Histamine Intolerance: Is it something I ate?

Do you ever feel like you can’t enjoy a glass of wine without your face flushing? Do you have a strange reaction to many foods in the form of itchiness, irritability, headaches, or runny/congested nose without being able to pinpoint the culprit? What about gastrointestinal issues, reactions to medications, and motion sickness to the point you can’t even LOOK at a roller coaster?

If any or all of these apply to you, you may have histamine intolerance!

Histamine intolerance is a complex condition associated with an impaired ability to break down ingested histamine due to reduced DAO (D-amino acid oxidase) activity.

The DAO gene is responsible for producing the DAO enzyme that breaks down intestinal histamine. This enzyme is unevenly distributed throughout the body but is abundant in the small intestine. Histamine, on the other hand, is a biochemical produced from the amino acid precursor histidine via histidine decarboxylase which is present in all human tissues but is also particularly abundant in the GI tract. Histidine is one of the nine essential amino acids humans must obtain from their diet.

We all have DAO genes, but when outside factors interfere with how DAO functions, the presence of DAO enzyme in our gut can decrease. Low levels of DAO enzymes means histamine can be produced without regulation. This can lead to the accumulation of histamine in the body and subsequent adverse reactions.

In the GI tract, histamine is believed to have a major impact on GI motility, gastric acid production, and modification of mucosal ion secretion (mucosal maintenance and electrolyte regulation). Studies suggest histamine intolerance appears to be acquired mainly through the impairment of DAO activity as result of gastrointestinal diseases. Since the DAO enzyme is produced in the intestine, any damage or disruption to the intestine can result in decreased DAO enzyme, reducing histamine breakdown.

Outside factors contributing to histamine overload:

• Allergies (IgE reactions)

• SIBO (Small Intestinal Bacterial Overgrowth)

• Leaky Gut

• Histamine-rich foods

• Mast-Cell Activation 

• Anything that causes GI damage

Like so many biochemicals, histamine is a double-edged sword…

The right amount of histamine is essential! It signals your immune system to act against potential attackers. It causes blood vessels to widen to rush white blood cells where needed to protect you from harmful intruders during a response called inflammation. However, too much histamine can cause adverse responses to foods or even our own tissues! Yowch!

Aside from its primary roles in the mediation of allergic reactions, inflammation, and the GI tract, histamine also serves as a neurotransmitter in the central nervous system. Pretty important stuff!

Some signs and symptoms of an impaired DAO gene/ histamine intolerance:

        ·        Gastrointestinal disorders

        ·        Sneezing

        ·        Runny nose and congestion of the nose

        ·        Headache

        ·        Painful periods

        ·        Low muscle tone

        ·        Irregular heartbeat

        ·        Hives

        ·        Itchiness

        ·        Flushing

        ·        Asthma

        ·        Motion/car sickness

        ·        Low blood pressure

        ·        Mood disorders

        ·        Nausea and vomiting

        ·        Difficulty regulating body temperature

        ·        Fatigue

        ·        Insomnia

Histamine-rich foods

In a recent study conducted by Australian researchers to determine which food groups and specific food items IBS patients report causing GI symptoms, 58% of patients with IBS experienced GI symptoms from histamine-releasing food items such as milk, cheese, wine, and beer.

The downside of those fabulous, fermented foods we love…

Histamine is not only a component of many foods we eat, but it is also produced by the bacteria that live in or on certain foods such as fermented foods, cured meat, and aged cheese. Moreover, certain gut bacteria (that can be tested through the GI MAP) alone produce high amounts of histamine. So, you want to keep those fellows in check!

Those beloved lactobacillus buggers…

Many lactobacillus species, the “celebrities” in the probiotic world, are largely histamine producers. But do not fear! If you and histamine are not friends, there are certain lactobacillus species that do not produce histamine and many other probiotics strains that do not as well.

As always, STRESS is a MESS…

Some histamine is produced by our own immune system in response to stress!

Some major histamine containing or releasing foods:

        ·        Aged cheeses

        ·        Cured meats, notably dry-fermented sausages

        ·        Alcohol, all types but mainly beer and wine

        ·        Eggs

        ·        Chocolate (oh yes, it’s true)

        ·        Citrus fruits and juices

        ·        Spinach

        ·        Fermented foods, yogurt, sauerkraut, etc.

        ·        Fish and derivatives, especially smoked and canned

        ·        Fruit juices

        ·        Vinegars

        ·        Avocados

        ·        Shellfish

        ·        Tomato

        ·        Strawberries

        ·        Bananas

        ·        Pineapple

Before you start eliminating these items out of your diet, here are some things to consider:

Eliminating foods and entire food groups from your diet without the help of a licensed professional may only put you at risk for impaired nutritional status. Certain conditions such as actual allergies, mast cell disorders, or underlying digestive disorders can mimic histamine intolerance. The first step is to speak to your health care team to evaluate these potential “imposter” conditions. Once these areas have been addressed, an elimination diet overseen by a registered dietitian may be implemented to see if symptoms improve. If improvement is notable, a diet plan that avoids histamine-rich foods while providing adequate nutrition can be an effective approach at mitigating symptoms while any gut disorders present are addressed.

Histamine intolerance is NOT a food allergy. Some histamine intolerance symptoms mimic an allergic reaction, however, the immune response with histamine intolerance does not produce IgE antibodies as seen with true allergies. Therefore, skin testing and blood allergy tests will be negative and useless.

I can just take antihistamines though, right?

While this is actually a very logical question, the simple answer would be, “not exactly”.

Popular antihistamine brands such as Zyrtec® and Benadryl®, either impact how histamine binds to histamine receptors or block histamine receptors respectively. Whereas this may alleviate some of your symptoms, it does not affect histamine levels. The second you stop taking these medications, the symptoms come right back! Not to mention, long term use of some antihistamines may increase your risk of dementia! Diphenhydramine (Benadryl®) not only blocks histamine receptors in your brain, but it also blocks the effects of a neurotransmitter called acetylcholine. This neurotransmitter is vital for memory and learning. In a 3,000-patient study followed for seven years, diphenhydramine increased the risk of dementia by 54%!

While much research still needs to be done in the area of histamine tolerance, there is vast evidence to support that an unhealthy gut is a leading cause of histamine intolerance and the plethora of problems that come with it! Your best approach is to support your digestion so that you have adequate stomach acid, digestive enzymes, and bile flow. This is critical for maintaining a healthy gut, optimal DAO function, and keeping pathogens out.

If you need some extra support, we would love to help! Let’s hop on a call to discuss the next steps!

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