Join us for our Histamine and Hormones Training on September 28th! Learn more here.
Why do some women feel amazing during certain phases of their cycle while others feel absolutely wrecked?
In this episode, I’m joined by Michelle Shapiro, RD, a functional dietitian who works with clients navigating Mast Cell Activation Syndrome (MCAS) and histamine issues. She also lives with MCAS herself, bringing both professional insight and personal experience to the table.
Why do histamine flares hit hardest right when hormones shift? Tune in as we break down the menstrual cycle, step by step, and look at how mast cells and histamines interact with rising and falling hormones. The patterns aren’t always what you’d expect, and tracking them can change everything about how you handle symptoms.
You’ll Learn:
Timestamps:
[00:00] Introduction
[10:17] How estrogen and histamine interact to trigger symptoms during the menstrual cycle
[13:53] How progesterone and luteal phase shifts trigger unexpected symptoms in histamine, POTS, and hypermobility clients
[21:47] Tracking cycles and temperatures to spot patterns and histamine flares
[25:53] Using antihistamines and other strategies to manage flares and reduce stigma around medication
[48:09] Understanding the immune system’s role in endometriosis and its connection to histamine and progesterone
Listen to Other Hormone Healing Episodes with Michelle:
MCAS, POTS, & Hypermobility Part 1 | Listen Here
MCAS, POTS, & Hypermobility Part 2 | Listen Here
The Root Cause of Reflux | Listen Here
Resources Mentioned:
Ovia Cycle-tracking App | Website
Natural Cycles Fertility Awareness App | Website
Oura Ring | Website
Tempdrop Wearable Sensor | Website
Read Your Body App | Website
Podcast with Nina Boyce on Fertility Awareness Method | Podcast
Find more from Michelle:
Michelle Shapiro RD | Instagram
Michelle Shapiro RD | Website
Michelle Shapiro Nutrition | YouTube
Find more from Amanda:
Hormone Healing RD | Instagram
Hormone Healing RD | Website
Hormone Healing RD | Facebook
Hormone Healing RD | YouTube
Hormone Healing RD | TikTok
Transcript:
Michelle Shapiro: [00:00:00] The functions of histamines are so vital they can affect our heart, our nervous system, anxiety, depressive
like symptoms.
Amanda: Can you walk us through what can happen if you are someone dealing with histamine issues,
Michelle Shapiro: what they could experience in
days seven to 14 is flu-like symptoms, extreme anxiety.
Insomnia. I have to be honest with you. You have to use a sledgehammer approach with histamines in the beginning, and
you have to just bring them down.
Amanda: You have built these deep, deep paths in your brain as a protective mechanism, and we have to make new ones. Now,
Michelle Shapiro: everyone will tell you progesterone is calming and cooling.
The anxiety from the progesterone is so profound. I’ve never met a doctor who has warned a histamine client of this
reaction.
Amanda: Find your pattern, find your consistency, and then look for improvements from there. Don’t try to put yourself into a box, ’cause a lot of times it just doesn’t matter and it’ll drive you crazy.
Michelle Shapiro: It’s just not perfect, but. Your pattern will be perfect.[00:01:00]
Amanda: All right, we are now in season eight. I’m so excited to be here. It took a very long podcast break, but I am back and I have a very, very packed season for you. I asked you guys what you wanted to learn about, and I’m covering a ton of those topics as well as things that continue to come up for a lot of our clients.
So today we’re gonna be talking to Michelle Shapiro. She’s been on the podcast three times. This will be her fourth appearance on the podcast. If you have not listened to her previous episodes, I highly recommend it. She is an integrative and functional registered dietician in New York City, and she’s helped thousands of clients reverse their anxiety, heal longstanding gut and immune issues, and approach their weight in a loving way.
She has a virtual private practice with multiple nutritionists. They are constantly growing. I’m always amazed by her and her team and they work one-on-one towards these goals with their clients. So she also has quite the diet podcast. If you have not listened to that, I’ve been on it quite a few times.
It’s a [00:02:00] really great one. She does. She has a lot of really good interviews on there and she has her highly sensitive body hub where I actually have some lessons on minerals in there where she talks about more about histamine, mast cell activation, pots hypermobility, and all the things in there. So I really hope you guys enjoy this episode and all of the things to come for this season.
Here is me and Michelle. Alright, we are here to talk with Michelle Shapiro about histamines and the menstrual cycle. We got a ton of great questions from our listeners and we’re gonna dive right in. So Michelle, can you just define for us before we start getting into like the monthly cycle, the hormonal shifts, all that stuff?
What is a histamine? What is MCAS? We’ll put the links to Michelle’s other episodes that I’ve done with her, but just for the new people here.
Michelle Shapiro: Absolutely. So mast cells are a type of white blood cells. They’re a, they’re part of our immune system, and their goal is to basically help us if there’s an injury, an immune injury, or to prevent threats [00:03:00] from happening.
So our mast cells have sacks inside of them where they release chemical messengers, like a communication system, which is all of our immune system and our nervous system are these communication networks. There’s 1200 different type of chemical messengers that they send out. One of those is histamines.
We often hear about mast cells or mast cell activation syndrome. MCA, as I’m sure you know, a lot of your audience will have heard of in the context of. This scenario happening, your mast cells are perceiving an immune or nervous system threat. And so in response, they are releasing those chemical messengers repeatedly.
So those mast cells keep getting activated and activated. We need our mast cells to get activated because a lot of those messengers are essential for immune system, essential for many body functions. The problem is that when we keep releasing those messengers because of perceived threats or actual threats, the actual messengers themselves can cause it symptoms.
And one of those messengers that I think [00:04:00] causes the most symptoms is histamine, which is why we talk about and think about histamine so much and why I’m so glad this histamine conversation has exploded, honestly. Um, because. Functions of histamines are so vital and they can affect all of our vital signs as well.
So they can affect our heart, they can affect our nervous system anxiety, depressive like symptoms. They can affect our digestion. They can affect, again, like how dizzy we feel when we stand up. All any kind of symptom you can think of, it’s not always related to histamine, but when it is, the symptoms are very vast.
So it, they’re, they come into play very much with our hormonal system as well as our immune and nervous system. And what is
Amanda: MAs cell activation syndrome? Just when they become dysfunctional?
Michelle Shapiro: Yeah. So that’s when, for whatever reason our mast cells continuously activate, send out those granules, send out those messengers.
And our mast cells are so integrated within our nervous system, so integrated within their, within our connective tissue. So if there’s any changes [00:05:00] in ways of like injury. And connective tissue itself lines our blood vessels, our joints, our bones, and our organs. So if there’s dysfunction in those places, it will signal for our mast cells.
Please send out these messengers to help us. And mass activation syndrome is when your body is constantly perceiving or experiencing threat and sending out those
Amanda: signals repeatedly. And so we wanted to do this podcast episode because when it comes to histamine issues, whether you have mast cell activation syndrome or not, or maybe you’re just kind of making the connection now with like, man, I have all these random symptoms, and you’re down the histamine rabbit hole, right?
You’re there. And then you start to make another connection of, man, I noticed these at certain times in my cycle. Like, what’s going on there? What’s, why? How is this connected to my hormones? And that’s really our goal today to talk about where this intersection happens. So I’m gonna go through like the different phases of the menstrual cycle, what’s happening, and then we’ll talk about how those hormones can [00:06:00] affect.
Histamines levels, mast cells specifically and what can kind of pop up. And then we’re gonna give you some tips of like how you can start working on regulating this stuff and like, what if you’re in a flare, stuff like that. How you can reduce that. Or even just, you know, once you start tracking your cycle and you notice these things, at least you can be prepared to minimize symptoms.
Michelle Shapiro: The one thing that’s really important while we’re having this conversation is we already know about our menstrual cycles from you, right? We’ve learned about our menstrual cycles. You have been educating on this for 10 years. When we’re talking about mast cells and histamines in our menstrual cycle, we almost have to put on new goggles because we know the powerful positive effects of progesterone, right?
We know, we know how important progesterone is, but how progesterone makes people who have mast cell tation syndrome feel is completely different than how it makes people who do not have mast cell tation syndrome feel. So even something like PMS or PMD. Symptoms are completely different because our [00:07:00] perception of these hormones are different.
So for this conversation, I want people to kind of put new goggles on around these hormones too.
Amanda: Yes. ’cause you can have a reaction whether you have hormone imbalances or not. It, it, it doesn’t, just like with PMDD, it doesn’t mean that someone has like, well, like we’re gonna talk about estrogen, doesn’t mean you have really high estrogen.
