Histamine is a signaling protein that helps tell the body to exhibit certain actions. It is a necessary component for the processes required for immunity, communication of messages within the brain, inflammatory processes and triggers release of stomach acid. However, an excess of histamine can cause the following symptoms within the body:
- neurological – irritability, depression, brain fog
- dermatological – rash, flushing, hives, runny nose
- rheumatological – joint pain
- insomnia, fatigue
- cardiac – racing heart, palpitations
- gastrointestinal – altered bowel function, abdominal pain, non-celiac gluten sensitivity, reflux/GERD/heartburn.
There is new information now linking histamine intolerance to female reproductive conditions such as endometriosis and PCOS.
What causes histamine intolerance
Histamine intolerance is a multi-factor issue incorporating many systems within the body which help excrete histamine. Additionally, the food we consume adds to this load.
When histamine levels get too high or when it cannot break down properly, it can affect your normal bodily functions.
- Low functioning enzymes that help with the breakdown of histamine – DAO, HNMT, or monoamine oxidase
- Gut dysbiosis, IBS or inflammatory bowel disease
- Certain medications can block the breakdown. Ironically, antihistamines affect the breakdown of histamine. Other medications include analgesics, antibiotics, antidepressants, antacids, diuretics and non-steroidal anti-inflammatories.
- Certain foods can block the breakdown of histamine.
- Some foods can also liberate histamine in the body – cacao, citrus, bananas, egg white, crustaceans, nuts and seeds, pork, spinach, strawberries, tomatoes.
- Excessive consumption of foods that trigger the release of histamine (citrus, bananas, pork, egg white, chocolate, crustaceans, spinach).
- Hormonal imbalance (insufficiency or excess) – particularly an increase in oestrogen levels make women more susceptible to histamine intolerance
- Methylenetetrahydrofolate reductase (MTHFR) genetic mutations
- High levels of stress place high nutrient demands on the body.
- Presence of pathogens (many of which produce histamine or block methylation)
- Female reproductive issues are a risk factor for histamine intolerance as well as inversely high histamine having a direct effect on outcomes of PCOS, PMS and endometriosis.
Foods high in histamine
- additives and preservatives
- alcohol (particularly fermented drinks such as beer and wine)
- coffee and tea
- cured and smoked meats and seafood
- dried fruits
- fermented foods (cheese, kimchi, kombucha, sauerkraut, yoghurt)
- foods high in protein
- vinegars and food containing vinegar (e.g. pickles and mustard)
In general, fresher foods tend to have less histamine so the older leftovers are, the more histamine they contain.
How is it detected
The gold standard for assessing if you may have a histamine intolerance is by doing an elimination diet as this can show results quite quickly and you are treating it at the same time. We can also test histamine levels within the body, as well as levels of DAO, HMNT and monoamine oxidase.
A naturopathic approach
Fortunately, histamine intolerance is not like any other intolerance and can be treated relatively quickly and easily through your diet. Limiting amounts of histamine heavy foods like wine, cheese and aged meats can be a good start to reducing your symptom picture.
If antihistamines work well for you and reduce symptoms, this could indicate you may be histamine intolerant. Further, long-term use of antihistamines can lead to an intolerance, so it is best to try and address or manage the cause as opposed to masking the symptoms.
- Management of gut dysbiosis (most important) – through gut repair, potential microbiome mapping and introduction of specific probiotics related to histamine release. Repairing the gut can help to induce the production of the specific enzymes that breakdown histamine.
- A low histamine elimination diet (for one month) – with slow reintroduction of higher histamine foods to test for tolerance. This is going to quickly reduce histamine levels in the body and, as it causes gut issues, reduce any gut inflammation, helping to repair damage and increase excretion of histamine.
- Balancing hormones and addressing any associated conditions such as adrenal fatigue or high stress – there is a two-way relationship between histamine and cortisol, progesterone and oestrogen, which is why it is more likely to affect women.
- General anti-inflammatory and immune support – many herbs and nutrients help prevent the release of histamine and the processing of histamine in foods. Nutrient supplementation can include quercetin (antihistamine and anti-inflammatory properties), vitamin B6 (increases DAO activity), vitamin C (increases histamine metabolism and breakdown), vitamin E (may decrease mast cell activation) and magnesium sulfate (inhibits the release of histamines).
If symptoms do not improve, assessment of whether there may be MTHFR or other issues that may be causing the histamine load may be necessary.
Can you relate to this? Naturopathic treatment, testing and support is available. Book an appointment with one of our naturopaths. They are trained and experienced to work with you to get to the cause of your issues.
Written by Ally Stuart BHSc