Salt Cravings, Migraines, Fatigue, and Why You Can't Quit Pepcid

For years, I heard the same thing from women in my practice: “I have to stay on Pepcid. Every time I go off it, things spiral downhill—fast!”

And I didn’t get it. Pepcid (famotidine) blocks H2 histamine receptors in the gut. It’s for acid reflux. So why were these women using it for fatigue, insomnia, anxiety, migraines, bladder pain—and feeling worse without it?

Then one morning, I woke up and knew.

MCAS. Histamine overload.

It's funny how intuition shows up sometime. I'd been struggling myself for years with dysregulated cortisol due to undermedicated, then overmedicated, then not quite right titrating of thyroid hormone (I have autoimmune hypothyroidism aka Hashimoto's).

Even though I've largely reclaimed my cortisol curve, I still wake up all too frequently with either the worst migraine of my life or this "raw" feeling. My husband had finally put a name to it "yeah, you're histamine-y".

The question was, how could high histamine possibly tie into dysregulated cortisol?

On this fine morning, I'd woken with a few symptoms from my past (thanks to a mega stressful week). And, suddenly, my inbox made perfect sense.

All the women who felt wired but exhausted, inflamed, reactive to everything, craving salt like it was oxygen.The women who looked “normal” on paper—but were one skipped Pepcid away from full-on body revolt. The women who felt worse after eating.

They weren’t producing enough DAO—diamine oxidase, the main enzyme that clears histamine in your gut. And when DAO is low, histamine builds up in the bloodstream.

This doesn’t just cause a histamine reaction. It mimics the symptoms of MCAS (mast cell activation syndrome)—because histamine overload can trigger mast cells to release even more histamine and inflammatory chemicals, like prostaglandins, leukotrienes, and cytokines . In other words:

Low DAO can actually drive MCAS.

How Cortisol Dysregulation Keeps You Chained to Pepcid

And here’s where cortisol comes in:

Under normal conditions, cortisol helps upregulate DAO (increases production of DAO), which means your body easily processes histamine in the food you eat, low histamine in the gut = low histamine in the bloodstream and this keeps mast cells calm.

But when cortisol is too high for too long—or drops off too fast (like in stage 2 or 3 adrenal dysfunction), DAO production tanks. Mast cells get jumpy. Histamine gets stuck in circulation. And the whole system becomes one giant inflammatory feedback loop.

So the reason Pepcid “works” isn’t because it fixes the root problem.

It’s because it blocks some of histamine’s effects—especially in the gut—while the real problem, your stress response gone rogue—keeps dumping fuel on the fire.

Stage 2–3 Adrenal Dysfunction: When Your Stress Hormones Sabotage DAO and activate mast cells

This is where it all comes together.

In stage 1 adrenal dysfunction, cortisol is too high—you’re pushing through, running on adrenaline. But by stage 2 and 3, cortisol gets erratic or flatlined. And that’s when everything unravels.

This stage is where women report:

• Salt cravings (due to low aldosterone, another adrenal hormone)

• Deep, bone-heavy fatigue

• Migraines that hit like hurricanes

• Skin that feels on fire

• Food reactions out of nowhere

• GI flares: bloating, reflux, nausea, loose stools, or poo that's about as big around as a pencil

And when histamine is high + cortisol is broken?

It creates a feedback loop:

High histamine → more cortisol dysregulation → even lower DAO → more histamine.

And no supplement in the world can fix it until that loop is broken.

Why Pepcid Feels Like a Lifeline (But Isn’t the Fix)

When you’re in this loop, Pepcid feels like your only safe place.

It dials down histamine’s impact—especially in the gut and bladder. You finally get relief from the stomach pain, urgency, skin flares, maybe even the migraines.

But it’s just patching over the cortisol-histamine chaos.

And this is why you can’t just “go off Pepcid” and be fine. Your body is still drowning in histamine without the ability to clear it—and still running on a cortisol rhythm that’s completely off the rails.

How to Actually Heal: Breaking the Histamine–Cortisol Loop

This isn’t about managing symptoms. It’s about resetting your whole system—from the top down.

Here’s where I start with clients:

1. Regulate the nervous system

You can't repair dysregulated cortisol without supporting nervous system regulation. And, if you're in adrenal dysfunction, I'm willing to bet meditation and breathwork haven't worked for you. You need hands-on nervous system support.