It’s just like your body’s very sensitive to the rise in the fall, the rise and fall of hormones. So when it comes to, when we’re, when we’re talking about the menstrual cycle, we’re talking about an entire monthly cycle, including ovulation. And so menstruation, obviously that’s gonna be cycle day one, your first day of your bleed.
This is when hormones are at their lowest point. And we’re gonna get into some nuance of how you may not feel is great during this time too. But hormones are their lowest. You’re bleeding during this time, and then during, as once your period ends, that’s when your follicular phase starts. And this is when estrogen starts to rise, and so this can be a pretty symptomatic time for a lot of people.
Michelle and I were just talking before we started recording of how we’re [00:08:00] like, yeah. A lot of people are really symptomatic during this time in ovulation because of that rise in estrogen and just other things that can be happening. But basically during that follicular phase, your brain is releasing specific hormones that are talking to your pituitary gland that releases FSH, that stimulates our follicles and our ovaries and follicles Then release estrogen.
This starts to rise. FSH goes down, and then a dominant follicles selected for ovulation. From there, we get. Peak estrogen. The follicle bursts release an egg, and then that leads to a release of eventually progesterone. Your body makes that, that follicle turns into the corpus lium that then secretes progesterone, hopefully good levels.
And then you’re in your luteal phase, and ideally that’s close to like 12 to 14 days. So we get another peak of estrogen, right During this peak of progesterone, typically it’s like around cycle day [00:09:00] 21. So you’ll get another peak of those hormones. So it’s like low hormones during menstruation, they start to go up.
It’s a little different for everyone, but like I would say like cycle day six, seven for most people. Then you get your peak of estrogen, the surge, then you get your ovulation. Altium makes progesterone, you have another bump of estrogen, and that those are like the major shifts that are happening during your cycle.
So typically. After your period, women often feel really good, right? You have estrogen rising. You can, you’re more sensitive to carbohydrates. So like your blood sugar is more balanced. You typically recover better from workouts. You have better energy, so more social. Then you move into that ovulatory times kind of same thing.
It’s a good time. Like a lot of women tend to like be more resilient to stress and your body can often handle more, whether that be like mental, emotional stress, physical stressors, like more exercise or more intense exercise. You often feel great, libido’s good. Even your, your whole face can [00:10:00] change your, your smell can change ’cause your body’s trying to make a baby, right?
And then going into that lial phase, ’cause you’re getting another peak of those hormones again, this is often when things start to like slow down a bit. Mood can shift a little bit. You can become a little bit more fatigued and we’re a little less sensitive to insulin. So we’re a little more insulin resistant during this time.
Not a bad thing, just what’s happening with our hormones that are present. And I’m, I definitely want you to talk about this, Michelle, with the MCOs piece. ’cause obviously blood sugar plays a huge role and so you get a little more fatigued. It’s better to take it easier. You may not be recovering from workouts as well.
If you have imbalances you can like not feel so great during this time, and then eventually hormones drop and you get your period again. So that’s what a healthy cycle looks like. Can you walk us through what can happen if you are someone dealing with histamine issues? Absolutely. So
Michelle Shapiro: I just wanna say from my personal experience with MCAS, I was on Reddit at like 2:00 AM every night because I was so sick that I was awake at 2:00 AM typing, like why feel [00:11:00] weird day seven cycle?
Like, because I just was tracking it. And normally it’s like, everyone’s like, oh PMS. I’m like, no, I just stopped bleeding and this is, I’m violently ill like what is happening? So the frustrating thing is you can both have the symptoms of like regular PMS symptoms and then also have histamine symptoms, which can be really hard for women because then you feel sick a lot of the cycle.
But I just want everyone to know right at the beginning, there’s so much we can do for all of this, which is really exciting. So as estrogen rises and starts being released, that’s when people will start to notice if there’s a histamine issue symptoms. And that’s because estrogen and histamine have a direct relationship.
As estrogen rises, it will cause a release in histamine. As histamines are released, it’ll cause a rise in estrogen. So there is a circular relationship between them. And also, like you said, man, that’s not only that estrogen is too high, it’s that if estrogen is causing the histamine release, it’s that your histamines are too high.
So you’re not feeling the effects of the estrogen as much as you’re feeling the downstream effects of what [00:12:00] happens inside the body when estrogen is released. So, you know, it’s hard when people have this conversation of, oh, is it estrogen dominance? And it’s like, it’s not necessarily estrogen dominance.
It’s that your body is causing a side reaction on top of the hormones that’s creating that. So where people who do not have histamine issues actually feel amazing during ovulation, actually feel amazing leading up to ovulation. Those with histamine issues can start to notice that release even starting, like you said, day six or day seven, and then leading up to day 14 where it peaks.
Some of my clients notice that their symptoms are actually worse right after their period ends, and some it peaks during ovulation. It should technically be the worst during ovulation, but sometimes the initial release and buildup of estrogen is also creating that initial histamine dump, essentially. So it really depends.
But if someone has a histamine issue, what they could experience in day seven to 14 to start with, we’ll start with that period of time, is flu-like symptoms. Extreme anxiety, [00:13:00] insomnia, and then any histamine symptoms people have, because remember, they’re very vast. So people could experience dizziness, they could experience racing heart, they could experience chronic urination, they could experience diarrhea.
It’s really how does the histamine present for you? And for me, I’m like a nervous system presenter, so I’m like shaking insomnia. That’s how I know. I’m like, oh wow. Do I need a Pepcid? Like this is day seven. Whoa, do I know I need to prophylactically take a Pepcid on day seven or something. So the period tracking that you mentioned is so important because then if you can kind of get ahead of it and do what you need to do to help block histamines or reduce the impact of estrogen, which if you are also estrogen dominant, it might be important to address that safely with a practitioner.
But if you can track and identify, oh, I actually do feel worse on this first part of the cycle, you know, it’s, it’s also really funny ’cause I think about. Like the language around women’s cycles always frustrates me. ’cause I’m like, everyone’s speaking [00:14:00] this language that doesn’t apply to my clients. I know it doesn’t apply to yours, but everyone’s like, oh, I feel ter luteal phase is deadly.
I’m like, my clients are dead during the follicular phase. Like it’s, they always feel worse during the follicular phase. They do not feel worse during the luteal phase because there’s at least a calming down, like you said, of the hormones besides the progesterone pickup, which we’ll talk about too. But if you do notice that you feel tremendously worse during your follicular phase, it would point me in the direction of starting to ask questions about histamines.
For
Amanda: sure. Yeah. And we’ll talk about progesterone ’cause We’ll, we’re gonna talk about bioidentical progesterone too, guys. ’cause this is a, we get a lot of questions on this and like a lot of our clients will notice they get estrogen dumping during their follicular phase. And if they have histamine issues, it’s like, blah, like super exaggerated.
So this is why you gotta be careful with. You know, you gotta find information that applies to you, especially if you’re in a sensitive body. So that’s like leading up to ovulation. I think a lot of women are gonna connect with that and kind of highlight Is that like, they’re like, this is, yeah, that’s like my time.
What about [00:15:00] during your luteal phase when you get that increase in estrogen and then also the increase in progesterone? Yeah, so there’s two very symptomatic
Michelle Shapiro: histamine periods during the cycle days, seven to 14, I would say on, we’re talking about a 28 to 30 day cycle, but it’s gonna vary if people have longer or shorter cycles.
We’re, we’re, we’re thinking in the context of a 28 to 30 day cycle, and then around days 19 to 21, so one week before your period starts, and that would be a full week before, so that would not be the three days before that. We would see typically in PMS, which actually can be up to an entire week, but a full week before they get those flu-like symptoms, which gives you a week in between ovulation and that time and a week before your period, which I’m like, come on.
Because then people get PMS symptoms. It’s, it’s frus. It’s really frustrating. Yeah.
Amanda: You got two good weeks. Okay. No,
Michelle Shapiro: yeah, exactly. You know, this is where honestly I find a lot of clients really benefit from like Mira devices where people can measure their hormones at home ’cause they, when we can match up the hormones with what we’re [00:16:00] experiencing, it also helps with tracking.
And then that being said, interestingly progesterone, which we know is used in an immune response, is actually supposed to be mast cell stabilizing. So here’s an interesting part of the conversation. People who have mast cell issues can also have something called pots, postural orthostatic tachycardia syndrome.
They also can have something called hypermobility or hypermobility LS, danlos and related connective tissue disorders and syndromes. So sometimes clients feel not good from a histamine perspective and sometimes ’cause these clients, these conditions travel together often, but different parts of the cycle will present different issues.
So someone with pots. So this is someone who feel postural orthostatic tachycardia syndrome means you make a postural change and your heart rate starts racing. Your heart starts racing. That’s what tachycardia is, right? So many people with POTS also have low blood volume. They don’t have enough volume in their blood, so they actually feel worse [00:17:00] oftentimes during their actual period.
