Why Are We Sick?
Introduction and Disclaimer
The article that follows is the result of my research to help some family and friends who are suffering from food allergies, MCAS, POTS, and other maladies.
The genesis of my thinking in this area was being raised by a Mother who grew a garden, cooked incredibly well, was a first adopter of vitamins for kids in the 1960's and preached healthy eating. The accelerant was my beloved wife, who has been devastated by GI cancer surgeries and indefatigably bounces back from seemingly endless setbacks.
Her surgical and medical team at the MD Anderson Cancer Center in Houston is the best in the world and I am eternally grateful to that organization (and the rich guy who generously gave his money to start it). But an event in 2017 where she was in that great hospital for 18 days and the department chairs of gastroenterology and infectious disease were stumped changed my course. Through all the noise of data, medications and pain, I saw a faint signal that contradicted their formal tests. I postulated a solution, was rejected, but eventually convinced her surgeon to give it a try. She went home 2 days later, pain free.
I do not imagine that I am smarter than those doctors. What I am is someone who can see things from a different angle and who processes data and systems thinking differently than an MD. Sometimes, this different way is decisive when used as feedstock to these trained medical professionals.
It is crucial to understand that I am NOT a doctor and frankly I don't have the mind to be an MD. Med school and residency require a different kind of smart than the one I have and I respect all who climb that mountain.
These are my thoughts about the mechanisms and a path to work through food allergies, MCAS, dysbiosis, dysautonomia and achieve eubiosis and health. I urge you to take my thinking, test it with your own research and put it before your physician.
Dysbiosis
It is becoming increasingly clear that gut dysbiosis (where the gut microbiome is not harmonious, which is called eubiosis) is a likely root cause of an astounding array of medical issues. A partial list of diseases and syndromes where peer reviewed scientific papers have shown that dysbiosis is at least partly causal:
Crohn’s disease and ulcerative colitis
Obesity and Type 2 Diabetes/Metabolic Syndrome
Irritable Bowel Syndrome
Parkinson’s Disease
Autism Spectrum Disorder
Multiple Sclerosis
Non-celiac gluten sensitivity / progressive food intolerances
Mast Cell Activation Syndrome (MCAS) + POTS overlap
Depression/Anxiety and other neuropsychiatric disorders
Polycystic Ovary Syndrome (PCOS)
Colorectal Cancer
Breast cancer
Liver cancer (hepatocellular carcinoma)
Pancreatic cancer
Lung cancer, thyroid cancer, glioblastoma
Hematologic cancers
There are large studies being performed to attempt to fully understand and characterize dysbiosis and estimate the current incidence. Reasonable evidence points to somewhere between 20% and 50% of adult Americans are in some level of dysbiosis.
My conclusion is that (a) we have good evidence that dysbiosis is an extremely high risk state and (b) the likelihood of being in that state is high enough to take action even if no symptoms are present. If symptoms are present, then action is essential.
Mechanisms at Play
This is a very complex area of the the human body because it mostly occurs in the gut, although microbiome exists throughout the body. Probably the largest vector for dangerous microbial invasion is through the digestive tract, which means claims of "80% of the immune system is in the gut" at least reasonably sensible. Consider the incredible thing the gut must do: take a spicy burrito with a side order of bad bacteria and selectively pick out 1,000 useful molecules, welcome 2,000 strains of good bacteria, but kill the bad bacteria. A scientific lab that could do this would fill a four story building.
To do this, the body needs numerous chemical sensors that monitor status, mechanical and chemical system to break down the burrito into usable molecules, bioweapons to kill bad things, membranes that are permeable to a wild variety of molecules while being impermeable to many other molecules. Add feedback loops to control all of it unconsciously. Astounding.
All systems have a state space wherein they are stable, but they can become unstable outside of that regime. Self-regulating systems measure process outputs and parameters within, then adjust to maintain stability / goal seek. But if you get outside the region of stability, then the feedback loops and corrective measures can miss the mark. Corrections can begin to appear to the measurement systems as evidence of further degradation and spur the release of greater mitigations. This can cause a spiral of instability. This basic mechanism is true of a flight control system or your gut.
This is an example of a "positive feedback loop" where instead of generating a damping force, it accelerates the instability. Here, "positive" indicated acceleration, not "good." In mega systems, this is how hurricanes and tornados happen. It is how Chernobyl happened. This is how stock market bubbles happen. And it is how all these human maladies happen.
