Mold, Lyme, Gut Health, and the Mystery of Histamine Intolerance

Mark Hyman

Apr 21, 2025

Episode description

Many people struggle with mysterious symptoms like fatigue, brain fog, food sensitivities, and skin issues—only to be misdiagnosed or dismissed altogether. This conversation highlights how histamine intolerance and mast cell activation syndrome can be the hidden drivers behind a wide range of chronic conditions, and why they're often overlooked in conventional medicine. From the role of gut health, food triggers, and environmental toxins to deeper root causes like Lyme disease or mold exposure, it’s clear that personalized, Functional Medicine is key to uncovering real answers. Understanding the immune system’s role in histamine reactions—and how even “healthy” foods can be inflammatory for some—is a critical step toward healing.

In this episode, I talk with Dr. Todd LePine, Dr. Elizabeth Boham, and Dr. Mark Pimentel about what histamine intolerance is, how it can be related to gut health, and why it’s important to address it.

Dr. Todd LePine graduated from Dartmouth Medical School and is Board Certified in Internal Medicine, specializing in Integrative Functional Medicine. He is an Institute for Functional Medicine Certified Practitioner. Prior to joining The UltraWellness Center, he worked as a physician at Canyon Ranch in Lenox, MA, for 10 years. Dr. LePine’s focus at The UltraWellness Center is to help his patients achieve optimal health and vitality by restoring the natural balance to both the mind and the body. His areas of interest include optimal aging, bio-detoxification, functional gastrointestinal health, systemic inflammation, autoimmune disorders, and the neurobiology of mood and cognitive disorders. Dr. LePine enjoys skiing, kayaking, hiking, camping, and golfing in the beautiful Berkshires, and is a fitness enthusiast.

Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women’s Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine.

Dr. Mark Pimentel is a Professor of Medicine and Gastroenterology through the Geffen School of Medicine and an Associate Professor of Medicine at Cedars-Sinai. Dr. Pimentel is also the Executive Director of the Medically Associated Science and Technology (MAST) program at Cedars-Sinai, an enterprise of physicians and researchers dedicated to the study of the gut microbiome in order to develop effective diagnostic tools and therapies to improve patient care.

Dr. Pimentel has over 150 publications in many high-profile journals, and he is the author of the book, The Microbiome Connection: Your Guide to IBS, SIBO, and low fermentation eating.

This episode is brought to you by BIOptimizers.

Head

Episode description

Dr. Pimentel has over 150 publications in many high-profile journals, and he is the author of the book, The Microbiome Connection: Your Guide to IBS, SIBO, and low fermentation eating.

This episode is brought to you by BIOptimizers.

Head

Mindsip insights from this episode:

Avoid leftovers to prevent histamine sensitivity issues

As food sits, even in the refrigerator, bacteria break down the amino acid histidine into histamine, making leftovers problematic for sensitive individuals.

#bacteria

#nutrition

Space meals five hours apart for effective gut cleaning

Spacing meals at least five hours apart is critical because the gut's 'cleaning waves,' which clear out bacteria, only activate during fasting periods.

#digestion

#gut

Treat hydrogen sulfide SIBO with Rifaximin and bismuth combination

The newly identified hydrogen sulfide type of SIBO can be treated with a combination of the antibiotic Rifaximin and bismuth, the active ingredient in Pepto-Bismol.

#hydrogen

#SIBO

Reframe IBS as an autoimmune disease linked to gut nerves

A new paradigm suggests that Irritable Bowel Syndrome (IBS) is an autoimmune disease of the gut's nerves, often triggered by a past food poisoning event.

#autoimmunity

#IBS

Choose frozen fish to manage histamine intolerance

For those with histamine intolerance, fish that is frozen quickly after being caught is often a better choice than 'fresh' fish, which has had more time to accumulate histamine.

#fish

Avoid fermented foods if you have histamine intolerance

Fermented foods like sauerkraut and kimchi, while generally healthy, can act like 'gasoline on a fire' for individuals with histamine intolerance.

#deficiency

#nutrition

Perform at-home histamine test using dermatographism

You can perform a simple test for excess histamine by scratching your skin to see if a raised red line, known as dermatographism, appears.

#testing

Recognize EMFs as potential triggers for allergic responses

Emerging research suggests that electromagnetic frequencies (EMFs) from sources like WiFi and cell phones can cause mast cells to release histamine in susceptible people.

#allergy

#EMF

Identify Lyme disease as a potential trigger for histamine issues

Severe mast cell activation syndrome, a major histamine-related condition, can be triggered by an underlying and often undiagnosed Lyme disease infection.