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Histamine Intolerance

by Emma Lane(more info)

listed in immune function, originally published in issue 288 - August 2023

 

Put simply, histamine intolerance is when someone experiences various symptoms after consuming foods or drinks high in histamine or has exposure to environmental factors that cause histamine release. This is due to the body’s inability to break down and eliminate excess histamine effectively. It is therefore a complex condition.

 

Histamine_symptoms

https://www.longhaulwiki.com/index.php/File:Histamine_symptoms.png

Summary of histamine-mediated symptoms. Adapted with permission from
Maintz L et al. Dtsch Artzebl 2006;103:A3477-83

Courtesy of Wikipedia

Symptoms of histamine intolerance can vary widely as it travels throughout the bloodstream and can affect the digestive tract, lungs, skin, cardiovascular system and brain and symptoms may include the following:

  1. Headache
  2. Irritability
  3. Anxiety
  4. Itching
  5. Flushing
  6. Hives
  7. Premenstrual syndrome
  8. Nasal congestion/ runny nose
  9. Gastrointestinal issues, including diarrhoea, nausea, or vomiting
  10. Low blood pressure
  11. Heart rate changes
  12. Difficulty breathing

 

Hives

Hives

Research indicates that those susceptible to histamine may also have problems when in a warm environment. For example, when exercising at a high intensity, histamine rises and falls with oestrogen, so females can find themselves experiencing more symptoms around ovulation and in the premenstrual window. High stress also increases histamine levels and decreases the body’s ability to metabolize the histamine.

What is Histamine

Histamine is naturally found in certain foods; it is also a molecule produced by the body’s immune and nervous systems involved in physiological processes, including allergic reactions, inflammation, gastric acid secretion, and neurotransmission. Histamine is stored in specialised cells called mast cells and is released in response to injury or invasion by foreign substances such as allergens, bacteria, and viruses, causing a range of symptoms, including itching, swelling, redness, and increased mucus production.

However, histamine is a very important part of the immune system and plays a role in inflammation in the body. We also need histamine in order to digest food, move our bowels, boost exercise performance, increase attention, and get blood as well as nutrients and oxygen delivered to different parts of the body.

One of the major effects of histamine is causing the blood vessels to swell and dilate. When the body senses that it is threatened it will secrete higher amounts of histamine. This allows the white blood cells to quickly move through the blood stream and find the potential threat or infection. Obviously, this is an important component to a healthy immune response. With the right amount of histamine, the body is able to perform these functions effectively. Problems occur when there is too much histamine. When the histamine levels increase, the body tolerance decreases. At this point, histamine can cause a wide variety of symptoms, and these symptoms can vary depending on where it is released in the body.

Histamine Intolerance

Generally, histamine intolerance is thought to be due to a build-up of histamine in the body. This build-up can cause symptoms to occur but not for everybody – In an individual who does not have histamine intolerance, the histamine is broken down within the body by the enzymes diamine oxidase (DAO) and histamine N-methyltransferase (HNMT).

When histamine intolerance is present, there could either be a genetic or a simple impairment in either or both of the enzymes responsible for the histamine breakdown leading to histamine build-up.

The exact cause of histamine intolerance is not fully understood, but it is a multifactorial condition related to genetics, diet, and lifestyle. And the underlying cause can vary from person to person. The impairment of DAO or HNMT is a major cause of this condition and having impaired intestinal function is very common. The enzyme DAO is produced in the intestine so any impairment to the intestine could result in a lack of the DAO enzyme impairing histamine breakdown. Therefore, those who suffer from gastrointestinal conditions seem to suffer from histamine intolerance more often.

There are many potential contributing factors of histamine intolerance to consider:

  1. Histamine-rich Foods
    Certain foods, such as aged or fermented foods, cured meats, canned fish, and certain fruits and vegetables, can contain high levels of histamine, which can trigger symptoms in people with histamine intolerance.
  2. Medications
    Some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants can inhibit the activity of DAO, leading to an accumulation of histamine in the body.
  3. Excessive alcohol intake
  4. Stress
    Chronic stress can lead to an increase in histamine release, exacerbating histamine intolerance symptoms.
  5. Hormonal changes and excess, particularly oestrogen
  6. Genetics
    Some people may be genetically predisposed to histamine intolerance, as certain genetic variations can affect the activity of DAO and HNMT enzymes.
  7. Adrenal dysfunction
  8. Medical Conditions
    Certain medical conditions, such as mast cell activation syndrome (MCAS) and autoimmune disorders, can increase histamine levels in the body and lead to the development of histamine intolerance.
  9. Environmental causes such as mould, pollen and dust mites
  10. Nutrient deficiencies

We will go more into the specifics later; however, I want to make it clear that Histamine intolerance is complex and not just about a low histamine diet and taking supplements although this is part of the approach to managing the challenge- what is key is finding the underlying causes of why the body has problems with histamine and addressing and resolving those. So, lifestyle factors can also play an important role in histamine intolerance management.