How Dysbiosis Can Lead to Systemic Instability
One reason that gut biome is so complex is that these microbes are alive and they have their own complex goal seeking feedback systems. And there are an unknown number of species - maybe thousands. The combinatorial problem is at present incalculable - even if we knew all the species and how they work.
We do know that some of these species break down food for us and the byproducts of their chemical action is useful in that it makes some beneficial molecules. They also compete with each other by releasing local antibiotics - it is a literal gang war in there.
In response to insult, via bad bacteria or otherwise, the body releases a variety of chemicals: histamines, leukotrienes, tryptase, prostaglandins, cytokines, and serotonin. In the normal case, these dissipate after the threat is vanquished.
But sometimes they do not dissipate - because an infection or imbalance persists, or the intestinal wall has sustained damage, or genetic factors, diet, stress, antibiotics, food antigens, etc. In this case, they set up a positive feedback loop, where their actions make it worse, so the body produces more of them. This gets really complex. Here is an excerpt:
Leukotrienes (LTs), especially cysteinyl leukotrienes (CysLTs: LTC4, LTD4, LTE4) and LTB4, are potent lipid-derived inflammatory mediators produced via the 5-lipoxygenase pathway in mast cells, eosinophils, neutrophils, and macrophages.
They cause smooth muscle contraction, increased mucus secretion, vascular leakage, chemotaxis (recruiting inflammatory cells), and amplification of inflammation.
In the intestine:
CysLTs drive severe allergic/anaphylactic responses to ingested antigens (e.g., food allergies), often more than histamine in the gut — recent 2025 studies show specialized intestinal mast cells produce high levels of CysLTs (rather than histamine) upon allergen exposure, leading to anaphylaxis, inflammation, and barrier effects.
LTB4 is a strong chemoattractant for neutrophils and promotes chronic inflammation.
I really feel for the fundamental researchers trying to break all this down into component parts, then assemble the steps into the complete system. The complexity explosion makes AI look easy.
Medications and MCAS
MCAS or Mast Cell Activation Syndrome is a condition where Mast cells chronically overproduce histamine - essentially an allergic reaction. MCAS is linked to food allergies and is probably a good poster child for all of these problems.
The standard treatment is to attempt to remove food or environmental factors that stimulate this release (called Mast cell degranulation) and then take antihistamine medications.
The problem with most medications is that they seek to change how the body functions and we do not fully understand all the functions and feedback mechanisms of the body. Worse, lots of meds work by blocking a receptor. Many antihistamines, particularly the older ones, block the histamine receptor rather than blocking histamine release. I postulate that this methodology is doomed to failure. The body is trying to get a signal through and if you block receptors, the body will scream louder. This has been observed and measured, so I'm not off the mark here.
Other antihistamines do seek to stop the release of histamine. These are probably helpful temporarily, but there is always a risk because the histamine release is not the sole root cause - it is a step in the positive feedback loop. You have to deal with all of the major steps in the loop. Just suppressing histamine release will cause the body to seek ways to get the message across and release more histamine or other similar chemicals like leukotrienes.
The Components of the Loop
In order to treat this complex system, one cannot look to one or two factors. Returning the body to harmony - getting out of the positive feedback loop - must be done without trying to suppress the body's normal functions. Or, at least minimizing the use of suppressants like antihistamines.
Consider this: Imagine the body's many interrelated systems communicating with one another in a harmonious symphony where the signals from each are used in feedback loops to determine the actions of other systems. When you run and one foot hits an unstable surface, the results are communicated throughout your muscular system and back muscles on the opposite side of the body react to stabilize you. Now imagine you had a medication that partially cuts off or delays the messaging from foot to back. You would learn how to manage running, but it would not be the correct way and taking the meds away would result in relearning again.
This isn't an exact metaphor, but I think it is more apt than not. Medications - even really powerful ones with many side effects - are a huge blessing from medical science. But the goal must be to seek the harmonious balance that is built into our stupendously complex DNA. To restore the natural mechanisms and control systems to nominal functionality. Meds can be a crucial part of this reset, but we must keep our eye on the ball - get back to baseline function as best as possible (genetic defects and surgical impacts must be accounted for here).
Now then, let's simplify the major components of the loop:
Intestinal wall damage.
Incorrect quantity and/or distribution of microbes.
