A Look at Histamine Intolerance
Posted in Uncategorized on February 18, 2018
An Overview of Histamine Intolerance
If your body stops breaking down histamines (especially those sourced from foods) then it is possible that you may have developed an histamine intolerance.
Intolerance to histamines is the result of disequilibrium of accumulated histamines in the body. Normally, enzymes naturally break down any accumulated histamines in the body. Histamines that are present in the digestive system are broken down by the enzyme diamine oxidase (DAO), whereas Histamine N-methyltransferase (HMT) breaks down histamines in the central nervous system (CNS).
What are Histamines? An Histamine Definition
Histamine (2-(1H-imidazol-4-yl)ethanamine) is a neurotransmitter that is directly involved with the immune system, digestive system, and the CNS. The main beneficial role that histamines play within the body is to cause an immediate inflammatory response to alert the body of potential danger, and to trigger an immune response.
Histamine Intolerance is typically seen when an over-abundance of histamines occurs in the digestive system. In a healthy person, diamine oxidase breaks down histamines, before the histamines are able to trigger a response from the immune system. A person who is deficient in DAO is likely to display symptoms of intolerance.
Histamine Intolerance Feels Like an Allergy
If a person has experience with seasonal allergies or food allergies then they have already experienced a histamine reaction, and have experienced some of the same symptoms as a person with histamine intolerance. It is the histamines caused by the allergen that produce symptoms. The build-up of histamines in the body can cause watery eyes, itching, headaches, and a host of other symptoms. These symptoms are the result of the immune system trying to fend off harmful invaders.
It is common to take anti-histamines to relieve allergy symptoms. Anti-histamines work to reduce or block histamines from attaching to cells and thus causing discomfort.
But Histamine Intolerance and Allergies Are Not the Same
Histamine Intolerance is not the same as having an allergic reaction. With histamine Intolerance, skin tests and blood tests for allergies will be negative. This is because histamine intolerance is not mediated by the immune system, but is caused by a build-up of histamines (and not from the release of histamines, like with an allergy).
Histamines are stored in the body. The body has a certain level of histamines that it is able to tolerate without having a reaction. This means that a person may eat a meal high in histamines early in the day with no ill effects, but could eat a meal low in histamines later in the day and having a reaction due to the histamine limit being exceeded.
The Symptoms of Histamine Intolerance
The symptoms of histamine intolerance may be very similar to the symptoms of an allergic reaction. As histamines can travel through the bloodstream, histamine intolerance may result in a wide variety of troubling symptoms. Histamines can affect the skin, brain, lungs, and the cardiovascular system. Some of the most common histamine intolerance symptoms are listed below:
The Causes of Histamine Intolerance
- Negative for allergy or internal disorder
- Swelling, hives, or flushing
- Dysregulation of body temperature
- Abdominal cramping
- Nausea, vomiting, or diarrhea
- New or worsening asthma symptoms
- Unexplained headaches, migraines, or anxiety
- Itching eyes, post nasal drip, or nasal congestion
- Abnormal menstrual cycles
- Hypotension caused by vasodilation
- Cardiac arrhythmia
Biological mechanisms of histamine intolerance
The exact mechanisms involved in histamine intolerance are still under investigation. The condition is thought to be a genetic or environmentally caused impairment in one of the two enzymes (DAO, HMT) responsible for the breakdown of histamines.
The condition is most prevalent in those with gastrointestinal disorders such as celiac, small intestinal bacterial overgrowth (SIBO), leaky gut, and irritable bowel syndrome (IBS). Histamine intolerance can also be a side effect or certain medications. Medications that may cause histamine intolerance by blocking DAO include:
- NSAID’s (aspirin, ibuprofen, naproxen, and others)
- Antidepressants (Prozac, Effexor, Cymbalta, and others)
- Immune modulators (Plaquenil, Humira, and others)
- Histamine blockers (Pepcid, Zantac, and others)
- Antiarrhythmics (metoprolol, Cardizem, and others)
Is Histamine Intolerance a Medical Condition?