In this article I am primarily addressing high histamine issues however it is important to understand that low levels of histamine can also be a challenge although this is less likely than histamine intolerance.

Symptoms of insufficient histamine release

  1. Poor wound healing
  2. Poor digestion
  3. Weak immune response
  4. Low cognition / mood
  5. Slow to sweat / or no sweating

Symptoms associated with histamine intolerance are also not always immediate as for example they would be with an IgE food allergy response. Symptoms, however, can be triggered at any time when histamine has reached a certain level within the body. This is why identifying individual foods as culprits can be difficult.

Dealing with histamine intolerance can be challenging with a restrictive low-histamine diet, but the condition does tend to improve once underlying conditions are addressed. Many of these conditions are related to digestive health, which is why it’s critical to work with a practitioner who has experience with histamine intolerance and who will take an integrative approach to treating the condition. All systems in the body need to be supported or histamine intolerance may not improve.

Managing and Clearing Histamine Levels

Clearing histamine from the body can help alleviate the range of unpleasant symptoms. By reducing histamine levels through natural methods such as diet, supplements, and stress management, individuals with histamine intolerance can improve their quality of life.

Eat a Low Histamine Diet

Some foods naturally have more histamine content while others accumulate histamines as they age. Fermented and dried foods generally have the highest levels of histamines. A low histamine diet should be focused around getting foods at their peak level of freshness. 

High Histamine Foods

  1. Fermented foods: sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha, etc
  2. Cured meats: bacon, salami, pepperoni and luncheon meats
  3. Smoked fish and certain species of fish: mackerel, tuna, anchovies, sardines
    Fish needs to be frozen or as fresh as possible (research indicates that fresh fish has significantly less histamine content than frozen fish, however histamine levels rise in fresh fish very quickly with improper handling and storage due to the increase in histamine producing bacteria. So, if the fish is flash frozen immediately after it’s been caught it can be a safer bet. Ultimately, it’s difficult to know which is safer!
  4. Aged cheese including goat cheese
  5. Vinegar-containing foods: pickles, mayonnaise, olives
  6. Fermented alcoholic beverages, especially wine, champagne and beer
  7. Soured foods: sour cream, sour milk, buttermilk, sour bread
  8. Dried fruit: apricots, prunes, dates, figs, raisins
  9. Most citrus fruits
  10. Nuts: walnuts, cashews, and peanuts
  11. Vegetables: avocados, aubergine, spinach, and tomatoes
  12. Processed foods of all types – Preservatives are high in histamines
  13. Canned foods

People with histamine intolerance react in a multitude of different ways.  Some people cannot handle any high histamine foods while others can handle certain types but not all.

There are Also Histamine-Releasing Foods

These foods block the action of DOA and therefore they can raise the effects of elevated histamines.

  1. Nuts
  2. Black and green tea
  3. Alcohol
  4. Bananas (especially very ripe)
  5. Chocolate
  6. Cow’s Milk
  7. Papaya
  8. Pineapple
  9. Shellfish
  10. Strawberries
  11. Tomatoes
  12. Many artificial preservatives and dyes

Incorporate Supplements and Natural Antihistamines

Incorporating good quality supplements into your daily lifestyle can help reduce and manage histamine intolerance symptoms as well as supporting your wellbeing in general. The following list has the ones that I have found to be the most helpful with histamine intolerance.

DAO Supplement

Diamine oxidase (DAO) is a vital enzyme in the body and regulates presence of histamine, DAO can break down histamine when the body’s natural DAO production is insufficient. It is believed that using DAO supplements can help break down excess histamine in the digestive system, preventing it from being absorbed into the bloodstream and causing unwanted symptoms.

I like a product called Histamine block; this contains DAO. It is helpful to take before a histamine heavy meal because it will boost the DAO level reducing potential symptom expression.

Benefits - It can help reduce bloating and enhances digestion and other metabolic processes in the body. It can reduce severity of eczema and reduce the reaction in a person when they have ingested a high histamine food. It helps to support inflammatory responses in the digestive tract, boost the digestive processes and metabolism as a whole. It has an optimised stability as compared to some other supplements, a good source of diamine oxidase enzyme, and good effects when taken before meals.

https://www.holisticsonline.com/product/histamin-block-90-capsules/

Quercetin

Quercetin is a flavonoid found in several plants such as onions, apples, and berries. It is an antioxidant. Quercetin controls the mast cells from releasing histamine. It takes time to be absorbed into the body so it is advisable to be taken 15 – 30 minutes before a meal.

