Do you experience skin reactions, breathing difficulties, digestive issues, or headaches after consuming foods like cheese, bananas, seafood, milk, or certain fruits? These reactions may be linked to a condition known as histamine intolerance. These foods are not inherently harmful; however, some individuals may have difficulty processing them properly.
Histamine intolerance is a disorder that occurs when your body can’t break down histamine properly, often due to low levels of an enzyme called diamine oxidase (DAO). As histamine builds up faster than it’s cleared, it triggers a storm of symptoms that feel random, confusing, and frustrating.
These symptoms include itchy skin, digestive distress, breathing difficulties, and even cardiovascular problems. The root cause of histamine intolerance usually involves reduced DAO activity, which can stem from genetics, gut disorders, medications, or hormonal fluctuations. Even foods regarded as healthy, like oranges, bananas, and nuts, can trigger histamine intolerance symptoms.
While histamine intolerance symptoms can be disruptive, a low-histamine diet and supplementation can offer useful management strategies. Read on to learn more about these natural treatments, as well as the condition’s symptoms and causes.
What Is Histamine Intolerance
Histamine intolerance occurs when the body cannot effectively break down histamine, usually due to reduced activity of the enzyme diamine oxidase (the enzyme that breaks down histamine in the gut). Histamine is a naturally occurring chemical compound that the immune system releases which is involved in allergic reactions, but also helps regulate wakefulness and gastric acid secretion.
In histamine intolerance, histamine accumulates in the body at a rate faster than the body’s ability to metabolize and eliminate it. Also known as sensitivity to dietary histamine or enteral histaminosis, histamine intolerance has a prevalence of 3 to 6%, occurring more frequently in children.
When histamine is ingested, certain enzymes help break it down and prevent it from leaving the intestine and entering the blood. The chief of these enzymes is diamine oxidase (DAO), with the main supporting enzyme being histamine N-methyl transferase (HMNT). In people with histamine intolerance, there is usually a deficiency of DAO in the intestine.
This DAO deficiency causes histamine to accumulate in the blood. Histamine accumulation then affects various organs and systems in the body, including the skin, gastrointestinal, respiratory, reproductive, cardiovascular, and nervous systems, causing a wide range of symptoms.
Symptoms of Histamine Intolerance
The symptoms of histamine intolerance can be diverse, unexpected, and random. These symptoms usually affect several organ systems, including the gastrointestinal, respiratory, reproductive, cardiovascular, and nervous systems. Histamine intolerance also frequently causes skin reactions.
Here are some histamine intolerance symptoms, classified based on the part of the body they affect.
- Intestinal symptoms
- Bloating
- Constipation
- Diarrhea
- Abdominal pain
- Nausea
- Vomiting
- Extra-intestinal symptoms
- Respiratory: Breathing difficulties, sneezing, rhinitis
- Cardiovascular: Low blood pressure, fast heart rate
- Nervous: Headache, migraine
- Reproductive: Menstrual cramps
- Skin: Flushing, itching, rashes, hives, swelling
Intestinal symptoms are more common than extra-intestinal symptoms, with bloating being the most frequent among the intestinal symptoms. Most people also report bloating as the most severe of the symptoms they experience. The severity of these symptoms may vary with the individual and the amount of histamine actually ingested.
Causes of Histamine Intolerance
The main cause of histamine intolerance (HIT) is a deficiency of the gastrointestinal enzymes responsible for breaking down histamine, particularly diamine oxidase (DAO). Specific causes of this deficiency and histamine intolerance include genetics, intestinal microbiome disorders, drugs, and related conditions like food allergies.
Below are factors that are associated with DAO deficiency:
- Genetic mutations
- Medications, such as verapamil, clavulanic acid, isoniazid, and cimetidine
- Menstruation
- Vitamin C and copper deficiency
- Gastrointestinal disorders, including inflammatory bowel disease, irritable bowel syndrome, gastroenteritis, carbohydrate malabsorption, and nonceliac gluten sensitivity
- Alcohol
Natural Treatments of Histamine Intolerance
The two main natural treatments for managing histamine intolerance are adopting a low-histamine diet and supplementation. When symptoms are severe, health practitioners recommend addressing these symptoms with more invasive approaches, like epinephrine and steroid injections, before trying to treat the condition with natural therapies.
Below are the natural treatments for histamine intolerance.
Low-Histamine Diet
A low-histamine diet excludes foods with excessive amounts of histamine from a person’s regular diet. This approach is regarded as the gold standard in managing histamine intolerance, and its effectiveness has been frequently demonstrated in clinical studies. Lower histamine exposure directly translates to a lower risk of developing histamine intolerance symptoms.
Besides avoiding foods high in histamine, another crucial component of a low-histamine diet regimen is avoiding foods that may promote the release of histamine or inhibit DAO. These foods may not necessarily be high in histamine, but they can cause high histamine levels when eaten.
Some of the foods to avoid in a low-histamine diet include:
- Seafood
- Fermented foods, like soybeans, sausages, beer, wine, and sauerkraut
- Aged cheese
- Chocolate
- Nuts
- Milk
- Legumes
- Bananas
- Citrus fruits
Health practitioners may sometimes try reintroducing these foods into a person’s diet when symptoms are under control. This low-dose histamine diet approach usually starts with carefully monitored quantities of foods that contain histamine at levels that cannot trigger intolerance symptoms. Some of the foods low in histamine include:
- Bread
- Rice
- Eggs
- Honey
- Herbal teas
- Fresh juices
The entire process of using diet to manage histamine intolerance must be done with a health practitioner’s knowledge and guidance. This is particularly important as different information sources contain different foods to avoid. Talking to a professional can help you find what foods are right for you. If you need this kind of professional care and live in and around Panama City, Florida, reach out to us at the Bay Clinic of Chiropractic.