While some physicians question whether histamine intolerance is a true condition, it was recognized as one by the German Society for Allergology and Clinical Immunology in 2012. There is not a lot of data available on the number of incidences of the disorder.
Diagnosing and Treating Histamine Intolerance
As of now, there is no single definitive histamine intolerance test. It is possible to measure DAO activity in the bloodstream. Histamine levels can also be measured in the blood and urine, but these tests do not seem to correlate with the symptoms with any degree of significance.
Before deciding on a histamine intolerance diagnosis, other conditions, such as inflammatory bowel disease, mast cell disorders, colitis, SIBO, and allergies should be investigated. Histamine intolerance often occurs alongside other disorders. Treating any underlying disorders can improve histamine tolerance.
The Low Histamine Diet
A diet eliminating high histamine foods should be actively pursued if histamine intolerance is suspected. A low histamine diet should be supervised by a healthcare professional to ensure proper nutritional intake. The amount of histamines tolerated will vary from one person to the next. Here are a few of the guidelines for a diet aimed at being a low histamine cure.
- Eat fresh food whenever possible
- Fresh meat and fish (avoid canned and processed)
- Fresh fruit (except citrus and strawberries)
- Fresh vegetables (except cabbage, spinach, and tomatoes)
- Rice, oats, corn, sorghum, and millet
- Cooking oils
- Avoid drinking red wine as this may cause a wine allergy
High histamine food List
If you have histamine intolerance then it is important to avoid eating high histamine rich foods.
The histamine content of food is not an exact science. There are many variables such as ripeness, maturity, and storage that affect the amounts present.
The following common foods are considered to be high in histamines or compounds known to be histamine liberators. Fermented and aged foods are high on the lists of foods to avoid. High histamine foods include:
- Cooking oils
- Foods containing vinegar (mayonnaise, olives, and pickles)
- Smoked or fermented meats and fish (sardines, herring, and salami)
- Pickled and Fermented foods (relishes, pickles, and soy sauce)
- Dried prunes, dates, raisins, and figs
- Legumes and wheat
- Cinnamon and chocolate
- Citrus, papaya, pineapple, nuts, egg whites, and food additives (histamine releasers)
- Black & green tea, and energy drinks (these block the DAO enzyme)
Histamine Intolerance Cure Treatments
In addition to a low histamine or histamine free diet, some patients are treated with antihistamines, or prescribed DAO supplementation as a cure. Many other patients prefer a more natural approach and rely on antihistamine foods such as turmeric or ginger for histamine intolerance relief.
There are also several over-the-counter and prescription medications that inhibit the DAO enzyme.
Some of those medications include aspirin, naproxen, and diazepam. Medical contrast can also cause histamine release. Any person who is suspected of having histamine intolerance should discuss their medication use with their physician.
Frequently Asked Questions
What is a celiac disease rash?
A rash if this kind is often very itchy, and often results in burning and blistering of the skin. A gluten rash is also known as dermatitis herpetiformis.
How does histamine affect the body?
As they are involved in smooth muscle tissue contraction, blood vessel dilution, and gastric acid secretion they can affect numerous bodily functions.
What is a histamine reaction?
This is a reaction that triggers the immune system into overdrive to help defend the body.
What is Histamine poisoning?
This is a form of food poisoning that is usually caused by eating fish that are not fresh. If fish are stored poorly then they may build up high levels of histamines, and eating them may cause you to get sick.
Many symptoms of histamine intolerance are similar to the symptoms of an allergy, but the conditions are not the same. Allergy symptoms are caused by the body’s release of histamines as a reaction to the allergen. The symptoms associated with histamine intolerance are caused by the build-up of histamines due to the failure of enzymes (DAO and/or HMT) to break down histamines from foods.
A person with an intolerance to histamines will show negative results in skin and blood tests for allergies. Histamine intolerance can be caused by genetics, medications, or as an effect of underlying medical conditions. The condition is typically managed with dietary changes, antihistamines, or DAO supplementation. There is currently no one definitive test to diagnose intolerance to histamines, so other potential causes for HIT symptoms should be investigated by a healthcare professional.
References and further reading:
Antihistamines prevent ‘Asian flush’ (alcohol-induced facial redness)