Histamine Intolerance

Allergy, Eczema | November 2, 2016 | Author: Naturopath

Rhinitis, eczema, headache, anxiety

Histamine Intolerance

Itchy skin, migraines or reflux: Could it be histamine intolerance?

If you have never heard of histamine intolerance, you’re not alone. It’s a relatively unknown and underestimated condition that your health practitioner may not be aware of. The problem with diagnosing histamine intolerance is that its symptoms are multifaceted and it is often confused with other conditions like anxiety, rhinitis, eczema or headaches. If you are having strange reactions to foods like citrus, tomatoes, cheese, red wine, processed meats or seafood it could be the result of accumulated histamine in the bloodstream that the body is then unable to break-down efficiently.

So what is it?

Histamine intolerance is caused by a decrease in activity of the enzymes that break down naturally occurring histamine in foods, resulting in its accumulation. In the digestive system the main histamine-degrading enzyme is diamine oxidase or in other parts of the body, like the skin or brain, the enzyme that breaks down histamine is histamine N-methyltransferase. Approximately 1% of the population suffer from histamine intolerance, with 80% of sufferers being middle-aged.

What is histamine?

Histamine It is a molecule that is essential for good health. It acts as a neurotransmitter, is a component of stomach acid that helps in breaking down food and is involved in the inflammatory response. It causes dilation of the blood vessels to allow white blood cells to quickly reach and neutralise invaders. But can cause serious side effects when its levels are too high.

High histamine levels can be caused by:

  • Allergies (IgE reactions)
  • Genetic defects in enzyme production (Diamine oxidase deficiency)
  • Enzyme production problems due to inflammatory bowel disease, ulcerative colitis, Crohn’s disease, bacterial overgrowth (SIBO), leaky gut, gluten intolerance etc.
  • Enzyme inhibitors as a result of taking certain medications (antidepressants, non-steroidal anti-inflammatories, anti-histamines, immune-modulators, antiarrhythmics and histamine (H2) inhibitors)
  • Enzyme competitors naturally found in foods that block diamine oxidase
  • Histamine rich foods

Symptoms of histamine intolerance

The excess of histamine in the body results in a broad range of symptoms, many of which resembling an allergic reaction. These include:

  • Itchy skin, eyes, ears and nose
  • Hives, eczema/rashes, skin redness/flushing, red spots
  • Swelling of the facial and oral tissue and sometimes the throat
  • Hypotension or hypertension
  • Dizziness or vertigo
  • Difficulty regulating body temperature
  • Increased heart rate and arrhythmia
  • Anxiety/panic attacks and difficulties falling asleep
  • Breathing problems
  • Nasal congestion, runny nose and seasonal allergies
  • Conjunctivitis
  • Headaches and migraines
  • Nausea and vomiting
  • Reflux, indigestion, diarrhoea and heartburn
  • Fatigue, confusion and irritability
  • Abnormal menstrual cycle

Another reason why histamine intolerance is hard to diagnose is because its effects are accumulative. For example you may not react if you have a smaller intake of foods containing histamine but you may go over your “threshold” if you eat a lot of foods high in histamine. Individual tolerances to histamine containing foods vary significantly, some people need complete avoidance while others can tolerate small amounts.

Foods to avoid

For people with histamine intolerance it is advisable that they avoid the following foods as they either contain high amounts of histamine, contribute to its release or block the enzyme needed for its degradation:

  • Tomatoes, avocado, eggplant, spinach, mushrooms, bananas, papaya, strawberries and pineapple
  • Citrus fruits
  • Dried fruit
  • Fermented foods such as sauerkraut, fermented soy products, relishes, pickles and kombucha
  • Shellfish (prawns, crab and lobster) and smoked fish
  • Some species of fish including mahi-mahi, sardines, mackerel, tuna and anchovies
  • Vinegar and vinegar containing foods (olives, pickles and mayonnaise)
  • Cured meats (deli meats, bacon, salami and hot dogs)
  • Alcohol
  • Matured and fermented dairy products
  • Chocolate and cocoa
  • Beans and pulses
  • Nuts (walnuts and cashews)
  • Many artificial food preservatives and colourings
  • Energy drinks
  • Tea (black, green and mate)
  • Spices (cinnamon, chili, nutmeg, cloves, curry powder and cayenne)
  • Yeast