So that’s when people, you’re bleeding, so you’re losing blood, right? So that’s that. Even that minute blood loss can lead people to feeling dizziness, heart racing. So I notice a lot of people in the first seven days of the cycle, if they have pots, can feel really symptomatic as well, and blood pooling issues during that time too.
So now people, this is the confusing part. People with hypermobility can feel worse during the progesterone time ’cause progesterone relaxes. It’s a, it, it creates ligament laxity. Amanda, you can tell us why progesterone, the, the function of why progesterone does that for us and what the reason is. And so I notice people with hypermobility.
Also feel worse when progesterone rises. So they actually feel worse during the luteal phase and they can also feel dizziness, joint pain. And really they describe it as a feeling of extreme fatigue. And then I have a lot of clients who, when they have new fatigue, it creates a lot of anxiety. So I’ll have clients who are like, I [00:18:00] was really exhausted for a few days and then I started getting really nervous about it, and then their stress hormones kick on.
So I’ve seen that a lot too, where high progesterone and also high progesterone with the relaxing of our musculature too. Smooth muscle contractions that also can lead to like diarrhea and digestive issues for people as well. So where we generally think of progesterone as the good one, and it’s mast cell stabilizing.
And we also think of it as the good one in ways of like if you go to doctors, they’re always gonna wanna put people on progesterone supplementation, right? That’s like the first thing they wanna do. Progesterone can cause tremendous symptoms, even endogenous progesterone.
Amanda: Yeah. Like that you’re making yourself, and I, I definitely see this in practice with histamine clients where it’s usually a, like the week leading up to ovulation is horrendous.
It’s their hardest time. And then luteal phase, because we work on so many things that support that time, it typically ends up not being quite as intense unless [00:19:00] they have hypermobility, in which case they just experience a lot more. Instability in their bodies. And so that can obviously be very difficult.
But the with bioidentical progesterone, which again, it’s tricky. I mean, a huge part of my population wants to get pregnant. Right? That’s like probably like their number one goal. Or maybe they already have had pregnancies, they want more children. And a big part of that is like, well, I heard bioidentical progesterone can be helpful.
Maybe they have a history of miscarriage and they’ve been told to take it. Or luteal phase defect or something that’s Yeah. Causing an issue. Absolutely. Yeah. Right. Or so like they’re, they’re being recommended to take it and then they’re like, I tried take a teeny tiny amount. ’cause just like a good histamine client would, right?
Microdosing any new supplement. And they’re like, I feel terrible. Terrible. Yeah. What are, what are the symptoms that you notice that they report? I will often, and it’s, it’s, it’s the opposite of everything that progesterone is supposed to do is what I see. Insomnia can’t sleep, even though it’s supposed to be [00:20:00] calming, a lot of times they, they’ll have, instead of like being more constipated, which progesterone can do, ’cause it literally slows your gut motility.
So why a lot of women get constipated in pregnancy. It’s opposite loose tools, diarrhea, heartburn, which that can be happen in pregnancy and stuff too, but anxiety, even though it should be calming, crazy nightmares, things like that. So
Michelle Shapiro: I think it’s related to the fatigue I have to say. ’cause the anxiety from the progesterone is so profound.
It’s, and every doctor, I’ve never met a doctor who has not, who has warned a histamine client of this reaction, they always say, you know what? Histamine, um, progesterone is mast cell stabilizing. You should have absolutely no problem with this because it should make your histamines better. But if there’s other things going on in the body, it’s still not going to have that positive reaction.
I don’t really find it to be mast cell stabilizing in ways of stabilizing histamine symptoms and never seen it. Literally. Never seen it. Never seen it.
Amanda: Yeah. It’s supposed to be. So is magnesium is supposed to be too though. And I have some kind with [00:21:00] I know. It’s too relaxing. These things are too relaxing.
Yeah, exactly. So it’s one of those things where like if you feel like you’ve tried things like biodentical, progesterone had a horrible reaction, like you’re not alone. And if you have histamine or you suspect histamine issues, it’s just this, the change in hormones, just like after your, your period ends and your, your progesterones slowly start in your eyes.
Even that slight change, especially as you get closer to a day like seven and eight, that can lead to a flare. It can cause that histamine flare. Same thing with the luteal phase. I think that’s why that time. It’s around cycle day 21, usually like five to seven days after you ovulate, when your progesterone should really be increasing and peaking.
A lot of women struggle with histamine issues because it, it’s like, and if you look at your chart, it’s like a huge jump in temperature, right? And then it sustained. So it’s just the body is more sensitive to the hormonal shifts and then if you also throw in hormone imbalances [00:22:00] on top of that, it just kind of fuels that fire a hundred percent.
Michelle Shapiro: And I feel like, again, when you’re looking at what you see online compared to the experience of someone with histamine issues, you’re going to get basically the opposite information. Everyone will tell you progesterone is calming and cooling. It’ll make you sleep, it’ll make you feel relaxed, like it helps anxiety.
It’s, it’s almost always a paradoxical reaction whereby estrogen also gives you it’s thought to give you energy and feel like empowering and uplifting. It can feel like that dinginess, that people experience. So. Don’t ever feel alone in this, know that this is, this is honestly so common that Amanda, we expect these symptoms and those who have histamine clients, it’s, there is definite patterns you can pick up on.
And then once you kind of identify and track your own pattern, you can start to make those changes as well. Okay. So
Amanda: we talked about tracking the cycle, ’cause I think that’s kind of step one for everyone and, and that can be as complex or as chill as you want, honestly. You [00:23:00] know, it doesn’t have to be anything intense.
You could track your hormones if you want to. I’m a very like minimalist person and I’m like, I wear my ora ring. I connected to the Natural Cycles app. I used to use a temp drop, which was also very easy and they have a really good read Your Body app that connects with that. But it’s like, you know, it doesn’t have to be anything that is super time consuming for you.
You could even, I have clients that just write it down in their notes app, just cycle day. Write it down,
Michelle Shapiro: down. And it should be that simple. Yeah, there’s, you know, there’s apps like Ovia too where you just, you just pick diarrhea, you just pick, you know, just pick your symptoms and that’s like really easy. I found that I, I think I did use Ovia actually when I was tracking originally and while I was doing it, I would look back from the previous cycle and when I would see headache, like day 21, it was such a relief to me to look back and see that, ’cause I’m like, is something horribly wrong with my body?
No, actually it’s happened every month for the past five months. So now I have a pattern. Having that pattern recognition is such freedom and empowerment honestly. And it’s [00:24:00] such a simple task. And I, and I’m sure honestly much of your audience already is tracking their cycles, but if, if you’re really trying to get that understanding, I think the more even detailed.
But again, the simplest way you can possibly track the, the more value we can get from it.
Amanda: Natural cycles is like that too, where it’s like you just go and choose a symptom, you can see the history and if you’re like it, you know the ora ring takes your temperature. That’s why I do it. ’cause I’m like, I just need the easiest way possible to prevent pregnancy.
Right now I have a question for you about the temperature.
Michelle Shapiro: Do you notice that? Histamine clients temperatures are, are more exaggerated. I notice that during the ovulatory, like during ovulation, like I feel like they’re, when they’re in a histamine flare, I’ll notice more on the ora ring exaggerated temperatures in ways of like, it’ll spike a little bit higher on a higher, on a higher histamine month.
Yeah, for
Amanda: sure. And I think that’s just kind of like the, I mean, the stress response and stuff happening in the body. And I’ll also notice they just don’t have as tight up charts. Right. So like they have more erratic temperatures, typically, you won’t have [00:25:00] perfect 14 days up. 14 days down. Yeah. Yeah. And, and like, but usually you go in and you’re like, oh, well I had like a flare that day or something.
So you can like typically connect it to it. But yeah, I definitely, definitely see that. I
Michelle Shapiro: think it might be worth mentioning also is if just, again, your audience is so primed and so knowledgeable that they’re gonna be like, of course we know this. But generally the, the temperature cycles that would be typical in a healthy cycle would be the day of menstruation.
The temperature drops. It stays low until it starts to peak around day 14 during ovulation, and then it should stay elevated until the next cycle. So a lot of times clients don’t even know how to, um, which is like completely, where, where do we learn this information if you don’t learn it yourself? Dude, there’s no way to know that.
But it’s important also to know, like you’re saying that, well, some people might notice a little temperature spike again when estrogen rises a little bit. It can happen. Um, but generally that’s what we’re talking about. We’re talking about temperature rises and drops.
Amanda: Yeah. Like, and ’cause you could use your basal body temperature to just track and see, okay, can, can I [00:26:00] confirm ovulation?
