The Healthy Skin Show Jennifer Fugo, CNS, MS, Skin Rash Expert

Have you ever heard of mast cell activation syndrome but thought it was the same thing as histamine intolerance? It’s not… MCAS or mast cell activation disorder is much more serious!
Today’s guest dives into what are mast cells and will show you how mast cell activation syndrome (MCAS) is distinctly different and more complex than histamine intolerance.
Though I have spoken about histamine intolerance before (I do see a lot of clients who struggle with this along with chronic hives and dermatographia), it’s important to know if what you’re dealing with is in fact mast cell activation syndrome (MCAS) because of how it will impact your MCAS treatment plan.
So, today I’m joined by the perfect person to talk about what are mast cells and how to deal with MCAS mast cell issues, Dr. Jill Carnahan! She is Your Functional Medicine Expert® dually board certified in Family Medicine for 10 years and in Integrative Holistic Medicine. She is the founder and Medical Director of Flatiron Functional Medicine. As a survivor of breast cancer, Crohn’s disease, and toxic mold illness, she specializes in searching for the underlying causes of illness through cutting-edge lab testing and personalized medicine protocols.
Have you ever suspected or been treated for MCAS? Share your thoughts and experience in the comments below or join the conversation in my Youtube comments!
In this episode: What is MCAS? (Why is it different from histamine intolerance?)  MCAS mast cell diet and environmental triggers Is there a genetic component to MCAS cases? MCAS testing + current diagnostic criteria for MCAS Mast cell activation disorder treatment options  Thoughts on feeling hopeless from chronic illness Quotes "Mold just has this deep predisposition to trigger our immune system to be overactive through the mycotoxins it produces." [09:09]
“It can be a very mild case, but the latest research from the CDC says one in five adults [who] have long COVID symptoms, including mast cell activation.” [14:29]
Links Find Dr. Carnahan online | Instagram | Facebook
Dr. Jill's book Unexpected: Finding Resilience through Functional Medicine, Science, and Faith and film Doctor/ Patient
Healthy Skin Show 036: Using Low-Dose Naltrexone (LDN) For Chronic Skin Rash Conditions
Healthy Skin Show 166: Mold + Histamine Connection w/ Dr. Jill Crista
Healthy Skin Show 257: Itchiness + Histamine Intolerance - Why Am I Itchy?
Healthy Skin Show 261: Chronic Hives: Why They Aren't Going Away
Mast Cell Current Diagnostic Criteria (Consensus-2)

Did you know that the inflammation that drives your eczema, psoriasis, rosacea, etc., could be triggered by your oral microbiome?
That's right...
Inflammation that shows up on your skin is often triggered elsewhere! And one often overlooked spot in the body is your mouth.
Like your gut microbiome (which I've talked a lot about on the show), your oral microbiome is also incredibly diverse and can, due to a variety of factors, become dysbiotic or imbalanced.
The resulting immune response from your body can trigger cytokines that then end up elsewhere, increasing inflammation.
My guest today -- Dr. Victoria Sampson -- is a brilliant dentist who joined me to blow your mind about all of the intricate relationships between inflammation, cytokines, oral microbiome, testing and best dental practices to keep your teeth and gums healthy.
She's a functional dentist and researcher based in central London. She obtained her Bachelor's in Dental Surgery from Barts and the London School of Medicine and Dentistry and is now known for her work in developing salivary diagnostics, microbiome testing and incorporating artificial intelligence into everyday care. Her work has been acknowledged worldwide resulting in her becoming a scientific advisor, board member and clinical lead of multiple dental companies globally. Victoria has published numerous papers in the UK and internationally and was the first dentist in the world to link gum disease with worse COVID complications. Victoria is also the first dentist to be shortlisted for Forbes 30 under 30 in Healthcare and Science in Europe and has now founded her own multidisciplinary health center in London aimed at putting the mouth back in the body and connecting the oral microbiome with general health.
Because of my own journey overcoming gingivitis (which I firmly believe was due to both poor habits and a dysbiotic oral microbiome), I'm fascinated by this information. So if you've also struggled with dental issues or are looking for clues to what's driving the inflammation under the surface, this is an excellent conversation!
