Over the course of my research into health, wellness, and optimal digestion, I’ve frequently been reminded of the value of consuming bitter foods to stimulate the liver and produce more bile.  We evolved eating many more bitter-tasting foods than your average person eats today, with the primary and sometimes only bitter food consumed by most westerners in a given day now being coffee.

Most digestive bitters marketed for medicinal purposes are supplied in the form of a tincture of herbs in alcohol.  This is one reason that I’ve avoided bitters for the most part in my healing journey, along with many other tinctured medicines.  While grain alcohol does not contain the same level of histamine-triggering compounds as other alcohols like wine or beer, in my worst times of histamine overload I felt it was still better to avoid tinctures along with other fermented foods.  I knew that I could simply stimulate my liver health by consuming dandelion greens or adding some aloe vera to a smoothie or onto my tongue.  Yet I never got into a regular practice of consuming bitters until now.

Guido Masé

Recently I’ve been reading over an excellent book by master herbalist Guido Masé called “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”  Guido Masése is the chief herbalist at Urban Moonshine, a Vermont-based company that sells bitters and other exquisite herbal concoctions.  Guido is also a clinician at the Burlington Herb Clinic and teaches herbal medicine at the Vermont Center for Integrative Herbalism and the University of Vermont.  As I discovered in the course of reading his book, he’s also a historian, expertly weaving together herbal lore, mythologies and historical context with his cutting-edge scientific understanding of plant properties. You can visit his blog, A Radicle, here.

How can bitters help those of us with migraine?

Because migraine is a chemical sensitivity issue, we need to not only reduce the number of chemicals we are exposed to but also support our body’s ability to manage, neutralize, and excrete environmental toxins (especially herbicides, pesticides, and chemical treatments sprayed on our food) and metabolic waste products via improved liver function and bile flow.  Bitters help us to do that. As Guido explains:

Let’s take a moment to examine the ‘detector’ our physiology uses to assess the degree of metabolic challenge that our food contains.  The bitter taste receptor is part of a family of proteins known as TRs (taste receptors).  There seem to be six different types of TRs and some degree of variation within each different type.  For example, the receptor for sweet flavor is one type of protein, coded for by three genes, and able to detect sugars.  The receptor for umami is similarly simple and detects amino acids (protein). Sour taste is mediated through two different receptor subtypes, able to detect hydrogen ions (responsible for acidity). We have a receptor for fats and another for salt (sodium). . . . But the bitter taste receptor family, known as the T2R receptor family, is made of over twenty different subtypes, coded for by some thirty-four genes, and able to detect over one hundred often completely unrelated chemical compounds. . . . Stimulating T2Rs has profound implications throughtout the digestive system and in the liver . . . For now, suffice it to say that getting the signal of bitterness on the tongue increases the antioxidant enzyme and bile secretions in the liver through the combined action of the hormones, such as cholecystokinin, and nerves, such as the vagus nerve.  . . . Interestingly, T2R receptors are found in many other tissues of the body, indicating that their chemosensory ability is not limited to the tongue.  . . . Researchers have discovered these bitter taste receptors in the airways of the lungs, and even in brain cells. (Source: “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”, Masé)

The liver is the central hub where most of our detoxification pathways are carried out – and picks up the slack from the detoxification that would normally be provided by an intact gut microbiome.  When our gut flora are out of balance and the bacteria that help us to detoxify are wiped out by antibiotics, medications, and environmental assaults, our liver has to work extra hard.  When the liver is overloaded, bile flow is affected (and with it, our ability to emulsify fats and absorb fat-soluble vitamins crucial for health).  Reduced bile flow in turns can potentially lead to gallbladder attacks or stones.  (Conversely, one of the best ways to support the liver and gallbladder is to heal your gut – as outlined in the SimplyWell Migraine Relief Protocol). Guido describes below how liver cells need stimulation and chemical challenge in order to function (unlike other kinds of cells, which simply need nutrition):

If we are talking about processing chemicals, we have to talk about the liver.  While many tissues in the body have the ability to produce enzymes and antioxidants that help to neutralize toxins, none compare to the four-pound sponge located no our right upper abdomen, halfway hidden behind the ribcage.  It is a tireless metabolic workhorse – but, curiously enough, if left alone it does very little.  Isolated liver tissue and isolated liver cells do not seem to do much of anything, neither synthesizing bile nor producing high levels of metabolic enzymes.  Researchers attempting to study how liver cells behave have learned that, in order to better replicate the conditions found in living beings, the cells have to be bathed not only in nutrients, but also in a cocktail of chemicals.  It is only then that they begin to act like their true selves. (Source: “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”, Masé)

What role does the liver play in histamine intolerance and overload?

Alison Vickery addressed this in a blog post on that exact topic (“What if This Was About the Liver?“).  In this post, she describes her recovery in terms of the following steps 1) address any gut dysbiosis, 2) Reduce toxin exposure, 3) eat a high protien, nutrient-rich, anti-inflammatory diet, 4) rebuild with specific foods and herbs, and 5) consume liver protective and regenerative supplements.

