Finally on a path to healing
in which our intrepid intolerant loses nearly all the food and a big part of her identity and regains a few ingredients, all with the health of her friendly neighborhood naturopath.
Hey friends, welcome back. To set the stage, go back and read the last one. Or just start here. I’m not fussy.
What happened next was not linear. I was still feeling unwell a lot of the time, even on my very limited diet, and was still feeling very stressed around food. It was debilitating to not be able to reliably go anywhere or make plans with anyone , or to go out and only drink agua con gas (fizzy water), and even then half the time wake up feeling unwell. I fled many a social engagement, including one time having to jump off of a bus on my way to a winery basically by the side of the highway and had to hail an Uber, who abandoned me a few miles later, all the while, breathing like I was in labor (maybe?) to try to control how ill I felt and hopefully not to actually fall apart in public. Spoiler: I made it home and stayed in bed, shivering for two days.
Prior to the mysterious ailment which I called my “stomach snafu,” I had been a mostly vegetarian (though I ate fish) yet adventurous eater, eating out a few times a week, and being quite social, squeezing in a cup of coffee or an ice cream frequently in different parts of the city with friends. I was excited to showcase Santiago’s (then) growing food scene, and together with a friend, started an Instagram about food and restaurants. We would each (or together) go to restaurants and order and photograph food and write a little bit about each dish we’d eaten. It was pretty popular, with a few thousand followers, and people would frequently contact us on or off line to ask about restaurants or ingredients that we’d tracked down. I bike and walk around the city quite a lot and am practically a pathalogical noticer (hello, hypervigilance), and love poking around small stores and neighborhoods I don’t know. Over the years, I have developed a fairly encyclopedia-like knowledge of where every Asian supermarket or minimarket in the city is, and for example, which one of them has buckwheat noodles (foreshadowing on the buckwheat, recipe/instructions for buckwheat crepes at the bottom).
The instagram and street-research was in addition to writing about food and travel for work. At the time, I wrote articles and developed content for magazines, websites, apps and a local high-end tour company, and had written a few chapters in a local guidebook. I would travel near and far, and interview chefs and winemakers, and go to winetasting events and wineries all around Chile. I was never a big drinker, but I appreciated the small producers and had become friendly with a number of them, and appreciated the touches like smoked cheese or turmeric ice cream or whatever interesting thing they thought would pair well with their beautiful wines.
In that time I also traveled outside of Chile quite a bit. In one crazy one month period I went to Surinam to meet up with a friend who was writing a guidebook for French Guiana, which we ran around together, sleeping in hammocks and watching an actual rocket take off from the launch spot there, and visiting a Lao village, drinking nam van (coconut milk and jelly dessert) and eating stewed fish and eating pho, and drinking so much very strong coffee, and snacking on French pastries. In Surinam I bought Brazil nuts from a woman about my age at the market and she showed me how to open them with my jackknife (and I only stabbed myself once), and we feasted on local vegetables including the very bitter antroewa, which I referred to in a blog post as a “very agressive vegetable” and someone in Surinam read that post and it made me briefly famous in a very specific circle of Surinamese living at home and abroad. Really, you should try it. I could taste the bitterness in my teeth. Except if you think you have histamine intolerance, in which case that would be most inadvisable.
On that trip, I had a few-day stopover in Curaçao on the way home and I walked and bussed all over, spying flamingoes and eating boiled peanuts and Surinamese roti and “Creole food,” hot, savory stews with salted codfish. I then stopped home to refresh clothes and and do more research, and then flew back north to Bogotá to review a newly-reopened 5 star hotel for a magazine, biking around the city, eating my fill of almojábanas and going to the main market on a private tour, sampling every piece of cut fruit put before me. Mangosteen, and genipe, chontaduro and tiny berries the color of the night sky. While I was there I finagled my way into a restaurant opening and wrote about that for another magazine, and I was wined and dined and I thought about moving to Bogotá as I always think of moving to a new city when I visit.
So to find myself suddenly grounded, suddenly unable to eat anything other than my four ingredients, or go anywhere farther than a quick sprint from my house, was pretty shocking. My vast world, with a radius as far as I could fly overnight, or fly, bus, boat and then bike or hike in about 24 hours shrank down to about a half hour’s slow walk from my house, ever conscious of where the closest bathroom might be, and many, many tupperwares filled with cooked rice and broccoli that I would cart around. (As an aside, because I am prone to asides, and you can’t stop me, the pandemic impeding my ability to eat at restaurants has not been that much of a shock to me personally, and in many ways I feel I’ve been in training for this, what with pretty much having to cook all of my food over the past years). But I digress.
