What is Histamine Intolerance?
Histamine intolerance can lead to many symptoms but the most common are allergic-type reactions like stuffy nose, watery eyes, and sinus headaches. We often reach for the anti-histamines to reduce the symptoms when we should be checking out what is in our pantry.
The body produces histamine for many reasons with the most important being defending the body against foreign invaders playing a major role in our immune system. It is also found in food with fermented foods and leftover meats having some of the highest amounts.
Because our body produces it and it is in our food, our bodies have ways to make sure that histamine stays at healthy levels. When histamine levels become too high, it can lead to allergic-type reactions. But not for all of us.
For some of us, myself included, symptoms may vary resulting in migraines, headaches, skin conditions, and even insomnia. Histamine intolerance is where our bodies are not able to manage healthy levels of histamine resulting in a myriad of symptoms.
Symptoms of Histamine Intolerance
Histamine plays many roles in our body including regulating stomach acid. It is also an “excitatory neurotransmitter”, a brain signaling chemical. Therefore, it plays a role in brain function and our mental health.
Because histamine plays so many different roles in our bodies, symptoms of histamine intolerance can vary from one person to the next. This is one of the reasons it is so difficult to determine if you have this food intolerance. We reach for the antihistamines, pain medications, or more instead of looking at our diet.
What are the Symptoms of Histamine Intolerance?
- Itching Skin, Eyes, Ears, and Nose
- Hives, Skin rashes, Eczema
- Autoimmune Flares – Psoriasis
- Low Blood Pressure
- Increased pulse rate
- Anxiety, Panic Attacks
- Headaches – Migraines, Cluster
- Chest Pain
- Fatigue, Confusion & Irritability
- Heartburn, GERD
- Bloody Noses
- Sweaty Feet
- Menstrual Irregularities including PMS
Causes of Histamine Intolerance
As with most food intolerances, it is a lack of an enzyme that leads to intolerance. An excellent example of this is lactose intolerance with dairy foods. Lactose intolerance is where we lack enough of the enzyme, lactase, to properly digest the sugars in dairy products.
With histamine, the enzyme known as diamine oxidase (DAO) produced in our gut, works a little differently than the enzyme, lactase. This enzyme actually blocks the absorption of histamine from the foods that we consume. Thereby reducing and managing histamine levels.
On the other hand, we produce another enzyme known as histamine-N-methyltransferase, (HNMT). This enzyme actually breaks down histamine thereby reducing levels. Once levels get too high, HNMT, starts breaking down histamine to a manageable level.
What Could Go Wrong with these Two Enzymes?
The enzyme DAO is produced by the bacteria in the gut as well as our body produces it. One of the major causes of histamine intolerance is dysbiosis and a condition known as “leaky gut”.
Dysbiosis is a condition where our gut bacteria become imbalanced and, in most cases, we have an infection of bad bacteria. This leads to a reduction of DAO and we over absorb histamine from our food leading to histamine intolerance.
With HNMT, this enzyme depends on a process known as methylation which produces a compound known as SAMe. This process depends highly on certain nutrients like folate, vitamin B12, and B2. If you are deficient in these nutrients or there a great demand for these nutrients, you could become histamine intolerant.
Some of the causes of deficiencies in folate, vitamin B12, and B2 are chronic stress and chronic hidden infections like dysbiosis. So, you can see that the role of gut health plays a major role in whether you will become histamine intolerant or not.
Looking at the fact that HNMT, needs SAMe one would think that supplementing with SAMe would do the trick. Unfortunately, like most dietary supplements, it depends on many other factors and nutrients to balance out nutrient deficiencies.
Supplementing with SAMe can lead to anxiety and insomnia, therefore, it is recommended and that you support methylation instead. Instead, you can promote healthy methylation by consuming foods that are rich in folate like green leafy vegetables and foods rich in vitamin B12 (found mostly in animal products).
Can you resolve histamine intolerance?
With most food intolerances, you have to first identify if you have it and then it is a matter of managing your food intolerance. This is for two reasons.
