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Understanding Histamine Intolerances


When we see the word “histamine,” our mind may automatically go to antihistamines, which we take in order to aid in treating our cold and flu symptoms, as well as our allergies. But what if we take a step back to think about what these drugs are working against in our bodies?

What is histamine?

Histamine is a type of vasoactive amine, which plays a role in acute inflammatory response. They are a chemical responsible for multiple processes within our bodies; histamine can stimulate gastric acid secretion, play a part in inflammation, dilate our blood vessels, affect muscle contractions within the intestines and lungs, as well as affect our heart rates.

Histamine also helps transmit messages between our nerve cells in addition to aiding the movement of fluids throughout blood vessel walls. Our body may also release histamine if there is a threat from a particular allergen, which can lead to our common allergy symptoms when our vessels dilate and swell.

What are histamine intolerances?

Histamine intolerance, which is also known as enteral histaminosis or sensitivity to dietary histamine, is a disorder in which an individual may experience an impaired ability to digest the histamine we consume or ingest. Having a histamine intolerance does not mean that you’re allergic to histamine, rather, it actually means that you have developed too much of it. Thus, a build-up of histamine can prevent our bodily functions from carrying out properly.

It’s estimated that around 1-3% of the population have histamine intolerances, with 80% of those affected falling into the middle-aged group, specifically women over the age of 40. It’s thought that histamine intolerance is due to a lack of the enzyme diamine oxidase (DAO), but there aren’t any reliable tests to diagnose a sensitivity to vasoactive amines today.

When experiencing too much histamine, can trigger an inflammatory response across various regions of the body. Signs of histamine intolerance will manifest in a variety of ways, including headaches or migraines, hives, rashes, itchy skin, congestion, fatigue, digestive issues, nausea, and vomiting. In more serious cases, some individuals may also experience high blood pressure, an irregular heart rate, cramping of the abdomen, anxiety, and trouble with body temperature regulation.

What causes high levels of histamine?

Our bodies will naturally produce histamine and DAO, the enzyme responsible for breaking down the histamine that we ingest from foods we eat. Therefore, a deficiency in DAO could prevent our bodies from breaking down histamine, thus leading to a build-up. Gastrointestinal disorders and medications that block DAO functions or production can dramatically decrease DAO levels in our bodies. However, our diets and what we consume on the day-to-day play a role as well, with histamine-rich foods or foods that trigger histamine release causing a decrease in DAO levels, too.

There are three categories of food to look at when thinking of histamine intolerance: histamine-rich foods, foods that trigger histamine release, and foods that affect DAO levels.

Foods high in histamine include alcohol (wine, beer, cider, and champagne), coffee, fermented soy products (miso and tempeh), cheese (blue cheese, parmesan, old couda, hard cheese, etc), cured meat, many fresh or canned fish, tomatoes, peanuts, and tree nuts, as well as citrus fruits; foods that can trigger histamine release include cocoa and chocolate, egg whites, and fish; and foods that can affect DAO levels are energy drinks and tea (green, black, and maté).

If you’re seeking answers on whether you have histamine intolerance, it’s recommended that you first rule out an actual food allergy before beginning with diet experimentation and elimination. It’s suggested that individuals avoid certain items that could be a trigger for 2 to 4 weeks and monitor symptoms during that time. Gradually, one can begin to reintroduce the foods and try to understand how much your body can tolerate.

How to treat histamine intolerances?

Antihistamines, of course, will help with histamine intolerance. Beyond medication though, a diet that incorporates low-histamine foods can help reduce the aforementioned symptoms associated with intolerance. Foods that contain low amounts of histamine include non-citrus fruits, eggs, fresh meat, fresh fish, cooking oils (olive oil), and fresh vegetables (with the exception of avocados, eggplant, spinach, and tomatoes), dairy substitutes, and gluten-free grains.

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