Histamine intolerance (HIT) is a proposed condition when the body is unable to eliminate histamine from food and drink, leading to gastrointestinal and allergy-like symptoms. There are no official figures for those with a problem of HIT but it is estimated that 1% of the population suffer from this, which can be misdiagnosed or not diagnosed at all. A majority of those diagnosed are women in their 40s.¹

What is histamine?

Histamine is a natural chemical produced by the body and works to transmit messages between the body and the brain. It also plays an important role in digestion by triggering the release of stomach acid, as well as influencing the immune system. We need a certain amount of it but excess histamine can cause problems, which can occur, for example, when we eat foods high in histamine. Histamine levels are kept to within finite levels by the enzyme diamine oxidase (DAO).

Symptoms of histamine intolerance

An intolerance to histamine results in a wide range of symptoms due to histamine accumulation, which vary in individuals and may include:

• Nausea or vomiting
• Headaches
• Runny or a stuffy nose
• Itching
• Rashes or hives
• Bloating and/or diarrhoea
• Swelling of the lips or throat

It is important to understand that there is another concern called Mast Cell Activation Syndrome, MCAS, which people may mistakenly think of as histamine intolerance.

With histamine intolerance, the body cannot break down histamine properly and the symptoms may worsen when they eat histamine-rich foods.

With MCAS, the mast cells in the body, which are part of the immune system, become overly active and release histamine and a range of other chemicals which means that the symptoms may also include irregular heartbeat, difficulty in breathing, and more diverse digestive problems.

What causes histamine intolerance?

We do not fully understand the causes of histamine intolerance but what we do know is that an enzyme, DAO, is responsible for breaking down histamine.

A deficiency of DAO may be caused by:

• Medications that block DAO such as antihistamines and some antidepressants
• Foods that block DAO
• Inflammatory bowel disorders such as IBD and Leaky Gut Syndrome

Other causes include eating histamine-rich foods or foods that stimulate excess histamine production and large numbers of microorganisms in the gut, as is the case with SIBO, which can produce histamine.

What foods are high in histamine?

If you have HIT, you may wish to avoid foods high in histamine which include fermented beverages, alcohol, aubergines, avocados, smoked meat, dairy products, and shellfish.

You may also wish to avoid or reduce intake of foods that trigger histamine release, which include alcohol, citrus fruits, beans, tomatoes, chocolate, beans, and nuts, including cashews and peanuts.

Alcohol, bananas, black tea, green tea, and many energy drinks block the production of DAO which is required to break down histamine.

It is not possible to have a histamine-free diet, but a low histamine diet will certainly be of benefit in preventing symptoms.

Are there any histamine intolerance tests and how accurate are they?

Because HIT has a diverse range of symptoms associated with allergies and diseases, there is not one single test that can be deemed to be accurate in diagnosing histamine intolerance. Histamine intolerance is diagnosed by using blood tests to measure DAO levels, skin prick tests, histamine challenge tests, and genetic tests. It is better to use a combination of tests and medical history to prevent the wrong diagnosis and this should be carried out by a qualified professional. Ideally keep a food diary to identify if a specific food may be the cause of intolerance.

Treating histamine intolerance

Since a deficiency of DAO, an enzyme that breaks down histamine, is linked to histamine intolerance, it follows that any nutrient that enhances DAO levels will be of benefit. ²

Vitamin C is a powerful antihistamine and an anti-inflammatory nutrient. When vitamin C levels decrease, histamine levels increase.  Vitamin C is vital to produce the histamine degrading enzyme DAO.  Consider taking DoSe Liposomal Vitamin C since other forms of vitamin C do not enter the bloodstream in sufficient amounts to make a significant difference. When vitamin C is in a liposome, it is better absorbed than non-liposomal versions.

Probiotics for histamine intolerance

Food sensitivities to foods high in histamine almost always indicate that there is something going on in the gut.  Whilst there are many causes for histamine intolerance mentioned above, it appears that intestinal permeability, as in leaky gut, and SIBO remain top of the list.

There are many bacteria in the gut that can convert histidine in protein into histamine. This histamine can then enter the bloodstream, causing a variety of symptoms.

From the small amount of research available, it appears that the bacteria used to ferment yoghurt or fermented foods could exacerbate histamine intolerance. These typically include Lactobacillus casei and Lactobacillus bulgaricus. The probiotic strain Lactobacillus rhamnosus GG appears to have a positive effect on histamine intolerance symptoms by down regulating histamine receptors and by increasing anti-inflammatory compounds in the gut that may help to prevent intestinal permeability or a leaky gut, as well as prevent pathogenic bacteria from adhering to the gut walls, which affects the gut’s immune response.^3-6 Viridian Nutrition Synerbio Lactobacillus Rhamnosus GG supplement is the probiotic supplement of choice for those with histamine intolerance.

Supporting gut health is a top priority to manage histamine intolerance. Rebalancing the microbiome and improving the integrity of the gut wall should be beneficial.

Quercetin for histamine intolerance

Quercetin is a flavonoid antioxidant that is found in a variety of plants and foods including onions, parsley, sage, and kale. Quercetin has been shown to display potent antioxidant and reduce inflammatory compounds in the bloodstream. Additionally, it is thought to stabilise mast cells, which produce histamine and so works rather like a natural antihistamine. Lamberts Quercetin provides a full 500mg strength of this remedy to combat the symptoms of histamine intolerance.

You cannot cure histamine intolerance but by adapting your diet and taking the correct supplements, you can prevent or alleviate the symptoms of histamine intolerance.

References:

1. https://www.histamineintolerance.org.uk/
2. Izquierdo-Casas, J. et al. (2018) Diamine oxidase (DAO) supplement reduces headache in episodic migraine patients with DAO deficiency: A randomized double-blind trial. Clin Nutr. doi: 10.1016/j.clnu.2018.01.013. [Epub ahead of print].
3. Deepika Priyadarshani, W. M. and Rakshit, S. K. (2011), Screening selected strains of probiotic lactic acid bacteria for their ability to produce biogenic amines (histamine and tyramine). Inter J Food Sci & Tech. 46: 2062–2069. doi: 10.1111/j.1365-2621.2011.02717.x
4. Capozzi, V. et al. (2012) Biogenic Amines Degradation by Lactobacillus plantarum: Toward a Potential Application in Wine. Front Microbiol. 2012; 3: 122. Published online Apr 2, 2012. Prepublished online Mar 4, 2012.doi: 10.3389/fmicb.2012.00122
5. Spiller, R. (2008), Review article: probiotics and prebiotics in irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 28: 385–396. doi: 10.1111/j.1365-2036.2008.03750.x
6. Dev, S. et al. (2008). Suppression of histamine signaling by probiotic Lac-B: a possible mechanism of its anti-allergic effect. J Pharmacological Sci. 107(2), 159-166