SIBO, Histamine Intolerance, POTS, and Dysautonomias: The Gut Connection

If you are one of the 70 million people worldwide with postural orthostatic tachycardia syndrome (POTS), chances are, you are always on the lookout for new solutions to improve your symptoms. I am happy to share that new research has found a connection between your gut health, histamine intolerance, and dysautonomias, including POTS. Dysautonomia or autonomic dysfunction is a condition in which the autonomic nervous system (ANS) does not work properly. This may affect the functioning of the heart, bladder, intestines, sweat glands, pupils, and blood vessels. This means that improving your gut health may also improve your POTS symptoms and increase your overall well-being.

In this article, you will learn how dysautonomias and your gut are connected. You will understand what POTS is and its connection to small intestinal bacterial overgrowth (SIBO) and histamine intolerance. Finally, I will offer some natural solutions for histamine intolerance, SIBO, and POTS to help you regain your health and happiness. 

Dysautonomia and Your Gut

Dysautonomia is an umbrella term used for various medical conditions that are related to your autonomic nervous system (ANS). Your ANS is responsible for your body’s automatic functions. These functions include your breathing, heart rate, blood pressure, digestion, dilation, temperature regulation, and anything else that you don’t have to consciously think about. 

You may wonder how your ANS is related to your gut. Your gut is part of your enteric nervous system (ENS). It is also called your second brain because it affects your entire body, including your immune system, digestion, metabolism, nutrition, physiology, brain, and mental health. Gut bacteria balance is critical for healthy gut function and overall health (1).

Your gut is in constant communication with your central nervous system (CNS) through the vagus nerve and ANS. This phone line between your gut and your CNS is a two-way system. This means that your gut affects your nervous system, while your nervous system influences your gut health. The two are connected and mutually affect each other (2).

Understanding the connection between your gut and your nervous system, you can understand how an unhealthy gut may contribute to neurodegenerative disorders and brain health issues. Different parts of your nervous system are connected through nerves as well. If your enteric nervous system inside your gut experiences imbalance, it affects your autonomic nervous system as well and can lead to chaos all over your body (3).

What Is POTS?

Postural orthostatic tachycardia syndrome (POTS) is a common autoimmune disease that affects 70 million worldwide.

Symptoms of POTS include:

• Increased heart rate (30 beats/minute resting heart rates, increase to 120 or over when standing)
• Fainting
• Dizziness
• Fatigue
• Weakness
• Shaking
• Sweating
• Bloating, cramping, diarrhea, and other gastrointestinal issues
• Sleep difficulties
• Shortness of breath

Causes of POTS

The exact cause of dysautonomias is not yet completely understood. While in some cases, they may be inherited, in other cases, they may be the result of a degenerative disease, prolonged inflammatory reactions, injury, or another disease. A recent case report has linked gut health to dysautonomia. The patient with POTS experienced a near full reduction of symptoms after successful treatment for small intestinal bacterial overgrowth (SIBO) (4, 5).

Does this mean that SIBO is connected to dysautonomias and POTS? As you already know, your gut health is strongly connected to your autonomic nervous system. It is only logical to think that SIBO or other gut imbalances can, in fact, contribute to dysautonomia. By treating the gut, you may be able to reduce or eliminate your symptoms of POTS or other types of dysautonomia as well (6).

The SIBO and Dysautonomia Connection

SIBO is an overgrowth of bacteria in your small intestine. Research has connected SIBO to various autoimmune and neurological disorders, including Parkinson’s disease, Alzheimer’s, and fibromyalgia. Stress on your immune system can also lead to an increase of norepinephrine from your sympathetic nervous system resulting in a flight-or-fight reaction. However, your gut microbiome balance is also closely connected to your nervous system. Gut bacteria imbalance is stress on the body and can result in the release of norepinephrine. As a result, SIBO can lead to your dysautonomia symptoms (7, 8, 9).

It is important to note that, one study has found that 27 out of 35 patients with POTS also had SIBO. This is 69% of POTS patients with SIBO. Connecting the dots between these research findings, it is critical that POTS patients get tested for SIBO and receive treatment for it if they have it (10).

Histamine Intolerance and POTS

POTS is a complex health issue, so it is important to cover everything and treat the root cause of your problems. This is why we have to look at histamine intolerance and mast cell activation syndrome (MCAS), especially because research has found a connection between MCAS and POTS due to the prolonged inflammatory reactions caused by MCAS (11). 

Histamine is a chemical that is responsible for a variety of functions in your body, including getting rid of allergens as part of your immune response, communicating with your brain, and triggering stomach acid release for optimal digestion. Normally, histamine release is beneficial and your body releases enzymes to break down histamine build-up. However, if you have MCAS, your body cannot turn off the release of histamine leading to histamine intolerance (12, 13). 

Histamine intolerance means that you have too much histamine which can lead to various health issues. Symptoms of histamine intolerance include fatigue, headaches, irregular heartbeat, acid reflux, digestive problems, cramps, itching, sleep troubles, and anxiety. You may notice that some of these symptoms are very similar to symptoms of dysautonomias and POTS, while others correspond with the symptoms of SIBO. This is not surprising, considering your entire body is connected.

SIBO can often lead to leaky gut syndrome, which can also result in histamine intolerance and food intolerances. As you can see, SIBO, histamine intolerance, and POTS or dysautonomias can become a vicious cycle, unless you address the root cause of your issues.