What's been your experience with gingivitis and dental issues? Have you ever considered that there could be an oral microbiome imbalance partly to blame? Share your thoughts in the comments!
In this episode: Connection of oral microbiome + severity of Covid-19 (research) The spectrum of oral and gum disease- what it looks like How pathogenic bacteria travels throughout the body in leaky gum syndrome What are the red complex pathogens? Top nutritional deficiencies or even diseases seen from the oral standpoint and the symptoms WHY you shouldn't be using mouthwash right after brushing your teeth Quotes "You're nine times more likely to be in the ICU and to be intubated [with COVID] if you have severe periodontal disease." [05:55]
"You can get a lot of nutritional deficiencies in the mouth. It presents in the mouth first before you might see symptoms elsewhere, and the reason for that is because the oral mucosa, so the skin lining the inside of your mouth, it regenerates at a much faster rate than most other parts of your body." [20:07]
Links Find Dr. Sampson online | Instagram
Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections? {RESEARCH}
Healthy Skin Show ep. 303: How To Reverse Gingivitis + Bleeding Gums
Healthy Skin Show ep. 293: Watch Out For This Inflammatory Mouth Bacteria To Your Skin + Health w/ Dr. Mark Cannon, DDS
Healthy Skin Show ep. 260: Oral Microbiome-Skin Rash Connection w/ Dr. Mark Burhenne
Try Risewell for some great toothpaste and oral care products (no fluoride). Use HEALTHYSKINSHOW for 10% OFF!

Can you get a rash from thyroid disease? Yes, yes you can. And in this episode, I’m connecting the dots between autoimmune thyroid disease and chronic hives.
Today, we’re digging into how your thyroid can affect your skin, and how you can determine if yours is part of your rash trigger.
If you’ve been struggling with a rash that just won’t disappear and you feel like you’re running out of options (and hope!) be sure to download the Stop My Rash Guide here so you can figure out your root cause combo and finally get to the bottom of your skin rash.
In This Episode: What are urticaria, chronic hives, and dermatographia? Chronic hives treatments and why they don’t always work The interesting connection between chronic hives, thyroid, and autoimmunity What is Hashimoto’s and are you at risk of developing a thyroid disease rash? How to get your doctor to run a full thyroid panel Quotes “While it’s true that hives, dermatographia, and urticaria are associated with histamine overload, if Zyrtec for urticaria doesn’t work for you, you’re often left with few options. Maybe, if you’re lucky, your doctor might order allergy testing, but most people find themselves at a frustrating dead end if antihistamines for urticaria aren’t a magic bullet.”
“For some people, one of those early symptoms is chronic urticaria. But they can’t connect that back to their thyroid because their doctor is possibly only running cursory thyroid bloodwork — looking for levels of thyroid-stimulating hormone, or TSH. Problem is, your TSH is only going to be elevated after your thyroid has been significantly damaged. So TSH isn’t enough to tell you what’s going on.”
Links Get labs run HERE that you can order yourself at a flat rate
Healthy Skin Show ep. 261: Chronic Hives: Why Won’t They Go Away
RESEARCH - Relationship between Chronic urticaria and autoimmune thyroid disease
Stop My Skin Rash Guide FREE download

Elimination diets can be therapeutic tools to support your health. But they also have the power to trigger disordered eating patterns + food fear.
Except for a few instances, elimination diets aren't meant to be long-term health solutions — even when it comes to chronic skin problems like eczema or psoriasis or any of the other skin conditions I talk about here.
Health books + wellness influencers who declare otherwise have unfortunately helped perpetuate a state of deep confusion, fear, anxiety + even cult-like thinking that doesn't necessarily serve your relationship with food.
As a result, people are more confused than ever about what's “good or bad”, “safe or unsafe”, healthy vs unhealthy…
I have a deep concern as a clinical nutritionist about the way elimination diets have been glorified.
Especially when you become so afraid to eat based on what you've read in a book or online (especially in facebook groups) that it seems like everything is poison.
We have research proving the damage that elimination diets can cause (especially in those with chronic skin conditions).
And one issue worth raising is that the disordered eating patterns + food fear can be triggered by the trauma caused as a result of doing excessive elimination diets (especially for an extended period of time).