The trick with a histamine-free diet is to eat fresh foods and avoid processed, smoked, cured, fermented, tinned or even left-over foods, especially meat. Consume freshly caught fish and freshly cooked poultry. Enjoy any of the vegetables and fruits except those listed above. Enjoy gluten free grains such as rice, oats and quinoa and dairy alternatives such as coconut water, milk or yoghurt and almond or rice milk. Eggs, fresh peanut butter, leafy herbs and most herbal teas are also ok to consume, unless you have an allergy. For cooking use coconut or olive oil.

Anti-histamine Foods

Foods that have been shown to reduce histamine and inflammation and stabilise mast cells include the following:

  • Watercress, pea sprouts and mung beans
  • Ginger, turmeric, onions, thyme, tarragon and garlic
  • Apples, peaches and pomegranate
  • Black rice

Herbs and nutrients to reduce histamine

  • Albizia, chamomile, hemidesmus, baical skullcap and feverfew
  • Vitamin C and zinc
  • Quercetin

Probiotics may also be helpful to improve intestinal permeability (leaky gut), improve the balance of good and bad bacteria and support a healthy immune and digestive system.

Vitamin B6 is an important co-factor in over 100 biochemical reactions in the body. In regards to histamine intolerance it helps in the production of diamine oxidase, reduces the allergic response and acts as a potent antioxidant.

Identifying histamine intolerance

The best way to identify if this is a problem for you is to eliminate the foods from the list above until your symptoms have improved (usually 2-4 weeks) and reintroduce the foods one at a time to see if your symptoms flare-up. It is a good idea to keep a food dairy to record any offending foods and their reaction.

The underlying cause

It is also important to find the cause of the problem as it can be different for each person. It is important to address dysbiosis in the gut with a specific protocol to resolve this problem or discuss the effects of potential medications that decrease diamine oxidase with your doctor. If leaky gut is contributing to histamine intolerance then follow a special diet avoiding processed foods, gluten and dairy and consider taking a probiotic. If you also suffer from allergies avoid mast cell degranulation by avoiding allergens such as dust mites, pollens, certain foods, physical stress and chemicals in the air and products.

Identifying histamine intolerance is difficult due to the condition showing similar symptoms to that of other conditions. Following a histamine free diet is advisable for people who suffer from this food intolerance and identifying an underlying cause such as the use of certain medication or dysbiosis in the gut is important. Eating histamine reducing foods and taking supplements such as antiallergy herbs, probiotics, vitamin B6 and vitamin C may also be of assistance.

References

  • http://www.histamine-intolerance.info/
  • Maintz L, Novak N. Histamine and histamine intolerance. Am J Clin Nutr. May 2007;85(5);1185-1196
  • http://ajcn.nutrition.org/content/85/5/1185.full
  • Kovacova-Hanuskova E, et al. Histamine, histamine intoxication and intolerance. Allergol Immunopathol (Madr). 2015 Sep-Oct;43(5):498-506
  • https://www.ncbi.nlm.nih.gov/pubmed/26242570
  • Wagner N, Dirk D. A popular myth – low-histamine diet improves chronic urticarial – fact or fiction? J Eur Acad Dermatol Venereol. 2016 Sep 13 [Epub ahead of print]
  • https://www.ncbi.nlm.nih.gov/pubmed/27624921
  • http://www.histamineintolerance.org.uk/
  • http://alisonvickery.com.au/anti-histamine-foods/
  • Thomsen M. (2010). Phytotherapy desk reference edition three. Michael Thomsen, Australia
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