Do my temperature go up and stay high? ’cause progesterone increases your metabolism and that will raise your basal body temperature. So ideally you see that on the chart. And I’ve, I’ve done many podcast episodes on fertility awareness method. I did a really good one with Nina Boyce that you guys can go back and listen to.
But I just wanna say, don’t obsess about your temperatures. Like it’s not in the optimal range. It didn’t drop the first day of my period. Don’t. Find your pattern, find your consistency, and then look for improvements from there. Don’t try to put yourself into a box. ’cause a lot of times it just doesn’t matter and it’ll drive you crazy.
So outside of like, okay, let’s track our cycles, let’s make note of our symptoms so we can see patterns. What is like the next step for like, all right, how can I actually reduce these like big histamine flares that I’m seeing? And I think we could talk about like overall reduction and then also like, Hey, I’m in the middle of a flare.
Like what can I do in the moment? Absolutely. And I’m
Michelle Shapiro: putting a reminder both of our heads to talk about insulin, by the way too. So what we can do [00:27:00] for, if I know that I’m going to have a potential histamine response, I’m going to do whatever I can to reduce my histamine load from diet and I’m going to do whatever I can to reduce my stress and I’m gonna do whatever I can to, uh, get rid of the histamines that have already been released or block them using antihistamines.
So a lot of my clients will kind of cycle antihistamines as well. So if they’re using either Claritin, Allegra, Zyrtec, H ones, or an H two Heid, which is an antihistamine, they would kind of cycle them during that time. So they might not actually use those antihistamines the entire cycle. They may actually only use them starting day seven prophylactically.
And I will tell you the relief that my clients have, like when we first identify what that day is, and then we can just put an antihistamine in place, or even drinking net leaf tea, taking a DAO supplement that helps to break down histamine in the gut, something, whatever the intervention is. Even if it’s taking a little extra quercetin, drinking a little ginger tea, whatever that intervention is, that works for them.
And that’s what you have to [00:28:00] trial on yourself. ’cause everyone reacts differently. You wanna put things in place prophylactically and that would not be a day that I would say I would encourage eating pickles or chocolate or spinach or bananas or tomatoes or vinegar or citrus. Those would be days where I would try to be eating more bland, low histamine foods just to again, prevent the dumping
Amanda: from happening.
Okay. And I think that’s helpful too. And there’s like such an array of things you can try. And I will say like so many people are like, you want me to take over the counter medications? And I know, I know that there is a huge stigma. It kind of makes me sad ’cause I’m like, I don’t demonize medication. I mean, I used to take thyroid medication like.
I don know, and I’ve definitely used my fair share of antihistamines, especially with like my first pregnancy and stuff. First of all, I wanna de-stigmatize antihistamine medications. Yeah, yeah.
Michelle Shapiro: And also there’s actually, I just learned this, I didn’t even tell you this recently. There’s a, this is a friend of my friend who’s a functional medicine doctor, knows a gyno in Manhattan who the second someone gets [00:29:00] pregnant, if they have M Cs or they don’t, they put them on Pepcid and Zyrtec immediately.
Oh, interesting. During pregnancy, just to like keep the immune response focused inwards and not on external. Oh, that’s a really, people get a, people get scared of that. And during pregnancy too, I’m like, it’s safe. It’s safe. Of course. I mean, Benadryl and even a version of Unisom is not poten, not all.
There’s two different versions of Unisom. One of them is safe in pregnancy and many people use it actually for morning sickness as well. Yeah. We’re gonna have that pregnancy. That’s a big conversation to have too. And, you know, destigmatizing antihistamines. So when we’re talking about antihistamines, like H one and H two, we’re not talking about.
Benadryl. Benadryl is kind of in a different category. I will be honest. I, I do caution people about regularly using Benadryl in an emergency, especially if it’s a food reaction and it’s severe. And like you, you might need hospitalization. Yes, I would say definitely like using that and then going to hospital anyway, please.
But if you have the massive immune response that’s happening chronically in your body and you’re [00:30:00] having symptoms from that immune response all the time, and those symptoms are making your life not livable and or just the actual, having that extreme response in the body is also a state of inflammation.
So the question is, what’s more dangerous? To have a constant, extreme state of symptoms and inflammation or one of these medications. And I would have to say in a lot of cases. The medications, if they are, if they work with someone, because some people react very negatively to the medications as well.
Yeah, for sure. Which is totally true. So it’s a very individual basis. But you know, the way that histamine, that mast cells and histamines work, once your mast cells release histamines, those will be circulating in your body for three months. I don’t say that to be scary, but blocking the symptoms of that, like, are you supposed to suffer for three months then because you ate tomato soup?
I mean, it’s, it’s, it’s not reasonable. And also these symptoms are so extreme and so frightening that people are sometimes bedbound from them. People can’t leave their houses. People are having severe digestive episodes, severe anxiety [00:31:00] episodes. So to me, if we have a tool that can quell the symptoms and our histamines are very odd because the more our body releases histamines, the more it releases histamines.
It’s the weirdest thing in the world. So if you eat a high histamine food, your body goes, oh look, histamines, I’ll release more now. I don’t know why the body does this. It’s just, it’s like a little cascade. So anything that blocks our perception of histamines or blocks, histamines. Is going to stop that cycle and is actually a root cause support.
So I, I know there’s a lot of fear. I’m not, you and I are, are not lovers of taking medication. It’s not our wish. It’s not what I, as a functional dietician was like, I can’t wait to recommend Pepcid to people one day. And you really struggled with it when you were in the thick of your, I mean, you really, you’re like, do I do this?
Our friend Jillian, who was like, girl, it’s three. You gotta take three antihistamines at once. And that’s, you know. Yeah. And then once you re receive that relief at one point you’re like, oh, okay. And then you can actually start working on the root Cause if you get enough symptom relief, then you can actually [00:32:00] start getting into what do I need to do?
Is it a, is it a gut protocol? You know, what do I actually need to do in there? Do I need to fix my hormones? What, what do I need to do? But you can’t do that if you’re living in a horrific.
Amanda: Quality of life state and you’re constantly reacting to everything. So I think that, I just wanna say that because people hear like Pepcid and stuff and Zyrtec and they like have like a physical reaction typically, and I’m really hoping that this helps them be like, oh, okay, this is a short-term solution so that I can actually not deal with this forever.
There are definitely more natural options, like Michelle talked about Diego Enzyme. I love that. Personally, I find it works really well for a lot of our clients to take it with their meals or even between meals, just to bring the levels down. In general, I love Quercetin, especially like a quercetin Brolin combo.
I find most people tolerate that. And some, if someone’s pregnant, I do use a lot of Perla extracts, a lot of things you can’t use during pregnancy, but you can do Pepcid, Zyrtec, all that stuff. But I like Perilla and I, um, typically will use DEO enzyme [00:33:00] stuff too. So. There’s options. And again, like sometimes people try them more natural and they’re like, it didn’t do anything.
Like, I’m still miserable. And like that’s when you could take the next step to using over the counter for the short term. And then let’s talk about, so that’s kind of like what you’re doing in the moment for a flare. Now it’s not incredibly different what you do over time if you’re trying to reverse the histamine issues.
But ’cause you, I really love like your approach to this and you have like a whole system with how to tackle it. Can you kind of go through that in like why you do it in that order and why it’s the most effective? Yeah,
Michelle Shapiro: absolutely. So remembering that once your body releases histamines, they’re hanging out for three months.
So we have to at least block the symptoms or try to get them out of the body during that time. Right. There is no, you know, let’s say we, again, you know, hormones, first of all, when we talk about hormones and ways of the system and the order of operations, hormones are the last downstream effect of everything else you do with all the organs in your body.
And you know, [00:34:00] people will say, oh, we just take Vitex and then it’ll fix my progesterone issue, or something like that. And Amanda, you’ve literally built your entire career on the premise that hormones are the end of the system, right? That’s when you start to see hormone changes. When you see the rest of the inflammatory changes, the liver changes, the gut changes.
The problem is that if we want to work on our hormones, which some histamine clients will need to and some won’t, honestly, you first have to address the symptoms and the histamine. So the first two steps of any histamine protocol is you have to address the histamines. Whether that means reducing them, preventing them, getting them outta the body.
And you have to address your nervous system because your nervous system, hi histamines are actually a neurotransmitters. They act like neurotransmitters. So they will also, they literally, the nervous system and the immune system communicates so tightly that your body can receive kind of this like immune threat from the nervous system.
So it can, it, it will perceive it the exact same way. There’s like that very, um, now overutilized phrase, like, my body [00:35:00] doesn’t know the difference between if I’m sitting in traffic or there’s a bear. Well, your mast cells don’t know the difference between those threats either, for sure. And, and if they’re primed to be activated, they will continue to be activated.