Benefits – reduces allergic symptoms, helps support the bodies’ ability to quench free radicals, reduces inflammatory responses which may lead to allergic reaction, reduces respiratory side effects, can help with side effects of dust, pollen, hay fever and the sun. Quercetin is very helpful with sleep challenges caused by histamine dysregulation, taken at night before bed or if woken during the night as it can help reduce the symptoms that can be disturbing to your sleep.

https://www.holisticsonline.com/product/quercitin-ascorbate/

Vitamin C

This is a natural anti-histamine. It is a co-factor for diamine oxidase and also alcohol dehydrogenase, this is the final enzyme that helps in the breakdown of histamine, so whenever experiencing symptoms, taking 1500mg of vitamin C can help calm symptoms down. The best forms to use would be liposomal as these also contain phosphatidylcholine which help to support the cell membranes. You can also take a separate phosphatidylcholine such as Optimal PC alongside a vitamin C, as that also helps in the regulation of histamine within the body.

Benefits – Vitamin C would help relieve the stuffy nose, help prevent symptoms of allergies and histamine, help in the digestive process and other methylation processes and reduce oxidative stress.

https://www.holisticsonline.com/product/liposomal-vitamin-c-120ml/

Probiota Histamin X

Many probiotics can cause more harm than good for histamine, Research suggests that certain strains of high-quality probiotics, such as Lactobacillus rhamnosus, Bifidobacterium lactis, and Lactobacillus plantarum, may help to reduce histamine levels in the body. These probiotics improve gut health, reduce inflammation, and promote the growth of beneficial bacteria that can help break down histamine. Probiota Histamin X is my preferred probiotic as it contains entirely histamine friendly strains of bacteria that are safe for the gut, it reduces histamine rather than a flare up, helps to reduce the histamine producing bacteria, it has both herbal and plant derived compounds that work together to ease inflammation, and histamine affects. Its best to take in the afternoon or evening.  It is also good to take if you feel histamine symptoms coming on as this can help relieve them.  

https://www.holisticsonline.com/product/probiota-histaminx-powder-60-servings/

Magnesium

Vital for human cells due to cell processes. It is thought that histamine intolerances are partly due to magnesium deficiency because magnesium is needed in the production of DAO therefore if you don’t have sufficient DAO the body’s histamine levels will increase. Many of the symptoms you will experience when intolerant to histamine emanate from the release of histamine from immune cells, so when you lower the blood histamine levels you reduce these symptoms. One way to achieve this is through the use of magnesium – taking a dose around 300mg or higher daily.

https://www.holisticsonline.com/product/liposomal-magnesium/

https://www.holisticsonline.com/product/magnesium-malate/

https://www.holisticsonline.com/product/magnesium-glycinate-malate/

https://www.holisticsonline.com/product/ionic-magnesium-2floz/

Colostrum

Colostrum is rich in antibodies. These antibodies help to boost an individual’s immune system, therefore are good for immunity especially when run down or ill. Helps to prevent allergic reactions, helps ease gastrointestinal challenges and can help ease diarrhoea caused by infections and allergies.

https://www.holisticsonline.com/product/oramune-max/

https://www.holisticsonline.com/product/liquid-gold-colostrum-100ml/

Nettle leaf: A natural antihistamine that can help to reduce allergy symptoms.

Butterbur: A plant with natural antihistamine properties available in supplement form.

We have a large selection of histamine related products on our website www.holisticsonline.com. Some products will not be visible as they are practitioner only products, however if you are a practitioner and would like to register with us, please send an email to sales@holisticsonline.com. To order any of the products above please call the office on 01924 242851 and quote Positive Health.

 

Healthy Mind

Healthy Mind

Decrease your Stress

Stress is a common trigger for histamine intolerance symptoms, as it can increase inflammation and trigger histamine release. So, managing stress through meditation, yoga, or deep breathing exercises can help reduce histamine level.

Drinking water can help with histamine intolerance:

  1. Histamine is a byproduct of many cellular processes in the body and needs to be eliminated through urine. Drinking enough water can help to flush out histamine and other toxins from the body and prevent it from building up and triggering symptoms.
  2. Dehydration can trigger the release of histamine in the body, leading to symptoms

Exercise will increase blood flow and lymphatic drainage, which can help to remove histamine from the body.

  1. Try incorporating low-impact activities such as cycling, dancing, resistance training, yoga, swimming, walking.
  2. Gradually increase activity levels, this prevents overexertion and the release of histamine. 
  3. Consider the timing for exercise: exercising in the morning can be beneficial when histamine levels are naturally lower.

How Quickly can Histamine Levels be Reduced

The time it takes to lower histamine levels in the body will vary depending on the individual and the cause of the histamine intolerance. In some cases, such as exposure to a histamine-rich food, symptoms may resolve within a few hours to a few days.

