Could Histamine Intolerance be the Cause of Your Symptoms

Do you get a flushed face when you drink red wine? Do you suffer from unexplainable head aches or anxiety? Maybe you get an itchy tongue or flu like symptoms after eating certain foods?

If you answered yes to any of these questions you may have histamine intolerance. 

What is Histamine?

Histamine is a chemical compound involved in the immune response, digestion and the central nervous system. Histamine is involved in:

• Fighting off foreign invaders (even mild allergic reactions)

• Acting as a neurotransmitter

• Regulating stomach acid production, muscle contraction, brain function, sleep and more. 

You may be familiar with histamine if you have ever suffered from seasonal allergies and been prescribed antihistamine tablets to help combat symptoms. This is due to histamines role in producing an immediate inflammatory response, notifying your immune system that there is a potential threat. 

Histamine causes blood vessels to dilate, so that white blood cells can rapidly infiltrate the area and attack the offending substance or problem. As histamine begins to build up in the area symptoms begin to appear, such as flushing of the face, headaches, itchy skin, or sinus leaving you feeling terrible. 

This is all part of the bodies natural immune response, but if histamine is left to build up and isn't metabolised properly, histamine intolerance can occur. 

Symptoms of Histamine Intolerance

The most common symptoms of histamine intolerance include:

• Head aches & migraines

• Dry skin, eczema, psoriasis and other skin disorders.

• Gastrointestinal disorders such as bloating, irritable bowel syndrome, constipation, diarrhoea & flatulence.

• Fatigue & lethargy

• Vertigo or dizziness

• Anxiety or panic

• Sneezing, watery eyes, sinusitis

• Itchy skin, hives or welts.

• In children deficiency in diamine oxidase enzyme has been linked to ADHD

Causes of Histamine Intolerance

Under normal conditions, excess histamine in the body is broken down by specific enzymes. In the central nervous system this is histamine N-methyltransferase (HMT), while in the gut it is primarily diamine oxidase (DAO) which is responsible for metabolising food sources of histamine. 

Histamine intolerance is often due to one or several factors:

• DAO enzyme deficiency

• Consuming to much food high in histamine or that can alter enzyme functional

• Genetic alteration

• Allergies (IgE)

• Bacterial overgrowth 

• Leaky gut

• Inflammatory conditions of the digestive tract

• Medication (NSAIDS, Antidepressants, Immune modulators)

Dietary Sources of Histamine

While histamine can be produced naturally within the body, it can also be obtained from the diet. These food sources can be responsible for one of three things. They can either contain natural histamine, block the enzyme responsible for breaking down histamine or stimulates the release of histamine. 

A list of these foods can be found below

Foods high in histamine 

• Alcohol (red wine in particular)

• Other fermented beverages such as kombucha & kefir

• Fermented foods: vinegar, soy sauce, sauerkraut, & yoghurt

• Aged cheese including goats 

• Vinegar containing foods such as olives, mayonnaise & pickles

• Processed meat (i.e. bacon, salami etc)

• Spinach

• Avocado

• Dried fruit

• Some nuts

• Night shade vegetables (potato, capsicum, chili, eggplan,tomatoes, eggplant

• Some spices: cinnamon, anise, chilli, nutmeg, cayenne & cloves

• Leftover meat (this is because the bacteria that begins to grow on it produces histamine. For this reason it is advised to eat freshly cooked meat and store properly)

• Coffee, cacao, green tea & matcha

• Preservatives

• Smoked fish

Foods that trigger histamine release

• Alcohol

• Fermented foods

• Eggs

• Citrus fruit

• Strawberries

• Tomatoes

• Banana

• Chocolate

• Dairy products

• Wheat germ

• Shellfish

• Artificial colours and preservatives

Foods that block diamine oxidase

• Alcohol

• Fermented foods

• Sugary soft drinks

• Black tea, Matcha tea and green tea

Histamine intolerance & the gut microbiome

The enzyme Diamine oxidase, which we spoke of earlier that breaks down histamine in the gut, is produced and stored within the cell walls of the small intestine and colon. When food is consumed this enzyme is released to metabolise any histamine present. 

When there is structural damage to the intestinal walls due to inflammation, disease or microbial imbalance, DAO cannot be produced or stores, resulting in deficiency. 

Gastrointestinal disorders such as IBS, Crohn's disease, small intestinal bacterial overgrowth (SIBO), and dysbiosis are all characterised  by an imbalance in "good" and "bad" gut bacteria. It is the "bad" bacteria which are responsible for producing histamine and causing inflammation which can damage the intestinal lining. If inflammation persists leaky gut can result. 

Treating histamine intolerance

Its not enough to just treat the symptoms of histamine intolerance alone, the underlying cause needs to be identified and addressed.

Implementing a low histamine diet can be extremely helpful while treating the underlying cause. This involves removal of the foods listed above, focusing on foods low in histamine. This is usually for a period of time (anywhere from 1-4 months), at which point foods may be reintroduced into the diet one at a time to assess for any reactions.

Foods low in histamine

• Freshly cooked meat and poultry

• Fresh fish 

• Good quality extra virgin olive oil

• Pasture raised eggs

• Brown rice & Quinoa

• Fresh fruit other than pineapple, tomato, avocado, citrus, banana's and strawberries

• Fresh vegetables other than the above mentioned.

• Herbal tea

• Leafy herbs

• Almond butter

• Coconut oil and grass fed butter & ghee

• Oat & rice milk.

De-Stress

There are countless research papers out there on the health impacts of stress on human health. In regards to histamine, stress can actually be histamine liberating. This means that stress can cause histamine to be produced and secreted by the body. Implemented stress reduction techniques such as meditation or moderate intensity exercise can be of benefit in cases of histamine intolerance. 

Gut repair

In order to build up histamine tolerance once again, it is vitally important to repair the lining of the gut, reducing intestinal inflammation, and rebalancing beneficial bacteria. 

Probiotics

This is a tricky one, while probiotics are considered beneficial, some strains can produce histamine. Speak to your naturopath before beginning probiotic therapy. 

Olive oil

Good quality olive oil is a great way to increase diamine oxidase naturally. Olive oil is high in oleic acid, which can increase the amount of DAO released into the blood to metabolise histamine. 

Its important to seek the advice of a qualified practitioner before implementing any dietary change. If you suspect that histamine intolerance may be the cause of your symptoms, please feel free to get in contact or make a booking. 

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Melissa Briggs is an experienced Brisbane based Naturopath with a particular interest in women’s health and thyroid disorders. Need help with your health? Get in touch here.