Under the leadership of Dr. Tony Salamay, an experienced functional health practitioner with decades of experience in clinical nutrition and managing food intolerance, the Bay Clinic of Chiropractic can assist you in finding the perfect plan for your symptoms. Contact us at (850) 785-9372 or through our email at info@thebaydoctor.com.
Supplements
Supplementation can help manage histamine intolerance, typically by increasing diamine oxidase (DAO) levels in the intestine. Studies by the Humboldt University of Berlin, Germany state that exogenous DAO supplementation can significantly improve histamine intolerance symptoms.
Combining DAO supplementation with dietary modifications gave even better results regarding the patient’s quality of life. Using DAO supplements also increases the flexibility in drafting low-histamine diets, affording the individual a less restrictive diet. However, DAO supplementation is not as straightforward as it appears.
For one, advanced assay techniques are needed to determine the right amounts of DAO supplementation to prevent histamine intolerance symptoms. While DAO supplements show promise and many patients report symptom relief, more clinical studies are needed to establish standardized management protocols. Therefore, you should consult your healthcare provider before using any supplement.
Frequently Asked Questions
How Is Histamine Intolerance Diagnosed?
Histamine intolerance is diagnosed using a combination of tests and medical history, as there is no definitive test for the condition. The lack of a single diagnostic approach is due to the diversity of symptoms and the overlapping nature of histamine intolerance symptoms with other health conditions. Some tests used in histamine intolerance diagnosis are serum diamine oxidase assays, skin prick tests, histamine challenge tests, fecal histamine levels tests, and genetic testing.
These tests have pros and cons. For instance, skin prick tests can indicate the body’s reduced capacity to eliminate histamine but cannot accurately differentiate between histamine intolerance and other allergic conditions. Also, serum DAO assays can measure DAO levels by quantifying histamine degradation over time. However, these assays often have intra-subject variabilities, casting doubt on their validity as a single diagnostic test.
Therefore, the best approach is to use multiple tests rather than rely on one. Medical history also offers useful information when attempting to diagnose histamine intolerance. There is a genetic component to histamine intolerance, implying that having parents with the condition can increase one’s risk of developing it.
Is Histamine Intolerance a Food Allergy?
No, histamine intolerance is not a food allergy. A food allergy is an exaggerated response of the immune system to an antigen in food, typically mediated by IgE (immunoglobulin) or cellular immunological mechanisms. On the other hand, food intolerance is an abnormal, non-immunological response to a food component, such as histamine.
Food allergies typically cause more severe reactions than histamine intolerance, which rarely leads to life-threatening symptoms like anaphylaxis. Due to symptom overlap with allergies, histamine intolerance was often misdiagnosed and even referred to as a pseudoallergic reaction.
Are Women More Likely to Have Histamine Intolerance?
Yes, women are more likely to have histamine intolerance compared to men. According to study estimates in the National Library of Medicine, 8 in 10 people who have histamine intolerance are women. The exact reason for the gender disparity in histamine intolerance is not fully understood.
However, the dominant theory is a connection between histamine metabolism and female hormones, especially estrogen. Sensitivity to histamine in women also varies with the stage of the menstrual cycle, with the premenstrual phase marked by an increased histamine sensitivity. Diamine oxidase (DAO) levels are also influenced by the menstrual cycle and are usually higher in the luteal phase compared to the follicular phase.
Is Histamine Poisoning the Same as Histamine Intolerance?
No, histamine poisoning is not the same as histamine intolerance. Histamine poisoning occurs after consuming foods with unusually high amounts of histamine that overpower the degradation mechanisms. In contrast, histamine intolerance is a condition where individuals have a reduced ability to degrade histamine.
Ingesting moderate amounts of histamine-containing foods may cause symptoms in histamine intolerance cases, while histamine poisoning usually involves consuming too much histamine from foods. Fish of the Scombridae and Scomberesocidae families, like tuna, mackerel, and herring, are responsible for 98% of histamine poisoning cases, with other cases attributed to cheese.
Common symptoms of histamine poisoning include rash, headache, diarrhea, and flushing. Less common symptoms are abdominal cramps, dizziness, nausea, sweating, and tachycardia. Severe cases may lead to angioedema, tongue swelling, respiratory distress, cardiac arrest, and death. These symptoms usually appear within 2 hours of ingesting a fish in the Scombridae family.
Conclusion
Histamine intolerance is a disorder caused by the body’s inability to metabolize and eliminate histamine efficiently, often due to a deficiency of the DAO enzyme. This can lead to various symptoms affecting multiple organ systems, including the skin, gastrointestinal, respiratory, cardiovascular, reproductive, and nervous systems.
The main natural treatment approach to managing histamine intolerance is a low-histamine diet. This diet avoids foods rich in histamine or those that promote the release of histamine or inhibit DAO. Diamine oxidase supplementation can also help in some cases. However, ensure you talk to your healthcare provider before using any supplement.
If you need professional guidance in managing histamine intolerance, contact the Bay Clinic of Chiropractic at (850) 785-9372 or info@thebaydoctor.com.
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