Hypersensitivity of response mechanisms (like mast cell overactivity)
We must deal with all components roughly simultaneously. It is important to remember that the time to effect for all of these systems and the intervention strategies will vary considerably. Some interventions act quickly (like most meds) and the long term solution requires new cells to be built (intestinal wall, mast cells, etc.). Perhaps we'll need multiple generations of these new cells because there may well be an epigenetic adaptation going on here.
Epigenome Side Discussion
The epigenome is the instruction set that determines what parts of the genome are expressed in a cell and it is known to change throughout one's life. A skin cell and a brain cell have the same genome - it is the epigenome that determines the cell. You die with the same genome you have at conception, but the epigenome is known to change. I do not know if we've identified it as changing in reaction to stimulus . . . e.g. does it evolve? I'm going to bet that it does. The epigenome of someone with adult onset celiac is different vs what it was earlier in life. I'll further bet that if that person gets in balance the epigenome will begin to readapt away from celiac. I'm way out on a limb here and don't know if the science concurs with this postulation.
The point is, if I am correct, a serious condition will take multiple generations of that cell type to fully erase the condition. Luckily intestinal wall cells are among the fastest to be replaced. I dunno about mast cells, but I read somewhere that they turn over in about 6 months.
The Attack Strategy
Promote low inflammation. There are many substances which have been shown clinically to be anti-inflammatory in the gut, including: quercetin, vitamin C, curcumin with piperine, omega 3 fatty acids.
Reduce histamine in the gut. Some medications are sometimes useful like cromolyn sodium and montelukast. But I would prefer moving to them if the nutraceuticals aren't potent enough: quercetin, DAO, luteolin, resveratrol, vitamin D.
Kill the bad guys. Here, a real breakthrough has recently occurred. Nonprescription herbal biocides have come on the market that have been shown in clinical trials to be similarly effective as antibiotics in treating SIBO and other specific non-infection biome imbalances. There are several on the market, such as Dysbiocide by Biotics Research. They must be used with care - just because it is herbal doesn't mean you can just take as much as you like, forever. They should be thought of like medical antibiotics and used thoughtfully.
Populate with the good guys. This is the traditional probiotic route. But we should start with a specific mix that was developed to be low histamine. You see, some good probiotics produce histamine. This is advantageous when you are in harmony - eubiosis - but probably not good at the start of the journey. One such is VitaMonk (Biovy) Low Histamine Probiotics.
Promote intestinal wall healing. There are many nutrients which have been shown in clinical trials to aid in this healing. They include: L-Glutamine, zinc carnosine, butyrate, deglycyrrhizinated Licorice and aloe vera.
Program Pacing and Order of Action
The principle problem with this approach is that there are a lot of new substances to take. Any one of them might not react well for an individual person. They may also not interact well for an individual person. But since there are so many, just taking one for a week, then adding one for a week, etc. will take forever. Since most of the first three categories are low likelihood of problems (omega 3? vitamin C?), we'll progress in clusters.
Calm the situation. We start with the first two items on the attack plan. This will reduce inflammation, promote healing and set the stage for the war. It also provides some time to assure that the person doesn't react badly to any of it.
Start the biocide. Begin with the smallest dose to assess. Ramp up to a full dose. Keep this going for 2 weeks.
Begin the probiotic after a week in the non-SIBO case or in the case of SIBO, probably nearer to the end of the second week. The idea here is that if the person has SIBO (Small Intestine Bacterial Overgrowth), we probably need to reduce the overall load first. But there have been studies where adding probiotics before the end of an antibiotic cycle is useful.
Begin intestinal healing supplements.
Ramp down gradually as symptoms subside.
In the long term, I'm willing to bet that doing occasional partial cycles like this is a good idea. Particularly if you have a bout of food poisoning, an illness or surgery that includes an antibiotic, or international travel.
Furthermore, everything but the biocide are probably useful for occasional use anyway. Also, moving to a more complete probiotic is probably a good idea.
The Supplements
The good news: All of this is readily available and not expensive.
The bad news: Lots of bullshit out there. Sorry, but you have to spend some time on Amazon reading labels. It is a pain in the ass.
Do not pay any attention to anything on the label except the Nutrition Facts part, as that is the only part where it is illegal to obfuscate or lie. "Dr Dan's Gut Awesomeness: Includes quercetin, prebiotics, omega 3, blah blah blah!!!!!" Then you look and it has 200mg quercetin, which is 1/5 of the therapeutic dose and a trivial 20mg of omega 3.
