Headaches, rashes, gastrointestinal issues, fatigue, brain fog…sure there are a lot of potential causes to these seemingly unrelated symptoms. These symptoms are very common in my typical clients and we usually find that diet plays a role. Lately, I have had several clients where intolerance to histamine (a chemical naturally occurring in food and the body) is causing many of these symptoms.
Could histamine become the new gluten??
So many clients have been presenting with histamine intolerance, that I wanted to blog about it. It’s hard to tell if histamine intolerance is increasing in the population, or if the holistic medical community is just getting better at recognizing this condition. Either way, whenever you have an intolerance to any food or chemical, you want to get to the bottom of WHY you have that intolerance.
Ever feel a little out of it after eating? Maybe it’s a headache, anxiety, or you have a bad case of “brain fog”. Maybe you have allergic-like reactions to certain foods. Ever feel itchy or have trouble breathing after you eat? Ever get a flushed face after drinking red wine? If you are experiencing these symptoms then you may have histamine intolerance.
What is histamine?
Histamine is a chemical that occurs naturally in foods. Some foods contain greater amounts of histamine than others. Histamine is also naturally produced in the body. In the body, histamine is involved in immune responses, plays a role in regulating gut function and numerous other processes throughout the body.
What is histamine intolerance?
The build-up of histamine is usually caused by decreased activity of the enzymes that break down histamine. There are two enzymes responsible for breaking down histamine. These enzymes are diamine oxidase (DAO), which is the main enzyme that breaks down histamine, and Histamine N-methyltransferase (HNMT). If you suffer from histamine intolerance, the function of these enzymes is likely impaired.
Decreased function of the enzymes that break down histamine can be genetic or can develop from a variety of factors. These factors may include medical conditions, alcohol or drug use, or medication that may have DAO-blocking properties. If your symptoms are being caused by a medication, drugs or alcohol – getting rid of those symptoms is as simple as discontinuing the use of the substance. Of course, never discontinue a medication without the approval of your doctor.
What are the symptoms of histamine intolerance?
Symptoms of histamine intolerance can be chronic, sporadic, or sudden at onset and can include:
- Abdominal pain/spasms
- Chronic constipation
- Panic attacks
- “Leaden exhaustion” – during or after a meal; sleep does not restore vitality
- Chills, shivers, discomfort or low blood pressure
Symptoms may mimic other food intolerances or conditions. It is important to exclude conditions that can cause similar symptoms such as a food sensitivity, celiac disease, non-celiac gluten sensitivity or an intolerance to something else such as lactose or fructose.
How do I know if histamine intolerance is the cause of my symptoms?
If you have already excluded the above-mentioned food-related possibilities (food sensitivities, celiac disease, non-celiac gluten sensitivity or an intolerance to lactose or fructose) and are still experiencing symptoms you may want to explore the possibility of histamine intolerance. Because the underlying issue for those suffering from histamine intolerance is not an allergic response, but an overload of histamine in the body, allergy testing for histamine intolerance is not reliable.
The best way to determine if you have histamine intolerance is by following an elimination diet. To do this, exclude foods high in histamine for at least two weeks while keeping a food and symptom diary. If you notice you are feeling better and having fewer symptoms by the end of the second week, you may very well have an intolerance to histamine. If you add higher histamine foods back to your diet and have a negative reaction to those foods, you can be just about certain that histamine is playing a role in your symptoms.
How is histamine intolerance managed?
Management of histamine intolerance consists of following a low-histamine diet to the level of the individual. It is important to keep in mind that the amount of histamine tolerated will vary from person to person. Taking an antihistamine before meals may be helpful in some cases. The use of a DAO supplement to help breakdown histamine from ingested food also may improve symptoms.
What foods should you avoid if you have histamine intolerance?
If you think you may suffer from histamine intolerance, there are a few things to keep in mind when planning for your elimination diet:
- Some foods have a high content of histamine, these should be avoided for a few weeks while you monitor for improvement of symptoms
- While histamine is always produced by the body during digestion, some foods cause the body to release more histamine than other foods. Some people choose to avoid these foods during the elimination phase of the diet as well
- Additionally, some foods may contain different levels of histamine depending on their ripeness or how they are stored
- Not all histamine containing or histamine-releasing foods have been identified so you might discover intolerance to something not listed as you learn how to best manage your symptoms
- You may find you can tolerate some histamine containing foods, but not others, as each person with histamine intolerance has a different level of histamine they can tolerate.
Eliminating foods from your diet can reduce the nutritional quality of your diet. Therefore, it is important for anyone following a diet that restricts foods to maintain a nutritional balance. Substituting foods of equal nutritional value of those that are restricted becomes an essential part of management. It is a good idea to enlist the help of a registered dietitian in this process.