While histamine intolerance is starting to be recognized within the realm of natural, naturopathic, and functional medicine, most mainstream medical doctors have never heard of it. Your local MD may not take you seriously and question whether such a condition exists, so it’s worth checking in with reputable functional medicine doctors – like mine – Dr. Stephen Meeneghan, head of functional medicine at Cedars Sinai.
So, how do you defend your case? Here are a few tips for making your doctor listen to you.
PRINT MEDICAL STUDIES
It’s difficult to argue with clear evidence in front of you in peer-reviewed medical journals. Print studies that have clear titles and are to the point. For example, print the PDF of this one, entitled “Histamine and histamine intolerance” and published in the American Journal of Clinical Nutrition or this review article, “Histamine intolerance in clinical practice,” originally published in a German medical journal (in German).
For mast cell activation, you could print this one, published in the Journal of Allergy and Clinical Immunology: “Mast cell activation syndrome: proposed diagnostic criteria.” Or there’s this one from Journal of Hematology & Oncology: “Mast cell activation disease: a concise practical guide for diagnostic workup and therapeutic options.”
Maybe even highlight or circle some key points that seem to relate to your signs and symptoms. Doctors don’t have a lot of time to read, so pointing out some of the main concepts may make them more likely to pay attention.
BRING PHOTOGRAPHIC EVIDENCE
Now that so many people have smartphones this is pretty easy, but you can obviously use a regular camera. When visible symptoms flare up (rashes, extreme beach ball bloating, looking like a lobster), snap a quick photo, or have a family member or friend do it for you. Bring this along as evidence of symptoms to show your doctor. After all, he or she may think you’re exaggerating when you say you look 7 months pregnant after certain foods or stressors. A picture is worth a thousand words.
Additionally, if you can bring a food diary or symptoms diary to go along with your photographic evidence (indicating possible triggers of your signs & symptoms), all the better.
INCLUDE OUTSIDE TEST RESULTS
If you’re consulting with another practitioner and have gotten other testing done (food sensitivity screening, genetic testing, etc), bring along the test results to share with your doctor. A genetic test can show susceptibilities to histamine issues, and food sensitivity (or allergy) testing can show that you are definitely reacting to foods more than you should. These outside tests along with the scientific studies can help reinforce your case that something is going on.
Plan ahead. Know what you’re going to say, and in which order you’re going to introduce your studies, evidence, and other tests. And please read the studies you’re bringing. This is really important. You may even want to practice with a friend or family member and have them pose some potential questions or objections from your doctor. If you seem to have things together, well researched and organized, and you are confident in what you’re saying, you’re going to have a lot better impact.
You may even want to prepare your body. Before your appointment, make sure your body is in a balanced state and not in stress mode. Try some yoga, meditation, calming music, or herbal tea (chamomile or lavender are great). Getting your body and brain in a balanced state will help you to think more clearly, express yourself more effectively, and react with better judgment.
KEEP CALM AND CARRY ON
Remember to remain calm. It doesn’t help anything to show anger or frustration. Getting emotional as you’re trying to convince your doctor to do some further investigations into histamine is just going to reinforce any thinking that “it’s all in your head.” So stay calm and patient, but stand your ground. You’re always going to have to be your own advocate when it comes to your health but there are more and more tools out there to help you do so.
WANT TO START BEFORE THE APPOINTMENT?
You don’t have to wait until you get your doctor on board before you start eating a healing diet. Here’s a complete reset with recipes and lifestyle strategies to balance histamine levels and get your body on the path to healing, I highly recommend my comprehensive 28-Day Histamine Reset.
Akin, C., Valent, P., & Metcalfe, D. D. (2010). Mast Cell Activation Syndrome: Proposed Diagnostic Criteria: Towards a global classification for mast cell disorders. The Journal of Allergy and Clinical Immunology, 126(6), 1099–104.e4. http://doi.org/10.1016/j.jaci.2010.08.035
Maintz, L. & Novak, N. (2007). Histamine and histamine intolerance, The American Journal of Clinical Nutrition, 85(5), 1185–1196, https://doi.org/10.1093/ajcn/85.5.1185
Maintz, L. Bieber, T., & Novak, N. (2006). Histamine intolerance in clinical practice. Deutsches Ärzteblatt, 103(51-52), A3477-3883. Retrieved from: https://www.aerzteblatt.de/pdf/103/51/a3477e.pdf
Molderings, G. J., Brettner, S., Homann, J., & Afrin, L. B. (2011). Mast cell activation disease: a concise practical guide for diagnostic workup and therapeutic options. Journal of Hematology & Oncology, 4, 10. http://doi.org/10.1186/1756-8722-4-10