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All you need to know about Histamine Intolerances.
Ms. Stephanie Karl | 18, Oct, 2016

Have you ever experienced a sudden out of the blue and unexplained feeling causing anxiety, headaches, flushing, itchy nose and tongue, or a runny nose when you eat bananas, avocados, pineapple or eggplants? You scan through possible allergen antagonists, and other bad boys on the block – gluten, dairy, nuts and eggs, but still have no answer or consistency. You could have a histamine intolerance.

Histamine is a chemical involved in digestion, regulating your immune system, and your central nervous system. It is a component of stomach acid, helping the breakdown of food in the stomach and as a neurotransmitter, communicating messages from your body to your brain.ave you ever experienced a sudden out of the blue and unexplained feeling causing anxiety, headaches, flushing, itchy nose and tongue, or a runny nose when you eat bananas, avocados, pineapple or eggplants? You scan through possible allergen antagonists, and other bad boys on the block – gluten, dairy, nuts and eggs, but still have no answer or consistency. You could have a histamine intolerance.

You might be most familiar with histamine as it relates to the immune system when exposed to seasonal allergens such as pollen, as well as house dust, cat saliva and food allergens. Generally antihistamine medications such as Claratine, Zytrec and Benedryl provide quick relief of symptoms by dampening down the immediate inflammatory response the immune system set up as it notified the body of potential hacking.

Histamine causes the blood vessels to dilate, while the white blood cells come to the aid and quickly find and attack the infection or problem. This is part of the body’s natural immune response, and finally enzymes will break down the histamine so that it does not continue to build up. If for some reason the histamine response does not dampen down, we refer to this as histamine intolerance.

Histamine causes the blood vessels to dilate, while the white blood cells come to the aid and quickly find and attack the infection or problem. This is part of the body’s natural immune response, and finally enzymes will break down the histamine so that it does not continue to build up. If for some reason the histamine response does not dampen down, we refer to this as histamine intolerance.

Common Symptoms of Histamine Intolerance

  •  Headaches/migraines
  •  Difficulty falling asleep, easily arousal
  •  Hypertension
  •  Vertigo or dizziness
  •  Accelerated heart rate
  •  Difficulty regulating body temperature
  •  Anxiety
  •  Nausea, vomiting
  •  Abdominal cramps
  •  Flushing
  •  Nasal congestion, sneezing, difficulty breathing
  •  Abnormal menstrual cycle
  •  Hives
  •  Fatigue
  •  Tissue swelling

Causes of High Histamine Levels

  •  Allergies (IgE reactions)
  •  Small intestinal bacterial overgrowth (SIBO)
  •  Leaky gut or increased permeability of the intestinal lining and IgG intolerance
  •  GI bleeding
  •  Diamine Oxidase (DAO) deficiency
  •  Histamine-rich foods

In addition to the histamine produced inside your body, there are foods that naturally contain histamine, cause the release of histamine, or block the enzyme that breaks down histamine – diamine oxidase (DAO).

Foods to avoid if you have a histamine intolerance

Histamine-Rich Foods

  •  Fermented alcoholic beverages, especially wine, champagne and beer
  •  Fermented foods: sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha
  •  Vinegar-containing foods: pickles, mayonnaise, olives and vinegars
  •  Cured meats: bacon, salami, pepperoni, luncheon meats and hot dogs
  •  Soured foods: sour cream, sour milk, buttermilk, soured bread
  •  Dried fruit: apricots, prunes, dates, figs, raisins
  •  Most citrus fruits
  •  Aged cheese including goat cheese
  •  Nuts: walnuts, cashews, and peanuts
  •  Vegetables: avocados, eggplant, spinach, and tomatoes
  •  Smoked fish and certain species of fish: mackerel, mahi-mahi, tuna, anchovies, sardines

Histamine-Releasing Foods

  •  Alcohol
  •  Bananas
  •  Chocolate
  •  Cow’s Milk
  •  Nuts
  •  Papaya
  •  Pineapple
  •  Shellfish
  •  Strawberries
  •  Tomatoes
  •  Wheat Germ
  •  Many artificial preservatives and dyes

