would be maybe a year or longer.

It's nine and every individual. But I found that some clients start to have either some like weird thyroid things that begin to happen or they'll have like blood sugar issues. Mm-hmm. I'm not sure why. And there is some literature to show that there is this, there's something going on there. So I think.

If the goal would be you use it as a bridge to help you get to where you need to go, but eventually we wanna use it just as needed. Um, and typically people take like 500 milligrams once or twice a day. Mm-hmm. Seems to be a pretty standard amount. Um, there's also, uh, other bioflavonoids, like rootin can be helpful.

Nettles, the stinging nettles, the herb, and you can also make teas and all sorts of things from it. Um, that can be helpful. One of my favorites, and I don't, I apologize 'cause I have no data to back this up, but [01:00:00] I have seen this work clinically so many times is immunoglobulins. Mm-hmm. Bovine serum immunoglobulins are so helpful.

And I don't fully, I've asked the one, there's one company in the United States that makes them, and I have asked them repeatedly if there's any research or anything to explain this and they're, they, they don't know. 

Dr. Brighten: Yeah. 

Jennifer Fugo: My best guess is that. In within the GI tract, there is such a huge burden of endotoxins because it's really great at binding to LPS or lipopolysaccharides.

Dr. Brighten: Mm-hmm. 

Jennifer Fugo: That perhaps that's a factor in helping to stabilize things. I will say this. If you use the dosing on the bottles, you're probably not gonna see a result. You do have to go to higher amounts. So talk with your provider or your practitioner, whom you're working with about what would be appropriate for you.

Dr. Brighten: Yeah, 

Jennifer Fugo: because they are, you do need more. But I have seen. People who couldn't have [01:01:00] alcohol, all of a sudden, hey, I can tolerate having a glass of wine. And I was like, I didn't say you could have wine, but o okay, I'm happy for you, you, but like, I don't, don't think we were there yet. I just like, I was like, we're not there yet, but okay.

You know, they're on vacation, wanted to give it a go. Um, they're able to tolerate higher histamine foods. They're less reactive. Mm-hmm. So it's not for life, but again, it's a, it's a nice bridge that helps get us more comfortable and give our body way more flexibility than what we originally started with.

Um, also I would. Highly encourage everybody, like vitamin C is amazing. Um, but the other thing is look at your probiotics. Mm-hmm. Because some can be histamine producers and so there are certain blends on the market that are lower in histamine. Um, lactobacillus r Gnosis GG has a lot of great research on it and tends to be very well tolerated.

And it's available in all different formulas, whether it's a professional grade or [01:02:00] something like ll. So you have a variety of price points, but that can also, and we love it for the vagina too, everybody, 

Dr. Brighten: very good for your down there ecology. 

Jennifer Fugo: And it has to be the GG strain. It can't just be lactobacillus prognosis.

Um. So those would be like some of my absolute favorites I would say. But the immunoglobulins, as long as again, you don't have a beef allergy 'cause they're derived from serum. Yeah, the blood of blood of cows, unfortunately. But, um, they are really, really 

Dr. Brighten: helpful for somebody who has been dealing. With chronic histamine issues, where would you advise that they start?

Jennifer Fugo: I would first start with the liver piece. Mm-hmm. Because I find that we have to think five steps down the road, what am I gonna need to be ready for once I start dealing with some of the underlying issues, like I talked about the gut microbiome, but you should never start there. Mm-hmm. Because if your liver's already overwhelmed, the last thing you [01:03:00] wanna do is start, you know, going after your SIBO and whatnot.

Because as you kill or rebalance what's happening in the GI tract, you know how more toxins, if you can't deal with what's already going on, the worst thing you wanna do is now start throwing even more at the, at the liver. 

Dr. Brighten: Mm-hmm. 

Jennifer Fugo: So I do think starting with the liver is really important, adding in some of these nutrients.

Like the bi bio flavonoids, like quercetin, immunoglobulins, maybe shifting up your probiotics can be really, really helpful. Talking with your doctor about what's happening and seeing if they can prescribe you something appropriate. There are mast cell stabilizing medications that sometimes can make a huge, huge difference in how you're able to tolerate food.

Because, and I think this is an a a point that you were also kind of mentioning when we were just discussing diet and how limited it is, the more we reduce diet diversity, we reduce gut microbiome diversity and nutrient [01:04:00] diversity. So the more we can keep foods in and get you back to eating a more quote unquote healthy diet that you like, that provides you nutrition, I think to me is like a really nice win.

And you shouldn't have to wait like. Two years to get there. That should be a priority to be able to expand the diet as quickly as possible. Um, I think those are really great places to start. And then considering do I have any environmental allergies that are not diagnosed yet. Um, and are there any other factors like mold or other environmental issues that you haven't quite considered at this current time that could be, you know, driving some of these histamine problems?

Dr. Brighten: Mm-hmm. Well, this has been so insightful. I really appreciate the information that you've shared with us, the unique perspective and the fact that you have so much clinical experience helping people overcome histamine issues. It's been a real pleasure to have you share your knowledge with us. Well, thanks for having me.