Histamine Intolerance and SIBO with Dr. Norm Robillard

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In this episode of The Functional Medicine Radio Show, Dr. Carri’s special guest Dr. Norm Robillard explains histamine intolerance and SIBO.

Norm Robillard, Ph.D., Founder of the Digestive Health Institute is a leading gut health expert. He specializes in functional gastrointestinal disorders (e.g., heartburn, acid reflux, GERD, LPR, IBS, etc.), SIBO and dysbiosis helping his clients transition from drug and antibiotic based treatments to the Fast Tract Diet and other holistic solutions.

The Fast Tract Diet was presented at the Digestive Disease Week meeting in 2014 to give gastroenterologists another treatment option for SIBO and related conditions. His award-winning Fast Tract Diet mobile app and Fast Tract Digestion book series make it easy to try the approach.

Main Questions Asked about Histamine Intolerance and SIBO:

Can you give a general overview of SIBO?
How do you go about the process of figuring out difficult SIBO cases?
What are some of the symptoms of histamine intolerance?

Key Points made by Dr. Norm about Histamine Intolerance and SIBO:

If we have too many bacteria in the small intestine and the cut off is loosely defined as more than 100,000 bacteria per mil in the small intestine, that’s technically considered SIBO.
When you do get a pathological number of bacteria in the small intestine, they really can impact our digestion. They produce proteases that can damage the enzymes that our own body is releasing at the tips of our microvilli. They can cause a lot of inflammation and basically wreak havoc.
Potential underlying causes include motility issues. We also hear about stomach acidity, any kind of liver or pancreas problems, Celiac, Crohn’s, diabetes. Another that I focus on is just consuming more fermentable carbohydrates than your body can process.
Past surgeries, especially abdominal surgeries, can cause SIBO because you’ve got a real possibility of having some scarring or adhesions.
Histamine intolerance can be due to gut bacteria producing histamine. So when you have a bacterial overgrowth, you will be producing more histamine.
A lot of people come in thinking they have histamine intolerance but they’re complaining about the GI symptoms: gas, bloating, diarrhea or constipation, nausea, vomiting, cramps. And those as we both know from our discussions are also symptoms of IBS and SIBO. Do they have IBS and just think they have histamine intolerance, or do they have IBS and SIBO and all these bacteria are producing more histamine?
Histamine intolerance can be due to a deficiency of the enzymes needed to break down histamine, excessive histamine in the diet, or histamine producing bacteria in your gut.
One thing to look for is if you have symptoms consistent with histamine intolerance, that’s the first clue. And then the other big one a lot of people talk about is an improvement of symptoms on a histamine restricted diet.
I’ve moved ahead creating an approach that is both low FP (fermentation potential) and low histamine. At the same time, I have questions about how histamine is being measured in these foods.