There is also lots of half-assed labelling: 3,000mg Omega 3!!!, but you find that there is only 600mg of the active ingredients (DHA and EPA). With omega, only DHA and EPA count, the rest is just fish fat (which isn't bad, just not what you are paying for).
Look on the bottle for both:
GMP Label (Good Manufacturing Practice, which is like UL listing for electronics)
3rd party tested
Some brands are uniformly good (Thorne Research is a famously good one - and you pay a premium for that).
Some Specific Items:
Dysbiocide from Biotics Research
https://www.amazon.com/dp/B07L41DQB6?ref=ppx_yo2ov_dt_b_fed_asin_title
VitaMonk Low Histamine Probiotics
https://www.amazon.com/dp/B07QXY4QRP?ref=ppx_yo2ov_dt_b_fed_asin_title
A Note on Histamine in Food
If you really are having trouble, particularly MCAS, you might need to eat a low histamine diet for a while. This was news to me - food contains histamine? Yep. This is normally not a bad thing, but in the MCAS positive feedback loop, it is fuel to the fire.
You can look up lists of specific foods, which is a huge pain in the ass. If you have MCAS that isn't responding easily, this may be necessary. But here is an easy category to abstain from for a while: anything fermented, old, aged, leftovers and seriously browned. This means old fashioned sauerkraut, parmesan cheese, wine, dry aged meat, canned fish, etc. Normally, these are all good things, and you'll get them all back later.
Specific Molecules
Here are the evidence-based dosages for the individual 8 nutraceuticals/supplements, focused on their use for reducing gut inflammation, supporting histamine management (e.g., mast cell stabilization or breakdown), and aiding intestinal barrier repair (e.g., in contexts like MCAS, histamine intolerance, IBS, IBD, or post-SIBO recovery). These draw from clinical trials, meta-analyses, reviews, and functional medicine protocols (up to 2025–2026 data). Dosages are typical therapeutic ranges — always start low (especially with MCAS sensitivity), divide doses, take with food where noted, and consult a practitioner for personalization, monitoring, and interactions.
Quercetin
Typical dosage: 500–1,000 mg per day (often divided into 2–3 doses, e.g., 250–500 mg twice daily).
Higher ranges in some protocols: Up to 1,000–2,000 mg/day for mast cell stabilization/histamine reduction (e.g., in MCAS or allergy support).
Evidence basis: Human and in vitro studies show mast cell stabilization and histamine/leukotriene inhibition at these levels; functional medicine protocols commonly use 500–1,000 mg/day. Liposomal or with bromelain/vitamin C enhances absorption. Start at 250–500 mg to assess tolerance.
Curcumin (bioavailable forms like Meriva, Longvida, or with piperine)
Typical dosage: 500–1,000 mg per day (often 500 mg twice daily).
Higher ranges: Up to 1–4 g/day in some anti-inflammatory protocols (e.g., for IBD or chronic gut inflammation).
Evidence basis: Trials and reviews for mast cell modulation, cytokine reduction, and gut barrier support use 500–2,000 mg/day. Bioavailable forms (with piperine/black pepper extract) are essential due to poor natural absorption. Often taken with meals.
DAO Enzyme (Diamine Oxidase, usually porcine kidney extract)
Typical dosage: 4.2 mg per dose (1 capsule/tablet), taken 15–20 minutes before meals containing histamine (up to 3 times/day, so 12.6 mg total daily).
Variations: Some products use 8.4 mg per dose or higher (e.g., plant-based); studies show efficacy at 4.2 mg/serving before meals.
Evidence basis: Clinical trials in histamine intolerance show symptom reduction at 4.2 mg 2–3× daily; often combined with vitamin C/catalase for better activity. Take before histamine-rich foods. DAO is something your body should be making and it breaks down histamine in food. Look at it like taking a digestive enzyme like beano when you eat beans.
Vitamin C (buffered or ascorbic acid)
Typical dosage: 500–2,000 mg per day (divided doses, e.g., 500–1,000 mg 2–3× daily).
Higher ranges: Up to 2–3 g/day in some MCAS/histamine protocols (with DAO support).
Evidence basis: Acts as a cofactor for DAO and mast cell stabilizer; studies and protocols use 500–2,000 mg/day for histamine breakdown and antioxidant effects in gut inflammation.
