Intermittent Fasting: Your Guide For Histamine & MCAS

Introduction and Guest Background 0:00

Hello and welcome back to our reversing mast cell activation syndrome and histamine intolerance summit. I'm your host, Dr. Meg Mill And today I'm joined by my esteemed colleague, Cynthia Thurlow. Cynthia, as a nurse practitioner, author of the bestselling book Intermittent Fasting Transformation A two time TEDx speaker and globally recognized expert in intermittent fasting and women's health. So we're going to talk to her today all about fasting and how that can affect our mast cells and how we can actually use this as a tool.

But, yeah. So I'm so excited to have her join us today and give us a lot of information. Thank you so much for joining us today, Cynthia. Yeah, thank you so much. I've been really looking forward to connecting with you and your community. Well, thank you for being here. So I'm so excited to talk everything fasting and how this can be used as a toll on all of the great things. But before we get started, I know you have a personal history with me, and I know so many of us come from a place where it's a personal journey for us.

I'd love to share some of that. Yeah. You know, I suspect because I have this genetic susceptibility that I was probably first exposed to a moldy environment when I was in college. I lived in a townhouse with my sorority sisters, and we had a flood in the basement and, of course, who lived in the basement. But me and so understanding that the very beginning stages of this, this exposure was when I was in college and initially started as asthma, allergies, you know, kind of written off as bad. And then kind of spiraled into living in some moldy apartments in Baltimore when I was in my training.

And then, you know, most recently when I lived in Washington, DC, we found out that there was some mold in the home that we had purchased. And so for me, it was this evolution of there was one insult and then this chronic exposure and then, you know, perimenopause, when so many of us, start to find that we're a weight loss resistant or thyroid underactive. And so that's really when it took root. And in many ways, I feel like that's when I discovered what was really driving a lot of the symptoms I was experiencing and really showing up, as, you know, high cortisol, fatigue, weird rashes being weight loss resistant when though it had never been something I had exposed to before, and having many health care providers, many of whom were friends, that were just telling me that, you know, weight gain is just a normal function of aging.

And I kept insisting that it didn't need to be. And so through my own journey and the healing journey, I've been able to figure out that I am part of that 25% that I get, a very provoked or provocative reaction when I'm exposed. And even now, to this day, you know, I live in the South. And if I'm in a moldy, you know, sometimes we love to look at old historic homes.

Personal Mold Exposure and Mast Cell Triggers 3:00

And as soon as I walk in, if I can smell that musty smell, it can retrigger a lot of, what I've been exposed to before. And so, you know, I'm completely sensitive to this. I know how debilitating it can be and how it evolves into this entire syndrome. Obviously, mine was considered to be mild, but I've had many patients and certainly many clients and colleagues that have had really, really significant and profound exposures and then, symptomatology related to those exposures. Yes. And you bring up so many important points there because you had that first exposure, exposure when you were living in that moldy basement.

And I think then sometimes people think, well, okay, my house right now isn't moldy or I just build a new house. It can't be affecting my health. And it's, you know, we can have those exposures from before we can be carrying mycotoxins in our body, all these things, so it can become so confusing for people. Yeah. And it's interesting because one of the things I've learned, I mean, it turned out everything I owned was destroyed. So I had to start over. But for many individuals understanding they may move out of the house where they were exposed to mold.

But if all of their items have also been exposed to the mold and the mold spores, then in many they will continue to be reactivated. And so I think, as troubling as that may be, it was probably a blessing many, many years ago, that everything I mean, I remember my even my textbooks were floating around in the water, and you just had to get rid of everything and start over. But thankfully, that was at a time when it was just me to have to worry about and not a whole family. Yes. Yeah. Because it can feel so overwhelming sometimes.

Absolute. Let's talk, let's move into fasting. So before we dive into how we can use fasting as a tool here, can you just actually give us I mean I think everyone's heard of fasting now and intermittent fasting and everyone knows about it for the most part. But just in case we have people out there that really haven't heard of fasting or how to do it, can you just tell us a little bit about intermittent fasting and what it really means? Yeah, so fasting is really just speaking to eating less often.

I know for some people that word fasting can be triggering. So I've kind of reframed it in saying eating less often. And in our modern day harried lifestyles, we have been convinced probably by the processed food industry and some, I have to believe, well-meaning government organizations that we have to eat frequently to stoke our metabolism. And so intermittent fasting is determining there's a time period in which we are eating, and then there's a time period in which we are not eating, aka when we are in a fasted state and being able to navigate, whether we're male or female, being able to determine what's the appropriate fasting window for you, what can you consume during this fasted state?

