I’ve come to the point in practice when I no longer can ignore HISTAMINE INTOLERANCE. Symptoms like allergies, rashes, and asthma, are common and hard to treat without addressing the histamine pathway. It is estimated that 1% of the population suffers from histamine intolerance (1).
Common HISTAMINE INTOLERANCE symptoms
Difficulty speaking (ie hoarseness)
Gastrointestinal symptoms: nausea, vomiting, abdominal pain
Low blood pressure, increased & irregular heartbeat, dizziness
Shortness of breath
Histamine is one of many, biogenic (produced by living organisms) amines with powerful signaling capacity. Our bodies can convert histamine from the food we eat. Microorganisms also produce histamine, and we consume this as well. Histamine producing organisms are everywhere, so virtually any human food source that is not absolutely fresh is likely to contain some quantity of histamine (2).
Our first line of defense against histamine is diamine oxidase (DAO). DAO is an enzyme that degrades histamine. In DAO deficiency, histamine backs-up and symptoms occur. Some foods and alcohol block DAO from degrading histamine. While there are many reasons for histamine intolerance, DAO deficiency is by far the most common (3).
Gut disorders decrease DAO output in the intestines, allowing histamine to cross into the blood. In addition, DAO requires nutrients such as vitamin C, vitamin B6, copper, and zinc; if you are deficient then, DAO function is compromised and histamine accumulates.
Histamine also requires processes like methylation to take place (4). Some of us are born with genetic SNP’s that inhibit us from methylating efficiently. This means that there may also be a genetic predisposition towards histamine intolerance.
So what do we do about this?
Remove food sources of histamine (this is not a forever thing with most of these foods, just until we get symptoms under control). This is any food that contains histamines precursor, histidine and isn’t strictly fresh, and any food that has been aged, cultured, fermented, cured, or smoked. Click here for a comprehensive list. We can also test the blood to see if certain foods cause histamine release.
Evaluate the microbiome and potential gut infection. Histamine is made in the gut by certain microbes and with imbalance, excess histamine is produced, potentiating histamine. In the presence of dysbiosis resistance to treatment will occur. I currently use GI MAP by Diagnostic Solutions.
Provide nutrients to support histamine clearance. These include: minerals, B-vitamins, DAO, and specific vitamins. Dosages are prescribed in a titrated manner to ensure tolerability and clinical outcome.
Other potential histamine triggers: mold/environmental toxicity and heavy metals.
According to Dr. Anderson, the key with histamine intolerance is to identify and treat the triggers for histamine buildup; this process may take up to 24 months in highly allergic people. During this process, potent doses of specific nutrients are provided to support histamine clearance.