Interview with Dr. Tina Peers Part II
This is the second part in our interview series with Dr. Tina Peers, a Consultant in Contraceptive and Reproductive Health in London, where she discusses the connection between hormones and histamine as it relates to Histamine Intolerance (HIT) and Mast Cell Activation Syndrome (MCAS).
- The connection between too much histamine in the body and progesterone and estrogen sensitivity
- The impact of histamine on your cycle
- Sensitivity with contraceptive pills and IUDs
- How too much histamine can increase your chances of a miscarriage
- What happens to the histamine levels in your body during pregnancy?
- The link between HIT / MCAS and perimenopause and menopause
The content provided is for informational purposes only and is not intended to medically diagnose or prescribe a solution for your condition.
The Full Interview Transcript
0:01: There’s a link between hormones and histamine and so when women start to get a fluctuation in their hormones, such as perimenopause, it seems to make their histamine worse. Some patients have told me that when they are mid-cycle, just before their periods when their progesterone is high, they will be worse. The other thing is that a lot of patients with this condition, women with this condition, are progesterone-sensitive. If we take a proper history from them, we find that they cannot get on with the combined pill, the mini-pill, with the Mirena (coil), anything that contains progesterone.
When we come to women with these conditions (HIT and MCAS) often young women have very painful periods and that goes with HIT often. Their periods are really agonizing.
Pregnancy, Miscarriages and Histamine Intolerance / Mast Cell Activation Syndrome
0:55: [Samia] what about fibroids? [Dr. Peers] No, not fibroids but miscarriages, I think because of the inflammation. I think, I believe, I’m hypothesizing but I believe, logically, if you’ve got a lot of inflammation in the body and your endometrium is inflamed, then the little ovum is going to find it difficult to implant and stay implanted. I’ve had patients who have had multiple miscarriages.
1:22: So before embarking on a pregnancy, you want to make sure your histamine is as low as possible. [Samia] You also can’t take antihistamines when you’re pregnant? [Dr. Peers] No you can’t but you don’t need to because your placenta will make diamine oxidase (DAO). When the woman is pregnant, the placenta naturally makes diamine oxidase and it makes 800 times more than you make yourself normally. So often the history is that when women who have this condition are pregnant, they feel great 1:[Samia] But yet they can miscarry? [Dr. Peers] Yes, so it’s the early pregnancies, very early pregnancy, when the placenta is trying to get a grip and impact properly into the endometrium, if it’s all a swollen endometrium, it’s going to be difficult. But after it’s established, then the placenta will actually produce diamine oxidase. So often women feel really well when they’re pregnant and they have this condition, which is lovely, but you can’t be pregnant all the time.
The Impact of Histamine on your Cycle
2:26: The other thing that happens with women and their hormones is that sometimes women notice with their cycle that their histamine is worse and better at certain times. There is a connection between estrogen and histamine. I don’t fully understand the mechanism of that but apparently, if your histamine goes up, it makes more estrogen, if your estrogen is high you make more histamine
Histamine Intolerance / Mast Cell Activation Syndrome and Contraception
2:50 The other thing that happens is if a woman tries to have hormonal contraception, they may find they really just don’t get on with it. [Samia] is that because of progesterone [Dr. Peers] Because of their progesterone sensitivity or progestogen-sensitivity so that would be the combined pill, the mini-pill, the Mirena, intrauterine device (IUD).
Histamine Intolerance / Mast Cell Activation Syndrome and Perimenopause and Menopause
3:11: And then of course when they become perimenopausal often their histamine symptoms get worse. Now that’s why I see a lot of these patients because I do menopause clinics and I see the women for their perimenopausal symptoms. Many of those symptoms are the same as histamine intolerance. So hot flushes, sweating, feeling dizzy, panic attacks, anxiety, insomnia. There is a big overlap between the two.
3:39: And if we just give them HRT and don’t sort out the histamine, we’re not dealing with it properly. SO we need to address both. And often they find with their histamine, once we get them settled,
3:50: because in perimenopause your hormones fluctuate like crazy, which is what causes the symptoms. And if we can stabilize the hormones with some HRT then often they feel that their histamine is more under control
4:05: and I’ve trained my doctors in my menopause clinic to look out for histamine and to be able to treat it so that it’s not just me being able to do that, they are now seeing patients with histamine intolerance because we need more of us.
How to Reach Dr. Peers
4:21: [Samia] How do people reach out to you? Is it possible for people in London to set up an appointment with you? [Dr. Peers] I work in Harley Street at Hormone Health. But I also am working in Surrey and I have a Menopause and Women’s health clinic in Surrey called Tillow Barn Health. And as I said before, I’ve got a group of doctors working with me who are trained in menopause management. They are GPs with special interest and they are learning, it’s a process, we are all learning. We haven’t got all the answers by any means, but we are very willing to help people who have this condition try so they can make sense of it. They can book in with them as well.
The importance of self-management
Education is critically important for people suffering from HIT and MCAS. Dr. Peers emphasized that it is 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.