And then also understanding that many people come to fasting with a curiosity, you know, they want to change body composition or lose weight. And I remind people that there's so much more to fasting. It's not new or novel. Despite what social media may suggest, it actually dates back to biblical times and is part of the three major religions and and many others for that matter. but helping people understand that there's a lot of substance to fasting beyond the physicality piece, which I understand as a female.

I totally understand when people are coming to it for that interest, but then stay for all the other health benefits. Yes. Okay. So and one of the health benefits is the effects of our immune system. So there's things that can change in your immune system when you're eating less often. Can we talk a little bit about that. Yeah absolutely. So there's a couple things that I think about from a very basic level. When we're eating less frequently, we're allowing our body to have the opportunity to go in and remove diseased or disordered cells.

So the concept of autophagy, this waste and recycling process where we can get rid of diseased organelles, mitochondria, the mitochondria are powerhouses of our cells. And in many instances, if we're fasting long enough, we get tremendous upregulation in autophagy. We can also talk about if you're fasting long enough and this is more than 2 or 3 days, you can get some stem cell activation. You know our telomeres impact our DNA. For many of us, this is really impacting, how we are aging, whether it's accelerating or if it's at a slower pace. And ideally, I think for most of us, we don't want to accelerate the aging process.

But understand that complex interrelationship between stem cell activation, prolonged bouts of fasting. By prolonged I don't mean 21 days. I'm really speaking to 3 to 5 days when we know that we can get some stem cell activation, and then understanding that when we're getting our bodies this degree of digestive rest, it allows us to go in and and improve machinery. When we talk about immune cells and immune function health, it's helping people understand on a lot of different levels that we're impacting that reducing inflammation in the body.

We're in a position where we are able to package up and get rid of disease and disordered cells. depending on where we are life stage wise. And I'm speaking to women when I say this, we know we get some immune cell dysregulation in perimenopause and menopause with that loss of estrogen. So there's a lot of different signaling molecules that can go on within the gut microbiome is one example that can be impacted by this eating less often stayed or this intermittent fasting that we can embrace. Yeah.

So I'd love to get a little bit more into the microbiome because when we talk about histamine metabolism we're looking at diamine oxidase. We see that certain actual microbes produce histamine. And we start to see some of these changes can make some of these things so much worse. So that is an important piece of all of this. Absolutely. And I think the more that we understand about the gut microbiome, and I feel like over the past year, there's really we're actually past ten years, there's really been this explosion of understanding between signaling molecules, polyphenols, helping to understand that like keystone bacteria like as one example, sacraments I think is is having a moment in terms of,

What Intermittent Fasting Means 9:00

looking at keystone bacteria, but understanding for a lot of us that it's involved in the mucin lining of the small intestine. For so many of us that are dealing with provocation of histamine, understanding that if that small intestinal permeability has been breached, we are more likely to have these provoked responses to certain foods. I always like to talk about how I see a lot of women in perimenopause as an example, that in the setting of these wild fluctuations in estrogen tend to be more prone to having this provocation of histamine response.

I certainly went through it during my book launch, when I was getting stressed, and I would break out in systemic hives because of this provocation, eating histamine rich foods as an example, like foods that are fundamentally healthy, like probiotic rich foods. I was having kombucha, I was having, you know, I think about some of the, you know, fermented foods like olives. And it was the constellation of symptoms that I experienced. It was like, okay, too many fermented foods, too many high histamine foods in the setting of high estrogen, in the setting of stress provoking this the stress response.

So when I think about the gut microbiome and helping people understand, I mean, I tend to focus in on Ackerman as one example because I think that that name is probably people have more exposure to it now than they did before, but helping them understand that that's one of many my microbiome pieces that is certainly very important, that mucin lining of the small intestine, certainly very important for, ensuring that we're not provoking food sensitivities in that setting. Yeah. And some of the things that are so interesting about this is the foods I am have been bringing up a lot.

The foods that we often think of gut healing, like the fermented foods and the bone broth, all of those can cause histamine issues. So you really have to look at it through a different lens. A lot of times, the things you're hearing out there to do can be backfiring. And when especially when you have that. Yeah, the estrogen making more histamine making more estrogen. And then you're putting in all of these things, you're doing all of the things that are intentional. But not working for you. Absolutely.

