Dr. Robert Pastore, PhD, CNS

Food Allergies

#072 - On Hormones & Allergies

Dr. Pastore continues on the topic of food allergies, this time covering the connection between food reactions and hormones, specifically the estrogen group. He discusses hormone replacement therapy, birth control, acid blockers and how each can intensify reactions and symptoms.

2020-07-3112 min read

The Pastore Podcast


Previous allergy episodes:

The functions of hormones [1:00]

  • Beyond sex chariteratisics
  • “Estrogen” generalized with women
    • Different types of estrogen - 4 main types
    • Estrone (E1)
    • Estradiol (E2)
    • Estriol (E3)
    • Estrone sulfate (E1S)
    • Running an “estrogen total” blood test is not as thorough as running all 4 types of estrogen

  • Hormones responsible for how we use, burn & store fat & energy sources
  • Hormone imbalances can lead to poor regulation of how mitochondrion will function
    • Glycolysis & electron transport chain
    • Disrupts cellular energy
    • Can cause negative relationship with some foods

  • Women & men diagnosed with imbalance or high estrogen
    • Men - should be testosterone dominant, high estrogen can increase risk of type 2 diabetes, more sensitive to processed/high sugar foods
      • Increased glucose/blood sugar/insulin response

  • Hormones play a role in tissue healing, recovery
  • Play a massive role in immunology
  • Smooth muscle relaxation inside arteries
  • Risk factor for cardiovascular disease
  • Age related mental decline
  • Bone health
  • Many types of hormones

Connection between hormones and negative food reactions [4:10]

  • Estrogen receptors widely distributed throughout immune system cells
  • Estrogens (4 types) can promote the release of histamine
    • Histamine is the chemical responsible for many allergy symptoms
    • Watery eyes, sinus congestions, coughing

  • Women who have high levels or imbalance of estrogen (more estrogens than progesterone) are more susceptible to…
    • Food allergies
    • Asthma-type allergies to environment & food
    • Pollen-based allergies

  • Food allergies themselves can generate hormone imbalances
    • Eating foods you react to can stimulate a negative hormone dominance or imbalance
    • Caused by food allergy creating pro-inflammatory response
    • Hormones “come to the rescue” when we’re faced with inflammation
    • Hormones promote building block of cell membranes
      • Cholesterol increases, will up-regulate hormone production so cholesterol & hormones can orchestrate growing & repairing of cells & tissues

  • Diagnosed with high estrogen & high cholesterol could mean you’re eating a food you’re reacting to [6:35]
    • Food reactions are the first thing that come to mind when Dr. Pastore sees a patient with a hormone imbalance
      • Low estrogens, elevated progesterone
    • The 4 types of estrogens all have different behavioural functions
      • Estrone
      • Estradiol
      • Estriol
      • Estrone sulfate does nothing but take up a receptor site, can block a good-hormone from doing something if estrone sulphate is too high
        • Causes pro-inflammatory response
    • Never had food allergies in the past, hormones changed (menopause, pregnancy, menstrual cycle changes), now have food allergies
    • Dr. Pastore’s biggest role in patients with hormone imbalance, finding secondary food reactions that are making the imbalance worse

New hormone imbalance & new food reactions can appear at the same time [8:10]

  • Can have both at the same time
  • Estrogens cause inflammatory cells (mast cells) to react more sensitively to allergens
  • Higher amount of total estrogens in serum + allergy-prone individual (family history of food allergies, suspected food reaction)
    • Having excess estrogens can make you hyper-react to the allergen
    • React to a smaller quantity of the allergen
    • Need less for a reaction, more of the allergen creates more severe reaction
  • +1 test result on immunoglobulin IgG rast reactions
    • Mild IgE to a food gets brushed off quite quickly
    • Estrogens are likely out of whack, progesterone low
      • + synthetic birth control, dominant in estrogen (burden on liver)
      • + drinking excess alcohol

Drinking excess alcohol contributes to hormone imbalances [10:10]

  • National Cancer Institute defines excess alcohol as more than 1 glass of wine per day for women
  • Causes delay in body metabolizing/utilizing estrogen
  • Alcohol uses same pathway as estrogen, prolongs the circulating estrogen metabolites, delays the metabolism of estrogen
    • Microsomal ethanol oxidizing system (MEOS) is an alternate pathway of ethanol metabolism
    • System will focus on alcohol/ethanol first even though it’s a direct pathway of estrogen metabolism
  • Can make a “+1” food reaction a “+3”
  • Favors processing alcohol before anything else
    • Clogs system down
    • Allows estrogens to circulate in system longer
  • Heavy male alcohol consumers can develop female sex charateristics (breast tissue, thick/full head of hair) becuase of higher circulating estradiol & lower testosterone
  • Alcohol-related elevated estrogens will cause a hyper-sensitivity to your environment
    • Family history of allergies, personal allergies/food reactions - at risk