So you really have to a little bit, I have to be honest with you, you have to use a sledgehammer approach with histamines in the beginning and you have to just bring them down. Because the other thing is not only are they then released for three months, but they then think, oh, we should kind of be operating at like a level 10 histamine all the time.
And you have to be like, don’t do that. Like, I actually don’t want you to do that. So you have to kind of bring it down. If you are, I think of kind of mass elevation syndrome as like the buck a bucket theory, right? So you have environmental toxicants, you have gut dysbiosis, you have stressors, you have environmental issues of all kinds.
You have, it could be you exercise too much, you were in the heat too much, you were in the cold too much. Anything that causes a state of, um, imbalance in the body can create that, that [00:36:00] can overload that histamine bucket. And again, once that histamine bucket is overloaded, you have to do everything you can to reduce the histamine load.
So that plus the nervous system, working on that at the same time is really important. And when I say nervous system work, I don’t really mean like just soothing the vagus nerve. I’m like, I’m so triggered honestly by the internet these days. I know, I know. I mean, anything that makes you feel legitimately safe and anything that pushes you towards a state of understanding yourself, seeing yourself.
And finding, you know, asking yourself, what do I need? And giving yourself what you need. That’s what I mean by true nervous system safety. So those two have to be addressed before you can go into the fun of, oh, do I have parasites? Do I have, uh, do I need to do a gut
Amanda: detox or anything like that. Even supporting your minerals, like the number of HTMA reviews I do for histamine people now I’m like, strap in guys.
Because it’s not just, [00:37:00] uh, mineral. We’re doing minerals at six months, ladies. Yeah, literally. So, and it can be hard for people, but minerals are incredibly detox supportive. So drainage pathways, all the things. And it’s like if you do that in the beginning, your gut, like, that’s why people are like, oh, I tried to, some people find their hasp issues that way.
They’re like, man, all I did was add in these two minerals. Literally it like sodium, potassium or something and it, they had a flare and, and I’m like, that’s typically a sign that there’s probably something that’s been brewing for a while that is like coming out. So I’m happy you mentioned that. I’m happy that you talked about nervous system not being something where you don’t need like a five step routine.
I also really like brain rewiring for clients with histamine issues. Oh my gosh. Limbic system programs. Yeah, like anything like that. And even, or even just knowing that, hey, you have built these deep, deep paths in your brain as a protective mechanism and we have to make new ones now. And like they have to literally tell [00:38:00] it, like, tell yourself you are safe.
Tell yourself what is true in that moment when you’re having a flare. Like it takes a lot of work, I’ll be honest, but. It doesn’t take a lot of time and energy. You just have to remember when you’re in those really hard moments to do it, and even just regularly each day, just like little things like that, and it doesn’t feel like you’re doing much.
And then until one day you’re like, man, I just had a flare and it was gone in 30 seconds and I’m fine and I’m moving out of my day. So I think that’s kind of like something that often gets left outta like the nervous system piece. I mean, it’s all part of it, but I love your approach to nervous system stuff.
It’s like, we don’t need you to do more stuff. We need you to do things that make you genuinely feel good that oftentimes we think aren’t worth it. They’re not a part of our healing, but like they really are.
Michelle Shapiro: Yeah.
Amanda: Especially with
Michelle Shapiro: histamines in the nervous system. So what happens is there’s again, this cycle that happens.
You have a really scary symptom. I mean, Amanda, we’re talking about people who it’s day seven of their cycle and like their heart is pounding out of their chest and they’re so dizzy when they stand up. We’re not talking about like, [00:39:00] ha ha, I’m a little grumpy kind of symptoms, which are not even, ha ha, I wouldn’t laugh at anyone’s symptoms, but.
These are tremendously frightening symptoms. So our inclination is to say, oh my God, I think I’m gonna die every single month. What is going on with me? I’m so frightened. And then unfortunately, your immune system hears how frightened you are and is like, something terrible is actually happening and I’m gonna release more histamines, unfortunately.
So there is this, this, this really quiet conversation that happens in our body that we don’t hear. So that’s where even this, the, my favorite thing about working with histamine clients is that once you understand these conditions, even if you’re listening to this episode right now and you’re getting this education and something clicked in your head and you said, oh my God, I always feel sick on day 10 of my cycle.
I always feel bad. That in and of itself creates a safety pattern in your brain. ’cause your brain’s going, oh. I know what the heck this is. This isn’t me dying. This is just this weird neurotransmitter like chemical [00:40:00] that’s wreaking havoc inside my body. Alright, I’ll go drink some nettle leaf tea, whatever I need to do, I’ll go have some baking soda.
That’s like a big Amanda Michelle tactic too for his plan too. Whatever the strategy is. So this is the one of the only syndromes or conditions in the world that learning about it helps to literally fix it. And that is so cool. So just know that even you hearing this right now is going somewhere in your brain so that when it happens you’ll go, okay, I’m gonna develop my toolkit basically.
And also the the hardest thing can ever ask of a client is that when you are feeling this way to be as non-reactive as possible, I’m laughing ’cause it’s like who would ever feel so dizzy? And their heart rate’s one 60 when they stand up and then be like, this is cool. This is totally fine. You know what?
There’s times when I wasn’t like that. And I think this is the most critical part of healing is also believing that we can. Heal. And once we unlock those patterns, especially because I think the menstrual cycle is one of the hugest drivers of histamine related [00:41:00] symptoms, it’s, it’s like a game changer.
And one thing I had to mention, because you mentioned minerals before, again, Amanda, you built your like knowledge base around minerals more than anyone else I’ve ever met in the entire world. You are my mineral queen. You know that. You always have like it’s, it’s really true. And I was thinking actually at the beginning of this episode when you said the histamine rabbit hole and I was thinking of a rabbit hole and then me at the bottom of it like, hi, you’re at the bottom of the mineral rabbit hole.
I’m at the bottom of the his. Hello everyone. When you go in that rabbit hole, you’ll find us there. And those are rabbit holes. But it’s really true because, and I had this comment yesterday that I had to tell you about. Someone commented on a histamine post I made and said. Actually histamine issues are just mineral issues.
So if you correct your mineral issues, I saw that and I was like, they’re not, they’re not. Oh, I’m surprised you saw it. Oh, I tagged you in it. That’s why I tagged you. Yeah. ’cause you never, you’re always so busy to see Instagram, like you never see Instagram. That’s so funny. And but ’cause the point of it is, even if minerals [00:42:00] are the root cause of a histamine issue, and they very well might be, by the way, you can’t correct histamine issues by correcting minerals because it’s gonna cause more histamine symptoms.
So even though we know these things are so essential, like exercise, right? Exercise can cause more histamine symptoms. And I would say if someone’s between day seven and 14, normally people would say follicular phase, it’s time to go hard. It would be the opposite with someone with a histamine issue.
’cause you know, exercise intolerance is very common in histamine issues to get, uh, you know, red flushing, flu-like symptoms. So just understanding that what we know about the cycle, it, it’s just so important to dissect and understand. Take a step back. It’s not going to be the same for everyone. Even if we know all this knowledge about minerals, we can’t just jump into a mineral protocol.
We can’t, and we know we need it. Even if you’re B12 deficient, but you have a histamine issue, you can’t take the B12. You have to titrate it really slowly. So that’s the frustrating part. But once you do manage histamines, then you get to go [00:43:00] all into those root causes. And, and minerals are a huge, you know, mineral imbalances are a
Amanda: huge cause of histamine issues.
A hundred percent. You 100% cannot start there. And like even in all the protocols that I give people, it’s like you lower your histamines first. A lot of them are already working to do that. And then, and I mean, it’s like if I, I love thymine. I don’t know, I That’s an independent treatment for pots, by the way.
I dunno if
Michelle Shapiro: we ever talked about that. It’s incredible. I don’t think so. Yeah. It’s an, it’s not only, it’s, it’s. Like study that’s an independent treatment for pots is how
Amanda: incredibly important it is. It’s so interesting ’cause it has a big impact on the adrenal glands in sodium and potassium. And I often get asked about how come my sodium potassium are not increasing on my hair tests when I retest my levels.
And it’s like if your, if your adrenals are not functioning well, your aldosterone levels are all off off, then it’s hard to retain everything you’re taking in. You’re probably using it so you, it’s ’cause they feel better. Right. But I feel better, my labs aren’t reflecting it. I’m like, you are probably using that and like, it’s not [00:44:00] bad.
You wanna keep doing what you’re doing. I mean, is vitamin B one, it’s like, I’m like currently obsessed for a lot of our, his being clients and just in general, I use it a lot for adrenaline, like mineral support. But it’s, it’s just incredibly interesting how if you started with that, I mean you would feel awful.