My guest today guest deeply understands this because of her own personal journey working with trauma as well as experiencing serious health challenges.
That's why I'm welcoming back MaryCatherine McDonald, PhD to the show! She's a research professor and life coach who specializes in the psychology of trauma, stress, and resilience. She has been researching, lecturing, and publishing on the neuroscience, psychology, and lived experience of trauma and stress since beginning her PhD in 2009. She is passionate about destigmatizing trauma, stress, and mental health issues in general, as well as reframing our understanding of trauma to better understand and treat it.
She's the author of Unbroken: The Trauma Response Is Never Wrong: And Other Things You Need to Know to Take Back Your Life — which I've personally read + give five stars on!
Have you experienced food fear or struggle with what foods are “safe” or “good” to eat because of elimination diets or things you've read online (or maybe were told by a practitioner)? I'd love to hear your thoughts in the comments!
In this episode: Understanding the relationship of trauma, elimination diets + food fear How food fear manipulates your body to experience physical symptoms Dangers of labeling food “good or bad” How disordered eating is related to control Thoughts on wellness influencers, cult-like behaviors + disordered eating Tips to soothe fear + anxiety (that don't involve elimination diets) Quotes “A lot of the reason that people go on elimination diets is because there's some sort of thing going on with them that doesn't make sense, and that can be experienced as a body betrayal. I'm trying to eat; I'm trying to do this very normal thing, and my body is betraying me- and that is potentially traumatic.” [03:24]
“You're creating a fear response. You're conditioning a fear into the system. You're labeling sometimes an entire food group as “bad, evil, problematic, or dangerous”, and your system is listening.” [11:22]
“There's different theories about where eating disorders come from and how they crop up, but there's at least one theory that says that it's a way to gain control over a world that feels outside of your control.” [22:01]
Links Find Dr. McDonald online | Instagram | TikTok
Get her book — Unbroken: The Trauma Response Is Never Wrong: And Other Things You Need to Know to Take Back Your Life
Healthy Skin Show ep. 305: Eliminations Diets, Food Fear + Healing Skin Rashes {NEW RESEARCH}
Healthy Skin Show ep. 087: Skin Picking Triggered By Chronic Skin Rashes
Healthy Skin Show 297: Deconstructing Trauma + Chronic Skin Pr

If you've ever wondered, "what is contact dermatitis?" -- you're in for a treat because this episode is going to blow your mind!
My guest Dr. JiaDe (Jeff) Yu lectured on contact allergic dermatitis at the Eczema Expo 2023 hosted by the National Eczema Association, and I found his presentation so valuable that I invited him here to share the ins + outs on the topic.
We covered a ton of information, but what I can say is that contact dermatitis is complex!
Allergic contact dermatitis isn't like a traditional allergy in specific ways (especially when it comes to using antihistamines to get things under control).
There's unfortunately a significant issue with both false positive AND false negative results from testing. AND how to treat contact dermatitis will vary depending on several factors (like whether it's a topical problem versus a systemic one).
If you aren't familiar with Dr. JiaDe (Jeff) Yu, he's an Assistant Professor of Dermatology at Harvard Medical School and a dual board-certified adult and pediatric dermatologist practicing at the Massachusetts General Hospital in Boston, MA. He is the Director of Occupational and Contact Dermatitis Clinic and the Associate Director of Clinical Trials. He has a niche interest in pediatric allergic contact dermatitis and has published numerous peer-reviewed articles on allergic contact dermatitis and atopic dermatitis in leading dermatology journals. He has received numerous research grants from the Dermatology Foundation, American Contact Dermatitis Society, and the Pediatric Dermatology Research Alliance to better understand the biomedical underpinnings of allergic contact dermatitis. Dr. Yu is the President-Elect of the American Contact Dermatitis Society and has been invited to lecture nationally and internationally on his areas of expertise.
Have you had any personal experience with contact dermatitis? I'd love to hear your story, comments + questions on this topic in the comments below!