In general, it will take longer for those with chronic histamine intolerance to lower histamine levels and alleviate symptoms. Making dietary and lifestyle changes, such as those mentioned above, will gradually help lower histamine levels over time.

In Conclusion

It’s important to remember that lowering histamine levels is not a quick fix and may require ongoing management to prevent symptoms from recurring. And if the individual has any underlying health conditions or is taking medications that affect histamine levels, it’s important to work with an experienced practitioner to identify the root cause and determine the best course of treatment for you. 

Over time as histamine content is reduced and underlying health issues are addressed - improving gut health, reducing inflammation, improving liver function and managing and balancing adrenal function and stress an individual will be able to handle more of the histamines. For some, this will mean they will be able to incorporate small amounts of all the higher histamine foods. For others they will only be able to handle certain foods.

Deep and lasting healing is only possible when the root causes of illness are addressed. Understanding the core systems of the body, how they are related, and how an individual’s function can be restored can prevent and even reverse histamine intolerance. 

References

Barrett-O’Keefe, Z., Kaplon, R. E. and Halliwill, J. R. (2013), Sustained postexercise vasodilatation and histamine receptor activation following small muscle-mass exercise in humans. Experimental Physiology, 98: 268–277

Shilpa Shah, “Hormonal Link to Autoimmune Allergies,” ISRN Allergy, vol. 2012, Article ID 910437

Maintz L, Novak N. Histamine and histamine intolerance. Am J Clin Nutr. 2007 May;85(5):1185-96. PMID: 17490952

Reilly, M. A. and Schayer, R. W. (1972), Effect of glucocorticoids on histamine metabolism in mice. British Journal of Pharmacology, 45: 463–469

Histamine and histamine intolerance. Am J Clin Nutr. 2007 May;85(5):1185-96. PMID: 17490952

Maintz L, Novak N. Histamine and histamine intolerance. Am J Clin Nutr. 2007 85(5):1185-96. doi:10.1093/acjn/85.5.1185

San Mauro Martin I, Brachero S, Garicano Vilar E.Histamine intolerance and dietary management. A complete review. Allergol Immunopathol (Madr). 2016;44(5):475-483

Reese I, Ballmer-Weber B, Beyer K, et al. German guideline for the management of adverse reactions to ingested histamine. Allergo J Int. 2017;26(2):72-79. doi:10.1007/s40629-017-011-5

Duelo.A.Diestistas nutricionistas especialistas en Deficit DAO-AD Dietestas. http://www.adrianaduelo.com/  .Accessed September 17, 2018

Parmasivam, Sadayan, Balanchandar, Balakrishnan Arulkumar A. Change in Histamine Levels and Microbial Load in the Eviscerated and Uneviscerated Inidian Mackerel Fish (Rastrelliger kanagurta) at Different Storage Temperatures. Am J Adv Food Sci Techol. 2015;3(2):94-106

Komericki P, Klein G, Reider N, Hawranek T, Strimitzer T, Lang R, Kranzelbinder B, Aberer W. Histamine intolerance: lack of reproducibility of single symptoms by oral provocation with histamine: a randomised, double-blind, placebo-controlled cross-over study. Wien Klin Wochenschr. 2011 Jan;123(1-2):15-20. PMID: 21165702

“Histamine Intolerance Originates in the Gut – PMC – NCBI.” 12 Apr. 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069563/

Acute stress modulates the histamine content of mast cells in … – NCBI.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2343625/

Diamine oxidase supplementation improves symptoms in patients ….” 24 May. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859183/

“Quercetin and Its Anti-Allergic Immune Response – PMC – NCBI.” 12 May. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6273625/

 

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About Emma Lane

Emma Lane ND Dip NT CMTA C.H.E.K IV HLC3 PEA RSA – Founder and Director of the Lane Wellness Group – has more than 30 years’ experience in the industry, working as a Naturopath, Naturopathic Nutritionist and Functional Medicine Practitioner. She is a registered practitioner of ISEAI (The International Society for Environmentally Acquired Illness). Emma has two busy practices in the north of England and central London and is also the Founder and Director of Integrative Health Education and PCI Europe. Emma regularly lectures around the world and is passionate about sharing her knowledge with other practitioners. She works closely with Dr Omar Amin, a world-renowned professor of parasitology. Emma is qualified to practise across a wide range of natural health sciences including Naturopathy, Naturopathic Nutrition, Functional Medicine, FSM (frequency specific microcurrent) Neuro-linguistic Programming, Timeline Therapy, Hypnotherapy, Auricular Acupuncture, Functional Corrective Exercise, Sound Therapy and Energy Healing. For further information please contact Emma on Tel: 01924 242 851 and via Energize, Mind, Body;    Holistics Online,    Parasite Testing,    Integrative Health Education ,   Lane Wellness Group

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