One depends on your genetic makeup as there many different genomic variances that come into play with histamine intolerance. The other depends on your gut health and being able to maintain a healthy gut and gut microbiota.
The first step to resolving histamine intolerance is to identify if you are histamine intolerant. Doing a food/symptom journal is a great place to start. By connecting what you eat to your symptoms you can begin to see if there a connection.
Due to the fact that food intolerances are dosage dependent, in other words, it depends on how much you eat not just what you eat. You will have to do a food journal for at least 1 week or so. This is how I found out I was histamine intolerant.
Foods High in Histamine
- Processed, cured, fermented meat
- Leftover meat, poultry, pork, and fish
- Fermented milk products like yogurt
- Seafood: shellfish, fresh, frozen, smoked, or canned
- Fish especially tuna fish (canned)
- Fermented foods – sauerkraut, kombucha, fermented soy products
- Artificial food colors and preservatives
- Chocolate, cocoa, and cola drinks
- Alcoholic Beverages – wine and beer
Almost all foods contain some histamine. This list does not include all foods high in histamine but includes the most commonly eaten foods high in histamine.
Unlike food allergies, where the response is immediate, food intolerances can take up to 2 days for symptoms to occur. For me, it was the realization that every time I indulged with a glass of red wine and pizza, I would get a migraine.
All of these foods are high in histamine. My migraines would usually start up around 3.00 am when histamine release is at its highest for most of us.
Once you have determined if you are histamine intolerant, then you have to try to determine the underlying root cause. In most cases, healing the gut is key to resolving histamine intolerance.
You may also have genomic variants that lead to poor enzyme functions like MTHFR, which can increase your need for folate and vitamin B12. For me, I have the rarest variant in MTHFR as well as variants in both DAO and HMNT. The key to truly managing your histamine intolerance is genomic testing and evaluation.
Are There Probiotic Strains That You Should Avoid?
Yes, definitely. I learned the hard way on this one. Trying to experiment with making my own yogurt, I purchased a culture to make my yogurt containing Lactobacillus bulgaricus. Oops…
Lactobacillus bulgaricus can be found in many popular yogurt brands, i.e. Fage. Always, read the labels on yogurt and other fermented products to see what strains that they are using. Avoid products that do not properly list probiotics strains.
Probiotic strains that are histamine producers:
- Lactobacillus bulgaricus
- Lactobacillus casei
- Lactobacillus reuteri
- S. thermophilus*
These stains should be avoided. Along with fermented products, be careful with probiotic supplements. Always read the label. For instance, S.thermophilus is commonly used in broad-spectrum supplemental probiotics.
What Are the Best Probiotics for Histamine Intolerance?
Just like there are probiotic strains that promote histamine, there are strains that degrade histamine. So along with DAO which blocks absorption, these strains degrade and breakdown histamine. These are also commonly found in fermented foods and dietary supplements.
- Bifidobacterium infantis
- Bifidobacterium longum
- Lactobacillus gasseri
- Lactobacillus rhamnosus
- Lactobacillus plantarum
- Lactobacillus salivarius
Using probiotic supplementation is a great way to improve your gut microbiota and resolve histamine intolerance. But don’t forget to add in the healthy foods that contain prebiotics to truly heal leaky gut and dysbiosis.
Some of the foods that high in healthy prebiotics like apples, onions, garlic, leeks, asparagus and even barley are all high in prebiotics. Root vegetables like beets and sweet potatoes provide the gut bacteria with the food that the good bacteria need to flourish. If you having problems digesting these foods, you might need a digestion tune-up.
- Histamine and histamine intolerance, Laura Maintz and Natalija, American Journal Clinical Nutrition, 2007;85:1185-96
- Headaches, Hives and Heartburn Could Histamine be the Cause, Chris Kresser
- Degradation of Histamine by Lactobacillus Plantarum Isolated From Miso Products, Kung, et al, PMID: 28885051
- Probiotic Lactobacillus Rhamnosus Downregulates FCER1 and HRH4 Expression in Human Mast Cells, Oksaharju, et al, PMID: 21390145