The ones I rave about are Spinal Flow Technique and Network Spinal—these hands-on therapies bypass the thinking mind and go upstream of hormones to downshift your entire being out of fight-or-flight. This is where the real work begins.

Studies show that craniosacral therapy (CST) also helps retrain the nervous system. I've tried CST, and it could be that the 2 practitioners I've tried weren't that good and/or didn't resonate with me. I encourage you to try all three of these therapies even if acupuncture, Reiki, sound healing, etc. haven't helped. Here's the list:

• Spinal Flow Technique:
  Redirects the subconscious mind toward the body’s innate healing state by activating specific spinal gateways. This gently cues the nervous system to shift out of fight-or-flight and into rest, repair, and regeneration—supporting increased cerebrospinal fluid (CSF) flow and whole-body coherence.

• Network Spinal:
  Retrains the nervous system to self-regulate by releasing stored tension patterns in the spine. These gentle, precise touches prompt waves of energy through the body that enhance spinal alignment, elevate CSF flow, and restore a baseline of ease, flexibility, and resilience.

• Craniosacral Therapy:
  Uses subtle touch to unwind restrictions in the cranial and sacral bones and balance the rhythm of CSF. By enhancing flow through the brain and spinal cord, it downshifts the nervous system into deep parasympathetic rest and supports emotional release, clarity, and reset.

2. Rebuild the adrenal axis

• Vitamin C, magnesium, B6

• Trace minerals (especially sodium, potassium, and zinc)

• Thyroid support (iodine and selenium)

• Stop adaptogens. Most adaptogens suppress cortisol further dysregulating healthy rhythms.

3. Stabilize blood sugar

Cortisol surges when blood sugar crashes. Keeping glucose steady is non-negotiable for cortisol and histamine balance.

4. Rebuild DAO from the root

DAO can’t come back online until your body stops living in alarm mode. Support it, yes—but regulate cortisol, or it won’t stick.

5. Test your cortisol rhythm

There's two ways to do this. My preference is usually monitor waking body temperature.

Why? It's free (if you have a thermometer already). And, it gives day over day indication of what's going on with waking cortisol levels.

If waking body temperature aligns with a healthy rising cortisol level, use a 4-point saliva or urine test to understand how cortisol is fluctuating over the day (and whether it's truly a healthy/normal rhythm).

The Real Takeaway

If you’re on Pepcid and scared to come off…

If your body feels raw, your stomach unpredictable, and your head feels like it's in a vice…

If salt tastes better than chocolate and your fatigue is bone-deep… chances are you feel this way because DAO is low. Histamine's high. Your mast cells are activating skyrocketing inflammatory cytokines (signaling molecules).

And, all of this is happening because stress is sabotaging your body's ability to clear histamine.

Even if you don't feel stressed. It's stress.
And, when you're stuck in the stress loop, the way out starts with retraining your nervous system.

Pepcid isn’t fixing it. It’s covering the symptoms of a deeper dysfunction.

Once I finally saw this pattern in my own body, everything clicked.
All the women I’ve supported through cortisol crashes over the years—they were stuck in the same loop.

And the thing I wish I’d had back then?
The one tool that changes everything now?

Nervous system regulation.

That’s the real way out.

If you’ve already tried everything and still get inflamed after breakfast, it’s time to regulate your nervous system—not your breakfast.

That’s exactly what we do inside Regulate—my 2-month reset for women stuck in cortisol chaos, histamine flares, or autoimmune burnout.

No protocol. No overwhelm. Just hands-on healing and a way back to ease.

Ready?

Email me at [email protected] or text “I’m in” to 760-495-1394.

I’ll send the details.

References

1. Theoharides TC. "Mast cells and stress—a psychoneuroimmunological perspective." J Clin Psychopharmacol. 2009.

2. Manzella C, et al. "Stress-induced modulation of intestinal diamine oxidase activity." J Physiol Pharmacol. 2013.

3. Jutel M, et al. "Histamine in inflammation." Allergy. 2006.

4. Chan JL, et al. "Stress-induced hyperglycemia and its effect on cytokine expression." Metabolism. 2003.

Want help getting off the histamine rollercoaster and fixing your cortisol rhythm for good? I’ve got you. Just say the word. Text me at 760-495-1394.