Histamine intolerance is becoming an increasingly common issue, affecting a growing number of people in the U.S. While histamine is essential for various bodily functions, an excess of it can cause significant health problems. Understanding what histamine is and how to manage its levels can help alleviate the symptoms of this often-misunderstood condition.
What is Histamine?
Histamine is a naturally occurring chemical in the body that plays a vital role in several processes:
- Neurotransmission: It helps transmit messages between nerve cells.
- Digestion: It stimulates the release of stomach acid to aid in digestion.
- Immune response: It triggers an inflammatory response to injuries or allergic reactions.
- Sleep regulation: Histamine helps regulate the body’s sleep-wake cycle.
While histamine is necessary for proper bodily function, issues arise when it accumulates to levels higher than the body can handle, leading to histamine intolerance.
What is Histamine Intolerance?
Unlike an allergy to histamine, histamine intolerance occurs when the body cannot break down histamine efficiently, leading to its buildup. The resulting excess of histamine in the body can cause a wide variety of symptoms that resemble an allergic reaction, affecting multiple body systems.
Symptoms of Histamine Intolerance
Histamine intolerance symptoms can vary based on the amount of histamine in the body. They can affect the gastrointestinal, neurological, cardiovascular, and skin systems, among others. Common symptoms include:
Gastrointestinal:
- Diarrhea
- Irritable bowel syndrome (IBS)
- Bloating and gas
- Heartburn
- Nausea or vomiting
Neurological:
- Chronic headaches
- Mood swings
- Brain fog
- Anxiety
Cardiovascular:
- Irregular or fast heart rate
- Low blood pressure
Skin:
- Rashes and hives
- Eczema
- Flushing (especially in the head and chest)
Ear, Nose, and Throat:
- Sneezing
- Itching
- Nasal congestion or sinus issues
Other:
- Fatigue
- Dizziness
- Sleep disturbances
- Menstrual pain
These diverse symptoms make histamine intolerance challenging to diagnose, as they overlap with other health issues.
What Causes Histamine Intolerance?
Histamine intolerance is primarily caused by an inability to break down histamine in the body. This can occur due to a deficiency in the enzymes diamine oxidase (DAO) and histamine N-methyltransferase (HNMT), which are responsible for breaking down histamine. Several factors can affect these enzymes and contribute to histamine intolerance:
- Genetic predisposition
- Chronic stress
- Gastrointestinal issues (e.g., leaky gut, small bowel overgrowth)
- Certain medications, like NSAIDs
- Diet high in histamine-rich foods
- Vitamin deficiencies
- Allergies
When the body cannot break down histamine efficiently, it leaks into the bloodstream, leading to a systemic immune response that causes symptoms throughout the body.
How is Histamine Intolerance Diagnosed?
To diagnose histamine intolerance, doctors often begin by ruling out other conditions or allergies that might cause similar symptoms. An elimination diet may be suggested to identify food triggers. Keeping a food diary and noting symptoms after eating certain foods can also help pinpoint histamine intolerance.
In some cases, the following tests may be recommended:
- Blood tests to measure DAO levels.
- Serum tryptase tests to rule out mast cell disorders (since mast cells release histamine).
- Skin-prick tests for histamine sensitivity (though this test is not always reliable).
The most effective diagnostic tool is often the elimination of high-histamine foods, with symptom improvement serving as confirmation.
Managing Histamine Intolerance
Treatment of histamine intolerance primarily involves avoiding histamine triggers and supporting the gut with proper diet and lifestyle changes.
Managing Histamine Intolerance with Diet
To manage histamine intolerance, it’s important to limit foods that contain high levels of histamine, trigger the release of histamine, or inhibit the function of DAO and HNMT enzymes.
High-Histamine Foods to Avoid:
Certain foods naturally contain high levels of histamine, especially those that are aged, fermented, or processed. These include:
- Alcohol, kombucha, and fermented beverages
- Aged cheeses
- Smoked meats (e.g., bacon, salami)
- Canned or smoked fish
- Pickled foods
- Dried fruits
- Certain fruits like strawberries, bananas, and citrus
- Vegetables like tomatoes, spinach, and eggplant
- Legumes like beans and lentils
- Peanuts, chocolate, and green tea
Foods that Trigger Histamine Release:
Even foods that aren’t high in histamine can trigger the body to release it, such as:
- Alcohol
- Shellfish
- Citrus fruits
- Tomatoes and avocados
- Beans, nuts, and chocolate
Foods that Inhibit DAO or HNMT Activity:
Some foods and drinks can interfere with the enzymes that break down histamine. These include:
- Alcohol
- Tea (green, black, and mate)
- Energy drinks
- Dairy (some yogurts) and raw egg whites
Low-Histamine Foods to Include:
To support a histamine-free diet, focus on fresh, low-histamine foods like:
- Fresh meats and fish (not canned or smoked)
- Cooked eggs, butter, and cream cheese
- Coconut oil and olive oil
- Most organic vegetables and fruits (excluding those high in histamine)
- Gluten-free whole grains like rice, quinoa, and oats
- Dairy-free beverages like coconut or rice milk
- Herbal teas (excluding green or black tea)
Supplements to Help with Histamine Intolerance
In addition to dietary changes, certain supplements can help manage histamine intolerance by supporting enzymatic activity and reducing inflammation. Helpful supplements include:
- Vitamin B1, B6, B12
- Vitamin C
- Magnesium
- Copper, zinc, calcium
- Folic acid
Natural antihistamines like stinging nettle, bromelain, butterbur, and quercetin can also be beneficial. Probiotics may help support gut health, but be cautious with fermented probiotics, as they can contain histamine.
For added relief, DAO enzymes are available over-the-counter and may support the body’s ability to break down histamine effectively.
Conclusion
Histamine intolerance is a complex condition that can significantly affect your quality of life, but with the right dietary and lifestyle changes, it can be managed effectively. By avoiding high-histamine foods, supporting gut health, and considering beneficial supplements, individuals with histamine intolerance can enjoy a healthier, more comfortable life.