So, sick as I was and with two people I knew and trusted encouraging me to seek additional care, I found a naturopath, who did an intake. Every serious ailment (mono, in college, did it matter?) and the age of my first period, and do I have cramps (yes, what does that mean?) and family health questions and how do I sleep and what is my digestion like and am I usually hot or usually cold and a million other questions. We had a first meeting on Skype, and then I went to see her in person. I told her about my four-ingredient diet, and that at times, even with that, I still felt sick.
More questions, and she reviewed sheaves of bloodwork results and parasite tests and abdominal scans and allergy test results and we talked about what I wanted to achieve, which was essentially, in the short term, to not feel like I was going to die most of the time, and in the longer term, get my life back, or at least get a new kind of life that made sense to me.
We talked about every time I had gotten sick in recent memory, and even some distant memories, including a year-long period where I had dermatographism which we thought at the time was brought on by chemical exposure as I was stripping furniture with solvents over one summer when I lived in DC, but maybe also related to biking among the ragweed, or maybe hanging my clothes to dry outside. I was put on Xyrtec and Zantac (h1 and h2 blockers, many people with histamine intolerance choose to go this route, I later found out). It took me a year and verrrry slow titration to finally wean myself off of the Xyrtec. But let’s get back to the naturopath.
After all the talking, she said that she suspected that I had at least histamine intolerance if not also perhaps paired with other intolerances. I cried more than is comfortable to cry with a stranger. I felt betrayed by my body and also that my identity as foodie-traveler-person had been stripped from me, to say nothing of how it was about to tank my carreer. Dating was obviously out of the question, and my social circle shrank to the people who could respect my bizarre eating habits and schedules. It was stressful and felt bleak, but also, I decided to surrender myself to her care, because clearly, I did not know what I was doing on my own, and nobody else seemed to, either.
Here is where I have to say, your personality will determine how you want to proceed. Maybe you are the kind of person that wants Western medical confirmation of what is wrong with you. I wish nothing but that for you. I hope you can find it. However, many Western doctors, especially in the Americas, are unaware of histamine intolerance, so even if testing were available, they may not think it appropriate. There is a 24-hour urine collection test to test for histamine, which may or may not indicate your histamine intolerance. This test was unavailable to me, and is not considered to be that reliable for various reasons. I also did, as mentioned in the last missive, a million and one blood allergy tests, both IGg and later, IGe. These revealed nothing interesting. Friends in Europe have gotten histamine testing, and found out they were histamine intolerant that way. If you can get the test and want it, I see no reason you shouldn’t get it. Try a doctor that claims to be a part of a functional medicine practice if you can.
Some people want that piece of paper. I get it. I want it for you, too. But for me, if the steps to take/treatment are the same regardless of the outcome of the test, then I don’t care. I particularly don’t care if I can’t get the test, as was the case with the histamine intolerance. But for example, I was in a bike accident several years ago in which I badly sprained my right big toe. I hobbled around for a long time, and finally went to a doctor, and did some scans. It was finally diagnosed as a probable fracture by avulsion in which a tiny piece of bone is pulled off by the tendon itself during a sprain. Eeew, I know. It still hurts. In the coming weeks of PT, I asked my therapist if we had any way of knowing if I had this fracture or not. The scans were unclear. And she said that no, but that it didn’t matter, because the course of PT was the same.
Why then? Why do the test if the treatment is the same no matter what it is? This is my thinking. It may not be yours. But it informed how I proceeded with the naturopath’s suspicions that I had histamine intolerance. Let’s go back to her pleasant office now, shall we?
She sent me a list of foods that are supposed to be low histamine. I say supposed to be because I am not sure where the science is on this. I have mentioned before the Alison Vickery and SIGHI lists. There is also an app, it has a strawberry on it. I have only ever used the Alison Vickery list. The lists conflict, and they may not work for you. But they are a good start. If I have one piece of advice to give today, it will be this: Pick a list and stick to it. Do not look at any other lists. You will make yourself insane if you cross reference lists. Start slowly and your body will tell you, and you will make your own list and hallelujah, it will work for you, and you will feel better and THAT is what you want.