And I think for a lot of people, I mean, you really speak to it in such a beautiful way that these healthy things that we do to support our bodies, that in the wrong circumstances, in the wrong setting can actually provoke more inflammation, can actually create more digestive distress, can create, you know, more skin manifestations. I mean, for me, I had never experienced hives before and to be covered head to toe in hives as I'm going in for, you know, interviews and things like that, and people ask me, are you okay?

And I'm like, yes, I know exactly what's going on. But it just goes to show you that even with all of the knowledge that we possess as clinicians, even we can fall prey to these opportunities, opportunistic opportunities that let our bodies know that, okay, there's something that we need to be focusing in on. And it's not more ferment. Yes. And you have the knowledge and the path to make those changes, which I'm trying to have been through the whole summit, trying to tell people that they have that option, because I think a lot of times we're just told, okay, live with this or we're not given answers.

And that's where you feel so stuck. So it's like hearing your story and okay, you went through that and it wasn't comfortable. It didn't feel good. But you could make changes and get out of that situation and live in a comfortable way. Oh, absolutely. And I think and I think it's important for clinicians to share their stories, because then it's so reassuring to people that are watching to understand that, yes, you can experience that. It can be transient. And for me, I jokingly say, like, I'll be working on my gut health for the rest of my life to ensure that I don't have this provocation of histamine or other types of sensitivities, because having gone through that, it makes me exquisitely sensitive to what other people experience as well.

Yes, absolutely. My I am one that my genetics did not serve me well in this area either.

Fasting, Autophagy, and Immune Benefits 13:00

So it's just that constant reminder, constantly being able to stay in a place where everything's under control and you're not being triggered all the time. Yeah. So so when we're looking at fasting, you know, do you see? Because I know people can feel better with histamine issues with fasting. Do you. So I want to talk about that. But you also see people with that are very sensitive have issues because I know like that's the thing you're very sensitive to a lot of things. So maybe have a little bit of fear of fasting.

Yes. I think that there's always a constellation or a continuum. There are people who are ready to start fasting immediately, and they feel so much better with the degree of digestive rest. They're allowing their bodies to have less bloating, more, you know, less digestive distress. And then I have, you know, people on the other end of the spectrum who've been convinced that if they don't eat every 2 to 3 hours, that they're going to starve and and helping them understand that there can be a therapeutic benefit.

I think that the challenge sometimes is that people have poor blood sugar regulation. You know, they have you know, they're not fueling their bodies properly. And it explains why they have this fear because they get energy slams, they get hypoglycemic episodes or low blood sugar. they want to go take a nap after they meal, they eat. And I always say, this is our body is giving us information. It gives us an opportunity to next time we eat, we're going to structure our meals together differently.

And I think for a lot of individuals that have, whether it's Marcus or they've got histamine issues, it's getting their meals really simple, like really, really simple and dialed in because we've overcomplicated things in so many ways. Like there's an explosion of information, like people have the ability to access information across social media, on podcasts and books, and it can be overwhelming trying to figure out like, what exactly should I be doing? And so I remind women in particular, like, let's get back to basics.

Instead of overcomplicating things like, let's just focus in on, you know, maybe we're just having stewed meats, or maybe we're just having very simple proteins and, you know, cooked vegetables if you tolerate them. And then adding in some healthy fat, but keeping it very simple. But yes, there is definitely a continuum. There's a fear of starving. There's also a fear of a loss of control, I think for a lot of individuals. And if and if anyone's ever had an eating disorder or eating disorder behavior, those are things that I kind of look out for as I'm coaching women through intermittent fasting and identifying those might be individuals that would do better with what I refer to as 12 hours of digestive rest.

Like you eat dinner, you don't eat again until breakfast. You're really just having 12 hours of digestive rest as opposed to making it about restriction. It's always finding that reframe so that people are able to navigate eating less often, or intermittent fasting in a way that feels feasible and reliable and something they can be consistent with. I feel that most people can do the 12 hours of digestive rest without a penis. Even my athletic teenagers, they're not even trying to do 12 hours of digestive rest.

But you know, they may eat their second dinner at 8 or 9:00 at night and then not eat again until 8 or 9:00 in the morning. And for them, they're not they're not fasting, but they are doing on their own because they're listening to their bodies. They're attuned to that. I just think that for many of us, we have gotten so disconnected from our bodies. But I think it's important to encourage patients to really pay attention to how things make them feel. I think for many of us, we eat without, you know, eating is an afterthought.

