Are any of these familiar; sneezing, nasal congestion, itching, nausea, diarrhoea, bloating, nausea, throat clearing, racing heartbeat, headache/migraine?
These are some of the symptoms of Histamine Intolerance (HIT). But they can also be symptoms of other conditions so please always speak to your Doctor and request some tests.
Why do people have high histamine?
Histamine is a chemical messenger and one of many chemicals produced in cells. It’s also found in some foods/drinks. HIT occurs when struggling to breakdown histamine contained in some foods. It can also happen then there is less activity from an enzyme called Diamine Oxidase (DAO). Both result in higher histamine levels.
Histamine triggers may include; allergies, leaky gut, genetics, medications, inflammatory bowel disease. Also, alcohol contains histamine and will slow histamine breakdown by DAO.
Interestingly, histamine sensitivity is often lower during pregnancy, and greater during perimenopause. A link with hormones may also explain why DAO activity is greater at the start of the reproductive cycle, and symptoms occur more towards the end of the reproductive cycle.
What triggers excessive histamine?
Foods;
Sardines/mackerel/tuna (tinned), salmon/tuna/mackerel/sardines/anchovy/shrimp/prawn/oyster/mussels, parmesan, cured meat (sausages, ham), camembert, gouda, cheddar, feta, tomato, sauerkraut, spinach, lemon/orange/grapefruit/strawberries/banana/plum/kiwi/pineapple, avocado, aubergine, miso, tempeh, soy sauce, wine, spirits, chocolate, cashew/almond/pistachio/walnuts, eggs.
Boiling vegetables in water can reduce the histamine content e.g. spinach, although boiling increases histamine in aubergine, green beans. In addition, grilling increases histamine in seafood and meat and boiling reduces it. Confusingly, cooking methods provide inconsistent results.
Generally, the fresher the food, the lower the histamine. So freezing meats rather than leaving them in the fridge would be a better option.
Medication;
Asprin, Ibuprofen, amitriptyline, monoaminoxidase 1 inhibitors, diazepam, verapamil, and alprenolol can increase histamine.
Insufficiency of nutrients
Low levels of vitamin C, copper, and vitamin B6 (cofactors in DAO enzyme) can also increase symptoms.
Probiotic strains – L. saerimneri 30a, L. casei TISTR 389, and L. bulgaris TISTR 895 appear to be histamine producing. L Rhamnosus may be beneficial.
Food usually considered safe in HIT
Coffee, tea, bread, pastry, potatoes, rice, pasta, cereals, lettuce, cauliflower, broccoli, carrot, garlic, onion, cucumber, pumpkin, courgette, pepper, rhubarb, asparagus, apple, pear, peach, watermelon, blueberries, vinegar, fresh/immediately frozen meat/fish, cooked eggs, honey, butter.
How is it diagnosed?
Many non-specific histamine symptoms could relate to other health conditions. Ask your Doctor to test for allergic disorders (IgE tests), Coeliac Disease, Crohn’s, faecal calprotectin, and Helicobacter pylori. Ideally take a food and a symptom diary to the Doctor appointment. The Doctor should be familiar with non-coeliac gluten sensitivity – which may confuse results. NCGS produces a negative Coeliac Disease result, yet people experience symptoms when consuming gluten. This may cause confusion as gluten is often consumed alongside many high HIT foods and perhaps the diagnosis is NCGS rather than HIT. A differential would include how you feel after consuming cereals (contain gluten but not histamine).
There is currently no valid laboratory test for HIT. Dietary trial elimination is often suggested whereby elimination of high histamine foods for 2-4 weeks then slowly reintroduce one food type at a time (every 2-3 days) and monitor symptoms. HIT symptoms usually appear within 4 hours of trigger.
Going forward
Ask your Doctor for a Vitamin D blood test. Vitamin D levels are often low (particularly Oct-Mar), but are required for the cells to function. UK Government guidelines are everyone in the UK to take vitamin D at least Oct-Mar.
You may also want to ask your Doctor to do a blood test for anaemia. Ferritin levels should be greater than 30mcg.
For further reading: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308327/