Natural Solutions for Histamine Intolerance, SIBO, and POTS

If you suspect that you have histamine intolerance or SIBO and it’s contributing to your POTS symptoms I have some simple natural solutions for you. This is what I recommend to my patients with histamine intolerance and SIBO:

Follow an Anti-Inflammatory and Low-Histamine Diet

Following an anti-inflammatory, antioxidant-rich, and nutrient-dense diet is important for your health. Reducing inflammation itself may help to reduce your symptoms. Reducing histamine may help to decrease histamine-related symptoms.

Remove inflammatory foods, including refined sugar, refined oils, canned and processed meat, artificial ingredients, junk food, and highly processed foods. Avoid high-histamine foods, such as fermented food (e.g., sauerkraut, kimchi, fermented vegetables, kombucha, etc.), aged food (e.g., aged cheese, processed meat, canned fish, etc.), over-ripe fruits and vegetables, leftovers, and foods that are naturally high in histamine (e.g., avocadoes, eggplant, spinach, dried fruits, etc.). Avoid foods that may trigger histamine releases, such as tomatoes, most citrus, bananas, most nuts, and dairy. Avoid foods that may block the DAO enzyme, including black tea, green tea, alcohol, and energy drinks. 

Eat a nutrient-dense, anti-inflammatory, and low-histamine diet rich in greens, vegetables, herbs, spices, fruits, healthy fats, and organic meat. Low-histamine foods include most fresh leafy greens and vegetables, non-citrus fruits, such as apples, pear, papaya, and grapes, fresh grass-fed meat, pasture-raised poultry and eggs, and wild-caught fish, olives, extra-virgin olive oil, ghee, coconut oil, leafy herbs, and herbal tea. My book, The 4-Phase Histamine Reset Plan includes an extensive list of foods that you can eat and should avoid on a low-histamine diet.

If you are new to a low-histamine diet, remember to have fun experimenting with new foods and recipes. I promise low-histamine meals can be delicious. I recommend all the low-histamine recipes in The 4-Phase Histamine Reset Plan and my new recipe book, Fifty One Low Histamine Air Fryer Recipes. They are all simple, easy to make, low-histamine, gluten-free, Paleo-friendly, and super healthy. Not to mention how delicious they are — your family will love them too.

Support Your Gut

Your gut health affects your entire body. Gut flora imbalance can trigger both histamine intolerance and related symptoms. Supporting your gut health is critical for your recovery. Along with a gut-friendly, low-histamine, anti-inflammatory diet, I recommend that you take a high-quality probiotics supplement, to support your gut microbiome balance. 

Try Some Supplements

I recommend HistoRelief. It is a synergistic blend of nutrients that provides natural support to balance your immune response. This blend features Tinofend®, a patented and clinically researched extract derived from the plant Tinospora cordifolia, which has a powerful ability to support immune regulation and immune response. As a result, it boosts your body’s ability to fight interstitial cystitis symptoms. It includes quercetin, nettle leaf, vitamin C, and bicarbonate salt to help inhibit histamine release, support normal histamine metabolism, and improve immune health.

If you are dealing with both histamine intolerance and gut health issues, I recommend working with a functional medicine practitioner (like me) to test your gut and see if opportunistic bacteria, yeast overgrowth, parasites, H. pylori and/or leaky gut can be what is driving your histamine issue. 

Reduce Your Histamine Bucket

If you are dealing with symptoms of histamine intolerance, reducing high-histamine foods is not enough. High stress, poor sleep, not moving your body, and high toxin exposure may add to your histamine load. Improving these areas of your lifestyle may help to reduce your histamine bucket and lower the risk of histamine-related issues.

Reduce your stress levels:

• I recommend practicing breathwork, meditation, positive affirmation, journaling, yoga, grounding, and time in nature for stress and anxiety reduction. 
• Taking an Epsom salt bath is another great way to relax your muscles, calm your mind, and detoxify your body. 

Improve your sleep:

• Your goal should be to sleep at least 7 to 9 hours a night. 
• Lower your stress levels throughout the day but especially in the evening time to support sleep. Take a bath, read a good book, listen to some music, journal, try coloring, and spend time with your family. Avoid sugar, alcohol, and heavy food in the evening. 
• Sleep on a supportive mattress with comfortable and supportive pillows and blankets, and quality, organic cotton sheets.

Move your body:

• Move your body throughout the day and stretch regularly.
• Exercise at least 20 to 30 minutes five days a week and move your body regularly. I recommend getting 10 to 15K steps in a day if you can. Add resistance and strength training to your routine. 

Reduce your exposure to environmental toxins:

• Choose purified water over tap water. Use a high-quality air filtration system for better indoor air.
• Choose natural, organic, and homemade cleaning, personal hygiene, and beauty products instead of conventional brands loaded with chemicals. 
• Choose glass, bamboo, wood, organic cotton, silicon, and other natural alternatives instead of plastic. 
• Avoid BPA plastic completely. 
• Choose organic food whenever possible and avoid overly processed packaged foods. If you must buy non-organic produce, follow the Dirty Dozen, Clean 15 list, and always wash and peel non-organic vegetables and fruits.

Final Thoughts

Your gut health is connected to your entire health. It is not surprising that new research has found an interesting connection between your gut and dysautonomias. To improve your overall gut health, repair SIBO, and histamine intolerance, and improve your POTS symptoms, I recommend that you follow the natural solutions I outlined in this article. 

If you are dealing with symptoms of histamine intolerance and interstitial cystitis, I invite you to schedule a consultation with us. We can help identify the root cause of your condition and recommend a personalized treatment plan to repair your body and regain your health and well-being. Schedule your consultation here. I also recommend that you check out my Histamine Online Program.

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