Jennifer Dunlap says, "A client with a lifetime history of plaque psoriasis has dysregulated
blood sugar and apparent histamine intolerance after six months of Humira, a medication used
for autoimmune diseases such as psoriasis and rheumatoid arthritis.
While he probably had some degree of histamine intolerance prior to this medication, his
blood sugar was quite stable and he could eat infrequently.
Do you think it's more likely that the new blood sugar instability is the result of immune
changes liver damage or some other mechanism?
He's eating frequently for now, but I'd like to tell him that his liver will recover the
resilience he had before."
Well, if his blood sugar is no longer as stable and he has histamine intolerance, then that
drug probably interferes with vitamin B6 metabolism.
Let me try to take one minute to see if I can find quick information on this.
I can't.
I can't find it quickly.
My instinct is to say that the drug is affecting vitamin B6 metabolism on the basis that 80%
of the vitamin B6 in the body is used for glycogen metabolism in liver, which is the
thing that stabilizes your blood sugar between meals.
If your blood sugar is not stable between meals any longer, then yeah, it could be a
hormonal thing.
What it really probably means is that there's something wrong with the liver's ability to
store glycogen or to access the glycogen when it's stored because your blood sugar is stabilized
between meals exclusively by the liver's glycogen metabolism.
How does that relate to histamine intolerance?
They're both caused by B6 deficiency.
That's my take.
I'd measure his blood levels of pyridoxal 5’-phosphate.
Off the top my head, I believe LabCorp has a test for that.
It would be helpful to look at his excretion of xanthurenate, kynurenate, and quinolinate
in organic acids test.
The Genova ION has all three of those.
I don't think the other one is available to have all three.
But every urinary organic acids test has some of those.
I would go from there.
I mean, if you want to save money, just trial a pyridoxal 5’-phosphate, which is the active
form of B6.
Trial a supplement of that to see if it helps.
I would do that at, maybe start with 10 milligrams, but feel free to work up slowly over a few
weeks to 100 milligrams.
If a few weeks at 100 milligrams doesn't treat that and he's off the drug, then there's something
else going on and I don't know what it is.
But that would definitely be first line thinking for me.
Thank you, Jennifer, for your question.
I'm glad that was helpful.