Food Freedom Friday Edition 327 - Histamine Intolerance

For many, the allergy symptoms you experience may not be due to allergies at all. Rather, these may be due to a common condition known as histamine intolerance. 

Histamine intolerance occurs when your body lacks the ability to process excess histamine and reacts negatively to the buildup that occurs.

What Is Histamine

Histamine is an essential part of a healthy immune system and is released after injury or when an invader is detected. When your body releases histamine it recruits other important immune cells to the site to deal with the injury or invader. Excess histamine that causes histamine intolerance is often absorbed through your gut from the food you eat or microorganisms living symbiotically in your intestines.

Under normal circumstances your body has enzymes in the gut that break down histamine. The production of these enzymes can be affected by genetics, and medications that prevent our body from breaking down histamine in the gut. When these enzymes are inhibited, high levels of histamine can build up in the bloodstream, and you are susceptible to histamine sensitivity. Common symptoms of histamine intolerance include, bloating, headaches, and rashes, among many others.

Histamine is produced and stored by cells in your immune system. 

When the immune system identifies foreign invaders, your immune cells release histamine. Histamine then triggers an immediate inflammatory response. This sends immune cells to the source of infection, which allows them to destroy the pathogens and fight infection. 

Sometimes, your immune system mistakenly identifies harmless substances like certain foods or pollen as foreign invaders. This process of mistaken identity results in an allergic reaction. 

In addition to playing an important role in the immune response, histamines regulate many other physiological functions in the body by:

·       Secreting gastric acid 

·       Dilating blood vessels 

·       Contracting and relaxing the airways and other smooth muscles

·       Transmitting messages between your body and brain 

·       Increasing vascular permeability 

·       Lowering blood pressure 

·       Producing airway mucus 

·       Regulating energy levels

·       Enhancing cognition

Histamine Metabolism 

Histamine metabolism occurs when histamine is released in the body and is eventually captured by receptors and broken down. When invasive compounds like pollen enter your body, histamine leaves your mast cells and flows to the affected area. This causes inflammation, which allows other immune cells to go to work fighting infection. Histamines then connect with receptors in your body where it’s eventually broken down and expelled as waste.  This prevents chronic inflammation and allows your body to return to a normal, healthy state. 

Your body metabolizes histamine through two pathways using the enzymes Diamine oxidase (DAO), and Histamine-N-methyltransferase (HNMT)

When you eat histamine with food, DOA acts like a scavenger, finding and breaking down histamine. It also scavenges histamine that your intestinal microorganisms produce. This prevents histamine from being absorbed into the bloodstream from the gastrointestinal tract.

The DAO enzyme accumulates in the following tissues:

·       Small intestine

·       Large intestine

·       Placenta

·       Kidneys

HNMT also prevents the absorption of dietary histamine, and breaks down histamine that has made its way into the blood. 

HNMT is found in many areas of the body including:

·       Kidneys

·       Liver

·       Spleen

·       Large intestine

·       Prostate

·       Ovaries

·       Spinal cord

·       Trachea

·       Respiratory tract

Histamine Intolerance

Histamine intolerance is a disorder that occurs as a result of an inability to metabolize dietary histamine. This is due to reduced DAO enzyme activity, which leads to an accumulation of histamine in the bloodstream. Histamine intolerance is not an allergy. Rather, it’s an intolerance to the chemical histamine.

Symptoms

Histamine intolerance often causes a combination of symptoms that range from mild to severe. In some cases, histamine intolerance can even result in death.

Histamine intolerance can present as symptoms that affect your entire body including, your gastrointestinal, nervous, cardiovascular, respiratory, and integumentary systems.  

Symptoms of histamine intolerance may include:

·       Abdominal distension

·       Bloating

·       Postprandial fullness

·       Diarrhea

·       Abdominal pain

·       Constipation

·       Dizziness

·       Fatigue

·       Headaches

·       Palpitations

·       Hay fever

·       Conjunctivitis

·       Pruritus 

·       Hives

·       Eczema

·       Erythema

·       Edema

·       Asthma

·       Hypoxia

·       Anaphylaxis 

Generally, the greater the buildup of histamine in the body the more severe the symptoms. 

Causes Of Histamine Intolerance

There are factors that may lead to the development of histamine intolerance.

Genetics

Your genetics can influence your ability to break down histamine.

Some genes can cause mutations in the DAO enzyme that reduce its ability to metabolize histamine.

Illness

Inflammatory bowel conditions may impair DAO activity by damaging intestinal mucosal integrity.

These conditions include:

·       Gastroenteritis

·       Irritable bowel syndrome (IBS)

·       Inflammatory bowel disease (IBD)

·       Short bowel syndrome

·       Gastrointestinal surgery

People with nonceliac gluten sensitivity (NCGS) may also have an increased risk of reduced DAO enzyme activity.

Medication

Certain medications may reduce the activity of the enzyme DAO. 

Reducing Histamine In The Body

Treatment for histamine intolerance focuses on decreasing the buildup of histamine levels. Some of the best strategies to reduce histamine in the body include.

Low Histamine Diet

Many foods naturally contain histamine. Consuming a low histamine diet can improve symptoms of histamine intolerance in 4 to 8 weeks by reducing histamine levels in the body.

A low histamine diet is a temporary measure that involves consuming foods that contain histamine levels below detection limits. 