DAO-Blocking Foods

  •  Alcohol
  •  Energy drinks
  •  Black tea
  •  Mate tea
  •  Green tea

You might be wondering what is left! Focus on what you can eat and fresh food is the key with histamine sensitivity.
Low-Histamine Foods

  •  Freshly cooked meat or poultry
  •  Freshly caught fish
  •  Cooked eggs
  •  Gluten-free grains: rice, quinoa, corn, millet, amaranth, teff
  •  Pure peanut butter
  •  Fresh fruits: mango, pear, watermelon, apple, kiwi, cantaloupe, grapes
  •  Fresh vegetables (except tomatoes, spinach, avocado, and eggplant)
  •  Dairy substitutes: coconut milk, rice milk, quinoa milk, hemp milk, almond milk
  •  Cooking oils: olive oil, coconut oil
  •  Leafy herbs
  •  Herbal teas

Breaking histamine broken down requires an enzyme specific to the system it is reacting in. DAO is the main enzyme responsible for breaking down ingested histamine, therefore low DAO may well spark a food triggered histamine intolerance.

Low DAO is often caused by gluten intolerance, increased permeability of the gut lining allowing antagonists to enter the blood system, bacterial imbalances in the intestine, DAO-blocking foods – alcohol, energy drinks, and tea, inflammatory bowel disease, Crohn’s, and ulcerative colitis.

Medications:

  • Non-steroidal anti-inflammatory drugs (ibuprofen, aspirin)
  • Antidepressants (Cymbalta, Effexor, Prozac, Zoloft)
  • Immune modulators (Humira, Enbrel, Plaquenil)
  • Antiarrhythmics (propanolol, metaprolol, Cardizem, Norvasc)
  • Antihistamines (Allegra, Zyrtec, Benadryl)
  • Histamine (H2) blockers (Tagamet, Pepcid, Zantac)

It would seem that histamine blockers, a class of acid-reducing drugs, would help prevent histamine intolerance, they also deplete DAO levels in your body creating a shortfall.

Following an elimination diet can proceed through a number of phases depending on what you already know are triggers. It can include a number of foods that are well known to cause a reaction as well as foods high in chemicals that can cause a response. Food chemicals such as mono sodium glutamate (MSG) or flavor enhancer E621, salicylates, amines which include histamines, preservatives such as suphites; proteins and fermentable carbohydrates tend to dictate the food choices. The simplest of diets may start with just a few vegetables, a peer, rice and chicken for a couple of weeks and be challenged with the addition of other foods once you are feeling well. A less restrictive plan could include a wider range of food choices or it could follow a 4 day rotation whereby you take a food once every four days. This is safer for children and people with more fragile health.

Blood Testing

In my clinic we test for histamine levels and DAO levels may be tested outside of the UAE. A high ratio of histamine to DAO signifies that you are ingesting too much histamine and that you don’t have enough DAO to break it down. When testing is unavailable, you could simply try a diet low in histamine and add DAO enzyme (readily available in pharmacy’s outside of the UAE) at each meal. If your symptoms resolve, you could have low DAO indicating that you follow a diet low in the foods listed above and keep enzymes on hand. This is a distinct alternative to taking anti-histamines which will suppress symptoms but does not address the underlying cause. Anti-histamines will also work as a broad spectrum treatment and possibly disrupt secretions that are functioning well such as eye health.

If you have a histamine intolerance, step one is to minimize your dietary histamine by eating a low-histamine diet and avoiding foods that block DAO as well as to take a DAO supplement. It can make quite a difference when you are unaware of trigger foods and become a little afraid to eat. Take one or two capsules no more than 15 minutes before you eat to prevent histamine intolerance symptoms

Addressing the root cause of your histamine intolerance is the key as it is rare that the food is the culprit but the functioning of your sensitive system. In particular, small intestinal bacterial overgrowth (SIBO) is a very common cause of altered gut health. A fructose, glucose and lactose breath test will identify if you have SIBO as the bacteria involved cause high hydrogen levels and often methane as they react with these food sugars.