Is it just food allergies, or can it be food intolerances and sensitivities too? [13:50]

  • Can be both
  • Not just immunoglobulin memory-type immune response
  • Immune system receptors for estrogen
    • Can create histamine response
    • But also can exacerbate clinical intolerances
  • Lactose intolerance - lacks the lactase enzyme to digest lactose
    • Elevated levels of estrogen magnifies steps of true lactose intolerance
    • If someone is estrogen dominant or has a hormone imbalance favoring estrogen, there is an increase in the amount of methane & hydrogen produced in the large intestine from the inability to process lactose
    • Hormones can negatively interfere with microbiota (gut bacteria balance)
      • Good bacteria helps process these sugars
      • Increased flatulence & abdominal pain
  • Premenstrual syndrome (PMS) women with lactose intolerance had a higher level of the osmotic effect of lactose intolerance
    • Osmotic effect = flushing of water within the large intestine
    • Adding water in large intestine, should be removing
    • Chloride ion channels widen & open
    • Wherever chloride goes, water goes
    • Diarrhea - uncomfortable, washes out minerals, can feel very sick

  • PMS women with elevated spikes of estrogen showed evidence of suppressed (lower) tryptophan metabolism due to the lactose intake
    • Can cause negative mood changes, depression
    • Tryptophan is a precursor to serotonin
    • Bulk of brain chemistry made in gut
    • Suppressed tryptophan = feel lousy for 2-7 days after consumption

  • Avoid chocolate & ice cream during period cravings if you’re lactose intolerant, will make symptoms worse
    • Don’t consume something that will exasborate your symptoms

Hormones & immunity - how do hormones contribute to new food allergies? [18:40]

  • Dr. Pastore living in “toxic” New York City high in pollutants
  • Boys had higher risk of developing asthma due to pollutants & allergies up to the age of 10
  • Girls - estrogen increased during puberty - become more vulnerable to asthma and allergies after
  • Up to the age of 15, boys more affected by general conditions (asthma until 10, 15 for food allergies, then reaction gets less severe)
  • After 15, girls would be more affected by general conditions
  • Clinical literature shows prevalence of food intolerances at the onset of puberty is 60% women, 40% men
    • More prone to having an allergic reaction
  • Another study showed women aged 13-21 more affected by food complaints
    • 24% women, 14% men
  • 10% increased risk for women

Path of physiology [20:50]

  • Direct affect of sex hormones on allergic diseases
  • Estrogens are a natural enhancer of humoral immunity / antibody production
  • Immune system stimulates b-cells to make antibodies when exposed to antigen (food threat/allergen)
  • Estrogen enhances the b-cell antibody stimulation
    • Mild reaction to food/environmental containment may become severe
  • Estrogen receptors are found on lymphocytes, monocytes, mast cells & immune system cells
    • Can drive the stimulation of immune-system memory
    • Constant exposure to a food/pollen you negatively react to can form a food allergy
    • Reaction & symptoms can get worse over time

Birth control pill/hormone replacement therapy & allergies [24:10]

  • Fluctuation & intensity of allergic diseases (asthma, eczema, food allergies) is linked to the intake of oral contraceptives and hormone replacement therapy, in addition to menstrual cycle changes
  • Food-based reactions + hormone imbalance + synthetic hormones
    • “But your period seems fine” despite suffering with IBS, or adult-onset-asthma
  • Food allergies should be considered before starting prescribed birth control pill or hormone replacement therapy
    • Measure estrogens before starting to get an understanding
    • Find the right form of hormones for them
  • Progesterone & testosterone dampen (lessen) the immune system response
    • Can suppress histamine
  • Ideally remove all immunological food reactions & re-test hormones before starting synthetic hormones
  • Adipose sites (fat tissue) have their own closed endocrine system
    • Adipose sites (fat) changes balance of hormones
    • Morbidly obese people have a change in circulating hormones
      • Can cause facial hair
    • As weight normalizes, hormones will start to normalize too
  • Calcium d-glucarate & cruciferous brassica genius vegetables (cooked broccoli, cauliflower, brussel sprouts, kale, asparagus) will provide indole-3-carbinol
    • Hydrochloric acid converts that to diindolylmethane
    • Removes negative estrogens & lowers allergy burden

The reaction to histamine can be most intensive on days 12–16 of the cycle [31:45]

  • Have a conversation with your doctor about this
  • Important for food reaction testing
    • When in their cycle did you test them
    • What was their reaction
    • When re-testing, should be tested at same time in cycle with similar estrogen levels

Elevated levels of artificial hormones - body stops producing the hormone you’re synthetically giving it [33:50]

  • Men & testosterone replacement - body lowers testosterone output from testes
    • DHEA sulfate or DHEA can cause breast tissue or food reactions
    • DHEA can convert into estradiol (estrogen) & testosterone
      • Which it converts to depends on the individual’s enzyme system & ability to convert hormones