I have dramatically improved my histamine tolerance, and put my mast-cell activation type symptoms into remission, and dropped by 2/3rds my inflammation markers, by supporting my liver. And it makes sense that the liver plays a role in histamine intolerance. Histamine is not just disassembled in the gut by diamine oxidase (DAO). It is also disassembled in the liver by histamine N-methyltransferase (HNMT or HMT) where it is in high concentrations. Why would HNMT be in the liver? The liver disassembles ALL inflammatory material including histamine released from mast-cells, along with a long list of chemicals manufactured by the body and those ingested. (Source)

Bitters: The Poison Antidote

The development of bitters came from the idea that if the body is regularly stimulated with a bitter or poison challenge, it will be better able and more used to processing an unexpected or unwanted poisonous assault. Historically, the creation of bitters is credited to Mithridates Eupator of Pontus, who reigned over what is now Turkey from 120 – 53 BC.

Mithridates. Photo Credit: https://commons.wikimedia.org/w/index.php?curid=408281

Mithridates had an urgent incentive in developing them as an attempt to prevent himself from being poisoned by his feuding and murderous family.  At age 14, his father was poisoned to death and his mother took control of the kingdom, sparking his interest in discovering a poison antidote. As Guido Masé describes it,

The young prince hit upon an interesting idea: perhaps, if full doses of poison could kill, then smaller doses might strengthen him against death.  Simply employing plants that tasted like poison but were not toxic themselves (like the root of high mountain gentian) might do the trick.  Mithridates retreated from palace life for a period and apparently delved deeply into venom brewing and antidote crafting, because when he returned, both his mother and his brother were poisoned and died.  The prince became king, married his sister, and set about building an army – all the while looking over his shoulder, fearing the murder in his evening meal, but confident that the regular use of his antidotes would keep him alive. (Source: “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”, Masé)

Mithridates’ poison antidote concoction likely involved a mixture of bitter and aromatic plants.  He experimented extensively with monkshood and nightshade, gentian, calamus, iris, parsley, carrot seed, and various resins, gums, and tree saps mixed with aromatic plants such as ginger, cardamom, and rose in smaller portions. He tried his concoctions on himself in order to discover proper dosages and build up a tolerance.  His primary aim was to create an antidote so powerful that it could reverse the effects of a poison administered by a scheming relative and save his life.  To help him with his task, he consulted with herbalists, shamans, and professional poisoners, where he learned to extract venom from vipers and use poisons from fly agaric mushrooms. (Incidentally, both venoms and magic mushrooms have been used successfully to combat chronic headache).

We Used to Eat More Bitters

During the Industrial Revolution, when many people moved from the countryside to cities to work in factories, the diversity of plants in the average person’s diet began to drop:

This change was slow at first, with many folks still connected to the country and the wild, bitter botanicals such a life offered.  Inevitably, after a few generations, however, families picked fewer dandelion greens in the spring, relying less on foraging for supplementing their meals.  Instead, for most people, the supplement became an extra helping of carbohydrate.  And while we blame so much of our modern public health concerns on the rise of sweet in the Western diet, we can’t forget that at the same time we handily eliminated much of what was bitter and wild in our food. . . we have decided that our diet should be free of uncomfortable foods, foods, that are wild, bitter, fibrous, weedy, or otherwise challenging. (Source: “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”, Masé)

The impacts of this change not only to consumption of sweeter foods but also less consumption of bitter foods had profound implications not only for the health of our bodies, but also the health of the land.  With more fields dedicated to the production of carbohydrates, we have seen a huge addition of chemical additives to the ecosystem.

Corn farmers applied 57 million pounds of glyphosate (Roundup), more than 51 million pounds of atrazine, and some 20 million pounds of other herbicides in 2010.  By comparison, all the herbicide applied to potatoes amounted to about 4 million pounds, of which more than half was actually fungicide. (Source: “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”, Masé)

The sweet flavor does very little to activate the gut (instead, it activates reward circuitry in the brain). This wasn’t as much of an issue in the past as it is now, since many sweeter foods were usually consumed in whole plant form along with the other bitter elements in the rind or peel and their respective benefits. However, our current penchant for sweet processed foods and lack of consumption of bitters is wreaking havoc not only on our digestive tracts but also on our environment in the form of Big Ag.

My Personal Use of Bitters

Currently my practice of ingesting bitters involves small amounts of neem powder placed on the tongue a few times throughout the day (the lovely neem plant is featured at the top of this page). Some traditional herbs for migraine, like feverfew, owe some of their effectiveness to their very bitter flavor. Since I am breastfeeding, I have opted out of taking larger quantities of neem or any other bitter plant, as it reduces milk supply.  However, simple stimulation of the taste buds with even very small amounts of bitter plants is a sufficient prompt to get the liver primed to detoxify other substances that enter our bodies via food, water, air, and pharmaceutical medications.

So, while we and our livers are currently inundated with no shortage of chemical assaults, most of them are foreign substances compared to the toxins that our liver evolved to process (which included toxins from bacteria, the bites of venomous insects and animals, or directly from poisonous roots, barks, leaves, seeds, and berries).  Perhaps by using the bitter plants which our liver is more evolutionarily designed to be stimulated by, we can help it to process the new chemicals that are relatively new to our environment. (Source: “The Wild Medicine Solution: Healing with Aromatic, Bitter, and Tonic Plants.”, Masé)

Like Mithridates, we do need to be vigilant in order to avoid being overwhelmed by our big bully family members – corporate polluters who care more about power and profit than the health of the whole.  Regular intake of bitters can help us to be more resilient to the world we live in.