Note: Though low histamine foods include certain fruits and plants, it is possible to confuse histamine intolerance with chronic low-grade food allergies. Plants are packed with numerous naturally occurring plant toxins. This is one of the many reasons I strongly recommend animal and dairy based diet to reduce diet-related disorders and inflammation. 

Low histamine foods that are safe to eat on a low histamine diet include:

·       Fresh meat

·       Fresh fish

·       Fresh fruits

·       Vegetables

o   Green pepper

o   Peas

o   Asparagus

o   Cauliflower

·       Beans

·       Eggs

·       Olive oil

·       Non-dairy milk

·       Coconut milk

·       Whole grains

o   Oats

o   Rice

o   Barley

Some foods that are low in histamine can be high in other biogenic amines that result in histamine intolerance. These reactions occur because the enzyme DAO also metabolizes biogenic amines including:

·       Putrescine

·       Cadaverine

·       Tyramine

Foods that contain high levels of biogenic amines may reduce the metabolism of histamine.

Low-histamine foods high in biogenic amines:

·       Soybeans

·       Mushrooms

·       Lentils

·       Chickpeas

·       Peanuts

·       Pears

·       Citrus fruits

·       Bananas

Many people with histamine intolerance may need to eliminate foods high in both histamines and biogenic amines. But others may not experience any symptoms when eating these foods. 

While following a low histamine diet, it is important to eliminate high histamine foods.

Foods high in histamine include:

·       Spoiled fish or meat

·       Fermented foods

o   Yogurt

o   Cheese

o   Kombucha

o   Sauerkraut

·       Vegetables

o   Spinach

o   Avocados

o   Tomatoes

o   Eggplant

o   Dried fruit or fruit juices

·       Alcohol

o   Beer

o   Wine

o   Champagne

Your symptoms should resolve within 3 weeks of starting a low histamine diet. After this, you can then begin adding higher histamine foods back into your diet one by one. 

If any of these foods trigger symptoms of histamine intolerance, you should continue to avoid them. But it is possible to safely consume high histamine foods that don’t bother you.

Maintaining a low histamine diet can improve your health and prevent complications related to histamine intolerance. However, this type of diet is only a temporary treatment and can result in malnutrition. 

To reduce histamines while providing your body the macro and micronutrients it needs to thrive, following high fat low carb eating plans, especially in the form of a  carnivore is recommended. 

Tips For Following A Low Histamine Diet:

·       Always eat fresh foods. Histamine and other biogenic amines may form during refrigerated storage. Spoiled foods can grow bacteria that produce histamine. 

·       Boil vegetables in water before eating. This can reduce the levels of histamine and other biogenic amines in food.

·       Keep a food journal to identify trigger foods. A food journal can help you determine what foods cause your symptoms. Keep track of the foods you eat, what time you eat them, and any uncomfortable symptoms that you experience.

·       Work with a qualified professional. A low histamine diet is restrictive. You should not follow this diet plan for more than 4 to 8 weeks. Working with a professional during a low histamine diet can ensure you receive the adequate levels of the nutrients you need.

·       Avoid processed foods. Processed foods typically contain long lists of complex ingredients. Stay away from anything with trans-fats. 

·       Cook your own meals. You’ll know exactly what you’re eating.

·       Avoid DAO blocking medications. Certain medications can slow down the healing process by impairing your ability to metabolize histamine. 

·       Take a DAO supplement. Increasing the enzyme DAO can reduce histamine in the body. 

·       Slowly reintroduce histamine-rich foods. A low histamine diet is only temporary. After you eliminate histamine-rich foods for 3 weeks, you can begin adding some foods back into your diet. Begin with full-fat dairy since it contains essential fat-soluble vitamins A and D. 

·       If certain foods reproduce your symptoms, cut them out whilst continuing to enjoy histamine-rich foods that don’t cause any problems.

Medications To Reduce Histamine Intolerance

Diamine Oxidase Supplementation

Histamine intolerance occurs with elevated histamine levels, which is likely due to an impaired ability of diamine oxidase to metabolize histamine.

Research shows that oral diamine oxidase supplements before meals can improve many of the symptoms of histamine intolerance. Diamine oxidase supplements may improve symptoms of histamine intolerance by increasing diamine oxidase levels, which facilitates the breakdown of histamine.

However, diamine oxidase supplements are not a cure for histamine intolerance. Without diamine oxidase supplementation, symptom intensity increases.

Antihistamines

Antihistamines are popular choices for the treatment of allergies. They can also help with histamine intolerance but only to a certain degree. Taking antihistamines will not reduce histamine in the body. Antihistamines only treat symptoms that you experience after ingesting foods high in histamine. 

Many antihistamines can cause side effects such as:

·       Drowsiness

·       Dizziness

·       Constipation 

·       Dry mouth 

·       Blurred vision

·       Headache

Histamine Intolerance Is Treatable

Histamine regulates many important physiological functions in the body, but it can also cause negative consequences like histamine intolerance. 

The best way to combat histamine intolerance is to follow a low histamine diet. High fat, low carb animal-based diets will allow you to cut out histamine rich foods while still providing your macro and micro nutrient needs. 

Proper food preparation is also key to prevent increasing levels of histamine. 

If you regularly experience symptoms of histamine intolerance even after practicing a low histamine diet, a good option would be eliminating most or all most plant foods. This will reduce your exposure to plant toxins. 

Histamine intolerance often occurs in combination with underlying intestinal disorders, and symptoms may not resolve unless you treat both. With a dedicated treatment plan, you can find long-term relief from histamine intolerance.