In this episode: What is contact dermatitis (and is it genetic)? Contact dermatitis compared to food or environmental allergies Which antihistamines don't work for contact dermatitis Top contact dermatitis allergies The antibiotic that's a common allergy If you're reactive to medical gloves... Crazy "hidden" sources of contact dermatitis allergens Testing for contact dermatitis (beware of your results) Quotes "When you do get a cut or a scrape, the skin barrier is physically damaged, therefore allowing the introduction of new allergens into the skin. So when you put on a triple antibiotic, which includes three different antibiotic components, neomycin, bacitracin, as well as polysporin, you give your body the opportunity to learn about these allergens and then become allergic to them. " [10:03]
"Disperse dyes are the most common thing that causes contact dermatitis in clothing- specifically disperse blue dyes. " [20:50]
"Vitamin B12 is very high in cobalt because vitamin B12 is also known as cobalamin and in the middle of it, there's a cobalt molecule. So, people who have high doses of vitamin B12 can actually get a rash due to the ingestion of cobalt if they have cobalt dermatitis." [24:39]
Links Follow Dr. Yu on Instagram | Twitter
Dr. Yu's clinic: The Contact Dermatitis & Occupational Dermatology Clinic
Healthy Skin Show 114: Why Preservatives In Skincare Can Be A Good Thing w/ Rachael Pontillo
Healthy Skin Show 246: Everything You Need To Know About Skin Tests (Done By Your Dermatologist) w/ Dr. Peter Lio
Healthy Skin Show 229: Lanolin Allergy + Vitamin D
Healthy Skin Show 037: Nickel Allergy And Eczema w/ Dr. Peter Lio

By now, I think everyone knows how I feel about protein intake. It's one of the reasons I was super excited to have back on a past guest to talk about protein myths and her NEW book, which I found utterly fascinating. It dives into the actual science as to WHY people need protein in their diets- for wound healing, blood glucose regulation, and so much more.
My guest today is Dr. Gabrielle Lyon. She is board certified in Family Medicine and completed a combined research and clinical fellowship in Geriatrics and Nutritional Sciences at Washington University in St. Louis. She completed her undergraduate training in Nutritional Sciences: Vitamin & Mineral Metabolism at the University of Illinois.
Dr. Lyon is a subject matter expert and educator in applying protein types and levels to health, performance, aging, and disease prevention. She has continued to receive mentorship from Dr. Donald Layman, Ph.D., over the course of two decades to help bring protein metabolism and nutrition from the bench to the bedside through her concept of Muscle-Centric Medicine®.
Dr. Gabrielle has been seeing patients since 2006 and has helped thousands reach their full health potential. Her clinical practice services the leaders, innovators, mavericks, and executives in their prospective fields. Dr. Lyon works closely with the Special Operations Military serving on the SEAL Future Foundation's medical board and the Hunter Seven Foundation's leadership board, helping establish protocols for early detection, education, and treatments for cancer and toxic exposures.
Have you ever counted calories or focused on certain macros and found protein to be the key for you?  I'd love to hear about what you did and how in the comments below!
In this episode: How Dr. Lyon came to understand muscle as she does today It's not about obesity; it's about being under-muscled What is sarcopenia and what's important about it NOW? How anyone can improve mitochondrial biogenesis The two big components of healthy skeletal muscle and healthy mitochondria Protein food fears and the science around them A mindset tip from working with Navy SEALs-- HUGE shift in thinking! Dr. Lyon's thoughts on GLP-1 agonists... you'll be surprised! Quotes "One of the reasons why I wrote this book and why this book is so important and why we have to be a unified front is that in the media, there's this push to go plant-based and there is this push that we need to decrease our dietary protein intake and nothing is further from the truth." [14:36]
"We are at the precipice of a new frontier of medicine that is really going to define amino acids as individual nutrients, as well as muscle as this organ of longevity." [06:41]
Links Follow Dr. Lyon on Instagram | Twitter | TikTok
ORDER Dr. Lyon's book Forever Strong: A New, Science-Based Strategy for Aging Well OUT NOW!
Try these brands for supportive products to help get protein intake up: Quell's Protein Powders | PaleoValley
Healthy Skin Show ep. 065: Why Protein Is Good For Your Skin (And Solving Skin Rashes)
Healthy Skin Show ep. 268: Plant-based Vs Carnivore Diet: What’s Best For Chronic Skin Issues?
Healthy Skin Show 281: Why Protein Intake Is So Important For Skin Health w/ Dr. Gabrielle Lyon