Omega-3 Fatty Acids (EPA + DHA from fish oil or algae)
Typical dosage: 1,000–3,000 mg combined EPA + DHA per day (e.g., 1–2 g total fish oil providing 500–1,500 mg EPA/DHA).
Higher ranges: Up to 2–4 g EPA/DHA in IBD/inflammation trials.
Evidence basis: Trials for gut inflammation (IBS/IBD) and mast cell modulation use 1–3 g EPA/DHA daily; anti-inflammatory resolvins form at higher doses. Take with meals; algae-based for vegan.
Butyrate (Tributyrin or Sodium Butyrate)
Typical dosage: 300–900 mg per day (often 300–600 mg, divided or once daily).
Higher ranges: Up to 1,000–4,500 mg/day in some gut repair protocols (tributyrin preferred for colon delivery).
Evidence basis: Studies for barrier repair and inflammation reduction use 300–1,000 mg/day; tributyrin forms show better tolerability and efficacy in post-dysbiosis recovery.
L-Glutamine
Typical dosage: 5–15 g per day (often 5 g 2–3× daily, or 10–30 g total in divided doses).
Higher ranges: 15–45 g/day in some gut repair trials (short-term <2 weeks at >30 g/day for permeability reduction).
Evidence basis: Meta-analyses and trials for intestinal permeability/leaky gut use 5–30 g/day; higher short-term doses (>30 g/day for <2 weeks) show significant barrier improvement. Take on empty stomach or with water.
Zinc Carnosine (Polaprezinc/PepZin GI®)
Typical dosage: 75–150 mg per day (often 37.5–75 mg twice daily, providing ~16–32 mg elemental zinc).
Evidence basis: Clinical trials for mucosal repair and permeability use 75–150 mg/day; commonly 75 mg twice daily in gut protocols.
These ranges are from peer-reviewed studies, meta-analyses, and clinical guidelines (e.g., for IBD/IBS, MCAS/histamine intolerance, leaky gut). Individual responses vary — especially with MCAS — so titrate slowly (start at low end), monitor symptoms, and work with a practitioner (e.g., test zinc levels, DAO activity, or gut markers). Many of these are synergistic (e.g., glutamine + zinc carnosine for barrier; quercetin + curcumin + vitamin C for mast cell/histamine control).
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More Notes on Potential Supplements
Top 8 Supplements:
Here are the top 8 evidence-based nutraceuticals/supplements for reducing gut inflammation and histamine levels (including mast cell stabilization, histamine degradation, and related pathways). These are prioritized based on clinical studies, reviews, and mechanistic research (up to 2025–2026), particularly in contexts like MCAS, histamine intolerance, IBS, IBD, and leaky gut.
They focus on:
Stabilizing mast cells (reducing histamine/leukotriene release).
Supporting DAO activity or histamine breakdown.
Lowering gut inflammation (e.g., via NF-κB/COX inhibition, cytokine reduction, barrier repair).
Note: These are generally well-tolerated in MCAS/POTS overlaps when introduced slowly/low-dose, but always consult a practitioner (especially with SIBO/MCAS) for dosing, interactions, and testing (e.g., DAO levels, zonulin). Start with 1 at a time.
Quercetin (top mast cell stabilizer & natural antihistamine) Flavonoid that stabilizes mast cells, inhibits histamine release, blocks H1 receptors, reduces cytokines/leukotrienes, and lowers inflammation (e.g., IL-8, TNF). Often more effective than cromolyn in mast cell models. Supports gut barrier indirectly. Evidence: Multiple in vitro/human studies show it outperforms cromolyn for mediator inhibition; used widely in MCAS/IBS protocols.
Curcumin (Turmeric extract, bioavailable forms like Longvida or Meriva) Potent anti-inflammatory (inhibits NF-κB, COX-2, cytokines); stabilizes mast cells, reduces histamine release, and supports gut barrier integrity. Helps with chronic gut inflammation in IBD/IBS. Evidence: Reviews and trials show benefits for IBD remission, mast cell modulation, and histamine reduction.
DAO Enzyme (Diamine Oxidase, often with vitamin C) Directly degrades dietary histamine in the gut lumen, reducing systemic load and gut inflammation from food triggers. Evidence: Clinical studies show symptom reduction in histamine intolerance; porcine kidney-derived DAO + vitamin C is most studied.