Using the list as a reference, my naturopath suggested that I look at the list of low-histamine vegetables, and try a new one every three days, in addition to the tinctures and milk thistle and different herbal teas. The idea behind the remedies was a collection of things I do and don’t believe in. I do believe in reducing inflammation. However, the turmeric tincture made me itchy (at the time, this is a moving target, and it seems I am a new human every day, but we wondered if that meant I had an oxalate intolerance, which it turns out I do not). I am not sure where I stand on “liver support” which was the milk thistle. But it didn’t make me sick. There were also the teas, some of which are natural antihistamines. I could get behind that, too, though I wasn’t really sure what any of it meant. They seemed harmless enough. I took probiotics (but not all probiotics are created the same, some increase histamine). I took careful assessments of how I was feeling. Sleep/itchiness/whoosh (feeling of unwell), digestion, general anxiety, energy, motion sickness.
As for using my 4-ingredient diet as a starting point and then trying one food at a time, it seemed too simple to actually work. But if you think about it, and I urge you to think about it, how many ingredients is a meal made up of? Let’s say you make something like chili. You’ve got your oil, onions, garlic, tomatoes (canned and fresh, maybe), ground beef, maybe cumin, oregano, paprika, cayenne (I don’t really know what goes in chili, but do you see what I’m saying here), then maybe a couple of kinds of beans. Chili is delicious and you serve it with some tortilla chips, or some corn bread (corn meal, milk, flour, sugar, salt, baking powder, possibly corn, maybe buttermilk and baking soda) and then top it with some sour cream and a little bit of cheese. Plus you’re thirsty, so you have maybe some water, or maybe a soda (egads, the ingredients), or a beer. Please don’t also have dessert, I’m running out of space (I am not running out of space, the internet is unlimited). But you get my point. Foods can be incredibly complex, with a gazillion ingredients. And that’s the food you make at home, from scratch. Add mixes or prepared foods or take out and I will type my fingers to the bone just thinking about how many ingredients are in there.
So basically, what the naturopath was saying was, you know those four ingredients? what if you eat a fifth? Don’t go get a ham sandwich (ha, see: I don’t eat meat), try adding some thyme to your rice. Vet every ingredient before you decide if it’s a keeper for you.
And keep a food diary. Which is, as we say in Chile, latero, a pain in the ass. But the problem with histamines, and I will say this until I am blue in the face, is that they have a long degradation cycle. They build up in your system, and can make you sick for up to 72 hours. So it’s a 72-hour moving average where you (I) have to keep the histamines down. This phenomenon is often referred to as the “histamine bucket.” And the fun part is, it’s not just food that can fill it. There is also stress, environmental factors, lack of sleep, estrogen (more on this soon, but if you are a uterus-haver, you have probably noticed a difference in your digestion depending on the stage of your cycle. This is probably not unrelated), allergens, and maybe even noise pollution and electromagnetic exposure (maybe?). But you cannot control for all of these things. What you can control for is your food.
So I added one food every three days, or sometimes once a week, if I was too scared, or had a reaction and needed to kind of reset. My reset meal was (surprise), the four ingredient special. I added sweet potatoes, then asparagus. I tried sunflower seeds and had a reaction. Take two steps back. I ate sugar snap peas. I added cucumber. This took a month and change, maybe six weeks, maybe two months. I went through every vegetable I could reasonably get in Chile on the low-histamine list. I remembered the buckwheat crepes that I had eaten in French Guiana. Buckwheat is generally non-reactive, and high in quercetin. I made them, and tentatively ate them, and they stuck. I was back in business, on the bread-like friend.
And the color started to come back to my skin, and I started to wander farther from home. I tried a single almond one day, and three days later, I tried two. I found I could eat green apples, and then I had a portable snack, and I could wander farther from home. I was still difficult to feed, always hungry and not feeling exactly right, and still occasionally getting sick for reasons I could not quite identify, but seven months after first becoming so very unwell, I was at least partially well.
It was a fantabulous start.
As mentioned above, buckwheat flour is high in quercetin and genenerally non-reactive. I grew up eating kasha, so it’s a familiar flavor but might be a little wholefoodsy for your average person, not sure. If you can also tolerate eggs, you can make these (photo above)
1/2 cup buckwheat flour
1 egg
enough water to make a runny batter, about the consistency of melted ice cream
Combine, whisk. Pour a thin layer into a heated, greased pan (I do not use nonstick cookwear, but maybe you do, your mileage may vary). Tip pan to coat. When bubbles are visible throughout the surface and the edges start to curl up use an offset spatula to slip under it and flip it to cook the other side briefly.
Excellent in place of pancakes, to wrap sweet or savory food. Travels reasonably well. Gluten free. One of my miracle foods.
It’s been great hearing from you on Intstagram and FB, but if you want to talk to other intolerants (ha!) or interested humans, or ask any questions, this is your place. Also, health and science writer, I see you. Welcome aboard. Welcome all of you, really.