So. You gotta do everything in order. That’s why I am, I love Michelle’s work. Let’s talk about insulin blood sugar a little bit and then I do wanna cover endometriosis before we end. I, we can’t talk about histamine and the menstrual cycle without talking about our endo peoples, it’s criminal. We wouldn’t commit such a crime.
Michelle Shapiro: We couldn’t, we could not leave our endo girlies out. We could not. So here’s the funny thing, Amanda, I don’t know, you have to tell me. Okay. I’m speaking anecdotally. Do you find that those with MCAS often have too high of
Amanda: blood sugar or too low of blood sugar? Usually too low and, but usually their calcium magnesium ratio on their hair test is like really high.
So they’re, they’re more likely to have low blood sugars because they [00:45:00] tend to be insulin resistant or, you know, it’s a spectrum. Totally.
Michelle Shapiro: I find that people tend to have lower blood sugar issues, whether it’s from reactive hypoglycemia and insulin resistance or natural. Lower blood sugar, to be honest. And they, they actually might be too effective of utilizers of sugar, honestly.
Which is an issue too. It’s really, it’s really interesting because again, if someone were to say, oh, you know what? My blood sugar is high in I-M-C-A-S, I wanna go on like a really low carb diet. I mean, this is a trigger word for Amanda. I exactly. Don’t say super low carved diet to us. Exactly. But I would notice those symptoms being really extreme.
So it’s funny because I actually find that people experience low blood sugar in the second half of their cycle because of that sensitization, which is very odd. So what I would say is, for anyone who has histamine issues, I would immediately rule out something like intermittent fasting. I find that it’s, um, really instigating because low blood sugar can also [00:46:00] cause a stress response, obviously.
And anything that causes a stress or an immune response, a stress, a nervous system response causes an immune response. And that can cause a histamine response too. So I find that clients are independently. Symptomatic from low blood sugar and I’m sure they are from high blood sugar, you just don’t notice the symptoms as much in the moment.
They just like
Amanda: quickly drop like very quickly. Experience low blood sugar. Yeah.
Michelle Shapiro: And then the symptoms kick on, whether it’s a pots like symptom or a histamine like symptom, but going many hours that eating is something that I would tremendously not recommend.
Amanda: Yeah, especially in the luteal phase because like most women are a little more insulin resistant ’cause of the higher hormone levels during that time.
So I typically recommend like during the follicular phase, you have so much more like flexibility I guess is the best way to put it in general for anyone. But I would also say for my histamine clients as well. And then during your luteal phase, it’s like you just need to nurture your body a little bit more.
Don’t go too crazy hard on workouts. Don’t overtrain, feed yourself regular throughout the day. You know, go to bed early if you [00:47:00] can. Like you’re just kind of like. Taking extra good care during that time. And it can make a really big difference. ’cause we do see, like once we help those clients balance blood sugar, they’re like, wow, I feel drastically different.
Michelle Shapiro: And then also people just, just in talking about eating during the different cycles, if people are having more drastic histamine symptoms, then we’re talking about perhaps a low histamine diet in the second half of the cycle when progesterone rises, a lot of people do notice more loose stools. So that might be where you don’t wanna go as uh uh, you know, I can find, I find that like if there’s bile reflux happening, higher fat can be triggering in the second half of the cycle as well.
Here’s the problem. Everything we’re talking about is so subjective to the person that I’m like, because I know people who have diarrhea during the estrogen, you know, spike part of their cycle. ’cause histamines can cause diarrhea. And I know people who get diarrhea from high progesterone. I know people get constipation from high progesterone.
So you have to line up. Here’s my hormones, here’s my days of my [00:48:00] cycle, here’s what the symptoms look like. And we’re, we’re kind of letting you know, here’s what a more histamine symptom looks like. Here’s what a progesterone hypermobility symptom looks like. Here’s what a pots period symptom looks like so that you can kind of play with your own map.
But it’s hard to say ’cause it’s not, it’s just not perfect. It’s just not, it’s, it’s not, and that’s like a frustrating thing. But your pattern will be perfect when you learn your own pattern. It will, there, you will find consistencies from month to
Amanda: month for sure. And then you can kind of be like, okay, this is my plan of attack for this.
The worst time in your cycle thing, even just like planning your life, you know, and things like that around that time. It just like really can relieve a ton of stress when you’re like. Oh, I was gonna do this work project or this thing on cycle day eight and I’m just, I’m not even gonna do it. And it it, like people talk about cycle, sinking your work with your cycle.
I don’t personally always do that. I’m like, I work when I can. I have kids, right? But if I had histamine issues, there’s no way that I would not be being [00:49:00] more intentional with like actually cycle sinking when I have flares.
Michelle Shapiro: And it’s again, your cycle sinking, not what you see online. Work out the hardest on day 14.
Good luck to us if we worked out the hardest on day 14, right? Like Yeah,
Amanda: exactly. No way. It’s so true. So let’s talk about end endometriosis a little bit. And endo is such a big conversation. I’m gonna do a whole episode on it as well. I’ve talked about it a lot in the past. This is a population I’ve worked with a ton, very near and dear to my heart.
Some of my, I know we’re not supposed to have favorites, but some of my favorite clients were endometriosis clients and they’re, that’s really who introduced me to histamine issues. That’s when I first really started digging into it. ’cause I was like, man, this is not a hormone issue. I mean, hormones are an issue with endometriosis, don’t get me wrong.
But I was like, wow, this is like their immune system. And then now it’s very well known that the immune system plays a huge role in endometriosis symptoms, especially basically when you have endometriosis. When you don’t have [00:50:00] endometriosis, your body is working properly, right? Your immune system is cleaning up cells that are in the wrong place, doing the wrong thing.
Anything that could be like stray endometrial tissue could wander outside the uterus. Endometriosis, that doesn’t happen. You don’t get the cleanup crew, it doesn’t work like it’s supposed to. Instead of clearing out these cells, the immune system basically tolerates them and it allows that tissue to implant grow and cause a ton of inflammation.
And then on top of that, the immune system actually adds to that problem even more by releasing more inflammatory chemicals like cytokines, like prostaglandins. It’s like, this isn’t supposed to be here. What’s going on with this? Yeah, yeah. Mm-hmm. We’re just gonna feed it and we’re gonna fuel it. And then, and it’s all around those lesions.
So there’s, there’s a ton of inflammation just even in within that tissue itself. And this creates that vicious cycle of pain, swelling, immune overreaction, and a lot of people with endo have [00:51:00] an overactive immune response. Like some of it doesn’t work, right? Some of it does not work properly, and that’s why the endometrial tissue can overgrow.
And then the rest of it is in overdrive. It’s high alert. It’s like a 10, like Michelle said previously. And that’s what can contribute to a lot of the fatigue. The food sensitivities. There’s typically the, there’s like co conditions, like autoimmune conditions and stuff like that, and there’s a lot of evidence around like natural killer cells, which normally help get rid of the abnormal cells.
They’re not as active in people with endometriosis, so it’s not only is it’s not cleaning them up, but it’s also firing off these inflammatory compounds and the bodies and just like missing like that natural protection. So this is why endo is not just a hormone issue, it is impacted by hormones.
Everything we just went through with how histamine clients can react to estrogen. Like that’s, anyone with endometriosis is like, yep, that’s, that’s me over here. That’s hundred percent. To an extreme degree because the other piece of [00:52:00] it is that the endometrial lesions, they’re not just hormone sensitive, they’re also packed with mast cells and histamine.
Exactly.
Michelle Shapiro: They are, especially because when we’re talking about any tissue lining in our body, even we’re talking about muscle. Okay? These things don’t just sit there in our bodies. Muscle fat, endometrial lining, connective tissue. These are communication centers for our body. You mentioned two actually very important chem, um, chemical messengers.
One is prostaglandins and one is cytokines. Both of those are released by mast cells. Those are two of the other chemical messengers that are released by mast cells. So if the actual endometrial lining is releasing these chemicals out, mast cells will catch with and go, let me contribute and help here as well.
And then it’s that cyclical and there’s actually, they’re actually being released not only from the endometrial lining, but from mast cells within the endometrial lining as well. So you’ll have those excess symptoms as well. And remembering that again, it’s like we hear, first of all, [00:53:00] prostaglandins I think are a major piece of this puzzle as well.
’cause of the cramping that they can cause and, and a lot of like those endo symptoms. I think we can tie back to prostaglandins too, but remembering this conversation is different systems of our body communicating. And then once again, you have the lesions already, the communication. It’s like you’re playing a different, you’re on a different communication line because then your immune system and nervous system and different parts of your immune system even are communicating with each other in a way that is, it believes is productive.