Vitamin C (high-dose, buffered forms) Cofactor for DAO production/activity; antioxidant that stabilizes mast cells, reduces histamine release, and lowers oxidative stress/inflammation in the gut. Evidence: Supports histamine breakdown; used in MCAS protocols to enhance DAO.
Omega-3 Fatty Acids (EPA/DHA from fish oil or algae) Reduce pro-inflammatory eicosanoids (including leukotrienes), modulate mast cell activation, and lower gut inflammation (e.g., resolvins/protectins promote resolution). Evidence: Trials show benefits for IBD inflammation; reduces mast cell reactivity and histamine-related symptoms.
Butyrate (or Tributyrin/Sodium Butyrate) Short-chain fatty acid that fuels colonocytes, strengthens tight junctions, reduces inflammation (downregulates NF-κB), and supports mucus production — indirectly lowers histamine-driven permeability. Evidence: Strong data for gut barrier repair in IBD/IBS; post-dysbiosis recovery.
L-Glutamine Primary fuel for enterocytes; promotes tight junction integrity, reduces permeability (zonulin), and aids mucosal healing — helps break inflammation-histamine loops. Evidence: Clinical use and studies show barrier repair in leaky gut/post-SIBO.
Zinc Carnosine (Polaprezinc) Stabilizes gut mucosa, enhances tight junctions, protects against oxidative damage, and promotes healing — reduces inflammation and permeability that amplifies histamine effects. Evidence: Strong clinical data for small intestinal repair; often paired with glutamine.
Top Evidence-Based Additions for Barrier Repair & Healing
L-Glutamine (most studied and widely recommended)
Primary fuel for enterocytes (intestinal epithelial cells); promotes tight junction integrity, reduces permeability (zonulin levels), and supports mucosal regeneration.
Dosing: 5–15 g/day (often 5 g 2–3× daily in powder form, away from food if tolerated).
Evidence: Multiple reviews (e.g., 2023–2025) and clinical use in post-antibiotic/SIBO recovery show it accelerates epithelial repair and decreases leaky gut markers. Safe in MCAS when pure (avoid flavored versions).
Zinc Carnosine (Polaprezinc)
Stabilizes gut mucosa, enhances tight junctions, protects against oxidative damage, and promotes ulcer/mucosal healing.
Dosing: 75–150 mg/day (often 37.5 mg twice daily).
Evidence: Strong clinical data for gastric/small intestinal repair; frequently paired with L-glutamine in leaky gut protocols. Well-tolerated and MCAS-friendly.
Butyrate (or Tributyrin/Sodium Butyrate)
Short-chain fatty acid (SCFA) that fuels colonocytes, strengthens tight junctions, reduces inflammation, and supports mucus production.
Dosing: 300–600 mg/day (tributyrin is better absorbed and less odorous).
Evidence: Post-dysbiosis studies show butyrate supplementation improves barrier function and SCFA-producing bacteria recovery. Often added after antimicrobials to prevent relapse.
Deglycyrrhizinated Licorice (DGL)
Soothes and coats the mucosal lining, reduces inflammation, and supports healing without licorice's blood pressure risks.
Dosing: 380–760 mg chewable tablets before meals (2–3× daily).
Evidence: Used in functional protocols for post-SIBO mucosal support; anti-inflammatory effects complement curcumin/quercetin.
Aloe Vera (Inner Leaf Gel, low-anthraquinone/decolorized)
Mucilaginous; soothes irritation, supports mucus layer, and may reduce permeability.
Dosing: 50–100 mL/day of pure inner leaf gel/juice (start low to avoid loose stools).
Evidence: Clinical observations and some studies show benefits for digestive lining repair; generally safe in MCAS when pure.
Collagen Peptides (or Bone Broth Concentrate)
Provides glycine, proline, and hydroxyproline for connective tissue/mucosal repair; supports tight junctions indirectly.
Dosing: 10–20 g/day (unflavored powder in water/tea).
Evidence: Emerging data link collagen to improved gut integrity post-inflammation; popular in leaky gut protocols.
Other Supportive Options (if tolerated)
Slippery Elm or Marshmallow Root (demulcents): Coat and soothe lining (tea or powder, 1–2 tsp/day).
N-Acetyl Glucosamine (NAG): Supports mucus production and glycosaminoglycan repair (500–1000 mg/day).
Saccharomyces boulardii (if not already in low-histamine probiotic rotation): Yeast probiotic that aids barrier function and prevents relapse.