Interview with Dr. Tina Peers Part III

This is the third part in our interview series with Dr. Tina Peers, a Consultant in Contraceptive and Reproductive Health in London, U.K. where she discusses some of the root causes of Histamine Intolerance (HIT) and Mast Cell Activation Syndrome (MCAS), in particular the connection with gut health.

The content provided is for informational purposes only and is not intended to medically diagnose or prescribe a solution for your condition.

Key Points

Poor gut health is thought to be one of the root causes of histamine intolerance and mast cell activation syndrome.

Inflammation of the gut lining leads to food particles entering the bloodstream, causing the body to react as if it’s a foreign object, releasing more histamine into the body.

This leads to poor food absorption and a deficiency in vitamins and minerals

The gut wall is a prominent place for the mast cells to gather. Sodium cromoglicate acts as a mast cell stabilizer, reducing the number of mast cells in the gut.

When you have a high amount of histamine in the body, your mast cells receive a signal to release more, forming a vicious cycle. Ingesting high histamine foods can have the same effect on mast cells, causing them to release more histamine into the body.

Other root causes include genetics, toxicity and the hormone/histamine connection.

To gradually improve gut health, Dr. Peers recommends shifting to a low histamine diet and recolonize the gut with the correct bacteria by taking a Symprove, a liquid probiotic.

The Full Transcript

0:01: [Samia] How do you try to identify the root causes (of histamine intolerance and mast cell activation syndrome). What are some of them and is this all really just gut health-related? [Dr. Peers] Well, it’s really interesting that you say that. We’re now, as you say, believing more and more is coming from our gut and the microbiome in our gut is crucial to our good health. And so many of us have had loads of antibiotics as children, adults and so on. And then the bacteria in our gut will change and won’t be so supportive of good health but also what happens with this condition, in particular, is you get inflammation of the gut and the cells lining the gut, you’re going to get leaky gut

0:43: So if you imagine, normal, healthy cells are like bricks all lined up with no gaps because there is mortar between the bricks. So in your digestion, you digest food and that’s digested by the enzymes in your stomach and that’s broken down into protein, carbohydrate, sugars and the those are absorbed in the right place in your gut into your bloodstream and your body recognizes that as food. If you have swollen cells so that your bricks are not oblong with nice, square corners, they are sort of like swollen stones, and then they will be gaps between them and then your body doesn’t just absorb the digested food it starts to allow, through these gaps, the semi-digested food. Now your body thinks that is a “foreign body”, quite rightly, and will react as if it’s an infection, and release more histamine into the body

1:38: [Samia] it can also cause autoimmune issues? [Dr. Peers] It can cause autoimmune issues and it’s because you’re hypersensitized and your body can then turn on itself really which is what autoimmune really is

1:48: So you can have vitamins and mineral deficiencies because you’re not absorbing them terribly well but you can also have the wrong stuff get into your bloodstream and you can also have the gut affected because the bacteria have changed so they’re not supporting you.

2:06: So we need to look at leaky gut, we need to look at probiotics for the gut to try and calm everything down. We also need to look at the mast cells in the gut. Now, it’s a particularly prominent place for the mast cells to gather in the gut wall. And often when people have tendinous in their epigastrium, the upper part of their gut and the lower part is full of mast cells, the wall is full of mast cells and in that case, I usually prescribe something called sodium cromoglicate which is a mast cell stabilizer that stays in the gut. 96% of it is not absorbed and stays in the gut but it affects the mast cells in the gut and reduces their numbers

2:47: [Samia] isn’t there danger in reducing the mast cells. I mean, we need the mast cells they are white blood cells [Dr. Peers] No, not that much. We’ve got plenty. You’ve got billions so don’t worry. There’s

2:56: The problem is they get confused. Because when you have an infection, your histamine goes up, your mast cells then have a signal to release more. When you have high histamine, because you’ve eaten histamine in your diet, your mast cells think there is an infection so they release more so that is a vicious cycle too.

3:18 [Samia] In terms of root causes there is possibly genetics, there’s leaky gut, you were talking about the link between progesterone so there is a hormonal connection. I know there are many [root causes] but what are the common ones. I’ve heard SIBO is one of them but I don’t know if that’s related to leaky gut. It’s a gut issue. Anything else that you’ve seen in terms of patterns. Is that the next step. Once you’ve figured out the protocol for [managing histamine intolerance and mast cell activation syndrome] do you then look to the gut and think how can I improve the gut. [Dr. Peers] At the same time as lowering the histamine in the diet, I think it’s quite important to have something like Symprove, which is a liquid probiotic, which is expensive but very good. You take a 12-week course of that to recolonize the gut with the correct bacteria which patients find very helpful. [Samia] Does that fix it [Dr. Peers] It helps to fix it because you want to recruit the good bacteria in your body to help you

4:28: I think that if you have the good bacteria then you are less likely to have the IBS symptoms and therefore you must be calming things down. This is very early days and we are learning so much [Samia] People still don’t know how to treat IBS [Dr. Peers] Well, that’s right because I think this is the cause of IBS. So when we start to treat this properly, all my patients, their IBS symptoms start to improve. And some of them go away completely because we are tackling it at the root cause.

The importance of self-management

Education is critically important for people suffering from HIT and MCAS. Dr. Peers emphasized that the important to take a “low and slow” approach to these conditions. It is imperative when on a low histamine diet, that you reintroduce foods slowly into the diet as trying to accelerate the process may take you back to square one. It is necessary to be as patient as possible when experimenting with foods.

More information on Dr. Tina Peers

Since qualifying in Medicine at Guys’ Hospital London in 1983, Dr. Tina Peers has developed her skills and knowledge in Women’s health, first working as a GP in Surrey, then becoming a Consultant in Contraception and Reproductive Health in 1996, and leading these services in Surrey until 2018. Please visit her website for more information on how to get in touch.

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