Of your body, but becomes very symptomatic for you. So that’s just really important to acknowledge also, is that these pieces of our body are talking to the other pieces of our body. And the way they do that is through these chemical messengers, through hormones, through neurotransmitters. That is how our body communicates and goes back and forth and, and then the emphasis on, unfortunately, once our body learns a certain way of existing, it kind of like exists that [00:54:00] way.
And it’s like, okay, this is the way we’re supposed to behave and this is the way we’re supposed to be. So that’s why I think that the endometrial like surgeries are very effective for people or can be. But you, you, I’m sure you have, you know, many, many, I have a lot of thoughts on surgery, but I won’t get into that now and you can totally disagree, but in some I, what I’ve seen in clients is at least it gives a little bit of a fresh start for to create a new immune environment.
Although, yes, it would come back again, but if you’re not doing anything else, if you don’t do anything, it’ll come back again. Of course,
Amanda: yes. And then the risk of scar tissue, just. No, I feel like there’s such poor informed consent there and people end up having to get so many sur it just like, I’ve seen it go really well and I’ve seen it go really, really, really bad.
And it’s so interesting now with the research, like now that we know more about immune system and inflammation and how that affects endometriosis. A lot of the, at least in Australia, a lot of the physicians there, they really focus on like, Hey, surgery’s actually not gonna be our [00:55:00] first thing and we might not even do it depending on the person.
And they’re really much more into like, we have to get the immune system inflammation in a better place.
Michelle Shapiro: You have this pledge hammer, it’s the same thing. It’s like you’re out of 10. Of this communication system existing, and we have to completely reroute the way that your body’s operating and the way that your body’s communicating within itself.
Amanda: Yeah. I think it’s kind of like, uh, and I don’t know, I don’t have endometriosis. I’ve worked with like hundreds of clients, like at a minimum that have, and I’ve had a lot of friends and family members, and I just found out that someone on Ian’s side of his family has, it won’t say who, and now I’m like, okay, the girls are at a higher risk.
I know basically nothing about his health history. It’s incredibly frustrating. So when I find things out like this, I’m like, Ooh, that’s important for me to know. Yeah, we have, I’d love to know that piece of information. Yes, that would be helpful. Yeah. Also knowing that you have sickle cell trait probably also helpful, you know?
But that’s okay. Yes, please inform.
Michelle Shapiro: Thank you. So it’s, it’s like you need to get Jewish family members, Amanda, because we talk about every single, every single time we go to the [00:56:00] bathroom, we talk about it. This is what we need. We need, we need Jewish family members for you. Oh,
Amanda: it would really make my, uh, piecing together, you know, not that your DNA NA is everything epigenetics matter, but it’s like that is helpful, especially we have daughters.
Obviously it’s good to know, but it’s like I have, I have done so much research and thought about this so much because I’ve seen it affect women differently. And you can have endometriosis and not necessarily have like an mc CA diagnosis. And it’s not always like. You know a hundred percent, but you’re typically, it’s not one plus one equal.
Yeah, like it’s not A plus B equals C. Like it’s not that perfect, but you’re typically gonna have histamine symptoms. ’cause a lot of ’em like, oh, digestive issues. I’m like, yes. From like typically a histamine response typically don’t make enough digestive juices. They end up getting sibo, lots of gut overgrowth, more inflammation and all the things.
I think the biggest difference is that a lot of women with endo are progesterone resistant because of all the inflammation and they don’t always react as poorly to it. I will say a lot of ’em do. I have seen a lot of women with endo not [00:57:00] handle bioidentical progesterone. Well, some of them I’ve never seen some
Michelle Shapiro: of Themas handle it.
Well, they ha someone in menopause and they have to take it. We find the way. But I will also, something that we didn’t mention that I think is so important is that progesterone, because it’s utilized in an immune response, that’s why people can appear deficient. In progesterone as well. So the inclination is to give them progesterone, but it doesn’t mean that you won’t be symptomatic.
So I have seen a lot of MCAS clients have infertility issues only because of the G luteal phase defect and not producing enough progesterone. But MCAS is not distinctly correlated or correlative with infertility, by the way. So that’s not, it’s not, uh, it’s not some in a good way. I don’t want people to feel like, oh yeah,
Amanda: we’ve had so many clients conceive and stuff and not have issues.
It’s, but it’s like, they’re like, I just don’t wanna feel like death my whole pregnancy. So that’s usually that they’re trying to work on like a hundred percent.
Michelle Shapiro: And also, if you control the immune response, your body doesn’t need to shunt progesterone into the immune response as [00:58:00] much. That’s the critical piece.
So that’s where, like you’re saying, I don’t wanna use antihistamines, but if they can lower the overall immune load in any capacity, then your progesterone may naturally rise. I actually had a client, I’m obsessed with this happen recently that she, she wasn’t really experiencing infertility in the ways of.
She wasn’t consistently tracking or trying, but it had been four years since her daughter was born and they, they never used protection or anything, so she like suspected maybe, but she wasn’t so, um, clear on if there was an infertility picture or if she just wasn’t timing things properly or anything like that.
And then she ended up going on keto, which is a mast cell stabilizing drug, and she got pregnant like within a month be, and then her progesterone. That cycle also we realized, came up a lot and we realized it’s probably because your body wasn’t shunting progesterone into the immune response. So it’s like you don’t have to directly take progesterone.
In order for progesterone
Amanda: to rise. And I think that’s like where a lot of confusion is and just like fear and a lot of, I mean a lot of physicians [00:59:00] don’t know this information un unless they’re like really deep into working with clients and they have a more holistic, functional mindset. But people like don’t realize.
I’m like, yeah, progesterone just goes where it’s needed, right? It, it’s anti-inflammatory and it goes where the body needs it, which is often the gut and immune system. And so that’s why people be like, I’m taking progesterone. My levels aren’t going up. I’m like, you’re probably using it somewhere else.
Which is why I never use that until like the end, you know, it’s kind of like a last resort or a cautionary thing during pregnancy, like the first trimester for someone. But women with endo, I would say like same thing. Track your cycle. See when your flares are, it’s probably gonna line up with exactly what Michelle went through previously.
And same thing with like stress. Getting the histamines down, finding what works for you. I have seen amazing things with using antihistamines with endometriosis clients and it just like, and there’s
Michelle Shapiro: studies on it now too, which is fantastic. Pepcid, there’s Zyrtec studies, there’s studies on it. It’s amazing.
I have to tell you, this is [01:00:00] like my biggest confession and something that I am sleepless about. I had an endo client like five or six years ago, and it was before I knew the histamine mast cell link clearly. And I just think about her all the time and sometimes she was a, she was a client of the practice and I’m like.
Asked the practitioner who was working with her, I’m like, can you just email her one more time and tell her, like, we’ll offer her a session or something to come back. Because I, I’m just like, now we know so much clearer that I’ve never now seen an endo client without MCAS before. Now whether they have a diagnosis or not, I’ve never seen them not have histamine issues.
Uh, when there’s an endo diagnosis, I’ve
Amanda: never seen that. It’s really rare. I’ve definitely seen people like that are not as deep on the spectrum. Like it’s not as bad. Not as histamine. Yeah. Yeah. Not as histamine, but you still have to be really careful. ’cause as soon as you start doing things like supporting detoxification or a gut protocol, it just like.
It just stirs up a big mess. His basically that, that immune reaction in the body. And so that’s why we’re always like, so alright, you have endometriosis. Let’s [01:01:00] dip our toe in really slowly here and just kind of test everything out and see how it goes. But the last thing I wanna talk about, I wanna leave people with is something that you go through a lot and it’s like giving your, like it’s, you talk about like taking care of yourself and doing little things for yourself every single day and like having like a little routine and how that just like, ’cause I think people hear like something that makes my body feel safe and it’s kind of like, I don’t know, like what that quite is for me or like how do I incorporate that into my day?
What are things that you have people do? It doesn’t have to be specific things, but like what is the idea behind giving yourself a specific routine every single day with histamine issues?
Michelle Shapiro: So you have to find out what is your deal. So my deal is this, Amanda, if I don’t walk 10,000 steps a day, I’m gonna be very sick.
My hypermobility symptoms will kick on, my histamine symptoms will kick on. We’ll kick on. I know that about myself. I know I’m a very poor hydrator. I’m a person. I have like pretty low stomach acid, so when I drink a lot of water, I get really bad reflux. I hate drinking water. It’s just like I’m a, a [01:02:00] very poor hydrator.
