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Histamine, Gut Inflammation, Protein Requirements
Healthy Gut Healthy Thyroid Newsletter!
Dr. Eric Osansky
March 16, 2025
Welcome to Healthy Gut Healthy Thyroid!
This is your weekly roundup of the BEST actionable steps for those people with thyroid and autoimmune thyroid conditions who want to restore their health…by healing their gut. Whether you have hyperthyroidism or Hashimoto’s you will benefit from the content in this newsletter.
In today's issue:
Main Topic: Let's Talk About Histamine and Thyroid Health
Podcast Review: How Does the Thyroid Affect the Mitochondria?
Understand Your Tests: Testing for Gut Inflammation
Ask Dr. Eric:
✔️How much protein do I need?
✔️How harmful is mercury to the thyroid?
Let’s Talk About Histamine and Thyroid Health
In my most recent book, The Hyperthyroid Healing Diet, I dedicate an entire chapter to histamine—a chemical messenger synthesized from the amino acid histidine. Histamine plays a crucial role in inflammatory responses, allergic reactions, and stomach acid secretion, and its receptors are found in nearly all tissues throughout the body.
Stored in mast cell granules, histamine is released in response to tissue injury or immune activation. A histamine intolerance occurs when there is an imbalance between the amount of histamine released and the body’s ability to metabolize it efficiently.
Symptoms of Histamine Intolerance
Common symptoms of a histamine intolerance include:
Heart palpitations
Tachycardia (rapid heartbeat)
Headaches
Itching
Swelling
Hives
Abdominal pain
Gas, diarrhea, bloating
Hypo- or hypertension
Fatigue
Anxiety
Insomnia
Notably, some of these symptoms overlap with hyperthyroidism, particularly tachycardia, palpitations, and anxiety.
However, the key difference is that hyperthyroid symptoms tend to be persistent as long as thyroid hormone levels remain elevated, whereas histamine intolerance symptoms can fluctuate—often triggered by the consumption of high-histamine foods.
Interestingly, histamine intolerance can also contribute to hyperthyroid-like symptoms in individuals with Hashimoto’s thyroiditis. As a result, if someone with Hashimoto’s experiences hyperthyroidism, while it’s possible that they have Hashitoxicosis, a histamine intolerance is also a possibility.
What Can You Do If You Have a Histamine Intolerance?
If you suspect a histamine intolerance, several approaches can help manage symptoms and address the underlying cause:
Follow a Low-Histamine Diet. While eliminating high-histamine foods does not address the root cause, it can reduce symptoms in the short term and provide relief.
Consider Supplements. Certain supplements can help regulate histamine levels, including:
✅Quercetin – A polyphenol flavonoid with antioxidant and anti-allergic properties, quercetin has been shown to inhibit histamine production.1
✅Diamine oxidase (DAO) supplements – DAO is responsible for breaking down histamine in the gut and can be highly beneficial for individuals with low DAO activity.
Use Antihistamines. H1 antihistamines are commonly prescribed to block histamine receptors and manage allergic symptoms. H2 blockers may be more effective for individuals experiencing gastrointestinal issues such as acid reflux or hyperacidity.
Long-term reliance on antihistamines is not recommended, as the goal should be to address the root cause of histamine intolerance.
Correct Gut Dysbiosis. Since gut dysbiosis (imbalanced gut flora) can contribute to histamine intolerance, supporting gut health is essential. This is one of the main focuses of this newsletter—as improving gut function can lead to long-term relief.
Improve Methylation. Methylation is critical for histamine metabolism, so methylation dysfunction can contribute to histamine buildup. Supporting optimal methylation through proper nutrition and lifestyle choices may help to reduce histamine intolerance.
Conclusion. I explore histamine intolerance in greater detail in my podcast and my latest book, The Hyperthyroid Healing Diet. If this topic interests you, I encourage you to check out these resources.
While following a low-histamine diet can be beneficial in the short term, addressing the root cause—whether through gut health, methylation support, or targeted supplementation—is essential for long-term improvement.
5 Steps To Reverse Hyperthyroidism and Avoid Radioactive Iodine and Thyroid Surgery
If you have hyperthyroidism (i.e. Graves’ disease, toxic multinodular goiter), visiting an endocrinologist is likely to result in one of the following three recommendations:
A prescription for antithyroid medication
Radioactive iodine
Thyroid surgery
While there is a time and place for conventional medical treatment, it’s crazy that most medical doctors don’t do anything to address the underlying cause of your condition.
The good news is that you can do things to reverse hyperthyroidism, which I discuss in my free webinar entitled “5 Steps To Reverse Hyperthyroidism and Avoid Radioactive Iodine and Thyroid Surgery”.