It's a means to an end. It's not something people savor or enjoy. They're just like, oh, it's it's something I do purposefully, but it's not something that I'm thinking about as I'm doing it. where they're using food as a comfort and a mechanism, a coping mechanism, too, so it feels hard to get rid of because they're using that for pleasure. Absolutely, absolutely. Some of the things and sometimes I see that people with histamine issues,

Gut Microbiome, Histamine, and Food Triggers 17:00

like your histamine levels go down and some of the reactions go down when you're fasting. Yes. And I think for a lot of people, it's that that awareness of like, how do you feel in your body now typically it's the bloating that I think for many women that they've gotten so disconnected with, they just think bloating is just part of their day to day, or having loose stools or having constipation and or, brain fog or getting tired after eating meals. And I think when individuals go through a process of whether it's 12 hours, 14 hours, 16 hours, 18 hours, even 24 hours, if that's appropriate for you.

I think for many people, it builds awareness on how they feel within their body. And that's that's a sensation. A lot of people have disconnected for a variety of reasons, but I think it can be very powerful and transformative. Yeah. And where do you have people start who are coming? Who are new to fasting? Usually we're starting with the donate after dinner, donate again until breakfast. And for a lot of people, they're already doing 12 or 13 hours of not eating or, you know, digestive rest. And it's that and then it's building on really incorporating three meals a day, 2 to 3 meals a day, and not snacking in between.

So it's helping them understand we want to have enough protein in our meals to help us to tidy. And we know, based on research, that first meal of the day is the most important meal to set up. Not just food cravings, but also blood sugar regulation, satiety. So I say no less than 30 to 40g of protein in that first meal. And when I can get patients to consume at least that, it makes it much more easy for them to go from that point till 4 to 5 hours and eating again. And so it's helping them understand that snacks aren't your friend.

obviously, if you are navigating, being hypoglycemic, having some blood sugar regulation problems, and it is helping people understand by eating enough protein in your meal, you're going to help not being hungry in between necessitating a snack. And so once I can get people to 2 to 3 solid meals a day, then we can start opening up that feeding window. Now, if someone is eating a standard American diet, they're very sedentary and they take 4 to 6 weeks to get to a point where they're fasting for 14, 16, 18 hours, people that tend to be able to use different types of fuel substrates.

And by that I mean fats or carbohydrates. Let's simplify this as a fuel substrate. If they're effectively able to utilize either type of fuel substrate to fuel their body as food, they're going to be able to fast longer, usually a bit more quickly. And so part of that readiness to change model is really getting assessment for where patients are. And I would say the majority of people, it takes them a month or two to be at a point where, you know, they've done away with their fatty coffees. I look at fatty coffees as a bridge, like if someone's really struggling, like let's say they have coffee every morning and they add a lot of heavy cream, and drinking black coffee is a challenge.

Yeah, there's all sorts of tricks to help them navigate. Or a green tea or black tea. You know, the bitter teas, those polyphenols that are providing valuable information to our bodies, but helping them understand there's ways to prolong a fast if you're really struggling, you know, adding things like MCT oil, which is usually my preferred fat, over things like butter and ghee. And, you know, people can end up sitting down with a fatty coffee that's 400 to 500 calories before they realize it. And then they're wondering why they're not hungry.

But I think that can be a bridge if someone's that sedentary standard American diet really trying to do the right thing, really struggling with maintaining their blood sugar in between meals. I think a fatty coffee in the morning might be a nice first step, but that's typically how I do it. You know, not eating after dinner, really trying to make sure that first meal of the day and when you break your fast, it could be at 8 a.m., 9 a.m., 10 a.m., 2 p.m., making sure they have enough healthy fat.

Excuse me? Nuts. How the protein to be able to help with satiety, help with blood sugar

How to Start Fasting Safely 21:00

regulation and then not to mention the protein synthesis piece, which I won't go down that rabbit hole, but helping people understand how important that first meal of the day really is. Like it may not be breaking your fast with cornflakes, the breaking your fast with eggs, or, you know, leftovers in the night before. I would say don't make it complicated. Try to find things that make it easy. Like we do a lot of food prep, and oftentimes my kids are eating leftovers from the night before for breakfast.