  • Serum diamine oxidase (DAO) [36:40]
    • Extremely important in women with a potential estrogen imbalance
    • Tell your physician: “I am aware that serum diamine oxidase causes histamine release if my levels are too low. And I am aware that that is the enzyme that metabolizes histamine, particularly in the presence of a negative estrogen imbalance. Can you please measure my serum levels?”
    • DOA & allergenicity are connected
      • Histamine intolerance
      • Then track down what’s causing the histamine response
    • Low DOA is bad - want enzyme to be high in blood to show capability to break down histamine

  • Medical statistical fact that allergies & autoimmune diseases are more common in women
    • Due to hormone & estrogen levels in women compared to men
    • Regulate womens’ hormones & get estrogen levels to healthy range, can turn off immunological switches

What other medication can make allergies worse, or spark the immune system to develop new allergies? [42:00]

  • Non-hormone related
  • Prescribed for reflux, GERD, heartburn
  • Over the counter or prescription acid blockers
    • Proton pump inhibitors
    • Stomach acid suppressor
  • Drugs that suppress the normal quantity/production of hydrochloric acids & gastric juices for optimal digestion
  • Men & women who take gastric/acid suppressing drugs suppress efficient protein digestion
    • Allows protein to be larger molecules
    • Any history of food allergy or hormone imbalance can worsen immune response
  • Acid blockers are not benign
    • If you do need to go on them, should be medically warranted with smart medicine
  • Put you at risk for upper respiratory tract infection
  • Increase risk of mineral deficiency like calcium & magnesium
    • Osteopenia (thinning of bones)
  • Important to find and correct root-cause of acid reflux (food reaction) & get off drug as soon as possible

List to bring to your doctor regarding hormones & food allergies [47:45]

  • Write down a list before going to a physician
  • What you’re experiencing & why
  • Record family history
  • Record experience with certain foods
  • Menstrual regularity

  • As a women, ask for hormone evaluation
    • Total Estrogen
    • Estrone (E1)
    • Estradiol (E2)
    • Estriol (E3)
    • Estrone sulfate (ES1)
    • Progesterone
    • Testosterone
    • Precursors, depending on the case
      • Dehydroepiandrosterone
      • Androstenedione
      • Pregnenolone
    • Sex homrone binding globulin
      • Ties up certain hormones & makes them useless
      • High testosterone, but binding is insufficient so can’t use testosterone
    • Serum diamine oxidase (DAO)
      • Normal, or will show irregular histamine
        • Follow up with skin-prick test and/or IGE immunoglobulin rast assay of suspected foods & top 9 allergens

  • If having abnormal menstrual cycle - check estrogens & DAO

  • Use our podcast as a resource to educate your physician

Can you be allergic to hormones? [52:40]

  • Yes, you can
  • Can be undone
  • University of Texas research showed
    • Estrogen & progesterone can combine with food proteins you negatively react to
    • Hormone component is locked into moleculary
    • Body starts reacting to hormones

  • For example - a negative-estrogen-dominance syndrome induced allergen….
    • You’re allergic to wheat
    • Estrogen upregulates as a response to wheat consumption
    • IgE stimulation - antibody attaches to the protein component of wheat fragment (antigen/threat)
    • You now have an antibody-antigen complex
    • Estrogen gets stuck in the middle
    • Immune system recognizes hormone as temporary allergen
    • Key is to identify what is stimulating the estrogen response
    • Absence makes the immune system grow fonder

Wrap Up [58:45]


Food Allergy Podcast


On Pollen Food Allergy Syndrome


Speak to your doctor regarding:

  • Serum diamine oxidase (DAO) [36:40]
    • Extremely important in women with a potential estrogen imbalance
    • Tell your physician: “I am aware that serum diamine oxidase causes histamine release if my levels are too low. And I am aware that that is the enzyme that metabolize histamine, particularly in the presence of a negative estrogen imbalance. Can you please measure my serum levels?”

If the DOA does flag something isn’t right, Food Allergy Tests (not for sensitivities or intolerances)

  • A skin prick test
    • Stimulates to see if there is a histamine response

  • A total IgE
    • To ensure you have enough IgE to test for
    • If your body is not producing enough IgE, can lead to false negatives
    • Total IgE = how much IgE you produce at any given time, you should be producing some
    • Cutoff is 187, if less than 5 means you may be IgE deficient

  • IgE food allergy blood test against specific foods
    • IgE panel should be aggressive as possible, as many foods & environmental allergens as possible
    • Definitely run for the top 9 & any other suspected foods

  • If something was flagged, practice an elimination diet for at least two weeks
    • Then, if symptoms are not as severe as anaphylaxis, in the presence of your physician attempt an oral food challenging
      • Eating the suspected allergen to see if it causes a direct response
    • NOT appropriate for everyone, but is definitely helpful in revealing cause and effect