Click Here to register for the free webinar
Here are some of the things you’ll learn by attending this free webinar:
How to avoid radioactive iodine and restore your thyroid and immune system health so you can feel great again and live a healthy life!
The 4 main categories of Graves' disease triggers, and why you shouldn't overlook "hidden" hyperthyroid triggers
How to break the "hyperthyroid cycle"
How to address thyroid eye disease and toxic multinodular goiter
Click Here to register for the free webinar
Save My Thyroid Podcast Review
I have a podcast called "Save My Thyroid", where I discuss how people with hyperthyroidism and Hashimoto's can save their thyroid and regain their health. And during each edition of this newsletter I'll briefly discuss a recent podcast episode.
In a recent Q & A podcast episode I answered the question “How does the thyroid affect the mitochondria?” Mitochondria are the energy powerhouses of our cells. They use oxygen to convert glucose to an energy-storing molecule called ATP, which plays a role in numerous functions involved in neurotransmission, muscle contraction, DNA and RNA synthesis, and more.
With thyroid hormones playing a vital role in regulating energy production within the mitochondria, the relationship between thyroid health and mitochondrial function is critical to our well-being.
In this episode I discuss the relationship between thyroid health and mitochondrial function and why balanced thyroid hormone levels are needed to maintain optimal mitochondrial function and overall health.
Understand Your Tests
Patient Test: Calprotectin (as part of a GI-MAP)
Testing for Gut Inflammation
Most comprehensive stool panels include calprotectin, a marker used to assess mucosal inflammation in the gut.
Elevated calprotectin levels indicate the presence of gut inflammation. In the case of one of my past patients (as shown in the image above), the calprotectin levels were extremely high.
While this patient initially sought treatment for Graves' disease, she was also diagnosed with ulcerative colitis, which explained the significant elevation.
Does a Normal Calprotectin Result Rule Out Gut Inflammation?
Calprotectin is commonly used to differentiate inflammatory bowel disease (IBD), such as Crohn’s disease and ulcerative colitis, from irritable bowel syndrome (IBS). However, it may also be elevated in other conditions such as infectious enteritis or colorectal cancer.2
It’s important to understand that a normal calprotectin level does not necessarily mean the absence of gut inflammation.
Even if a comprehensive stool panel shows normal calprotectin levels, this may only rule out inflammatory bowel disease, and not all potential gut-related issues.
In fact, I find that most individuals with thyroid and autoimmune thyroid conditions have normal calprotectin levels—even when they test positive for:
H. pylori
Parasites
Yeast overgrowth
Other gut imbalances
Should You Test for Calprotectin?
When I recommend a comprehensive stool panel for my patients, calprotectin is just one of many markers I evaluate. For this reason, I typically do not recommend stool testing solely to check for elevated calprotectin levels.
Additionally, many conventional labs offer fecal calprotectin testing separately. If your calprotectin is elevated on a comprehensive stool test and you want to monitor it over time, you don’t necessarily need to retake the full panel—you can instead test calprotectin levels independently through a local lab.
You'll also notice that occult blood was positive in the image above. In this case it was related to the patient's inflammatory bowel disease, but other causes can include hemorrhoids, diverticulosis, or in some cases colon cancer.
Conclusion
A high calprotectin level confirms gut inflammation and should be addressed. On the other hand, a normal calprotectin level does not guarantee a healthy gut, as other factors—such as H. pylori, parasites, and dysbiosis—may still be present.
Comprehensive stool testing can provide valuable insights, but calprotectin is just one of many markers that should be considered in a broader assessment of gut health.
Ask Dr. Eric
During every issue I'll answer a few questions that I think can benefit most people with a thyroid or autoimmune thyroid condition. If you'd like for me to consider your question for a future edition of this newsletter email your question to [email protected].
QUESTION #1: HOW MUCH PROTEIN DO I NEED?
Dr. Eric, how much protein is required each day? Some healthcare providers seem to recommend very high amounts of protein, and I'd like to get your perspective on this.
This is a common question, and I discuss it in detail in my book, The Hyperthyroid Healing Diet. Below is an overview of the key points I mention.
Recommended Daily Protein Intake
The Dietary Reference Intake (DRI) for protein is 0.8 grams per kilogram of body weight, or 0.36 grams per pound. Based on this guideline, an individual weighing 150 pounds would require approximately 54 grams of protein per day.
However, some research suggests that higher protein intake is beneficial, particularly for muscle protein synthesis and the prevention of muscle loss in aging adults. A few studies indicate that consuming more than 1.2 grams per kilogram of body weight can be beneficial.3,4
Since one kilogram is approximately 2.2 pounds, this means that a 150-pound (68 kg) individual should aim for at least 82 grams of protein daily for optimal muscle maintenance.