That's a good point. Yeah, because most breakfasts are more carbohydrate. They're all carbohydrate heavy. When you think of like the traditional breakfast, I think it's also wrapping your head around, okay, breakfast doesn't have to be a bowl of cornflakes. It can be something like your your meat or eggs or with vegetables and fiber and things like that. Yeah. And I think it's it's helpful for people to know that just because the processed food industry tries to convince us that their bag of junk or their box of crap is, you know, healthy food, it's healthy.

People understand, like compare how you feel when you sit down and eat two bowls of cereal versus having leftover steak and some broccoli. As an example. Like you could insert any protein and non-starchy vegetable there, but I would I would imagine that more people than not would feel so much better eating a protein dense breakfast and feel like they can go about their day and not have to worry about eating again, versus the people that sit down and have the cornflakes or, you know, whatever carbohydrate laden cereal they're going to have.

And then an hour or two later, they feel terrible because their blood sugar is crashed. Absolutely. I do have to add, I ask a question here because there's a lot of misconception in the what you're actually allowed to have before you fat. So I know, you know, there are people online I've heard like, okay, if it's under 50 calories, all of these things. So I wanted to just talk through some of that. Yeah, it's a common question. And so my feeling is if you are hungry, please break your fast and eat like, by no means should anyone white knuckle fasting.

That is never the mindset we should have around it. But when we're thinking about fasting, I'm a proponent of a clean fast, which means we consume bitter coffee, bitter teas, you know, green tea, black tea, plain coffee. And as I said before, a lot of people don't like the bitter profiles that the bitter polyphenols actually are providing valuable input, signaling molecules to the body. there's lots of tricks around this. So I have lots of my patients. So I like high quality salt, like Redmond's to their their coffee.

It'll change the flavor profile. You can add cinnamon. That will not break a fast. But if you're adding cream, which is insulinemic, if you are adding sugars, I mean, you're technically breaking a clean fast. And I always like people to learn how to clean fast before they launch themselves into the fasting milieu. So when I think about fasting, it's it's the clean fast, which is what I'm a proponent of. And there are influencers out there will say, oh, it's okay to have 50, you know, 50 calories from grapes. No it's not.

I mean, the worst thing you can break a fast with is carbohydrate. Like, really, if you're going to break a fast, break your fast early, eat a protein dense meal, protein and carbs or protein and fat. That's really the way that you go about it. But in a fasted state, water or hydration is super important for those bitter, polyphenol rich, you know, beverages are certainly acceptable electrolytes that are unflavored. Oftentimes, I find a lot of people will struggle with fasting, and it has a great deal to do with when they start fasting.

They oftentimes are consuming less carbohydrates. They're releasing glycogen stores that will have more mineral law. So not just potassium but also sodium, magnesium chloride. And so adding in electrolytes kind of helps kind of offset this. In fact, electrolytes are kind of one of those easy fixes.

What You Can Consume While Fasting 25:00

When people start getting headaches or cramping they don't feel good and like, okay, I think just a little bit of electrolytes can make you feel like a different person adding salt to your meals if that's appropriate for you. I'm someone that's a huge proponent of adding minerals into the diet, so when I look at it as a as a clean, fast, as are usually my recommendations, obviously I mentioned earlier the fatty coffee, if you're someone that's really struggling and like I said, the whole concept of white knuckling fasting, I'm not a fan of.

So if you need to add a teaspoon or a tablespoon of MCT oil to your coffee to give yourself a little bit of added boost between you know, when you get up in the morning until you break your fast. I think that's acceptable. But understanding what it is, you know, fat is our most calorie dense macronutrient. So nine calories per gram can go a far away. Most people aren't overdoing it with MCT oil because it has a self-limiting side effect. I do have some male friends that can have 2 or 3 tablespoons, but most women should start with a teaspoon to be safe

Where to Find Cynthia Thurlow 26:00

because you can end up with some digestive distress. Right? Well, thank you so much. This has been so helpful. Thank you so much for all the information. Can you share where everybody can find you and find more about fasting? Yeah, absolutely. Thanks for having me. As part of the summit, you can go to my website www.Cynthiathurlow.com I have a podcast called Everyday Wellness. I am active on social media, probably most active on Instagram. I have a free Facebook group called Intermittent Intermittent Fasting Lifestyle/Cynthia Thurlow That is a Facebook group that is for men and women.

It is a drama free zone and we are steadily growing on YouTube, so definitely check out the content there as well. Right? Well, I love the drama free Facebook group. Those are the only way to be right. Yeah. So yeah, so yes. Thank you so much for being with us today, Cynthia. Thanks for having me. Have a great day. Everyone You too