When Amanda and I are in person, she’s pouring her minerals into, she’s like, I’ve seen Amanda go through like a bag of bumble root in a day, back in the day. So use bumble root and you’re just like six scoops later. We were in a very stressful event. Okay, let’s not, we can’t even talk about it exactly, but I’m a very poor hydrator and I also know if I do not hydrate, I’m going to feel terrible.
So I need to put, you know, I’m drinking outta a glass of water bottle right now. I’m embarrassed about it, but the deal is if I don’t, I refill the same one. I clean it at this point, like not with hot water, because I will not drink out of like a big cup. It’s just I know myself because I’m not gonna leave a cup on the floor.
It’s a whole thing. But you have to know these things about yourself. You have to know what makes my symptoms worse. And you have to know what do I need personally? The other thing I ask people to do is like, find out what those non-negotiables are for you. ’cause then I, I, I tease my clients. I’m like, oh, you thought you were gonna go to this like extremely hard workout class and then like not eat and then you were gonna feel awesome.
Like it’s your, I know all my clients’ [01:03:00] bodies. I’m like, are you joking? Like there’s no way you were gonna feel okay. Know what your triggers are and know what your non-negotiables are and your health. And then build your life around that. And I’m
Amanda: curious if, ’cause I know we’ve talked about circadian rhythm a lot and I’m like, get your morning light, Michelle.
Has that made a difference for you? Do you notice it with your clients when it comes to like getting morning light blocking blue light? Because that is one thing when we do circadian stuff with our clients, they’re like, oh man, it actually works
Michelle Shapiro: a hundred million percent. And also with clients who have pots, you can’t lay for so long.
So in the morning if they can do a five minute walk while in the sun and connect that there’s also just the heat of the sun that goes into the heat of the gut. There’s just so, I mean, besides it going into our eyes and that connecting with the rest of our body in this amazing way. There is something so profound about that morning movement being outside and that connection with the sun.
A hundred million percent, even if it’s five minutes, basically, because when you’ve been laying all day, your [01:04:00] blood flow is very poor. You know, you’ve been sleep. I mean, even sleeping at night, eight hours of not moving your blood flow is not juicy and moving. So yes, absolutely. And then I would just say the most important thing for nervous system safety is knowing yourself, being as weird as you possibly can and just constantly asking yourself, what do I need?
And then giving yourself whatever you need without judgment. Like, I’m a person. I can’t go out to dinner at like 8:00 PM I’m, I’m a New Yorker and obviously New Yorkers will have dinner at like 9:30 PM and I’m like, you can order me a ginger tea. I will have two sips and then I’m gonna go home. My friends will joke.
’cause I will literally show up and they will be like a hot cup of water. And they’re like, thank you for even gracing us with your time. I’m like, you’re literally welcome ’cause it’s 8:00 PM and it’s, if it wasn’t, if it wasn’t your birthday, I would never be here. But. Know these things about yourself. Know what makes you feel bad, know what makes you feel good, and then be unapologetic in that.
And I would also just say from a nervous system perspective, once we learn all these things, set boundaries with the people that you love. The, the sickest people in the world are the [01:05:00] biggest people pleasers. You know, I, I actually learn a lot from you in that way, Amanda. ’cause you’re really good at being boundaried.
And even though, I mean, not with like your daughters or husband, but like in life, not, not in the slightest bit. You give all of your heart, but, and really not with friends either. You would literally do anything for your friends, but you do set good boundaries and you say, this is what I can do. This is what I wanna do.
And I’ve learned a lot from you in that. ’cause it’s really hard for me. I’m just very people pleasing.
Amanda: It’s a, it’s a childhood. I was like that before I had kids. And then I was like, oh, nothing else matters and I can’t drain myself. To help others anymore because I have to keep these humans alive, you know?
But I love that, and I love that about you, that you are completely yourself and you encourage others to do that. It’s, it sounds silly, but it’s like it is really healing. And I know it can be really hard. I’m thinking of a few of our clients in particular who, like, they’re, they’re really struggling with histamine issues and their family members think that like, they’re like annoyed with them, that they feel ill all the time.
And I’m just, yeah, I
Michelle Shapiro: would just call [01:06:00] it, by the way, I don’t, even though it’s factually untrue, I call it autoimmune, even. It’s not autoimmune by the way. It has histamine issues are not autoimmune. They’re hyperimmune, they’re autoimmune. But people do not, what are we gonna intricately understand the immune system in regular conversational people, I just tell clients say, oh, I’m in an autoimmune flare.
I have an autoimmune condition. I’m in an autoimmune flare. Autoimmune seems to be more recognized for some reason and acceptable. So I would just say I’m in an autoimmune flare. And that’s why, and I know people are really embarrassed about histamine issues. I don’t like making any medical diagnosis a personality.
I, I would just say like, and this is true, I would just be like, yeah, I feel like I’m gonna die if I eat a tomato. I don’t really know what to tell you. It’s just, it’s just, what do you want me to eat one right now? And then you wanna come to the bathroom with me and see what happens? Like I’ll, I’ll do it if you wanna do it, but it’s, don’t identify with, I have MCAS, I can’t do these things.
Just find your things and then help yourself in your way. Right? Like, oh, I can’t work out these days in my cycle because the internet said cycle sinking, whatever. No, what’s [01:07:00] your deal? Find out what your deal is and the more you you can be and the more you can advocate for yourself. Now, I actually don’t, I just don’t go to dinner at 8:00 PM unless it’s a very special occasion.
And lean into that and be bold and weird and be as, you know, rock and roll as possible. That’s how I, that’s how I live my life.
Amanda: Um, and if you wait to the end, I love you. Thanks for being here. And Michelle and I are actually doing a hormone and histamine webinar then I’m so excited for, it’s so needed.
Where we are gonna get into all the details, we’ll get even more into endometriosis. I wanna talk about PCOS too in that, because there’s Ooh, a lot going on with PCOS and histamine. Just, I think we’re even doing pregnancy in that, by the way too. Yeah. We’re, oh, pregnancy is probably the biggest thing that we’re gonna cover and postpartum.
So I’m giving you a
Michelle Shapiro: spoiler, Amanda, that my last just histamine essentials webinar was three hours. So you guys, you gotta save some time for us because it’s gonna be brutal. It’s, we’re gonna, we’re really gonna do it. [01:08:00] We’re gonna lay it
Amanda: all on the field. Yeah. And it’ll be something where. It’s not just us, like, just kinda like today where we go into like solutions and stuff, but it’ll get super specific.
We’ll probably have a guide and I, I, I’m like very visual. I need a handout, you know what I mean? So I always make ’em, handout was about
Michelle Shapiro: 160 pages or something for the last one. So we’ll have, yeah, we’ll have a handout where people can actually take notes at the same time too.
Amanda: Yes. So that’s like the goal is like we, for people that are struggling with this type of thing or practitioners that I get so many questions from practitioners that wanna learn more about this stuff.
So we are gonna put the link for that in the show notes. You guys can sign up. It’s gonna be incredibly fun. We, it’s gonna be on September 28th and it’s gonna be live, but we’re gonna send out the replay. So, you know, if you can’t stay the whole time, don’t worry about it. But it’s, it’s gonna be incredible and I cannot wait.
You guys can’t give us four hours of your life. I’m kidding. Watch the replay. It’s totally fine. Exactly. Yeah, exactly. And if you guys are new to Michelle and you’re not already following her, where, where’s the best place for them to connect [01:09:00] with you?
Michelle Shapiro: Yeah, it’s just my Instagram, Michelle Shapiro rd Super.
And then on my website I have some other information, other podcast information as well. Um, but really easy. And then, uh, we’ll have these webinars when, where we will really get to know each other and we’ll have a way people can submit questions in advance as well. Yeah. So that’s why they end up being so long,
Amanda: because we go.
Step into the questions, but I cannot wait. I hope to see you. It’s gonna be the best afternoon of our lives. Yeah, yeah. Afternoon. ’cause that was my boundary, right? I’m like, I have kids. I can’t do it at night. Exactly. And I honor it and love it. Awesome. Thank you so much for being here, Michelle. Love you.
And thank you for sharing your knowledge with us. Thank you, babe. Thank you for tuning into the Hormone Healing RD podcast. If you found this episode with Michelle helpful, the best way to support the show is by leading us a review. It helps more women discover this message and feel empowered on their healing journey.
And if you wanna go deeper and stay in the loop with everything I’m sharing, make sure you’re subscribed to my Feminine Periodical Newsletter. It’s a free weekly newsletter that I put out every Sunday at 6:00 PM Eastern Time, where you get exclusive [01:10:00] tips, tons of tools behind the scenes insights to support your hormones, minerals, and overall health.
You can find the link in the show notes. I’m so glad you’re here and cannot wait to connect to you again next week.