Protein Intake Frequency
Research also suggests that how often you consume protein matters. Instead of simply focusing on total daily intake, it may be beneficial to distribute protein consumption evenly throughout the day.
Some sources recommend consuming at least 25 to 30 grams of high-quality protein per meal, ideally spread across three meals per day.5,6,7,8
If this is accurate, many people—including myself in the past—may not have been consuming enough protein consistently throughout the day.
Additionally, some experts I have interviewed on my podcast recommend 1 gram of protein per pound of body weight. According to this recommendation, a 150-pound individual would require 150 grams of protein daily—a significantly higher intake than the DRI suggests.
My Daily Protein Recommendations
After researching this extensively for my book, I have found that a practical daily protein target for many people is around 75% of their ideal body weight (in pounds).
For example, if your ideal body weight is 120 pounds, I recommend consuming at least 90 grams of protein per day.
To make this intake manageable, it is best to divide protein consumption into two or three meals, as most individuals cannot consume 90 grams in a single serving.
A Personal Example
When I was dealing with Graves’ disease, I lost 42 pounds, and at one point, my actual weight dropped to 140 pounds. However, my ideal weight was approximately 165–170 pounds.
Following my recommendation of 75% of ideal body weight, I would have aimed to consume protein based on my ideal weight (165–170 lbs.), not my actual weight (140 lbs.).
By adjusting your protein intake and distribution, you can better support muscle health, metabolic function, and overall well-being.
QUESTION #2: HOW HARMFUL IS MERCURY TO THE THYROID?
Dr. Eric, how detrimental is mercury exposure to my thyroid and immune health?
There are several ways in which we are exposed to mercury, a heavy metal that can negatively impact thyroid health and overall well-being.
Two Main Sources of Mercury Exposure
✅Dental Amalgams – Many individuals still have mercury amalgam fillings, which continuously leach mercury into the body’s tissues.
✅Methylmercury from Fish – Certain fish, such as tuna, contain methylmercury, a bioaccumulative form of mercury.
Mercury and Thyroid Autoimmunity
Several studies have identified a link between mercury exposure and thyroid autoimmunity, as well as other autoimmune conditions.9,10
While mercury has the potential to trigger autoimmunity, the organ most affected by this heavy metal is the brain. Research suggests that mercury from dental amalgam fillings can contribute to an increased body burden of mercury in the brain.11
Additionally, methylmercury from fish has been shown to inhibit thyroid hormone synthesis, secretion, and metabolism.12 However, research indicates that selenium—particularly in the forms of selenite, selenomethionine, and selenocysteine—can aid in the elimination of methylmercury.13
Fish and Mercury: Weighing Risks vs. Benefits
As with microplastics, it is important to weigh the risks versus benefits of consuming fish.
For most individuals, eating fish two to three times per week is considered safe. However, opinions vary—some practitioners believe daily fish consumption is acceptable, while others advise greater caution due to mercury contamination.
Recommendations:
✅Avoid larger predatory fish such as swordfish, king mackerel, and tuna, which contain higher mercury levels.
✅Opt for smaller fish like salmon, sardines, and trout, which are lower in mercury and rich in omega-3 fatty acids.
✅Consider incorporating selenium-rich foods to support mercury detoxification.
Should You Remove Your Mercury Fillings?
The International Academy of Oral Medicine and Toxicology (IAOMT) has conducted extensive research on the risks associated with dental amalgam fillings. Their findings indicate that mercury vapor is released at higher rates during:
Brushing
Dental cleanings
Teeth clenching
Chewing
For optimal health, eliminating mercury exposure is ideal. However, this does not necessarily mean that removing mercury amalgams is required to achieve remission from thyroid and autoimmune thyroid conditions.
If you choose to remove your silver fillings, it is crucial to do so under the guidance of a biological or IAOMT-certified dentist, as improper removal can cause significant mercury exposure.
By taking measured steps, you can reduce mercury exposure and support long-term thyroid health.
Additional Thyroid-Related Resources
Click Here for Histamine and Thyroid Health (episode 37)
Click Here for Histamine, MCAS, and Thyroid Health (episode 149)
Click Here to access hundreds of thyroid-related articles and blog posts
Click Here to join the Graves’ disease and Hashimoto’s community
Click Here to purchase one of Dr. Eric’s thyroid-related books
Click Here to work with Dr. Eric and his team
References:
I hope you enjoyed this week’s newsletter!
Dr. Eric
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